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Prognostic Significance of Cyclin E and p27 in Stage 1 Non-Small Cell Lung Cancer (제1병기 비소세포폐암에서 Cyclin E와 p27의 발현과 예후)

  • 조봉균;조성래;천봉권
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.7-14
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    • 2003
  • Cyclin I plays a pivotal role in the regulation of G1-S transition and could consequently be a deregulated molecule in tumors. The activity of the cdk2-cyclin E complex is increased by degradation of cdk inhibitor p27kip1. Little is known about the expression and prognostic significance of cyclin E and p27 in non-small cell lung cancer(NSCLC). Material and Method: The expression of cyclin E and p27 in eighty-one cases of resected stage I NSCLC tissues and its relation to major clinico-pathological factors, including histology, differentiation, size of tumor, pleural invasion and survival rate were studied and analyzed. Immunohistochemical analysis with monoclonal antibodies specific for cyclin E and p27 were performed by ABC method. Result: Expression rates of cyclin E and p27 in stage I NSCLC tissues were 29.6% and 28.4% respectively. Cyclin E was expressed higher in cases of pleural invasion(p=0.04), and p27 was expressed higher in diameter of tumor less than 3cm(p=0.015). The 5-years survival rate was lower in cases of Positive expression of cyclin E than in cases of negative expression of cyclin E(44.4% vs 68.2%, p=0.015), and the 5-years survival rate was 72.2% in positive expression of p27 and 56.2% in negative expression of p27(p=0.09). The 5-years survival rate was higher in negative expression of cyclin E and positive expression of p27 than in cases of positive expression of cyclin I and negative expression of p27 (73.5% vs 36.3%, p=0.0029). In multivariate analysis, expression of cyclin I was an unfavorable prognostic factor(RR=3.578, p=0.006) and p27 was a favorable prognostic factor(RR=0.183, p=0.019) independently. Conclusion: Cyclin E and p27 may play a pivotal role for the biological behavior of stage I NSCLC, so that the expressions of cyclin I and p27 nay be new prognostic markers.

Animal Experiments on an Antithrombogenic Small-Caliber Vascular Prostheses and Vascualr Patch : Observation in Canine Models (항혈전성 소구경 인조 혈관 및 봉합편에 대한 동물 실험)

  • 김수철;김원곤;유세영
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.63-72
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    • 2003
  • Although a variety of synthetic vascular grafts are available in modern vascular surgery, no ideal prosthesis ha,4 yet been developed. Small-caliber vascular grafts with low flow, as used in the lower extremity, continue to become thrombosed at unacceptable rates. We have developed and evaluated the new antithrombogenic blood contacting surfaces in canine model. Material and Method: Two now antithrombogenic blood contacting surfaces(Polyvinylalcohol -Polyurethane(PVA-PU) blend and natural Graphite-polyurethane(G-PU) blend) have been developed and evaluated in canine model, using vascular grafts and patches. The luminal surfaces of the test vascular grafts(5 mm ID) were fabricated by dipping a glass rod in PVA-PU blend solution(50 % PVA) using phase separation method. Mongrel dogs of either sex weighing 18-22 kg were anesthetized by endotracheal intubation using halothane and their lungs were ventilated with a volume-cycled ventilator, Maintenance anesthesia with 0.5-1.0% halothane and supplemental oxygen was used. Two pairs were used for comparison in the bilateral femoral arteries for both vascular grafts(PVA-PU vs. PU) and vascular patches(G-PU vs. PU). Bilateral groin incisions were made and the arteries were exposed and clamped. After an excision of 1 cm of the artery between clamps, a grail of 2.5 cm in length was implanted end-to-end using 6-0 polypropylene suture. The vascular patch was implanted as a form of on-lay patch. Animals were sacrificed at 1, 2, 4, 6, 8 and 16 weeks for vascular grafts and 1, 2. 4 and 6 weeks for vascular patches. Result The vascular grafts of PVA-PU blends showed patent lumina in the 2 and 16 weeks animals, while those of PU showed a patent lumen in 2 weeks animal. PVA-PU graft of 16 weeks showed a fairly clean luminal surface. A light microscopic finding of this graft demonstrated good tissue infiltration through porosity, The animals with vascular patches showed patent arteries in both groups except 2 weeks animal. Scanning electron microscopy of the luminal surfaces of G-PU patches in 4 and 6 weeks animals showed endothelial cell covering with microvilli. PU patches showed qualitatively less endothelial cell covering. Conclusion: In conclusion, PVA-PU and G-PU blends can be a promising blood contacting surfaces for application in a synthetic vascualr graft. However, further animal study is needed to determine the real long-term effects of these methods of surface modifications.

Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.56-63
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    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

The Safety and Usefulness of Combined Video-Assisted Mediastinoscopic Lymph Adenectomy and Video-Assisted Thoracic Surgery Lobectomy for Left-sided Lung Cancer (좌측 폐암 환자에서 동반 시행한 비디오 종격동경 림프절 절제술과 흉강경 폐엽 절제술의 안정성과 유용성)

  • Jung, Hee Suk;Kim, Yong Hee;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.33-38
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    • 2010
  • Background: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. Material and Method: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. Result: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (${\geq}$10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. Conclusion: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.

Studies on the Processing and Management Forms of Filatures (우리나라 제사공장의 공정 관리실태에 관한 조사연구)

  • 송기언;이인전
    • Journal of Sericultural and Entomological Science
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    • no.12
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    • pp.37-45
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    • 1970
  • The processing management forms of our country's filature factories in 1969 are summarized as follows. (1) About 80% of total cocoon collection is made within 5 days involving peak day, and 10% of cocoon collection is finished until 3 days before and after the peak day, (2) About 92% of alive cocoons transported on unpaved road, and about 40% of the cocoons purchased by all factories are loaded on trucks from common selling station which is far beyond 40km, therefore a new packing system of alive cocoons to drop the damage of cocoon qualities, should be taken. (3) 22% of all factories in our. country have only low-temperature cocoon drying machine. Therefore the installment of hot-air cocoon drying machine is required urgently. (4) In view of cocoon qualities in our country, the grouping method of cocoon for reeling. taken by about 50% of the factories at percent, which classify cocoons for reeling as high group (1,2,3,4 grades) and low group(5,6 grades), will have to be replaced by the method tat classify them high group (1,2 grades) middle group (3,4 grades), low group (5,6 grades). (5) The .ratio of cocoon assorting stood about 10% in multi-ends reeling, about 15% in automatic reeling, conclusively, the ratio of cocoon assorting for automatic reeling was higher tan that for multi-ends reeling. One person's ability for a day in cocoon assorting reaches to about 80-100kg. (6) Cocoon cooking condition requires the increase of the cooking time, the pressure and temperature used to be prolonged as much as the qualities of cocoons are material cocoon ior automatic and double cocoon machines are treated uncompletely. (7) Automatic silk reeling is being performed at 1-2$^{\circ}C$ lower in reeling water temperature and operated at about twice velocity. (8) The temperature and humidity of rereeling room stood at 25$^{\circ}C$, 67.2% R.H and 32.3$^{\circ}C$, 51.9% R.H of rereeling machine are showed, Average rereeling velocity is 233m/min and large reefs charged for one person are 7.5 reels and form of skein used in all factories is double skein. (9) About 73% of water sources for filature used under-earth water. About 48% of all filature factories in our country have not yet water purifying equipments. Installation of the equipment for these factories seems to be urgent, (10) Denier .balance, sizing reel, seriplane, are being used in most factories as self-inspection apparatus. (11) More than 90% of the factories use the vacum tank in rereeling process and about 20% of them use it in cocoon cooing process (12) Only 21% of the factories use chemicals in filature process. About all them use "Seracol 100" in cocoon cooking process and "Seracol 500" in rereeling process, (13) Above survey results explain each all factories show large difference in the processing management. Therefore, it is believed that intercommunication through seminar or technical exchange will contribute to the production evaluation of cocoon in our filature industry.

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The Role of Axillary Artery Cannulation in Surgery for Type A Acute Aortic Dissection (급성 상행대동맥 박리증 수술에서 액와동맥 삽관술의 역할)

  • 유지훈;박계현;박표원;이영탁;김관민;성기익;양희철
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.343-347
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    • 2003
  • Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.

Calculation of Renal Depth by Conjugate-View Method Using Dual-head Gamma Camera (이중 헤드 감마 카메라를 이용한 Conjugate-View 계수법에 의한 신장 깊이 도출)

  • Kim, Hyun-Mi;Suh, Tae-Suk;Choe, Bo-Young;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo;Lee, Hyoung-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.378-388
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    • 2001
  • Purpose: In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigrams in a dual-head gamma camera, considering the attenuation factor $e^{-{\mu}x}$ of the conjugate-view method. Material and Method: We developed abdomen and kidney phantoms to perform experiments using Technetium-99m dimercaptosuccinic acid ($^{99m}Tc$-DMSA). The phantom images were obtained by dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators (ICONf, Siemens). The equation was derived from the linear integration of omission ${\gamma}$-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Results : Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm ($0.029{\pm}0.15cm,\;mean{\pm}S.D.$). Conclusion: The present study showed that the use of the derived equations for renal depth measurements, combined with quantitative planar imaging using dual-head gamma camera, could provide more accurate results for individual variation than the conventional method.

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Clinical Outcome of Emergency Coronary Artery Bypass Grafting after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 실패에 의해 발생한 응급환자의 임상경과)

  • Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.209-214
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    • 2007
  • Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

The Role of GADD45 ${\beta}$ in Acute Myocardial Injury (급성 심근 손상에서 GADD45 ${\beta}$의 역할)

  • Cho, Suk-Ki;Hong, Jong-Myeon;Lee, Hak-Mo;Oh, Byong-Chul;Lee, Jae-Woong;Lee, Jeong-Ryul
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.25-33
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    • 2008
  • Background: A critical shortage of donor organs has necessitated an investigation of new strategies to increase the availability of additional organs available for human transplantation. We investigated the amount of apoptosis and expression of GADD45 ${\beta}$ in two groups, a GADD45 ${\beta}$-transfected group and untransfected group. Material and Method: The experimental groups consist of a control group (normal H9C2 cell line) and GADD45 ${\beta}$-transfected group. After injury of the each group, we evaluated the expression of GADD45 ${\beta}$ and the level of apoptosis in each group. Result: There was a significant increase in the expression of GADD45 ${\beta}$ in the GADD45 ${\beta}$-transfected group at 1 hour, 2 hours, and 3 hours after stimuli as compared with the control group. The amount of cardiac myoblast cell line apoptosis was significantly lower in the GADD45 ${\beta}$-transfected group as compared with the control group. The concentration of annex in in the GADD45 ${\beta}$-transfected group was significantly lower than that of the control. group after cell. injury. Conclusion: Transfection of a rat myoblast cell line with the GADD45 ${\beta}$ gene results in. decreased susceptibility to cell injury of human serum.

Improving effect of psoriasis dermatitis by yakuchinone A in the TNF-α stimulated HaCaT cells (TNF-α 자극에 활성화된 HaCaT 세포주에서 Yakuchinone-A에 의한 건선 피부염 개선 효과)

  • Kim, Min Young;Hwang, Hyung Seo
    • Journal of Applied Biological Chemistry
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    • v.63 no.1
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    • pp.95-101
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    • 2020
  • Psoriasis is an autoimmune skin disease that is accompanied by hyper proliferation of the epidermis, erythema of various sizes, and ulceration. However, the mechanism of the development of psoriasis dermatitis is unclear. Recently, it is known that the inflammatory cytokines and Th17 cells as well as chemokine (CC motif) ligand 20 (CCL20) are involved in the process of keratinocytes hyper-differentiation, which is common in psoriasis dermatitis. Therefore, we studied the effects of yakuchinone-A, an active ingredient of Alpinia oxyphylla Miquel known for its anti-inflammatory activity, to improve psoriasis dermatitis. First, cytotoxicity of yakuchinone-A was observed in cell counting kit-8 assay and not observed in 10 ㎍/mL concentration on the human keratinocyte HaCaT cells. Yakuchinone-A in the presence of tumor necrosis factor-alpha (TNF-α) on HaCaT cells inhibited mRNA expression of IL-6, IL-8, and TNF-α by up to 61.4±7.5, 23.6±1.5, 46.0±4.8%. CCL20, a chemokine that attracts immune cells such Th17 cells to the inflammation location, was also significantly suppressed by yakuchinone-A. In addition, IκB and STAT3 phosphorylation involved in the CCL20 expression was inhibited by yakuchinone-A in a concentration-dependent manner up to the level of 79.1±5.0, 80.8±2.3%. Furthermore, yakuchinone-A downregulated CCL20 mRNA expression level on IL-17A-activated HaCaT cells as a concentration-dependent manner. Based on these results, yakuchinone-A is expected to be developed as a new material for improving psoriasis dermatitis in the future.