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Introduction: Human papillomavirus, particularly Type 16, plays a central role in the development of anogenital squamous-cell carcinomas. A common sequence variation of human papillomavirus Type 16 in cervical cancer cell lines and in cervical cancer tissues from Korean patients was recently reported. The present study was performed to determine the integration type of human papillomavirus DNA in anal epidermoid carcinoma and to identify the common sequence variations in the human papillomavirus Type 16 E7 gene that had been previously reported., Methods: Twenty-one formalin-fixed, paraffin-embedded specimens collected from 29 patients with anal epidermoid carcinomas treated at the Seoul National University Hospital over a ten-year period (1989-1998) were investigated. Genomic DNA from the 21 specimens was extracted and analyzed using the polymerase chain reaction with a general primer and a type-specific primer for human papillomavirus Types 16 and 18. Direct sequencing was performed. As a control, 13 normal anal epithelia available from these patients were microdissected. As another control, 21 hemorrhoidal squamous epithelia obtained from a demographically adjusted group were also analyzed., Results: Human papillomavirus Type 16 DNA was present in all 21 anal epidermoid carcinomas. All controls were negative for human papillomavirus DNA. Sequence analysis revealed that 57 percent (12/21) specimens showed two types of sequence variation in the E7 gene. One variant with a single nucleotide change at position 647 (amino acid 29, AAT-->AGT, asparagine to serine) was found in 38 percent (8/21) of the samples. This variant has been detected in cervical cancers from Korean patients: 19 (39 percent) of 49 cervical cancer tissues and 6 (50 percent) of 12 cervical cancer cell lines. Another single nucleotide change at position 645 (amino acid 28, TTA-->TTC, leucine to phenylalanine) was found in 19 percent (4/21) of the samples. These two variants exhibit a change of amino acid affecting the critical sites for Rb binding., Conclusion: Human papillomavirus Type 16 was found to be present in all 21 anal epidermoid carcinomas. Furthermore, in the Korean population, the most common sequence variant found in cervical

Pancreatogastrostomy (PG) for restoring pancreaticoenteric continuity after pancreatoduodenectomy (PD) has been recommended by a few surgeons on the basis of certain theoretic and practical advantages of this procedure over pancreatojejunostomy (PJ). The purpose of this study was to determine whether PG can be a safe alternative to PJ. Eighty-six PDs performed by the same surgeon for periampullary carcinoma were analysed to compare early and late postoperative results of PJ (n = 38) and PG (n = 48). The two groups were comparable for age, sex, diagnosis, stage, and operation time. PJ leakage developed in six patients (15.8%) and PG leakage in one (2.1%) (p < 0.05). Overall rates of morbidity/hospital mortality were 34.2/7.9% and 18.8/4.2% in the PJ and PG groups, respectively. In conclusion, PG showed a more favorable early outcome than PJ. PG is recommended for surgeons who encounter difficulties with PJ for reconstruction after PD.