Showing papers in "Journal of Korean Medical Science in 1998"

The Causative Organisms of Bacterial Meningitis in Korean Children in 1996-2005

Abstract: Bacterial meningitis remains a serious cause of morbidity and mortality in childhood, despite the availability of effective vaccines against Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae. The purpose of this study was to analyze data on bacterial meningitis cases in Korea from 1996 through 2005. The information of all hospitalized bacteria-proven meningitis cases was obtained from 17 university hospitals nationwide. A total of 402 cases were identified. Of these, 125 (29.9%) cases were neonates. Streptococcus agalactiae was the most common bacteria responsible for 99 (24.6%) of all cases regardless of age, followed by S. pneumoniae for 91 (22.6%) and H. influenzae for 67 (16.7%) patients. The common etiology beyond the neonatal period was S. pneumoniae for 91 (33.0%) followed by H. influenzae for 63 (22.8%) patients. The overall case fatality rate was 9.4%, which was similar with that in 1986-1995. In conclusion, S. agalactiae, S. pneumoniae and H. influenzae were important etiologic agents of bacterial meningitis in children in the last 10 yrs. It is required to establish the preventive strategy of the three bacteria. The nationwide epidemiologic study should be continued to evaluate immunization strategy and efficacy.

Left main coronary artery dissection after blunt chest trauma presented as acute anterior myocardial infarction: assessment by intravascular ultrasound: a case report.

Abstract: Coronary artery injury after blunt chest trauma is very rare, but this can result in a serious acute myocardial infarction. Coronary artery dissection is an uncommon complication of thoracic injuries. We report a case of a 17-year-old male who was presented with an anterior myocardial infarction following blunt chest trauma after a bicycle accident. His coronary angiography revealed aneurysmal dilatation with dissection of the distal left main stem coronary artery. Intravascular ultrasound showed a dissecting flap at the left main stem coronary artery. The patient was treated conservatively and discharged without serious sequelae. When symptoms and electrocardiographic findings are compatible with acute myocardial infarction, careful evaluation is important in patients with thoracic injuries for proper management. If the patient is stable, medical therapy may be appropriate. But early intervention should be considered in the presence of ongoing myocardial ischemia.

A study of the viral etiology of histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease)

Abstract: Histiocytic necrotizing lymphadenitis (HNL) or Kikuchi's disease is a distinctive, self-limited disorder characterized by necrotizing cervical lymphadenopathy in young individuals. HNL is more prevalent among Asians and is a relatively common disorder among Koreans. A preceding fever, lymphopenia, and occasional skin rashes suggest a viral etiology and there have been sporadic reports of viral association. However, so far, no infectious agent has been proven to be etiologically related. In the present study, the authors examined HNL tissue samples for the presence of the genome of herpesviridae. A polymerase chain reaction was performed on 12 freshly frozen lymph nodes with HNL with a single pair of consensus primers selected within a highly conserved region of the DNA polymerase gene of the Epstein-Barr virus (EBV), designed to detect herpes simplex type 1 (HSV1), herpes simplex virus type 2 (HSV2), and cytomegalovirus (CMV) in addition to EBV. The amplified products of known sizes were then analyzed by a single restriction enzyme treatment for confirmation. No viral DNA was amplified in any of the 12 cases of histiocytic necrotizing lymphadenitis. The authors conclude that there is no evidence that HSV1, HSV2, CMV, or EBV plays any role in the pathogenesis of histiocytic necrotizing lymphadenitis.

Expression of osteopontin and osteonectin in breast cancer

Abstract: Osteopontin (OP) and osteonectin (ON) are bone matrix proteins produced by mammary and other cancers. These proteins may play a role in tumor invasion and metastasis through integrin-mediated signal transduction. We evaluated expressions of OP and ON in 253 resected infiltrating ductal carcinoma of the breast, using immunohistochemical staining and follow-up data. OP and ON were detected 87.4% and 54.2% of 253 cases, respectively. The OP and ON positive staining were localized in the cytoplasm of carcinoma cells. OP and ON did not correlate with various clinicopathological parameters, such as age, lymph node involvement, tumor size, histologic grade, expression of p53 and estrogen receptor (ER). In the multivariate model, lymph node involvement and histologic grade were statistically significant prognostic factors. Assessed by a log rank test, the 5-year-survival rates of OP and ON positive groups and their negative groups were not statistically different. In conclusion, OP and ON immunopositivity of infiltrating ductal carcinomas of the breast provide no additional prognostic information in this study.

Heterogeneity of IgE response to TDI-HSA conjugates by ELISA in toluene diisocyanate (TDI) -induced occupational asthma (OA) patients.

Abstract: Toluene diisocyanate (TDI), a low molecular weight reactive chemical, is known to be a main cause of occupational asthma (OA) in Korea. Although it is thought that inhaled TDI may act as a hapten, the precise mechanisms of TDI-induced OA are unknown. In this study, TDI-human serum albumin (HSA) conjugates (5, 10, 20 and 30 min) were prepared in the range of 1.5 to 5.0 TDI mole/HSA mole. Specific binding of serum IgE to TDI-HSA (30 min) was observed using IgE ELISA as well as ELISA inhibition assay. Around 40% of TDI-induced OA patients were positive for serum specific IgE by ELISA. Degrees of serum IgE binding were different depending on which TDI-HSA conjugate was used as an antigen. Moreover, binding patterns were different depending on the individuals. Interestingly, higher binding of IgE to TDI-HSA (5 min) than to TDI-HSA (30 min) which was more highly substituted was observed in some patients. Probably new antigenic epitopes on carrier proteins were targets of the specific IgE. The results of this study indicated that IgE responses to TDI-HSA conjugates were heterogeneous in TDI-induced OA patients and self-proteins modified by reactive chemicals can become a major target antigen of IgE in certain cases.

A case of central pontine and extrapontine myelinolysis with early hypermetabolism on 18FDG-PET scan.

Abstract: We report a 63 year-old woman who developed central pontine and extrapontine myelinolysis after rapid correction of hyponatremia. Lesions on brain MRI showed hypermetabolism on 18FDG-PET scan in the early stage of the disease and became hypometabolic on the follow-up scan. We suggest that active microglia and astrocytes are the main cause of the increased glucose metabolism.

Prevalence and Patterns of Left Ventricular Hypertrophy in Patients with Predialysis Chronic Renal Failure

Abstract: Left ventricular hypertrophy (LVH) is an independent risk factor for cardiac death. This study evaluates the prevalence and patterns of LVH in patients with predialysis chronic renal failure (CRF) and analyses the relationship between LVH and various predisposing factors. Sixty-two CRF patients were recruited from the renal clinic with serum creatinine over 2 mg/dl. Using echocardiography, we calculated the left ventricular mass index (LVMI) and relative wall thickness (RWT), and classified the patients into four groups (Group 1: normal, Group 2: concentric remodelling, Group 3: concentric hypertrophy, Group 4: eccentric hypertrophy). Prevalence and patterns of LVH in patients with CRF were as follows; 6.5% in Groups 1 and 2, 56.5% in Group 3 and 30.5% in Group 4. LVMI increases with progressive renal function decline. There were linear correlations between LVMI and systolic and diastolic blood pressure (BP), serum creatinine (Scr) and intact parathyroid hormone (PTH) in patients with predialysis CRF and also inverse linear correlations between LVMI and creatinine clearance (Ccr) and hemoglobin. In conclusion, we demonstrate the high prevalence of LVH (87%) in patients with predialysis CRF and concentric hypertrophy (56.5%) was the main pattern of LVH. Several factors such as anemia, systolic and diastolic BP, renal function and PTH influence LVMI.

Expression of cyclin D1 and cyclin E in human gastric carcinoma and its clinicopathologic significance.

Abstract: Cyclin D1 and cyclin E are the mammalian G1 cydins that are both required and rate limiting for entry into S phase. Alterations in cell cycle regulators and subsequent deregulation of the cell cycle are frequently involved in tumorigenesis and/or tumor progression. We investigated the expression of cyclin D1 and cyclin E protein in 84 gastric carcinoma by immunohistochemical staining and also the relevance of each cyclin expression to the clinical outcomes. Overexpression of cyclin D1 and cyclin E was noted in 21 of 84 (25.0%) and 34 of 84 (40.5%) gastric cancer tissues, respectively. There was a significant correlation between overexpression of cyclin E and lymph node metastasis (p=0.003), recurrence (p=0.043), disease free survival (p=0.0378) and overall survival (p=0.0319), but no correlation was noted between overexpression of cyclin D1 and other clinicopathologic variables. These findings suggest that overexpression of cyclin E and cyclin D1 is a frequent finding in gastric cancer and immunohistochemical analysis for cell cycle regulators, especially cyclin E might be a useful prognostic indicator in gastric cancer.

Temporal lobe epilepsy caused by intrahippocampal calcified cysticercus: a case report.

Abstract: The major differential diagnoses of epilepsy associated with small solitary lesion are tuberculous or cysticercus granuloma which are enhanced in CT and/or MRI study. We report of a 47-year-old man with intractable temporal lobe epilepsy as the presenting feature of a solitary intrahippocampal calcified mass without enhancement, which turned out to be a Taenia solium cysticercus. There was no apparent evidence of systemic cysticercosis. Imaging studies revealed a small solitary intrahippocampal calcification without perilesional enhancement, and atrophy of the hippocampal head portion. Cysticercosis should be considered as an etiology in the differential diagnosis in lesional medial temporal lobe epilepsy even without perilesional enhancement.

Brain tumor in the first year of life: a single institute study

Abstract: Brain tumors in infants present special diagnostic and therapeutic challenges. To figure out the clinical features, pathological classification of the tumors and the treatment outcome of infantile brain tumors, 458 children (age<16) with brain tumors were reviewed retrospectively. Among them 21 cases (4.6%) were diagnosed during the first 12 months of life. Two tumors were definitely of congenital origin. The majority of infants with brain tumors presented with increased intracranial pressure. Fourteen tumors were located at the supratentorial area. Sixteen cases had neuroepithelial tumors; astrocytoma (optic pathway), supratentorial primitive neuroectodermal tumor (PNET) and medulloblastoma were found in three cases each. There were two treatment-related mortalities. Compared with the outcomes in older children, the treatment outcome was poorer in medulloblastoma and the optic pathway glioma which showed a higher growth potential. Because of the limited application of postoperative adjuvant therapy, radical surgical removal played a more important role in this age group. The prognosis of patients in whom the tumors could not be totally removed, largely depended on the pathological malignancy of the tumors. Though the treatment outcome was not always dismal, immaturity of the brain, higher growth potential, perioperative risks, limitations in adjuvant therapy, and pessimistic attitude on the part of parents made management more challenging.

Prevalence of Viral Hepatitis Markers in Korean Patients with Hepatocellular Carcinoma

Abstract: The positive rates of hepatitis B surface antigen (HBsAg) and antibody to hepatitis C virus (anti-HCV) were analyzed according to year, sex, age, and serum ALT levels in 1,370 patients with hepatocellular carcinoma (HCC) who visited the Korea Cancer Center Hospital between January 1989 and December 1994. The positive rate of HBsAg was 68.8 to 76.0% per year in patients with HCC, while that of anti-HCV was 3.2 to 9.8% per year. No sex predominance was found in the positive rates of HBsAg and anti-HCV. HBsAg positivity was distributed mostly in the 41 to 50 age group, whereas anti-HCV positivity was distributed mostly in the over 50 age group. Higher positive rate of anti-HCV was observed in HCC patients with serum ALT levels above the normal range than in those with serum ALT levels within the normal range. However, elevated serum ALT levels above the normal range was not related to the positive rate of HBsAg. The relatively low prevalence of anti-HCV in patients with HCC suggests that the role of HCV infection in the development of HCC lower than that of HBV infection in Korea. However, our results suggest that HCV is another potent risk factor for HCC even in HBV endemic areas.

Myxoid leiomyosarcoma of the uterus: a case report and review of the literature.

Abstract: A case report of myxoid leiomyosarcoma of the uterus in a 54-year-old woman is presented as a rare variant of uterine sarcoma. Only 14 cases have been described in the literature. These tumors have a striking myxoid appearance and exhibit highly malignant behavior despite their low mitotic index. Although it is difficult to establish the nature of the neoplastic cells in the myxoid areas, both light microscopical and immunohistochemical characteristics showed features of smooth muscle cells in some of the cellular areas. Our patient had a tumor which arose in association with hyalinized benign leiomyomatous lesion. Like other reported cases of myxoid leiomyosarcoma, the tumor behaved aggressively.

Female sex hormones and body mass in adolescent and postmenopausal Korean women.

Abstract: A cross-sectional study was conducted to evaluate the relationship between body mass and serum level of female sex hormones among 153 adolescent girls, and 153 postmenopausal women in Korea. Information on lifestyles, and both menstrual and reproductive factors was collected by personal interview. Serum total estradiol (E2), progesterone (Pg), and sex hormone binding globulin (SHBG) concentrations were measured by radioimmunoassay. Multiple linear regression analysis was used to determine whether the hormonal levels would be affected by the obesity indices. Body weight and body mass index (BMI) were inversely related to SHBG level in both premenopausal (p<0.005) and postmenopausal women (p<0.005) after adjusting for age. E2 levels during any phase in premenopausal girls were not related to BMI, whereas heavier girls had significantly higher levels of late luteal-phase Pg (p<0.05). Taller postmenopausal women had lower E2 levels (p<0.05). Results on the association between SHBG and BMI are consistent with previous results in Caucasian women, and might suggest the potential role of bioavailable estradiol in breast carcinogenesis in pre- and post-menopausal women. The finding that progesterone might be related to body mass in premenopausal women should be pursued in further studies.

Low prevalence of activated protein C resistance and coagulation factor V Arg506 to Gln mutation among Korean patients with deep vein thrombosis

Abstract: Activated protein C (APC) is a naturally occurring anticoagulant that interacts with factor V and VIII to inhibit the clotting cascade. The prevalence of APC resistance among Korean patients with deep vein thrombosis is ill defined. The aim of the present study was to investigate the prevalence of APC resistance and factor V Leiden mutation in Korean patients with deep vein thrombosis. The presence of factor V Leiden mutation was determined in 49 patients who visited Asan Medical Center. APC ratio was performed in 33 individuals from the above 49 patients. Three patients were excluded from the analysis because their baseline aPTT was prolonged. Resistance to APC was diagnosed when the APC ratio was below 2.55. APC resistance was documented in 8 individuals, representing 27% (8/30) of the patients on whom APC resistance test was performed. The 2 patients, who showed APC resistance, were positive for lupus anticoagulant. None of the 49 patients demonstrated factor V Leiden mutation. These findings indicate that factor V Leiden mutation is rare and APC resistance is less prevalent in Korean patients with deep vein thrombosis than in Caucasians. APC resistance not caused by factor V Leiden mutation may be a risk factor for deep vein thrombosis in this population.

Primary CD56-positive NK/T-cell lymphoma of median nerve: a case report

Abstract: Primary extranodal lymphomas of the central nervous system constitute 2% of all malignant lymphomas. The involvement of the peripheral nervous system is very rare. A solitary primary CD56-positive NK/T-cell lymphoma of the median nerve is described in a 70-year-old woman. On physical examination, a rubbery hard mass measuring 2.0 cm in diameter was palpated on the volar aspect of second to third finger of left hand. Excisional biopsy was performed. Under the fascia, a large fusiform tumor of the median nerve encapsulated with the epineurium was noted. Microscopically, the enlarged nerve showed extensive infiltration of atypical lymphoid cells. The lymphoid elements had abundant pale cytoplasm and large vesicular nuclei with peripheral prominent nuclei. The cells strongly expressed T-cell marker (UCHL-1) and natural killer cell marker (CD56). Gene rearrangement study showed rearrangement of T cell receptor (TCR-gamma).

Effects of Ginkgo biloba extract on the cochlear damage induced by local gentamicin installation in guinea pigs.

Abstract: Investigations evaluating the protective effect of Ginkgo biloba extract (EGb) on gentamicin (GM) ototoxicity were undertaken. Guinea pigs treated with 5 mg/kg gentamicin sulfate on the round window niche (RWN) showed acute changes on electrocochleogram and hair cell or microvilli damage on scanning electron microscopy (SEM). There was accumulation of GM in the whole cochlea, especially in the organ of Corti, stria vascularis, and type III fibrocyte on immunohistochemical study. However, the guinea pigs pretreated with local or systemic EGb revealed no significant changes by local GM installation. From these results, we concluded that EGb has a protective effect on the development of GM ototoxicity in the cochlea.

Transverse testicular ectopia found by preoperative ultrasonography.

Abstract: Transverse testicular ectopia, an extremely rare anomaly, is a deviation of testicular descent resulting in unilateral location of both testes, usually associated with an inguinal hernia, with the spermatic cord of the ectopic testes originating from the appropriate side. In most reported cases, the correct diagnosis was not made preoperatively. But we made a diagnosis of transverse testicular ectopia preoperatively by using the ultrasonography in patient with right-side inguinal hernia and left-side cryptorchism. Left testis was found on the right inguinal area and right testis was found in the right scrotum by ultrasonography, so we could make a diagnosis of transverse testicular ectopia. After right inguinal hemiorraphy, both testes were easily brought down sequentially through the right groin into the scrotum. Left testis was placed in the left hemoscrotum through transceptal incision to the scrotal subdartous pouch.

Manganese induced parkinsonism : A case report

Abstract: Manganese (Mn) intoxication is known to induce parkinsonism. Mn-induced parkinsonism preferentially affect the globus pallidus in contrast to idiopathic parkinsonism where degeneration predominantly involves the nigral pars compacta. We describe a 51-year-old man who had been occupationally exposed to Mn. He had parkinsonian features including masked face, resting tremor, and bradykinesia. He also had a cock walk and a particular propensity to fall in a backward gait. There was no sustained therapeutic response to levodopa. A fluorodopa PET scan was normal. This case indicates that Mn-induced parkinsonism can be differentiated from idiopathic parkinsonism in that the former has unique clinical features and a normal fluorodopa PET scan.

Arthritic manifestations of inflammatory bowel disease

Abstract: Inflammatory bowel disease (IBD) is commonly associated with arthritic manifestations. They are divided into three clinical categories; peripheral arthritis, spondylitis, and sacroiliitis. To evaluate the incidence of arthritis associated with IBD in Korea, we retrospectively reviewed one hundred and twenty-nine patients with IBD, 77 with ulcerative colitis (UC) and 52 with Crohn's disease (CD). Arthritis occurred in twenty-two patients (17.1%); 15 with UC(19.6%), 7 with CD (13.5%). Patients with arthritis had more active inflammations and all were seronegative except one patient. Peripheral arthritis was found in twenty patients (15.5%) and more common in UC (19.6%) than in CD (9.6%). Joint involvements tended to be monoarticular or pauciarticular, and most frequently developed in the knee and ankle. Spondylitis was diagnosed in one patient (1.6%) who showed HLA B27 positivity. Radiographic sacroiliitis was observed in eight patients (6.2%) who revealed HLA B27 negativity. Both peripheral arthritis and sacroiliitis were found in six patients (4.6%). In CD, arthritis occurred in 20% of the patients with colonic involvement but in none of the patients without colonic involvement. In conclusion, arthritis was frequent in patients with IBD. Peripheral arthritis was more common in patients with UC than CD. All the patients with CD and arthritis had colonic involvement.

Primary hepatic carcinoid tumor with a paranuclear clear zone: a case report.

Abstract: Carcinoid tumors having distinct paranuclear clear zones seen on hematoxylin and eosin stain are rare and few cases have been reported in the literature. Furthermore, primary hepatic carcinoid tumor with a paranuclear clear zone is extremely rare. We recently experienced a case from a 48-year-old man who presented a large single mass, 12 cm in largest diameter, in the right lobe of the liver. Histologically, the tumor revealed characteristic organoid pattern with central hyaline degeneration. The tumor cells had a prominent paranuclear vacuolated dear zone. On immunohistochemistry, tumor cells were diffusely positive for synaptophysin and focally stained for chromogranin A. Ultrastructural examination revealed paranuclear aggregation of intermediate filaments and membrane-bound clear vesicles, which corresponded to the paranuclear vacuolated clear zone.

Psoriasiform eruption triggered by recombinant granulocyte-macrophage colony stimulating factor (rGM-CSF) and exacerbated by granulocyte colony stimulating factor (rG-CSF) in a patient with breast cancer

Abstract: Colony-stimulating factors (CSFs) are commonly used for the treatment of neutropenia following chemotherapy and for the mobilization of peripheral blood stem cells (PBSC). We recently experienced a rare case of a new onset of psoriasiform eruption by GM-CSF (granulocyte-macrophage colony-stimulating factor) which was exacerbated by G-CSF (granulocyte colony-stimulating factor) in a patient with breast cancer. A 36-year-old woman had received neoadjuvant chemotherapy (cyclophosphamide, epirubicin and 5-fluorouracil), modified radical mastectomy and adjuvant chemotherapy with paclitaxel and mitoxantrone followed by GM-CSF administration for the treatment of locally advanced breast cancer. She had developed a psoriatic skin lesion on face and both upper arms during leukocyte recovery in spite of no previous history of psoriasis. Next, the chemotherapy course was complicated by a flare of mild psoriatic skin lesion, although CSF was changed into G-CSF due to GM-CSF-associated psoriasis. Subsequently, she had had high-dose chemotherapy and autologous peripheral blood stem cell transplantation for consolidation therapy. GM-CSF was administered for the mobilization of PBSC and post-transplant period, but psoriatic skin lesion did not appear. During 6 months after PBSCT, psoriasiform eruption did not appear.

Clinicopathologic study of basaloid squamous carcinoma of the upper aerodigestive tract

Abstract: The clinicopathologic and immunohistochemical characteristics of nine cases of basaloid squamous carcinoma (BSC) of the upper aerodigestive tract are reported, along with the results of an in situ hybridization for human papilloma virus (HPV) DNA. The cases were selected through a review of 237 head and neck carcinomas, and were located in the supraglottic larynx (5), hypopharynx (2), and the base of tongue (2). The patients were 7 males and 2 females with the mean age of 62. BSCs were histologically characterized by lobules and nests of basaloid cells with scanty cytoplasm, comedonecrosis and adenoid features, and by concomitant presence of squamous cell carcinoma. Immunohistochemically, all BSCs showed positivity for high molecular weight cytokeratin (HMW CK) with heterogeneous or diffuse staining pattern, but lacked reactivity for neuroendocrine markers and bcl-2 oncoprotein. No HPV DNA was detected in BSCs. This study reaffirms that BSC is a rare carcinoma with a peculiar topographic distribution and distinct pathologic features.

Improvement of gas exchange by apneic oxygenation with nasal prong during fiberoptic intubation in fully relaxed patients.

Abstract: To evaluate the effect of apneic oxygenation with a nasal prong during fiberoptic orotracheal intubation (FOI) in fully relaxed patients, 46 patients, who underwent tympanomastoidectomy under general anesthesia whose intubation lasted more than 3 but less than 4 minutes, were studied. Changes of arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2) and vital signs were measured every minute. Twenty-three patients who underwent FOI in apneic state without oxygen administration (Group I), showed similar increases in heart rate (HR) and mean arterial pressure (MAP) to the other 23 patients who received 5 L/min of apneic oxygenation (Group II) with nasal prong. PaCO2 increased less and PaO2 decreased less in Group II at 3 minutes. In summary, apneic oxygenation during fiberoptic orotracheal intubation in fully relaxed patients is useful because it could delay the onset of hypoxia and hypercarbia, thereby providing extra time for intubation. And attempts to intubate a fully relaxed patient could probably be kept at least under 3 minutes.

Molecular analysis of prion protein gene (PRNP) in Korean patients with Creutzfeldt-Jakob disease

Abstract: Creutzfeldt-Jakob disease (CJD), a relatively uncommon human dementia, is caused by an unconventional slow infectious agent. Several cases of CJD, clinically or histopathologically diagnosed, have been reported in Korea. In order to confirm the diagnosis of CJD and also differential diagnosis of sporadic and familial types of CJD in Korea, we studied two patients who had symptoms of CJD. The histopathological and immunohistochemical studies showed spongiform neurodegeneration and expression of abnormal isoform of prion protein (PrPSc) in astrocytes. Thus, these two patients were diagnosed CJD. To investigate whether these patients were sporadic or familial type of CJD, the molecular analyses of the prion protein gene (PRNP) were done by restriction fragment length polymorphism (RFLP) and DNA sequencing. In the cases of a healthy Korean and two CJD patients, no point mutation was detected in the known hot spots (178, 180, 200, 210, and 232) and they exhibited wild type PRNP sequences. We concluded that both patients have a sporadic type of CJD, but not familial type.

A Case of Multilocular Prostatic Cystadenoma

Abstract: We recently experienced a 43-year-old man with a large, multiloculated, cystic tumor that appeared on the pelvis The tumor was composed of glands and cysts lined by prostatic-type epithelium and attached microscopically to the prostate by a pedicle The prostatic nature of the lesions was confirmed by immunohistochemical staining of epithelium for prostate specific antigen (PSA) Our review of literature disclosed nine similar cases in men of various ages, originated from the prostate and grew to massive proportions The lesions in these reported cases did not invade contiguous structures but they can adhere to viscera in their proximity The multilocular prostatic cystadenoma is a pathologically benign entity, and they can be definitively treated by a carefully planned complete surgical excision This lesion should be included in the differential diagnosis of retroperitoneal cystic tumors in man We report a rare case of multilocular prostatic cystadenoma that did not invade adjacent organs and showed no evidence of recurrence after complete surgical excision

Loss of heterozygosity on chromosome XP22.2-p22.13 and Xq26.1-q27.1 in human breast carcinomas

Abstract: In an attempt to investigate the X chromosome harboring putative tumor suppressor genes (TSGs) in sporadic breast carcinoma, we performed loss of heterozygosity (LOH) studies on 23 breast carcinomas using 15 polymorphic markers covering the whole X chromosomes. Matched DNA extracted from tumor samples and corresponding normal tissues were analyzed by polymerase chain reactions (PCR) using microsatellite markers. In 10 cases (43.5%), LOH was detected for at least 1 of the 15 polymorphic markers of the X chromosome tested. Four cases carried a LOH at Xp, and three cases LOH on Xp and Xq. Three cases carried a LOH Xq. Percentage of LOH was relatively high in DXS987 (26.7%), DXS999(30.0%), HPRT(21.4%), DXS1062(23.1%) loci. Common regions of deletions were found on Xp22.2-p22.13 (30% of LOH) measuring about 4.5Mb and Xq26.1-q27.1 (23.1% of LOH) measuring 10 Mb. The deleted allele was an active copy of the X chromosome. The results indicate the TSGs on the X chromosome are involved in breast cancer.

Reduced expression of tissue inhibitor of metalloproteinase in nodal metastasis of stomach cancer.

Abstract: The matrix metalloproteinases (MMPs) have been associated with tumor cell invasion and metastasis of human cancers by mediating the degradation of extracellular matrix components. Therefore, these enzymes and their inhibitor (TIMP-2) constitute promising targets in the development of anticancer therapies. In order to investigate the correlation between expressions of TIMP-2, MMPs and clinical outcome, immunohistochemical staining of MMP-2, MMP-9, and TIMP-2 were performed on paraffin-embedded tissue sections of 15 early gastric cancers (EGC) and 15 advanced gastric carcinomas (AGC) without nodal metastasis and 15 AGC with nodal metastasis (AGCn+). MMP-2 and MMP-9 were expressed in neoplastic cell plasma membrane in 83.3% and 88% of cases of AGC, respectively with inter-tumoral variability of staining intensity. MMP-2 and MMP-9 staining were not correlated with presence of nodal metastasis or degree of invasion depth at the time of diagnosis (p>0.05). The immunoreactivity of TIMP-2 was detected in the peri-tumoral stroma. Residual benign stomach tissue showed no or weak immunoreactivity for TIMP-2 staining. Among AGC, neoplasms with diffuse and strong TIMP-2 staining have less frequent metastasis (28.6%) than cases with focal and weak (68.8%) (p<0.05). Early gastric cancer revealed diffuse and strong TIMP-2 expressions. We conclude that clinical outcome such as depth of invasion or metastasis is more closely related to the expression of TIMP-2 than the corresponding MMPs.

Anticardiolipin and anti-beta2-glycoprotein I antibodies in Behcet's disease.

Abstract: To investigate prevalence of anticardiolipin antibodies (aCL) in patients with Behcet's disease (BD) and to determine whether they are related to anti-beta2-glycoprotein I antibodies (aGPI), we measured aCL and aGPI in 47 patients of BD and 14 patients of systemic lupus erythematosus (SLE). The levels of aCL and aGPI were determined by conventional enzyme immunoassay for both IgG and IgM classes. Twelve (25.5%) patients with BD were positive for IgG or IgM aCL and no patient was positive for aGPI. Eleven (78.6%) patients with SLE were also positive for aCL and among them, 8 (72.7%) patients were positive for aGPI. Positive IgG aCL patients with BD showed lower level of IgG aCL than those with SLE (15.7+/-7.3 vs 34.1+/-16.0 GPL, p<0.05). There was no relation between the presence of aCL in BD and either dinical activity or clinical features. In the patients with BD, aCL are found but it would not be associated with aGPI as they are in patients with SLE. In patients with BD, aCL seem to be authentic aCL unlike those in patients with SLE and may not be related with vascular complications in BD.

A case of spontaneous cervical and mediastinal emphysema.

Abstract: Subcutaneous cervical and mediastinal emphysema usually can occurs as a result of surgery or trauma. Spontaneous cervical subcutaneous emphysema and pneumomediastinum, occurring in the absence of previous disorders or provocating factors, is very rare. The following case report of spontaneous cervical and mediastinal emphysema is assumed to be the first of its kind in Korea. The patient has been followed up for three years without recurrence or sequelae.

Immunohistochemical characterization of the cellular infiltrate in airway mucosa of toluene diisocyanate (TDI)-induced asthma: comparison with allergic asthma

Abstract: Toluene diisocyanate (TDI) is the most prevalent agent in occupational asthma (OA) in Korea. The immuno-pathologic mechanism for TDI-induced bronchoconstriction remains to be clarified. We studied the immunohistochemical finding of inflammatory cells in bronchial mucosa in subjects with TDI-induced asthma. Fiberoptic bronchial biopsy specimens were obtained from nine subjects with TDI-induced asthma. Six allergic asthma sensitive to house dust mite were enrolled as controls. Bronchial biopsy specimens were examined by immunohistology with a panel of monoclonal antibodies to mast cell tryptase (AA1), secretary form of eosinophil cationic protein (EG2), pan T-lymphocyte (CD3) and neutrophil elastase (NE). There was a significant increase in the number of AA1+, EG2+ and NE+ cells in TDI-induced asthma compared to those of allergic asthma (p=0.02, p=0.04, p=0.03, respectively). No significant differences were observed in the number of CD3+ cells (p=0.27). These findings support the view that neutrophil recruitment together with eosinophil and mast cell, may contribute to the bronchoconstriction induced by TDI.