The authors report a case of malignant teratoma in a 3-year-old girl who suffered from occipital headache and vomiting for about 2 months. The tumor occupied left cerebellopontine angle resulting in a moderate degree of hydorcephalus. Histologically, the tumor consisted mainly of neuroepithelial tissues showing varying degrees of differentiation, with areas of epidermis, mature fat tissue, connective tissue, gastrointestinal glands and smooth muscle bundles containing ganglions. Also noted are groups pf polygonal or spindle cells representing immature mesodermal tissue. In contrast to two malignant intracranial teratomas previously reported in Korean literatures, this case is characterized by the presence of predominent neuroepithelial components and by uncommon tumor location, the posterior fossa far from middle line of the body.

To evaluate the expression of transforming growth factor-alpha(TGF-alpha) and proliferating cell nuclear antigen(PCNA) and its relation to the differentiation of the tumors, immunohistochemical studies were performed in 49 human gliomas. Tumors were graded by a 3-grade-system; grade I=low grade glioma, grade Il=anaplastic glioma, grade III=glioblastoma multiforme. TGF-A and PCNA were predominantly expressed in malignant gliomas compared with benign gliomas. Malignant gliomas revealed 87% TGF-A reactivity, while benign gliomas revealed 26% TGF-A reactivity. The proliferation index with PCNA was 26%+/-7%(mean+/-standard deviation) in malignant gliomas and 5%?% in benign gliomas. A strong positive correlation between tumor grade and extent of TGF-A and PCNA expression was found(P<0.0001, Chi square and P<0.002, T-test). Synchronous expression of TGF-A and PCNA was observed in 16 cases(33%). The results of this study support the suggestion that the expression of TGF-A might be a useful prognostic indicator in human gliomas.
Humans

BACKGROUND: beta-Catenin has dual functions: adhesive molucule and transcriptional activator. Subcellular accumulation of beta-catenin and subsequent formation of beta-catenin- Tcf/Lef-1 complexes, as well as c-myc and cyclin D1 genes which were recently defined as target genes of beta-catenin- Tcf/Lef-1, has been shown to be important in the development of colorectal and breast carcinomas. The author investigated the rate of subcellular accumulation of beta-catenin and overexpression of c-myc and cyclin D1, and also investigated the association between them in the pulmonary adenocarcinomas. METHODS: Fifty-one surgically resected primary adenocarcinomas of the lung, including 11 bronchioloalveolar carcinomas, were investigated by immunohistochemical analysis with monoclonal antibodies specific for beta-catenin, c-myc and cyclin D1. Clinico-pathological information were collected from the patient charts and surgical pathology reports. RESULTS: Accumulation of beta-catenin in the nucleus and/or cytoplasm and overexpression of c-myc and cyclin D1 were observed to be 20%, 37%, 16%, respectively. Ten cases showing accumulated patterns of beta-catenin revealed alternative overexpressions of c-myc (7 cases) and cyclin D1 (3 cases). In nonmucinous tumors, 9 cases showing overexpression of c-myc or cyclin D1 revealed accumulations of beta-catenin. The accumulation of beta-catenin was not statistically related to clinico-pathological parameters. The association between c-myc overexpression and histological subtype of tumors was observed. CONCLUSIONS:It is suggested that the accumulation of beta-catenin is closely associated with tumorigenesis in a minor subset (20%) of peripheral adenocarcinomas of the lung. It is also suggested that transactivation of beta-catenin may closely be associated with the overexpression of c-myc or cyclin D1 in the nonmucinous adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Bronchiolo-Alveolar ; Adhesives ; Antibodies, Monoclonal ; beta Catenin* ; Breast Neoplasms ; Carcinogenesis ; Cyclin D1* ; Cyclins* ; Cytoplasm ; Genes, bcl-1 ; Humans ; Lung ; Pathology, Surgical ; Transcriptional Activation

BACKGROUND: Survivin, a novel member of inhibitor-of-apoptosis, is undetectable in most terminally differentiated nonproliferative adult tissue, but is overexpressed in some human malignancies. The survivin gene expression is repressed by binding of wild-type p53 with the survivin promotor. In this study, we investigated the prevalence of survivin expression, its association with p53 overexpression and proliferative index, and clinicopathological significance in non-small cell lung carcinomas (NSCLC). METHODS: Immunohistochemical stainings were performed in 59 cases of primary NSCLC for survivin, p53 and Ki-67. Correlations between the survivin expression, p53 overexpression and Ki-67 labeling index were analyzed. RESULTS: Survivin expression was detected in 47 carcinomas (80%) with nuclear immunoreactivity (56%). Survivin nuclear immunoreactivity revealed significantly worse prognosis in NSCLC patients (p=0.003), and correlated with lymph node metastasis (p=0.014), lymphovascular invasion (p=0.032), p53 overexpression, and Ki-67 labeling index (KI 24.2 +/- 6.9, p=0.045). Survivin expression was not correlated with histological type and pT status. CONCLUSIONS: High incidence of survivin overexpression in NSCLC suggests that survivin is involved in lung carcinogenesis, and nuclear expression of survivin can be used as a poor prognostic predictor in NSCLC patients. Expression of mutant p53 seems to be a possible mechanism of survivin up-regulation in NSCLC.
Adult ; Biology* ; Carcinogenesis ; Cell Proliferation ; Gene Expression ; Humans ; Incidence ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prevalence ; Prognosis* ; Up-Regulation

BACKGROUND: Recently, it has been established that plateletpheresis needs more efficiency and shorter processing time. Fenwall laboratories developed a new collection chamber for CS-3000 Plus, PLT-30TM collection chamber, which can reduce the processing time with efficient collection. We evaluated the PLT-30TM collection chamber by comparing it with A-35 collection chamber that has been used as a standard collection chamber of CS-3000 Plus us. METHODS: Thirty platelet collection procedures were performed using the CS 3000 Plus with A-35 collection chamber and PLT-30TM collection chamber. The changes of the hematologic parameters between pre- and post-donation in donors and the total platelets yields and the contaminated WBCs in the plateletpheresis products were evaluated. In processing, the yield predictor calibration was adjusted to 1.00 and 1.13 in A-35 and PLT-30TM respectively. Yield predictors of pheresis were the same as 3.5x1011 in both and end point volumes were calculated from the CS-3000 Plus. Processing volume and processing times were compared between A-35 and PLT-30TM groups. RESULTS: With PLT-30TM collection chamber, 3.38+/-0.72x1011/L platelets were harvested, whereas 3.20+/- 0.73x1011/L were collected with A-35 collection chamber, which was not significantly different. But processing time with the PLT-30TM collection chamber was more reduced than that with the A-35 collection chamber by about 20 minutes (PLT-30TM : 88.6+/-8.4 min, A-35 : 106.7+/-11.7min). Collection efficiency of PLT-30TM chamber was 50.7+/-12.5% and that of A-35 chamber was 44.4 + 8.8%. The leukocyte contamination of the platelet concentrates were not statistically different(PLT-30TM: 0.0-3.6x106, A-35 : 0.1-4.1x106). CONCLUSIONS: PLT-30TM collection chamber has the advantages of shortening the donation time and decreasing the processing volume with better collection efficiency and flexibility of platelet concentrate volume.
Blood Component Removal ; Blood Platelets ; Calibration ; Humans ; Leukocytes ; Plateletpheresis ; Pliability ; Tissue Donors

BACKGROUND: Tissue hypoxia is characteristic of many human malignant neoplasm, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increasing O2 delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1alpha has been reported in many human malignancies, but in non-small cell lung carcinoma the influence of HIF-1alpha on tumor biology, including neovascularization, is not still defined. In present study the relationship of HIF-1alpha expression on angiogenetic factors, relationship between the tumor proliferation and HIF-1alpha expression, interaction of HIF-1alpha expression and p53, and relationship between HIF-1alpha expression and clinico-pathological prognostic parameters were investigated. MATERIAL AND METHOD: Archival tissue blocks recruited in this study were retrieved from fifty-nine patients with primary non-small cell lung carcinoma, who underwent pneumonectomy or lobectomy from 1997 to 1999. HIF-1alpha, VEGF (vascular endothelial growth factor), and p53 protein expression and Ki-67 labeling index in tumor tissues were evaluated, using a standard avidin-biotin-peroxidase complex (ABC) immunohistochemistry. Relationship between the HIF-1alpha expression and VEGF, p53 overexpression and correlation between the HIF-1alpha expresseion and Ki-67 index were analyzed. Clinico-pathologic prognostic parameters were also analyzed. RESULT: HIF-1alpha expression in cancer cells was found in 24 of 59 cases of non-small cell lung carcinoma (40.7%). High HIF-1alpha expression was significantly associated with several pathological parameters, such as pathological TMN stage (p=0.004), pT stage (p=0.020), pN stage (p=0.029), and lymphovascular invasion (p=0.019). High HIF-1alpha expression was also significantly associated with VEGF immunoreactivity (p<0.001), and aberrant p53 expression (p=0.040). but was marginally associated with Ki-67 labeling index (p=0.092). The overall 5-year survival rate was 42.3%. The survival curve of patients with a high HIF-1alpha expression was worse than that of patients with low-expression (p=0.002). High HIF-1alpha expression was independent unfavorable factors with a marginal significance in multivariate analysis performed by Cox regression. CONCLUSION: It is suggested that high HIF-1alpha expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway, and high HIF-1alpha expression could be associated with lymph node metastasis and post operative poor prognosis in patients with non-small cell lung ca
Anoxia ; Biomarkers* ; Biology ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Immunohistochemistry ; Lung ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Proteins ; Pneumonectomy ; Prognosis* ; Signal Transduction ; Survival Rate ; Vascular Endothelial Growth Factor A

BACKGROUND: Cyclin E 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 E and negative expression of p27 (73.5% vs 36.3%, p=0.0029). In multivariate analysis, expression of cyclin E 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 E and p27 may be new prognostic markers.
Antibodies, Monoclonal ; Carcinoma, Non-Small-Cell Lung* ; Cyclin E* ; Cyclins* ; Lung ; Multivariate Analysis ; Survival Rate

Cutaneous metastases from Internal carcinomas are relatively rare. We report a case of cutaneous metastasis believed t.o originate from primary lung carcinoma in a 69-year-old male patient. The patient presented with localized well defined multiple variable sized, hard eryt,hematous papules, nodules and pustules on the right chest, back and upper arm. Biopsy specimens from the nodules upper chest revealed scatt,ered islands of tumor cells and fi brosis of the dermis. To evaluate the role of p53 protein in the development of skin tumors, we examed p53 expres sion at protein level by imnunoperoxidase stain using monoclonal antimouse human p53 antibody on paraffin embeded tissues The patient died after four months from the appearance of cutaneous lesions.
Aged ; Arm ; Biopsy ; Dermis ; Humans ; Islands ; Lung ; Male ; Neoplasm Metastasis ; Paraffin ; Skin ; Thorax

BACKGROUND: The stomach is the most common extra nodal site for non-Hodgkin's lymphoma: primary gastric lymphomas are uncommon, constituting only 1% to 5% of malignant gastric lesions. METHODS: To elucidate the clinicopathologic features of this lymphoma, we retrospectively analyzed 33 patients with primary gastric lymphoma who had been treated at our hospital from Jan. 1986 to Dec. 1995. RESULTS: Primary gastric lymphomas were 1.2% of all gastric cancers. The mean age 46 years (range 25 to 68 years). There were 23 men and 10 women. The most frequent chief complaint was epigastric pain. The most common location was the gastric antrum and body. According to the working formulation, the malignancy grades were 4 low, 26 intermediate, and 3 high. The overall 5-year survival rate was 60%. Survival of five years according to the TNM stage of the disease was as follows: stage 1, 88%; stage II, 71%; stage III, 33%; and stage IV, 29%. Patient with stage I, II disease had a 5-survival rate of 80% versus 35% for stage III, IV disease (p<0.05). Tumor serosal involvement and 5-year survival was follows: no perigastric serosal involvement, 93%; serosal infiltration, 33% (p=0.0016). In cases undergoing a subtotal gastrectomy, 5-year survival rate was 70%, whereas patients undergoing a total gastrectomy had a 5-year survival rate of 30% (p<0.05). Those with tumors smaller than 7 centimeters had a 5-year survival rate of 66% versus 38% for larger neoplasms (p=0.09). CONCLUSIONS: By univariate analysis, the stage, operation methods, and serosa involvement were significant prognostic factors. However, in multivariate analysis, only the serosa involvement was significant prognostic factor.
Female ; Gastrectomy ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Multivariate Analysis ; Pyloric Antrum ; Retrospective Studies ; Serous Membrane ; Stomach ; Stomach Neoplasms ; Survival Rate

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of gastrointestinal bleeding. The diagnosis of PAEF is difficult to make. The classic triad of symptoms, i.e. gastrointestinal bleeding, abdominal pain, and a pulsating abdominal mass is overemphasized, as it occurs in less than 11~25% of the patients. For two thirds of the patients, the diagnosis is made in the operating room. Endoscopic and radiographic studies are very helpful, but the absence of abnormalities can not exclude the diagnosis. PAEF is a clinical and surgical challenge associated with high mortality. A high index of suspicion, early diagnosis and prompt and appropriate surgical intervention are essential to patient survival. Two primary aortoenteric fistulas (aortoduodenal and aortoesophageal) cases are presented and the related literature are reviewed.
Abdominal Pain ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Early Diagnosis ; Fistula ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Fistula ; Operating Rooms ; Vascular Fistula