BACKGROUND AND OBJECTIVES: MAGE (melanoma antigen gene) gene, coding for a tumor antigen recognized by cytotoxic T lymphocytes, is expressed specifically in a variety of cancers, but not in normal tissues that exclude those of the testis. Therefore, most studies of MAGE gene are reported for the cancer immunotherapy. There are, however, few reports for the molecular diagnosis of cancers with MAGE gene. The purpose of this study is to evaluate the MAGE common primers in discriminating the malignant from benign lesions of the head and neck. MATERIALS AND METHODS: Reverse transcriptase-polymerase chain reaction (RT-PCR) and the nested PCR with the MAGE common primers (C1/C2, C3/C4) designed to detect MAGE 1-6 genes in this study were conducted in 37 cancer tissues (27 squamous cell carcinomas and 10 nonsquamous cell carcinoma lesions) and 18 benign tumors and 20 normal tissues of the head and neck . The PCR product was also assayed by RT-PCR with the MAGE 1-6 specific primer (M1-M6) to investigate which MAGE isotypes were detected. RESULTS: At least more than one isotype of MAGE 1-6 genes were detected in 70.4% (19/27) of squamous cell carcinomas and 30% (3/10) of non-squamous cell carcinoma lesions. But there was no MAGE expression in 18 benign lesions and 20 normal tissues. CONCLUSION: MAGE common primers designed in this study showed high sensitivity and specificty in discriminating the malignant from benign lesions of the head and neck. This result suggests MAGE gene might be a potential tumor marker in the head and neck cancer.
Carcinoma, Squamous Cell ; Clinical Coding ; Diagnosis ; Head and Neck Neoplasms ; Head* ; Immunotherapy ; Neck* ; Polymerase Chain Reaction ; RNA, Messenger* ; T-Lymphocytes, Cytotoxic ; Testis ; Biomarkers, Tumor

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal (GI) tract, but the lesion occurs rarely in the esophagus. Although only 10~30% of GISTs are malignant at the time of diagnosis, many reports show that it is difficult to predict the prognosis and underlying potential of non-malignant ones. Thus, the surgical removal of GISTs is even being proposed as a standard treatment. Recently the endoscopic removal of submucosal tumors of the GI tract is being done in popular, but it has been still considered as both difficult and risky to resect a tumor originating from the muscularis propria layer using the endoscopic methods. Herein, we report a case of an incidentally found submucosal tumor originating from the muscularis propria treated with an endoscopic submucosal dissection method which was performed after a preceding mucosectomy using a transparent cap. The mass turned out to be an esophageal GIST.
Esophagus ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Prognosis

BACKGROUND AND OBJECTIVES: Absence of incus is one of the most common ossicular anomalies and also frequently found in chronic otitis media or chornic otitis media with cholesteatoma. Ossiculoplasty with malleus footplate assembly (MFA) can be an excellent option in the above situations. We reviewed our procedures and evaluated the hearing results of ossiculoplasty using the MFA. SUBJECTS AND METHODS: This study retrospectively reviews a series of 32 patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in an academic tertiary referral center. The autologous incus or hydroxyapatite (HA) was used as materials for reconstruction. RESULTS: Thirteen of 32 patients (40.6%) had ossicular chain anomaly, 9 patients (28.1%) had congenital cholesteatoma and 8 patients (25.0%) had chronic otitis media with cholesteatoma and 2 patients (6.3%) had chronic otitis media. The patients with ossicular chain ano-maly showed the greatest air-bone gap (ABG) closure. Overall, postoperative ABG was 17.7+/-11.7 dB at postoperative 6 months and 19.7+/-14.3 dB at postoperative 1 year, compared with preoperative ABG of 37.9+/-9.3 dB. There was no statistical difference of ABG at postoperative 12 months, 24 months between MFA using incus (n=17) and HA (n=15)(p=0.300, and p=0.563). There was no meaningful difference of postoperative ABG between the patients with combined mastoidectomy (n=10) and those without mastoidecmoy (n=22)(p=0.555). No extrusions occurred. CONCLUSIONS: MFA can be an effective option in the case of absent incus expecting good postoperative hearing results.
Cholesteatoma ; Durapatite ; Hearing ; Humans ; Incus ; Malleus ; Ossicular Prosthesis ; Otitis Media ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND: Several cancer-testis antigen genes or gene families have been isolated to date, including Melanoma Antigen Gene (MAGE) and Synovial Sarcoma on X chromosome (SSX). This study attempted to investigate the possibility of immunotherapy for ovarian cancer and to explore the prevalence of the expression of MAGE and SSX. METHODS: The fresh tissue samples were obtained from 5 cases of normal ovaries, 6 cases of non-neoplastic disease, 21 cases of benign ovarian tumors, and 12 cases of malignant ovarian tumors. The expression of MAGE A1-6 and SSX 1-9 was detected by nested reverse transcriptionpolymerase chain reaction using each common primers sets for MAGE A1-6 and SSX 1-9. RESULTS: The expression rate of MAGE 1-6 mRNA was 23.0% (5/21) for the benign ovarian tumors and 91.7% (11/12) for the malignant ovarian tumor, whereas the normal ovaries (0/5) and non-neoplastic ovarian tissues (0/6) did not express MAGE (p<0.05). The expression rate of SSX was 40.0% (2/5) for the normal ovaries, 23.0% (5/21) for the benign ovarian tumors, and 33.3% (4/12) for the malignant ovarian tumors, while the non-neoplastic ovarian tissues showed no expression of SSX (p>0.05). A relationship between the two genes was not observed (kappa coefficient=0.32). CONCLUSION: These results suggest that the gene products of MAGE and SSX can be useful for the immunotherapy of ovarian cancer patients and that MAGE can be a more promising target than SSX from the viewpoint of applicability and cancer-specificity.
Female ; Humans ; Immunotherapy ; Melanoma* ; Ovarian Neoplasms ; Ovary ; Prevalence ; RNA, Messenger ; Sarcoma, Synovial* ; X Chromosome*

Xanthogranulomatous inflammation is a rare chronic inflammatory condition that is characterized by aggregation of lipid-laden foamy macrophages (xanthoma cells). Although the precise pathogenesis of xanthogranulomatous inflammation is not well understood, various mechanisms have been proposed, including chronic recurrent infection, the presence of gallstones, immunologic disorders and defective lipid transport. This disease entity is well recognized in the kidney and gallbladder, yet involvement of the gastrointestinal tract is extremely rare and the involvement of both the stomach and colon has never been reported on. A coexisting malignancy rarely has been reported in a patient with xanthogranulomatous inflammation. This might present as an inflammatory mass-like lesion with infiltration to the surrounding tissues, and so this often mimics advanced cancer. Therefore, a surgical operation together with careful pathological evaluation is required for making the precise diagnosis. We herein report on a case of xanthogranulomatous inflammation that presented as a submucosal mass in the stomach which was a huge irregular mass involving transverse colon.
Colon ; Colon, Transverse ; Gallbladder ; Gallstones ; Gastrointestinal Tract ; Humans ; Inflammation ; Kidney ; Macrophages ; Stomach

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, but also occurs at a lower frequency in extra-gastrointestinal regions such as omentum, mesentery, retroperitoneum and undefined abdominal sites. This tumor is called extragastrointestinal stromal tumor (EGIST). EGIST is mostly diagnosed as a cystic mass, but rarely occurs as a disseminated abdominal tumor. We experienced a 70-year-old man with primary EGIST presenting as peritoneal dissemination. Abdominal CT showed diffuse peritoneal thickening with a large amount of ascites, but no definite mass lesion. Laparoscopic biopsy was performed and histologic findings showed tumor composed of epithelioid cells. In the results of immunohistochemical stains, the tumor showed positive reactivity with CD117 (c-kit), CD34, vimentin and actin, but negative reactivity with desmin and S-100 protein. On account of unresectability and histologic parameters of malignant behavior, he was started on imatinib.
Actins/metabolism ; Aged ; Antigens, CD34/metabolism ; Gastrointestinal Stromal Tumors/*diagnosis/pathology ; Humans ; Laparoscopy ; Male ; Peritoneal Neoplasms/*diagnosis/secondary ; Positron-Emission Tomography ; Proto-Oncogene Proteins c-kit/metabolism ; Tomography, X-Ray Computed ; Vimentin/metabolism

Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited colon cancer-predisposing disorder, characterized by the development of innumerable adenomas in the large intestine. Polyps are present in the upper gastrointestinal tract in almost all FAP patients and there is a peculiar predilection for adenomatous change in the duodenum. Colonic adenomas in FAP are commonly observed as polyps but nonpolypoid adenomas can also be seen in the upper gastrointestinal tract. Careful endoscopic examination is needed for detecting such nonpolypoid lesions. At present, the adenoma-carcinoma sequence is thought to exist also in the duodenum, and malignancy of the duodenum represents one of the most common causes of mortality among patients with FAP. Therefore, careful periodic follow-up of upper intestinal endoscopies are recommended in patients with this disease, in consideration to the possible development of duodenal nonpolypoid adenomatous lesions. A case involving an experience of antral and duodenal nonpolypoid adenomas in a patient with FAP is herein reported.
Adenoma* ; Adenomatous Polyposis Coli* ; Colon ; Duodenum ; Follow-Up Studies ; Humans ; Intestine, Large ; Mortality ; Polyps ; Pyloric Antrum ; Upper Gastrointestinal Tract

It is very important to be aware of occurrence and distinctive histologic features of gastric glomus tumor because its clinical presentation and endoscopic ficdings are indistinguishable from other gastric tumors. A 58-year-old man was admitted because of intermittent epigastric pain and indigestion for 2 months. Physical examination and laboratory findings revealed within normal limits. Upper gastroendoscopy demonstrated a submucosal mass near the antrum with central mucosal depressionand peripheral multiple erosions. Endoscopic ultrasonography revealed a circumscribed mass that continued to the third and fourth layers which demonstrated a heterogeneous low echo pattern mixed with internal high echo spots. Histologically, the tumor cells have uniform small nuclei with inconspicuous nucleoli. Immunochemical analysis on the tumor cells expressed alpha 1 smooth muscle actin and the tumor cells are enveloped by reticulin fiber, individually or grouped. A case of glomus tumor of the stomach is herein reported with a review of literature.
Actins ; Dyspepsia ; Endosonography ; Glomus Tumor* ; Humans ; Middle Aged ; Muscle, Smooth ; Physical Examination ; Reticulin ; Stomach*

Atrial fibrillation occurs in 10 to 25% of patients with thyrotoxicosis. Several recent studies have found a high frequency of cerebral thromboembolism in such patients. Thus anticoagulation has been recommended for patients with thyrotoxic atrial fibrillation to prevent embolic complications especially when associated with predictors of an increased risk of arterial thromboembolism in nonrheumatic atrial fibrillation such as recent congestive heart failure, history of hypertension, previous thromboembolism, left atrial enlargement, and global left ventricular dysfunction. Most reported cases of embolic events involving central nervous system in thyrotoxic atrial fibrillation affected cerebrum, and cerebellar embolic infarction from the heart was rarely seen. We herein report our experience of a case of cerebellar embolism in thyrotoxic atrial fibrillation.
Atrial Fibrillation* ; Central Nervous System ; Cerebrum ; Embolism ; Heart ; Heart Failure ; Hepatitis ; Humans ; Hypersensitivity ; Hypertension ; Infarction* ; Thromboembolism ; Thyrotoxicosis ; Ventricular Dysfunction, Left

We report a case of the isolation of the Aspergillus versicolor complex, initially misidentified by morphological characteristics as the Scopulariopsis species, from a homograft with a bicuspidalized pulmonary valve. An eighteen-month-old female, who had critical pulmonary stenosis, underwent pulmonary valve replacement. On postoperative day 8, she developed a fever, which did not respond to empiric broad-spectrum antibiotics. While no definitive source was identified, a filamentous fungus was isolated from the thawed homograft tissue culture prior to implantation on the operation day. The colonies were powdery green with white edges on Sabouraud dextrose agar. Microscopic examination showed septate hyphae with branched conidiophores and chains of spiny conidia, which suggested Scopulariopsis species. After direct sequencing of the internal transcribed spacer (ITS) regions, the fungus was identified as the A. versicolor complex. To our knowledge, the isolation of the A. versicolor complex from a homograft valve has not been previously described. This case shows that laboratory staff should be aware that microscopic morphology of the A. versicolor complex can resemble that of a number of other genera, including Scopulariopsis species.
Agar ; Anti-Bacterial Agents ; Aspergillus ; Bicuspid ; European Continental Ancestry Group ; Female ; Fever ; Fungi ; Glucose ; Humans ; Hyphae ; Pulmonary Valve ; Pulmonary Valve Stenosis ; Scopulariopsis ; Spores, Fungal ; Transplantation, Homologous