PURPOSE: To search for evidence of B cell activation and superantigen involvement in Kawasaki disease. METHODS: Peripheral lymphocytes were first isolated from Kawasaki disease patients in the acute and subacute phases. The T cell and B cell distributions were analyzed, cDNA was generated from the total RNA extracts, and PCR amplification of the cDNA for each immunoglobulin heavy chain family was performed to determine the presence of VH family-specific oligoclonal expansion. CDR3 size analysis was then conducted by two-stage PCR. RESULTS: The percentage of B cells increased significantly(P<0.05) in both the acute and subacute phases. Random utilization of diverse VH family genes was observed in the acute phase, and no family-specific expansion was detected. In 13 out of 15 Kawasaki disease patients, an increase in B cells expressing the VH3 family was seen during the acute phase, making it the most frequently utilized family. Analysis of B cell clonal expansion showed the VH6 family clone of 9 amino acids to be the most common clone, observed in 5 out of 15 Kawasaki disease patients. Analysis of the CDR3 size profile in two patients showed that in the acute phase various prominent bands appeared, some disappearing in the subacute phase, while other newly developed bands appeared. CONCLUSION: VH family-specific B cell expansion was not detected, and clonal expansion of B cells was observed, suggesting that Kawasaki disease may be caused by a conventional antigen, and the antigenic stimulation seen during the acute phase seems to be continuous, resuming after clinical resolution.
Amino Acids ; B-Lymphocytes ; Clone Cells ; DNA, Complementary ; Humans ; Immunoglobulin Heavy Chains ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; RNA

The vascular lesions in FK506 nephrotoxicity are similar to cyclosporine A, in which mediators related to vascular constriction and thickening such as endothelin, TGF-beta and PDGF may have some roles. Their expressions may be different in terms of degree and time sequence as well as overlapping ischemia, which made us to perform this experiment. Male Sprague Dawley rats received FK506 daily at a dosage of 2 mg/kg by intramuscular route for 4 weeks at maximum and were sacrificed 3 days, 1, 2 and 4 weeks after the initiation of the study, respectively. The control rats received saline. Renal ischemia was induced by occluding the left renal artery for 45 minutes and rats were sacrificed up to 2 weeks after reperfusion. Kidneys were processed for light microscopy and stained with PAS method and with antibodies against endothelin, TGF-beta and PDGF. The number of juxtaglomerular apparatus(JGA) and arterioles positive for each antibody was counted under light microscope and was expressed as mean +/- S.D per mm2 cortex. In FK506 treated rats, JGA and afferent arterioles were prominent with PAS positive granules, which was extended proximally to interlobular arteries with increased duration of FK506 treatment. With increasing duration, TGF-beta reactivity was increased in afferent arterioles. However, no such results were shown in cases of PDGF and endothelin. Renal ischemia itself increased vascular TGF-beta as well as endothelin and PDGF reactivities. Renal ischemia in FK506 treated rats further upregulated the expression of these markers in a similar distribution. However, the expression of endothelin was mostly found in endothelial cells of peritubular and glomerular capillaries. PAS staining was decreased in ischemic kidneys regardless of FK506 treatment. These results indicate that FK506 toxicity was comparable to CsA toxicity. Since expression levels of endothelin, TGF-beta and PDGF were increased in ischemic kidney, it might be helpful to prevent ischemic damage as well as to hinder secretion of these factors in order to reduce FK506 nephrotoxicity.
Animals ; Antibodies ; Arteries ; Arterioles ; Capillaries ; Constriction ; Cyclosporine ; Endothelial Cells ; Endothelins* ; Humans ; Ischemia ; Kidney ; Male ; Microscopy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Reperfusion ; Tacrolimus* ; Transforming Growth Factor beta*

Trichoblastoma is a rare benign neoplasm that arises in the follicular germinative cells. The terminology and histopathological definition of this tumor is both complex and confusing. Trichoblastoma occurs only on the hair bearing areas such as the scalp, face and pelvic area with varying degrees in size. We describe a case of trichoblastoma occurring as a nodule on the nose. The tumor was composed of numerous lobules of basaloid epithelial cell nests with distinct peripheral palisading of nucleoli that were clearly demarcated from the stroma.
Epithelial Cells ; Hair ; Nose ; Scalp

PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

OBJECTIVES AND METHODS: The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. RESULTS: Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinorna: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer..patients was 32.y %(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+GEM>22%) in lung cancer patients was 42.9% (15/35), but none in benign diseases. In (iffy-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. CONCLUSIONS: The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Aneuploidy ; Biopsy ; Cell Cycle ; Diagnosis ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Ploidies* ; Surgical Instruments ; Thoracotomy

PURPOSE: The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients. MATERIALS AND METHODS: We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients. RESULTS: The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male. CONCLUSION: In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.
Female* ; Humans ; Laparotomy ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

OBJECTIVE: The purpose of this study was to verify the appropriateness of ovariectomized rats as the osteoporosis animal model. METHODS: Twelve female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy [the ovariectomy (OVX) group]. Eight weeks after operations, serum biochemical markers of bone turnover were analyzed; osteocalcin and alkaline phosphatase, which are sensitive biochemical markers of bone formation, and C-terminal telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption. Bone histomorphometric parameters and microarchitectural properties of 4th lumbar vertebrae were determined by micro-computed tomographic (CT) scan. RESULTS: The OVX group showed on average 75.4% higher osteocalcin and 72.5% higher CTX levels than the sham group, indicating increased bone turnover. Micro-CT analysis showed significantly lower bone mineral density (BMD) (p=0.005) and cortical BMD (p=0.021) in the OVX group. Furthermore, the OVX group was found to have a significantly lower trabecular bone volume fraction (p=0.002). CONCLUSION: Our results showed that bone turnover was significantly increased and bone mass was significantly decreased 8 weeks after ovariectomy in rats. Thus, we propose that the ovariectomized rat model be considered a reproducible and reliable model of osteoporosis.
Alkaline Phosphatase ; Animals ; Biomarkers ; Bone Density ; Bone Resorption ; Collagen Type I ; Female ; Humans ; Lumbar Vertebrae ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; X-Ray Microtomography

Laryngeal leukoplakia is seen in a number of pathologic settings such as keratosis without atypia(KWOA), keratosis with atypia(KWA), squamous cell carcinoma in situ(CIS) and invasive squamous cell carcinoma, and it continues to be a confusing and controversial topic for both otolaryngologist and pathologist. This is largely due to the use of ambiguous and inconsistent terminology, the lack of unanimous agreement on the definition of these terms, failure of the clinician to obtain a representative biopsy, and the subjectivity of the pathologist interpreting the biopsy. To evaluate the applicability of the expression pattern of p53 and PCNA in borderline cases of histopathologic classification, we performed a histopathologic analysis of leukoplakia to includ clinical follow-up, correlation of disease progression and degree of atypia, and expression of p53 and PCNA according to the degree of atypia. Histologically, laryngeal leukoplakia included seven cases of KWOA, fourteen cases of KWA (mild-2, moderate-8, severe-4), three cases of CIS, and one case of invasive squamous cell carcinoma. Keratosis with atypia, a moderate degree or more, showed a strong tendency to progress to invasive carcinoma(p<0.05). The degree of p53 and PCNA expression correlated with the degree of atypia(p<0.05). p53-positive cases at the initial biopsy clearly tended to recur and develop into invasive carcinoma(p<0.01).
Biopsy

Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year-old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature.
Adolescent ; Alkalies ; Burns ; Caustics ; Constriction, Pathologic ; Deglutition ; Dilatation ; Epithelium ; Esophageal Stenosis* ; Female ; Humans ; Lye* ; Phenobarbital

Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year-old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature.
Adolescent ; Alkalies ; Burns ; Caustics ; Constriction, Pathologic ; Deglutition ; Dilatation ; Epithelium ; Esophageal Stenosis* ; Female ; Humans ; Lye* ; Phenobarbital