The author investigated serum immunoglobulin (IgG, IgA, and IgM) and complements (C3) of cord blood in 74 cases of normal fullterm infants and 50 cases of premature infants. Serum immunogloblin and complement levels were measured by the single radial immunodiffusion method. The following results were obtained; 1) The mean seru IgG levels of cord blood in 74 cases of the normal full term infants was 1407.3+/-230.5mg/dl. 2) The mean serum IgG levels of cord blood in 50 cases of the premature infants was 675.2+/-329.4mg/dl. In comparison of serum IgG levels between the premature infants and the normal full term infants, serum IgG levels in the premature infants was significantly lower than that level of the normal infants (P< 0.05). 3) The serum IgA levels were measured in 28 (37.8%) of 74 cases of the normal full term infants and in 6 912%) of 50 cases of the premature infants. The serum IgA levels measured ranged from 0.4mg/dl to 3.7mg/dl in the normal full term infants and ranged from 0.4mg/dl to 2.4mg/dl in the prematre infants. 4) The mean serum IgM levels of cord blood in 74 cases of the normal full term infants was 4.05+/-3.53mg/dl and that in 50 cases of the premature infants was 2.20+/-2.15mg/dl. 5) The mean serum C3 levels of cord blood in 74 cases of normal full term infants was 49.7+/-18.1mg/dl and those of the premature infants was 30.9+/-10.5mg/dl. In comparison of serum C3 levels between the premature infants and the normal full term infants, the mean levels of serum C3 in the premature infants was significantly lower A statistically significant increase of IgG and C3 levels of cord blood in newborn infants were observed in accordance with the increase of the gestational age. It has been suggested that decreased IgG levels among premature infants may provide a rationale for prophylactic gamma globulin administration.
Complement System Proteins* ; Fetal Blood ; gamma-Globulins ; Gestational Age ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant ; Infant, Newborn* ; Infant, Premature

PURPOSE: Although alpha-fetoprotein is one of the most commonly used tumor markers in Korea, most of the radioimmunoassay kits for alpha-fetoprotein have been imported from foreign countries. The purpose of this study was to evaluate the performance of a recently developed domestic immunoradiometric kit for alpha- fetoprotein (Riakey AFP IRMA CTR, Sin-Jin Medics, Seoul, Korea). MATERALS AND METHODS: We evaluated intra- and inter-assay precision, recovery rate, parallelism, and sensitivity of serum alpha-fetoprotein measurement using Riakey AFP IRMA CTR kit. The values of alpha-fetoprotein measured by Riakey AFP IRMA CTR kit were compared with those measured by two foreign commercial kits (alpha-fetoproteina of Radim and alpha-feto.riabead of Abbott). RESULTS: Intra-assay coefficients of variation on three different levels were 5.3% for 18.9 ng/ml, 3.4% for 133 ng/ml and 1.6% for 330 ng/ml. Inter-assay coefficients of variation were 9.7% for 20.9 ng/ml, 3.2% for 137 ng/ml and 4.1% for 330 ng/ml respectively. Recovery rate tests on all three different levels showed within 100+/-10%. Parallelism was also good and the sensitivity was 0.63 ng/ml. There was strong correlation between the measurement of alpha-fetoprotein by Riakey AFP IRMA CTR and that by two foreign commercial kits(r=0.98). CONCLUSION: The first Korean domestic immunoradiometric kit for alpha-fetoprotein, Riakey AFP IRMA CTR, performed well for clinical use.
alpha-Fetoproteins* ; Fetal Proteins ; Immunoradiometric Assay* ; Korea ; Radioimmunoassay ; Seoul ; Biomarkers, Tumor

We experienced a case of a gallbladder carcinoma detected incidentally by elevated serum alpha- fetoprotein. The patient had a symptom of mild intermittent indigestion, and a routine medical examination revealed elevation of serum alpha-fetoprotein. A mass, 4 cm 3 cm, was located in the gallbladder and it had not infiltrated the liver. The serum level of alpha-fetoprotein decreased after a cholecystectomy. The gallbladder mass was an adenocarcinoma of hepatoid differentiation. Cytoplasms of the tumor cells had positive reactivity to immunohistochemical staining of alpha-fetoprotein. In the course of postoperative follow up, the serum alpha-fetoprotein level increased continuously, and abdominal CT scanning proved multiple intrahepatic metastases.
Adenocarcinoma ; alpha-Fetoproteins ; Cholecystectomy ; Cytoplasm ; Dyspepsia ; Fetal Proteins ; Follow-Up Studies ; Gallbladder* ; Humans ; Liver ; Neoplasm Metastasis ; Tomography, X-Ray Computed

A case of primary choriocarcinoma in the stomach of a 60-year-old male is herein presented. The tumor was diagnosed as a choriocarcinoma by histologic examination and the immunohistochemical method of endoscopic biopsy of a specimen. Serum alpha- fetoprotein and beta-human chorionic gonadotropin were found to be significantly elevated. Multiple distant metastasis of the liver, intraabdominal lymph nodes and malignant ascites were also discovered. The high alpha-fetoprotein level in the serum might have been due to the coexistence of embryonal cell carcinoma or hepatoid adenocarcinoma or both in the stomach.
Adenocarcinoma ; alpha-Fetoproteins ; Ascites ; Biopsy* ; Choriocarcinoma* ; Chorionic Gonadotropin ; Female ; Fetal Proteins ; Humans ; Liver ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Pregnancy ; Stomach

PURPOSE: Angiogenesis plays an important role in progression, invasion and metastasis of solid tumors. The Vascular Endothelial Growth Factor (VEGF) is thought to be a selective mitogen for endothelial cells. Hepatocellular carcinoma is a typical hypervascular tumor. However, the relationship between angiogenesis and angiogenic factor in hepatocellular carcinoma has not been evaluated. We investigated the relationship between microvessel density (MVD) and expression of VEGF in hepatocellular carcinoma. MATERIALS AND METHODS: Immunohistochemlcal staining, using anti-CD34 and anti-VEGF antibodies, was applied in 32 cases of hepatocellular carcinoma. Also, relationship between these neovascular factors (MVD and VEGF expression) and clinicopathologic parameters such as tumor size, bistologic grade, alpha-fetoprotein level, hepatitis B virus surface antigen, presence of cirrhosis and survival was evaluated. RESULTS: CD34 was reactive throughout the neoplastic tissue, albeit it was confined to a few periportal sinusoids and vessels in fibrous septa of adjacent cirrhotic liver. MVD was 59.6+22.7 and 44.3+21.5 in hepatocellular carcinoma and cirrhosis, respectively. VEGF was expressed in 9 cases (28.1%) of hepatocellular carcinoma, which was localized to the cytoplasm. MVD and VEGF expression was not significantly correlated (P>0.05). MVD was correlated with presence of cirrhosis and inversely conelated with alpha- fetoprotein level (p<0.05). MVD was not correlated with tumor size, presence of HBs antigen, histologic grade and survival (P>0.05). Expression of VEGF was not correlated with all clinicopathologic parameters (P>0.05). CONCLUSION: These results indicate that MVD in hepatocellular carcinoma is not directly correlated with VEGF expression, and suggest that other angiogenic factor may be involved in neovascularization of hepatocellular carcinoma. However, CD34 expression is closely associated with neovascular process in cirrhosis and hepatocelluar carcinoma.
alpha-Fetoproteins ; Angiogenesis Inducing Agents ; Antibodies ; Antigens, Surface ; Carcinoma, Hepatocellular* ; Cytoplasm ; Endothelial Cells ; Fetal Proteins ; Fibrosis ; Hepatitis B virus ; Immunohistochemistry ; Liver ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

BACKGROUND/AIMS: In spite of improved diagnostic and therapeutic methods, the prognosis of hepatocarcinoma( HCC) is still poor because of the high recurrence rate. Early detection and active treatment of recurrent HCC are important to improve the survival. The objective of this study is to compare the effectiveness of diagnostic tools for early detection of the recurrence of HCC. METHODS: We retrospectively studied 236 patients who underwent curative hepatic resection for HCC at SNUH between 1993 and 1995. Postoperatively, we checked radiologic studies every three months and serum alpha- fetoprotein level monthly first, then every three months to detect recurrence. The patients were divided into four group (Low-Low;L-L, Low-High;L-H, High-Low;H-L, High-High;H-H) according to the serum levels of pre- and post-operative(3 months) alpha-fetoprotein levels (Low ; <20ng/ml, High >20ng/ml). RESULTS: Overall recurrence rate was 55.1%. The recurrence rates in L-L gr., L-H gr, H-L gr., and H-H gr were 40.7%, 75.0%, 42.9% and 91.8% respectively. Increasing levels of alpha-fetoprotein at the time of dectection of recurrence were found in 13.6%, 66.7%, 25.9% and 92.9%, respectively(p<0.05). The 3- year disease-free survival rates are 62.1%, 25.0%, 57.8% and 6.3%, respectively(p<0.05). The 3-year overall survival rates are 79.2%, 50.0%, 83.6% and 51.1%, respectively(p<0.05). The detection rates of ultrasonography(US) and computed tomograpy(CT) were 82.4% and 97.2% respectively. Seven patients had lung metastasis on chest X-ray and two bone metastasis on bone scan, two spinal metastasis on spine X-ray and MRI and 2 adrenal metastasis by US and CT were detected. CONCLUSION: The patients who have high serum levels of alpha-fetoprotein postoperatively have a tendency to recur early. On the other hand, patients who have low serum levels of alpha-fetoprotein postoperatively recur late, usually without its elevation. Therefore, in former cases, early recurrence or remnant tumor should be suspected and in latter cases, regular US and/or CT is a more useful method for early detection of recurrent HCC than frequent checking of serum alpha-fetoprotein.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Fetal Proteins ; Hand ; Humans ; Lung ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Prognosis ; Recurrence* ; Retrospective Studies ; Spine ; Survival Rate ; Thorax

PURPOSE: To evaluate patterns of recurrence and factors which influence them in radiofreqency (RF) ablation for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Between May 1999 and March 2000, 69 patients with 82 HCCs underwent RF ablation for complete necrosis. They were diagnosed by tissue biopsy or tumor marker, and the results of triphasic spiral CT. The indications were that nodular lesions were clearly visualized at sonography, less than 5 cm in size and less than four in number, and that patients had no history of previous treatment. Local therapeutic efficacy such as complete necrosis and marginal recurrence, and new lesions were evaluated by means of triphasic spiral CT performed at least six months after the completion of ablation. We then analyzed the correlation between local therapeutic efficacy and various influential factors such as tumor size, whether the tumor was attached to the portal vein, gross morphology, Child-Pugh classification, and alpha- fetoprotein level before the procedure, as well as the correlation between new lesions and influential factors which included the alpha-fetoprotein level before the procedure, Child-Pugh classification, and multiplicity per person. RESULTS: During a mean follow-up period of 8.95 (range, 6-14) months after RF ablation, the rate of complete necrosis and of marginal recurrence was 91% and 12%, respectively. When a tumor was larger and was attached to a large branch of the portal vien, the incidence of incomplete necrosis and marginal recurrence was greater. The occurrence rate of new lesion was 19.4%. When the alpha-fetoprotien level before the procedure was higher and a tumor was multiple in number, new lesions occurred more frequently. CONCLUSION: Sufficient knowledge of patterns of recurrence and the factors which influence them might improve the therapeutic effects of RF ablation in patients with HCC.
alpha-Fetoproteins ; Biopsy ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Classification ; Fetal Proteins ; Follow-Up Studies ; Humans ; Incidence ; Necrosis ; Portal Vein ; Recurrence ; Tomography, Spiral Computed

PURPOSE: Alpha-fetoprotein (AFP) is widely accepted as a useful tumor marker for diagnosis of hepatocellular carcinomas. On rare occasions, however, an abnormal elevation of serum AFP also has been reported in an adenocarcinoma of the gastrointestinal tract. We evaluated the influence of preoperative abnormal elevation of serum AFP (AFP positivity) on the prognosis of resectable gastric cancers. MATENRIALS AND METHODS: 812 gastric cancer patients, who were investigated for serum AFP before their operations and who underwent gastric resections with D2 or more extended lymph node dissection, were enrolled in the study. The survival rates were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. A multivariate analysis was performed using the Cox proportional hazards model. RESULTS: Fifty patients (6.2%) were AFP positive (10.1~4322.6 ng/ml). The survival rate of the AFP positive group was significantly lower than that of the AFP negative group ( 46.6% vs. 67.0%; P=0.0002). The depth of tumor invasion, the degree of regional lymph node metastasis, distant metastases, the TNM stage, the gross type, differentiation, the extent of gastric resection, and the curability of the surgery also significantly influenced survival. Multivariate analysis revealed that the depth of tumor invasion, the degree of regional lymph node metastasis, the curability of the surgery, and AFP positivity were independent prognostic indicators. CONCLUSION: Preoperative serum AFP can be used as an independent prognostic factor of resectable gastric cancer.
Adenocarcinoma ; alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Diagnosis ; Fetal Proteins* ; Gastrointestinal Tract ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Proportional Hazards Models ; Stomach Neoplasms* ; Survival Rate

To further define the prognostic factors associated with long term survival of hepatocellular carcinoma, we retrospectively studied 371 patients with pathologically diagnosed hepatocellular carcinoma who underwent curative hepatic resection between 1991 and 1995. We included the 16 patients who underwent noncurative hepatic resection in calculating overall survival. The male to female ratio was 5.1 to 1 and their average age was 52.5 years. About 20 variables were subject to univariate and multivariate analysis and their survivals were calculated using the Kaplan-Meier method. 55.6% of (220 of 396) patients had liver cirrhosis and 73.2% of (290 of 396) patients were positive in HBsAg. Operative mortality and inhospital death rate were 1.5% and 0.8%, each and postoperative morbidity rate was 22.5%. The cumulative 1, 3 and 5 year survival rates including noncurative resected cases were 85.9%, 67.2% and 54.8%, respectively. The cumulative 1, 3 and 5 year survival rates of 371 curative resected cases were 87.3%, 68.7% and 56.4%, respectively. Disease free 1, 3, 5 year survival rates of 371 curative resected cases were 74.8%, 48.2% and 40.8%, respectively. The factors such as alpha- fetoprotein, Child's classification, prothrombin time, extent of liver resection, and number of tumor were statistically significant factors associated with cumulative survival.(p<0.05) And alpha-fetoprotein, total necrosis after TACE, viral hepatitis, and invasion of portal vein were significant factors associated with cumulative disease free survival. Only alpha-fetoprotein was associated significantly with cumulative survival and cumulative disease free survival. Length to the resection margin was not significantly associated with survival.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Classification ; Disease-Free Survival ; Female ; Fetal Proteins ; Hepatectomy ; Hepatitis ; Hepatitis B Surface Antigens ; Humans ; Liver ; Liver Cirrhosis ; Male ; Mortality ; Multivariate Analysis ; Necrosis ; Portal Vein ; Prothrombin Time ; Retrospective Studies ; Survival Rate

No abstract available.
Fetal Blood* ; Intercellular Signaling Peptides and Proteins* ; Stem Cell Transplantation* ; Stem Cells* ; Umbilical Cord*