PURPOSE: The genetic polymorphism and intracellular activity of methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) is clinically associated with carcinogenesis and biological therapeutic effect in gastrointestinal malignancies. We aimed to elucidate the susceptibility of gastric cancer according to MTHFR and TS gene polymorphism. METHODS: This study was designed as a hospital-based case-control study in a single institute. The gastric cancer group (n=300) for the study was diagnosed at first time as tubular adenocarcinoma, and the control group (n=100) was diagnosed as no malignancy in the endoscopic biopsy. The genetic polymorphism of TS and MTHFR were confirmed by PCR. RESULTS: The MTHFR mutant type had a more than 2-fold increased risk of developing gastric cancer (RR: 2.341). But, only heterozygote type (677CT) revealed significantly higher susceptibility compared to wild type (RR: 2.581). In TS gene genotype, the mutant genotype rate (2R/3R and 3R/3R) was significantly higher in gastric cancer group compared to control group (P=0.008), and the mutant type had a more than 3-fold increased risk of developing gastric cancer (RR: 3.222). In combined MTHFR and TS, 677CT+2R/3R and 677CT+3R/3R there was more than a 3-fold increased risk rate of developing gastric cancer compared with other combinations (RR, 3.474 in 677CT with 2R/3R; RR, 3.895 in 677CT with 3R/3R). CONCLUSION: This study shows a significant association between the MTHFR and TS polymorphisms and susceptibility to gastric cancer, providing a genetic basis. The polymorphisms study of two genes could be applied as susceptibility markers, clinically, for gastric cancer.
Adenocarcinoma ; Biopsy ; Case-Control Studies ; Genotype ; Heterozygote ; Methylenetetrahydrofolate Reductase (NADPH2) ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Stomach Neoplasms ; Thymidylate Synthase

PURPOSE: To evaluate the usefulness of ultrasonography in the diagnosis of local recurrent soft tissue tumors. MATERIALS AND METHODS: We retrospectively analysed the results of 113 sonographic examinations in 102 patients (38males, 64 females) after surgical treatment of soft tissue tumors (82 malignancies, 20 benignancies) during thelast five years. Follow-up included physical and sonographic examinations using a 5-10MHz transducer every twomonths. In 17 cases, MR images were obtained The criterion for local recurrence was discrete mass, and size,shape, margin, echogenicity, and homogeneity were also analysed. Forty-one patients underwent surgery. RESULTS: Among 113 cases, 41 local recurrences were proven by surgery and histological analysis; well-defined, ovoid,homogeneous hypoechoic masses of various sizes were apparent. Sonographic sensitivity and specificity were both97%. MR sensitivity and specificity were 83% and 100% respectively, but in most cases in which MR had been usedthe masses were greater than 3cm in diameter. Two cases were false positive; these were thought to be granulomas,but were shown during follow-up lasting 36 and 14 months, respectively, to be unchanged hypoechoic nodules. Onecase was false negative. CONCLUSION: For the diagnosis of local recurrent soft tissue tumors, ultrasonography isvery useful. For early detcction, it is superior to MR imaging.
Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Transducers ; Ultrasonography

The CT findings of pulmonary paragonimiasis are well known. However, the pathologic findings of nodular opacity have not been studied sufficiently. To clarify the nature of nodular opacity on CT in patient with paragominiasis, we reviewed CT scans of 9 patients retrospectively. Five of them were compared with pathologic findings of the resected specimen. Other four patients were confirmed by needle aspiration biopsy. CT scans showed nodular opacities of 5 to 30mm in diameter which were accompanied with perinodular air-space consolidations in all patients. The usual location of nodular opacities were peripheral zone of the lung. Correlation with pathologic findings demonstrated That the nodular opacity on CT scans corresponded to the parasitic granuloma with central ova and intracystic worm. The most frequent CT finding of pulmonary paragonimiasis was nodular opacities with perinodular airspace consolidations caused by parasitic granuloma or intracystic worm.
Biopsy, Needle ; Granuloma ; Humans ; Lung ; Needles ; Ovum ; Paragonimiasis ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. METHOD: Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). RESULTS: Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression n stromal cells was significantly associated with p-stage in non-small cell lung cancer (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T-factor, nodal involvement, differentiation. Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with progonosis showed that nodal involvement was the only independent prognostic factor in all patients. CONCLUSION: Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.
Adenocarcinoma ; Breast Neoplasms ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cathepsin D* ; Cathepsins* ; Humans ; Lung Neoplasms ; Multivariate Analysis ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Stromal Cells ; Survival Rate

PURPOSE: Stomach cancer is the most prevalent extracolonic malignancy of the many primary cancers that occur together with colorectal cancer in Koreans. The purpose of this study was to evaluate the characteristics of patients who present with double primary cancer of the stomach and colorectum. METHODS: From Sep. 1994 to Dec. 2004, in 4,305 patients were diagnosed with colorectal cancer. Among these patients, 51 patients were diagnosed synchronously or metachronously as also having stomach cancer. The mean age these patients was 60.8 years and the median follow up duration was 31.0 months. RESULTS: The incidence of double primary cancer of the stomach and colorectum was 1.2% of the total colorecal cancer patients and they were 0.6% of the total stomach cancer patients. There were 17 (33.3%) metachronous cases and 34 (66.7%) synchronous cases. For the metachronous cases, the mean interval was 15 months (12~98) and detection methods were postoperative CT, symptom of second a cancer, and routine endoscopic examination. In synchronous cases, second cancer was detected by routine endoscopic examination, preoperative radiologic evaluation, and intraoperative exploration. Intraoperatively the detected cancers were all colorectal cancer during the operation for stomach cancer. The stage of the colorectal cancer was higher than that of the stomach cancer in 30 cases. Local or systemic recurrences were seen in 9 cases (17.6%), and 7 cases were recurrence of colorectal cancer. The 5-year disease free survival rates was 55.8%. CONCLUSION: The incidence of cancer arising from colorectum and stomach has been reported to be increasing. Careful attention should always be paid to the possible presence of a second cancer in preoperative or postoperative evaluation of cancer patients.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Neoplasms, Second Primary ; Recurrence ; Stomach Neoplasms ; Stomach*

Mucinous cystadenocarcinoma (MC) of the kidney is a rare epithelial tumor originating from the renal pelvic urothelium and few study cases have been reported. Because of the rarity of these tumors and their unknown histogenesis, its diagnosis is difficult until surgical exploration. We report here on a 55-year-old man referred to the urology department from the hepatology department because of a cystic renal mass measuring approximately 5 cm in size, which was detected incidentally under ultrasonography during the routine examination of liver. The renal mass was finally diagnosed as MC originating from kidney after partial nephrectomy and the patient still showed no evidence of recurrence until 12 months postoperatively. This is the first report on a case of renal MC in a patient who underwent partial nephrectomy. The aim of this report is to present our unusual case of MC and also review the previous literature on the pathological and radiological aspects of MC of kidney.
Cystadenocarcinoma, Mucinous* ; Diagnosis ; Gastroenterology ; Humans ; Kidney* ; Liver ; Middle Aged ; Mucins* ; Nephrectomy* ; Recurrence ; Ultrasonography ; Urology ; Urothelium

PURPOSE: This study was performed to determine the outcome after treatment of osteosarcoma with intraarterial cisplatin as a preoperative chematherapy regimen. MATERIALS AND METHODS: Twenty five patients with extremity osteosarcoma were treated with intraarterial cisplatin at Seoul National University Children's Hospital from January 1987 to April 1996. The dose of cisplatin was 130 mg/m2 and three to six courses were repeated two- to three-week intervals, Systemic doxorubicin was added to six of these patients. This was followed by surgical resection(limb salvage or amputation) and postoperative adjuvant chemotherapy. RESULTS: Limb-salvage was possible in twenty of these twenty five patients. Pulmonary metastasis was present in five patients at diagnosis and developed later in three patients. In six patients treated with systemic doxorubicin, pulmonary metastasis was absent at diagnosis and during follow-up period. Local recurrence after limb salvage was occurred in one patient and treated with amputation and systemic chemotherapy. Seven patients died from pulmonary metastssis and one from unknown cause. The follow-up duration of these patients was three to eighty eight months(median twenty two months) and the overall five-year survival and event free survival rate were 62.1% and 57.5%, respectively. CONCLUSION: These data demonstrate that intraarterial cisplatin can be used as an effective regimen preoperatively for pediatric patients with extremity osteosarcoma. The combined use of systemic doxorubicin is expected to improve survival in patients with pulmonary metastasis.
Amputation ; Chemotherapy, Adjuvant ; Cisplatin* ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Extremities ; Follow-Up Studies ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma* ; Recurrence ; Seoul ; Survival Rate

Gastric lipoma is rare submucosal tumor, accounting for less than 3% of all be- nign gastric tumor. Most are usually asymptomatic, but on occasion, they may present with abdominal pain, obstruction, dyspepsia, intussuception and gastrointestinal bleeding. Surgical resection is definitive diagnostic and therapeutic procedure. Surgical removal of gastric lipoma should be considered in the following situations: 1) the lesion is large, 2) the lesion is difficult to differentiate from malignant tumor, 3) the patient is symptomatic or has recurrent bleeding or obstruction. We report a case of gastric lipoma with bleeding in a 67-year-old male. Gastroscopy showed active gastric ulcer with fresh blood clot. Although medical conservative treatment was done, bleeding was continued. We referred patient to general surgical department for open surgical procedure and subtotal gastrectomy was performed. Histopathological examination of surgical gastric segment showed 5 5.5 cm sized ulcerated mass. Microscopic finding of cross section showed uniform and mature adipose cell, finding consistent with lipoma. We confirmed it submucosal gastric lipoma with ulcer bleeding.
Abdominal Pain ; Adipocytes ; Aged ; Dyspepsia ; Gastrectomy ; Gastroscopy ; Hemorrhage* ; Humans ; Lipoma* ; Male ; Stomach ; Stomach Ulcer ; Ulcer