Malignant transformation develops in a little less than 2% of mature cystic teratomas. A wide variety of malignant tumors may arise within benign mature cystic teratomas, and the most common of these is squamous cell carcinoma, which account for 75~85%. In general, the tumors are in an advanced stage and the prognosis is poor as most patients die within a year. However, when the tumor is confined to the ovary, they have a good prognosis and the 5-year survival rate is 63~83%. We experienced three cases of squamous cell carcinoma arising in mature cystic teratoma. Two of the carcinomas occurred in postmenopausal women: 58-(case 1) and 66-(case 2) year-old, and were confined to the ovaries. They were alive 37 months and 18 months after the operation, respectively. The third case was a 45-year-old premenopausal woman who had an extraovarian extension of the tumor and early recurrence within two months. Histologically, cases 1 and 3 were conventional well to moderately differentiated squamous cell carcinomas and case 2 showed a well-differentiated squamous cell carcinoma with exuberant proliferating trichilemmal tumor-like areas.
Carcinoma, Squamous Cell* ; Female ; Humans ; Middle Aged ; Ovary* ; Prognosis ; Recurrence ; Survival Rate ; Teratoma*

BACKGROUND: RUNX3 is expressed throughout the luminal gastrointestinal tract. RUNX3 is on chromosome 1p36, a location considered to carry an important tumor suppressor for many types of cancers. Epigenetic silencing of RUNX3 is causally related to human gastric cancer. METHODS: Colorectal cancers, adenoma, and the corresponding normal mucosa were obtained from 26 individual patients. To identify methylation of RUNX3 in colonic carcinogenesis, methylation-specific PCR was performed. RESULTS: RUNX3 methylation was found in one case of colonic carcinoma. The normal mucosa and tubular adenoma of this case had no methylation. No other cases were found to have methylations. CONCLUSIONS: These results are very different from the findings of gastric carcinomas, where frequent DNA methylation in the vicinity of the RUNX3 promoter is found. Although, the possibility of a role of RUNX3 methylation in the colon can not be completely ruled out, these results suggest that methylation of the RUNX3 promoter region might not contribute to the adenoma-carcinoma sequence of the colon.
Adenoma* ; Carcinogenesis ; Colon* ; Colorectal Neoplasms ; DNA Methylation ; Epigenomics ; Gastrointestinal Tract ; Humans ; Methylation* ; Mucous Membrane ; Phenobarbital ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Stomach Neoplasms

Taxol is an active chemotherapeutic agent against a variety of solid tumors and a potentially useful drug for augmenting the cytotoxic action of radiotherapy against certain cancers. Taxol blocks cells in the mitotic phase of cell cycle. The aim of this study was to define the in vivo response of rapidly dividing cells of the small intestinal mucosa to taxol. We studied the numbers of apoptotic and mitotic cells and the expression of bcl-2 and p53 in rat jejunal crypt cells at 1, 2, 4, 8, 12, 16, and 24 hours and 3 and 5 days after intraperitoneal injection of taxol. Mitosis peaked at 2 and 4 hours and 12 and 16 hours. Apoptosis peaked at 16 hours and returned to normal after five days. The glands in crypts showed marked distortion with atypical lining cells after three days, which returned to normal at 5 days. bcl-2 expression was markedly decreased at 8 to 24 hours and subnormally recovered after three to five days. p53 showed no significant changes throughout. The histopathological changes in small intestine due to taxol were transient with complete recovery. bcl-2 expression was inversely corresponded to numbers of apoptosis. The changes were p53 independent. Further studies to understand the conditions that maximize the cell-cycle modulating effects of taxol cl-may greatly enhance its anti-tumor effectiveness.
Animals ; Apoptosis ; Cell Cycle ; Injections, Intraperitoneal ; Intestinal Mucosa ; Intestine, Small* ; Mitosis ; Paclitaxel ; Radiotherapy ; Rats*

BACKGROUND: TB-PCR is a faster and more sensitive method to detect mycobacterium than acid-fast bacilli (AFB) stain, which is laborious and time consuming. We compared the sensitivity and specificity of AFB stain and TB-PCR and examined the possibility of TB-PCR as a confirmative test without AFB stain in the diagnosis of tuberculosis. METHODS: We performed Ziehl-Neelsen stain and nested PCR using a commercially available TB-PCR kit amplifying IS6110 sequence in 81 cases of paraffin-embedded tissues diagnosed as chronic granulomatous inflammation. In addition, we evaluated the morphology of granuloma and the presence of caseation necrosis. RESULTS: Of the 81 cases studied, 22 (27.2%) and 40 (49.4%) were positive for AFB stain and TB-PCR, respectively. Of 49 cases accompanying caseation necrosis, 19 (38.8%) were AFB stain positive and 37 (75.5%) were TB-PCR positive; a result that is comparable with that of other reports. Of the 22 AFB-positive cases, 2 were TB-PCR negative. CONCLUSION: TB-PCR is very helpful for the diagnosis of tuberculosis in routinely processed, formalin-fixed, paraffin-embedded tissue samples. Nevertheless, AFB stain should continue to be performed at the same time.
Coloring Agents ; Diagnosis ; Granuloma ; Granulomatous Disease, Chronic ; Inflammation* ; Mycobacterium tuberculosis ; Mycobacterium* ; Necrosis ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Tuberculosis

No abstract available.
Hepatitis C* ; Interferons* ; Polymyositis*

We report clinical, cytogenetic, and fluorescence in situ hybridization (FISH) studies of a patient with ring chromosome 9. She presented with failure to thrive, facial dysmorphysm and mild psychomotor development delay in the absence of major malformations. Peripheral blood karyotype of the patient was 46,XX,r(9)(p24q34). G-band analysis suggested no loss of material in the ring chromosomes. FISH analysis using the subtelomere-specific sequences on chromosome 9p and 9q, revealed 46,XX,r(9)(p24q34),ish r(9)(D9S913-,D9S325+). Failure to detect any hybridization of a probe for the subtelomeric sequences in the ring 9p terminal suggested that this ring arose from breakage in the distal short arm. The cytogenetic and FISH data in our case provided further evidence for the existence of a "complete ring" phenotype with incomplete subtelomeric sequences.
Arm ; Chimera ; Cytogenetics ; Failure to Thrive ; Fluorescence ; Humans ; In Situ Hybridization ; Karyotype ; Phenotype ; Ring Chromosomes

BACKGROUND AND OBJECTIVES: Paper patching for the treatment of traumatic tympanic membrane perforation is a safe, simple, and inexpensive method. This study was designed to evaluate the therapeutic effect of proper paper-patch techniques for traumatic tympanic membrane perforation using more objective measurement of perforated area by image analyzer. SUBJECTS AND METHOD: A prospective study of paper-patch techniques was carried out on 55 patients with traumatic perforations of the tympanic membrane. Objective semiquantitative measurement of the perforated area was performed using computerized image analyzer. Immediate eversion of inverted flaps and single to multiple patching techniques were used in all cases. Treatment results were analyzed according to various variables which may affect the healing rate. RESULTS: The closure rate of tympanic membrane with this paper patching method was 98.2% and the mean healing time was 2.9+/-1.9 weeks. Hearing impairment was correlated with the size of perforation which was measured quantitatively by image analyzer and the healing rate was decreased with infectious signs such as otorrhea. There were no side effects or complications. CONCLUSION: Multiple paper patching with proper technique for traumatic tympanic membrane perforation produced an excellent success rate and could be considered as part of initial therapeutic methods for all cases of large perforation with inverted flap.
Hearing Loss ; Humans ; Prospective Studies ; Tympanic Membrane ; Tympanic Membrane Perforation

A Hyalinizing Trabecular Tumor (HTT) is a very rare tumor. We report one case that was confirmed to be HTT after an operation. A 44-year-old female visited our hospital with about a 1.3-cm-sized mass on the left thyroid. Fine Needle Aspiration Biopsy (FNAB) indicated papillary thyroid cancer. After a left hemithyroidectomy, a frozen section biopsy reported the possibility of HTT. Therefore, we did not proceed with the surgery. According to the final report, she was diagnosed with HTT. Five lymph nodes were dissected and were found to be benign. Thyroid transcription factor-1 and neuron specific enolase were positive, and in addition calcitonin was negative. Ki-67 was recorded to be less than 5%. She was discharged without any complication. HTT is benign in most cases, but the possibility of malignancy should be considered. Because it is hard to differentiate between it and PTC or MTC, an accurate diagnosis through histologic examination of specimens and surgical resection is necessary.
Adult ; Biopsy ; Biopsy, Fine-Needle ; Calcitonin ; Diagnosis ; Female ; Frozen Sections ; Humans ; Hyalin* ; Lymph Nodes ; Phosphopyruvate Hydratase ; Thyroid Gland* ; Thyroid Neoplasms

A careful approach is required for managing esophageal perforation after thyroidectomy, and esophageal perforation can cause serious infectious complications. However, reports on the treatment and management of esophageal perforation after thyroidectomy are lacking. We report here on a case of esophageal perforation that was successfully managed using vacuum-assisted closure. A patient underwent total thyroidectomy for papillary carcinoma. Near the lower pole of the left thyroid, a metastatic lymph node with direct invasion to the esophagus was detected. The esophageal wall, which was injured during lymph node dissection, was repaired. An esophageal leak occurred on the 5th postoperative day, and a 1 cm sized esophageal wall defect was identified. After irrigation, the defect was primary repaired, and the wound was closed using a vacuum assisted closure system. The patient was kept in a oral-fasting state, and subsequent wound dressing with vacuum change was repeated every 3~4 days. During this period, gradual formation of granulation tissue was noted. After negative leakage was confirmed by an esophagogram on the 18th postoperative day, the patient resumed an oral intake. The wound was closed successfully on the 22nd postoperative day, and the patient was safely discharged one week later. In conclusion, vacuum assisted wound closure could reduce the risk of infection and also induce granulation tissue. We think this could be an alternative treatment strategy for esophageal perforation after thyroidectomy.
Bandages ; Carcinoma, Papillary ; Esophageal Perforation* ; Esophagus ; Granulation Tissue ; Humans ; Lymph Node Excision ; Lymph Nodes ; Negative-Pressure Wound Therapy ; Thyroid Gland ; Thyroidectomy* ; Vacuum ; Wounds and Injuries

The enhanced process of proteolysis of both the basement membrane and the stromal extracelluar matrix (ECM) contributes to the escape of breast cancer cells into the neighboring tissues, eventually leading to the formation of distant metastases. A group of enzymes thought to play a role in tumor cell invasion are the matrix metalloproteinases (MMPs). Much attention has been focused on MMP-2 and MMP-9, which are 2 members of the MMP family active against collagen of the basement membrane. The enzymatic activities of MMP-2 and MMP-9 are inhibited by the tissue inhibitors of metalloproteinases (TIMPs). TIMP-2, one member of TIMPs, inhibits MMP-2 and MMP-9. The imbalance between TIMPs and MMPs permits to tumor invasion and metastasis. Theretore, TIMPs constitute promising targets in the developmemt of anticancer terapies. Immunohistological stainings of MMP-2, MMP-9 and TIMP-2 were performed on paraffin-embedded tissue sections of 31 invasive breast carcinomas. MMP-2 and MMP-9 were associated with neoplastic cell cytoplasms in 65% of the cases and exhibited inter-tumoral variability of the staining intensity. The MMP-2 and MMP-9 stainings did not correlate with presence of metastases at time of diagnosis. TIMP-2 was detected in the peri-tumoral stroma and was present in 81% of the cases. Residual benign breast tissue was negative for TIMP-2 staining. Neoplasms with diffuse TIMP-2 staining (32%) have metastasis significantly more frequently (50% metastasis) than ceses with focal (20% metastasis) or absent (0% metastasis) TIMP-2. We conclude that the clinical outcome such as metastasis is more closely related to the presence of TIMP-2 than the corresponding MMPs. Enhanced TIMP-2 expression, therefore, may denote a stromal response to tumor invasion, indicative of aggressive behavior in the subset breast carcinoma.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Collagen ; Cytoplasm ; Diagnosis ; Humans ; Matrix Metalloproteinases ; Metalloproteases ; Neoplasm Metastasis ; Proteolysis ; Tissue Inhibitor of Metalloproteinase-2 ; United Nations