BACKGROUND AND OBJECTIVES: The exact pathogenesis of middle ear cholesteatoma is still unknown to some extent. Recently, however, advances of immunology have opened a new chapter in investigating the etiology and pathogenesis of cholesteatoma through immunohistochemical techniques. Matrix metalloproteinases (MMPs) are a group of enzymes thought to be responsible for both normal connective tissue matrix remodelling and the accelerated breakdown associated with tumor development. The aim of this study was to investigate the immunohistochemical expression of MMP-2, MMP-3, and MMP-9 in correlation with the expression of basement membrane antigen (laminin), fibronectin and T lymphocyte in middle ear cholesteatoma to compare them with those in external auditory canal skin as a control group. Material and Methods: The biopsy specimens of cholesteatomatous tissue and external auditory canal skin were obtained during undergoing the middle ear surgery. Immunohistochemical staining was carried out using monoclonal mouse antibodies against MMP-2, MMP-3, MMP-9, laminin, fibronectin and pan T lymphocyte (UCHL1) were used. RESULTS: The results are as follows: In cholesteatomatous tissue, a number of T lymphocytes were expressed and a large number of MMPs were expressed in the basal cell layer and in the stroma of cholesteatoma. Both MMP-2 and MMP-3 showed positive signals in the basal and parabasal cell layer. A strong expression of MMP-9 was shown in granuloma area. Expression of MMP-3 had a significant correlation with a distribution of T lymphocyte (r=-0.522, p<0.05). Expression of MMP-2 had a significant correlation with a distribution of laminin (r=0.662, p <0.05). CONCLUSION: These results indicate that spatial distribution of matrix metalloproteinases in the extracellular matrix show a specific relation to extracellular matrix molecules such as laminin, fibronectin and T-lymphocyte in middle ear cholesteatoma especially inflammatory and immune state.
Allergy and Immunology ; Animals ; Antibodies ; Basement Membrane ; Biopsy ; Cholesteatoma ; Cholesteatoma, Middle Ear* ; Connective Tissue ; Ear Canal ; Ear, Middle* ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Fibronectins ; Granuloma ; Laminin ; Lymphocytes* ; Matrix Metalloproteinases* ; Mice ; Skin ; T-Lymphocytes

Malignant melanoma is a common malignancy that has potential to metastasize to any site. Metastatic disease involving the stomach and liver are difficult clinical problem and presenting symptoms include weight loss, fatigue, and nonspecific epigastric pain. Laboratory results, barium X-ray study, endoscopy, CT, arteriography, and MRI suggest a metastatic malignant melnoma of the stomach and liver. The diagnosis may be confirmed by endoscopic biopsy of the stomach and aspiration needle biopsy of the liver. Metastatic melanoma is generally incurable, with survival in patients with visceral metastases generally <1 year. A case is reported of a metastatic malignant melanoma of the stomach and liver in a 60-year-old male patient, that was discovered 11 years after an enucleation of a choroidal melanoma of the right eye.
Angiography ; Barium ; Biopsy ; Biopsy, Needle ; Choroid ; Diagnosis ; Endoscopy ; Fatigue ; Humans ; Liver* ; Magnetic Resonance Imaging ; Male ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Stomach* ; Weight Loss

BACKGROUND AND OBJECTIVES: Cancer is a disease characterized by deregulation of cell cycle control. During the last decade, many alterations in the signaling pathways that ultimately lead to DNA replication and mitosis have been identified in various tumor types. DNA analysis by flow cytometry is considered to be of prognostic value in squamous cell carcinoma of the head and neck. However, a few and contradictory studies have been made on squamous cell carcinoma of the larynx. Expression of the cell cycle control gene cyclin D1 may, at least in some tumor types, provide a prognostic marker. Cyclin D1 is expressed during the G1 phase of the cell cycle and becomes associated with its catalytic partner CDK4 or CDK6. The authors evaluated the prognostic significance of cyclin D1, DNA ploidy and S-phase fraction (SPF) in the squamous cell carcinoma of the larynx to determine their relationship with the various clinicopathological parameters. MATERIALS AND METHODS: Paraffin embedded tissue specimens from 28 cases of squamous cell carcinoma of larynx were studied by the immunohistochemical method using cyclin Dl antibody and by flow cytometric DNA analysis. RESULT: The positive expression of cyclin D1 protein was 60.7% in squamous cell carcinoma of the larynx. In 28 cases of flow sytometric DNA analysis, 23 cases (82.1%) were diploidy and 5 cases (17.9%) were aneuploidy. The SPF ranged from 0.0% to 83.9% (mean 41.4, median 35.2). The mean SPF of DNA diploid cases was 34.2%, whereas that of DNA aneuploid cases was 74.7%. Expression of cyclin D1 protein was found in 52.2% of the diploid cases and in 100% of the aneuploid cases. This expression was statistically significant (p<0.05). Among the multiple factors, only the lymph node metastasis was found to be statistically significant in aneuploid cases and in higher SPF (> or = 35.2). The expression of cyclin D1 protein did not correlate with clinical features. CONCLUSION: The expression of cyclin D1 protein may be related with development of squamous cell carcinoma of the larynx, but not correlated with prognostic indicators. In cases of aneuploidy/higher SPF (> or = 35.2), The expression of cyclin Dl protein did not significantly correlate with lymph node metastasis, but showed a high expression rate of cyclin Dl protein. However, these correlations were not sufficient for the prognostic indicators in squamous cell carcinoma of the larynx.
Aneuploidy ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cell Cycle Checkpoints ; Cyclin D1* ; Cyclins* ; Diploidy ; DNA Replication ; DNA* ; Flow Cytometry ; G1 Phase ; Head ; Larynx* ; Lymph Nodes ; Mitosis ; Neck ; Neoplasm Metastasis ; Paraffin ; Ploidies

PURPOSE: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. METHOD: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. RESULTS: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. CONCLUSIONS: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.
Adenoviridae ; Child* ; Female ; Gastroenteritis* ; Humans ; Immunoenzyme Techniques ; Male ; Norovirus ; Prospective Studies ; Republic of Korea ; Rotavirus ; Sapovirus ; Weights and Measures*

Rotavirus (RV) is one of the most important viral etiologic agents of acute gastroenteritis (AGE) in children. Although effective RV vaccines (RVVs) are now used worldwide, novel genotypes and outbreaks resulting from rare genotype combinations have emerged. This study documented RV genotypes in a Korean population of children with AGE 5 yr after the introduction of RVV and assessed potential genotype differences based on vaccination status or vaccine type. Children less than 5-yr-old diagnosed with AGE between October 2012 and September 2013 admitted to 9 medical institutions from 8 provinces in Korea were prospectively enrolled. Stool samples were tested for RV by enzyme immunoassay and genotyped by multiplex reverse-transcription polymerase chain reaction. In 346 patients, 114 (32.9%) were RV-positive. Among them, 87 (76.3%) patients were infected with RV alone. Eighty-six of 114 RV-positive stool samples were successfully genotyped, and their combinations of genotypes were G1P[8] (36, 41.9%), G2P[4] (12, 14.0%), and G3P[8] (6, 7.0%). RV was detected in 27.8% of patients in the vaccinated group and 39.8% in the unvaccinated group (P=0.035). Vaccination history was available for 67 of 86 cases with successfully genotyped RV-positive stool samples; RotaTeq (20, 29.9%), Rotarix (7, 10.4%), unvaccinated (40, 59.7%). The incidence of RV AGE is lower in the RV-vaccinated group compared to the unvaccinated group with no evidence of substitution with unusual genotype combinations.
Child, Preschool ; Feces/virology ; Gastroenteritis/immunology/prevention & control/virology ; Genotype ; Humans ; Infant ; *Mass Vaccination ; RNA, Viral/genetics ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus/*classification/*genetics/isolation & purification ; Rotavirus Infections/immunology/*prevention & control/virology ; Rotavirus Vaccines/*immunology ; Vaccines, Attenuated/immunology

BACKGROUND: Neurotrophin-3 (NT-3), a member of the NT family, has only been considered an ancillary compound that provides anti-apoptotic benefits by inactivating tropomyosin receptor kinase C (TrkC)-induced apoptotic signals. However, little is known about the clinical relevance of NT-3 expression itself in neuroblastoma. The purpose of this study was to assess NT-3 expression in patients with neuroblastoma and its relevance to clinicopathologic findings and treatment outcomes. METHODS: In this study, expression of NT-3 and TrkC was analyzed using immunohistochemistry in 240 patients with newly diagnosed neuroblastoma. RESULTS: The results of the study revealed that NT-3 expression was associated with older age at diagnosis, localized tumors, and more differentiated tumors but was not associated with early treatment response (degree of residual tumor volume after three cycles of chemotherapy) and progression-free survival (PFS). However, when analysis was confined to patients with MYCN amplified tumors, NT-3 expression was associated with better early treatment response with borderline significance (P = 0.092) and higher PFS (86.9% vs. 58.2%; P = 0.044). In multivariate analysis in patients with MYCN amplified tumors, NT-3 was independent prognostic factor (hazard ratio, 0.246; 95% confidence interval, 0.061–0.997; P = 0.050). In another subgroup analysis, the early treatment response was better if NT-3 was expressed in patients without TrkC expression (P = 0.053) while it was poorer in patients with TrkC expression (P = 0.023). CONCLUSION: This study suggests that NT-3 expression in neuroblastoma has its own clinical significance independent of TrkC expression, and its prognostic significance differs depending on the status of MYCN amplification and/or TrkC expression.
Diagnosis ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Neoplasm, Residual ; Neuroblastoma ; Phosphotransferases ; Tropomyosin