It has been claimed that CNS lymphoma, a rare neoplasm accounting for only a small fraction of malignant brain tumors, occurs with increasing frequency in immunologically normal as well as immunocompromised individuals. We investigated the prognostic value of Ki-67 index, p53, and bcl-2 oncoprotein expression in relation to the clinicopathological parameters in the primary CNS lymphoma patients. The tumors were graded by Kiel classification and the Working formulation and included 33 high-grade, 4 intermediate-grade, and 5 low-grade lymphomas. The phenotype was determined in 38 cases: 30 were B cell type and 8 were T cell type. All cases displayed variable degrees of nuclear Ki-67 staining from 1.0% to 92.0% (mean 51.1%). A highly significant correlation was established between the proportion of Ki-67 positive cells and the classification into grades (p=0.0002) and phenotypes (p=0.0002). Overexpression of p53 and bcl-2 protein was found in 37.1% and 51.4% of 35 patients, respectively. And p53 expression was significantly increased in B cell type (p=0.02). On Kaplan-Meier survival curve, the phenotype, grade of tumors, and p53 and bcl-2 protein expression were not correlated with overall survival. On multivariate analyses, overall survival was independently influenced by Ki-67 index. In conclusion, it is suggested that Ki-67 proliferating index is the most important marker for predicting biologic behavior of the primary CNS lymphoma.
Brain Neoplasms ; Central Nervous System* ; Classification ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Multivariate Analysis ; Phenotype

Infantile form of histiocytosis X is commonly presented as multiorgan desseminated form such as Letterer-Siwe disease. Lymph node involvement of histiocytosis X is usually accompanied by adjacent bone or skin lesion. Solitary nodal eosinophilic granuloma without evidence of other organ involvement is very rare. A case herein report is a 11 month-old female infant presented with fever and palpable both inguinal lymph nodes. There was neither skin lesion nor hepatosplenomegaly. Laboratory evaluation was within normal range except increased alkaline phosphatase and many neutrophils in urine. Radiologic examination revealed no remarkable bone lesions. And she showed good clinical outcome without evidence of other organ involvements. On microscopic examination of inguinal lymph node it was replaced by infiltration of histiocytes mainly along the sinusoid. Some of histiocytes showed morphologic features of "histiocytosis X cell" having nuclear grooves or multilobulation. Multinulceated giant cells were frequently see. Numerous eosinphils were also infiltrated and showed multifocal microabscess formation. Immunohistochemical staining revealed that majority of histiocytes were postitive for S-100 protein but multinucleated histriocytes, phagocytic histiocytes and those around the abscess were positive for macrophage marker, suck as CD68 and alpha-1-antichymotrypsin. Interestingly some histiocytes showed positivity for both S-100 protein and macrophage marker. These results suggest that histiocytosis X is proliferative disorder of phenotypically heterogenous population of histiocytes in contrast to the theory that it is a proliferative disorder of Langerhans cells.
Infant ; Male ; Female ; Humans

We studied the left ventricular function with the use of M-mode and 2-D Echocardiography to 32 patients with congestive heart failure before and 2 weeks after medication of prazosin 2 mg tid during July 1979 and Dec. 1980 in Heart Center, Paik Hospital, In-Je Medical College, Busan, Korea. The results were following; 1) LVDeD before and after vasodilaor therapy was each 5.64+/-0.76 and 5.04+/-0.57.cm, LVSeD before and after therapy each 4.52+/-0.51 and 3.70+/-0.57cm, and F.S. before and after therapy 19.87+/-3.66 and 26.59+/-6.75%. The difference of LVSeD, LVDeD and F.S. was each statistically significant. 2) LVDeV before and after therapy was each 182.2+/-58.07 and 132.80+/-47.01 ml LVSeV before and after therapy each 92.35+/-23.60 and 50.65+/-27.21ml, and E.F. before and after therapy each 49.31+/-7.07 and 61.86+/-11.74%. The difference of LVDeV, LVSeV and E.F. was each statisitically significant. 3) LVPWTh before and after therapy was each 0.89+/-0.11 and 0.77+/-0.08cm, and Vcf before and after therapy 0.83+/-0.11 and 1.03+/-0.27 cir./sec. The difference of LVPWTh and vcf before and after therapy was each statistically significant. 4) The difference of VSTh, RVD, LAD, and Aorta Dimension before and after therapy was each statisitically significant.
Aorta ; Busan ; Echocardiography* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Heart Ventricles* ; Humans ; Korea ; Prazosin ; Ventricular Function, Left

OBJECTIVES: E-cadherin is a transmembrane protein that is one of the key players involved in cell to cell adhesion. Loss of E-cadherin expression is suggested to promote tumor invasion and distant metastasis in tumor development. Recently, it has been proposed E-cadherin function requires its linkage to the cytoskeleton through catenins. So defects in catenins may cause defective E-cadherin function and promote tumor invasion. We intend to evaluate the expression of E-cadherin and alpha-, beta-, gamma- catenin in tissues of human endometrial carcinoma to analyze the patterns of cell adhesion molecules' expression in endometrial carcinoma and to investigate the relationship between status of cell adhesion molecules and various clinicopathological factors. MATERIALS AND METHODS: The present study investigated the immunohistochemical expression of E-cadherin and alpha-, beta-, gamma- catenin in 33 paraffin embedded formalin fixed tissues of endometrial carcinomas. RESULTS: Aberrant E-cadherin, alpha-, beta-, gamma- catenin expression was observed in 33.3(11 of 33), 27.3(9 of 33), 18.2 (6 of 33), and 51.5(17 of 33) % of the specimens, respectively. Statistically significant correlation was found between aberrant expression of E-cadherin and lymph node metastasis and cell types other than endometrioid adenocarcinoma. Aberrant pattern of gamma- catenin expression also correlated with deep myometrial invasion. But alpha-, beta- catenin expression were not correlated with any clinicopathological parameters. Using Kaplan-Meier curves, abnormal expression of E-cadherin correlated closely with poor survival (p<0.05). CONCLUSION: We revealed aberrant expression of these cell adhesion molecules in part of patients with endometrial carcinoma. Aberrant expression of E-cadherin was correlated with lymph node metastasis and cell types other than endometrioid adenocarcinoma and aberrant expression of gamma-catenin was related with deep myometrial invasion.
Cadherins* ; Carcinoma, Endometrioid ; Catenins* ; Cell Adhesion ; Cell Adhesion Molecules ; Cytoskeleton ; Endometrial Neoplasms* ; Female ; Formaldehyde ; gamma Catenin ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

No abstract available.
Evoked Potentials* ; Spinal Cord* ; Spine*

No abstract available.
Osteochondroma*

PURPOSE: This study was performed to evaluate differentiating features of spinal compression fractures between benign and metastatic lesions. MATERIALS AND METHODS: We reviewed MR imaging in 52 patients (benign 38, metastasis 14) with vertebral compression fracture. Signal intensity of fracture and uninvolved areas, presence of contrast enhancement, fragmentation, and paravertebral mass were analyzed retrospectively. RESULTS: Signal intensity of fracture site was variable in benign lesions, but low signal intensity on T1-weighted image and high on T2*-weighted image were seen in all cases of metastasis. Signal intensity of uninvolved area was high on T1-weighted image and low on T2*-weighted image in 84% of benign lesions. On the contrary, normal marrow signal intensity was not seen in the uninvolved areas of all metastatic fractures. Contrast enhancement were observed in all cases of benign & metastatic compression fractures. Fragmentation were seen in 1 case of metastasis(7%) and in 11 cases of benign lesions(29%). Paravertebral mass were seen in 5 cases of metastasis(36%) and in 7 cases of benign lesions(18%). CONCLUSION: Presence of normal marrow signal intensity in the uninvolved area of fracture site could be the most useful sign for differentiating benign causes from metastasis.
Bone Marrow ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Neoplasm Metastasis* ; Retrospective Studies

Authors report the radiologic findings of two cases of multiple bile-duct hamartoma in the liver. Ultrasonography and computed tomography of the liver were performed in two female patients. In one patient, ERCP was performed. Ultrasonography and computed tomography showed scattered multiple hypoechoic and low attenuated lesions, measuring up to 2cm in both lobe and ERCP showed communication of these lesions with the biliary system. Multiple bile-duct hamartoma should be included in the differential diagnosis of multiple small cystic lesions in the liver.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Female ; Hamartoma* ; Humans ; Liver ; Ultrasonography

OBJECTIVE: This study was to define clinical characteristics and formulate the management strategies of the patients with posterior cerebral artery (PCA) aneurysms. PATIENTS AND METHOD: The authors reviewed the database and imaging studies as sources for identification and analysis. During the past 14 years, 16 consecutive patients with PCA aneurysms were treated either by surgery or neurointervention. RESULTS: Ten patients had ruptured PCA aneurysms: 4 patients were Hunt and Hess Grade I, 1 Grade II, 4 Grade III, and 1 Grade IV. Six patients had unruptured PCA aneurysms: one patient was Grade 1, and the other patient was Grade IV due to ruptured multiple aneurysms. Seven aneurysms were small, 9 (56.2%) were large or giant. Thirteen aneurysms were saccular, 2 were fusiform, and 1 was serpentine. Seven of the 16 patients (43.7%) had multiple aneurysms. Pterional (8) or subtemporal (5) approach was done in 13 patients. The obliteration methods of the aneurysms were neck clipping in 10 patients, and trapping in 3 patients. Endovascular treatment was performed in 3 patients. Five patients showed transient oculomotor nerve palsy and contralateral hemiparesis after the surgery. Persisting oculomotor nerve palsy occurred in one patient. All patients showed favorable outcome (food recovery 14, moderate disability 2). CONCLUSIONS: As a result, PCA aneurysms were characterized by high frequency of non - saccular shape, large or giant size with mass effect, and multiple aneurysms. Surgical treatment was necessary for large or giant aneurysm of the distal PCA to decompress midbrain. Wrapping and clipping technique were useful for treatment of fusiform aneurysms. Although ultimate management outcome of the patients with PCA aneurysms were better than the patients with aneurysms of the other location, intra-aneurysmal treatment with Guglielmi detachable coil would be useful for the proximal PCA aneurysms to avoid surgical injury of the P1 perforator or the oculomotor nerve.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Intraoperative Complications ; Mesencephalon ; Neck ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paresis ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery*

OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
Adenocarcinoma ; Aorta ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Magnetic Resonance Imaging ; Mediastinoscopy ; Neoplasm Metastasis ; Pulmonary Artery ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed