Met protein is a transmembrane 190 kD heterodimer with tyrosine kinase activity, encoded by c-Met oncogene. It serves as a high affinity receptor for hepatocyte growth factor (HGF)/scatter factor (SF), a cytokine which stimulates cell proliferation, motility, and invasion. In this study, we immunohistochemically evaluated the expression of Met/hepatocyte growth factor receptor in colorectal cancers. Met protein was expressed in 31 of 72 patients (43.1%). The staining pattern was cytoplasmic in nature, present throughout the tumor, and showed variable intensity from case to case. The relationship between the expression rate and intensity, and age and sex of patients, tumor size (p=0.645), tumor site (p=0.902) and tumor differentiation (p=0.844) was not statistically significant. The expression rate and intensity were significantly correlated with lymphovascular invasion (p=0.001), lymph node metastasis (p=0.010), depth of invasion (0.019), and stage (p=0.023). Cytoplasmic accumulation of Met protein was not associated with enhanced PCNA index of tumor cells (p=0.052). These results suggest that Met protein may play an important role in the invasion and metastasis of colorectal cancer cells.
Cell Proliferation ; Colorectal Neoplasms* ; Cytoplasm ; Hepatocyte Growth Factor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Protein-Tyrosine Kinases

Cri-du-chat syndrome is a rare genetic disorder in which the patient presents with a characteristic high-pitched monotonous cry and recurrent aspiration pneumonia, attributed to abnormalities in the larynx, epiglottis, and nervous system. The most prominent brain MRI findings are the presence of pontine and cerebellar hypoplasia, which primarily involve posterior cranial fossa structures. Although atrophy of supratentorial structures were also a common radiological finding, it was considered to be a secondary change due to pontine hypoplasia. Here, we present the case of a three-month-old patient presenting with cri-du-chat at our institution. The patient also showed the presence of prominent pontine hypoplasia similar to previously reported cases; however, contrary to other cases, there was a general delayed myelination of brain instead of decreased myelination of anterior limb of internal capsule. Since the larynx, pons, and cerebellum all originated from similar notochord level, which suggests anomaly in early stage of development, laryngeal, and brain anomaly characteristically observed in the cridu- chat syndrome.

Fentanyl intoxication has occasionally been reported since fentanyl patches became available for medical use. Delayed post-hypoxic leukoencephalopathy is a complication of hypoxia. However, its neuropsychiatric symptoms can be delayed, and it can progress to leukoencephalopathy even after full recovery from coma due to acute intoxication. Herein, we report a case of fentanyl intoxication in a 65-year-old man who was presented to the hospital because of unconsciousness for 13 hours after using ten fentanyl patches simultaneously. Initial brain CT findings were non-specific. Twenty days later, delayed neuropathologic symptoms manifested, and MRI showed bilaterally symmetrical, heterogeneous, confluent high signal intensities on T2-weighted/fluid attenuated inversion recovery MRI in the cerebral white matter with diffusion restriction. This was followed by rapid exacerbation of neuropathological symptoms with diffuse severe cerebral atrophy over 1 year.

Incisional metastases following surgery for cervical cancer are extremely rare. We report a case of a recurrence which occurred at a incisional site following radical hysterectomy and pelvic lymphadenectomy for squamous cell carcinoma of the cervix. The recurrence was found at the incisional site just below umbilicus that was not included for post-operative adjuvant radiotherapy. We performed wide local excision and postoperative adjuvant radiotherapy for 5 weeks. She has been under follow up until now, and there is no evidence of recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Follow-Up Studies ; Hysterectomy ; Lymph Node Excision ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence* ; Umbilicus ; Uterine Cervical Neoplasms

Tailgut cysts are known to originate from the remnants of the embryonic hindgut. They occur exclusively in the retrorectal and presacral spaces. There have been limited reports of tailgut cysts occurring in the left perirenal space. The present case features a huge tailgut cyst extending from the right perirenal to the perivesical space. We believe that this case report will help to further elucidate the characteristics of perirenal and perivesical tailgut cysts.

Pulmonary aspiration of gastric contents is a very rare but one of the most feared complications of anesthesia. The risk factors are gastroesophageal reflux, previous aspiration, renal failure, difficult intubation and trauma. The incidence of aspiration during anesthesia of children has been reported to be more common than adults. This report describes the case of a 7-year-old female patient who had experienced pulmonary aspiration during induction of anesthesia. With fiberoptic brochoscopy, the aspirates in both bronchi were carefully suctioned, and the following chest X-ray and blood gas findings improved. She was transferred to the intensive care unit for respiratory support and showed no further problems.
Adult ; Anesthesia* ; Bronchi ; Child* ; Female ; Gastroesophageal Reflux ; Humans ; Incidence ; Intensive Care Units ; Intubation ; Renal Insufficiency ; Risk Factors ; Suction ; Thorax

BACKGROUND: Insulin-like growth factor binding protein 3 (IGFBP3), a member of six proteins with a high affinity for insulin-like growth factors (IGFs), seems to modulate the effects of IGFs on cells and to regulate cell proliferation through the IGF-independent pathway. We assessed the role of IGFBP3 in the colorectal carcinoma detected by cDNA microarray. METHODS: To identify molecular alterations in the colorectal carcinoma, we analyzed gene expression profiles of the colorectal adenocarcinoma by means of a cDNA microarray representing 7,500 genes. Of the differentially expressed genes, the author assessed the insulin-like growth factor binding protein 3 (IGFBP3) gene at the protein level using immunohistochemistry. RESULTS: The expressions of 21 and 16 genes were noted to have more than fivefold increases or decreases in the colonic adenocarcinoma tissue compared with the noncancerous colonic mucosal tissue. The differentially expressed genes include those associated with cell proliferation/apoptosis, signal transduction/transcription, metabolizing enzymes, cytoskeleton, angiogenesis, ion channel, extracellular matrix and others. Of the total 68 cases of colorectal adenocarcinomas observed, 34 cases (50%) showed positive immunohistochemical stainings for IGFBP3. CONCLUSIONS: In this study, it is suggested that IGFBP3 plays a role in colorectal carcinogenesis. And combining an immunohistochemistry with a cDNA microarray can facillitate the rapid characterization of a candidate novel molecular target.
Adenocarcinoma ; Carcinogenesis ; Cell Proliferation ; Colon ; Colorectal Neoplasms* ; Cytoskeleton ; DNA, Complementary* ; Extracellular Matrix ; Immunohistochemistry ; Insulin-Like Growth Factor Binding Protein 3* ; Ion Channels ; Mucous Membrane ; Oligonucleotide Array Sequence Analysis* ; Somatomedins ; Transcriptome

Background: Physicians and caregivers are conflicted over whether to inform patients that their disease is terminal. Studies examining the effect of awareness of prognosis on the survival and quality of life of terminally ill cancer patients report conflicting results. This study aimed to assess the effects of prognosis awareness on the survival time and psychological health of terminally ill cancer patients. Methods: Patients in the hospice wards of two general hospitals were asked to complete a questionnaire. All were mentally alert and could express themselves clearly. Awareness of prognosis was defined as knowing both the diagnosis and exact prognosis. Survival time was defined as the time from hospital admission to death. Multiple psychological examinations were conducted to verify the effect of prognosis awareness on psychological health. Results: Of the 98 subjects who met the inclusion criteria, 65 (66.3%) were aware of their terminal status. The patients’ awareness was significantly related to survival time after adjusting for clinical variables with a hazard ratio of 1.70 (95% confidence interval [CI], 1.01–2.86). Furthermore, the unaware group had a higher risk of cognitive impairment (Mini-Mental State Examination <24; adjusted odds ratio [aOR], 3.65; 95% CI, 1.26–10.59) and a poorer quality of life (physical component summary of the Short Form 36-item Health Survey <20; aOR, 3.61; 95% CI, 1.12– 11.60) than the aware group. Conclusion Knowledge of the exact prognosis might have a positive effect on the survival and quality of life of terminally ill cancer patients.

Background: Osteoporosis is characterized by a decrease in bone mineral density (BMD) and increased risk of fragility fractures. Serum iron level may interact with bone health status. This study investigated the correlations of BMD with serum iron level, hemoglobin level, and total iron-binding capacity (TIBC). Methods: We performed a retrospective analysis of data from the medical records of premenopausal women in South Korea. The women’s BMDs and the Z scores of the BMDs were verified using dual-energy X-ray absorption. The participants were stratified into quartiles for analyses of the associations of BMD with serum iron level, TIBC, and hemoglobin level. Results: A simple linear regression analysis revealed associations of changes in BMD with iron level (β=-0.001, standard error [SE]=0.001, P<0.001), hemoglobin level (β=0.015, SE=0.003, P<0.001), and TIBC (β=0.001, SE=0.001, P<0.001). This pattern was also observed in a multiple linear regression analysis. A multivariate logistic regression analysis of iron level and TIBC for low BMD revealed odds ratios of 1.005 (P<0.001) and 0.995 (P<0.001), respectively. Conclusion This study demonstrated clear relationships of changes in BMD with serum iron level and TIBC, and thus confirms the usefulness of these markers in the clinical evaluation of iron storage and BMD in younger women.

Vitamin B12 deficiency causes a variety of symptoms in the hematologic, gastrointestinal tract, and neurologic deficit. We report a rare case of progressive gait disturbance, bradykinesia and dysarthria which was that vitamin B12 deficiency was diagnosed as the cause, and symptoms improved after intramuscular cobalamin treatment. Vitamin B12, homocysteine, and methylmalonic acid tests are recommended for patients with progressive gait disturbance, even in the absence of obvious anemia symptoms.