The most common pancreatic cystic lesion is pancreatic pseudocyst which represents about 85%. Primary cystic neoplasms represent about 10 to 15% of the lesion. Pathologically cystic neoplasms can be classified into serous cystadenoma, mucinous cystadenoma and papillary cystic neoplasm by epithelial lining-cell, whereas pseudocyst is characterized by fibrotic capsules. Mucinous form is known to be premalignant or malignant and serous cystadenoma was known to be benign in the past, but recently 4 cases of malignant transformation have been reported. Serous cystadenoma is described under a variety of names, including microcystic adenoma and glycogen-rich cystadenoma but recently macroqystic variants have been reported. Serous cystadenoma is most commonly seen in middle aged women with symptoms of vague upper abdominal pain or palpable mass. It is sometimes associated with extra- pancreatic diseases such as gallstones, diabetes mellitus, hypertension, duodenal ulcers, sterility, obesity and thymic dysfunction, but coexisting papillary thyroid cancer have been reported in only 2 cases to our knowledge. The pathogenesis of associated diseases is unknown and appears to be due to function of age of the patients or incidental occurrence. Herein, we report a patient who had a pancreatic serous cystadenoma coexisting with papillary thyroid cancer. Since pancreatic serous cystadenoma can occur in association with papaillary thyroid cancer, examination of thyroid seems to be advisable when pancreatic serous cystadenoma is found.
Abdominal Pain ; Adenoma ; Capsules ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous* ; Diabetes Mellitus ; Duodenal Ulcer ; Female ; Gallstones ; Humans ; Hypertension ; Infertility ; Middle Aged ; Mucins ; Obesity ; Pancreatic Cyst ; Pancreatic Diseases ; Pancreatic Pseudocyst ; Thyroid Gland* ; Thyroid Neoplasms*

Angiosarcomas are extremely rare in the nasal cavity and para-nasal sinus. Upto the present only nineteen cases have been reported in the literature. A 31-year-old male presented with right facial swelling and large oral cavity mass. He was treated with wide excision of the tumor by radical maxillectomy. The tumor was diagnosed as angiosarcoma by immunohistochemical staining with factor VIII-reactive antigen. No adjuvant radiotherapy after surgery was done. After 9 montbs from surgery, the tumor recurred in the primary sites of oral cavity and right maxillary sinus and metastasized to the both lungs. He was treated with palliative chemotherapy and showed a stable disease in follow-up magnetic resonance image of para-nasal sinus and simple chest X-ray after second cycle of chemotherapy. He is undergoing further chemotherapy without any problems. We report first in Korea a case of primary angiosarcoma of the right maxillary sinus in a 31-year-old male.
Adult ; Drug Therapy ; Follow-Up Studies ; Hemangiosarcoma* ; Humans ; Korea ; Lung ; Male ; Maxillary Sinus* ; Mouth ; Nasal Cavity ; Radiotherapy, Adjuvant ; Thorax

Small cell carcinoma is derived from APUDcells of any parts of the body. Usually the cases are discovered in the lungs and have poor prognosis. Small cell carcinoma has been increasingly reported in various organ outside the lungs, such as the larynx, thymus, esophagus, stomach, pancreas, uterine cervix, and prostate. Primary small cell carcinoma of the stomach is extremly rare. The histology of the tumor was similar to that of ordinary small cell carcinoma of the lung, and the secretory granules were identified by electron microscopy. We report a patient with gastric pure small cell carcinoma who treated by a radical total gastrectomy and chemotherapy.
Carcinoma, Small Cell* ; Cervix Uteri ; Drug Therapy ; Esophagus ; Female ; Gastrectomy ; Humans ; Larynx ; Lung ; Microscopy, Electron ; Pancreas ; Prognosis ; Prostate ; Secretory Vesicles ; Stomach ; Thymus Gland

PURPOSE: The goal of this study is to understand the activation processes that take place within the liposomal formulation of lipophilic diaminocyclohexane platinum (DACH-Pt) complexes, to identify the activated species of this class of compounds, and to use that information to develop a reproducible liposomal formulation of DACH-Pt complexes. MATERIALS AND METHODS: Liposomal DACH-Pt complexes were prepared by lyophilization-rehydration method using PC, PG and PA. Their intraliposomal stability and biological activity were determined by HPLC and in vitro/in vivo experiments. RESULTS: DACH-Pt complexes in a liposomal formulation have shown significant promise in preclinical studies and clinical phase I, II trials. Interestingly, they are prodrugs which converts into one or more undetennined activated platinum species within the liposomes ex vivo. Our studies have shown that the stability of liposomal DACH-Pt complexes is inversely related with the antitumor activity of those complexes. The configuratian of leaving group in the complexes and pH of the liposome suspension affect significantly the degradation/activation process that takes place within the liposomes. DACH-Pt complexes with linear (L10) leaving groups are more stable than complexes with branched ones (B10 and NDDP), but also significantly less potent. The presence of PG and PA in the liposome is a prerequisite for the degradation/activation process of DACH-Pt complexes. As PG and PA formulation gave more dramatic changes of the original complexes than PC alone due to lower pH, the cytotoxicity and antitumor activity at those fonnulations increased against PC alone. DACH-Pt complexes are very stable in liposomes containing PC alone but inactive in vitro/in vivo experiments. CONCLUSION: These results also support that the active species produced within the liposomal DACH-Pt complexes is DACH-Pt-Cl2.
Chromatography, High Pressure Liquid ; Hydrogen-Ion Concentration ; Liposomes* ; Platinum* ; Prodrugs

PURPOSE: Sarcomas arising in intraperitaneal cavity and retroperitoneal space are relatively uncommon. Thus, studies characterizing the results of long-term follow-up are limited. The purpose of this study was to identify the clinicopathologic features and prognostic factors of intraperitoneal and retroperitoneal sarcomas. Materials and Method: Thirtyeight patients with intraperitaneal or retroperitoneal sarcoma who had been treated at Department of Surgery, Korea Cancer Center Hospital during the period from January 1987 to December 1997 were reviewed retrospectively. RESULTS: The ratio between male to female was 0.9: 1. The mean age of the patients was 48.3 (32-75) years. The most common symptom was abdominal pain or discomfort (61%), followed by palpable mass (55%), GI bleeding (34%), weight loss (26%), and change of bowel habits (21%). The most comman histologic type was leiomyosarcoma (73.7%), followed by liposarcoma (23.7%), and malignant fibrous histiocytoma (2.6%). The mean tumor size was 15.5 x12.1 x 8.7 cm. Among 38 cases, 25 cases developed in intraperitoneal cavity and 13 cases arose in retroperitoneal space. Overall, 44 operations were performed in 31 patients. Among them, complete surgical resection constituted 73%. In 20 cases, combined resection of adjacent organ was performed to accomplish complete surgical resection of tumors. During the median follow up period of 23 months (3~116 months), the overall 5-year survival rate was 34.7%. The patients who had been treated by complete surgical resection showed better survival than those in whom palliative resection or biopsy only was performed (38.6% vs 0% of 5 YSR, P=0.015). Liposarcoma showed better prognosis than leiomyosarcoma (41.7% vs 34.2% of 5 YSR, P=0.0000). The size of tumor (10 cm>vs 10 cm< or =) was not a statistically significant prognostic factor. CONCLUSION: In this series, The histologic type and complete surgical resection were important factors that can affect the survival of the patients. Aggressive surgical resections are therefore wananted to obtain better outcome of the patients with intraperitoneal and retroperitoneal sarcomas.
Abdominal Pain ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Leiomyosarcoma ; Liposarcoma ; Male ; Prognosis ; Retroperitoneal Space ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Weight Loss

PURPOSE: The purpose of this study was to clarify the risk factors of early recurrence within 1 year by comparing them with patients without recurrence within 3 years after curative liver resection in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Three hundred and twenty six patients with HCC who underwent curative liver resection between 1991 Jan, to 1995 June were observed for possible recurrence for least 3 years. These patients were divided into two groups: 79 patients who had recurrence within 1 years (early recurred group) and 132 patients who had no recurrence within 3 years (no recurred group). RESULTS: Overall survival rates in 5 years after 1iver resection were 17.5% in early recurred group and 94.9% in no recuned group. Risk factors of early recurrence in multivariate analysis were the presence of liver cirrhosis in nontumorous parenchyme (p=0.011, relative risk (RR)=2.5), tumor size (p=0.004, RR 2.9), multiple mass (p 0.015, RR=3.4), the presence of angioinvasion (p=0.043, RR=3.7), serum alpha-fetoprotein more than 20 ng/dl (p=0.007, RR=2.7), major liver resection more than lobectomy (p=0.039, RR=3.2). However, other factors such as age, sex, preoperative transcatheter arterial embolization (TAE), several liver function tests, Child classification, reseetion margin, total necrosis of tumor after preoperative TAE, tumor encapsulation, histologic type, Edmondsons grade, were not significant in our study. CONCLUSION: The risk factors of early recurrence were liver cirrhosis, tumor size, number of tumor, angioinvasion, serum alpha-fetoprotein, and major liver resection. Biologic characteristics of tumor were the most important risk factors of early recurrence. Because the extent of liver resection is the only risk factor that depends on surgeons decision, we must consider this factor in liver resection for HCC.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Child ; Classification ; Humans ; Liver ; Liver Cirrhosis ; Liver Function Tests ; Multivariate Analysis ; Necrosis ; Population Characteristics ; Recurrence ; Risk Factors* ; Survival Rate

PURPOSE: Multidrug resistance mediated by several drug resistant genes impedes the successful outcome of anti-cancer chemotherapy. In this study, we investigated the expressions of drug resistant genes encoding multidrug resistance (MDR1), multidrug resistance-associated protein (MRP), topoisomerase I (Topo I), topoisomerase II g (Topo II a) in narmal volunteers (n=12) in and patients with myeloid leukemia (n=34). Material and Method: We compared the levels of their transcripts in bone matrow mononuclear cells by semiquantitative RT-PCR. The amount of specific transcripts was represented as the optical density ratio of PCR product of target gene to that of B2- microglobulin (MG). Twenty patients of acute myelogenous leukemia (eight in remission state, twelve in refractory) and fourteen patients of chronic myelogenous leukemia (nine in chronic phase and five in blastic crisis) were examined. Twelve normal healthy persons were compared with leukemic patients. RESULTS: The expression levels of all resistant genes in normal volunteers were relatively high as those of AML patients. Regardless of the disease status including remission status of AML (complete remission versus refractory) and the phase of CML (chronic phase versus blastic phase), the expression levels of all resistant genes in patients with CML were significantly lower than in the patients with AML (p < 0.05). Of interest, the patients with refractary AML did not show any statistical difference in comparison with normal controls and even the patients with AML in complete remission. Among the four drug resistant genes, the optical density ratio of MDRl was significantly lower than that of any other genes (p<0.05). Using HL-60 cell line, we compared the changes of various resistant gene expressions before and after differentiation induced by dimethylsulfoxide. The expressions of resistant genes declined in paralle1 with granulocytic differentiation, suggesting that the induction of cell differentiation might make leukemic cells susceptible to chemotherapeutic agents. CONCLUSION: It is impossibble to explain the mechanism of drug resistance by comparing the level of drug resistant gene expression between nonnal subjects and patients with myeloid leukemias. Therefore, we suppose that longitudinal study of drug resistant gene expression is necessary to demonstrate the development of drug resistant during chemotherapy.
Bone Marrow* ; Cell Differentiation ; Dimethyl Sulfoxide ; DNA Topoisomerases, Type I ; DNA Topoisomerases, Type II ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Gene Expression ; Healthy Volunteers ; HL-60 Cells ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Multidrug Resistance-Associated Proteins ; Polymerase Chain Reaction ; Volunteers

PURPOSE: The inhibitory effect of TGFbeta1 on survivals of L1210 and anticancer drug- resistant L1210 sublines was investigated and the gene expression of TGFbeta1 in these cells was examined. MATERIALS AND METHODS: The survivals of L1210, adriamycin-resistant(L1210AdR), vincristine-resistant(L1210VcR) or cisplatin-resistant(L1210Cis) cells were measured by MTT assay after treatment of TGFbeta1. Northern analysis was performed for TGFbeta1 gene expression in L1210, L1210AdR, L1210VcR or L1210Cis. RESULTS: There was no different survival ratio between two groups, control and TGFbeta1(10 ng/ml) treated groups in L1210 cells. However, the survival ratio of L1210AdR was 59% in TGFbeta1 treated group for 96 hours. The survival ratio of L1210VcR was 61% for 96 hours in TGFbeta1 treated group. The survival ratio of L1210Cis was 40% for 96 hours in TGFbeta1 treated group. Expressions of TGFbeta1 gene in drug-resistant sublines were significantly decreased than that of L1210 cells. CONCLUSION: Growth of anticancer drug-resistant L1210 sublines were inhibited by TGFbeta1 but not in L1210 cells. So, it is suggested that TGFbeta1 gene expression may have a part in anticancer drug-resistance.
Control Groups ; Gene Expression

PURPOSE: To gain insight on the role of AP-1 in transcriptional regulation of vimentin gene during differentiation of HL-60 cells by 12-0-tetradecanoylphorbol-13-acetate (TPA), the levels of vimentin mRNA and AP-1 have been investigated with Northern blot hybridization and DNA mobility shift assay. MATERIALS AND METHODS: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum and antibiotics in a humidified 5% CO2 at 37 degree C. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe(Upper strand, 5'-CGCTTGATGAGTCAGCCG- 3') for AP-1 binding activity was mixed with nuclear extracts in a 20 microliter reaction volume containing 300 mM KC1, 60 mM HEPES, pH 7.9, 25 mM MgCl2, 1 mM EDTA, 1 mM DTT, 60% glycerol, and 2 microgram of poly[dI-dC]. RESULTS: TPA increased vimentin mRNA levels, with maxima1 stimulation reached at 24 hr. The level of vimentin mRNA was induced in proportion to the concentration of TPA. TPA-induced vimentin mRNA was almost reduced by actinomycin-D pretreatment. TPA- induced stimulation of vimentin gene was completely reduced by staurosporin pretreatment. In DNA mobility shift assay, AP-I newly appeared at 24 hr during TPA- induced differentiation and was almost not detected after the pretreatment of staurosporin. CONCLUSIONS: These results suggest that the induction of vimentin mRNA during TPA- dependent differentiation in HL-60 cells may be mediated by protein kinases C signal transduction and AP-1 is important to transcriptional regulation.
Anti-Bacterial Agents ; Blotting, Northern ; DNA ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Glycerol ; HEPES ; HL-60 Cells* ; Humans ; Hydrogen-Ion Concentration ; Magnesium Chloride ; Protein Kinases ; RNA ; RNA, Messenger ; Signal Transduction ; Transcription Factor AP-1* ; Vimentin*

Isolated involvement of the epididymis by malignant lymphoma is very rare and almost invariably is associated with lymphoma in the adjacent testis. To date, there are four case reports of primary epididymal lymphoma. In this case, 74-year-old man presented with a 3 cm, painless left epididymal swelling. Extensive staging work-up showed no evidence of extraepididymal spread. The epididymectomy was performed. The enlarged epididymis was firm and entirely replaced by whitish gray homogenous tumor measuring 1.8x0.9 cm. Microscopically, the tumor revealed an interductal, highly cellular infiltration, distorting the normal epididymal architecture. The lymphomatous infiltrate was polymorphic, though the predominant cell type exhibited a large irregular and vesicular nucleus. In many areas, small reactive lymphocytes, eosinophils, and occasional plasma cells were interspersed among the neoplastic cell population. Mitoses were frequent. The small lymphoid cells focally infiltrate through the wall of some tubules and small veins. A variable pattern of sclerosis was present throughout much of the tumor. Also there were non-specific granulomas. Immunohistochemical staining revealed that the large cel1s were B cells (CD20 positive) and conclusively lambda light chain restriction. The smaller reactive lymphoid cells were composed of a mixture of B cells and T cells (CD3, UCHL-1 positive). The DNA analysis of lymphoma shows a diploidy DNA content. S phase fraction is 21%. To date, the patient, who treated with chemotheraphy, remains well 9 months after diagnosis. Most lymphomas of testis and epididymis occur in older men, have an intermediate or high grade, diffuse histology, disseminate early, and follow an aggressive clinical course. This case is some similar to the conventional most lymphomas of testis and epididymis. But unusual fetures included that the tumor showed only confined to the epididymis and marked sclerosis.
Aged ; B-Lymphocytes ; Diagnosis ; Diploidy ; DNA ; Eosinophils ; Epididymis* ; Granuloma ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell* ; Male ; Mitosis ; Plasma Cells ; S Phase ; Sclerosis ; T-Lymphocytes ; Testis ; Veins