To investigate the role of cyclin B1 and cdc2 in the pathogenesis and progression of malignant lymphoma, 68 cases of nodal non-Hodgkin's lymphoma were examined about the expression of cyclin B1 and cdc2 along with p53 and Ki-67 by immunohistochemical method. The correlation of their expression with various clinicopathologic findings was also analyzed. Cyclin B1 and cdc2 were diffusely expressed in 39 cases (57.4%) and 54 cases (79.4%) out of 68 cases studied, respectively. The mean labeling indices of cyclin B1 and cdc2 in malignant lymphoma were 31.9% and 68.0%, respectively. In normal lymphoid tissues, cyclin B1 and cdc2 were expressed predominantly in the germinal center with mean labeling indices of 13.9% and 28.3%, respectively. The correlation between the expression of cyclin B1 and cdc2 was noted (p=0.013). The expression of Ki-67 was correlated with that of cyclin B1 (p=0.023) and marginally correlated with that of cdc2 (p=0.056). The expression of cdc2 and p53 in complete remission group to chemotherapy was lower than that of progressive disease group (p=0.047, p=0.049). In multivariate analysis, the clinical stage alone showed significance on overall survival (p=0.049). In conclusion, cyclin B1 and cdc2 appeared to be involved in the genesis or progression of malignant lymphoma and cdc2 can be a useful marker for response to chemotherapy.
Adolescent ; Adult ; Aged ; CDC2 Protein Kinase/*biosynthesis ; Child ; Child, Preschool ; Cyclin B/*biosynthesis ; Cyclin B1 ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/biosynthesis ; Lymph Nodes/metabolism/pathology ; *Lymphoma, Non-Hodgkin/metabolism/mortality/pathology ; Male ; Middle Aged ; Palatine Tonsil/metabolism/pathology ; Predictive Value of Tests ; Prognosis ; Survival Analysis ; Tumor Suppressor Protein p53/biosynthesis

Fifty three bile specimens from 42 patients were reviewed to assess the diagnostic role of the bile cytology and to define more reliable cytologic indicators of malignancy. Forty three bile specimens came from 34 patients with malignant biliary strictures and 10 bile specimens were from eight patients with benign conditions. There were no false positives. The diagnostic specificity of bile cytology was 100% while diagnostic sensitivity was 55.8%. Overall diagnostic accuracy was 64.2%. We identified four key criteria as cytologic indicators of malignancy among 20 variables by using multiple regression analysis: loss of honeycomb arrangement, hyperchromatism, increased N/C ratio, and coarse chromatin. When bile specimens with three or more of these four criteria are thought to represent malignancy, the sensitivity of diagnosis of malignancy was 65.2%, specificity was 90% and diagnostic accuracy was 69.8%.
Adult ; Aged ; Bile/cytology* ; Bile Duct Neoplasms/diagnosis* ; Cell Nucleus/pathology ; Cholestasis/diagnosis* ; Chromatin/pathology ; Diagnosis, Differential ; Female ; Human ; Male ; Middle Age ; Pancreatic Neoplasms/diagnosis* ; Regression Analysis ; Sensitivity and Specificity

The author classified 38 cases of malignant lymphoma involving the skin primarily or secondarily by the new WHO classification with minor modifications and carried out RNA in situ hybridization and/or polymerase chain reaction (PCR) to investigate the role of Epstein-Barr virus (EBV). A case was follicular lymphoma of B cell origin and 37 cases were malignant lymphomas of T cell origin, including 15 cases of Mycosis fungoides/Sezary syndrome, five cases of subcutaneous panniculitis-like T cell lymphomas, a case of anaplastic large cell lymphoma, and four cases of primary cutaneous CD30 T cell lymphoproliferative disorders. There were eight cases of unspecified peripheral T cell lymphomas, in which four cases were composed of medium-sized cells, three cases of large cells, and a case of lymphoepithelioid cells. Four cases of nasal and nasal type NK/T cell lymphomas and three cases of unspecified peripheral T cell lymphomas showed EBV genome. The nasal and nasal type NK/T cell lymphomas, especially those involving the nasal cavity, showed close association with the EBV infection.
Classification ; Epstein-Barr Virus Infections ; Genome ; Herpesvirus 4, Human* ; In Situ Hybridization ; Lymphoma* ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphoproliferative Disorders ; Nasal Cavity ; Polymerase Chain Reaction ; RNA ; Skin*

Primary spinal glioblastoma multiforme is very rare, especially in childhood. 13-year-old boy was admitted to our neurosurgical department because of paraparesis, sensory loss below T10 and sphincter disturbance. Thoracic myelogram showed complete obstruction at T10 level and total laminectomy with partial removal of the intramedullary cord tumor mass was performed under the impression of spinal cord tumor. Postoperatively, his symptoms and signs unchanged. Pathological diagnosis was intramedullary glioblastoma multiforme involving thoracic cord.
Adolescent ; Child* ; Diagnosis ; Glioblastoma* ; Humans ; Laminectomy ; Male ; Paraparesis ; Spinal Cord Neoplasms

Malignant Meningioma is rare and its initial clinical course tends to be short but otherwise indistinguishable from that of benign meningioma. And although it has been noted that many of them have propensities for invading the dural venous sinuses, the skull, and even extracranial tissues by direct spread, there seems little tendency for these to metastases. The changes of recurrence and eventual death are high in malignant meningioma. Recently we have experienced a case of malignant meningioma involving the right frontal bone and frontal lobe with infiltration to the adjacent structures.
Frontal Bone* ; Frontal Lobe* ; Meningioma* ; Neoplasm Metastasis ; Recurrence ; Skull

Malignant Meningioma is rare and its initial clinical course tends to be short but otherwise indistinguishable from that of benign meningioma. And although it has been noted that many of them have propensities for invading the dural venous sinuses, the skull, and even extracranial tissues by direct spread, there seems little tendency for these to metastases. The changes of recurrence and eventual death are high in malignant meningioma. Recently we have experienced a case of malignant meningioma involving the right frontal bone and frontal lobe with infiltration to the adjacent structures.
Frontal Bone* ; Frontal Lobe* ; Meningioma* ; Neoplasm Metastasis ; Recurrence ; Skull

Pineal germinoma is one of the most radiosensitive intracranial tumors and so recently a regime of radiotherapy combined with ventricular shunting was advocated. But not infrequently seeding through the subarachnoid space and shunting system was observed. We have experienced a pineal tumor, which was treated completely by irradiation following ventriculo-atrial shunt but without evidence of intracranial recurrence spinal metastasis occurred 16 months later. After myelography total laminectomy from L1 to L3 was performed and intradural tumor was removed. Histopathological diagnosis was germinoma. After would healing spinal axis irradiation was performed with symptomatic improvement.
Axis, Cervical Vertebra ; Cauda Equina* ; Diagnosis ; Germinoma* ; Laminectomy ; Myelography ; Neoplasm Metastasis* ; Pinealoma ; Radiotherapy ; Recurrence ; Subarachnoid Space

Cytologic features of conventional chordoma have been described and most reports emphasize the presence of large cells with numerous well defined cytoplasmic vacuoles or physaliferous cells. We report fine needle aspiration cytologic (FNAC) findings of a case of chordoma without physaliferous cells. The smear was cellular and composed of large cohesive clusters or individually scattered cells in mucinous background. The round or cuboidal cells had centrally located nuclei with fine granular chromatin, inconspicuous nucleoli, and occasional vacuolated cytoplasm. Mild to moderate pleomorphism was noted. Physaliferous cells are extremely helpful when present in cytologic material, but they are not necessary for diagnosis. Thus clinical history, roentgenographic appearance, and exact location of the lesion are required for the successful interpretation of presacral aspirates together with cytologic findings.
Biopsy, Fine-Needle ; Chordoma* ; Chromatin ; Cytoplasm ; Diagnosis* ; Mucins ; Vacuoles

BACKGROUND: Subarachnoid block is widely used for cesarean section due to the rapid induction, the complete analgesia, the low failure rate and the prevention of aspiration pneumonia. The addition of intrathecal opioids to local anesthetics seems to improve the quality of analgesia & prolong the duration of analgesia. Therefore we compared the effects of fentanyl 20 microg and sufentanil 2.5 microg, which were added to intrathecal hyperbaric bupivacaine. METHODS: Seventy two healthy term parturients were randomly divided into three groups: Group C (control), Group F (fentanyl 20 microg) and Group S (sufentanil 2.5 microg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen by Harten et al. We observed the maximal level of the sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and the side effects. RESULTS: There were significant differences between the control and the fentanyl 20 microg and sufentanil 2.5 microg groups for the degree of muscle relaxation, the quality of intraoperative analgesia, the maximal sedation level and the duration of effective analgesia. The frequencies of side effects such as nausea and pruritis in the opioid groups were higher than those in the control group. But there were no differences between fentanyl 20 microg and sufentanil 2.5 microg for the frequencies of nausea and pruritis. CONCLUSIONS: The addition of fentanyl 20 microg or sufentanil 2.5 microg for spinal anesthesia provides adequate intraoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Humans ; Infant, Newborn ; Mothers ; Muscle Relaxation ; Nausea ; Pneumonia, Aspiration ; Pregnancy ; Pruritus ; Sufentanil

Eisenmenger's syndrome describes the elevation of pulmonary arterial (PA) pressure to the systemic level caused by an increased pulmonary vascular resistance with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. We report a case of an emergent craniotomy for cerebellar abscess in a 21-year-old male patient with Eisenmenger syndrome secondary to Large VSD. A PA catheter was inserted via right femoral vein, but could not be advanced pass the pulmonic valve. After futile attempts to place the catheter tip in the right ventricle. Anesthesia was induced with etomidate, rocuronium, midazolam and fentanyl and maintained with only high dose fentanyl. Milinone and norepinephrine were infused continuously to decrease right to left shunt. He was transferred to the intensive care unit under intubated state and treated with antibiotics for a few days due to intermittent high fever. The operation ended without major complications and the patient was discharged 42 days later.
Abscess ; Androstanols ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Craniotomy ; Eisenmenger Complex ; Etomidate ; Femoral Vein ; Fentanyl ; Fever ; Heart Ventricles ; Humans ; Hypogonadism ; Intensive Care Units ; Male ; Midazolam ; Milrinone ; Mitochondrial Diseases ; Norepinephrine ; Ophthalmoplegia ; Vascular Resistance ; Young Adult