PURPOSE: As neoplasia is the result of unbalanced cell growth and cell death, alternations in the growth control pathway including the immunity within the individual host-tumor relationship has been attributed to the development of breast cancer. Interferon(IFN)-gamma based immunity was recently reported to have an antitumor effect and some new methods to assess the state of interferon-gamma based immunity have been introduced. Interferon regulatory factor(IRF)-1 and interferon regulatory factor(IRF)-2 are transcriptional factors that mediate the effects of Interferon-gamma. It was suggested that the loss of IRF-1 expression is associated with the loss of tumor suppression and the development of IRF-2 expression is associated with oncogenic activation. Thus, we studied the significances of the IRF-1 and IRF-2 expressions as they are related with some clinicopathological parameters to determine the biological behavior of breast cancer including the menopausal status, tumor size, lymph node status, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the expression of p53 protein. METHODS: Formalin-fixed paraffin embedded specimens from 82 patients with invasive ductal carcinoma were used to evaluate the expression of IRF-1 and IRF-2 by performing immunohistochemical staining with using an avidin-biotin-peroxidase complex technique. RESULTS: The expression of IRF-1 was observed in 80.5 % of the study group. However, the expression of IRF-1 did not show any correlation with menopausal status, tumor size, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the p53 expression. Only lymph node metastasis showed a decreasing tendency of IRF-1 expression, but this was without statistical significance (p=0.075). The expression of IRF-2 was observed in 58.5% of the study group and it did not show any significant relationship with any of the above mentioned clinicopathological parameters. CONCLUSION: This study suggests that the expression of IRF-1 and IRF-2 does not affect the previously established parameters for determining such biological behaviors of breast cancer as the tumor size, lymph node metastasis, the histologic grade, the expression of steroid receptors, the expression of c-erb B2 and the expression of p53. In spite of these results, We'd like to recommend that another study be done to evaluate the role of IRF-1 and IRF-2 for the proper selection of the patients who are suitable for immunotherapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Death ; Humans ; Immunotherapy ; Interferon Regulatory Factors* ; Interferon-gamma ; Interferons* ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Receptors, Steroid

The mainstay of treatment in primary breast cancer is still a radical mastectomy. In the case of advanced breast cancer, preoperative chemotherapy is an alternative treatment method to induce surgical therapy. Although the number of elderly patients with breast cancer is increasing, the knowledge about the possible differences in the biology and clinical outcomes of breast cancer according to age is limited. In addition, elderly patients have difficulties with surgical treatment because of the higher rate of coincident systemic illness, high anesthetic risk and high rate of operation refusals for an operation than those in young patients. As it was well known that elderly patients have better prognoses than younger patients and more estrogen and progesterone receptors in tumor tissue, it was expected that oral chemoendocrine and radiation therapy could be an alternative in elderly patients who refuse surgery. Good results were experienced in our three elderly breast cancer patients when applying these non-surgical treatments.
Aged* ; Biology ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Estrogens ; Female ; Humans ; Mastectomy, Radical ; Prognosis ; Receptors, Progesterone

PURPOSE: Laparoscopy-assisted distal gastrectomy (LADG) is gaining wider acceptance for the treatment of early gastric cancer. However, firm evidence supporting the long-term outcome after LADG for gastric cancer is unknown. This study compared long-term quality of life after LADG versus an open distal gastrectomy (ODG) for early gastric cancer. METHODS: This study included 29 patients who underwent LADG and 57 patients who underwent ODG for the treatment of stage I gastric cancer. Quality of life was evaluated based on the Korean version of EORTC QLQ-C30 (version 3.0) and EORTC QLQ-STO22 one year after surgery. All patients underwent a Billroth II gastrectomy for stage I gastric cancer between January 2003 and December 2004. RESULTS: A total of 86 (58%) out of 154 patients responded to the questionnaire. Demographic features showed no difference between the two groups of patients for age, sex, depth of invasion, lymph node metastasis except for tumor size and the number of retrieved lymph nodes. The mean score for global health status was not statistically different (LADG, 60.3+/-20.4 vs ODG, 57+/-20.6; P=0.413). The total score of 21 items related to stomach cancer (EORTC QLQ-STO22) also was not statistically different (LADG, 68.9+/-64.9 vs ODG, 94.5+/-97.3; P=0.340). CONCLUSION: Based on the results of the Korean version of EORTC QLQ-C 30 (version 3.0) and EORTC QLQ-STO22, LADG does not seem to have any long-term benefit over ODG on 'quality of life'.
Gastrectomy* ; Gastroenterostomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Quality of Life* ; Surveys and Questionnaires ; Stomach Neoplasms

PURPOSE: A colorectal cancer (CRC) is defined as T4 when the tumor directly invades other organs or structures and/or perforates the visceral peritoneum. The purpose of this study was to evaluate the results of a surgical approach and to determine the significant prognostic factors for tumor resectability and survival in patients with advanced T4 CRC. METHODS: A total of 61 patients with T4 CRC with adjacent organ adhesion, who received multivisceral resections at Chonnam University Hospital, Korea, between Jan. 1990 and Dec. 2001, were analyzed retrospectively. RESULTS: Cancer invasion to contiguous organs was present in 51 (83.6%) of the 61 patients who received a multivisceral resection and was absent in 10 (16.4%). Postoperative rates of complications and death were 22.9% and 4.9%, respectively, in the 61 patients. Lymph-node (LN) metastases were presented in 25 patients (41.0%). The 5-year survival rate (5 YSR) was 22.2% in patients with LN metastases, but was significantly higher (66.7%) in patients without LN metastases. The 5 YSRs for the 61 patients according to the AJCC cancer stage (TNM classification) were as follows: stage II (66.7%), stage III (46.4%), and stage IV (0%). CONCLUSIONS: T4 CRC without distant metastases requires multivisceral en-bloc resection of any organ or structure to which the primary tumor is adhered. The presence of LN metastases at the time of surgery is one of the significant factors with a poor prognosis in T4 CRC.
Colorectal Neoplasms* ; Humans ; Jeollanam-do ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Peritoneum ; Prognosis ; Retrospective Studies ; Survival Rate

PURPOSE: Dendritic cells (DCs) are the most potent antigen- presenting cells for initiating the T cell immune response in vivo. Recent studies have shown that active immunotherapy with tumor antigen pulsed DC tumor antigen specific cytotoxic T lymphocyte (CTL) response. The aim of this study was to establish clinically compatible procedures for generating human DCs and to determine if the CEA peptide- pulsed DCs can activate the CEA specific CTL responses in vitro. METHODS: DCs were generated from the peripheral blood monocytes (PBMCs) of HLA A2+ healthy donors using GM-CSF and IL-4. Phenotypic analysis was performed using flow cytometry with FITC- or PE-conjugated Abs against CD1a, CD14, CD80, HLA-DR, CD83 and CD86. The immature DCs were pulsed with a CEA peptide (HLA A2 epitope, [YLSGANLNL]) and the tumor lysates isolated from HLA A2+ CEA positive cell line, NCI-H498, and were incubated with the autologous PBMCs in order to generate an antigen specific CTLs in vitro. After three rounds of stimulation, the presence of a CEA-specific CTL response was determined using a CEA positive cell line as the specific targets with the standard 51Cr release assay, the ELISPOT assay, and the flow cytometry using CEA peptide-MHC tetramer. RESULTS: The DCs obtained after 6 days of culture expressed high levels of CD1a, HLA-DR, and CD80, which corresponded to the immature DC phenotype. The 51Cr- release assay showed that DCs pulsed with the CEA peptide or the lysates of the CEA-positive NCI-H498 cell line could stimulate the CEA-specific CTL responses. The CTL response to DCs pulsed with the CEA peptide was also generated using the DCs pulsed with the CEA peptide. In the ELISPOT assay, the number of CEA peptide-specific, INF-gamma-secreting spots were increased in the CTLs generated by DCs pulsed with the CEA pepide and the tumor lysates. In the peptide-MHC tetramer assay, the CD8+ T cells with the receptors specific to CEA-peptide were increased by stimulation with the DCs pulsed with the CEA peptide and the tumor lysates. CONCLUSION: These findings show that the CEA peptide pulsed DCs can generate CEA specific CTL responses and antigen bearing DCs can be used as the target cells for a cytotoxicity assay. This study provides the foundations for DC-based cancer immunotherapy for CEA expressing solid tumors.
Carcinoembryonic Antigen* ; Cell Line ; Dendritic Cells* ; Enzyme-Linked Immunospot Assay ; Flow Cytometry ; Foundations ; Granulocyte-Macrophage Colony-Stimulating Factor ; HLA-DR Antigens ; Humans ; Immunotherapy ; Immunotherapy, Active ; Interleukin-4 ; Lymphocytes ; Monocytes ; Phenotype ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic* ; Tissue Donors

OBJECTIVE: The overexpression of p16(INK4A) is induced by human papillomavirus (HPV) and associated with the carcinogenesis of cervical epithelia. So, immunostaining of p16(INK4A) may be useful biomarker in detecting CIN of cervix uteri in abnormal cervical lesions. The potential of p16(INK4A) as a biomarker for Atypical squamous cells of undetermined significance (ASCUS) examined in liquid-based specimens. METHODS: We collected samples 30 cases of ASCUS in Thinprep(TM) smears between March 2003 and August 2003. 23 control Thinprep(TM) cases were included; 10 negative for intraepithelial lesions, 13 cervical squamous intraepithelial lesions. p16(INK4A) immunochemial staining was performed on 53samples. At the same time, we tested another cervical swabs of patients by the Hybrid Capture II(TM) test. The cut off value was scored positive if it contained above 5 abnormal cells with nuclear and cytoplasmic immunostaining. RESULTS: The results of p16(INK4A) immunochemial staining comparing with one of HC II(TM) showed negative results with low kappa coefficient of 0.034. The sensitivity of p16(INK4A) immunochemial staining were 30.8% and the specificity were 82.4% respectively (p<0.01). p16(INK4A) is a useful marker for the detection of the cervical intraepithelial neoplasia but is not ASCUS. CONCLUSION: Immunostaining of p16(INK4A) is not useful triage test in detecting abnormal lesion of ASCUS in liquid-based specimens.
Carcinogenesis ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Cyclin-Dependent Kinase Inhibitor p16* ; Cytoplasm ; Female ; Humans ; Sensitivity and Specificity ; Triage

PURPOSE: Bone is the most common site of metastasis from breast cancer. An abnormal bone scan finding, however, is not specific in differentiation of bone metastasis from traumatic or inflammatory bone diseases. The purpose of this study was to identify clinical findings that could help evaluate the etiology of solitary costal hot spots on a bone scan. METHODS: The study included 32 patients (all women, mean age 51+/-1 years) showing solitary costal hot spots on postoperative bone scans performed between January 1998 and December 2002. In order to classify the etiology of solitary costal hot spots as non-malignant or malignant, all available clinical, scintigraphic, laboratory and other radiographic examinations were taken into consideration. RESULTS: The mean follow-up period was 42.5 months. Among 32 hot spots, 7 (21.8%) were metastatic, and the remaining 25 (78.2%) non-malignant. The mean period of first detection after operation was 17.0+/-16.3 months in the metastatic and 26.0+/-21.3 months in the non-malignant groups. The metastatic group was significantly associated with advanced breast cancer. In the localization of rib lesion, 20 (62.5%) of the solitary costal hot spots were in the anterior arc, 5 (15.6%) in the lateral arc and 7 (21.9%) in the posterior arc. In the group with a location at the anterior arc, 16 (80%) were non-malignant, whereas 4 (20%) were malignant. In those localized at the anterior arc, 12 (60%) were on ipsilateral and 8 (28%) were on contralateral. The difference between the hot spots in the ipsilateral and contralateral locations was not significant. The carcinoembryonic antigen (CEA) and CA15-3 were elevated: in 5 (51%) and 3 (43%) patients with metastatic spots, and in 4 (16%) and 1 (4%) patient with non-malignant lesions, which were significantly different. CONCLUSION: It was found that an advanced state of primary breast cancer and the increase of tumor markers (CEA and CA15-3) were the significant factors for the direction of the nature of solitary costal hot spots on postoperative bone scans in patients with breast cancer.
Bone Diseases ; Breast Neoplasms* ; Breast* ; Carcinoembryonic Antigen ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Ribs ; Biomarkers, Tumor

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced diffuse trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin (androgenesis). Partial hydatidiform moles appear to be focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies and associated with a risk of persistent gestational trophoblastic tumor. Recently, hydatidiform moles with a fetus have become more common due to use of assisted reproductive technology. Most patients with hydatidiform mole and coexisting normal fetus must cautioned about the potential for risks of malignant change and severe medical complications, such as preeclampsia, hyperthyroidism and antepartum hemorrhage, that may necessitate prompt pregnancy termination. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 15 gestational weeks. A brief reviews of related literature was done.
Classification ; Female ; Fetus* ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hyperplasia ; Hyperthyroidism ; Incidence ; Pre-Eclampsia ; Pregnancy ; Reproductive Techniques, Assisted ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography

OBJECTIVE: To understand the injury pattern of contact burns from therapeutic physical modalities. METHOD: A retrospective study was done in 864 patients with contact burns who discharged from our hospital from January 2005 to December 2008. The following parameters were compared between patients with contact burns from therapeutic modalities and from other causes: general characteristics, burn extent, cause of burn injury, place of occurrence, burn injury site, treatment methods, prevalence of underlying disease, and length of hospital stay were compared between patients with contact burns. RESULTS: Of the 864 subjects, 94 patients were injured from therapeutic modalities. A hot pack (n=51) was the most common type of therapeutic modality causing contact burn followed by moxibustion (n=21), electric heating pad (n=16), and radiant heat (n=4). The lower leg (n=31) was the most common injury site followed by the foot & ankle (n=24), buttock & coccyx (n=9), knee (n=8), trunk (n=8), back (n=6), shoulder (n=4), and arm (n=4). Diabetes mellitus was associated with contact burns from therapeutic modalities; the odds ratio was 3.99. Injuries took place most commonly at home (n=56), followed by the hospital (n=33), and in other places (n=5). CONCLUSION: A hot pack was the most common cause of contact burns from therapeutic modalities, and the lower leg was the most common injury site. Injuries took place most commonly at home. The patients with contact burns from therapeutic modalities showed high correlation to presence of diabetes mellitus. These results would be helpful for the prevention of contact burns due to therapeutic modalities.
Animals ; Ankle ; Arm ; Burns ; Buttocks ; Coccyx ; Diabetes Mellitus ; Foot ; Heating ; Hot Temperature ; Humans ; Hypogonadism ; Knee ; Leg ; Length of Stay ; Mitochondrial Diseases ; Moxibustion ; Odds Ratio ; Ophthalmoplegia ; Physical Therapy Modalities ; Prevalence ; Retrospective Studies ; Shoulder