Adenoid cystic carcinoma of the major salivary gland is a relatively rare tumor which is well known for its high local recurrence rate and frequent distant metastasis. Metastasis of this tumor to kidney has not been reported previously to our knowledge. We report two cases of renal metastasis from adenoid cystic carcinoma of the salivary gland.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Kidney ; Neoplasm Metastasis* ; Recurrence ; Salivary Glands*

PURPOSE: To describe MR findings of cerebral venous sinus thrombosis. MATERIALS AND METHODS: We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow-up study obtained in 4 patients. RESULTS: The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transvere sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1 - and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was present in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow-up study of seven to 29 days intervals. CONCLUSION: It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thromosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.
Diagnosis, Differential ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sinus Thrombosis, Intracranial* ; Thrombosis

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Cytokines produced by immune cells infiltrating pancreatic islets have been implicated as one of the important mediators of beta-cell destruction in insulin-dependent diabetes mellitus. In this study, the protective effects of epigallocatechin gallate (EGCG) on cytokine-induced beta-cell destruction were investigated. EGCG effectively protected IL-1beta and IFN-g-mediated cytotoxicity in insulinoma cell line (RINm5F). EGCG induced a significant reduction in IL-1b and IFN-gamma-induced nitric oxide (NO) production and reduced levels of the inducible form of NO synthase (iNOS) mRNA and protein levels on RINm5F cells. The molecular mechanism by which EGCG inhibited iNOS gene expression appeared to involve the inhibition of NF-kB activation. These findings revealed EGCG as a possible therapeutic agent for the prevention of diabetes mellitus progression.
Animals ; Blotting, Western ; Catechin/*analogs & derivatives/*pharmacology ; Cell Line ; Cell Survival/drug effects ; Cytokines/*antagonists & inhibitors/pharmacology ; Interferon Type II/antagonists & inhibitors/pharmacology ; Interleukin-1/antagonists & inhibitors/pharmacology ; Islets of Langerhans/cytology/*drug effects ; Nitric-Oxide Synthase/metabolism ; Nitrites/metabolism ; Tea/*chemistry

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

BACKGROUND: Although regional lymph-ode metastasis from early gastric cancer (EGC) is rare, it is well known that EGC patients with lymph-ode metastasis constitute a high-isk group for recurrence. Thus, it is important to clarify the characteristics of patients having lymph-ode metastasis in order to ascertain the optimal therapy. METHODS: We analyzed the clinical aspects of 34 cases of node-ositive EGC and compared them to 197 cases of node-egative EGC. All patients were operated on from June 1994 to December 1997 at Ajou University Hospital. Also, by using immunohistochemical staining, we examined the expression of cathepsin D in the tumors to identify its significance in EGC. RESULTS: Lymph-ode involvement correlated significantly with deeper tumor invasion, severity of lymphatic invasion, and larger tumor size. Age, sex, histologic type, location, gross appearance, and serum carcinoembryonic antigen (CEA) level were unrelated to lymph-ode involvement. Positive cytoplasmic staining for cathepsin D was detected in 100% of the tumors, and strongly positive staining was found in 33.3%. Also, strong positivity was found more frequently in tumors with lymph-ode involvement. CONCLUSION: Prophylactic lymph-ode dissection may be necessary for patients with EGC with submucosal invasion, lymphatic invasion, and larger tumor size. Also, cathepsin D can be a useful tool for understanding the pathophysiology of early gastric cancer.
Carcinoembryonic Antigen ; Cathepsin D ; Cytoplasm ; Humans ; Neoplasm Metastasis* ; Recurrence ; Risk Factors* ; Stomach Neoplasms

Gastric emptying in patients after several upper gastrointestinal surgeries was studied using the acetaminophen method. The subjects consisted of 23 gastric cancer patients, 2 duodenal ulcer patients, 5 periampullary cancer patients and 4 normal subjects. As an indicator of the gastric emptying rate, the serum acetaminophen concentration was measured by fluorescence polarization immunoassay, in units of g/ml, at 0, 30, 60, 120, and 180 minutes after ingestion of a liquid meal with 1.5 g of acetaminophen. In the normal subjects, the acetaminophen concentrations were 0, 16.35+/-5.06, 18.71+/-5.58, 16.38+/-4.82, and 11.09+/-3.62 g/ml at time 0, 30, 60, 120, and 180 min, respectively. The concentration peaked at 60 min after ingestion of the test meal in the normal subjects. We observed significant delayed gastric emptying after pancreas preserving pancreaticoduodenectomy (PPPD) and a standard Whipple's operation in the early postoperative period. In all patients with a subtotal gastrectomy, a truncal vagotomy was done. However, in patients with a pancreaticoduodenectomy, the vagus nerves were preserved. The gastric emptying pattern was different between the patients with a subtotal gastrectomy and the patients with a pancreaticoduodenectomy, despite similar reconstructions of the gastroenterostomy (Billroth I or Billroth II type reconstruction). There was more rapid gastric emptying in patients with a truncal vagotomy and pyloroplasty than in the normal subjects. Hence, we speculate that the truncal vagotomy was the main cause of the different gastric emptying between the patients with a pancreaticoduodenectomy and the patients with a subtotal gastrectomy.
Acetaminophen* ; Duodenal Ulcer ; Eating ; Fluorescence Polarization Immunoassay ; Gastrectomy ; Gastric Emptying* ; Gastroenterostomy ; Humans ; Meals ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Period ; Stomach Neoplasms ; Vagotomy, Truncal ; Vagus Nerve

PURPOSE: To evaluate characteristic MR findings of primary cardiac and pericardiac tumors. MATERIALS AND METHODS: There were myxomas (n=7), malignant lymphoma (n=l), lipoma (n=l), and pericardiac mesotheliomas (n=2). We analyzed location, size, shape, signal intensity, contrast enhancement, and associated findings of adjacent structures such as pericardiac and pleural effusion, and mediastinal lymph node enlargement. RESULTS: Locations of the myxomas were left atrium in four cases, left ventricle in one, right atrium in one, and right ventricle in one. Mean diameter was 3.5cm (range, 2-7cm). They were polypoid or Iobulated in shape, and attached to interatrial or interventricular septurn in all cases except in right atrial myxoma which was attached to lateral wall. Their peduncles were demonstrated in three left atrial myxomas. The signal intensities were iso or slightly high on T1-weighted images and high on T2-weighted images. Pleural and pericardial effusions were shown in the three cases. Malignant lymphoma was manifested as large mass in right ventricle infiltrating to right atrium, interventricular septum, right paratracheal and retrocardiac area. It had slightly high intensity in both T1- and T2-weighted images with a strong contrast enhancement and associated with both pericardiac and pleural effusion. Lipoma was polypoid in shape and attached to lateral wall of left ventricle with bright T1 and high T2 signal intensity. Pericardiac mesothelioma was manifested as a pericardiac and atrial mass with diffuse irregular uneven thickening of pericardium which had iso signal on T1- and high T2-weighted images with moderate contrast enhancement. Conculsion: MR imaging is a very useful method in demonstration of the location, extent, tissue characteristics of the mass, and relationship with its adjacent structu res in evaluation of cardiac and pericardiac tumors.
Heart Atria ; Heart Ventricles ; Lipoma ; Lymph Nodes ; Lymphoma ; Magnetic Resonance Imaging* ; Mesothelioma ; Myxoma ; Pericardial Effusion ; Pericardium ; Pleural Effusion

This essay illustrates the various CT findings of the hepatic venous invasion of the hepatocellular carcinoma with an anglographic correlation. The thrombosed hepatic vein is directly visualized as a dilated tubular structure or multiple nodules of the similar attenuation to that of the parenchymal tumor, connecting the parenchymal tumor and the inferior vena cava on contrast enhanced CT scans. Enhancement of the thrombosed vein on spiral CT scans obtained in early arterial phase can suggest thrombosis caused by tumor invasion rather than a simple thrombosis. When the thrombosed hepatic vein is not directly visualized and replaced by a large tumor, the tumor thrombi within the inferior vena cava or right atrium can suggest the presence of the hepatic venous invasion.
Carcinoma, Hepatocellular* ; Heart Atria ; Hepatic Veins* ; Thrombosis ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Veins ; Vena Cava, Inferior

BACKGROUND/AIMS: The most effective method of improving survival in patients with HCC is early diagnosis and curative hepatic resection. However, longterm survival after curative resection remains low because of high recurrence rate after resection. The purpose of the study is to assess the prognosis and the efficacy of the various treatment modalities on recurrent HCC after curative resection. METHODS: The clinical records of 50 patients with recurrent HCC were reviewed retrospectively who underwent curative surgery in Yonsei University, Severance Hospital from Jan. 1987 through Oct. 1994. The cummulative recurrent rate after resection, the response rate of treatment after resection, the median progression free survival and the survival after recurrence according to the treatment modalities were evaluated. RESULTS: The cummulative recurrent rate after resection was 3.9% at 3 month, 8.3% at 6 month, 14.1% at 12 month, 21.5% at 24 month, 23.4% at 36 month and 24.4% at 60 month. The response rate of treatment after recurrence was 23.7% (9 patients). The median progression free survival of the patient with reoperation and hepatic embolization was 13.9 months, that of conservative treatment group was 6.8 months and that of no treatment group was 4 months(p = 0.004). The survival after recurrence of HCC was 19.7 months in reoperation and hepatic embolization group, 11.4 months in multimodality group, 16.9 months in conservative treatment group and 8.4 months in no treatment group(p=0.0998). CONCLUSION: Reoperation and hepatic embolization for HCC after curative resection was effective in improving progression free survival, but overall survival were not significantly different according to the treatment modalities. This results proposed that reoperation and hepatic embolization for recurrent HCC after curative resection improve progression free survival.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Early Diagnosis ; Humans ; Prognosis* ; Recurrence ; Reoperation ; Retrospective Studies