F-18 FDG-PET/CT could be used to evaluate the surveillance of recurrent stomach cancer, but some cases reported as false-positives. The authors found an activated charcoal granuloma from intraperitoneal chemotherapy by using a curative resection and mitomycin C for stomach cancer. A mass behind the right colon that showed on CT 6 months after an operation in a 46-year-old male patient had no progression in size, but 36 months after the operation, an increase was seen on F-18 FDG-PET/CT, and a metastatic tumor was suspected. The tumor was resected by an explorative laparotomy and was diagnosed as being an activated charcoal granuloma based on the histologic finding. Based on this case, we should be reminded of the possibility of a false-positive on analysis of F-18 FDG-PET/CT caused by an activated charcoal granuloma in a patient who has intraperitoneal chemotherapy.
Charcoal* ; Colon ; Drug Therapy* ; Granuloma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Mitomycin ; Stomach Neoplasms

BACKGROUND: The correlation between the high resolution computed tomography(HRCT) emphysema score and the physiologic parameters including resting and exercise pulmonary function test was investingated in 14 patients(60.6±10.3 years) with pulmonary emphysema. METHODS: The patients underwent a HRCT, a resting pulmonary function test, and incremental exercise testing(cycle ergometer, 10 W/min). Computed tomography scans were obtained on a GE highlight at 10 mm intervals using 10 mm collimation, from the apex to the base after a full inspiration. The emphysema scores wer determined by a CT program 'Density mask' outlining the areas with attenuation values less than -900 HU, indicating the emphysema areas, and providing an overall percentage of lung involvement by emphysema. RESULTS: Among the resing PFT parameters, only the diffusing capacity(r=-0.75) and PaO2 (r=-0.66) correlated with the emphysema score(p<0.05). Among the exercise test parameers, the emphysema score correlated significantly with the maximum power(r=-0.74), maximum oxygen consumption(r=-0.68), anaerobic threshold(V-slope method : r=-0.69), maximal O2-pulse(r=-0.73), and the physiologic dead space ratio at the maximum workload(r=-0.80)(p<0.01). CONCLUSION: We could find that exercise testing parameters showed a much better correlation with the HRCT emphysema score, which is known to have a good correlation with the pathologic severity than the resting PFT parameters. Therefore it is suggested that exercise testing is superior to resting PFT for estimating in the estimation of the physiologic disturbance in emphysema patients.
Emphysema* ; Exercise Test ; Humans ; Lung ; Oxygen ; Pulmonary Emphysema ; Respiratory Function Tests

BACKGROUND: Histological analysis of tuberculosis shows a spectrum of findings, from well formed granulmatous inflammation with few bacilli in patient with normal immune response to M. tuberculosis to poorly formed granulomatous inflammation with many bacilli in patient with defective immune response. To evaluate the degree of immune response to M. tuberculosis, we studied the histologic features, including the presence of acid fast bacilli(AFB) in lymph node of patients with cervical tuberculous lymphadenitis, and compared them with clinical characteristics. METHODS: We reviewed the histologic features of 33 cases of cervical tuberculous lymphadenitis and processed the excised nodes for auramine-rhodamine staining to detect AFB. The AFB positivity in tissue was compared with the histologic features(degree of granuloma formation, presence of caseation necrosis, presence of neutrophilic infiltration) and clinical characteristics (lymph node size, duration of symptom, presence of local symptom or radiologic evidence of pulmonary tuberculosis). RESULTS: 1) The mean age at diagnosis was 42.4 years, and male to female ratio was 1 : 45. 2) Histologically, all cases showed well formed granuloma and variable degrees of caseation necrosis, and 39% of the cases showed neutrophilic infiltration in the granulomatous inflammation. 3) AFB were confirmed in 52% of the cases, and they were found extracellularly and at the periphery of caseation necrosis. 4) There was no association between AFB Positivity and histological features or clinical characteristics. CONCLUSION: Cervical tuberculous lymphadenitis showed well formed granulomatous inflammation with caseation necrosis, and there was no association between AFB positivity in the tissue and histological or clinical characteristics.
Diagnosis ; Female ; Granuloma ; Humans ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Male ; Necrosis ; Neutrophils ; Tuberculosis ; Tuberculosis, Lymph Node*

Increased expression of glucose transporter1 (GLUT1) has been reported in many human cancers. We hypothesized that the degree of GLUT1 might provide a useful biological information in gastric adenocarcinoma. RT-PCR and immunostaining were used to analyze GLUT1 expression in gastric cancer. RT-PCR showed GLUT1 expression was not largely detected in normal gastric tissue but was detected in cancerous gastric tissue of counterpart. By immunohistochemistry, GLUT1 protein was absent in normal gastric epithelium and intestinal metaplasia. 11 of 65 patients with gastric adenocarcinoma had specific GLUT1 immunostaining in a plasma membrane pattern with varied intensities. GLUT1 protein did not show any significant correlation with tumor stage and nodal metastasis (p+AD4-0.05 by Mann-Whitney test). However, the positive immunostaining for GLUT1 is associated with intestinal differentiation (p+AD0-0.003). Our results suggest that GLUT1 protein is associated with intestinal type of gastric cancer.
Adenocarcinoma/pathology ; Adenocarcinoma/chemistry+ACo- ; Adult ; Aged ; Female ; Gastric Mucosa/pathology ; Gastric Mucosa/chemistry+ACo- ; Human ; Intestines ; Male ; Metaplasia ; Middle Age ; Monosaccharide Transport Proteins/analysis+ACo- ; Neoplasm Proteins/analysis+ACo- ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms/pathology ; Stomach Neoplasms/chemistry+ACo- ; Tumor Markers, Biological/analysis+ACo-

Increased expression of glucose transporter1 (GLUT1) has been reported in many human cancers. We hypothesized that the degree of GLUT1 might provide a useful biological information in gastric adenocarcinoma. RT-PCR and immunostaining were used to analyze GLUT1 expression in gastric cancer. RT-PCR showed GLUT1 expression was not largely detected in normal gastric tissue but was detected in cancerous gastric tissue of counterpart. By immunohistochemistry, GLUT1 protein was absent in normal gastric epithelium and intestinal metaplasia. 11 of 65 patients with gastric adenocarcinoma had specific GLUT1 immunostaining in a plasma membrane pattern with varied intensities. GLUT1 protein did not show any significant correlation with tumor stage and nodal metastasis (p+AD4-0.05 by Mann-Whitney test). However, the positive immunostaining for GLUT1 is associated with intestinal differentiation (p+AD0-0.003). Our results suggest that GLUT1 protein is associated with intestinal type of gastric cancer.
Adenocarcinoma/pathology ; Adenocarcinoma/chemistry+ACo- ; Adult ; Aged ; Female ; Gastric Mucosa/pathology ; Gastric Mucosa/chemistry+ACo- ; Human ; Intestines ; Male ; Metaplasia ; Middle Age ; Monosaccharide Transport Proteins/analysis+ACo- ; Neoplasm Proteins/analysis+ACo- ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms/pathology ; Stomach Neoplasms/chemistry+ACo- ; Tumor Markers, Biological/analysis+ACo-

PURPOSE: The expression of matrix metalloproteinase-2 (MMP- 2) by cancer cells has been implicated in metastasis through cancer cell invasion of the basement membranes mediated by a degradation of collagen IV. However, the MMP-2 proenzyme requires proteolytic activation for its physiologic or pathologic role. We tried to 1) compare expression and activation of MMP-2 in breast cancers with benign tumors, 2) determine the correlation between the actviation of MMP-2 in breast cancer and established prognostic factors, 3) observe whether MMP-2 is expressed and activated in axillary lymph nodes as well, and 4) determine the degree of correlation between MMP-2 activity in lymph nodes and metastatic status, if MMP-2 is expressed in lymph node. METHODS: The specimens came from 11 fibroadenomas, 32 invasive ductal carcinoma and 129 axillary lymph nodes from cancer cases. Pro-MMP-2 cDNA transfected MDA-MB-231 cells were cultured and the conditioned media from them was used for a control. Zymography was used to monitor MMP-2 activation through the detection of the inactive proenzyme form (72 kDa) and the active form (62 kDa). Immunohistochemical staining was also performed for the localization of MMP-2 expression in tissues. RESULTS: 1) 72 kDa was expressed in all fibroadenomas and cancers, while 62 kDa was expressed in only 10 cases of fibroadenomas and all cancers. MMP-2 activity (62 kDa/72 kDa +62 kDa) was significantly higher in cancers than in fibroadenomas (P=0.014). 2) MMP-2 activity in cancers was significantly correlated with nodal metastasis (P=0.040). 3) The expression of MMP-2 in lymph nodes was very low and MMP-2 activity was not correlated with metastatic status. However, the immunohistochemical staining showed different staining patterns between the metastatic and non-metastatic nodes. CONCLUSION: We suggest that a measurement of the activation of MMP-2 could be useful as a prognostic marker representing metastatic potential in breast cancer. However, the low expression of MMP-2 in lymph nodes is an interesting subject for further study.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Collagen ; Culture Media, Conditioned ; DNA, Complementary ; Fibroadenoma ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis*

PURPOSE: The expression of matrix metalloproteinase-2 (MMP- 2) by cancer cells has been implicated in metastasis through cancer cell invasion of the basement membranes mediated by a degradation of collagen IV. However, the MMP-2 proenzyme requires proteolytic activation for its physiologic or pathologic role. We tried to 1) compare expression and activation of MMP-2 in breast cancers with benign tumors, 2) determine the correlation between the actviation of MMP-2 in breast cancer and established prognostic factors, 3) observe whether MMP-2 is expressed and activated in axillary lymph nodes as well, and 4) determine the degree of correlation between MMP-2 activity in lymph nodes and metastatic status, if MMP-2 is expressed in lymph node. METHODS: The specimens came from 11 fibroadenomas, 32 invasive ductal carcinoma and 129 axillary lymph nodes from cancer cases. Pro-MMP-2 cDNA transfected MDA-MB-231 cells were cultured and the conditioned media from them was used for a control. Zymography was used to monitor MMP-2 activation through the detection of the inactive proenzyme form (72 kDa) and the active form (62 kDa). Immunohistochemical staining was also performed for the localization of MMP-2 expression in tissues. RESULTS: 1) 72 kDa was expressed in all fibroadenomas and cancers, while 62 kDa was expressed in only 10 cases of fibroadenomas and all cancers. MMP-2 activity (62 kDa/72 kDa +62 kDa) was significantly higher in cancers than in fibroadenomas (P=0.014). 2) MMP-2 activity in cancers was significantly correlated with nodal metastasis (P=0.040). 3) The expression of MMP-2 in lymph nodes was very low and MMP-2 activity was not correlated with metastatic status. However, the immunohistochemical staining showed different staining patterns between the metastatic and non-metastatic nodes. CONCLUSION: We suggest that a measurement of the activation of MMP-2 could be useful as a prognostic marker representing metastatic potential in breast cancer. However, the low expression of MMP-2 in lymph nodes is an interesting subject for further study.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Collagen ; Culture Media, Conditioned ; DNA, Complementary ; Fibroadenoma ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis*

PURPOSE: The present study is to investigate the clinical utility of tumor marker cutoff ratio (TMR) and develop a TMR combination scoring system based on preoperative tumor marker (TM) levels to prognosis prediction in gastric cancer. METHODS: We include 1,142 patients for whom two or more TMs were measured and who underwent radical gastrectomy between 1990 and 2003. RESULTS: Five-year risk of recurrence (5 YRR) for carcinoembryonic antigen (CEA) TMRs were 18.3%, 29.8%, 61.4% for TMR < 1.0, 1.0 < or = TMR < 2.0, TMR > or = 2.0 respectively. 5 YRR for carbohydrate antigen 19-9 (CA 19-9) TMR were 19.7%, 35.6%, 58.4% for TMR < 1.0, 1.0 < or = TMR < 3.0, TMR > or = 3.0, respectively. 5 YRR for carbohydrate antigen 72-4 (CA 72-4) TMR were 15.2% and 33.6% for TMR < 1.0 and TMR > or = 1.0, respectively. We defined high TMR (TMR > or = 2.0 for CEA, TMR > or = 3.0 for CA19-9), low TMR (1.0 < or = TMR < 2 for CEA, 1.0 < or = TMR < 3.0 for CA 19-9 and 1.0 < or = TMR for CA72-4) and negative TMR (TMR < 1.0 for all TMs). A TMR combination scoring system was devised with negative scored as zero points, low as 1 and high as 2 for each TMR. TMR scores were divided into four categories (score 0, 1, 2, 3 and above) based on the calculated TMR score and 5 YRR were found to be 12.8%, 23.9%, 45.5%, and 68.3%, respectively (P < 0.05). Multivariate analysis showed that our scoring system was a significant independent prognostic factor. CONCLUSION: Preoperative TMRs such as CEA, CA 19-9, and CA 72-4 show a correlation with prognosis and the TMR combination scoring system could be a useful tool for the prediction of prognosis in gastric cancer.
Biomarkers, Tumor ; Carcinoembryonic Antigen* ; Cinnarizine ; Gastrectomy ; Humans ; Multivariate Analysis ; Prognosis ; Recurrence ; Stomach Neoplasms*

OBJECTIVE: This study evaluated the prognostic factors that influence the surgical outcomes of elderly patients older than 65 years old with an aneurysmal subarachnoid hemorrhage. METHODS: Ninety-two patients older than 65 years old, who were operated in our hospital between 1998 and 2005, were reviewed retrospectively. The clinical outcomes were evaluated using the modified Rankin Scale three months after surgery. RESULTS: The preoperative neurological status, such as the Hunt-Hess grade (p<0.001), World Federation of Neurological Surgeons (WFNS) grade (p<0.001), and the Fisher grade (p=0.001), was significantly associated with the surgical outcomes in this series. The vasospasm (0.016) and ventriculostomy (0.039) are factors influencing the surgical outcomes. However, the other factors including hypertension (0.831), smoking (0.228), accompanying disorder (0.706), size of aneurysms (0.177), location of aneurysms (0.755), shunt operation (0.356), and timing of surgery (0.194) had no influence on the surgical outcome. CONCLUSION: In elderly patients with intracranial aneurysms, the preoperative neurological status, vasospasm, and ventriculostomy are the most significant prognostic factors.
Aged* ; Aneurysm* ; Humans ; Hypertension ; Intracranial Aneurysm ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage* ; Ventriculostomy

OBJECTIVE: This study was designed to investigate the correlation between insertion depth of artificial disc and postoperative kyphotic deformity after Prodisc-C total disc replacement surgery, and the range of artificial disc insertion depth which is effective in preventing postoperative whole cervical or segmental kyphotic deformity. METHODS: A retrospective radiological analysis was performed in 50 patients who had undergone single level total disc replacement surgery. Records were reviewed to obtain demographic data. Preoperative and postoperative radiographs were assessed to determine C2-7 Cobb's angle and segmental angle and to investigate postoperative kyphotic deformity. A formula was introduced to calculate insertion depth of Prodisc-C artificial disc. Statistical analysis was performed to search the correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity, and to estimate insertion depth of Prodisc-C artificial disc to prevent postoperative kyphotic deformity. RESULTS: In this study no significant statistical correlation was observed between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity regarding C2-7 Cobb's angle. Statistical correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity was observed regarding segmental angle (p<0.05). It failed to estimate proper insertion depth of Prodisc-C artificial disc effective in preventing postoperative kyphotic deformity. CONCLUSION: Postoperative segmental kyphotic deformity is associated with insertion depth of Prodisc-C artificial disc. Anterior located artificial disc leads to lordotic segmental angle and posterior located artificial disc leads to kyphotic segmental angle postoperatively. But C2-7 Cobb's angle is not affected by artificial disc location after the surgery.
Congenital Abnormalities ; Humans ; Retrospective Studies ; Total Disc Replacement