Malignant pleural effusion in multiple myeloma (MM) is extremely rare and is associated with poor prognosis. We experienced two cases of MM IgA type with malignant pleural effusion. The diagnoses were based on characteristic cytology and CD138 immunocytochemistry. The patients received several cycles of combination chemotherapy, since symptoms were more aggressive with an uncontrolled pleural effusion. We review the clinical features of these cases and literature concerning myelomatous pleural effusion.
Drug Therapy, Combination ; Humans ; Immunoglobulin A ; Immunohistochemistry ; Multiple Myeloma ; Pleural Effusion ; Pleural Effusion, Malignant ; Prognosis

BACKGROUND: HPV-other samples are designated as being positive on HPV-PCR, but negative when using specific HPV hybridization probes. We wanted to determine the types on the HPV-other samples by performing sequencing, and to know the pathologic status of the uterine cervix according to the HPV type detected on sequencing. METHODS: For HPV genotying, we used the commercially available HPV DNA Chip test, which contains 15 types of high-risk HPV and 9 types of low-risk HPV. The HPV DNA sequencing was performed for the HPV-other samples of 209 patients who subsequently underwent cervical biopsy. RESULTS: For 204 of the 209 samples, the HPV types detected by sequencing were absent types at used HPV DNA chip. For the remaining 5 samples, sequencing was impossible due to mixed peaks. HPV-81 (19.6%), HPV-61 (18.6%), HPV-62 (16.7%) and HPV-84 (13.9%) were frequently detected. For the HPV-81, -62, -71, and -72 samples, most of the samples displayed normal or LSIL. However, HPV-84 and -61 were more associated with HSIL or worse, as compared to the other types. Conclusion: HPV-81, -61, -62 and -84 were frequently found on sequencing analysis of the HPV-other samples. The pathologic status was diverse, according to the HPV type detected on sequencing.
Biopsy ; Cervix Uteri ; Chimera ; DNA ; Female ; Humans ; Oligonucleotide Array Sequence Analysis ; Papillomaviridae ; Sequence Analysis, DNA

Aged ; Aged, 80 and over ; Esophagus ; pathology ; virology ; Herpes Simplex ; diagnosis ; genetics ; pathology ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Simplexvirus ; genetics

Splenic metastasis from gynecologic tumors is extremely rare, especially in the absence of apparent disease at other sites. We report two patients that underwent splenectomy for a solitary splenic metastasis from uterine cervical carcinoma. In case 1, a 54-year-old woman with FIGO Stage IIb squamous cell carcinoma of the uterine cervix treated with radiotherapy and chemotherapy developed a solitary splenic metastasis 10 months after initial treatment. In case 2, a 46-year-old woman with FIGO Stage IIb adenocarcinoma of the uterine cervix treated with radiotherapy and chemotherapy was found to have a solitary splenic metastasis 11 months after treatment. Thus all abdominal organs including the spleen must be evaluated for metastases during follow-up of gynecologic tumors.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

BACKGROUND: Elevated levels of microsatellite alterations at selected tetranucleotide repeat regions (EMAST) have been recently described, and they are a distinct type of microsatellite instability (MSI). We investigated the prevalence of EMAST in squamous cell carcinoma (SCC) of the uterine cervix and we determined the correlation between EMAST and the clinicopathologic parameters, HPV infection and the p53 mutation. METHODS: We examined the 3 mono-, 3 di-, and 5 tetranucleotide repeat markers in 47 cases of SCC, and we performed immunohistochemical staining for p53. HPV detection and genotyping was performed using a commercially available HPV DNA chip. RESULTS: Thirteen out of 47 cases (27.7%) were EMAST(+) with at least one of five tetranucleotide repeat markers. However, MSI at mono- and dinucleo- tide markers was noted in only one case (2.1%). EMAST was not related with stage, size, lymph node metastasis, vascular/lymphatic invasion or the depth of invasion. Positive immunostaining for p53 was significantly more common in EMAST(+) tumors than in the EMAST(-) tumors (p=0.04). HPV-infection was positive in 32 cases. EMAST was not correlated with the state of HPV infection state or the HPV genotype. CONCLUSIONS: 27.7% of the invasive SCCs of the uterine cervix exhibited EMAST, and EMAST in the SCC of the uterine cervix was significantly associated with the p53 mutation.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Genotype ; Lymph Nodes ; Microsatellite Instability* ; Microsatellite Repeats* ; Neoplasm Metastasis ; Oligonucleotide Array Sequence Analysis ; Prevalence

Claudin-7 has recently been suggested to be a distal nephron marker. We tested the possibility that expression of claudin-7 could be used as a marker of renal tumors originating from the distal nephron. We examined the immunohistochemical expression of claudin-7 and parvalbumin in 239 renal tumors, including 179 clear cell renal cell carcinoma (RCC)s, 29 papillary RCCs, 20 chromophobe RCCs, and 11 renal oncocytomas. In addition, the methylation specific-PCR (MSP) of claudin-7 was performed. Claudin-7 and parvalbumin immunostains were positive in 3.4%, 7.8% of clear cell RCCs, 34.5%, 31.0% of papillary RCCs, 95.0%, 80.0% of chromophobe RCCs, and 72.7%, 81.8% of renal oncocytomas, respectively. The sensitivity and specificity of claudin-7 in diagnosing chromophobe RCC among subtypes of RCC were 95.0% and 92.3%. Those of parvalbumin were 80.0% and 88.9%. The expression pattern of claudin-7 was mostly diffuse in chromophobe RCC and was either focal or diffuse in oncocytoma. All of the cases examined in the MSP revealed the presence of unmethylated promoter of claudin-7 without regard to claudin-7 immunoreactivity. Hypermethylation of the promoter might not be the underlying mechanism for loss of its expression in RCC. Claudin-7 can be used as a useful diagnostic marker in diagnosing chromophobe RCC and oncocytoma.
Tumor Markers, Biological/metabolism ; Tumor Cells, Cultured ; Tissue Distribution ; Sensitivity and Specificity ; Reproducibility of Results ; Nephrons/metabolism ; Neoplasm Proteins/metabolism ; Membrane Proteins/analysis/*metabolism ; Kidney Neoplasms/*diagnosis/*metabolism ; Humans ; Carcinoma, Renal Cell/*diagnosis/*metabolism ; Adenoma, Oxyphilic/*diagnosis/*metabolism

This study was conducted to evaluate the temperature rise on the root surface while the root canal is being obturated using continuous wave of condensation technique. Maxillary central incisor was prepared for repeated canal obturation. Ten thermocouples (Omega Engineering Inc., Stanford, USA) were placed at 1 mm increment from the anatomical root apex. The real temperature of Buchanan plugger was recorded before insertion into the root canal. The root canal was obturated with continuous wave of condensation technique as described by Buchanan and the root surface temperature was recorded during obturation at 150degrees C, 200degrees C, 250degrees C and 300degrees C temperature settings of System B HeatSource (Model 1005, Analytic technologies, Redmond, WA, USA). After completion of the temperature recording, the dentinal-cementum thickness at each sites was measured. The data were analyzed using one-way ANOVA followed by Scheffe' s test and linear regression test. The results were as follows. 1. When the temperature was set at 150degrees C, 200degrees C, 250degrees C and 300degrees C on the digital display of System B HeatSource, the real temperature of the plugger at the 1mm point from the tip revealed 130.82+/-2.96degrees C, 158.00+/-5.26degrees C, 215.92+/-6.91degrees C and 249.88+/-3.65degrees C respectively. 2. The position of 8 mm from the anatomical apex showed the highest temperature increase at each temperature settings and it was significantly higher than those of other positions (p<0.01). The temperature rise was constantly increased toward coronal portion from apex of the root. 3. The maximum temperature increase on the root surface was 2.37+/-0.09degrees C at 150degrees C setting, 3.11+/-0.12degrees C at 200degrees C setting, 3.93+/-0.09degrees C at 250degrees C setting and 5.69+/-0.15degrees C at 300degrees C setting respectively. These results suggest that it be relatively kind to the supporting tissues of the root that the root canal is obturated using continuous wave of condensation technique at 150degrees C, 200degrees C, 250degrees C and 300degrees C temperature settings on digital temperature display of System B HeatSource.
Dental Pulp Cavity ; Incisor ; Linear Models

This study was performed to evaluate the actual temperature rise on the surface of Buchanan plugger using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, Redmond, WA, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200degrees C on digital display and the power level on it was set to 10. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 mm increments from the tip to the 4 mm length of shank. The heat control spring was touched for 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01 using Data Logger. The data were statistically analyzed by one-way ANOVA. The results were as follows. 1. The position at which the temperature peaked was approximately at 1~2 mm far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25+/-2.28degrees C in F plugger, 185.94+/-2.19degrees C in FM plugger, 169.51+/-9.12degrees C in M plugger, and 160.79+/-1.27degrees C in ML plugger and the peak temperature was highest in F plugger and followed by, in descending order, FM plugger, M plugger. ML plugger showed the lowest peak temperature (p<0.01). 3. The temperature on the pluggers was decreased with the increase of touching time. This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.
Hot Temperature

BACKGROUND: While neurofibromas have generally been regarded as polyclonal hyperplastic lesions, it remains unclear whether the tumor is a true neoplasm or a hyperplastic lesion. METHODS: Determination of clonality by X chromosome inactivation pattern was investigated in twenty-one cases of neurofibroma employing enzyme digestion and PCR of the HUMARA gene. The histological, immunohistochemical, and ultrastructural characteristics of the tumors were also examined. RESULTS: Immunohistochemically, most of the tumor cells showed vimentin and S-100 protein positivity. Axons were demonstrated by neurofilament protein positivity and were seen mainly at the periphery and rarely in the central portion of the tumor. Ultrastructurally, the tumors were composed of a variety of cell types: perineurial cells, Schwann cells, fibroblasts, and axons. X chromosome inactivation analysis was completed on thirteen out of fifteen cases in which DNA was successfully extracted. Of thirteen neurofibromas that were heterozygous at the HUMARA loci, eleven showed a polyclonal pattern. The remaining two cases were considered as indeterminate for clonality because of unequal band intensity and failure to obtain the normal control DNA. CONCLUSION: The results from this study suggest that neurofibromas are polyclonal in origin and might be a neoplastic lesion comprising non-neoplastic cells among constituent components.
Axons ; Digestion ; DNA ; Fibroblasts ; Immunohistochemistry ; Neurofibroma* ; Polymerase Chain Reaction* ; S100 Proteins ; Schwann Cells ; Vimentin ; X Chromosome Inactivation

BACKGROUND: Tumors are usually considered to be clonal progeny of single transformed cells. Carcinosarcomas and malignant mixed epithelial tumors are examples where controversies exist regarding the singularity or multiplicity of their cell of origin. METHODS: The authors examined the clonality of carcinosarcomas (7 cases) and malignant mixed epithelial tumor (5 cases) in female patients by X-chromosome inactivation as a marker. Each component of the tumors were picked up by the laser capture microscope. The polymorphic exon 1 CAG trinucleotide repeat in the X-linked human androgen receptor (HUMARA) gene was amplified by a polymerase chain reaction before and after treatment of the methylation-sensitive endonuclease HpaII. RESULTS: Eleven cases were informative for clonality determination. Six out of seven carcinosarcomas and three out of four malignant mixed epithelial tumors revealed the same patterns of X-chromosome inactivation, which suggests that they are monoclonal. In contrast, the patterns of X-chromosome inactivation were different between the two tumor components in each cases of carcinosarcoma and malignant mixed epithelial tumor, indicating that they are of polyclonal origin. CONCLUSIONS: These observations show that although most of carcinosarcomas and malignant mixed epithelial tumors are of monoclonal origin, some of them are of polyclonal origin. This finding suggests that these tumors are genuinely polyclonal, and that they originated in the neoplastic transformation of more than one somatic cells
Carcinosarcoma* ; Deoxyribonuclease HpaII ; Exons ; Female ; Humans ; Polymerase Chain Reaction ; Receptors, Androgen ; Trinucleotide Repeats