Intramedullary spinal cord metastases (ISCM) account for only 3.4% of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM in the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.
Brain ; Humans ; Korea ; Lung Neoplasms ; Neoplasm Metastasis* ; Neurologic Manifestations ; Radiotherapy ; Sphenoid Sinus ; Spinal Cord* ; Syringomyelia

Most of malignant tumors in the urinary bladder is transitional cell carcinoma (TCC) deriving from the urothelium. Clinical stage and histopathologic grading of the TCC of the urinary bladder is important in the determination of the patient's prognosis. To investigate the correlation between the prognostic factors and the expression of the various oncoproteins and growth factors in each grade of the TCC, immunohistochemical stains for c-erbB2, c-myc, c-fos, bcl-2, p53, proliferating cell nuclear antigen (PCNA), and transforming growth factor-alpha (TGF-alpha) were performed in the formalin fixed paraffin embedded tissues of the TCC (Grade I; 15 cases, Grade II; 20 cases, Grade III; 15 cases) of the urinary bladder. The immunoexpression rate of c-erbB2 was immunoexpression 78.0% in the grade I, 85.0% in the grade II, and 95.0% in the grade III TCC. The immunoexpression rate of c-myc, c-fos and bcl-2 was below 5% in each grades of TCC. The p53 immunoexpression was identified in 11.5%, 24.3% and 30.6% of the grade I, II, and III TCC, respectively. The PCNA and TGF-alpha expression was 53.0% and 27.6% in the grade I, 77.3% and 32.7% in the grade II, and 78.2% and 37.3% in the grade III TCC, respectively. These results suggest that the expressions of c-myc, c-fos, bcl-2, and TGF-alpha are similar in each grade of the TCC and the positivity of c-erbB2, p53, and PCNA shows an increasing tendency for the higher grade TCC of the urinary bladder. Therefore, c-erbB2, p53, and PCNA are clinically useful predictors of the patient's prognosis.
Carcinoma, Transitional Cell* ; Coloring Agents ; Formaldehyde ; Intercellular Signaling Peptides and Proteins ; Oncogene Proteins ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Transforming Growth Factor alpha* ; Urinary Bladder* ; Urothelium

Human lymphoblastoid B-cell lines immortalized by Epstein-Barr virus (EBV) were established from peripheral blood of patients with acute myeloblastic and chronic lymphocytic leukemia and chronic fatigue syndrome. The sera of patients with acute myeloblastic and chronic lymphocytic leukemia did not show antibodies to Epstein-Barr viral capsid antigen (VCA), but serum of a patient with chronic fatigue syndrome disclosed antibodies to VCA (IgG, IgM), and EBNA was demonstrated in peripheral blood mononuclear cells by polymerase chain reaction. The established cell lines were mature B-cell phenotypes with polyclonal proliferation in early passage and no evidence for commitment to other lineages. The immortalized cells by EBV were designated as CSUP-1 and CSUP-2 (from acute myeloblastic leukemia, FAB classification M2 and M1), CSUP-3 (from chronic lymphocytic leukemia) and CSUP-4 (from a patient with chronic fatigue syndrome). The CSUP-1, 2, 3, and 4 grew in suspension forming clumps with a doubling time of 38 to 49 hours. Colony formation was not recognized in plate. By light and electron microscopic examination, the immortalized cells showed features of lymphoblastoid to plasmacytoid lymphocytes, and multinucleated giant cells. The lymphoblastoid cells showed scanty cytoplasm with poorly developed organelles. Immunophenotypic analyses of CUSP-1, 2, 3, and 4 with monoclonal antibodies by flow cytometry showed B-cell phenotype with polyclonal proliferation in early passage. Epstein-Barr virus nuclear antigen was confirmed in the extracted DNAs from immortalized cells by polymerase chain reaction. DNA analysis showed a normodiploid stemline with a DNA index of 1.12. The established cells were strongly reactive for CD10, CD30 (Ki-1) in early passage, and bcl-2 and c-myc onco-protein in early and late passage. Karyotypic analysis of CSUP-1, 2, 3 and 4 showed 46, XY or 46, XX. No tumorigenesis in heterotransplanted SCID mouse was recognized. This immortalized cells by EBV should be a valuable cell lines to study the pathogenesis of EBV-related malignant lymphoma.
Animals ; Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes* ; Capsid ; Carcinogenesis ; Cell Line ; Classification ; Cytoplasm ; DNA ; Fatigue ; Fatigue Syndrome, Chronic ; Flow Cytometry ; Giant Cells ; Granulocyte Precursor Cells ; Herpesvirus 4, Human* ; Humans* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Leukemia, Myeloid, Acute ; Lymphocytes ; Lymphoma ; Mice ; Mice, SCID ; Organelles ; Phenotype ; Polymerase Chain Reaction

PURPOSE: To evaluate whether spontaneous apoptosis has prognostic value among patients with squamous cell carcinoma of lung. MATERIALS AND METHODS: Material from 19 patients who received thoracic irradiation between 1990 and 1994 was analyzed. Their stages were II (1), IIIa (8), IIIb (5), and IV (5). Patients were observed from 5 to 67 months (median : 17 months). The spontaneous apoptosis index (AI) and p53 mutation were measured by immunohistochemical stains. RESULTS: AI was found to range from 0 to 1% (median 0.4%). Patients with low AI (AI< or =median) had a much higher distant metastasis rate at diagnosis than patients with high AI. By analysis of prognostic factors for survival, M stage was significant in univariate analysis. AI, chemotherapy, M stage, T stage, and stage were significant in multivariate analysis. The correlation between the AI and p53 mutation was not seen. CONCLUSION: AI was related with distant metastasis at diagnosis and not with p53 mutation. Also low AI group tended to have shorter survival time than high AI group.
Apoptosis* ; Carcinoma, Squamous Cell* ; Coloring Agents ; Diagnosis ; Drug Therapy ; Humans ; Lung Neoplasms ; Lung* ; Multivariate Analysis ; Neoplasm Metastasis*

Intracranial involvement by adenoid cystic carcinoma (ACC) is very rare and there is no report of intracranial extension from the palate ACC in Korea. Intracranial involvement can occur in one of three ways : direct extension, perineural spread, and hematogenous spread. A case report of a 35-year-old woman with intracranial ACC is presented. Initially she had ACC of the right palate and was treated by surgery and postoperative radiation therapy. Three years and 10 months later, the paresthesia in the distribution of ophthalmic and maxillary branch of right trigeminal nerve developed without evidence of recurrence in CT scan. Ptos and total ophthalmoplegia developed sequentially and the second operation was performed. It was suggested that the tumor was spread perineurally along the trigeminal nerve into the Gasserian ganglion and then cavernous sinus and orbit. Seven years and 6 months after the first operation, direct intracranial extension into the right temporal lobe developed via sphenoid bone, sphenoid sinus and temporal bone and the third operation was done. And then lung metastasis was diagnosed. She is alive for 9 years 5 months after first operation.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic* ; Cavernous Sinus ; Female ; Humans ; Korea ; Lung ; Neoplasm Metastasis ; Ophthalmoplegia ; Orbit ; Palate* ; Paresthesia ; Recurrence ; Sphenoid Bone ; Sphenoid Sinus ; Temporal Bone ; Temporal Lobe ; Tomography, X-Ray Computed ; Trigeminal Ganglion ; Trigeminal Nerve

A 33-year-old man with alopecia totalis presented with facial erythema and flares, conjunctival injection, and dyspnea developed within several minutes following the ninth application of dinitrochlorobenzene (DNCB). A scratch skin test produced positive reactions in concentrations of 0.01, 0.05, 0.1% DNCB showing flares and wheals, whereas concentrations of 0.001, 0.01, 0.05% diphenylcyclopropenone (DPCP) showed negative results. Contact urticaria due to DNCB is very rare, but this complication must be fully noted because of the widespread and frequent use of DNCB in dermatotherapeutic fields. We report herein a rare case of contact urticaria following topieal application of DNCB in the treatment of alopecia totalis.
Adult ; Alopecia ; Dinitrochlorobenzene* ; Dyspnea ; Erythema ; Humans ; Skin Tests ; Urticaria*

A 34-year-old man visited our hospital with alopecia areata on the occipital scalp, which began to develop two months prior to his visit. He was sensitized with 0.2% diphenylcyclopropenone(DPCP) in acetone that was applied to the inner side of his right arm. Two weeks after sensitization, we applied DPCP on his bald lesion once weekly for skin challenge. Following the third application of DPCP, polycyclic erythematous target-like lesions developed around the sensitized area. A clinical diagnosis of erythema multiforme was made. Histologically, the target-like lesion showed few eosinophilic dyskeratosis, exocytosis, and hydropic de-generation of basal layer in the epidermis, and mononuclear infiltration around superficial blood vessels in the dermis. We report herein a rare case of erythema multiforme following topical application of DPCP in the treatment of alopecia areata. This complication must be noted because of the wide-spread and frequent use of DPCP in dermatotherapeutic fields.
Acetone ; Adult ; Alopecia Areata ; Arm ; Blood Vessels ; Dermis ; Diagnosis ; Eosinophils ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Humans ; Scalp ; Skin

Ameloblastoma is a rare epithelial tumor of the jaw, comprising approximately 1% of all tumors and cysts of odontogenic origin. The tumor has been the subject of much controversy and discussion. Ameloblastoma is slow growing, locally invasive, and has a high rate of local recurrence, but rarely metastasizes. The neoplasm has been considered radioresistant, so it has been treated with surgery primarily except some cases. Recently it is suggested that ameloblastoma is radiosensitive, so radiation therapy (RT) would be used in addition to or, in certain cases, in place of surgery. We report these two cases which were referred to the Department of Therapeutic Radiology for deciding the need of postoperative RT, because ameloblastoma is rare and has been known to be radioresistant. Postoperative RT was given to one of these two patients.
Ameloblastoma* ; Humans ; Jaw* ; Radiation Oncology ; Recurrence

PURPOSE: To get the data for public information and education of medical students about radiation therapy (RT). MATERIALS AND METHODS: We evaluated the knowledge and attitudes towards the RT and cancer in the third grade medical students who did not receive a lecture before starting the poly-clinic education about radiation oncology in our medical school. We obtained a total of 142 answers from the students that completed the questionnaire. RESULTS: More than half of the third grade medical students answered 1 question correctly and 5 questions incorrectly among 6 questions about knowledge of RT. Incorrect answers were done about the frequency of RT, hair loss, the period of RT, re-RT, cost of RT. Fifty-six percent of students didn't wish to prolong the survival time from 1 year to 3 years with long courses of chemotherapy and RT. They had bad images about cancer of colorectum, lung, esophagus, liver, breast, cervix which consist of 56.3% of patients receiving RT. CONCLUSION: Public information about the basic points of RT should be considered. Also the students showed the pessimism about the anticancer treatments such as chemotherapy and RT, so the exact results and positive aspects of anticancer treatment should be educated more. Especially it is needed to inform the students and the public the positive aspects of RT in some cancers (colorectal, lung, esophageal, hepatic, breast, cervix cancers) which the students had bad images about.
Breast ; Cervix Uteri ; Drug Therapy ; Education ; Esophagus ; Female ; Hair ; Humans ; Liver ; Lung ; Surveys and Questionnaires ; Radiation Oncology ; Schools, Medical ; Students, Medical

PURPOSE: Primary sphenoid carcinoma is rare. It accounts for 0.3% of all primary paranasal sinus malignancies. Because of the rarity of sphenoid carcinoma, large series of patients with outcome and survival statistics are currently unavailable. So we followed up the 1 case of sphenoid sinus carcinoma treated in our hospital and reported the course of the disease. METHODS AND MATERIALS : In a review of case reports and small series of patients, 2-year survival was 7%. Our case is alive at 29 months after diagnosis of sphenoid sinus carcinoma. Intramedullary spinal cord metastasis (ISCM) is an unusual complication of cancer. In our case rapidly progressive paraparesis and urinary retention developed at 25 months after diagnosis of sphenoid sinus carcinoma. MRI of the thoracic spines showed the intramedullary spinal cord tumor mass at T3 and T4 level with accompanying syringomyelia.Here we report a case of ISCM associated with syringomyelia which has developed after primary sphenoid sinus carcinoma with a review of literature about the clinical behavior and treatment of this lesion.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Paraparesis ; Sphenoid Sinus* ; Spinal Cord Neoplasms ; Spinal Cord* ; Spine ; Syringomyelia* ; Urinary Retention