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

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

Adenosis tumor is a ra re tumor of the breast and primarily consists of adenosis. Authors report a case of surgically proved adenosis tumor in a 31-year-old woman. Mammogram showed a Iobulated, well-circumscribed mass with several surrounding radiolucent halos. In the center of the mass several linear radiolucent densities were seen with the appearance of a conglomerated well-circumscribed mass such as fibroadenoma. These linear radiolucent densities were consistent with the fat between the fibrous sclerosis in pathologic specimen. Ultrasonogram showed a well-circumscribed mass with homogeneous low echogenicity, partial posterior enhancement, and bilateral acoustic shadowings.
Acoustics ; Adult ; Breast* ; Female ; Fibroadenoma ; Humans ; Sclerosis ; Shadowing (Histology) ; Ultrasonography

Malignant fibrous histiocytoma(MFH) of the maxilla is a rare malignant bone tumor. Seven percents of all MFH occur in the head and neck. Approximately 12% of these tumors occur in the maxilla. Local recurrence or distant metastasis was reported in 55% of cases of maxillary MFH. The mean survival time of 30 months was reported from a review of 14 MFHs in he masxilla, mandible and oral soft tissues. MFH of the maxilla is best treated surgically but radical neck dissection dose not appear to be indicated unless there is clinical evidence of lymph node metastases. Although the use of radiation therapy for head and neck MFH has not been studied for a series of cases, individual cases of regression or histological change have been reported. Other authors have reported numbers of cases who received radiation therapy without benefit. Response to combination chemotherapy has been reported in 33% of 23 patients with recurrent or metastatic MFH. We report here a case of MFH occurring in the maxilla with a review of literature about the clinical behavior and treatment of these lesions.
Drug Therapy, Combination ; Head ; Histiocytoma, Malignant Fibrous* ; Humans ; Lymph Nodes ; Mandible ; Maxilla* ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Recurrence ; Survival Rate

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

Ten patients with deep muscle-invading bladder carcinoma (clinical stage T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the trmors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60% for all patients. The complete responses were achieved in 4 of 5(80%) with stage cT3a, in 2 of 3(67%) with stage cT3b and in none of 2(0%) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80%. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher cancer. Six patients who showed complete responses after treatment. Distant metastases developed in 3 patients : lungs in 2 (cT4b) of those who were never locally free of disease and spine in 1 patient follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.
Carcinoma, Transitional Cell ; Cisplatin* ; Cystectomy ; Diarrhea ; Drug Therapy ; Follow-Up Studies ; Humans ; Lung ; Neoplasm Metastasis ; Retrospective Studies ; Spine ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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*