PURPOSE: There is no standard second-line regimen for malignant melanoma patients with disease progression after first-line chemotherapy, and platinum-alkylating agents combined with paclitaxel have shown modest efficacy. MATERIALS AND METHODS: We conducted a phase II, open-label, single-arm study to test the efficacy of docetaxel combined with carboplatin for malignant melanoma patients who failed previous treatment with dacarbazine. Intravenous docetaxel (35 mg/m2 on days 1 and 8 of each cycle) and carboplatin (area under the curve 3 on days 1 and 8 of each cycle) was administered every 21 days. Primary end point was objective response rate (ORR). RESULTS: Thirty patients were enrolled in the study, and the median follow-up duration was 19.8 months. Among 25 per-protocol patients, there were three responders (1 with complete response and 2 with partial response) and 17 stable disease patients (ORR, 12.0%). Among the per-protocol population, the median progression-free survival (PFS) was 4.3 months and the median overall survival (OS) was 9.6 months. Uveal melanoma patients (n=9) showed the best prognosis compared to other subtypes (median PFS, 7.6 months; OS, 9.9 months). The most common grade 3 or 4 adverse event was neutropenia (n=15, 50.0%). CONCLUSION: Docetaxel combined with carboplatin showed association with an acceptable safety profile and overall efficacy for patients with malignant melanoma who had progressed on chemotherapy containing dacarbazine.
Carboplatin* ; Dacarbazine* ; Disease Progression ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Melanoma* ; Neutropenia ; Paclitaxel ; Prognosis

PURPOSE: Dermatofibrosarcoma protuberans (DFSP) carries a translocation resulting in the collagen type I alpha 1 (COL1A1)-platelet-derived growth factor beta (PDGFB) fusion gene, which is responsible for PDGFB activation. The purpose of this study is to evaluate the clinicopathological, genetic, and therapeutic features of DFSP in Korean patients. MATERIALS AND METHODS: Clinicopathological features of 37 patients with DFSP were reviewed. Multiplex reverse transcriptase-polymerase chain reaction (PCR) was carried out in 16 patients using formalin-fixed, paraffin-embedded tissues and specific primers for COL1A1 and PDGFB. RESULTS: The mean age of 37 patients was 37.4 years old. The most common tumor location was the trunk. All patients were treated primarily with surgery: 34 (91.7%) cases with Mohs micrographic surgery (MMS) and 3 (8.3%) cases with wide local excision. The median follow-up time was 33.7 months. Two patients, one in each treatment group, demonstrated local recurrence during the follow-up period. The COL1A1-PDGFB fusion gene was expressed in 14 (87.5%) cases, demonstrated by reverse transcriptase PCR analysis. No association was found among the different COL1A1-PDGFB fusion transcripts, the various histological subtypes and clinical features. CONCLUSION: Our results support the effectiveness of MMS in treating DFSP. The COL1A1-PDGFB fusion transcript was observed in 87.5% of patients. Therefore, COL1A1-PDGFB is a useful and accurate tool in diagnosing DFSP in Koreans.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Collagen Type I/*genetics ; DNA Primers ; Dermatofibrosarcoma/ethnology/*genetics/*pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Mohs Surgery ; Multiplex Polymerase Chain Reaction ; Neoplasm Recurrence, Local ; Oncogene Proteins, Fusion/*genetics ; Proto-Oncogene Proteins c-sis/*genetics ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Skin Neoplasms/ethnology/*genetics/*pathology/surgery ; Treatment Outcome

PURPOSE: Dermatofibrosarcoma protuberans (DFSP) carries a translocation resulting in the collagen type I alpha 1 (COL1A1)-platelet-derived growth factor beta (PDGFB) fusion gene, which is responsible for PDGFB activation. The purpose of this study is to evaluate the clinicopathological, genetic, and therapeutic features of DFSP in Korean patients. MATERIALS AND METHODS: Clinicopathological features of 37 patients with DFSP were reviewed. Multiplex reverse transcriptase-polymerase chain reaction (PCR) was carried out in 16 patients using formalin-fixed, paraffin-embedded tissues and specific primers for COL1A1 and PDGFB. RESULTS: The mean age of 37 patients was 37.4 years old. The most common tumor location was the trunk. All patients were treated primarily with surgery: 34 (91.7%) cases with Mohs micrographic surgery (MMS) and 3 (8.3%) cases with wide local excision. The median follow-up time was 33.7 months. Two patients, one in each treatment group, demonstrated local recurrence during the follow-up period. The COL1A1-PDGFB fusion gene was expressed in 14 (87.5%) cases, demonstrated by reverse transcriptase PCR analysis. No association was found among the different COL1A1-PDGFB fusion transcripts, the various histological subtypes and clinical features. CONCLUSION: Our results support the effectiveness of MMS in treating DFSP. The COL1A1-PDGFB fusion transcript was observed in 87.5% of patients. Therefore, COL1A1-PDGFB is a useful and accurate tool in diagnosing DFSP in Koreans.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Collagen Type I/*genetics ; DNA Primers ; Dermatofibrosarcoma/ethnology/*genetics/*pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Mohs Surgery ; Multiplex Polymerase Chain Reaction ; Neoplasm Recurrence, Local ; Oncogene Proteins, Fusion/*genetics ; Proto-Oncogene Proteins c-sis/*genetics ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Skin Neoplasms/ethnology/*genetics/*pathology/surgery ; Treatment Outcome

In this study we investigated the effects of fucoidan on the proliferation of fibroblasts and the reconstruction of a skin equivalent (SE). Fucoidan significantly stimulated the proliferation of CCD-25Sk human fibroblasts and Western blot analysis demonstrated that fucoidan markedly increased the expression of cyclin D1 and decreased the expression of p27. Fucoidan was used to reconstruct SE. Immunohistochemical staining showed that the addition of fucoidan to dermal equivalents increased expression of proliferating cell nuclear antigen (PCNA) and p63. In addition, expression of alpha6-integrin was significantly increased by fucoidan, whereas expression of beta1-integrin, type 1 collagen, elastin, fibronectin did not markedly change. These results suggest that fucoidan has positive effects on epidermal reconstruction and will therefore be beneficial in the reconstruction of SE.
Blotting, Western ; Collagen Type I ; Cyclin D1 ; Elastin ; Fibroblasts ; Fibronectins ; Humans ; Proliferating Cell Nuclear Antigen ; Skin*

This study investigated the effects of proline-serine (PS) and valine-serine (VS) dipeptides on melanogenesis in Mel-Ab cells. Proline-serine and VS significantly inhibited melanin synthesis in a concentration-dependent manner, though neither dipeptide directly inhibited tyrosinase activity in a cell-free system. Both PS and VS down-regulated the expression of microphthalmia-associated transcription factor (MITF) and tyrosinase. In a follow-up study also described here, the effects of these dipeptides on melanogenesis-related signal transduction were quantified. Specifically, PS and VS induced ERK phosphorylation, though they had no effect on phosphorylation of the cAMP response element binding protein (CREB). These data suggest that PS and VS inhibit melanogenesis through ERK phosphorylation and subsequent down-regulation of MITF and tyrosinase. Properties of these dipeptides are compatible with application as skin-whitening agents.
Cell-Free System ; Cyclic AMP Response Element-Binding Protein ; Dipeptides ; Down-Regulation ; Follow-Up Studies ; Melanins ; Microphthalmia-Associated Transcription Factor ; Monophenol Monooxygenase ; Phosphorylation ; Signal Transduction

Acute hemorrhagic edema of infancy is an unusual form of leukocytoclastic vasculitis occuring in children from the age 4 months to 2 years. The etiology remains unknown. Numerous studies, however, suggest acute hemorrhagic edema of infancy as an immune-mediated vasculitis in response to a variety of antigenic stimuli. We report a case of an acute hemorrhagic edema of infancy; 11-month-old boy with a history of fever for 3 days and a history of purpuric rash on the extremities, trunk, buttock and oral mucosa for 2 days.
Acute Disease ; Biopsy ; Edema/immunology/*pathology ; Exanthema/immunology/pathology ; Hemorrhage/immunology/*pathology ; Human ; Infant ; Male ; Vasculitis, Hypersensitivity/immunology/*pathology

Neuroendocrine carcinomas of the colon and rectum are rare and have been known as either carcinoid tumors or undifferentiated cancers in the past. This type of tumor frequently occurred at cecum and is known for its aggressiveness and poor prognosis, differing from adenocarcinoma of colon. There has been no literature which describes endoscopic findings of colonic neuroendocrine carcinoma. Therefore, we report a case of neuroendocrine carcinoma of cecum in 36-year-old man with endoscopic findings. After right hemicolectomy followed by adjuvant chemotherapy, we have followed up the patient for 6 months without the evidence of recurrence.
Adenocarcinoma ; Adult ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Cecum* ; Chemotherapy, Adjuvant ; Colon ; Humans ; Peritonitis* ; Prognosis ; Rectum ; Recurrence

Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is a benign, idiopathic histiocytic proliferative disorder affecting lymph nodes as well as extranodal sites. It is accompanied by fever, leukocytosis, elevated erythrocyte sedimentation rate, and polyclonal hypergammaglobulinemia. Although cutaneous involvement in RDD is common, a purely cutaneous disease is very rare. Histologic findings show characteristic large, pale, histiocytic cells exhibiting cytophagocytosis (emperipolesis). Immunohistochemically, these histiocytes are positive for S-100 protein and CD68, but negative for CD1a. The etiology is unknown, although it is thought to be a reactive disorder rather than neoplastic. We report two cases of Rosai-Dorfman disease showing involvement limited to the skin.
Adjustment Disorders ; Blood Sedimentation ; Cytophagocytosis ; Fever ; Histiocytes ; Histiocytosis, Sinus* ; Hypergammaglobulinemia ; Leukocytosis ; Lymph Nodes ; S100 Proteins ; Skin

BACKGROUND: Anthracofibrosis, a descriptive term for multiple black pigmentation with fibrosis on bronchoscopic examination, has a close relationship with active tuberculosis (TB). However, TB activity is determined in the later stage by the TB culture results in some cases of anthracofibrosis. Therefore, it is necessary to identify early markers of TB activity in anthracofibrosis. There have been several reports investigating the serum levels of IL-2 sRalpha, IFN-gamma and TBGL antibody for the evaluation of TB activity. In the present study, we tried to measure the above mentioned serologic markers for the evaluation of TB activity in patients with anthracofibrosis. METHODS: Anthracofibrosis was defined when there was deep pigmentation (in more than two lobar bronchi) and fibrotic stenosis of the bronchi on bronchoscopic examination. The serum of patients with anthracofibrosis was collected and stored under refrigeration before the start of anti-TB medication. The serum of healthy volunteers (N=16), patients with active TB prior to (N=22), and after (N=13), 6 month-medication was also collected and stored. Serum IL-2 sRalpha and IFN-gamma were measured with ELISA kit (R&D system, USA) and serum TBGL antibody was measured with TBGL EIA kit (Kyowa Inc, Japan). RESULTS: Serum levels of IL-2 sRalpha in healthy volunteers, active TB patients before and after medication, and patients with anthracofibrosis were 640+/-174, 1,611+/-2,423, 953+/-562, and 863+/-401 pg/ml, respectively. The serum IFN-gamma levels were 0, 8.16+/-17.34, 0.70+/-2.53, and 2.33+/-6.67 pg/ml, and TBGL antibody levels were 0.83+/-0.80, 5.91+/-6.71, 6.86+/-6.85, and 3.22+/-2.59 U/ml, respectively. The serum level of TBGL antibody was lower than that of other groups (p<0.05). There was no significant difference of serum IL-2 sRalpha and IFN-gamma levels among the four groups. CONCLUSION: The serum levels of IL-2 sRalpha, IFN-gamma and TBGL antibody were not useful in the evaluation of TB activity in patients with anthracofibrosis. More useful ways need to be developed for the differentiation of active TB in patients with anthracofibrosis.
Bronchi ; Constriction, Pathologic ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Healthy Volunteers ; Humans ; Interleukin-2* ; Pigmentation ; Refrigeration ; Tuberculosis* ; Tuberculosis, Pulmonary

OBJECTIVES: The microdose of gonadotrophin-releasing hormone agonist (GnRHa) has been suggested as a beneficial method of ovulation induction for poor responders. However, the effect of microdose of GnRHa itself has not been evaluated yet. We performed a prospective sutdy to assess the effect of microdose of GnRHa (5 microgram of triptorelin acetate) on the luteinizing hormone (LH) and follicle stimulating hormone (FSH). Secondary objective of this study is to assess how long the down-regulation of gonadotrophin secretion by microdose GnRHa persists. METHODS: Five microgram of triptorelin was injected daily into five normally menstruating women for 7 days starting from cycle day 3. The blood sample was drawn for 12h with 4h interval, then for 6days with 4 h interval and once a day for 14days, In next cycle, same amount of triptorelin was injected into the same subjects daily for 3 days. The blood sample was drawn twice a day for 20days. Serum FSH, LH and extradiol level was measured. RESULTS: The serum LH and FSH level increased rapidly after injection of first GnRHa. The FSH level reached peak (27.53+/-6.34 IU/l) in 5h while LH level reached peak (34.35+/-7.18 IU/l) in 4h. The flare of gonadotrophins persisted even after second and third day injection of GnRHa, although the peak levels were not as high as first injection. The down regulation of gonadotrophin was established in 4-5 days. The estradiol level increased for 4-5 days then decreased. When GnRHa was given for 7days, the estradiol level began to rise 7-8 days after last injection; when given for 3days, the estradiol level began to rise 3-6 days after last injection. CONCLUSION: Even with ultra-low dose of GnRHa, the down-regulation of gonadotrophin could be achieved. The flare-up of gonadotrophin would persist for 3days with this dose. The duration of down regulation was influenced by the duration of GnRHa administration.
Down-Regulation ; Estradiol* ; Female ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Luteinizing Hormone ; Ovulation Induction ; Prospective Studies ; Triptorelin Pamoate