Primary airway tumors are rare in children and no literature reviewed their characteristics each location. We evaluate the clinical characteristics and outcomes of Korean children with primary airway tumors, from the larynx to bronchi. A retrospective chart review of children with primary tumors of the larynx, trachea, and bronchi at Asan Medical Center from January 2000 to July 2016 was conducted. Nineteen children were diagnosed with primary airway tumors of the larynx (47.4%), trachea (10.5%), and bronchi (42.1%). Median follow-up duration was 2.8 years and there were recurrences in 21.1%. Laryngeal tumors were associated with a younger median age at onset (2 months) and diagnosis (4 months), and most were relatively small (median size = 5.3 mm) and symptomatic. Tracheal and bronchial tumors were found in older children (age at onset and diagnosis > 11 years) and large (> 15.0 mm). Most (75%) patients with bronchial tumors were asymptomatic and all the patients with tracheal tumors were symptomatic. This study suggests that we should consider different the locations in primary airway tumor based on the age at onset and diagnosis, initial symptoms or signs, and size of tumor.
Age of Onset ; Bronchi* ; Child ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Humans ; Larynx* ; Pediatrics ; Recurrence ; Retrospective Studies ; Trachea*

PURPOSE: Hypermethylation of the CpG island of p16(INK4a) occurs in a significant proportion of colorectal cancer (CRC). We aimed to investigate its predictive role in CRC patients treated with 5-fluorouracil, leucovorin, irinotecan (FOLFIRI), and cetuximab. MATERIALS AND METHODS: Pyrosequencing was used to identify KRAS mutation and hypermethylation of 6 CpG island loci (p16, p14, MINT1, MINT2, MINT31, and hMLH1) in DNA extracted from formalin-fixed paraffin-embedded specimens. Logistic regression and Cox regression were performed for analysis of the relation between methylation status of CpG island methylator phenotype (CIMP) markers including p16 and clinical outcome. RESULTS: Hypermethylation of the p16 gene was detected in 14 of 49 patients (28.6%) and showed significant association with KRAS mutation (Fisher exact, p=0.01) and CIMP positivity (Fisher exact, p=0.002). Patients with p16-unmethylated tumors had significantly longer time to progression (TTP; median, 9.0 months vs. 3.5 months; log-rank, p=0.001) and overall survival (median, 44.9 months vs. 16.4 months; log-rank, p=0.008) than those with p16-methylated tumors. Patients with both KRAS and p16 aberrancy (n=6) had markedly shortened TTP (median, 2.8 months) compared to those with either KRAS or p16 aberrancy (n=11; median, 8.6 months; p=0.021) or those with neither (n=32; median, 9.0 months; p < 0.0001). In multivariate analysis, KRAS mutation and p16 methylation showed independent association with shorter TTP (KRAS mutation: hazard ratio [HR], 3.21; p=0.017; p16 methylation: HR, 2.97; p=0.027). CONCLUSION: Hypermethylation of p16 was predictive of clinical outcome in metastatic CRC patients treated with cetuximab and FOLFIRI, irrespective of KRAS mutation.
Colorectal Neoplasms* ; CpG Islands ; Cyclin-Dependent Kinase Inhibitor p16 ; DNA ; Drug Therapy* ; Fluorouracil ; Genes, p16 ; Humans ; Leucovorin ; Logistic Models ; Methylation ; Multivariate Analysis ; Phenotype

OBJECTIVES: This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole. METHODS: We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other. RESULTS: Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080). CONCLUSION: There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.
Antipsychotic Agents ; Automobile Driving ; Haloperidol ; Humans ; Imidazoles ; Nitro Compounds ; Piperazines ; Psychomotor Performance ; Quinolones ; Sample Size ; Schizophrenia ; Aripiprazole

PURPOSE: Chemokines are structurally related, small polypeptide signaling molecules that bind to and activate a family of transmembrane G proteincoupled receptors, the chemokine receptors. Recently, interaction between the chemokine receptor CXCR4 and its ligand, stromal cell-derived factor 1 (SDF-1 or CXCL12), has been found to play an important role in tumorigenicity, proliferation, metastasis and angiogenesis in many cancers such as lung cancer, breast cancer, melanoma, glioblastoma, pancreatic cancer and cholangiocarcinoma. Hence, the goal of this study is to identify the correlation of clinicopathological factors and the up-regulation of SDF-1 expression in oral squamous cell carcinoma. MATERIAL AND METHODS: We studied the immunohistochemical staining of SDF-1, quantitative RT-PCR (qRT-PCR) of SDF-1 gene in 20 specimens of 20 patients with oral squamous cell carcinoma. RESULTS: 1. In the immunohistochemical study of poor differentiated and invasive oral squamous cell carcinoma, the high level staining of SDF-1 was observed. And the correlation between immunohistochemical SDF-1 expression and tumor nodes metastases (TNM) classification of specimens was significant.(chi-square test, P < 0.05) 2. In the SDF-1 gene qRT-PCR analysis, SDF-1 expression was more in tumor tissue than in carcinoma in situ tissue. Paired-samples analysis determined the difference of SDF-1 mRNA expression level between the cancer tissue and the carcinoma in situ tissue.(Student's t-test, P < 0.05) CONCLUSION: These findings suggest that up-regulation of the SDF-1 may play a role in progression and invasion of oral squamous cell carcinoma.
Breast Neoplasms ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Chemokine CXCL12 ; Chemokines ; Cholangiocarcinoma ; Glioblastoma ; Humans ; Lung Neoplasms ; Melanoma ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Receptors, Chemokine ; RNA, Messenger ; Up-Regulation

Academic Medical Centers ; Conscious Sedation ; Deep Sedation ; Dental Care ; Dentistry ; Humans ; Midazolam ; Monitoring, Physiologic ; Outpatients ; Postoperative Complications ; Retrospective Studies

Tailgut cysts (TGCs) are rare congenital cysts that occur in the retrorectal or presacral spaces. Although most tailgut cysts have been reported as benign, there have been at least 9 cases associated with malignant change. We report herein on an unusual case of a 40-year-old woman with a carcinoembryonic antigen (CEA) -producing adenocarcinoma arising within a TGC who underwent surgical resection and local radiation therapy. Despite the complete resection, metastatic adenocarcinoma developed five months after surgery. CEA-producing adenocarcinoma from a TGC is extremely rare and only two cases, including this case, have been reported in the English medical literature. Besides CEA, the serum levels of CA 19-9 became markedly elevated in this patient. Given that the serum CEA level decreased to the normal range after complete resection of tumor and that the tumor recurrence was associated with a rebound of the CEA serum level, our case shows that serial measurements of serum CEA can be used for treatment planning and for assessing the patient's treatment response for this rare disease.
Adenocarcinoma/blood/pathology/*therapy ; Adult ; CA-19-9 Antigen/blood ; Carcinoembryonic Antigen/*blood ; Cysts/blood/pathology/*therapy ; Female ; Hamartoma/blood/pathology/*therapy ; Humans ; Rectal Neoplasms/blood/pathology/*therapy ; Sacrococcygeal Region

PURPOSE: Membranous glomerulopathy is a glomerular disease characterized by the presence of subepithelial immune deposits with thickening of the capillary wall of the glomerulus without inflammatory change. The pathogenesis of membranous glomerulopathy is still unknown. Its incidence is higher in males, and it is rarely found in infants and adolescents. Among the clinical manifestations proteinuria is most common, while edema and hematuria are present. According to reports from other countries, among few patients diagnosed with membranous glomerulopathy by renal biopsy, show isolated microscopic hematuria without the clinical manifestations. Little research in this area has been performed in Korea, and so we conducted retrograde studies on membranous glomerulopathy associated with isolated microscopic hematuria. MATERIALS AND METHODS: We analyzed retrogradely 109 cases of asymptomatic isolated microscopic hematuria that were diagnosed as membranous glomerulopathy by renal biopsy at Yonsei University Severance hospital from January, 1992 to July, 2001. RESULTS: In 87 of the 109 cases patients were over 15 years old while in 22 cases patients were under 15 at the time of dignosis. Only three patients showed isolated microscopic hematuria without the clinical manifestations and abnormal laboratory findings and they were all male patients under 15 years old. CONCLUSION: Few cases of the membranous glomerulopathy show only asymptomatic isolated microscopic hematuria. However, since membranous glomerulopathy can be found in patients who present with asymptomatic isolated microscopic hematuria only, if adequate indication for renal biopsy is present, we conclude that renal biopsy must be aggresively pursued in order to find the underlying disease.
Adolescent ; Biopsy ; Capillaries ; Edema ; Glomerulonephritis, Membranous* ; Hematuria* ; Humans ; Incidence ; Infant ; Korea ; Male ; Proteinuria

OBJECTIVES: The purpose was to investigate the distributions and the effects of genetic polymorphism of aldehyde dehydrogenase 2(ALDH2), cytochrome P450 1A1(CYP1A1), and cytochrome P450 2E1(CYP2E1) on the toluene metabolism. METHODS: The subjects consisted of 160 workers who were exposed to toluene in different industries such as paint manufacturing, painting on steel and wood products, printing, bonding, and coating. The exposed toluene level was monitored by passive air sampler, and the questionnaire variables were age, sex, smoking, drinking, previous nights drinking, use of personal protective equipment, work duration, and taking benzoic acid containing food. The urinary hippurric acid collected in the end of shift was corrected by urinary creatinine concentration. The genotypes of ALDH2, CYP1A1, and CYP2E1 were investigated using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) methods with DNA extracted from venous blood. RESULTS: The geometric mean and the geometric standard deviation of urinary hippuric acid concentration were 0. 44 g/g creatinine and 2. 80. The urinary hippuric acid concentration was significantly related to personal exposed toluene level among personal exposed toluene level, use of personal protective equipment, and benzoic acid containing food diet. The slope differences of the regression for ALDH2, CYP1A1, and CYP2El genetic polymorphism, age, smoking, and work duration tended to be significant. In multiple regression analysis, the regression coefficient of toluene, ALDH2, CYP1A1, CYP2E1 genetic polymorphism were significant. CONCLUSIONS: Prom the above results, urinary hippuric acid level after toluene exposure was significantly affected by the genetic polymorphism of ALDH2, CYP1A1, CYP2E1. It is needed further investigation of the urinary hippuric acid level considering the effect of genetic polymorphism.
Aldehyde Dehydrogenase ; Benzoic Acid ; Creatinine ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; Cytochrome P-450 Enzyme System ; Diet* ; DNA ; Drinking ; Genotype ; Humans ; Life Style* ; Metabolism ; Paint ; Paintings ; Polymorphism, Genetic ; Questionnaires ; Smoke ; Smoking ; Steel ; Toluene* ; Wood

PURPOSE: We measured and compared the uPA, plasminogen activator inhibitor-1 (PAI-1) and uPA receptor (uPAR) levels in breast cancer tissues and blood of the patients to evaluate their clinical relevance for biotherapy. MATERIALS AND METHODS: uPA, PAI-1 (Monozyme, Netherland), uPAR (American Diagnostics, USA) levels were measured by ELISA assay in 192 breast cancer tissues, in 18 normal breast tissues and in 163 blood from breast cancer patients. RESULTS: There was a tendency of uPA increment from ductal carcinoma in situ while increment of PAI-1 and uPAR occurred from Ti. With the progression of cancer, uPA, PAI-1, uPAR tended to decrease; however, the uPA/uPAR, uPA/PAI-1 ratios remained unchanged. There was a correlation of uPA expression between normal and cancer tissues ( r(2)= 0.49). Correlation of uPA and PAI-1 was found in normal tissue and stage I cancer tissue while correlation of uPAR and PAI-1 was found with cancer progression. Between cancer tissue and blood significant correlations were found in uPA, PAI-1, uPAR levels. CONCLUSION: uPA, PAI-1, uPAR levels in cancer tissue elevated from the early stage maintaining correlative expressions with cancer progression. A positive correlation between cancer tissue and blood level suggested the applicability of the levels of uPA, PAI-1 or uPAR for detecting patients for biotherapy.
Biological Therapy* ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Enzyme-Linked Immunosorbent Assay ; Humans ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Urokinase-Type Plasminogen Activator*

Primary cardiac lymphomas diagnosed antemortem are extremely rare. We present a case of primary cardiac lymphma diagnosed antemortem by transvenous biopsy under transesophageal echocardiographic guidance. The patient who was a 62 years old male presented with facial edema, dyspnea on exertion and syncope. The chest X-ray film showed double contour at right cardiac border and the ECG showed marked sinus bradycardia. Transesophageal echocardiography (TEE), chest computed tomography (CT) and magnetic resonance imaging (MRI) showed intracardiac tumor of right atrium, invasing interatrial septum and inlets of superior and inferior vena cava and lateral wall of right atrium. Abdominopelvic CT and bone scan failed to show any extracardiac location. Transvenous biopsy confirmed the diagnosis of malignant lymphoma (diffuse large cell, B cell type). After chemotherapy was begun, the tumor makedly shrunk and symptoms resolved. Primary cardiac lymphoma is extremely rare and almost uniformly fatal, but this case showed that early diagnosis and intensive che-motherapy might contribute to a better prognosis for patients with malignant lymphoma of the heart.
Bays ; Biopsy* ; Bradycardia ; Diagnosis* ; Drug Therapy ; Dyspnea ; Early Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Edema ; Electrocardiography ; Heart ; Heart Atria ; Humans ; Lymphoma* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Syncope ; Thorax ; Vena Cava, Inferior ; X-Ray Film