A fusion gene between echinoderm microtubule-associated protein-like 4 (EML4) and the anaplastic lymphoma kinase (ALK) has been identified in non-small cell lung cancers (NSCLCs). Although a few studies have evaluated EML4-ALK fusion genes in Korean NSCLCs, the prevalence of different EML4-ALK fusion variants has yet to be clearly assessed. Herein, we have examined the profiles of EML4-ALK fusion gene variants in Korean patients of NSCLCs. EML4-ALK fusion genes have been detected in 10 (6.0%) of 167 patients of NSCLCs and in 9 (7.4%) of 121 patients of adenocarcinoma. Of the 10 patients with fusion genes identified, 8 (80%) were E13;A20 (variant 1) and 2 (20%) were E6;A20, with an additional 33-bp sequence derived from intron 6 of EML4 (variant 3b). These results indicate that the profiles of EML4-ALK fusion gene variants in Korean patients of NSCLC may differ from those in other ethnic populations. Herein, we describe for the first time the profiles of EML4-ALK fusion variants of Korean patients with NSCLCs.
Adenocarcinoma/diagnosis/genetics ; Aged ; Asian Continental Ancestry Group/*genetics ; Base Sequence ; Carcinoma, Non-Small-Cell Lung/diagnosis/*genetics ; Exons ; Female ; Humans ; Introns ; Lung Neoplasms/diagnosis/*genetics ; Male ; Middle Aged ; Oncogene Proteins, Fusion/chemistry/*genetics ; Republic of Korea ; Sequence Analysis, RNA ; Smoking

PURPOSE: X-ray microscopy with synchrotron radiation might be a useful tool for novel x-ray imaging in the clinical and laboratory settings. This technique provides detailed images of internal structures non-invasively. It also has the potential to resolve some of the limitations of conventional breast imaging. We evaluated high resolution synchrotron imaging of breast tissues from normal breasts and breasts with fibroadenomas and cancer. METHODS: A new x-ray microscope was installed on the 1B2 beamline of a Pohang Light Source, at a third generation synchrotron radiation facility in Pohang, Korea. The phase contrast x-ray energy was set at 6.95 keV and the x-ray beam was monochromatized by a W/B4C monochromator. Formalinfixed or unfixed female breast tissue from normal breast as well as breasts with fibroadenomas and carcinoma were attached onto the Kapton film. The sample was positioned 25 m away from the beam source. The x-ray image of the sample was converted into a visual image on the CsI (TI) scintillation crystal, and magnified 20 times by the microscopic objective lens. After an additional 10 fold digital magnification, this visual image was captured by a full frame CCD camera. RESULTS: The monochromated x-ray microscopic images of female breast tissue from normal breast, fibroadenoma and carcinoma cases were evaluated. The total magnifying power of the microscope was x200. This synchrotron radiation imaging enabled us to observe detailed structures of breast tissue without sample preparation such as staining or fixation. CONCLUSION: Using monochromated synchrotron radiation, the x-ray microscopic images of the normal breast and breasts with fibroadenomas and cancer were obtained. From the images obtained, the x-ray microscopic imaging of breast tissue with synchrotron radiation appears to have great potential for clinical and research purposes such as oncology studies, early detection of cancer and as an aid to the pathological diagnosis in the future.
Breast ; Early Detection of Cancer ; Female ; Fibroadenoma ; Humans ; Korea ; Light ; Microscopy ; Synchrotrons

PURPOSE: Bronchial wash fluid may be a useful for detecting lung cancer. To increase the detection rates, we performed molecular analysis with using MAGE A1-6 and SSX4 RT-PCR on bronchial wash fluid specimens. MATERIALS AND METHODS: We obtained 57 lung cancer tissue specimens by bronchoscopic biopsy and 131 bronchial washes from 96 patients with lung cancer and 35 patients with benign lung diseases. The MAGE A1-6 and SSX4 gene expressions were investigated in the cancer tissue specimens and bronchial wash fluids. We evaluated the positive detection rates of these methods according to the cytology results and the clinical findings. RESULTS: For the cancer tissue specimens and the bronchial wash fluid, the positive detection rate of MAGE or SSX4 was 91.2% and 75.0%, respectively. Combined MAGE and SSX4 PCR and cytology tests showed an 83.3% detection rate for the bronchial wash fluid. From bronchial washes of patients with benign lung diseases, the positive rates of using MAGE or SSX4 was 11.4%. In the bronchial wash fluid of lung cancer patients, 66.7% of the peripheral cancers were detected by MAGE or SSX4, while examination with cytology did not detect any peripheral lung cancer. CONCLUSION: The application of both MAGE and SSX4 showed high sensitivity and specificity for the detection of lung cancer. Thus, MAGE and SSX4 RT-PCR may be effectively utilized as additional methods to improve detection of lung cancer with using bronchial wash fluids.
Biopsy ; Gene Expression ; Humans ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Polymerase Chain Reaction ; Sensitivity and Specificity

Laryngeal mask airways (LMAs) have several advantages compared with conventional endotracheal tube (ETT) in tracheal surgery. LMAs cannot penetrate the airway below the level of the glottis, but enable the access to the larynx and tracheobronchial tree while avoiding airflow impairment, tracheal stimulation, trauma, and the interference of tracheal mucosal blood flow. Moreover, LMAs have lower airway resistance than ETTs. We describe the use of a proseal laryngeal mask airway (PLMA) in patients with high grade upper tracheal stenosis. We suggest that PLMA might have advantages over the classic LMA by preventing aspiration and by allowing the evacuation of air from the stomach in high-grade upper tracheal stenosis.
Airway Resistance ; Glottis ; Humans ; Laryngeal Masks* ; Larynx ; Stomach ; Tracheal Stenosis*

PURPOSE: 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET) is known to be useful in the detection of lung cancer. However, the degree of FDG uptake was variable. To correlate FDG activity on PET with various histopathologic factors,we assessed the relationships between 18F-FDG uptake and glucose transporter 1 (Glut1) expression, histologic subtypesand Ki-67 labelling indices. MATERIALS AND METHODS: One hundred two patients with non-small cell lung cancer (NSCLC) who had surgery and preoperative 18F-FDG PET scan as a part of the staging work-up were enrolled in this study. The amount of FDG uptake in the primary lesion was measured by a standardized uptake values (SUVs) and correlated with tumor size, histologic subtypes, and immunohistochemical results of Glut1 and Ki-67 labelling indices. RESULTS: Cell type of NSCLC were 52 adenocarcinomas, 36 squamous cell carcinomas, 14 other NSCLC. All tumors could be detected by FDG PET. Uptake was correlated with tumor size (p<0.01). The FDG uptake was significantly lower in adenocarcinomas than in squamous cell carcinomas or other NSCLC (p<0.001). The percentages of Glut1- positive area and staining intensity of the tumor were also significantly lower in adenocarcinomas than in squamous cell carcinomas or other NSCLC (p<0.001). Ki-67 labelling indices of the tumor correlated with the percentage of Glut1 intensity and SUVs in NSCLC (p7lt;0.001). CONCLUSION: These results suggest that overexpression of Glut1 and proliferating activity is related to 18F-FDG uptake in NSCLC. Glut1 expression appear to be different among histologic subtypes. Glut1 expression, as well as FDG uptake, is lower in adenocarcinomas than squamous cell carcinomas or other NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Fluorodeoxyglucose F18 ; Glucose Transport Proteins, Facilitative ; Humans ; Lung Neoplasms ; Lung* ; Positron-Emission Tomography

Primary cardiac lymphoma is an extranodal malignant lymphoma of any cell type involving only heart and pericardium without dissemination. Patients usually present symptoms of heart failure, arrhythmias, pericardial effusion and cardiac tamponade. Diagnosis of primary cardiac lymphoma can be performed by echocardiogram, CT and MRI and cytologic examination of pericardial effusion or transvenously biopsied cardiac tissue. Prognosis of primary cardiac lymphoma is poor. Because of poor prognosis, early diagnosis and complete surgical excision is essential and postoperative systemic chemotherapy or radiotherapy is useful. In this case extensive tumor infiltration on the right ventricle and atrioventricular groove preclude surgical excision. Tissue biopsy revealed primary cardiac lymphoma. After postoperative chemotherapy and radiotherapy, the size of intracardiac mass is decreased in follow up chest CT scan and echocardiogram and symptoms of patient are relieved. Therefore, we report a case of primary cardiac lymphoma with review of literatures.
Arrhythmias, Cardiac ; Biopsy ; Cardiac Tamponade ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Neoplasms ; Heart Ventricles* ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Magnetic Resonance Imaging ; Pericardial Effusion ; Pericardium ; Prognosis ; Radiotherapy ; Tomography, X-Ray Computed

BACKGROUND: Cigarette smoking is the leading cause of the lung cancer. However, mechanism of action underlying the carcinogenesis in the lung still remains to be elucidated. The present study attempted to look into the carcinogenic potential of tobacco-specific nitrosamine, NNK (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone) and the effects of protein kinase C (PKC) isoforms in an immortalized human epithelial cell model. MATERIAL AND METHOD: Immortalized human epithelial cells were exposed with NNK and examined for its carcinogenic potential as measured by saturation density, soft-agar colony formation, and cell aggregation assay. The specific isoform of PKCs involved in the cellular transformation was analysed through western blot with monoclonal antibody and measured separately in cytosolic fraction and membrane fraction. RESULT: Human epithelial cells exposed with NNK showed prominent carcinogenic potential in saturation density, soft agar colony formation, and cell aggregation assay. PKC isoform analysis results are as follows: PKC-alpha showed significant translocation of protein levels from cytosolic fraction to membrane fraction, as analyzed by immunoblot. PKC-epsilon showed a dose-dependent increase of translocation. PKC-lambda was not affected by NNK treatment. CONCLUSION: The study demonstrated that there was a certain specificity in the patterns of isoform induction following chemical carcinogen exposure. Thus, it is suggested that identification of specific isoform be a clue to find target molecules in the carcinogenesis.
Agar ; Blotting, Western ; Carcinogenesis ; Carcinogens ; Cell Aggregation ; Cytosol ; Epithelial Cells ; Humans ; Lung ; Lung Neoplasms ; Membranes ; Protein Isoforms ; Protein Kinase C* ; Protein Kinases* ; Sensitivity and Specificity ; Smoking ; Tobacco

Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.
Bronchi ; Dermatitis, Phototoxic ; Esophageal Neoplasms ; Esophagus ; Follow-Up Studies ; Humans ; Lung ; Palliative Care ; Patient Education as Topic ; Photochemotherapy* ; Referral and Consultation ; Skin ; Stomach Neoplasms ; Stomach* ; Trachea

An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10x6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.
Cardiopulmonary Bypass ; Cough ; Echocardiography ; Endocarditis* ; Fever ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hyperthermia, Induced ; Male ; Methicillin-Resistant Staphylococcus aureus ; Parturition ; Pulmonary Infarction* ; Sternotomy ; Thoracic Surgery* ; Thrombectomy ; Tricuspid Valve Insufficiency ; Tricuspid Valve*

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.
Airway Resistance ; Humans ; Lung Compliance ; Lung* ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema* ; Respiration, Artificial ; Ventilation*