• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.440-448
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• 1996

Bronchial carcinoid tumors are uncommon, constituting approximately 3-5% of all primary lung cancers. Classification of these tumors has evolved substantially as our understanding of the cellular, biologic, and clinical aspects of these neoplasms has improved. Initially, bronchial carcinoids were thought to be benign and therefore were classified as bronchial adenomas. Currently, however, they are well recognized as having the potential for both local invasion and distant metastatic involvement. Consequently, carcinoid tumors are frankly malignant. Thus bronchial adenoma is a misnomer that should no longer be used for bronchial carcinoids. Most investigators currently favor classifying carcinoid tumors as a type of neuroendocrine neoplasm because of their potential to secrete a variety of chemical substances found in both the central nervous system and the epithelial cells of numerous organs. Bronchial carcinoids are usually characterized by a slow growth pattern and a low incidence of metastasis, and histologically conformed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Atypical carcinoid tumor was first defined by Arrigoni et al, who proposed the following criteria for separation of atypical carcinoid from typical carcinoid tumor : 1) increased mitotic activity with 1 mitotic figure per 1-2 high power fields(or 5-10 mitoses /10 HPF), 2) nuclear pleomorphism, hyperchromatism, and an abnormal nuclear-cytoplasmic ratio, 3) areas of increased cellularity with disorganization of the architecture, and 4) tumor necrosis. In contrast, typical carcinoid tumor may have focal cytologic pleomorphism, but necrosis is absent and mitotic figures are rare. Recently we experienced a case of atypical bronchial carcinoid with multiple distant metastasis, so we report this case with a review of the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.115-119
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• 1996

Myoepithelioma is composed exclusively of myoepithelial cells. Myoepithelial cells are ectodermally derived contractile cells that can be routinely identified in many normal tissues having secretory function such as major and minor salivary glands, lacrimal gland and sweat gland. Tumors composed exclusively of myoepithelial cells, so-called myoepitheliomas, are rare-less than 1% of all salivary gland tumors. Grossly, these tumors are well demarcated. The external surface is smooth and may be bosselated. The cut surface is white and homogenous. Microscopically, these tumors are surrounded by a thin fibrous capsule. They are composed of benign-appearing spindle- shaped and/or polygonal cells. Mitoses are rare. Frequently these tumors contain myxomatous stroma which is susceptible to alcial blue stain. Clinically, myoepitheliomas present as slow-glowing, painless masses and can not distinguished from pleomorphic adenomas. Treatment is the same as for pleomorphic adenoma, and the surgical excision should include a margin of normal tissue. Although the majority of myoepitheliomas have behaved in a beingn manner, pleomorphism and mitotic activity have been associated with local aggressiveness.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권5호
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• pp.405-416
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• 2007

Objective : Lots of papers have revealed that tumor growth related factors such as EGF, EGFR, c-erbB-2 play an important role in tumorigenesis and proliferation. These factors are found in most tumors of ectodermal origin. But, documentations of tumor growth related factors on salivary gland tumors were rare. Therefore, we determined expressions of tumor growth related factors; PCNA, p53, EGF, EGFR, cerbB2(HER-2), Maspin, DMBT-1, N-Ras in representative salivary gland tumors. Materials and methods : A few types of salivary tumors were examined by immunohistochemical assays. Each antibody was applied to specimens of tumors. Specimens were composed of 5 pleomorphic adenomas (PA), 3 mucoepidermoid carcinomas (MEC), 2 adenoid cystic carcinomas (ACC) and 2 squamous cell carcinomas (SCC) from 12 patients. One specimen was selected randomly as negative control. For evaluation of staining intensity, each stained sample was divided into 5 grade; no staining, obscure, weak staining, moderate staining, strong staining. Results : Strong expressions of PCNA were found in all tumors except of PA. EGF was expressed strongly in SCC, ACC sequently. But in both PA and MEC, EGF expression was weak. EGFR and c-erbB-2 expression showed similar patterns in all salivary gland tumor tissues. P53 showed weak expression generally in all salivary gland tumors. DMBT-1 was expressed in SCC rather than in ACC or in MEC. N-Ras showed weak expressions in all salivary gland tumors except of squamous cell carcinoma. Conclusion : Taken together, tumor growth related factors were expressed in salivay tumors as well as mucosal squamous cell carcinoma. Especially EGFR and c-erbB-2 could be candidates as diagnostic markers for estimating clinical grade of salivary gland tumors. But further studies with reliable methods will be needed to confirm the results of this study.

• 대한두경부종양학회지
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• 제21권1호
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• pp.15-20
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• 2005

Objectives: The hepatocyte growth factor(HGF)/c-Met pathway may play various roles in the carcinogenesis of various organs. Although HGF/c-Met signalling pathway has been shown to demonstrate various cellular responses including mitogenic, proliferative, morphogenic and angiogenic activities, the study on their expression related to clinicopathological parameters in thyroid tumor is relatively rare. So we want to find out the clinical significance of the c-Met in thyroid tumor. Materials and Methods: We assess the mRNA and protein expression of the c-Met genes by means of RT-PCR method and the immunohistochemical stain in 100 cases of thyroid tumors(50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasia). Results: By RT-PCR, c-Met mRNA was detected in 43(86%) in papillary carcinoma, 4(40%) in follicular carcinoma, 4(20%) in follicular adenoma and 2(10%) in nodular hyperplasia cases. By immunohistochemistry, c-Met protein expression was detected in 44(88%), 2(20%), 3(15%) and 1(5%). Expression of the c-Met mRNA and protein expression was significantly highly recognized in papillary carcinoma. The c-Met protein overexpression was significantly correlated with the grade of the differentiation. Conclusion: These results suggest that c-Met expression may be associated with thyroid papillary cancer progression. The differential expression of c-Met protein and mRNA suggests that these molecules may be a reliable diagnostic marker in thyroid papillary cancer.

• 대한두경부종양학회지
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• 제19권1호
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• pp.3-8
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• 2003

Background: Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into the issue of recurrent pleomorphic adenoma and more specifically to evaluate our experience and results of treatment, a retrospective study was carried out. Materials and Methods: During the period from 1989 to 2002, the medical records of 14 patients who underwent a operation for recurrent pleomorphic adenoma of the parotid gland were reviewed retrospectively. The initial operation for parotid tumor, clinical features of recurrence, reoperation after recurrence, po stop complication were analysed. Results: The male to female ratio was 6 : 9. Median age of the patients at the time of the initial operation was 33 years and at the time of the reoperation was 43 years. The median interval until recurrence was 105 months (6-252 months). The initial operations performed were excision or enucleation in 10 patients, superficial parotidectomy in 3 patients, total parotidectmy in 1 patients. The thirteen patients were underwent reoperation (8 superficial parotidectomies, 3 total parotidectomies, 1 neartotal parotidectomy, 1 wide excision). The facial nerve paralysis after the reoperation occured in 6 patients but all of them were recovered from 3 months to 1 year after surgery. Conclusion: In the management of pleomorphic adenoma of the parotid gland, excision or enucleation is to be avoided due to the higher recurrence rate and superficial or total parotidectomy with preservation of the facial nerve are to be preferred. Because the risk of facial nerve injury during operation for the recurrent tumor was higher than initial surgery, more careful surgical procedure is mandatory for preserving the facial nerve.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.137-143
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• 2001

Objective : Telomerase, a ribonucleoprotein adds telomere repeats to the ends of telomeres to compensate for the progressive loss. A favorable prognosis associated with low or no telomerase activity in some tumors, and cells transfected with antisense human telomerase lost telomeric repeats and die. We studied about the relationship between telomerase activity and apoptosis in the human brain tumors. Material and Methods : Between July 1998 and December 1999, 62 patients with brain tumors underwent surgery and their surgical specimens were obtained. Telomerase activity was investigated by telomeric repeats amplification protocol(TRAP) assay. Apoptosis was also evaluated by DNA fragmentation analysis. Differences and correlation in data were analyzed using Mann-Whitney test and Wilcoxon-signed rank test. Results : Expression rate of telomerase activity and apoptosis were 80% and 30% in malignant gliomas, 33% and 0% in low grade gliomas, 63% and 38% in meningiomas, 67% and 33% in pituitary adenomas, 33% and 33% in metastatic tumors, 67% and 17% in acoustic neurinomas, 100% and 100% in pineoblastomas, 100% and 0% in the hemangioblastoma, respectively. There was no significant difference of telomerase activity and apoptosis between histological types. But a significant difference was noted in the expression of telomerase activity between malignant gliomas and low grade gliomas(p = 0.022). Brain tumors with telomerase activity expressed the lower rate of apoptosis. A significant correlation was also found between telomerase activity and absence of apoptosis in the human brain tumors(p = 0.005). Conclusions : Our data suggests that telomerase may protect from apoptosis of the human brain tumors and also may play an important role in the biological malignancy of the gliomas.

• Journal of Korean Neurosurgical Society
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• 제38권1호
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• pp.12-15
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• 2005

Objective : Cerebral edema develops in the brain tumors by loosening of the endothelial tight junction. Tight junction[TJ] proteins, such as occludin and claudin bind adjacent cells tightly. Authors examine the expression rate of occludin in human brain tumors to evaluate the effect of altered expression of occludin on cerebral edema. Methods : Seventy surgical specimens stored at $-70^{\circ}C$ were used. It included 14 astrocytic tumors, 27 meningiomas, 12 scwannomas, 7 pituitary adenomas, 6 hemangioblastomas. and 4 craniopharyngiomas. After protein extraction, expression of occludin was investigated by Western blot analysis. The tumors were classified according to World Health Organization[WHO] classification. Results : The expression rates of occludin in brain tumors were : glioma [8/14=57.1%]. meningioma [16/27=59.3%], schwannoma [10/12=83.3%], pituitary adenoma [6/7=85.7%], hemangioblastoma [6/6=100%], and craniopharyngioma [3/4=75.0%]. The expression rate in glioma and meningioma was lower than other brain tumors. In gliomas, high grade tumor [1/4=25.0%] exhibited lower expression rate of occludin than low grade one [7/10=70.0%]. Conclusion : These results suggest that the expression of occludin is different among the various kinds of brain tumors. In gliomas, its expression is correlated with the histological grade. It may indicate that occludin plays a role in the development of edema in the brain tumors.

• Korean Journal of Radiology
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• 제22권2호
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• pp.243-252
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• 2021

Objective: To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors. Materials and Methods: We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D^*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis. Results: Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin's tumors (WTs) (p < 0.001). The D^* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720). Conclusion: IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.

• Clinical Endoscopy
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• 제56권3호
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• pp.325-332
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• 2023

Background/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas. Methods: Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen. Results: Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers. Conclusions: Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

• Clinical Endoscopy
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• 제56권5호
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• pp.623-632
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• 2023

Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. Conclusions: NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.