• Title/Summary/Keyword: malignant tumors

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Retinoid Receptors in Gastric Cancer: Expression and Influence on Prognosis

  • Hu, Kong-Wang;Chen, Fei-Hu;Ge, Jin-Fang;Cao, Li-Yu;Li, Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1809-1817
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    • 2012
  • Background: Gastric cancer is frequently lethal despite aggressive multimodal therapies, and new treatment approaches are therefore needed. Retinoids are potential candidate drugs: they prevent cell differentiation, proliferation and malignant transformation in gastric cancer cell lines. They interact with nuclear retinoid receptors (the retinoic acid receptors [RARs] and retinoid X receptors [RXRs]), which function as transcription factors, each with three subclasses, ${\alpha}$, ${\beta}$ and ${\gamma}$. At present, little is known about retinoid expression and influence on prognosis in gastric cancers. Patients and Methods: We retrospectively analyzed the expression of the subtypes RARa, $RAR{\beta}$, $RAR{\gamma}$, RXRa, $RXR{\beta}$, $RXR{\gamma}$ by immunohistochemistry in 147 gastric cancers and 51 normal gastric epithelium tissues for whom clinical follow-up data were available and correlated the results with clinical characteristics. In addition, we quantified the expression of retinoid receptor mRNA using real-time PCR (RT-PCR) in another 6 gastric adenocarcinoma and 3 normal gastric tissues. From 2008 to 2010, 80 patients with gastric cancers were enrolled onto therapy with all-trans-retinoic acid (ATRA). Results: RARa, $RAR{\beta}$, $RAR{\gamma}$ and $RXR{\gamma}$ positively correlated with each other (p < 0.001) and demonstrated significantly lower levels in the carcinoma tissue sections (p < 0.01), with lower $RAR{\beta}$, $RAR{\gamma}$ and RXRa expression significantly related to advanced stages (p < =0.01). Tumors with poor histopathologic grade had lower levels of RARa and $RAR{\beta}$ in different histological types of gastric carcinoma (p < 0.01). Patients whose tumors exhibited low levels of RARa expression had significantly lower overall survival compared with patients who had higher expression levels of this receptor (p < 0.001, HR=0.42, 95.0% CI 0.24-0.73), and patients undergoing ATRA treatment had significantly longer median survival times (p = 0.007, HR=0.41, 95.0% CI 0.21-0.80). Conclusions: Retinoic acid receptors are frequently expressed in epithelial gastric cancer with a decreased tendency of expression and RARa may be an indicator of a positive prognosis. This study provides a molecular basis for the therapeutic use of retinoids against gastric cancer.

Open Heart Surgery 600 Cases for 5 Years (5년간 개심술 600예에 관한 검토)

  • 조광현
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.404-420
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    • 1991
  • Surgical treatment of congenital and acquired heart disease preceded the development of accurate techniques for diagnosis, heart lung machine and cardiopulmonary bypass, intraoperative myocardial protection, operative techniques and cardiac anesthesia. For 5 years from Sep. 1985 to Sep. 1990, six hundred cases of open heart surgeries [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. The results were summarized as follows. 1. The annual number of OHS[cases per year] was above 100 since 1987, and the increasing rate of cases was 23.5% per year since 1986. 2. Among the total 600 cases, there were 470 cases of congenital heart diseases and 130 cases of acquired. Age range of the congenital patients was 8 months to 44 years with the mean age of 10 years, and acquired patients was 16 to 56 years with the mean age of 36 years. 3. Among the 470 congenital anomalies, there were 429 cases of acyanotic and 41 cyanotic patients. Totally, VSD was 286 cases[60.6%], ASD 103 cases[21.9%], TOF 35 cases [7.4%], PS 20 cases [4.1%], ECD 12 cases [2.0%], Ebstein`s anomaly 3 cases [0.6%], Valsalva sinus rupture 3 cases [0.6%] and others. The appropriate one stage radical operations were applied to the all congenital cases with the result of 2.6% immediate postoperative hospital mortality rate. 4. Among the 130 acquired cases, there were 122 cases of valvular heart diseases, 6 of heart tumors [5 myxoma, one malignant histiocytoma], one of LA thrombus and one of annuloaortic ectasia. Cardiac tumors and LA thrombus were removed through the atrial septal approach. Bentall procedure was adopted to the annuloaortic ectasia case. AVR, MVR and TVA [DeVega procedure] were applied to 120 valve diseases, and there were also one of OMC and one of MVA[Jerome-Kay procedure]. 5. Among the 120 valve replacement cases, there were 87 of single valve replacement cases [AVR: 8, MVR: 79], 11 of double valve replacement [AVR+MVR: 11], 12 of MVR+TVR and 10 of MVR+AVR+TVA. The total number of implanted prosthetic valves were 141. In MVR, 45 of St. Jude Medical valves, 63 of Carpentier-Edward valves and 4 of Ionescu-Shiley valves were used. In AVR, 18 of St. Jude Medical valves and 11 of Carpentier-Edward valves were used. in MVR, 29mm and 31mm sized valves were used mostly and In AVR, 23mm sized valves were used mostly. 6. Postoperatively many kinds of complications were occurred. Among them, wound problems [30 cases], low output syndrome [29 cases], arrhythmia [20 cases], pleural effusion and pneumothorax [13 cases] were occurred frequently. The postoperative immediate hospital mortality was 3.0% in total [congenital 2.6%, acquired 4.6%].

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Endobronchial Metastasis of Extrapulmonary Malignancies (폐외 악성 종양의 기관지내 전이)

  • Kim, Do-Hoon;Park, Moo-Suk;Chung, Jae-Ho;Cheong, Jae-Hee;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.285-293
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    • 2002
  • Background : The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. Materials and Methods : The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. Results : The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. Conclusion : An endobronchial metastasis is an ominous finding, and is associated with advanced-stage diseases. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.

A Case of Imatinib-mesylate associated Hypersensitivity Pneumonitis (Imatinib-mesylate에 의한 과민성 폐렴 1예)

  • Lee, Jae Wong;Kim, Hye Jin;Kim, Kyu Jin;Shin, Kyeong Cheol;Hong, Yeong Hoon;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.423-426
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    • 2005
  • Imatinib-mesylate (Gleevec, Glivec) is a protein-tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase created by the Philadelphia chromosome abnormality in CML. Imatinib is also used to treat patients with c-kit (CD 117)-positive unresectable tumors, or metastatic malignant gastrointestinal stromal tumors, or both. Imatinib is a welltolerated drug with few side effects. However, it has been associated with gastrointestinal irritation, fluid retention and edema, skin rashes, depigmentation, hepatotoxicity, hemorrhage, and hematological toxicity (anemia, neutropenia, and thrombocytopenia). In addition, imatinib has been associated with dyspnea and cough, which are mainly secondary to the pleural effusion and pulmonary edema, which represent local or general fluid retention. These events appear to be dose related and are more common encountered in the elderly. However, there has been no report of hypersensitivity pneumonitis associated with imatinib-mesylate in Korea. We report a case of 51-year old woman who developed hypersensitivity pneumonitis that might have been induced by imatinib-mesylate during the treatment of a gastrointestinal stromal tumor.

THE IMMUNOHISTOCHEMICAL STUDY ON THE EXPRESSION OF p53 PROTEIN AND CYCLIN D1 IN ORAL SQUAMOUS CELL CARCINOMAS (구강 편평세포암종에서 p53 단백과 Cyclin D1발현에 대한 면역조직화학적 연구)

  • Kim, Jong-Yub;Kim, Kyung-Wook;Lee, Jae-Hoon;Kim, Chang-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.139-148
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    • 1999
  • Oral cancer is a common neoplasm in humans and etiologic mechanism is not well known, so treatment and evaluation of oral cancer is difficult problem. Traditional TNM classification between prognosis of tumors and classification of histopathologic differentiation has problem like lack of objectivity through operators. In molecular biology, cancer is developed by alteration of activation of oncogene and/or inactivation of tumor suppressor gene. The p53 gene, one of the tumor suppresor genes, is believed to play an important role through mutation and overexpression in the progression of human cancers. The p53 mutation is most frequent genetic disorder in humans. The Cyclin D1 has tumor suppresion activity by regulation of cell cycle. The Cyclin D1 regulate activity of Rb tumor suppresor gene by stimulation of CDK4 The purpose of this study was to observe the expression of p53 protein and Cyclin D1 in oral squamous cell carcinoma, and to get expectation of the malignancy and prognosis of oral squamous cell carcinoma. Using the 15 cases of squamous cell carcinoma and the microscopic H&E and immunohistochemical stain. We divided it into 3 groups according to the stain extent, clinical stage and histologic differentiation. The results were as follows1.In the features of immunohistochemical stain of 15 cases of squamous cell carcinoma, positive reaction of p53 was identified in 8 cases (53.3%) and positive reaction of cyclin D1 was identified in 3 cases (20%). Both positive reaction of p53 protein and Cyclin D1 was show in only one case. 2.8 of p53 positive cases were linked in 87.5% of the end stage tumor, 62.5% of neck node involvement, 87.5% of poorly and moderately histopathplogic differentiation. 3. All 3 of Cyclin D1 positive cases were linked in the end stage tumor, neck node involvement, poorly and moderately histopathologic differentiation. From above results, expression of p53 protein was identified in 53.3% of 15 cases and these results mean oral squamous cell carcinoma was drived by mutation of p53 protein. Especially, highly positive reaction of p53 protein and Cyclin D1 was identified in cases that involvement of neck lymph node and the end stage tumors and it means that the evaluation of p53 protein and Cyclin D1 was useful for evaluation of malignant tumor as specific tumor marker.

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Diagnostic Approach to a Soft Tissue Mass (연부조직 종양의 진단적 접근)

  • Chun, Young Soo;Song, Seung Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.293-301
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    • 2019
  • Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

Examination Techniques and Imaging Findings of Hepatic Hemangioma (간혈관종의 검사기법과 영상소견)

  • Chang-Hoe Koo;Jong-Wan Keum;Ji-Eun Seok;Dong-Chul Choi;Yun-Ho Choi;Man-Seok Han;Min-Cheol Jeon
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.375-384
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    • 2023
  • Most Hepatic hemangiomas are asymptomatic and small in size, making them difficult to find by pathological examination. Therefore, radiological diagnosis is essential for the early finding and diagnosis of Hepatic hemangioma. Three-phase method using contrast medium in computed tomography, T1, T2-weighted imaging in magnetic resonance imaging, dynamic magnetic resonance imaging using contrast medium, echo planar imaging method, diffusion-weighted imaging method, blood pool scan using 99mTc-labeled red blood cells in nuclear medicine, we looked at the color doppler method In ultrasound, and it is important to accurately understand the imaging findings of hepatic hemangioma and perform the examination in order to make an accurate diagnosis. most hepatic hemangioma are benign tumors, care should be taken not to confuse them with malignant tumors such as hepatocellular carcinoma to prevent unnecessary procedures. Therefore, in order to make an accurate diagnosis, it is important to accurately understand the imaging findings of hemangioma and perform the examination.

Clinical Analysis and Surgical Results of Skull Base Meningiomas (뇌기저부 수막종의 임상분석 및 수술성적)

  • Kim, Young Wook;Jung, Shin;Kim, Jae Sung;Lee, Jung Kil;Kim, Tae Sun;Kim, Jae Hyoo;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1437-1444
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    • 2000
  • Objectives : Traditionally intracranial meningiomas are regarded as benign and curable tumors. About half of all intracranial meningiomas locate in the skull base region. However, surgical removal of these tumors may be challenging and require special considerations. Here general aspects of skull base meningiomas including clinical presentation, surgical approaches, complications and their recurrence rate are discussed based on our experiences. Methods : A retrospective analysis of 61 consecutive patients with skull base meningioma among 210 patients of meningioma between 1989 and 1998 were done. Results : There were 41 women and 20 men ranging from 13 to 74 years(mean 52 years). These tumors were divided into seven categories according to location : olfactory groove(n=9), sphenoid ridge(n=16), cavernous sinus(n =2), tuberculum sellae(n=8), tentorium(n=13), cerebellopontine angle(n=12), and foramen magnum meningiomas (n=1). Surgical approaches were selected on the basis of the tumor attachment, size and extension on preoperative radiologic findings. Total removal(Simpson grade I and II) was achieved in 50 cases(82%), and subtotal removal (Simpson grade III) in 11 patients(18%). According to WHO classification, there were 52 of cases of benign meningioma( 86%), 6 atypical cases(10%), and 3 malignant cases(5%). The most common postoperative complications were CSF leakage(23.0%) and cranial nerve injury(8.2%). Three patient died related with tumor(one was due to surgical complication and the other two due to recurrence) but three patients died from other systemic causes. Mean follow-up period was 51.7 months after surgery. Recurrence occurred in six patients(10.9%) ; three with tentorial meningioma, two with sphenoid ridge, and one in cerebellopontine angle. Conclusion : With advances in neuroradiology and microsurgical techniques, the surgical outcome of miningiomas has been markedly improved with acceptable morbidity and mortality rates. Overall, our surgical results of skull base meningiomas is comparable to other reports. Therefore, with the appropriate operative strategy and techniques, these tumors can be completely removed and good surgical results can be expected.

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Oncologic Results and Functional Assessment of Limb Salvage Surgery in Primary Bone Tumors Around the Shoulder Girdle (견관절 주위 원발성 골 종양에서 사지 구제술의 종양학적 결과 및 기능적 평가)

  • Lee, Sang-Hoon;Yoo, Jae-Ho;Oh, Joo-Han;Suh, Sung-Wook;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.96-105
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    • 2002
  • Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.

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Enhanced Immune Cell Functions and Cytokine Production after in vitro Stimulation with Arabinoxylans Fraction from Rice Bran

  • Choi, Eun-Mi;Kim, Ah-Jin;Hwang, Jae-Kwan
    • Food Science and Biotechnology
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    • v.14 no.4
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    • pp.479-486
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    • 2005
  • Arabinoxylan, a complex polysaccharide in cereal cell walls, has recently received research attention as a biological response modifier. The immunomodulating effect of arabinoxylans from rice bran (AXrb) was studied using a combined process of extrusion and commercial hemicellulase treatment in order to elucidate the augmentation mechanism of cell-mediated immunity in vitro. The cytotoxicity of mouse spleen lymphocytes against YAC-1 tumor cells was significantly enhanced by treatment with AXrb at $10-100\;{\mu}g/mL$. In an attempt to investigate the mechanism by which AXrb enhance NK cytotoxicity, we examined the effect of AXrb on cytokine production by spleen lymphocytes. Culture supernatants of the cells incubated with AXrb were collected and analyzed for IL-2 and IFN-${\gamma}$ synthesis by ELISA. IL-2 and IFN-${\gamma}$ production were increased significantly. These results suggest that AXrb may induce Th1 immune responses. Macrophages play an important role in host defenses against tumors by killing them and producing secretory products, which protect against bacterial, viral infection and malignant cell growth. AXrb were examined for their ability to induce secretory and cellular responses in murine peritoneal macrophages. When macrophages were treated with various concentrations ($10-100\;{\mu}g/mL$) of AXrb, AXrb induced tumoricidal activity, as well as increasing phagocytosis and the production of NO, $H_2O_2$, TNF-${\alpha}$, IL-$1{\beta}$, and IL-6. These results indicate that reactive oxygen species, reactive nitrogen species, and inflammatory cytokines are likely to be the major mediators of tumoricidal activity in AXrb-treated macrophages. Therefore, AXrb may be useful in cancer immunotherapy and it is anticipated that AXrb obtained using extrusion and subsequent enzyme treatment can be used as an ingredient in nutraceuticals and cereal-based functional food.