Cho Eun-Chol;Sub Jin-Hak;Chung Woong-Yun;Kim Ho-Geun;Park Cheong-Soo
Korean Journal of Head & Neck Oncology
/
v.17
no.2
/
pp.205-209
/
2001
Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.
Renal ischemia-reperfusion injury is great clinical important because viability of the transplanted organ depends on the tolerance of the graft to ischemia-reperfusion injury, an inevitable processing during surgery. The purpose of this study was to investigate the effects of irrigation-aspiration in ischemia-reperfusion injury model induced by cross-clamping of renal vessels. Blood samples were collected from these dogs for measurement of kidney function and antioxidant enzyme activity, and RI at the intrarenal artery was measured at different time intervals. And the kidneys were taken for histopathologic evaluation at day 14. Kidney function (Cr and BUN) showed a significant increasing in untreated group compared to treated group. Resistive index of intrarenal artery was no significant difference among the groups. Activity of antioxidant enzymes in plasma was significant decrease in untreated group compare to control group while in treated group was no significant difference compared to control group. In histopathologic finding, treated group was showed less damage than that of untreated group. This result suggests that the processing of irrigation-aspiration is useful to reducing ischemia-reperfusion injury.
Background: Although roles of genetic polymorphisms of leptin receptor (LEPR) gene in several cancers have been documented, the association between polymorphisms of LEPR and clear cell renal cell carcinoma (CC-RCC) remains unknown. The aim of this study was to explore any relation. Materials and Methods: The study population consisted of 77 patients with CC-RCC and 161 healthy control subjects. Polymorphism analyses of Lys109Arg and Gln223Arg were performed by direct DNA sequencing and PCR-restriction fragment length polymorphism approaches respectively. Results: Comparisons of allelic and genotypic frequencies in Lys109Arg and Gln223Arg showed no significant difference between the cases and controls. However, when evaluating the combined genotype of Lys109Arg and Gln223Arg, risk with GG/GG was increased (OR=1.85, 95%CI=1.04-3.30) and with GA/GG or GG/GA was decreased (OR=0.07, 95%CI=0.01-0.54; OR and 95%CI of the latter could not be calculated for a value of zero). Furthermore, the G-G haplotype frequency of Lys109Arg and Gln223Arg in the cases was higher (OR=1.68; 95%CI=1.02-2.76). In contrast, the A-G and G-A haplotype frequencies in the cases were lower than those in the controls (OR=0.06; 95%CI=0.01 to 0.47; OR and 95%CI of the latter could not be calculated for a value of zero). In addition, the Lys109Arg A allele was in LD with the Gln223Arg A allele (d'=0.9399) in the CC-RCC subjects, but not in the controls. Conclusions: Our data suggest that the GG/GG combined genotype and G-G haplotype of Lys109Arg and Gln223Arg can act as evaluating factors for CC-RCC risk.
Rhabdoid tumor has been considered to be a rare subtype of Wilm's tumor with Rhabdomyoma features. Since rhabdoid tumor that developed in the kidney was described for the first time in 1989, it has been reported in the gastrointestinal tract, although this is rare. The appropriate treatment is radical resection, and the effect of adjuvant chemotherapy has not yet been reported on. The outcome of extra-renal rhabdoid tumor is different from renal rhabdoid tumor and the former shows a poor prognosis. Among extra-renal rhabdoid tumors, undifferentiated gastric adenocarcinoma with rhabdoid features is very rare and its prognosis is poor. A 63 years old male patient underwent total gastrectomy for a tumor that developed in the greater curvature of the gastric body and this was diagnosed as undifferentiated gastric adenocarcinoma with rhabdoid features, according to the histopathology. We experienced an undifferentiated gastric adenocarcinoma with rhabdoid features that was diagnosed by immunohistochemical staining and we report here on this case.
Renal cell carcinoma (RCC) is the most frequent urological malignant tumor in adults and it occurs mostly between the fifth and the sixth decades of life. The male-female ratio is 3:1 and it is more common in smokers. It accounts for approximately 3% of adult malignancies; 90~95% of neoplasms of the kidney. The classic triad of presenting symptoms of RCC is hematuria, back pain and a mass in the flank. More than 50% of RCCs show metastasis to breast, lung and regional lymph nodes, and 15% present in the orofacialmaxillary region. This case is about a 66 year-old man who was treated for painless swelling in the left masseteric area. The mass was surgically excised and sent for biopsy. It was diagnosed as RCC and two weeks later nephronectomy of the left kidney was performed. Metastasis to other organs was detected and the patient received radiation therapy. In this case we were able to find the primary lesion by the metastatic lesion.
Kim, Hyool;Jung, Tae-Young;Kim, In-Young;Jung, Shin;Moon, Kyung-Sub;Park, Seung-Jin
Journal of Korean Neurosurgical Society
/
v.54
no.2
/
pp.107-111
/
2013
Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.
Kim, Byoung-Gwon;Kim, Sung-Ryul;Hong, Young-Seoub;Rha, Seo-Hee;Kim, Jung-Man;Jung, Kap-Yull;Kim, Joon-Youn
Journal of Preventive Medicine and Public Health
/
v.29
no.1
s.52
/
pp.43-50
/
1996
We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.
Chronic exposure to cadmium (Cd) is known to adversely affect renal function. Our previous studies indicated that Cd induces p53-dependent apoptosis by inhibiting gene expression of the ubiquitin-conjugating enzyme (Ube) 2d family in both human and rat proximal tubular cells. In this study, the effects of Cd on protein expression of p53 and apoptotic signals in the kidney and liver of mice exposed to Cd for 12 months were examined, as well as the effects of Cd on p53 protein levels and gene expression of the Ube2d family in various cell lines. Results showed that in the kidney of mice exposed to 300 ppm Cd for 12 months, there was overaccumulation of p53 proteins in addition to the induction of apoptosis, which was triggered specifically in the proximal tubules. Interestingly, the site of apoptosis was the same as that of p53 accumulation in the proximal tubules. In the liver of mice chronically exposed to Cd, gene expression of the Ube2d family tended to be slightly decreased, together with slight apoptosis without the accumulation of p53 protein. In rat small intestine epithelial (IEC-6) cells, Cd decreased not only the p53 protein level but also gene expression of Ube2d1, Ube2d2 and Ube2d4. In human brain microvascular endothelial cells (HBMECs), Cd did not suppress gene expression of the Ube2d family, but increased the p53 protein level. In human brain astrocytes (HBASTs), Cd only increased gene expression of UBE2D3. These results suggest that Cd-induced apoptosis through p53 protein is associated with renal toxicity but not hepatic toxicity, and the modification of p53 protein by Cd may vary depending on cell type.
Late recurrence over 10 years after surgery and endobronchial metastasis are some of the specific biological behaviors of renal cell carcinoma (RCC). The current report describes a case of solitary endobronchial metastasis at a subsegmental bronchus that developed 20 years after curative nephrectomy for RCC. A 71-year-old male was admitted to our hospital for pneumonia. Chest radiography showed multifocal ill-defined nodular opacities in the right lower lung zone, suggesting pneumonia. Subsequent chest CT confirmed pneumonic infiltration in the right lung. However, a 4.3-cm, well-defined, elongated mass with a branching pattern was also identified in the right lower lobe, and a right nephrectomy scar was detected on the covered upper abdomen. The patient had undergone right nephrectomy 20 years ago due to clear cell RCC. After right lower lobectomy, the postoperative pathological diagnosis was endobronchial metastatic clear cell RCC. Endobronchial metastasis should be considered in a patient with a history of RCC who presents with a suspected endobronchial tumor, even decades after curative surgery.
Jee, Jung-Hoon;Keum, Yoo-Hwa;Bae, Jun Sung;Lee, Chae Won;Yang, Chan Yeong;Choi, Sang-Hoon;Kang, Ju-Chan;Park, Kwan Ha
Journal of fish pathology
/
v.32
no.2
/
pp.113-121
/
2019
Effects on glutathione-related antioxidant parameters were examined after a chronic exposure of olive flounder, Paralichthys olivaceus to dietary 4-tert-octylphenol (4-tert-OP). Fish were fed diets containing 4-tert-OP at 0, 1, 5 and 10 mg/kg diet for 6 weeks. Antioxidant parameters examined were reduced glutathione (GSH) contents and enzyme activities of glutathione reductase (GR), glutathione S-transferase (GST) and glutathione peroxidase (GPx) in tissue homogenates of the liver, kidney and gill. It was observed that all parameters examined increased although there were some differences in dose responses and temporal patterns in the increase. GSH contents increased after exposure to 4-tert-OP in the three organs examined. However, the GSH increase was evident only after 4 weeks in the liver whereas it was elevated after 2 weeks in the kidney and gill. GR activity exhibited a significant increase in response to 4-tert-OP at 1 mg/kg in all three organs, however, its activity returned to control levels when exposed to 5 and 10 mg/kg. Hepatic GST activity showed an earlier increase at week 2 in contrast to the kidney and gill where they increased after 4 weeks of 4-tert-OP exposure. Temporal patterns in GPx activity changes to 4-tert-OP exposure were dissimilar among the organs: hepatic activity increased from week 2 through week 6; renal activity increased transiently at week 2; gill levels were higher through weeks 4 - 6. The results suggest that elevation of several GSH-related antioxidant parameters can be considered as evaluation criteria for 4-tert-OP-induced oxidative stress in a fish.
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