Expression of Vascular Endothelial Growth Factor and Interleukin-6 in Multiple Myeloma / 대한혈액학회지

BACKGROUND: Vascular endothelial growth factor (VEGF) is a multifunctional cytokine involved in angiogenesis as selective mitogen for endothelial cells as well as potent permeability factor. And interleukin-6 (IL-6) is also known to be a growth factor of myeloma cells. To determine the role of angiogenesis, VEGF and IL-6 in the patients with multiple myeloma, the relationship between the level of VEGF expression, microvessel count (MVC), IL-6 expression in the bone marrow specimen of multiple myeloma patients and stage, response, survival duration were evaluated in 18 patients with multiple myeloma who underwent bone marrow biopsy. METHODS: VEGF expression, MVC and IL-6 expression were assessed by immunohistochemical stain with polyclonal antibody to VEGF, factor VIII related antigen and IL-6 respectively. RESULTS: VEGF expression was higher in multiple myeloma than that of control (61.4+/-34.4% vs 19.0+/-25.9%, P<0.001), and MVC was also higher in multiple myeloma than that of control (11.7+/-6.1 vs 6.2+/-3.8, P=0.005). IL-6 was expressed in 66.7% of multiple myeloma but not in control (P<0.001). Between high VEGF expression group and low VEGF expression group, there were no significant differences in the stage, response or survival. There were no significant differences between hypervascular group and hypovascular group. Also IL-6 expression was not a prognostic indicator. After treatment, VEGF expression, MVC and IL- 6 expression were decreased in the responder, but these differences were not statistically significant (P=0.23, P=0.07, P=0.06), probably due to limited number of cases. CONCLUSION: VEGF, angiogenesis and IL-6 can play a role in the pathogenesis of multiple myeloma. But we cannot confirm the prognostic role of those parameters. Further study with more cases in longer duration as well as prospective study would be necessary for the establishment of relationship between VEGF expression, neovascularization, IL-6 expression and disease severity and prognosis of multiple myeloma.

Twenty four cases of idiopathic bronchiolitis obliterans organizing pneumonia, reported in Korea and a review of literatures / 결핵

BACKGROUND & METHOD: Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. RESULTS: Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. CONCLUSION: If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation is recommended for the definitive diagnosis of BOOP.

Primary Bilateral B-cell Renal Lymphoma: A Case Report and Review of the Literature / 대한내과학회지

Primary lymphoma of the kidney is rare, and in most cases is attributable to lymphomatous renal infilitration of systemic non-Hodgkin's lymphoma or an extension from an adjacent site of the disease. Since the renal parenchyma is not a lymphoid organ, the mechanism by which renal lymphoma occur remains poorly understood. We report here a case of primary bilateral B-cell renal lymphoma in 26-year-old man who was treated successfully with combination chemotherapy.