ABSTRACT
PURPOSE : E-cadherin is a tumor suppressor adhesion molecule that has an anti-invasive role and it is often considered as a useful marker for differentiating the lobular types from the ductal types of breast cancer. Yet the biological functions of E-cadherin in the invasive ductal types of breast cancers are unclear. METHODS : The E-cadherin expression was assessed immunohistochemically in 84 case of surgically resected invasive ductal carcinoma. Only the membranous expression of E-cadherin was considered and its expression was categorized as positive (>95% stained) or negative (<95% stained). The relationship between the E-cadherin expression and tumor size, the lymph node status, the histologic grade, the ER and PR status, The HER2/neu and p53 expressions was studied by performing prospective aspect. RESULTS : We analyzed 84 invasive ductal carcinomas for the E-cadherin expressions. Variable degrees of E-cadherin expression were noted in 79 cases and the complete absence of its expression was noted in 5 cases(5.9%) which showed all HER2/neu positive and p53 negative. Positive expression of E-cadherin was noted in 66cases(78.5%). Significant associations were found between the E-cadherin expression and the tumor size and the estrogen receptor status. The expression of E-cadherin was not found to be related to the lymph node status, histologic grade, the progesteron receptor status, the HER2/neu and p53 expressions. CONCLUSION: We confirmed that there was a strong correlation between the negative membrane expressions of E-cadherin and the T-stages and a negative estrogen receptor status. E-cadherin immunostaining appears to have a minimal prognostic value and it can be efficiently used for determining tumor progression of invasive ductal carcinomas of the breast.
Subject(s)
Breast Neoplasms , Breast , Cadherins , Carcinoma, Ductal , Estrogens , Immunohistochemistry , Lymph Nodes , Membranes , Prospective StudiesABSTRACT
PURPOSE: A heterotopic pancreas is defined as one for which pancreatic tissue is present outside its usual or habitual location and without an anatomic relation either of continuity or of vascularization with the pancreas proper. Most heterotopic pancreases are incidentally encountered during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been directly attributable to the presence of a heterotopic pancreas. The purpose of this article is to report the clinical characteristics of the heterotopic pancreas. METHOD: We retrospectively observed 24 patients, who had been pathologically proven to have a heterotopic pancreas, at the Department of Surgery, Korea University Hospital, from Jan. 1990 to Dec. 1998. RESULTS: 16 of the 24 cases were found incidentally during operations due to by other primary diseases; 8 cases were symptomatic. The ratio of males to females was 1.18:1 and most common sites were the stomach and the duodenum (71%). The mean size of the lesion was 1.26 cm, and the sizes in symptomatic cases were larger (mean 1.89 cm) than those in cases where the lesions were found incidentally (mean 0.94 cm). We experienced a case of a ductal adenocarcinoma originating from the heterotopic pancreas in the jejunum of a 73 year old man. CONCLUSION: A heterotopic pancreas should be considered in the differential diagnosis of submucosal tumors, polyps, ulceration, and intestinal tumors, When suspected, an intraoperative frozen section is recommended, and the range and the method of the operation should be decided based on the results of the frozen section.
Subject(s)
Aged , Female , Humans , Male , Adenocarcinoma , Diagnosis, Differential , Duodenum , Frozen Sections , Gastric Outlet Obstruction , Hemorrhage , Intussusception , Jejunum , Korea , Pancreas , Polyps , Retrospective Studies , Stomach , Ulcer , Weight LossABSTRACT
Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Subject(s)
Adolescent , Adult , Female , Humans , Autopsy , Chlorpheniramine , Death, Sudden , Diverticulum , Hashimoto Disease , Hepatitis, Chronic , Hypothyroidism , Korea , Spleen , Thyroid Gland , ThyroiditisABSTRACT
Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Subject(s)
Adolescent , Adult , Female , Humans , Autopsy , Chlorpheniramine , Death, Sudden , Diverticulum , Hashimoto Disease , Hepatitis, Chronic , Hypothyroidism , Korea , Spleen , Thyroid Gland , ThyroiditisABSTRACT
Central nervous system cryptococcosis is common in the AIDS patients with reported incidences ranging from 1.9% to 11.0%. Cryptococcosis may be the initial manifestation of HIV infection or occur simultaneously with other opportunistic infections. HIV-infected patients with central nervous system cryptococcosis complain of fever, headache, nausea and vomiting, and cognitive dysfunction. Meningeal signs and photophobia are less common than in HIV-negative patients. Focal neurologic signs and seizures are uncommon. Disseminated cryptococcosis is often concomitantly found at the time of central nervous system cryptococcosis. We report a case of 49 year-old Korean female with HIV infection who died of disseminated cryptococcosis with autopsy findings.
Subject(s)
Female , Humans , Middle Aged , Autopsy , Central Nervous System , Cryptococcosis , Fever , Headache , HIV Infections , Incidence , Nausea , Neurologic Manifestations , Opportunistic Infections , Photophobia , Seizures , VomitingABSTRACT
OBJECTIVE: To investigate the frequency of gut inflammation in the ankylosing spondylitis and the role of gut lesion in the pathogenesis of the ankylosing spondylitis. METHODS: Ileocolonoscopy and biopsy were performed in 24 patients with. ankylosing spondylitis. RESULTS: 1) Endoscopic lesions were observed in 7 patients(29.2%) of 24 patients and more often in the terminal ileum(6/7) than in the colon(I/7). Among 7 patients with endoscopic lesions, 5 patients were presented as juvenile chronic arthritis. 2) Histologic signs of gut inflammation were detected in 14 patients(58. 3%). Actue lesions were seen in 2 patients (8. 3%) and chronic lesions were seen in 12 patients (50%). 3) In 12 patients without the involvement of peripheral joints, acute lesion was not seen(0%), and chronic lesions were seen in 6 patients(50%). In 12 patients with the involvement of peripheral joints, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 6 patients(50%). Gut inflammations were more frequent in patients with the involvement of peripheral joints than in those without the involvement of peripheral joints. 4) In 12 patients without the administration of sulfasalazine, acute lesion was not seen(0%), and chronic lesions were seen in 7 patients(58.7%) In 12 patients with the administration of sulfasalazine, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 5 patients(41.6%). The frequency of gut lesions in patients without the administration of sulfasalazine was not different from that in patients with the administration. of sulfasalazine (p<0.05). CONCLUSION: Gut inflammation was frequently found in patients with ankylosing spondylitis. Chronic gut inflammation could play a role in the pathogenesis of the ankylosing spondylitis.
Subject(s)
Humans , Arthritis, Juvenile , Biopsy , Inflammation , Joints , Spondylitis, Ankylosing , SulfasalazineABSTRACT
The p53 gene product has been detected in various human tumors. To investigate the overexpression of the p53 protein in bladder tumor as a marker of tumor progression, the correlation between the overexpression of the p53 protein in bladder and the pathologic grade, stage and survival rate was studied. Among specimens of 47 patients, 19 were from patients of superficial bladder tumor, 28 were from invasive bladder tumor according to pathologic stage, while 15 were from low grade and 32 were from high grade tumors according to Ash grade p53 overexpression was determined by immunohistochemistry using DO-7 primary antibody on paraffin embedded sections and flow cytometry was performed on cell suspensions derived from the same blocks. Histologically normal bladder tissue was used as a control group Conclusions were made as follows: 1. p53 protein overexpression was observed in 31 of 47 cases(65.9%). 2. Seven of 15 specimens from well differentiated tumor(Ash grade I, II) showed positive p53 staining while 24 of 32 cases from poorly differentiated tumor (Ash grade III,IV) showed positive staining. There is a significant correlation between p53 expression and poor pathological grade(p=0.05). 3. Nine of 19 cases with superficial bladder tumor showed positive staining while 22 of28 cases of invasive tumor showed positive staining. There is a significant correlation between p53 protein overexpression and invasive tumor(p=0.027). 4. Flow cytometric examination revealed that 24 of 30 cases with aneuploid group showed positive staining while 7 of 17 cases with diploid group showed positive staining. Aneuploid group showed high correlation with p53 protein overexpression(p=0.007). 5. The survival rates of patients, exhibiting p53 protein overexpression, were slightly worse than those with p53 negative tumor(p=0.08, Wilcoxon test) but this difference was not significant enough to count. 6. p53 protein overexpression was well correlated with grade, stage and flow cytometric analysis in bladder tumor. 7. Multiple linear regression study to survival rate showed the overexpression of p53 protein had little prognostic significance in bladder tumor compared with tumor grade and stage.