Bronchial Atresia Associated with Spontaneous Pneumothorax : Report of A Case

A 32-yr-old male patient with recurrent pneumothorax associated with bronchial atresia of the subsegmental branch of the posterior segmental bronchus of the right upper lobe was successfully treated with right upper lobectomy. Before surgery, the bronchial atresia with pneumothorax was suspected on the chest radiograph and CT scans, which showed the findings of bronchocele with localized hyperinflation of the right upper lobe. The examination of surgical specimen from the resected right upper lobe suggests that the cause of the recurrent pneumothorax was the rupture of the subpleural bullae in the hyperinflated lung segment distal to the atretic bronchus.

Immunohistochemical Analysis of the Bullae in Patients with Primary Spontaneous Pneumothorax / 대한흉부외과학회지

BACKGROUND: Bulla is an air-filled space within the lung parenchyma resulting from deterioration of the alveolar tissue. Molecular mechanism of the formation of the bulla is not well described. Fibroblast growth factor(FGF)-7, bone morphogenetic protein(BMP) receptor, and transforming growth factor(TGF)-beta receptor are known to have a stimulatory or inhibitory role in the lung formation. We investigated to see if these growth factor or cytokine receptors are involved in the bulla formation by immunohistochemical staining of bullous lung tissues from patients with primary spontaneous pneumothorax. MATERIAL AND METHOD: Bullous lung tissues were obtained from 31 patients with primary spontaneous pneumothorax, including 30 males and 1 female from 15 to 39 years old. The bullous tissues were obtained by video-thoracoscopic surgery and/or mini-thoracotomy and fixed in formalin. Blocks of the specimens were embedded with paraffin and cut into 5~6 micrometer thick slices. The sections were deparaffinized and hydrated and then incubated with primary antibodies against FGF-7, BMP-RII, or TGF-RII. RESULT: Of the 31 patients, 24 were TGF-RII positive including 18 strong and 6 weak positives. Observation with high magnification showed that strong immunostaining was detected in the boundary region between bullous and normal lung tissues. In contrast, all of the sections were negative with FGF-7 or BMP-RII antibodies. CONCLUSION: These results suggest that overexpression of TGF-beta RII may be involved in the formation of bulla, although further molecular studies are needed to find out more detailed molecular mechanisms.

A Case of Centronuclear Myopathy

Centrinuclear myopathy, an uncommon condition, is one of the congenital myopathies. It is characterized by the presence of central nuclei of muscle cells which can be detected on electronmicroscopy. It is believed to arise as a result of maturational arrest with persistence of microtubes postnatally. We report a boy with generalized hypotonia and muscle weakness who was diagnosed as centrinuclear myopathy by muscle biopsy.

Nitric Oxide Synthase (NOS) Expression in Breast Cancer

PURPOSE: NO, a diatomic free radical, plays a diverse physiological and pathophysiological roles in the vascular, neuronal and immune systems. It is produced by nitric oxide synthase (NOS) which consists of three different isoforms. In this study we investigated NOS expression in 84 human breast carcinomas and its associations to other clinicopathological factors. METHODS: The immunohistochemical staining for NOS expression in 84 human breast carcinomas were performed and their medical records were reviewed retrospectively. RESULTS: iNOS expression in tumor cells was observed in 48.2% and eNOS expression was detected in 51.9%. iNOS expression in tumor cells has positive correlation with eNOS expression in tumor and is associated with iNOS expression in stroma and endothelial cells. Although iNOS expression in tumor cells has negative correlation with tumor size (P=0.047) and lymph node metastasis (P=0.002), it has no effects on 5 year overall and disease free survivals. iNOS expression in stroma also has negative correlation with tumor size (P=0.016) and nuclear grade (P=0.025). No significant correlation between eNOS expression and clinicopathological factors was observed but eNOS expression in tumor cells contributed to worse 5 year overall survivals (92.1% vs 77.0%) in marginal significance (P=0.053). CONCLUSION: These data suggest that iNOS expression in tumor may have an inhibitory effect in tumor growth and lymph node metastasis. These results may be further investigated.

Correlation between VEGF Expression and Angiogenesis in Advanced Gastric Carcinoma / 대한암학회지

PURPOSE: VEGF is thought to be an important angiogenic factor playing significant a role in the aggressiveness of malignant tumor by stimulating neovascularization. We morphologically investicated the tumor angiogenesis in terms of the presence of VEGF expression in advanced gastric carcinoma. MATERIALS AND METHODS: We performed immunohistochemical stains for VEGF, CD 34, and MIB-1 (Ki-67) on the 51 paraffin-embedded tissue sections. The degree of angiogenesis was determined by counting microvessel densities and their Ki-67 labelling indices of endothelial cells within the tumors. We evaluated the correlation between the expression of VEGF, angiogenesis and clinicopathologic factors such as histologic differentiation, depth of invasion, and lymph node metastasis. RESULTS: Immunoreactivity for VEGF revealed positivity in 34 out of 51 cases (66.7%). Microvessel densities and Ki-67 labelling indices of endothelial cells reflecting angiogenesis were higher in VEGF-positive tumors than VEGF-negative tumors. There were no conelations between VEGF expression, histologic differentiation and the depth of invasion. We failed to evaluate the conelation of VEGF expression and lymph node metastasis. CONCLUSION: This study suggests that VEGF expressian is closely related to tumor asso- ciated angiogenesis in advanced gastric carcinoma. Considering that tumor growth depends on angiogenesis, therapies reducing VEGF may be a means of inhibiting angiogenesis and tumor aggressiveness.