The Clinical Implications of Death Domain-Associated Protein (DAXX) Expression

BACKGROUND: Death domain-associated protein (DAXX), originally identified as a pro-apoptotic protein, is now understood to be either a pro-apoptotic or an anti-apoptotic factor with a chromatin remodeler, depending on the cell type and context. This study evaluated DAXX expression and its clinical implications in squamous cell carcinoma of the esophagus. METHODS: Paraffin-embedded tissues from 60 cases of esophageal squamous carcinoma were analyzed immunohistochemically. An immune reaction with more than 10% of tumor cells was interpreted as positive. Positive reactions were sorted into 2 groups: reactions in 11%–50% of tumor cells and reactions in more than 51% of tumor cells, and the correlations between expression and survival and clinical prognosticators were analyzed. RESULTS: Forty-three of the 60 cases (71.7%) showed strong nuclear DAXX expression, among which 19 cases showed a positive reaction (31.7%) in 11%–50% of tumor cells, and 24 cases (40.0%) showed a positive reaction in more than 51% of tumor cells. A negative reaction was found in 17 cases (28.3%). These patterns of immunostaining were significantly associated with the N stage (p=0.005) and American Joint Committee on Cancer stage (p=0.001), but overall survival showed no significant difference. There were no correlations of DAXX expression with age, gender, or T stage. However, in stage IIB (p=0.046) and stage IV (p=0.014) disease, DAXX expression was significantly correlated with survival. CONCLUSION: This investigation found upregulation of DAXX in esophageal cancer, with a 71.7% expression rate. DAXX immunostaining could be used in clinical practice to predict aggressive tumors with lymph node metastasis in advanced-stage disease, especially in stages IIB and IV.

Surgical Treatment of Primary Pulmonary Myopericytoma

Myopericytoma is a benign tumor that occurs in soft tissues. Myopericytoma in the lungs is very rare. We report the case of a 63-year-old woman presenting with cavitary masses in the left lung and multiple tiny nodules in both lungs. She underwent surgery, and a histological examination revealed primary pulmonary myopericytoma.

The Antitumor Effect of C-terminus of Hsp70-Interacting Protein via Degradation of c-Met in Small Cell Lung Cancer

BACKGROUND: The mesenchymal-epithelial transition factor (MET) receptor can be overexpressed in solid tumors, including small cell lung cancer (SCLC). However, the molecular mechanism regulating MET stability and turnover in SCLC remains undefined. One potential mechanism of MET regulation involves the C-terminus of Hsp70-interacting protein (CHIP), which targets heat shock protein 90-interacting proteins for ubiquitination and proteasomal degradation. In the present study, we investigated the functional effects of CHIP expression on MET regulation and the control of SCLC cell apoptosis and invasion. METHODS: To evaluate the expression of CHIP and c-Met, which is a protein that in humans is encoded by the MET gene (the MET proto-oncogene), we examined the expression pattern of c-Met and CHIP in SCLC cell lines by western blotting. To investigate whether CHIP overexpression reduced cell proliferation and invasive activity in SCLC cell lines, we transfected cells with CHIP and performed a cell viability assay and cellular apoptosis assays. RESULTS: We found an inverse relationship between the expression of CHIP and MET in SCLC cell lines (n=5). CHIP destabilized the endogenous MET receptor in SCLC cell lines, indicating an essential role for CHIP in the regulation of MET degradation. In addition, CHIP inhibited MET-dependent pathways, and invasion, cell growth, and apoptosis were reduced by CHIP overexpression in SCLC cell lines. CONCLUSION: CHIP is capable of regulating SCLC cell apoptosis and invasion by inhibiting MET-mediated cytoskeletal and cell survival pathways in NCI-H69 cells. CHIP suppresses MET-dependent signaling, and regulates MET-mediated SCLC motility.

Simultaneous Laparoscopy-Assisted Resection for Colorectal Cancer and Metastases / 고신대학교의과대학학술지

With advancement of minimal invasive surgery, a simultaneous laparoscopy-assisted resection for colorectal cancer and metastasis has become feasible. Hence, we report three cases of simultaneous laparoscopic surgery for colorectal cancer with liver or lung metastasis. In the first case, laparoscopic right hemicolectomy and left lateral segmentectomy of liver was performed for ascending colon cancer and liver metastasis. In the second case, laparoscopic right hemicolectomy and wedge resection of right lower lung was performed for cecal cancer and lung metastasis. In the third case, laparoscopic right hemicolectomy and wedge resection of left lower lung was performed for ascending colon cancer and lung metastasis. In the first two cases, patients quickly returned to normal activity. In the third case, postoperative bleeding was observed, but spontaneously stopped. There was no postoperative mortality. Simultaneous laparoscopic surgery represents a feasible option for colorectal cancer with metastases on the other organs.

Expression of the Brother of the Regulator of Imprinted Sites Gene in the Sputum of Patients with Lung Cancer

BACKGROUND: Brother of the regulator of imprinted sites (BORIS) is a putative new oncogene that is classified as a cancer germline gene; however, its role in the development of cancer is unclear. This study investigated the expression of BORIS in lung cancer and its clinical implications. METHODS: The expression of BORIS messenger ribonucleic acid (mRNA) in the sputum of 100 patients with lung cancer (50 with squamous cell carcinoma, 36 with adenocarcinoma, and 14 with small-cell carcinoma) was evaluated by reverse transcription polymerase chain reaction. RESULTS: The overall expression rate of BORIS in patients with lung cancer was 36.0%: 19 of 50 squamous cell carcinomas (38.0%), 13 of 36 adenocarcinomas (36.1%), and 4 of 14 (28.6%) small-cell carcinomas. There was no significant difference in the BORIS expression according to age, gender, or histologic type. However, the mRNA expression of BORIS was significantly related to the pathologic cancer stage (p=0.004) and lymph node metastasis (p=0.001). The expression of the melanoma antigen gene family A1-6 was not associated with the expression of BORIS. CONCLUSION: Our results suggest that the expression of BORIS might be a negative prognostic factor in lung cancers and implicate BORIS as a molecular target for immunotherapy.

Saccular Aneurysm of the External Jugular Vein: A Case Report

Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer.

Primary Epithelial Myoepithelial Lung Carcinoma

Primary epithelial-myoepithelial carcinoma (EMC) of the lung is an extremely rare neoplasm that originates from submucosal bronchial glands and has been found in the salivary glands, breast tissue, and sweat glands. However, only a few cases in the respiratory tract have been identified. In the literature, most pulmonary EMCs have been reported to have developed endobronchially although a few EMC cases have been presented as intraparenchymatous tumors. We have identified a case of primary EMC that developed in the peripheral lung parenchyma.

An Endobronchial Inflammatory Myofibroblastic Tumor Treated by Modified Left One-stoma-type Carinoplasty

Endobronchial inflammatory myofibroblastic tumor is a rare primary lung disease. A 39-year-old woman with dyspnea and a productive cough underwent complete surgical resection of a small-sized inflammatory myofibroblastic tumor that invaded the left main bronchus and the carina with lung-saving modified left one-stoma-type carinoplasty. We report this case with a review of literature.

Comparison of Treatments in Patients with Inoperable Stage IV Advanced Esophageal Cancer / 대한소화기학회지

BACKGROUND/AIMS: The aim of this study was to compare palliative treatments such as chemotherapy, chemoradiotherapy or radiotherapy with best supportive care in patients with inoperable advanced esophageal cancer. METHODS: A total of 67 patients with inoperable advanced esophageal cancer visiting Kosin University Gospel Hospital between January 2000 and July 2010 were included in a retrospective analysis. Patients were categorized as having palliative treatment or best supportive care to compare their prognosis. RESULTS: The median survival was 6.4 months in 67 patients. There was significant difference in median survival between the palliative and best supportive treatment (9.8 months vs. 4.5 months, p=0.01). The patients who underwent palliative treatment had superior 1-year and 3-year overall survival rate than those with best supportive treatment (27%, 10% vs. 5%, 5%, respectively). The 1-year and 3-year overall survival rate of palliative treatment was 18% (1-year overall survival rate) in chemotherapy, 33% (1-year overall survival rate) in radiotherapy, 45% and 9% in concurrent chemoradiotherapy, and 20% and 20% in sequential chemoradiotherapy, respectively. CONCLUSIONS: These results may suggest that palliative treatments are more effective than best supportive care. Further prospective studies are still needed to elucidate beneficial effect of palliative treatments on inoperable advanced esophageal cancer.

Localized Empyema due to Mycobacterium bovis / 대한내과학회지

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.

Localized Empyema due to Mycobacterium bovis / 대한내과학회지

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.

Benign Schwannoma of the Esophagus: Surgical experience of two cases / 대한흉부외과학회지

Esophageal schwannoma is very rare and almost of all cases are diagnosed as esophageal submucosal tumor preoperatively. Final diagnosis is made by postoperative immunohistochemical (IHC) staining of the surgical specimen. We experienced two cases of esophageal submucosal tumor, one was 63 year old female suffering from three months of dysphagia and another was 39 year old female complaining of two months of intermittent dysphagia. Two esophageal tumors were completely removed by esophagectomy and enucleation through right thoracotomy respectively. Postoperative IHC staining demonstrated S-100 positive without mitotic figures and confirmative diagnosed was made as benign esopphageal schwannoma.

Endobronchial Chondroid Hamartoma Removed by Segmentectomy: Surgical Experience of One Case / 대한흉부외과학회지

In comparison to parenchymal hamartoma, endobronchial hamartoma is rare benign neoplasm of the lung. Most parenchymal hamartomas are asymptomatic and are found incidentally. However, endobronchial hamartomas are frequently discovered through respiratory symptoms as a result of bronchial irritation or obstruction. A 47-year-old male patient was admitted to our hospital due to dry cough 1 month prior to admission. On bronchoscopic examination, a polypoid mass was found completely obliterating the anterior segmental bronchus of the left upper lobe. We report a case of endobronchial chondroid hamartoma, which was resected by anterior segmentectomy of the left upper lobe.

Percutaneous Radiofrequency Ablation of Inoperable Primary Lung Cancer

PURPOSE: To present the initial experience of percutaneous radiofrequency ablation (RFA) of inoperable primary lung cancer, and to assess the technical feasibility and potential complications. MATERIALS AND METHODS: Twenty patients with inoperable lung cancer underwent percutaneous RFA. Nineteen of 20 patients had stage III or IV non-small cell lung cancer, and the remaining one had stage I lung cancer with pulmonary dysfunction. The mean tumor size was 4.6+/-0.4 cm (range, 1.8-8.4 cm). RFA was performed with a single (n=18) or cluster (n=2) cool-tip RF electrode and a generator under CT guidance using local anesthesia and conscious sedation. Twenty tumors were treated in 28 sessions. Patients were assessed by contrast-enhanced CT in all cases at 1 week, 1 month, and 3 months. Eleven patients received chemotherapy (n=10) or radiotherapy (n=1) after RFA. RESULTS: RFA was technically successful and well tolerated in all patients. Complete necrosis was attained in 7 lesions (35%), near complete (90-99%) necrosis in 10 lesions (50%), and partial (50-89%) necrosis in 3 lesions (15%). During the mean follow up of 202 days (21 to 481 days), tumor size was decreased in 13 patients, unchanged in 3, and increased in 4. In the latter four, additional RFA was performed. One patient underwent surgery three months after RFA and the histopathologic findings showed a large cavity with thin fibrotic wall suggestive of complete necrosis. During or after the procedure, pneumothorax (n=10), moderate pain (n=4), blood tinged sputum (n=2), and pneumonia (n=2) were developed. Chest tube drainage was required in only 1 patient due to severe pneumothorax. Other patients were managed conservatively. Seven patients died at 61 to 398 days (mean, 230 days) after RFA. The remaining 13 patients were alive 21 to 481 days (mean, 187 days) after RFA. CONCLUSION: RFA appears to be a technically feasible and relatively safe procedure for the cytoreductive treatment of inoperable, non-small cell lung cancer and warrants further investigation as a complementary treatment to chemotherapy or radiation therapy.

Human Lung Cancer Cell Xenografts Implanted under the Capsule of Kidney, Spleen and Liver / 대한흉부외과학회지

BACKGROUND: Complete resection by the surgery has been selected as the treatment of choice in lung cancer patients, but in cases of recurrence after excision or inoperable cases, the importance of anticancer chemotherapy has been emphasized. If one can select a set of the sensitive chemotherapeutic agents before anticancer chemotherapy, it will give more favourable results. Subrenal capsular assay has been recognized as a useful in-vivo chemosensitivity test of thoracic and abdominal tumors and it can be done in a short time for a rapid interpretation of tumor responsiveness to anticancer chemotherapeutic drugs. It has been reported that various kinds of cancer cells can be implantable to the kidney, but so far there is no comparative study of xenogeneic cell implantation on liver, spleen and kidney. The author implanted the human lung cancer cells under the capsule of S.D rat's liver, spleen and kidney respectively and compared the pattern of growth and histology. MATERIAL AND METHOD: After incubation of human lung cancer cell line (SW-900 G IV) in RPMI 1640 (Leibovitz L-15 medium) culture media, 3x3x3 mm size fibrin clots which contain 108 cancer cells were made. Thereafter the fibrin clots were implanted at subcapsule area of liver, spleen and kidney of S.D. female rat. For immune suppression, cyclosporin-A (80 mg/Kg) was injected subcutaneously daily from post-implantation first day to sixth day. The body weight was measured at pre and post implantation periods. The growth pattern and the size of tumor mass were observed and the pathologic examination and serum tumor marker tests were performed. RESULT: Body weight increased in both of control and experimental groups. Serum Cyfra 21-1 was not detected. Serum levels of CEA and NSE revealed no significant change. The SCC-Ag increased significantly in implanted group. The growth rate of human lung cancer cells which was implanted on spleen was higher than on liver or kidney. The surface area, thickness, and volume of tumor mass were predominant at spleen. The success rates of implantation were 80% on kidney, 76.7% on spleen and 43.3% on liver. Pathologic examination of implanted tumors showed characteristic findings according to different organs. Tumors that were implanted on kidney grew in a round shape, small and regular pattern. In the spleen, tumors grew well and microscopic neovascularization and tumor thrombi were also found, but the growth pattern was irregular representing frequent daughter mass. Human lung cancer cells that were implanted in the liver, invaded to the liver parenchyme, and had low success rate of implantation. Microscopically, coagulation necrosis and myxoid fibrous lesion were observed. CONCLUSION: The success rate of implantation was highest in the kidney. And the mass revealed regular growth that could be measured easily. The SCC-Ag was presented earlier than CEA or Cyfra21-1. The Cyfra21-1 was not detected at early time after implantation. The best model for tumor implantation experiment for chemosensitivity test was subrenal capsular analysis than liver and spleen and the useful serum tumor marker in early period of implantation was the SCC-Ag.

Choriocarcinoma in the Pulmonary Artery Diagnosed and Treated by Emergency Pulmonary Embolectomy / 대한흉부외과학회지

A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.

Expression of the Epidermal Growth Factor and Tumor Necrosis Factor-alpha in Lung Cancer / 대한흉부외과학회지

BACKGROUND: Release of Epidermal Growth Factor(EGF) af fects the growth of the lung cancer in various ways and tumor necrosis factor-alpha (TNF-alpha), which is known as acute immune reactants and now used in lung cancer t reatment, supress carcinogenesis of the lung. In this study, expression rates of EGF and TNF-alpha in the lung cancer tissue and the serum of lung cancer patients were measured. MATERIAL AND METHOD: In twenty cases of lung cancer and four cases of benign tumor or granuloma, all patient's peripheral blood was sampled pre, and postopertively, and tumor tissues and tumo r free lung tissues were obtained from resected surgical specimens in all patien ts. Then, all blood samples and tissues were frozen and kept safely in the liqui d nitrogen tank. Human EGF kit(Amersham pharmacia biotech, England) and TNF-alpha I RMA kit (Biosouce, Belgium) were used in quantitation of EGF and TNF-alpha respecti vely. RESULT: 1. Both EGF and TNF-alpha were expressed in all tissues and control tissue, benign tumor or granuloma tis sue, cancer tissue and pre- and postoperatively sampled serum. 2. The amount of EGF and TNF-alpha were significantly higher in cancer tissue than in control and be nign tumor tissues. 3. The expression of TNF-alpha was more potent in adenocarcinom a tissue. 4. The expressed amounts of serum EGF and TNF-alpha were 5.7 times and 1. 3 times higher than in tissue respectively. 5. The expression rates of TNF-alpha in cancer tissue was different according to histologic types of cancer but not dif ferent for EGF. 6. As TNM stages go up the amount of EGF in cancer tissue increa sed but TNF-alpha ecreased. 7. The amount of EGF in serum was increased at immediat e postoprative period but TNF-alpha was decreased. CONCLUSION: The presence of di fference in the expressed amount of EGF and TNF-alpha between cancer tissue and con trol tissue was proven, also the difference was found between tissue and serum r epresenting the concentration of EGF and TNF-alpha which were higher in serum than in tissues. EGF and TNF-alpha are released in all of normal tissue, benign tumor ti ssue and lung cancer tissue and their expression rates were variable according t o cell function. Further research is needed to for the expression of EGF and TN F-alpha in various kinds of cells.

The Contents of Tumor Necrosis Factor-alpha and Interleukin-6 in Right Auricular Tissue / 대한흉부외과학회지

BACKGROUND: TNF-alpha plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-alpha and IL-6 on the assumption that TNF-alpha and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. MATERIAL AND METHOD: Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-alpha and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. CONCLUSIONS: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-alpha IL-6 in each group were independent of each data.

The Contents of Tumor Necrosis Factor-alpha and Interleukin-6 in Right Auricular Tissue / 대한흉부외과학회지

BACKGROUND: TNF-alpha plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-alpha and IL-6 on the assumption that TNF-alpha and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. MATERIAL AND METHOD: Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-alpha and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. CONCLUSIONS: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-alpha IL-6 in each group were independent of each data.

Endovascular Stent-Graft Placement for the Treatment of the Aneurysm of the Superior Vena Cava: A Case Report

Venous aneurysm of the superior vena cava(SVC) is a rare congenital lesion and can be classified morphologically as either fusiform or saccular. Although there is a controversy with regard to the need for either conservative or surgical treatment, surgery is recommended for the saccular type as major complications of the aneurysm may occur. We report a case of saccular aneurysm of the SVC, treated by means of an endoluminal stent-graft.