Familial diffuse gastroesophageal leiomyomatosis: A presentation in a mother and her son with Alport syndrome / 대한내과학회지

Diffuse gastroesophageal leiomyomatosis is a rare, benign neoplastic condition characterized by thickening of the esophageal wall as a result ofaberrant smooth muscle proliferation. Gastroesophageal leiomyomatosis may occur in isolation or as a familial disorder and has been associated with other conditions, such as Alport syndrome. Alport syndrome is a hereditary disorder of basement membrane type IV collagen, characterized by progressive nephritis, sensorineural deafness and ocular abnormalities. In this article, we present an interesting case of gastroesophageal leiomyomatosis occurring in a single family in whichthe mother and her son had Alport syndrome. This case is the first report in Korea that gastroesophageal leiomyomatosis is associated with two generations of Alport syndrome.

Alfuzosin-induced Acute Liver Injury / 대한간학회지

We describe a 56-year-old man who developed an acute liver injury after taking alfuzosin for 1 month to control his newly diagnosed benign prostatic hypertrophy (BPH). There was no history of alcohol consumption or the taking herbal or traditional remedies. Viral causes, autoimmune hepatitis, and biliary tree obstruction were excluded. Other rare causes of hepatitis such as hemochromatosis, primary biliary cirrhosis and Wilson's disease were also absent in this patient. His liver test results began to improve after discontinuing the alfuzosin. Two weeks later, alfuzosin was administered again because the patient complained of dysuria. After 10 days of alfuzosin reuse, his liver test results worsened. Five months later after the complete discontinuation of the drug, his liver test results had returned to normal. This clinical sequence suggests that alfuzosin caused his acute liver injury.

Increased ERCC Expression Correlates with Improved Outcome of Patients Treated with Cisplatin as an Adjuvant Therapy for Curatively Resected Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: It has been reported that the overexpression of the excision repair cross-complementing 1 (ERCC1) gene, which is essential for the repair of cisplatin (CDDP)- DNA adducts, negatively influences the effectiveness of CDDP-based therapy for primary gastric cancer. We investigated whether the ERCC1 expression was associated with survival for gastric cancer patients in an adjuvant setting. MATERIALS AND METHODS: We retrospectively analyzed 44 patients who were diagnosed with stage II or higher disease after undergoing curative resection and they had also received cisplatin-based chemotherapy. The ERCC1 expression was examined by performing immunohistochemical (IHC) staining, and this was divided into two groups according to the percentage of IHC staining of the tumor cell nuclei (negative: 10% or less, positive: more than 10%). RESULTS: Among the 44 patients (ERCC1-negative/ERCC1-positive group=16/28), 32 patients were male and their median age was 52 years. There was no difference for the baseline characteristics of the two groups. The median follow-up duration was 41 months. The median disease-free survival (DFS) and the overall survival (OS) for the ERCC1-positive group were significant higher than those of the ERCC1-negative group (DFS: 40.4 vs. 14.6 months, p=0.02, OS: undefined vs. 20.4 months, p=0.008). CONCLUSION: The overall survival in gastric cancer patients who received cisplatin-based adjuvant chemotherapy after a curative resection is higher in those patients showing the overexpression of the ERCC1 gene. However, prospective studies using the ERCC1 gene expression as a prognostic marker for the DNA repair activity are needed.

A case report: A case of fibroepithelial polyp on vulvoperineal area / 대한산부인과학회지

A case of fibroepithelial polyp on vulvoperineal area is described. Her age is 20 year old and the tumor measured 9 cm in its largest diameter and was connected to the left labium majus. This case is very unusual in that almost all reported vulvar fibroepithelial polyps are small and sessile, and should distinguish from malignant cancer. We have experienced an unusually large vulvoperineal mass that was surgically excised and histologically diagnosed as benign fibroepithelial polyp and present this case with a brief review of literature.

Randomized Phase III Trial of Cisplatin, Epirubicin, Leucovorin, 5-Fluorouracil (PELF) Combination versus 5-fluorouracil Alone as Adjuvant Chemotherapy in Curative Resected Stage III Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The combination of cisplatin, epirubicin, leucovorin and 5-fluorouracil (PELF) administration, as adjuvant chemotherapy after curative resection for gastirc cancer, was compared with 5-fluorouracil (5-FU) administration alone. This paper reports the results of a prospective randomized comparison of the two regimens, PELF and 5-FU. METHODS: From August 1996 to July 1999, 54 patients were selected subsequent to being diagnosed with stage III cancer after a curative resection for gastric cancer. The patients were stratified according to stage IIIA/IIIB and subtotal/total gastrectomy, and then they were randomized into each treatment group, i.e. the PELF or 5-FU alone groups. RESULTS: 54 assessable patients were enrolled in this study: 28 received PELF and 26 received 5-FU alone. 12 patients relapsed in each group and the median follow-up duration was 42 months (range: 10~77 months). The overall survival rate and disease-free survival rate (DFS) were not significantly different between two groups, (5-year survival of PELF vs. 5-FU: 57% vs. 64%, 5-year DFS: 54% vs. 51%). The PELF combination was more toxic in terms of anemia, anorexia, nausea and diarrhea than the 5-FU. CONCLUSIONS: This study showed that the PELF combination, as an adjuvant therapy for gastric cancer after a curative resection, was a less effective treatment, and it had more toxic effects than the 5-FU.

Prognostic Effect of Vascular Endothelial Growth Factor and Angiogenesis in Gastric Carcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Many studies have shown that angiogenesis has an important role in the growth, progression, and metastasis of solid tumors. Recently, several angiogenic factors have been identified. Vascular endothelial growth factor (VEGF) is a well characterized inducer of angiogenesis. In this study, we investigated the prognostic significance of the expression of VEGF in patients with an advanced gastric carcinoma. MATERIALS AND METHODS: Specimens from 54 gastric adenocarcinoma patients were stained using a polyclonal antibody against VEGF. Correlations of the expression of VEGF, microvessel density, and various other clinicopathological factors were analysed. RESULTS: Seventeen (31.5%) and 37 cases (68.5%) were VEGF-negative and positive, respectively. There was significant correlation between the expression of VEGF and pathological differentiation. There were no significant correlations between the expression of VEGF, stage and recurrence of a gastric carcinoma. The microvessel density was significantly higher in the VEGF-positive than the VEGF-negative tumors. Survivals of the VEGF-negative patients were significantly prolonged compared to those of the VEGF-positive patients. CONCLUSION: The results of this study show that the expression of VEGF may be a useful prognostic factor for patients with a gastric adenocarcinoma.

Expression of Glucose Transporter Gene in Colorectal Cancer

PURPOSE: The primary metabolic characteristic of malignant cells is an increased uptake of glucose and its anaerobic glycolysis. Recent studies have demonstrated that facilitative glucose transport across the plasma membrane is mediated by a family of proteins, i.e., glucose transporters. PURPOSE: In order to evaluate the clinicopathologic correlations of glucose transporter genes expressed in colorectal cancer, the author studied the expression of glucose transporter genes in human colorectal cancer and analyzed their expression in normal and malignant colorectal tissues. METHODS: A reverse transcriptase-polymerase chain reaction (RT-PCR) was applied to quantitatively determine the levels of the glucose transporter genes, GLUT1 and GLUT3, from Crohnes diseases (N=2), adenomatous polyps (N=4), and colorectal cancers (N=40) and their normal counterparts. RESULTS: The expresssion of the GLUT1 gene was detected in 50% of the inflammatory colonic mucosae and adenomatous polyp tissues, but the levels of expression were not significantly different from their normal counterparts. Among the 40 colorectal cancer patients, 23 patients (57.5%) showed GLUT1 gene expression and the levels of expression were increaed by 1.8 as compared to their normal counterparts (p<0.05). The expression of the GLUT3 gene was detected in almost all tissues examined, and the levels of expression were not significantly different from their normal counterparts. In colorectal cancers, there was correlation between GLUT1 expression, the extent of lymph node involvement and the stage of colorectal cancers (p<0.05). But, the correlation between the expressions of the GLUT3 gene and the clinicopathologic prognostic factors of colorectal cancers could not be determined because almost all tissues showed a GLUT3 gene expression. CONCLUSIONS: In conclusion, the GLUT1 glucose transporter expression in colorectal cancer was associated with high possibilities of lymph node metastases and poorer prognosis, and the assessment of GLUT1 expression in colorectal cancer would be useful in identifying high risk patients.

Clinical Significance of Occult Micrometastases in Colorectal Cancer

BACKGROUND: One of the most important prognostic factors in colorectal cancer is lymph node metastasis, which predicts a reduced survival time. Although lymph node metastases were not detected by a conventional hematoxylin-eosin stain technique, 20 to 30 percent of patients fail long-term survival on account of a local or systemic recurrence. Recurrent disease in these patients is believed to develop from occult tumor in lymph nodes. PURPOSE: The authors have conducted an immunohistochemical study with two different antibodies against cytokeratin to identify occult micrometastases in lymph nodes which were diagnosed as tumor negative by conventional histopathology. METHODS: Paraffin blocks of sixty-five patients with colorectal cancer (T2/3, N0, M0) after a curative resection between January 1991 and December 1993 at Kyung-Hee University Hospital were stained with avidin-biotin-peroxidase complex technique using two monoclonal antibodies (anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, DAKO, Hamburg, Germany). To assess the clinical correlation between micrometastasis in lymph node and patients survial, 5-year disease-free survival rates were calculated by Kaplan-Meier method and the significance of the differences was estimated by the log-rank test. P values <0.05 were taken to be significant. RESULTS: Of the sixty-five patients with 1133 lymph nodes, tumor cells detected by anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, were 2.4 percent (27/1133) and 3.4 percent (38/1133), respectively. Micrometastases were detected in twenty-six patients (40.0 percent). The histologic stage of four cytokeratin positive cases was upstaged from T2, N0, M0 to T2, N1/2, M0, and twenty-two of T3, N0, M0 to T3, N1/2, M0. Cytokeratin-positive cases showed statistically significant recurrence rate (42.3 percent) compared to that of cytokeratin -negative cases (17.9 percent)(x2 test, p=0.032). With the median follow-up of 62 months, 5-year disease-free survival rates of the micrometastses negative and positive cases were 81.7 percent and 61.3 percent, respectively (p=0.0438). CONCLUSIONS: In conclusion, immunohistochemical technique to identify the occult micrometastases in lymph nodes overlooked in conventional histopathology is a useful staging method to anticipate a recurrence and a prognosis more precisely.

A Case of Atypical Ulcerative Colitis Initially Presented as the Appendiceal Lesion / 대한소화기내시경학회지

Ulcerative colitis (UC) is an inflammatory disease primarily involving the colonic mucosa. The extension of classic UC is uniform and continuous with no intervening areas of normal mucosa. The rectum is usually involved and the inflammation extends proximally in a continuous fashion for a variable distance. However, as more patients get colonoscoped, it had been reported that there is a wide spectrum to what is called UC. There appear to be a few patients with otherwise typical UC but with rectal sparing. And also there are patients with classic distal UC who have an isolated area of cecal disease and segmental UC with skipped area. We have experienced a case of atypical UC initially presented as a isolated lesion around the appendiceal orifice with the segmental distribution of inflammatory change without an active inflammatory lesion in the rectum. It was considered that understanding of the significance of an isolated lesion in the appendix would contribute to the elucidation of the pathogenesis of UC.

Analysis of Peritumoral Edema in MRI of Meningioma

PURPOSE: The purpose of this study is to evaluate the incidence and the degree of peritumoral edema on MRI in meningioma and to correlate other MR findings with the edema. MATERIALS AND METHODS: MR images of 35 patients with histologically-confirmeal meningioma were retrospectively reviewed. We analyzed the MR findings with special attention to the presence or absence and degree of edema. The edema was graded as absent, mild (extending less than 1 cm from outer margin of mass), moderate (1 to 3cm with mild mass effect), and severe (more than 3cm with marked mass effect). We also evaluated size and margin of the tumor, heterogeneity of mass signal, enhancement pattern and dural enhancement of the masses. In 24 patients with cerebral angiography, cerebral vascularity on angiogram was correlated with MR findings. Statistic correlation analysis was done using SAS ver 6.04. RESULTS: Twenty-five of 35 cases (72%) had edema; mild in 11 cases, moderate in 10 cases, and severe in 4 cases. Heterogeneous signal intensity of mass (0.05), dural enhancement (>0.05), and histologic type (>0.05) were not correlated with edema. CONCLUSION: In meningioma, moderate to severe peritumoral edema occurred in 41% (14/35). The edema was correlated with heterogeneous enhancement, size, location, heterogeneous signal intensity and vascularity of the mass on angiography.

Clinocopathological study about malignant potentiality of gall-bladder adenoma

No abstract available.