Expression of Hypoxia-inducible Factor-1alpha in Non-small Cell Lung Cancer: Relationship to Prognosis and Tumor Biomarkers / 대한흉부외과학회지

BACKGROUND: Tissue hypoxia is characteristic of many human malignant neoplasm, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increasing O2 delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1alpha has been reported in many human malignancies, but in non-small cell lung carcinoma the influence of HIF-1alpha on tumor biology, including neovascularization, is not still defined. In present study the relationship of HIF-1alpha expression on angiogenetic factors, relationship between the tumor proliferation and HIF-1alpha expression, interaction of HIF-1alpha expression and p53, and relationship between HIF-1alpha expression and clinico-pathological prognostic parameters were investigated. MATERIAL AND METHOD: Archival tissue blocks recruited in this study were retrieved from fifty-nine patients with primary non-small cell lung carcinoma, who underwent pneumonectomy or lobectomy from 1997 to 1999. HIF-1alpha, VEGF (vascular endothelial growth factor), and p53 protein expression and Ki-67 labeling index in tumor tissues were evaluated, using a standard avidin-biotin-peroxidase complex (ABC) immunohistochemistry. Relationship between the HIF-1alpha expression and VEGF, p53 overexpression and correlation between the HIF-1alpha expresseion and Ki-67 index were analyzed. Clinico-pathologic prognostic parameters were also analyzed. RESULT: HIF-1alpha expression in cancer cells was found in 24 of 59 cases of non-small cell lung carcinoma (40.7%). High HIF-1alpha expression was significantly associated with several pathological parameters, such as pathological TMN stage (p=0.004), pT stage (p=0.020), pN stage (p=0.029), and lymphovascular invasion (p=0.019). High HIF-1alpha expression was also significantly associated with VEGF immunoreactivity (p<0.001), and aberrant p53 expression (p=0.040). but was marginally associated with Ki-67 labeling index (p=0.092). The overall 5-year survival rate was 42.3%. The survival curve of patients with a high HIF-1alpha expression was worse than that of patients with low-expression (p=0.002). High HIF-1alpha expression was independent unfavorable factors with a marginal significance in multivariate analysis performed by Cox regression. CONCLUSION: It is suggested that high HIF-1alpha expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway, and high HIF-1alpha expression could be associated with lymph node metastasis and post operative poor prognosis in patients with non-small cell lung ca

The Clinical Results in Compression Plate Fixation with Autogenous Cancellous Bone Graft for Humerus Diaphyseal Nonunion

PURPOSE: A The purpose of this retrospective study was to evaluate the results of compression plating and autogenous iliac bone graft in the management of humeral diaphyseal nonunion. MATERIALS AND METHODS: Twenty patients who underwent the surgical treatments between May. 1998 and May. 2002 were included in this study. Nine of them are males and the others are females. The average age of them, when they was on operation, was 45 years. The symptoms lasted 23 months on average. They have been followed up for 33 months at an average. Treatment of nonunion consisted of resecting the atrophic nonunion, shortening the bone, apposing bleeding diaphyseal surface. Rigid fixation was then achieved using a compression plate and autogenous bone graft. RESULTS: Solid bony union was achieved in all patients. In one patient, the bone was not healed at the first operation of plating and autogenous bone graft, but achieved union after the use of intramedullary nailing. In another patient, because of infected nonunion, we achieved union after several surgical debridement and stabilization by internal fixation. CONCLUSION: This study documents that compression plate fixation with autogenous cancellous bone graft is a viable option with predictable and satisfactory results for humerus diaphyseal nonunion.

Penetration of Joints by Screws on Anterior Process of Calcaenus

PURPOSE: This study was performed to determine the involvement of joints by screws, inserted on the anterior process of the calcaneus, using cadaveric specimens. MATERIALS AND METHODS: An L-shaped lateral incision was performed on 32 embalmed feet (16 cadavers). An H-plate was applied on lateral wall of the calcaneus and it's anterior margin was located at 4 mm posterior to the lateral margin of the calcaneocuboidal joint. 3.5 mm cortical screws were inserted perpendicularly to the lateral calcaneal wall through the plate. Each calcaneus was dissected and taken out from the foot, and whether the tips of screws penetrated joints on the anterior process was evaluated. RESULTS: 11 (17.2%) of 64 screws, inserted on the anterior process, penetrated joints. Among them, seven screws involved the calcaneocuboidal joint and four screws penetrated the anterior facet of the subtalar joint. In two cases, both joints were penetrated by screws. CONCLUSION: This study shows that joint surfaces could be penetrated by screws inserted from the lateral surface on the anterior process of the calcaneus. Care should be given to selecting the length and insertional angle of screws. Intraoperative radiography would be needed to observe the articular surface on the anterior process, when screws were inserted to the anterior process close to the calcaneocuboidal joint.

Correlation between Prognostic Factors and Lymph Node Metastases in Endometrial Cancer / 대한산부인과학회잡지

OBJECTIVE: To determine the valuable predictors of lymph nodes metastasis by analysing correlation with some prognostic factors in women with endometrial cancer. METHODS: A retrospective study was conducted in 49 women with endometrial cancer who underwent surgery with lymph node dissection or biopsy from 1988 to 2001 at our department. The prognostic factors analysed were age, obesity, histopathologic type and grade, depth of myometrial invasion, cervical invasion, adnexal metastasis, tumor size, hormone receptor, and preoperative CA-125. Univariate analysis was performed by x2 test and Fisher's exact test. RESULTS: Overall incidence of lymph node metastases was 28.6% (14/49). Lymph node metastases were statistically correlated with histopathologic type (P=0.048), depth of myometrial invasion (P=0.036), cervical invasion (P=0.001), and adnexal metastasis (P=0.015), however age, obesity, histopathologic grade, tumor diameter, estrogen and progesterone receptors, and preoperative CA125 were not statistically correlated. CONCLUSION: Histopathologic type, depth of myometrial invasion, cervical invasion, and adnexal metastasis were considered as predictors for lymph node metastases in endometrial cancer. Further studies for a large number of cases with multivariate analysis are needed.

A Case of Ectopic Breast Tissue in the Vulva / 대한산부인과학회잡지

Ectopic breast tissue can occur anywhere along the primitive embryonic milk line, which extends from axilla to groin. However, the occurrence of ectopic breast tissue in the vulva is rare and less than 50 cases had been reported. We experienced a case of ectopic breast tissue in the vulva, which is the first case of ectopic breast tissue in the vulva in Korean literature.

A Case of Ectopic Breast Tissue in the Vulva / 대한산부인과학회잡지

Ectopic breast tissue can occur anywhere along the primitive embryonic milk line, which extends from axilla to groin. However, the occurrence of ectopic breast tissue in the vulva is rare and less than 50 cases had been reported. We experienced a case of ectopic breast tissue in the vulva, which is the first case of ectopic breast tissue in the vulva in Korean literature.

A Case of Hepatic Metastasis of Granulosa Cell Tumor of the Ovary / 대한산부인과학회잡지

Ovarian granulosa cell tumors are uncommon low-grade malignancies. They are characterized by their long history and their tendency to recur years after an apparent clinical cure. Only a small percentage of granulosa cell tumors metastasize, and they rarely do so to the liver. In this paper, we present a case of hepatic metastasis treated by surgery and BEP combination chemotherapy, with a brief review of corresponding literatures.