Bilateral symmetrical lipoma of the buccal fat pad as an incidental finding in a woman with weight gain after tamoxifen: a case report

Although lipoma is a common benign tumor, it occurs relatively infrequently in the oral and maxillofacial areas, and only 31 cases of lipoma in the buccal fat pad have been reported. Herein, we present an extremely rare case of symmetric lipomas in both buccal fat pads. These masses were incidentally discovered during a facelift procedure in a 50-year-old woman with a 4-year history of tamoxifen use. during which she had gained 10 kg. The patient stated that cheek protrusion had developed concomitantly with weight gain and was exacerbated by an injection lipolysis procedure she had received 1 year previously. This case underscores the importance of paying careful attention to the patient’s medication use and surgical history when evaluating suspected cases of lipoma, and sheds light on tamoxifen use and subcutaneous injections of phosphatidylcholine and deoxycholate as potential risk factors for lipoma development.

Peripheral Osteoma in the Mandibular Angle

No abstract available.

Endogenous Gastric-Resident Mesenchymal Stem Cells Contribute to Formation of Cancer Stroma and Progression of Gastric Cancer

BACKGROUND: Carcinoma-associated fibroblasts (CAFs) contribute to carcinogenesis and cancer progression, although their origin and role remain unclear. We recently identified and investigated the in situ identity and implications of gastric submucosa-resident mesenchymal stem cells (GS-MSCs) in the progression of gastric carcinogenesis. METHODS: We isolated GS-MSCs from gastric submucosa using hydrogel-supported organ culture and defined their identity. Isolated cells were assessed in vitro by immunophenotype and mesengenic multipotency. Reciprocal interactions between GS-MSCs and gastric cancer cells were evaluated. To determine the role of GS-MSCs, xenografts were constructed of gastric cancer cells admixed with or without GS-MSCs. RESULTS: Isolated cells fulfilled MSCs requirements in regard to plastic adherence, stromal cell immunophenotype, and multipotency. We demonstrated a paracrine loop that gastric cancer cells enhanced the migration, proliferation, and differentiation of GS-MSCs; additionally, GS-MSCs promoted the proliferation of gastric cancer cell in vitro. Xenograft experiments showed that GS-MSCs significantly promoted cancer growth and angiogenesis. GS-MSCs that integrated into gastric cancer became not only CAFs but also rarely endothelial cells which contributed to the formation of cellular and vascular cancer stroma. CONCLUSIONS: Endogenous GS-MSCs play an important role in gastric cancer progression.

Adipose-tissue-derived Stem Cells Enhance the Healing of Ischemic Colonic Anastomoses: An Experimental Study in Rats

PURPOSE: This experimental study verified the effect of adipose-tissue-derived stem cells (ASCs) on the healing of ischemic colonic anastomoses in rats. METHODS: ASCs were isolated from the subcutaneous fat tissue of rats and identified as mesenchymal stem cells by identification of different potentials. An animal model of colonic ischemic anastomosis was induced by modifying Nagahata's method. Sixty male Sprague-Dawley rats (10-week-old, 370 +/- 50 g) were divided into two groups (n = 30 each): a control group in which the anastomosis was sutured in a single layer with 6-0 polypropylene without any treatment and an ASCtreated group (ASC group) in which the anastomosis was sutured as in the control group, but then ASCs were locally transplanted into the bowel wall around the anastomosis. The rats were sacrificed on postoperative day 7. Healing of the anastomoses was assessed by measuring loss of body weight, wound infection, anastomotic leakage, mortality, adhesion formation, ileus, anastomotic stricture, anastomotic bursting pressure, histopathological features, and microvascular density. RESULTS: No differences in wound infection, anastomotic leakage, or mortality between the two groups were observed. The ASC group had significantly more favorable anastomotic healing, including less body weight lost, less ileus, and fewer ulcers and strictures, than the control group. ASCs augmented bursting pressure and collagen deposition. The histopathological features were significantly more favorable in the ASC group, and microvascular density was significantly higher than it was in the control group. CONCLUSION: Locally-transplanted ASCs enhanced healing of ischemic colonic anastomoses by increasing angiogenesis. ASCs could be a novel strategy for accelerating healing of colonic ischemic risk anastomoses.

Neoplastic Stromal Cells of Intracranial Hemangioblastomas Disclose Pericyte-derived Mesenchymal Stromal Cells-like Phenotype

BACKGROUND: Stromal cells (SCs) of hemangioblastomas (HBs) have been regarded as true neoplastic components, but their ontogeny remains unclear. Convincing evidence suggests that embryonic mesenchymal cells may be the cells of origin of HBs. The aim of the present study was to investigate the immunophenotypic characteristics of neoplastic SCs using a set of markers against endothelial cells (ECs), vascular smooth muscle cells (vSMCs), mesenchymal stromal cells (MSCs), and pericytes. METHODS: Intracranial HBs (n=46), angiolipoma (n=9), and pyogenic granuloma (n=11) were retrieved and the immunophenotypic profile of SCs was determined by immune stainings. RESULTS: The MIB-1 labeling index was significantly higher in SCs compared to that of ECs and vSMCs, regardless of the type of lesion. The neoplastic SCs of HBs consistently expressed both MSC and pericyte markers, but did not express markers of ECs and vSMCs. Double immunofluorescent staining demonstrated that the neoplastic SCs of HBs expressing MSC or pericyte markers directly abutted onto the ECs of capillaries/venules. CONCLUSIONS: The results suggest that the neoplastic SCs of HBs share the immunophenotypic profile and distribution with those of pericyte-derived MSCs. Thus, HBs might originate from a distinctive population of pericyte-derived MSCs in the central nervous system.

Unilateral administration of a drug into the lung of a small animal / 대한마취과학회지

BACKGROUND: The selective unilateral administration of drugs into a single lung of a rat is difficult because of the small airway diameter. Therefore, a simple method for unilateral administration into rat lung is needed. METHODS: Rats were assigned to 1 of 2 groups according to the direction of the catheter used for drug administration. Anesthetized rats were intubated, and curved epidural catheters were rotated up to a maximum of 90degrees toward the left lung (group L) or right lung (group R). Bronchial catheters were then inserted via a tracheal tube and fixed. Methylene blue (0.3 ml) was injected via the epidural catheter. Additionally, to compare survival rates, rats were assigned to one of two groups according to the drug administration route. In group T, bleomycin hydrochloride (20 mg/kg) in 0.3 ml of phosphate-buffered saline (PBS) was administrated into the lung intratracheally via a tracheal tube. In group B, the same dose of bleomycin was administrated into the lung intrabronchially via a bronchial catheter, targeting the left lung. RESULTS: Gross examination revealed that targeted administration was 100% successful. Methylene blue was observed in the right lung of all rats in the R group and in the left lung of all rats in the L group. The survival rate was higher in group B than in group T. CONCLUSIONS: The intrabronchial method offers an advantage over tracheal administration as it decreases mortality and allows the administration of a drug unilaterally into a single lung or into a localized area without the need for double-lumen tubes or more invasive procedures.

Septic Peripheral Embolism in Left Leg fromAggregatibacter aphrophilus Endocarditis / 대한임상미생물학회지

Aggregatibacter aphrophilus is a facultatively anaerobic gram-negative coccobacillus or bacillus that grows with no dependence on X factor and variable requirement for V factor. The organism is normal flora in the human oral cavity and upper respiratory tract and, rarely, causes invasive infections such as bacteremia, endocarditis, brain abscess, or osteomyelitis. We report a case of septic peripheral embolism in left leg from A. aphrophilus endocarditis. A 49-year-old man with known hypertension presented with acute muscle pain in the left leg. On physical examination, a regular heartbeat with a pansystolic murmur was heard. There were decreased pulses in the left popliteal and dorsalis pedis arteries and coldness of the left foot, although sensory and motor functions were intact. Angiography revealed an embolus in a branch of the left femoral artery. He underwent emergency embolectomy, and gram-negative bacilli grew in the embolus cultures. The same microorganism was isolated in two pairs of blood culturs and subsequently identified as A. aphrophilus. Transthoracic echocardiography revealed mitral regurgitation and multiple vegetations on the mitral valve. The patient was treated with a third-generation cephalosporin for 4 weeks and mitral valve replacement in view of the diagnosis of infective endocarditis and septic peripheral embolism.

The Role of Endothelial Progenital Cells and Fibrin on Vascularization and Stability in Orbital Implant

PURPOSE: The effects of endothelial progenitor cells (EPCs) and fibrin on fibrovascular growth into porous polyethylene orbital implants (Medpor(R) sheet) were investigated using stem cells. METHODS: EPCs were separated from human adipose fat tissue for culture. Fluorescence-activated cell sorting (FACS) was used to identify the phenotype and to analyze the purity of EPCs cultivated from human adipose tissue. Processed Medpor(R) sheets were inserted in each quadrant of the subcutaneous fat layer under the dorsal surface of 20 anesthetized athymic nude mice, using sterile methods. Medpor(R) sheets processed with endothelial progenitor cells and fibrin were inserted into the two top quadrants, a Medpor(R) sheet processed with fibrin was inserted in the lower right quadrant, and an unprocessed Medpor(R) sheet was inserted in the lower left quadrant of each mouse. The mice were sacrificed on the seventh day. The adhesiveness and blood vessel formation were quantified by weight and the number of blood cells within the Medpor(R) sheets. Hematoxylin and eosin (H&E) and toluidine blue stains were used to analyze fibrovascular and cell growth within the Medpor(R) sheets. RESULTS: The sheets processed with EPCs and fibrin were heavier and contained more white and red blood cells (p<0.001) than the other sheets. The sheets processed with fibrin alone were heavier (p<0.01) and contained more blood cells (p<0.001) than the unprocessed sheets. The degree of vessel formation and tissue adhesiveness was greatest in the group of Medpor(R) sheets processed with EPCs and fibrin. The sheets processed with fibrin only had greater tissue adhesiveness and fibrovascular proliferation than the unprocessed Medpor(R) sheets. CONCLUSIONS: Endothelial progenitor cells and fibrin applied to Medpor(R) sheets improve fibrovascular proliferation and tissue adhesiveness. When both are applied together, a synergistic effect is seen.

The Effect of a Fibirn-Collagen Sponge Scaffold on Osteogenic Differentiation of Rabbit Mesenchymal Stem Cells / 대한정형외과연구학회지

PURPOSE: To investigate whether collagen sponge with or without fibrin reinforcement can be used as a biocompatible scaffold for in vitro osteogenic differentiation of bone marrow-derived mesenchymal stem cells of rabbit (rBMSC). MATERIALS AND METHODS: rBMSC were isolated and expanded from the femur of New Zealand White rabbit. The nucleated cells were separated from red blood cells by Percoll(R) -gradient centrifuge. The porous collagen sponge with pore size 150~250 mm (Collacote(R), Sulzer Dental Inc. Carlsbad, CA) was used. rBMSC were seeded at a density of 2x10(5)/cm2 on two types of scaffold. In this study, type I scaffold consisted of collagen sponge without fibrin, while type II scaffold consisted of collagen sponge with fibrin. Fibrin composition used in this experiment was 0.5% fibrinogen and 0.5 unit/ml thrombin solution (Tisseel kit(R), Baxter AG, Vienna, Austria). After rBMSC seeded into scaffold, cells were induced into osteogenic differentiation by dexamethasone, -glycerol phosphate, and ascorbic acid. The contraction rate of the scaffold and pore size were measured by photoplanimetric method. Cell-mediated contraction rate was calculated by after normalization by DNA content in scaffold. The alkaline phosphatase activity and calcium content were measured by colorimetric method. The degree of mineralization and cellular distribution within the scaffold were analyzed by histomorphologic method. RESULTS: The contraction rate of scaffold was similar during the first 3 days in culture. The type II scaffold was contracted less than 20 % and type I scaffolds was contracted more than 20 %. After 7 days in culture, the type I scaffold was markedly decreased in size than type II scaffold (p<0.05). Type II scaffold showed more resistance to cell-mediated contraction than type I scaffold (p<0.05). The pore size of scaffold was markedly decreased on 14 days after culture in type I scaffold, but structure and size of pore in type II scaffold were well preserved. The degree of osteogenic differentiation of rBMSC did not showed any difference in both types of scaffold biochemically. However, cells were more evenly distributed and mineral intensity was more increased in type II scaffold than those of type I scaffold. CONCLUSION: The fibrin reinforcement into collagen sponges could prevent cell-mediated contraction of scaffold and could support in vitro osteogenic differentiation of rBMSC.

Study on HBV Gene Replication and Expression of Experimental Hepatitis B Model Using Baculovirus Gene Delivery System

PURPOSE: The lack of reliable in vitro infection systems or convenient animal models has hindered the progress of hepatitis B virus (HBV) research and the development of new treatment options. We established an in vitro model of hepatitis B, using recombinant HBV encoding baculovirus, which provided HBV replication and antigens expression in HepG2 cells. The objectives of this study were to characterize the magnitude of HBV expression and the level of replication obtainable in HepG2 cells, to establish the optimum infection and culture conditions of HBV expression and replication. METHODS: Replication of a competent HBV genome encoding the baculovirus, RC-HBV-Bac, was generated for delivering the HBV genome to HepG2 cells. HBV replication and antigens expression were determined in relation to the infection and culture conditions. RESULTS: In RC-HBV-Bac infected HepG2 cells, HBsAg, HBeAg and HBcAg were expressed in the cytoplasm and nuclei, and secreted into the medium. HBV replication was evidenced by the presence of a replication complex and covalently closed circular (ccc) DNA in the cytoplasmic fraction of infected cells. The level of HBV expression was directly proportional to the multiplication of RC-HBV-Bac infection. Polyethylene glycol was able to enhance the infection efficiency of the baculovirus to HepG2 cells. High levels of HBV replication were achieved under culture conditions supplemented with dimethyl sulfoxide and a low serum concentration. CONCLUSION: This in vitro model of hepatitis B, generated by baculovirus gene delivery, represents a simple and flexible system for the study of HBV replication and drug testing.

Kinesin Superfamily KIF1A Protein Binds to Synaptotagmin XI / 대한해부학회지

The kinesin proteins (KIFs) make up a large superfamily of molecular motors that transport cargo such as vesicles, protein complexes, and organelles. KIF1A is a monomeric motor that conveys synaptic vesicle precursors and plays an important role in neuronal function. Here, we used the yeast two-hybrid system to identify the neuronal protein (s) that interacts with the tail region of KIF1A and found a specific interaction with synaptotagmin XI. The amino acid residues between 830 and 1300 of KIF1A are required for the interaction with synaptotagmin XI. KIF1A also bound to the tail region of synaptotagmin IV but not to other synaptotagmin in the yeast two-hybrid assay. KIF1A interacted with GST-synaptotagim XI fusion proteins, but not with GST alone. An antibody to synaptotagmin XI specifically co-mmunoprecipitated KIF1A associated with synaptotagimin from mouse brain extracts. These results suggest that KIF1A motor protein transports of synaptotagmin XI-containing synaptic vesicle precursors along microtubule.

The Effect of Selective Cyclooxygenase-2 Inhibitor on the Expression of Hypoxia-Inducible Factor-1alpha in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs in the world. NSAIDs are known to be potent inhibitors of the cyclooxygenase (COX) enzymes, a family of enzymes that catalyze the conversion of arachidonic acid to prostagladins. Expression of the gene encoding COX-2 might be regulated by hypoxia. Hypoxiainducible factors (HIFs) are activated by hypoxia. HIFs function in the hypoxic environment to orchestrate adaptational adjustments of vascular homeostasis through the activation of several dozens of target genes. The purpose of this study was to investigate whether a selective COX-2 inhibitor inhibits HIF-1alpha in human nasal polyps. SUBJECTS AND METHOD: Seven patients with nasal polyps with chronic sinusitis were selected. After the first biopsy, all patients were treated with selective cyclooxygenase inhibitor (Celebrax(R), 100mg, twice daily) for 7 days. At the end of the treatment period, a second set of biopsies was taken. HIF-1alpha messenger RNA (mRNA) production was measured by reverse transcriptase polymerase chain reaction and the protein expression of HIF-1alpha was determined by immunohistochemical staining. RESULTS: The expression of HIF-1alpha mRNA and protein were detected in nasal polyps. There was no significant difference in the mean level of HIF-1alpha mRNA between selective COX-2 inhibitoruntreated and treated nasal polyps (p>0.05). Immunohistochemistry shows diffuse and increased expression of HIF-1alpha in the nuclei of pseudostratified columnar epithelial cells. Endothelial cells and inflammatory cells including lymphocytes and histiocytes were expressed with HIF-1alpha in the stroma. Subcellular localization of HIF-1alpha were found mostly in the nucleus, but were occasionally observed in the cytoplasm of histiocytes. The expression of HIF-1alpha protein was not significantly different between selective COX-2 inhibitor-treated and selective COX-2 inhibitor-untreated nasal polyps (p>0.05). CONCLUSION: Selective COX-2 inhibitor did not inhibit HIF-1alpha expression in nasal polyps. Further studies are needed to find out the effect of selective COX-2 inhibitor on nasal polyps.

Tumor Necrosis Factor-alpha-308G/A Promoter Polymorphism is Associated with the Severity of Gastric Carcinomas

PURPOSE: The pro-inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha), is a central mediator of the immune response involved in a wide range of immuno-inflammatory and infectious diseases. There is increasing evidence that TNF-alpha may promote the development and spread of the cancer. Polymorphisms in the TNF-alpha promoter have been related to TNF-alpha production. Therefore, we investigated the potential association of TNF-alpha genotypes with gastric cancer in the Korean population. METHODS: The study included 66 patients with gastric adenoma, 75 patients with gastric carcinoma, and 551 healthy controls. The -308 and -238 polymorphisms in the TNF-alpha promoter were analyzed by PCR- restriction fragment length polymorphism (RFLP). Distributions of TNF-alpha promoter polymorphisms were compared between groups by chi2 test. P values smaller than 0.05 were considered to be significant. RESULTS: The proportion of individuals carrying the TNF-alpha -308A allele was higher in the carcinoma group compared to controls and adenomas, but the differences were not significant (P=0.124). However, the TNF-alpha -308A allele was significantly associated with advanced gastric carcinoma (P=0.026), serosa invasion (P=0.004), neural invasion (P= 0.021), and lymph node metastasis (P=0.005). On the other hand, the TNF-alpha -238G/A polymorphism was not associated with the development of gastric adenoma and carcinoma and the severity of gastric carcinoma. CONCLUSION: These results suggest that the TNF-alpha -308A allele is associated with the severity of gastric carcinoma in terms of invasion and metastasis in the Korean population. Therefore, TNF-alpha promoter polymorphism could be used as a predictive marker of the severity of gastric carcinoma.

Expression of Hypoxia-Inducible Factor-1alpha and Correlation between Hypoxia-Inducible Factor-1alpha and Vascular Endothelial Growth Factor in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The function of hypoxia-inducible factors (HIFs) in the hypoxic environment is to orchestrate adaptational adjustments of vascular homeostasis through the activation of several dozens of target genes including vascular en-dothelial growth factors (VEGF). It has been suggested that VEGF is involved in the pathogenesis of nasal polyp. The purpose of this study is to determine and correlate concentrations of HIF-1alpha and VEGF in nasal polyps. MATERIALS AND METHOD: Twenty-five nasal polyps were collected at the time of endoscopic sinus surgery. The production of HIF-1alpha and VEGF messenger RNA (mRNA) was measured by reverse transcriptase polymerase chain reaction (RT-PCR) and HIF-1alpha and VEGF proteins were determined by immunohistochemical staining. RESULTS: The expressions of HIF-1, VEGF mRNA and proteins were detected in nasal polyps. RT-PCR demonstrated that the level of mRNA expression of HIF-1alpha and VEGF were 1.12+/-0.33 and 1.11+/-0.42, respectively. A positive correlation was observed between HIF-1alpha and VEGF mRNA (correlation coefficient [r]=0.49, p<0.05). The immunohistochemical studies revealed that HIF-1alpha was predominantly expressed in surface epithelial cells, submucosal glandular cells, endothelial cells and inflammatory cells in the stroma and VEGF was more strongly and diffusely expressed in subglandular epithelial cells, vascular endothelial cells, and inflammatory cells than in surface epithelial cells. The expressions of HIF-1alpha and VEGF proteins were 3.24+/-1.80 and 3.52+/-1.89, respectively. A positive correlation was observed between HIF-1alpha and VEGF proteins (r=0.76, p<0.05). CONCLUSION: We suggest that HIF-1alpha has a role in inducing VEGF in nasal polyps, and hypoxia is an important factor in the growth of nasal polyps.

A Case of Giant Ethmoid Osteoma with Orbital Extension / 대한이비인후과학회지

Osteoma is a tumor of mature bone showing slow growth of well-differentiated bone. It occasionally produces symptoms of space occupying lesion and symptoms of ethmoid osteoma occur earlier than that of osteoma of the frontal sinus. Osteoma of orbital area is uncommon and it may produce ophthalmologic symptoms and cosmetic problems. Treatment remains controversial: open procedures are typically being used, however, small sized ethmoid osteoma are removed by intranasal procedure. Recently, the authors have experienced a case of giant ethmoid osteoma with orbital extension, which was removed with intranasal endoscopic and external ethmoidectomy approach. Hence, we report this case with a review of literature.

DCC Gene and Protein Expression in Colorectal Cancer

PURPOSE: The germline, or somatic, inactivation of tumor suppressor genes, through point mutation, or deletion, plays an important role in carcinogenesis. Several gene alterations, such as adenomatous polyposis coli (APC), deleted in colorectal cancer (DCC) and p53, have been detected in the development of colorectal cancer. Within these genes, a loss of heterozygosity (LOH) at the DCC gene locus was frequently associated with colorectal tumors, and the LOH of the DCC gene, and the expression of the DCC protein, might be related to malignant formation and metastasis. The aim of this study was to determine the DCC LOH and the expression of DCC protein in colorectal cancers, and evaluate their prognostic value and relationship with the clinicopathological data. MTHODE: Fifty colorectal cancer tissues were obtained from resected specimens. Using formalin-fixed paraffin- embedded sections as a source of DNA, we examined the DCC protein in the tissue through immunohistochemical stainings and immunoblotting analysis, the DCC LOH through a polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP). RESULTS: DCC LOH was observed in 24 of the 50 patients (48.0%). The expression of the DCC protein was decreased in the cancer tissue (62.3 23.6%) compared with the adjacent normal mucosa inform the immunoblotting analysis. A decreased DCC protein expression was also observed from the immunohistochemistry, which coincided with the immunoblotting analysis. However, both the DCC LOH and the decreased DCC protein were not related to the clinical and pathological parameters, such as location of tumor, tumor size, histological type and the venous, and lymphatic invasions. There were significant correlations between the DCC protein expression and tumor progression, and hematogenous metastasis (P<.05). CONCLUSIONS: A decreased expression of the DCC protein was noted in human colorectal cancers, and there was a significant relationship between the expression of the DCC protein and distant metastasis, but there was no correlation between the DCC LOH and distant metastasis. These results suggest that the expression of the DCC protein might be related to tumor progression and metastatic potential, and the DCC protein immunoreactivity may be a useful prognostic factor in patients with colorectal cancers.

Ex Vivo 1H MR Spectroscopy: Normal gastric and cancer tissue

PURPOSE: In this study, we attempted to ascertain the proton magnetic resonance spectroscopy (1H MRS) peak characteristics of human gastric tissue layers and finally to use the metabolic peaks of MRS to distinguish between normal and abnormal gastric specimens. MATENRIALS AND METHODS: Ex-vivo 1H MRS examinations of thirty-five gastric specimens were performed to distinguish abnormal gastric tissues invaded by carcinoma cells from normal stomach-wall tissues. High-resolution 400-MHz (9.4-T) 1H nuclear magnetic resonance (NMR) spectra of two gastric layers, a proper muscle layer, and a composite mucosa- submucosa layer were compared with those of clinical 64- MHz (1.5-T) MR spectra. Three-dimensional spoiled gradient recalled (SPGR) images were used to determine the size and the position of a voxel for MRS data collection. RESULTS: For normal gastric tissue layers, the metabolite peaks of 400-MHz 1H MRS were primarily found to be as follows: lipids at 0.9 ppm and 1.3 ppm; alanine at 1.58 ppm; N-acetyl neuraminic acid (sialic acid) at 2.03 ppm; and glutathione at 2.25 ppm in common. The broad and feature-less spectral peaks of the 64-MHz MRS were bunched near 0.9, 1.3, and 2.0, and 2.2 ppm in human specimens without respect to layers. In a specimen (Borrmmann type III) with a tubular adenocarcinoma, the resonance peaks were measured at 1.26, 1.36 and 3.22 ppm. All the peak intensities of the spectrum of the normal gastric tissue were reduced, but for gastric tumor tissue layers, the lactate peak split into 1.26 and 1.39 ppm, and the peak intensity of choline at 3.21 ppm was increased. CONCLUSION: We found that decreasing lipids, an increasing lactate peak that split into two peaks, 1.26 ppm and 1.36 ppm, and an increasing choline peak at 3.22 ppm were markers of tumor invasion into the gastric tissue layers. This study implies that MR spectroscopy can be a useful diagnostic tool for gastric cancer.

Ex Vivo 1H MR Spectroscopy: Normal gastric and cancer tissue

PURPOSE: In this study, we attempted to ascertain the proton magnetic resonance spectroscopy (1H MRS) peak characteristics of human gastric tissue layers and finally to use the metabolic peaks of MRS to distinguish between normal and abnormal gastric specimens. MATENRIALS AND METHODS: Ex-vivo 1H MRS examinations of thirty-five gastric specimens were performed to distinguish abnormal gastric tissues invaded by carcinoma cells from normal stomach-wall tissues. High-resolution 400-MHz (9.4-T) 1H nuclear magnetic resonance (NMR) spectra of two gastric layers, a proper muscle layer, and a composite mucosa- submucosa layer were compared with those of clinical 64- MHz (1.5-T) MR spectra. Three-dimensional spoiled gradient recalled (SPGR) images were used to determine the size and the position of a voxel for MRS data collection. RESULTS: For normal gastric tissue layers, the metabolite peaks of 400-MHz 1H MRS were primarily found to be as follows: lipids at 0.9 ppm and 1.3 ppm; alanine at 1.58 ppm; N-acetyl neuraminic acid (sialic acid) at 2.03 ppm; and glutathione at 2.25 ppm in common. The broad and feature-less spectral peaks of the 64-MHz MRS were bunched near 0.9, 1.3, and 2.0, and 2.2 ppm in human specimens without respect to layers. In a specimen (Borrmmann type III) with a tubular adenocarcinoma, the resonance peaks were measured at 1.26, 1.36 and 3.22 ppm. All the peak intensities of the spectrum of the normal gastric tissue were reduced, but for gastric tumor tissue layers, the lactate peak split into 1.26 and 1.39 ppm, and the peak intensity of choline at 3.21 ppm was increased. CONCLUSION: We found that decreasing lipids, an increasing lactate peak that split into two peaks, 1.26 ppm and 1.36 ppm, and an increasing choline peak at 3.22 ppm were markers of tumor invasion into the gastric tissue layers. This study implies that MR spectroscopy can be a useful diagnostic tool for gastric cancer.

A Case of Gastritis Cystica Profunda Suspiciously Caused by Gastric Foreign Body / 대한소화기내시경학회지

Gasritis cystica profunda (GCP) is a rare disease in which hyperplasia of mature glandular epithelium extends into the tissues beneath the submucosa. It shows multiple small cysts in the mucosa and submucosa of the stomach. It was firstly reported by Littler and Gleibermann on 1972. GCP is mainly observed at the site of gastroenterostomy but, it may occur in the stomach without a previous history of surgery. The proposed pathogenesis of the these abnormalities are related to ischemia, chronic inflammation and the presence of a foreign body. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps but also as a giant gastric mucosal fold rarely. It should be differentiated from Menetrier's disease, Zollinger-Ellison syndrome, inflammatory disease and malignancy. We present a case of gastritis cystica profunda without having had any previous surgery, suspiciously caused by gastric foreign body. We made a diagnosis based on findings from the esophagogastroduodenoscopy, endoscopic ultrasonography and histologic findings after surgery.

The Pattern of beta-Catenin Expression in Adenomas and Carcinomas of the Gallbladder

PURPOSE: beta-catenin is a key regulator of the cadherin-mediated cell adhesion system and also plays a role as a transcription regulating factor. Nuclear expression and mutation of beta-catenin have been identified in some benign and malignant tumors, and over expression of beta-catenin indicates an oncogenic potential. This study was designed to clarify the role of beta-catenin in the histogenesis of gallbladder carcinoma. METHODS: In benign hyperplastic lesions, adenomas, and carcinomas of the gallbladder, intracellular expression of beta-catenin was investigated by immunohistochemical stainings. Cyclin D1 and Ki-67 were also examined. RESULTS: All of the hyperplastic lesions showed membranous expression of beta-catenin. Adenomas and polypoid carcinomas showed significantly higher incidence of cytoplasmic and nuclear expression of beta-catenin than hyperplastic lesions and infiltrative carcinomas (P<0.01). Loss of beta-catenin expression was frequently noticed in infiltrative and poorly differentiated carcinomas. Nuclear expression of beta-catenin in carcinomas had unique pathologic characteristics, including polypoid growing, well differentiated tubular type, and early stage. Cytoplasmic and nuclear expression of beta-catenin showed good correlations with cyclin-D1 expression (P<0.05). The Ki-67 index was significantly higher in infiltrative carcinomas than in adenomas or polypoid carcinomas (P<0.05). CONCLUSION: Our results suggest that beta-catenin as a molecular marker may play a role in the carcinogenesis of the adenoma-carcinoma sequence of polypoid carcinomas. Infiltrative carcinomas, however, may have different mechanisms.