Morning Chronotype Decreases the Risk of Chemotherapy-Induced Peripheral Neuropathy in Women With Breast Cancer

Background@#The purpose of this longitudinal prospective cohort study was to investigate the role of chronotype in the incidence of chemotherapy-induced peripheral neuropathy (CIPN) among women with breast cancer. @*Methods@#We recruited women with breast cancer awaiting adjuvant chemotherapy, including four cycles of docetaxel. Participants reported peripheral neuropathy symptoms of numbness/ tingling at the baseline, and at 4weeks after completion of chemotherapy. Candidate psychiatric factors associated with CIPN were assessed at the baseline, using the Composite Scale of Morningness, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. To examine the association between chronotype and CIPN, we built logistic regression models, adjusting for demographic, clinical, and other psychiatric variables. @*Results@#Among 48 participants, 29 participants developed CIPN. The morning chronotype was inversely associated with CIPN (odds ratio, 0.06; confidence interval, 0.01–0.74; P = 0.028) after adjusting for age, BMI, education, type of operation, alcohol use, smoking, sleep quality, depression, and anxiety. @*Conclusion@#Our results suggest that the morning chronotype is a protective factor against the development of CIPN in patients with breast cancer who were treated with docetaxel.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors / 정신신체의학

Objectives@#：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. @*Methods@#：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. @*Results@#：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). @*Conclusions@#：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors / 정신신체의학

Objectives@#：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. @*Methods@#：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. @*Results@#：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). @*Conclusions@#：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Mediation effect of herpes zoster derived by statin use on cardiovascular disease risk

Background/Aims@#Although statins are widely used to reduce the risk of cardiovascular disease (CVD) including stroke and myocardial infarction (MI), it is reported that statin use increases the incidence of herpes zoster (HZ) that is associated with increased risk of CVD. So, we evaluated the mediation effect of HZ caused by statin use on CVD. @*Methods@#We analyzed a prospective cohort from the National Health Insurance Service-database of South Korea. All individuals received a medical check-up and were followed-up from 2002 to 2013. @*Results@#A total of 275,382 individuals > 40 years old were followed up for 11 years from 2003. Of these, 11,415 people (4%) were classified as statin users and 263,967 (96%) as non-statin users. Those who used statins had significantly lower risks of cardiovascular events, stroke, and MI compared with non-statin users; the adjusted hazard ratios in the multivariate analysis were 0.90 (95% confidence interval [CI], 0.82 to 0.98), 0.88 (95% CI, 0.80 to 0.98), and 0.91 (95% CI, 0.79 to 1.07), respectively. When we calculated the mediating effect of cardiovascular events by statin use through HZ, 11.6% of the total beneficial effect of cardiovascular events by statin use was mitigated through the occurrence of HZ caused by statin use. This mediating effect was higher in the younger age group (< 60 years). @*Conclusions@#This study showed that statin use reduced CVD by 10%, but the protective effect of statin use against CVD was mitigated by approximately 10% through the development of HZ caused by statin use.

Effect of Long-term Comprehensive Rehabilitation on Functional Recovery in Recurrent and Refractory Neuro-Behcet's Disease: a Case Report with 4-year Follow-up

Neuro-Behcet's disease (NBD) is rare, but it is the most serious complication of Behcet's disease, a vasculitis and multisystem inflammatory syndrome. NBD causes a variety of neurological deficits depending on the affected structure in the brain; cognitive impairment, motor weakness, ataxia, and dysphagia significantly affect functioning in independent life. Although steroid therapy usually ameliorates NBD symptoms, its therapeutic effects are limited to the chronic progressive type. In NBD patients with frequent recurrences, comprehensive rehabilitation can help to improve activities of daily living and neurological symptoms.

Cranial Polyneuropathy in Ramsay Hunt Syndrome Manifesting Severe Pharyngeal Dysphagia: a Case Report and Literature Review

Ramsay Hunt syndrome (RHS) is characterized by herpes zoster oticus, facial nerve palsy, and vestibulocochlear symptoms. Dysphagia caused by the involvement of multiple cranial nerves (CNs) in RHS is very rare. We encountered a rare case presented with severe dysphagia due to cranial polyneuropathy involving trigeminal nerve (CN V), facial nerve (CN VII), vestibulocochlear nerve (CN VIII), glossopharyngeal nerve (CN IX), vagus nerve (CN X), and hypoglossal nerve (CN XII) in RHS. This case report suggested that the prognosis for dysphagia in RHS seems favorable, and swallowing rehabilitation therapy could be beneficial in expediting tube removal.

Case of Follicular Bronchiolitis in Rheumatoid Arthritis

Follicular bronchiolitis is an uncommon bronchiolar disorder that is characterized by the presence of hyperplastic lymphoid follicles with reactive germinal centers. The condition is associated with connective tissue diseases such as rheumatoid arthritis, Sjögren’s syndrome, and immunodeficiency disorders. A 56-year-old man with rheumatoid arthritis was admitted to hospital with a progressively enlarging pulmonary nodule in the left upper lobe. A follow-up contrast tomography scan showed that the nodule had increased in size from 4.2 mm to 6.3 mm over a 3 month period. An open lung biopsy was performed to establish a definite pathologic diagnosis of the pulmonary nodule, which was suspected to be a lung malignancy. The nodule was diagnosed as follicular bronchiolitis based on the histopathology findings. We describe a patient with follicular bronchiolitis that was confirmed by an open lung biopsy, and is believed to have had rheumatoid involvement.

Reliability and Validity of the Korean Version of the Child Report of Post-Traumatic Symptoms (CROPS) and the Parent Report of Post-Traumatic Symptoms (PROPS)

OBJECTIVES: The Child Report of Post-traumatic Symptoms (CROPS) and the Parent Report of Post-traumatic Symptoms (PROPS) are screening measures for post-traumatic symptoms in children. The present study aimed to investigate the reliability and validity of the Korean versions of the CROPS and the PROPS. METHODS: The Korean versions of the CROPS and the PROPS were administered to a sample of 304 children aged 6 to 15 years old. The internal reliability, test-retest reliability, factorial validity, predictive validity and concurrent validity were evaluated. RESULTS: The reliability of the CROPS and the PROPS was shown to have excellent internal consistency and test-retest correlation. The single factor structure of the PROPS was good and that of the CROPS was borderline acceptable according to confirmatory factor analysis. Other validity measures such as the predictive validity and concurrent validity were also shown to be satisfactory. CONCLUSION: This study demonstrated that the Korean versions of the CROPS and the PROPS were reliable measures with satisfactory psychometric qualities. Because it takes less than 5 minutes to fill out the CROPS and the PROPS, respectively they can be quick and easy screening scales for assessing post-traumatic symptoms in Korean children.

Sintering behavior and mechanical properties of zirconia compacts fabricated by uniaxial press forming

PURPOSE: The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. MATERIAL AND METHODS: Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest(R) ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. RESULTS: Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. CONCLUSION: Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block.

Effects of titanium surface coating on ceramic adhesion / 대한치과보철학회지

STATEMENT OF PROBLEM: The adhesion between titanium and ceramic is less optimal than conventional metal-ceramic bonding, due to reaction layer form on cast titanium surface during porcelain firing. PURPOSE: This study characterized the effect of titanium-ceramic adhesion after gold and TiN coating on cast and wrought titanium substrates. MATERIAL AND METHOD: Six groups of ASTM grade II commercially pure titanium and cast titanium specimens(13mm x 13mm x 1mm) were prepared(n=8). The conventional Au-Pd-In alloy served as the control. All specimens were sandblasted with 110micrometer Al2O3 particles and ultrasonically cleaned for 5min in deionized water, and dried in air before porcelain firing. An ultra-low-fusing dental porcelain(Vita Titankeramik) was fused on titanium surfaces. Porcelain was debonded by a biaxial flexure test at a cross head speed of 0.25mm/min. The excellent titanium-ceramic adherence was exhibited by the presence of a dentin porcelain layer on the specimen surface after the biaxial flexure test. Area fraction of adherent porcelain(AFAP) was determined by SEM/EDS. Numerical results were statistically analyzed by one-way ANOVA and Student- Newman-Keuls test at alpha=0.05. RESULTS: The AFAP value of cast titanium was greatest in the group 2 with TiN coating, followed by group 1 with Au coating and the group 3 with Al2O3 sandblasting. Significant statistical difference was found between the group 1, 2 and the group 3 (p.05). The AFAP values of the cast titanium and the wrought titanium were similar. However the group treated with Al2O3 sandblasting showed significantly lower value (p<.05).

The bond characteristics of porcelain fused by titanium surface modification / 대한치과보철학회지

STATEMENT OF PROBLEM: Titanium is well known as a proper metal for the dental restorations, because it has an excellent biocompatibility, resistance to corrosion, and mechanical property. However, adhesion between titanium and dental porcelains is related to the diffusion of oxygen to the reaction layers formed on cast-titanium surfaces during porcelain firing and those oxidized layers make the adhesion difficult to be formed. Many studies using mechanical, chemical and physical methods to enhance the titanium-ceramic adhesion have been actively performed. PURPOSE: This study meant to comparatively analyse the adhesion characteristics depending on different titanium surface coatings after coating the casts and wrought titanium surfaces with Au and TiN. MATERIAL AND METHOD: In this study, the titanium specimens (CP-Ti, Grade 2, Kobe still Co. Japan) were categorized into cast and wrought titanium. The wrought titanium was cast by using the MgO-based investment(Selevest CB, Selec). The cast and wrought titanium were treated with Au coating(ParaOne(R), Gold Ion Sputter, Model PS-1200) and TiN coating(ATEC system, Korea) and the ultra low fusing dental porcelain was fused and fired onto the samples. Biaxial flection test was done on the fired samples and the porcelain was separated. The adhesion characteristics of porcelain and titanium after firing and the specimen surfaces before and after the porcelain fracture test were observed with SEM. The atomic percent of Si on all sample surfaces was comparatively analysed by EDS. In addition, the constituents of specimen surface layers after the porcelain fracture and the formed compound were evaluated by X-ray diffraction diagnosis. RESULT: The results of this study were obtained as follows : 1. The surface characteristics of cast and wrought titanium after surface treatment(Au, TiN, Al2O3 sandblasting) were similar and each cast and wrought titanium showed similar bonding characteristics. 2. Before and after the biaxial flection test, the highest atomic weight change of Si component was found in Al2O3 sandblasted wrought titanium(28.6at.% --> 8.3at.%). On the other hand, the least change was seen in Au-Pd-In alloy(24.5at.%--> 19.1at.%). 3. Much amount of Si components was uniformly distributed in Au and TiN coated titanium, but less amount of Si's was unevenly dispersed on Al2O3 sandblasting surfaces. 4. In X-ray diffraction diagnosis after porcelain debonding, we could see Au2Ti compound and TiN coating layers on Au and TiN coated surfaces and TiO2, typical oxide of titanium, on all titanium surfaces. 5. Debonding of porcelain on cast and wrought titanium surface after the biaxial flection is considered as a result of adhesion deterioration between coating layers and titanium surfaces. We found that there are both adhesive failure and cohesive failure at the same time. CONCLUSION: These results showed that the titanium-ceramic adhesion could be improved by coating cast and wrought titanium surfaces with Au and TiN when making porcelain fused to metal crowns. In order to use porcelain fused to titanium clinically, it is considered that coating technique to enhance the bonding strength between coating kKlayers and titanium surfaces should be developed first.

A comparison of fracture strengths of porcelain-fused-to-titanium crown among titanium surface coating treatments / 대한치과보철학회지

STATEMENT OF PROBLEM: Titanium and its alloy, with their excellent bio-compatibility and above average resistance to corrosion, have been widely used in the field of dentistry. However, the excessive oxidization of titanium which occurs during the process of firing on porcelain makes the bonding of titanium and porcelain more difficult than that of the conventional metal-porcelain bonding. To solve this problem related to titanium-porcelain bonding, several methods which modify the surfaces, coat the surfaces of titanium with various pure metals and ceramics, to enable the porcelain adhesive by limiting the diffusion of oxygen and forming the adhesive oxides surfaces, have been investigated. PURPOSE: The purpose of this study was to know whether the titanium-porcelain bonding strength could be enhanced by treating the titanium surface with gold and TiN followed by fabrication of clinically applicable porcelain-fused-to-titanium crown. MATERIAL AND METHOD: The porcelain-fused-to-titanium crown was fabricated after sandblasting the surface of the casting titanium coping with Al2O3 and treating the surface with gold and TiN coating followed by condensation and firing of ultra-low fusing porcelain. To compare with porcelain-fused-to-titanium crowns, porcelain-fused-to-gold crowns were fabricated and used as control groups. The bonding strengths of porcelain-fused-to-gold crowns and porcelain-fused-totitanium crowns were set for comparison when the porcelain was fractured on purpose to get the experimental value of fracture strength. Then, the surface were examined by SEM and each fracturing pattern were compared with each other. RESULT: Those results are as follows. 1. The highest value of fracture strength of porcelain-fused-to-titanium crowns was in the order of group with gold coating, group with TiN coating, group with Al2O3 sandblasting. No statistically significant difference was found among the three (P>.05). 2. The porcelain-fused-to-gold crowns showed the highest value in bonding strength. The bonding strength of crowns porcelain-fused-to-titanium crowns of rest groups showed bonding strength reaching only 85%-94% of that of PFG, though simple comparision seemed unacceptable due to the difference in materials used. 3. The fracturing patterns between metal and porcelain showed mixed type of failure behavior including cohesive failure and adhesive failure as a similar patterns by examination with the naked eye and SEM. But porcelain-fused-to-gold crowns showed high incidence of adhesive failure and porcelain-fused-to-titanium crowns showed high incidence of cohesive failure. CONCLUSION: Above results proved that when fabricating porcelain-fused-to-titanium crowns, treating casting titanium surface with gold or TiN was able to enhance the bonding strength between titanium and porcelain. Mean value of masticatory force was found to showed clinically acceptable values in porcelain bonding strength in all three groups. However, more experimental studies and evaluations should be done in order to get better porcelain bonding strength and various surface coating methods that can be applied on titanium surface with ease.

Mechanical properties of laser-welded cast titanium and titanium alloy / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effect of the output energy(voltage) of laser welding on the strength and properties of joint of cast titanium(CP Gr II) and titanium alloy(Ti-6Al-4V). MATERIAL AND METHOD: Cast titanium and its alloy rods(ISO6871) were prepared and perpendicularly cut at the center of the rod. After the cut halves were fixed in a jig, and the joints welded with a laser-welding machine at several levels of output voltage of 200V.280V. Uncut specimens served as the non-welded control specimens. The pulse duration and pulse spot size employed in this study were 10ms and 1.0mm respectively. Tensile testing was conducted at a crosshead speed of 0.5mm/min. The ultimate tensile strength(MPa) was recorded, and the data(n=6) were statistically analyzed by one-way analysis of variance(ANOVA) and Scheffe's test at alpha=0.05. The fracture surface of specimens investigated by scanning electron microscope(SEM). Vickers microhardness was measured under 500g load of 15seconds with the optimal condition of output voltage 280V. RESULTS: The results of this study were obtained as follows, 1. When the pulse duration and spot size were fixed at 10ms and 1.0mm respectively, increasing the output energy(voltage) increased UTS values and penetration depth of laser welded to titanium and titanium alloy. 2. For the commercial titanium grade II, ultimate tensile strength(665.3MPa) of the specimens laser-welded at voltage of 280V were not statistically(p>0.05) different from the non-welded control specimens(680.2MPa). 3. For the titanium alloy(Ti-6Al-4V), ultimate tensile strength(988.3MPa) of the specimens laser-welded at voltage of 280V were statistically(p<0.05) different from the nonwelded control specimens(665.0MPa). 4. The commercial titanium grade II and titanium alloy(Ti-6Al-4V) were Vickers microhardness values were increased in the fusion zone and there were no significant differences in base metal, heat-affected zone.

Histopathologic Resemblance of Ovarian Dermoid Cyst to Various Skin Tumors

BACKGROUND: The wall of ovarian dermoid cysts shows various kinds of morphologic patterns. Some of them resemble the features of epidermal and epidermal appendageal tumors. OBJECTIVE: The purpose of this study is to classify the morphologic features of the wall of ovarian dermoid cyst from the dermatohistopathologic viewpoint. METHODS: H&E stained slides of 203 ovarian dermoid cysts were reviewed RESULTS: Thirteen different patterns of morphologic features were found. They included features of organoid nevus, sebaceous hyperplasia, steatocystoma multiplex, epidermoid cyst, nevus comedonicus, epidermal nevus, apocrine hidrocystoma, syringoma and trichilemmal cyst. CONCLUSION: Various epidermal and epidermal appendageal tumors may be associated with ovarian dermoid cyst.

Solitary Fibrous Tumor Clinico: Pathological Analysis of 11 Cases / 대한암학회지

The clinico-pathological features of 11 solitary fibrous tumors (SFT) are described. The age of the patients ranged from 19 to 70 years (average, 43 years); 6 were male patients. Ten tumors were benign and arose in the pleura (three tumors), peritoneum (two), mediastinum (two), nasal cavity (one), thymus (one), and lacrimal gland (one). One tumor was histologically malignant and arose in the pleura. All of the tumors were grossly well circumscribed. The tumors measured from 0.8 cm to 50 cm in greatest diameter. Histologically, the tumors were composed of cytologically bland spindle cells arranged without obvious pattern; focally storiform, fascicular growth patterns and hemangioperi- cytoma-like vascular patterns were seen. Tumor cells were separated by thick bands of collagen demonstrating foci of keloid-like hyalinization. Increased mitotic activity (4 mitoses in 10 high-power fields) and high cellularity with mild cytologic atypia was noted in a pleural case, suspicious of malignant tumor, Immunohistochemically, all cases tested attained positivity for vimentin, CD34, and two cases showed focal myofibroblastic differentiation. Ultrastructural study of three cases showed mesenchymal cells with fibroblastic differentiation. Follow-up for 3 to 96 months (average, 39 months) showed no tumor recurrence or metastasis. SFT are easily overdiagnosed if strict criteria are not carefully applied, and strict diagnostic criteria are necessary to avoid confusion of SFT with more aggressive lesions.

Immunohistochemical Study on the Ha-ras p21 Expression in the Gastric Carcinoma

We have investigated an immunohistochemical expression of the Human-Ha-ras oncogene product p21 in tumor cells of the primary mass and metastatic lymph nodes with different histological features of gastric cancer by using avidinbiotin complex immunoperoxidase method in formalin-fixed tissue sections from 73 cases of primary tumor mass and 23 cases of metastatic lymph node. Histologic type of the gastric cancer was classification. The results obtained were as follows: 1) Expression of Ha-ras p21 was consistantly increased in the well differentiated tubular adenocarcinoma as compared with poorly differentiated tubular adenocarcinoma (p<0.01), and was substantially decreased in mucinous carcinoma and signet ring cell carcinoma. 2) Signet ring cell carcinoma showed that positive immunoperoxidase reaction for Ha-ras p21 exhibited in the majority of immature signet ring cell with scant cytoplasm rather than in the mature signet ring cells which have abundant cytoplasm filled with mucin. This findings indicate that mucin production from the tumor cell was not correlated with activation of ras gene in the tumor tissue of gastric carcinoma. 3) In general Ha-ras p21 expression was enhanced in the metastatic tumor cells of the regional lymph node compared with primary tumor, especially it was consistantly increase in the well differentiated tubular adenocarcinoma.

Biologic Significance of Hepatocyte Hepatitis B Core Antigen Expression in Chronic Hepatitis B Virus Infection II

Routine use of commercially available antisera against hepatitis B core antigen(HBcAg) has permitted a reevaluation of the histochemical distribution of the antigen in liver tissue. HBcAg, classically described almost exclusively in the nucleus, was found with a very high frequency in the cytoplasm of liver cells as well. To elucidate the biologic significance of HBcAg expression and its relation to the natural course of hepatitis B virus(HBV) infection, the patterns of activity in 33 needle liver biopsies of HBsAg carriers were analysed. A good correlation of liver HBcAg with disease activity was demonstrated. HBcAg was present in the hepatocyte nuclei(nHBcAg) or cytoplasm(cHBcAg), or in both(mixed). Pure nHBcAg was seen mainly in non-aggressive reactive liver tissue and cHBcAg was predominantly associated with chronic active hepatitis(95%). The results suggest that expression of HBcAg correlates with the liver pathology and the possibility of HBcAg to be an immunological target for T cell mediated hepatocyte damage.

Relation of alpha-1-antichymotrypsin and p53 Protein Expression to Bony Metastasis in Advanced Prostate Cancer / 대한비뇨기과학회지

PURPOSE: The purpose of this study was to investigate whether the expressions of alpha-1 -antichymotrypsin(ACT) and/or p53 protein in advanced prostate cancer were related with bony metastases. MATERIALS AND METHODS: The immunohistochemical study with ACT and p53 included 7 archival transurethral resection and 14 prostate biopsy specimens from patients with prostate cancer who showed high serum PSA level(>10ng/ml) and periprostatic or lymph node involvement on imaging study. Whole body bone scan was perfomed to detect bony metastatis in all patients. RESULTS: Four out of 5 cases showing strong expression patterns with ACT protein showed abnormal hot uptakes on whole body bone scan. ACT proteins were weakly expressed in seven out of eight cases without bony metastases. p53 protein was expressed in 13 cases, but there was no statistically significant relation between the expression of p53 protein and bony metastasis. Either, there was no significant relation between ACT and p53 protein expression patterns. CONCLUSIONS: Our results suggested that the strong expression of ACT protein combined with high serum PSA level(>10ng/ml) and whole body bone scan could be the useful method for confirming bony metastasis although not adequate for screening test. The expression of p53 protein appears to be associated with progression of prostate cancer, but there was no statistically significant relation with bony metastasis.

Angiomyofibroblastoma of Vulva: A case report

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.

Histopathologic Study of Post-irradiation Specimen

The number of post-irradiated surgical specimen appears to have risen in recent years due to the increasing utiliz ation of radiotherapy for cancer patients. Radiation therapy damages cells by its effects on the deoxyribonucleic acid and the spectrum of injury ranges from acute self-limited lesion to irreversible chronic lesion. We reviewed 24 cases of post-irradiated specimen and thought that time interval is the main factor influencing the morphologic change. Within six weeks, the individual cytologic changes such as biz arre nuclei, altered nucleus/cytoplasm ratio, amphophilic and vacuolated cytoplasm are noted. Chronic injury resulting from progressive changes in the fibrovascular tissue of the radiated area occur in six months after the initial course of radiation and the vascular changes of intimal thickening and fibrosis, foamy histiocytes within media, periadventital fibrosis and chronic inflammatory cells infiltration are present. Althouhg above mentioned finding are not pathognomonic, we thought them quite constant nd reproducible characteristics of radiation injury.