Clinicopathologic Implication of Ezrin Expression in Non-small Cell Lung Cancer

BACKGROUND: Ezrin, a member of the ezrin-radixin-moesin family, is implicated in tumor progression, metastatic dissemination, and adverse outcomes, in several cancer types. In this study, we explored the clinicopathological significance of ezrin expression in non-small cell lung carcinomas (NSCLCs). METHODS: Immunohistochemical analysis of tissue microarray with 112 surgically resected NSCLC specimens, was performed to examine the ezrin expression. We also correlated ezrin expression with other clinicopathological features and prognosis. RESULTS: The ezrin-positive group revealed significantly higher correlation with pleural invasion (p=0.016) and pathologic stage (p=0.050). Univariate survival analysis showed that ezrin-positive group had a significantly shorter cancer-specific survival than ezrin-negative group (p=0.016). Meanwhile, female (p=0.030), no pleural invasion (p=0.023), no lymphatic invasion (p=0.026), and early pathologic stage (p=0.008) significantly correlated with longer survival. Multivariate survival analysis showed that variables such as ezrin positivity (p=0.032), female (p=0.035), and early pathologic stage (p=0.001) were independent prognostic factors for NSCLC. CONCLUSIONS: Ezrin might be a molecular marker to predict poor prognosis of NSCLC.

Angiolipoma of the Breast: A Case Report / 한국유방암학회지

An angiolipoma is a common mixed connective tissue tumor that commonly occurs in the trunk and extremities, and has been rarely reported in the breast. It is a benign variant of a lipoma that shows various appearances on mammography. It is usually seen with a well circumscribed homogeneously hyperechoic pattern on ultrasound. We report a rare case of an angiolipoma of the breast with no definite abnormality on mammography, appearing as an irregular homogeneously hyperechoic lesion on ultrasound.

Expression of HER-2/neu and Paxillin in Ductal Carcinoma in situ, Invasive Ductal Carcinoma with Ductal Carcinoma in situ and Mucinous Carcinoma / 한국유방암학회지

PURPOSE: We purpose to determine the correlation of HER-2/neu and paxillin expression in ductal carcinoma in situ (DCIS), invasive ductal carcinoma with ductal carcinoma in situ (IDC with DCIS) and mucinous carcinoma. METHODS: To evaluate the expression of HER-2/neu and paxillin, the immunohistochemical staining was performed for 13 cases of DCIS, 13 cases of IDC with DCIS and 6 cases of mucinous carcinoma. RESULTS: The DCIS and IDC were associated with infiltration of the inflammatory cells, especially in the comedo type and solid type of tumor. In cases with infiltration of the inflammatory cells, HER-2/neu and paxillin were strongly expressed. When comparing the expression level of HER-2/neu from adjacent normal tissue between DCIS and IDC with DCIS, expression of HER-2/neu was similar to that of normal tissue adjacent to DCIS. However, in the adjoining normal ductal epithelial cells, paxillin was highly expressed in cells of all of the tumor types, and especially for IDC with DCIS. HER-2/neu and paxillin were not expressed in mucinous carcinoma cells in all cases. CONCLUSION: HER-2/neu in the DCIS and IDC with infiltration of inflammatory cells shows higher expression than non-inflammatory DCIS and IDC. If normal duct epithelial cells show a high level of HER-2/neu expression, the epithelial cells have a high probability of transformation into anaplastic cells. However, paxillin appears to have no value as a prognostic factor. The difference of expression of HER-2/neu between IDC with DCIS and DCIS suggests a different origin of tumor cells. The growth pattern of mucinous carcinoma cell is different from the that of DCIS or IDC cell, which grow slowly.

Prognostic Value of Apoptosis and the Survivin, bcl-2, and p53 Expressions in Breast Cancer Patients / 한국유방암학회지

PURPOSE: Survivin is a member of the inhibitor of apoptosis (IAP) protein family, and it is involved in the regulation of cell division. The over-expression of survivin has been reported to be associated with the parameters for a poor prognosis in most human cancers, including lung, breast, colon, stomach, esophagus, pancreas, etc. In this study, we examined the expression of a member of a novel IAP protein family, survivin, in breast cancer and its association with tumor cell apoptosis and the overall prognosis. METHODS: 80 cases of formalin-fixed paraffin-embedded breast cancer tissue were immunostained with, using polyclonal survivin (Novus Biologicals, Littleton, USA), monoclonal bcl-2 (DAKO, Carpinteria, USA), and monoclonal p53 antibodies (DAKO, Carpinteria, USA). The histochemical method used for the analysis of apoptosis was based on ApopTag. Peroxidase In Situ OligoLigation (ISOL) Apoptosis Detection Kit (CHEMICON International Inc. Temecula, USA). RESULTS: Immunohistochemical analysis showed that cytoplasmic survivin expression was positive in 43 of 80 cases (53.8%) of breast carcinomas and it was positive for 70% of the cases that showed a bcl-2 expression tumors. Statistical analysis revealed that the survivin expression was correlated with lymph node metastasis, the tumor stage, and the histological grade. Although the survivin expression was not correlated with p53 mutations, the survivin positive cases were associated with a bcl-2 expression (p=0.015) and a reduced apoptotic index (p=0.024). On the Cox proportional hazard model analysis, the apoptotic index was not identified as a significant independent predictor of overall survival (p=0.072), although the patients with a low apoptotic index ( or =0.2%). CONCLUSION: The results suggest that apoptosis inhibition of apoptosis by survivin may be a prognostic parameter for a worse outcome in breast carcinoma patients.

A Case of Acute Generalized Exanthematous Pustulosis / 소아알레르기및호흡기학회지

Acute generalized exanthematous pustulosis(AGEP) is a relatively rare exfoliative skin syndrome. It consists of a generalized eruption of pustules in response to medication or infection. Antibiotics are the most commonly implicated medications. Nonsteroidal anti-inflammatory drugs(NSAID) can also trigger AGEP. However, So far, a case of AGEP due to ibuprofen has not been reported in Korea. Therefore we report a case of acute generalized exanthematous pustulosis as a result of use of ibuprofen in a 10 years old female.

The Effects of Hyperosmolar Dextrose and Autologous Serum Injection in the Experimental Articular Defect of Rabbit

OBJECTIVE: Although the clinical effects of prolotherapy on osteoarthritis has been reported, there have been few previous studies showing the effects as a proliferant on articular cartilage. Also the autologous blood has been reported to used as a growth factor stimulant recently, we were trying to use dextrose and autologous serum for tissue regeneration respectively and evaluated the proliferative effect of autologous serum comparing with that of dextrose. METHOD: Twenty four rabbits were used for this study. The rabbits were divided into three groups. Group A did not get any special treatment. Group B was treated with 10% dextrose and group C with autologous serum. Six weeks later, gross appearance and histologic findings were evaluated. RESULTS: After sacrifice, the gross inspection of the knee joints revealed that group B and C were filled with the translucent tissue in defective cartilage. Group A still had defective cartilage. Histologic evaluation revealed increase of cellularity in the defect of the injected specimens when compared with the control. There was no morphological difference between group B and C. CONCLUSION: The repair process of the articular cartilage defects using dextrose and autologous serum were shown to be more effective than that of control group.

A Case of Periumbilical Perforating Pseudoxanthoma Elasticum / 대한피부과학회지

Perforating pseudoxanthoma elasticum is a rare disorder. It is an hereditary connective tissue disease involving progressive fragmentation and dystrophic calcification of elastic fibers. The localized lesions usually occur in a periumbilical location in obese, middle-aged, multiparous black women. It is characterized clinically by yellowish, lax, well-circumscribed, reticulated or cobblestoned patches or plaques of the periumbilical region. Herein, we report a case of periumbilical perforating pseudoxanthoma elasticum which occurred in an obese, multiparous woman with no signs of hereditary systemic pseudoxanthoma elasticum.

The Response of the Injured Articular Cartilage of Rabbit Knee after Injection of Autologous Blood

OBJECTIVE: To evaluate the effects of proliferant by injecting blood into the articular cartilage defect. METHOD: The patella of rabbits were dislocated laterally and 2 mm circular and 2 mm depth full-thickness defect was made in the articular cartilage. We injected 0.2 cc autologous blood to the right defect and normal saline to the left one at 1 week after operation for six times with a 1 week interval. After injection for six weeks, the articular cartilage defect were obtained and stained with H-E and S-100. RESULTS: The surface of the saline-injected group was easily distinguishable from the surrounding articular cartilage. But the blood-injected group had similar appearance to the surrounding cartilage, with the margin of the defect barely discerptible. Strong S-100 stained immune cartilage cells were observed in the blood-injected group. CONCLUSION: The repairing process of the injured articular cartilage using autologous blood was shown to be much better than that of saline-injected group although the observation period was short and the number of animal was small. So we found that autologous blood effectively repaired osteochondral defects.

Immunohistochemical Expression of p53 and Cathepsin D in Prostatic Carcinoma / 대한암학회지

PURPOSE: To evaluate the prognostic significances of p53 and cathepsin D in the prostatic carcinoma, we compared them to other prognostic factors, such as nuclear grade and clinical stage. MATERIALS AND METHODS: The material consisted of 40 paraffin-embedded, primary prostate carcinomas. We examined the expression of p53 and cathepsin D using immunohistochemical staining and compared their expression with the grade and stage. RESULTS: The expressions of p53 were noted in the nucleus of tumor cells and cathepsin D were noted in the cytoplasm of tumor cells. Thirteen of 40 tumors were positive for p53. There were more expressing p53 in samples (40%) from prostatic cancer with a high Gleason score group than in samples (28%) from prostatic cancer with low Gleason score group. The expression of p53 was 22% in clinical stage B and C groups and 35% in clinical stage D group. These results showed that p53 expression was not statistically correlated with Gleason score and clinical stage, but there were trends to increased p53 expression with high Gleason score and progressed clinical stage (p>0.05). Progressed clinical stage group showed higher expression of cathepsin D than early clinical stage group. However, there were no statistical correlations between expression of cathepsin D and Gleason score, and clinical stage (p>0.05). CONCLUSION: These results suggest that the overexpression of p53 and cathepsin D may be associated with tumor differentiation and clinical stage, but have limited prognostic value in prostatic carcinoma.

A Case of Cutaneous Cryptococcosis Resembling Pyoderma Gangrenosum / 대한피부과학회지

Cryptococcosis is a disease caused by Cryptococcus neoformans, that most commonly affects immunosuppressed patients. Cutaneous cyptococcosis occurs in 10-15% of disseminated cases and its clinical manifestation is variable. We have presented an unusual manifestation of cutaneous cryptococcosis in a patient with iatrogenic Cushing syndrome. Clinically, the ulcers were considered to be pyoderma gangrenosum but the tissue biopsy and culture revealed cryptococcosis. This case illustrates that in making the diagnosis of pyoderma gangrenosum, one must exclude deep fungal infection.

Two Cases of Henoch-Sch nlein Purpura Presenting as Bullous Lesions / 대한피부과학회지

Characteristic skin lesions of Henoch-Sch nlein purpura consist of small hemorrhagic macules, papules, palpable purpura, or urticarial lesions that appear in a symmetric distribution over the buttocks and extensor surfaces of the extremities. In rare cases, some lesions may become nodular, bullous, and ulcerative, especially in severe cases of leukocytoclastic vasculitis. We report two cases of Henoch-Sch nlein purpura presenting as bullous lesions, which should be differentiated from other bullous diseases such as bullous pemphigoid and impetigo.

A case of solar urticaria in a young child / 천식및알레르기

Solar urticaria is a rare disorder in which immediate erythema and wheals are induced by ultraviolet or visible irradiation. This condition usually occurs in the third and fifth decades of life and is very rare in childhood. A 3-year-old girl presented with a history of an erythematous rash which had occurred on the face and neck, immediately after exposure to sunlight for one month. A diagnosis of solar urtiacria was made on the clinical reviews and phototest. Other photosensitive disorders could be excluded by the clinical and laboratory findings. She was treated with ketotifen and sun protection showing good early results.

Four Cases of Acquired Ichthyosis after Bone Marrow Transplant / 대한피부과학회지

Acquired ichthyosis is similar to ichthyosis vulgaris clinically and histologically, but it may develop in patients with several systemic disease and secondary to multiple drugs. Acquired ichthyosis was observed in four patients who had recieved bone marrow transplantation. Immunosuppression or abnormality of the immune system after bone marrow transplants may have a role in the pathogenesis of acquired ichthyosis.

A Case of Hand-Foot-Mouth Disease in An Adult after Bone Marrow Transplantation / 대한피부과학회지

Hand-Foot-Mouth disease is a highly contagious disease most often seen in children. It is caused most commonly by the coxsackie virus A16. Other enterovirus have been implicated. A 41-year-old woman was presented with painful multiple vesicles on oral mucosa, tongue, both hands and feet. She had recieved a bone marrow transplant 16 months ago and had recieved immunosuppressive drugs. Immunosuppression may have a role in the development of Hand-Foot-Mouth disease. Prompt and accurate diagnosis is important because serious sequelaes are common in an elderly individual and immunocompromised patient.

Sweet's Syndrome Associated with a Benign IgA Gammopathy

A 71-year-old woman was presented with 5-year history of recurrent, multiple, painful or tender, erythematous plaques on her lower limbs accompanied by fever and arthralgia. Histopathological findings showed a dense infiltration of mature neutrophils in the upper and mid dermis without leukocytoclastic vasculitis. These clinical and histopathological findings were consistent with Sweet's syndrome. The laboratory investigations demonstrated elevated ESR and IgA gammopathy, but no leukocytosis or neutrophilia. Her eruption revealed good responses to systemic steroid therapy. We herein describe a patient with Sweet's syndrome without leukocytosis, probably associated with a benign IgA gammopathy.

Paraquat-poisoning in the rabbit lungs: high resolution computed tomographic findings and pathologic correlation

The authors evaluated high resolution computed tomographic (HRCT) findings of the isolated rabbit lungs with paraquat poisoning, and the findings were correlated with pathologic specimens. The purposes of this study are 1) to obtain the HRCT findings of the normal rabbit lung, 2) to find out if pulmonary pathology can be induced in rabbits by paraquat, and 3) to correlate the HRCT findings to those of pathology. Thirty rabbits were divided into three groups: group I included four control rabbits; group II included 16 rabbits given paraquat intraperitoneally(IP group); and group III included 10 rabbits given paraquat intravenously(IV group). The rabbits were sacrificed seven, 10 and 14 days after injection of various amount of paraquat, and then the lungs were isolated for HRCT and pathologic studies. Gross and microscopic findings of the three groups of control and paraquat-injected rabbit lungs were correlated with HRCT findings. Pulmonary congestion, mild thickening of alveolar walls and septae, and multifocal micro-atelectasis were the main pathologic findings of the lungs in both groups of the rabbits. Pulmonary hemorrhage was noted in five (31%) of 16 rabbits of IP group and three (30%) of 10 IV group. Pulmonary edema was seen in one rabbit (6%) of IP and four (40%) of IV group. Typical pulmonary fibrosis was seen in one rabbit of IP (6%) and IV (10%) group, respectively. There was no correlation between the amount of paraquat and frequency of the pulmonary pathology. Pulmonary fibrosis was seen at least one week after the paraquat injection. On HRCT, pulmonary hemorrhage and edema appeared as diffuse air-space consolidation and pulmonary fibrosis as linear or band-like opacities. However, minimal changes such as mild congestion.

Malignant Granular Cell Tumor: Report of One Case / 대한정형외과학회잡지

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.

Morphological Study on the Spleen following the Administration of 5-Fluorouracil or Mitomycin C / 체질인류학회지

This experiment was performed to evaluate the morphological responses of 5-fluorouracil or mitomycin C on the spleen of the mice. 5-fluorouracil (60 mg/kg) or mitomycin C (400 microgram/kg) were injected subcutaneously every other day, and the animals were sacrificed at 1 week and 2 weeks following the first injection. Pieces of the tissue were taken from the spleen, fixed in 10% neutral formalin for light microscopy. The paraffin sections stained with hematoxylin-eosin, Masson-trichrome, Bielschowsky's silver impregnation or aldehydefuchsin. For electron microscopy, the tissues were prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde followed by post-fixed with 1% osmium tetroxide. The ultrathin sections stained with uranyl acetate and lead citrate. The observed results were as follows: 1. On histological study, in the mitomycin C treated group, macrophages which contain pyknotic nuclei were observed more frequently than in those of 5-fluorouracil treated group. 2. In the 5-fluorouracil treated group, positive reactions to Masson-trichrome and Bielschowsky's silver impregnation were observed in the splenic capsule and traculae at the 1 week, and weak postive stains were observed at the 2 weeks. 3. In the mitomycin C and the 5-fluorouracil group, positive staining reaction to aldehyde-fuchsin were observed in splenic capsule, trabeculae and around artery at the 1 week and 2 weeks. 4. On the ultrastructural study, distended cisternae of granular endoplasmic reticula were observed frequently at 1 week. 5. In the mitomycin C treated group, myelin figures in the lymphocytes and reticular cells were observed more frequently than in those of 5-fluorouracil treated group. From the above results, it was concluded that lymphocytes and reticular cells of the spleen were slightly damaged by 5-fluorouracil or mitomycin C, and mitomycin C seems more harmful on the spleen than 5-fluorouracil does.

A Clinical Study of Acute Graft-versus-host disease after Allogeneic Bone Marrow Transplantation: Cutaneous Manifestation / 대한피부과학회지

BACKGROUND: Acute graft-versus-host disease(GVHD) has been a major obstacle of successful allogeneic bone marrow transplantation(BMT). Because the onset of cutaneous graft-versus-host reaction (GVHR) is usually the earliest and certainly the most common form of the disease, cutaneous manifestation of acute GVHD is important to detect as early as possible. Except for a few case reports, there has been no clinical study of acute cutaneous GVHR in Korea so far. OBJECTIVE: We investigated the clinical characteristics of acute cutaneous GVHR in recepients receiving allogeneic BMT from human leukocyte antigen(HLA)-identical sibling donor. METHODS: On the basis of the patients' charts and the records of Catholic BMT center, we investigated the incidence of acute GVHD and the clinical manifestation of acute GVHD occurring in 102 patients of whom 66 patients were confirmed by histopathology. RESULTS: 1. The incidence of acute GVHD was 23.5 %, and the incidence of male and female were 22.4 %, 25.0 % respectively. 2. The cutaneous GVHR usually developed within 10-40 days after BMT and usually the earliest and most common form of the GVHD. 3. The most common cutaneous involvement site were upper extremities and chest and 51.4 % of cutaneous GVHR patients complained pruritus, pain and tenderness. 4. The over all clinical grade was lower than that in western countries. CONCLUSION: We speculate that the lower incidence of acute GVHD and milder clinical characteristics than the reports in the western countries might be related to differences in genetic background.

The Expression of p53 and p21 in Intradermal Nevus, Junctional Nevus and Malignant Melanoma / 대한피부과학회지

BACKGROUND: The function of the p53 protein is known to regulate cell proliferation by inhibiting cells entering S phase, so DNA damaged cell proliferation is inhibited by apoptosis. p21 is a cyclin dependent kinase inhibitor induced by wild type p53, not mutant p53. Thus p21 is thought to mediate the signal of p53 induced by DNA damaged agents to arrest the cell cycle in G1 phase. p53 and p21 are expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis are important. OBJECTIVE: The purpose of this study was to analyze immunohistochemical expression of mutant p53 and p21 protein in melanocytic lesions. METHOD: 11 cases of intradermal nevus, 7 cases of junctional nevus and 6 cases of malignant melanoma were immunohistochemically stained with p53 and p21 monoclonal antibodies. RESULTS: 1. In intradermal nevus, the p53 was negative in 100% and the p21 was negative in 98%. These findings suggest that the composing cells of intradermal nevus is completely mature cell. 2. The positive rates of p53 and p21 in junctional nevus were 43% and 43%, respectively. The positive rates of p53 and p21 in malignant melanoma were 82% and 67%, respectively. CONCLUSION: If the expression of p21 is induced by p53 independent pathway, the cell cycle can be arrested in G1 phase, so the tumor cell proliferation is inhibited. But if the expressed p21 is mutated as p53, it means that the natural function of p21 disappears. More research is necessary about the nature of p21 which is expressed with mutant p53.