• Clinical Endoscopy
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• v.56 no.1
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• pp.119-124
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• 2023

Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.

• The Korean Journal of Nuclear Medicine
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• v.10 no.1
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• pp.1-14
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• 1976

The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, with chronic renal failure (13 with hypertension, 9 without hypertension) and with malignant hypertension. The results were as follows: 1. An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p<0.001) and normal renin essential hypertension(r=-0.551, p<0.05) and the chronic renal failure with hypertension. (r=-0.790, p<0.001) 2. NaE increased markedly the in chronic renal failure with hypertension ($66.9{\pm}8.69mEq/kg$ of LBM, p<0.001) and the chronic renal failure without hypertension ($54.9{\pm}9.28mEq/kg$ of LBM, p<0.05), while mild increase was noted in malignant hypertension ($51.7{\pm}6.24mEq/kg$ of LBM, 0.05$50.1{\pm}7.24mEq$) as well as in its renin subgroups.(p>0.1) 3. Absolute value of PRA was not deviated significantly from control group ($2.53{\pm}1.416ng/ml/hr$) except in malignant hypertension ($6.09{\pm}2.042$, p<0.001). But PRA was inappropriately high in relation to prevailing NaE in the chronic renal failure with hypertension (eleven of thirteen patients) and malignant hypertension (ten of fourteen patients), while PRA variatiation was within physiologic range in the chronic renal failure without hypertension. 4. The NaE-PRA product was markedly increased in the chronic renal failure with hypertension ($514.4{\pm}42.10$, p<0.001) and in malignant hypertension ($442.7{\pm}55.03$, p<0.001), while moderately increased NaE-PRA product was noted in the chronic renal failure without hypertension ($402.6{\pm}59.67$, p<0.001). No significant difference in NaE-PRA product was noted in essential hypertension ($354.4{\pm}62.38$, p>0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.219-227
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• 2005

Purpose: Abnormalities in the p53 gene are regarded as the most consistent genetic abnormalities detected in head and neck squamous cell carcinogenesis. Two new members of the p53 gene family, p73 and p63 have recently been identified. They share considerable sequence homology with p53 in the transactivation, DNA binding, and oligomerization domains, indicating possible involvement in carcinogenesis. Disruption of the homeostatic balance between proliferation and apoptosis is widely believed to contribute to human oral carcinogenesis. The aim of this study was to analyze expression of p63 in squamous cell carcinogenesis and to compare with immunochemical markers representing cell proliferation and apoptosis. Materials and Methods: Using the Syrian hamster oral cancer model, the fraction of apoptotic (apoptotic index-AI), proliferating (mitotic index-MI) and p63 expressing keratinocytes were examined at normal, dysplastic and malignant oral epithelium using the TUNEL assay, PCNA and p63 immunostaining. Results: p63 significantly increased between normal and dysplastic epithelium and between dysplastic and malignant epithelium. PCNA significantly increased between normal and dysplastic epithelium and between normal and malignant epithelium. However, increase between dysplastic and malignant epithelium, though still increasing, was not statistically significant. The percentage of TUNEL positive cells increased from normal to dysplastic epithelium and returned to normal keratinocyte level in the malignant epithelium. However, differences between tissue types were not significant. The ratio of MI:AI increased significantly only in the dysplastic-malignant epithelial transition. The increase of p63 expression closely reflected the change in the MI:AI ratio during oral carcinogenesis. Conclusion: The p63 may be associated with the regulation of epithelial proliferation and apoptosis in DMBA-induced hamster buccal pouch squamous cell carcinogenesis. Further study is required to investigate which p63 isoforms are involved in hamster buccal pouch carcinogenesis.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.309-316
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• 2009

Purpose: F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET /8 imaging for the differentiation of the colonic focal uptake lesions. Materials and Methods: One hundred thirty two patients (M:F = 77:55, Age 62.8$\pm$11.6 years) underwent $^{18}$F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of $^{18}$F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Results: Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of $^{18}$F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax ($\Delta$%SUVmax) was 20.8$\pm$18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%$\pm$24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, $\Delta$%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity, specificity, and accuracy. Conclusion: The dual time point $^{18}$F-FDG PET/CT imaging with SUVmax change evaluation could be an important noninvasive method for the differentiation of malignant and benign focal colonic uptake lesions including physiologic uptake.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.971-977
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• 2015

Malignant glioblastoma multiforme (GBM) is the most malignant brain tumor and despite recent advances in diagnostics and treatment prognosis remains poor. In this retrospective study, we assessed the clinical and radiological parameters, as well as fluorescence in situ hybridization (FISH) of 1p19q deletion, in a series of cases. A total of 816 patients with GBM who received surgery and radiation between January 2010 and May 2014 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patient progression free survival (PFS) and overall survival (OS). Age at diagnosis, preoperative Karnofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 and MMP9 expression level and adjuvant chemotherapy were statistically significant factors (p<0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ${\leq}50$ years, preoperative KPS score ${\geq}80$, KPS score change after operation ${\geq}0$, involvement of single frontal lobe, deep structure involvement, low Ki-67 and MMP9 expression and adjuvant chemotherapy were independent favorable factors (p<0.05) for patient clinical outcomes.

• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.120-128
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• 1997

Fine needle aspiration cytology of breast lesion is well known as a simple, economic and effective diagnostic modality. For the evaluation of cytohistologic correlation, 256 cases of cytologic smears and subsequent histologic sections during 2-year period from Jan. 1995 to Dec. 1996 were reviewed. 1. Fifteen cases(5.9%) were proven as insufficient for evaluation, and 13 of them were fibrocystic change histologically. One case of carcinoma exhibiting sufficient amount of aspirates with no malignant cells on smear was regarded as inadequate. 2. Cytohistologic correlation of 240 cases revealed sensitivity 87.0%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 97.0%, false positive rate 0.0% and false negative rate 13.0%. Total diagnostic accuracy is 95.7%. 3. Total 6 cases of negative were due to small amount of aspirates containing scantiness of malignant cells in two and underestimation in four. 4. Diagnostic concordance rates of fibrocystic change and fibroadenoma were 95.5% and 80.0%, respectively. Diagnostic discrepancies were noted in 7 cases of fibrocystic change and 6 cases of fibroadenoma, however, cytologic discrimination of two entities was not easy in seven of them. 5. In a case of phyllodes tumor and a case of duct ectasia, the discrepancy was due to targeting error. Other three cases(lymphoma, adenomyoepithelioma and granulomatous mastitis) were misinterpreted because of poor acquaintance with those entities. Diagnostic accuracy of fine needle aspiration cytology of breast lesions are relatively high. However, good technique on aspiration and adequate interpretation are necessary to reduce the false negative rate and the discrepancy between cytologic and histologic diagnoses.

• Journal of Radiation Protection and Research
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• v.11 no.1
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• pp.83-89
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• 1986

High energy radiation therapy using accelerator or radioioisotope teletherapy unit is now one of the most important modality in the field dealing with human malignant tumor. It's successful technology overcomes incurable disease to change into curable disease not only by the improvement of clinical technique but also by the development of radiation physics and biology. The author presented the principles of radiation therapy by means of basic knowledge of medicine. physics and biology, described the various ways to improve the result of radiation therapy, and reviewed recent status of radiotherapy field in Korea.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.79-87
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• 2004

Purpose: The recent development of MR has made to possible radiological diagnosis in various soft tssue tumors. But multifarious components within soft tissue tumors and their periodic change have made to difficult even differentiation of malignant from benign soft tissue tumors solely on the MR. So authors retry to differentiate malignant from benign soft tissue tumors with clinical and MR finding complex. Materials and methods: We were analysed 82 pathologically confirmed soft tissue solid tumors (37 cases as malignancy including intermediate tumors and 45 cases as benign including inflammatory masses) which are correlated with clinical findings such as age, size, and location, MR findings such as tumor border, texture on T2 and contrast-T1 images, and enhancement area retrospectively. Many typical lipoma and cysts including of ganglion and abscess are rejected in the benign soft tissue tumor group because not difficult to diagnose on MR. Results: Malignant soft tissue tumors were more frequent in 21~40 and 61~80 years old of the age, above 3.0 cm of the size, trunk-pelvis-lower extremities of the location, and MR findings with irregular border and above 50% of the enhancement area than those of benign soft tissue tumors. Conclusion: The clinical finding that divided to two locations as trunk-pelvis-lower extremities and upper extremities-shoulder-spine was statistically significant to differentiate malignant from benign soft tissue solid tumors. However, the others would provide some useful informations to differentiate them never specific.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.566-578
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• 2020

Objective : Radiation is known to induce autophagy in malignant glioma cells whether it is cytocidal or cytoprotective. Dexamethasone is frequently used to reduce tumor-associated brain edema, especially during radiation therapy. The purpose of the study was to determine whether and how dexamethasone affects autophagy in irradiated malignant glioma cells and to identify possible intervening molecular pathways. Methods : We prepared p53 mutant U373 and LN229 glioma cell lines, which varied by phosphatase and tensin homolog (PTEN) mutational status and were used to make U373 stable transfected cells expressing GFP-LC3 protein. After performing cell survival assay after irradiation, the IC₅₀ radiation dose was determined. Dexamethasone dose (10 μM) was determined from the literature and added to the glioma cells 24 hours before the irradiation. The effect of adding dexamethasone was evaluated by cell survival assay or clonogenic assay and cell cycle analysis. Measurement of autophagy was visualized by western blot of LC3-I/LC3-II and quantified by the GFP-LC3 punctuated pattern under fluorescence microscopy and acridine orange staining for acidic vesicle organelles by flow cytometry. Results : Dexamethasone increased cell survival in both U373 and LN229 cells after irradiation. It interfered with autophagy after irradiation differently depending on the PTEN mutational status : the autophagy decreased in U373 (PTEN-mutated) cells but increased in LN229 (PTEN wild-type) cells. Inhibition of protein kinase B (AKT) phosphorylation after irradiation by LY294002 reversed the dexamethasone-induced decrease of autophagy and cell death in U373 cells but provoked no effect on both autophagy and cell survival in LN229 cells. After ATG5 knockdown, radiation-induced autophagy decreased and the effect of dexamethasone also diminished in both cell lines. The diminished autophagy resulted in a partial reversal of dexamethasone protection from cell death after irradiation in U373 cells; however, no significant change was observed in surviving fraction LN229 cells. Conclusion : Dexamethasone increased cell survival in p53 mutated malignant glioma cells and increased autophagy in PTEN-mutant malignant glioma cell but not in PTEN-wildtype cell. The difference of autophagy response could be mediated though the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling pathway.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.77-81
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• 2000

Malignant peripheral nerve sheath tumors(MPNSTs) are uncommon sarcomas that mostly arise in the soft tissue. They can develop from the pre-existing neurofibromas or schwannomas, or denovo from the peripheral nerves, or they can occur following the radiation therapy. We report a case of MPNST that developed in the sciatic nerve of the patient with neurofibromatosis type-1(NF-1). The patient was a 39-year-old man with the history of NF-1, who's main symptom was a rapidly enlarging painful mass in his posterior thigh. The well demarcated tumor, $6.5{\times}5{\times}4.5$cm in size, was composed of closely packed spindle cells. Since the patients with NF-1 have a high risk for developing a recurred MPNST, the importance of the clinical follow up is emphasized.