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Aims To investigate the clinicopathological characteristics of programmed cell death ligand 1 (PD-L1) and programmed cell death 1 (PD-1) expression in the tumour microenvironments of diffuse large B cell lymphoma (DLBCL). Methods and results Tumour tissues from 126 DLBCL patients were immunostained for PD-L1 and PD-1. The expression of PD-L1 by tumour cells and/or tumour-infiltrating immune cells (mainly macrophages) was evaluated, and the number of tumour-infiltrating PD-1(+) cells was assessed. PD-L1 expression in tumour cells was observed in 61.1% of DLBCLs, with a weak intensity in 29.4%, moderate intensity in 21.4% and strong intensity in 10.3% of cases. Strong PD-L1 expression in tumour cells was associated significantly with the presence of B symptoms (adjusted P = 0.005) and Epstein-Barr virus (EBV) infection (adjusted P = 0.015), and tended to be higher in activated B cell-like immunophenotype (16.7%) than germinal centre B cell-like immunophenotype (2.5%) (adjusted P = 0.271). DLBCLs with PD-L1 expression in tumour cells/macrophages showed similar clinicopathological characteristics. The quantity of PD-1(+) tumour-infiltrating lymphocytes correlated positively with the level of PD-L1 expression in tumour cells (P = 0.042) or in tumour cells/macrophages (P = 0.03). Increased infiltration of PD-1(+) cells was associated with prolonged progression-free survival (P = 0.005) and overall survival (P = 0.026) in DLBCL patients treated with rituximab-cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP), whereas PD-L1 expression had no prognostic significance. Conclusions PD-L1 and PD-1 were expressed variably in DLBCLs by tumour cells and tumour-infiltrating immune cells and might be potential therapeutic targets using PD-1/PD-L1 blockade.

Background To compare clinicopathologic and molecular characteristics of low-grade gastric mucosa-associated lymphoid tissue lymphoma depending on Helicobacter pylori positivity and to find out a predictive factor for unresponsiveness to Helicobacter pylori eradication therapy in Korea. Methods A total of 53 Helicobacter pylori-positive and 13 negative mucosa-associated lymphoid tissue lymphoma patients were enrolled, and tissues from 21 patients were investigated to examine the presence of t(11;18)(q21;q21) with fluorescence in situ hybridization. Clinicopathologic features such as the endoscopic appearance, dominant site of lesion, depth of invasion, clinical stage, and the existence of MALT1 gene rearrangement were compared between these two groups. Fifty-six patients who underwent H. pylori eradication therapy were divided into responder and nonresponder groups. The two groups were analyzed to calculate odds ratios for resistance to the eradication. Results Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma patients averaged a more advanced clinical stage than H. pylori-positive (p = .023) patients. The frequency of t(11;18)/API2-MALT1 did not differ between H. pylori-positive (45.5%) and H. pylori-negative cases (55.6%). Thirty-eight of 51 (74.5%) H. pylori-positive patients achieved complete regression after the eradication, while 2 of 5 (40%) H. pylori-negative patients obtained regression. Presence of lesions in both distal and proximal parts of stomach (p = .041) and bearing of t(11;18)(q21;q21) (p = .007) were predictors for nonresponsiveness for H. pylori eradication. Conclusions Helicobacter pylori eradication could be performed as a primary therapy regardless of H. pylori status, and assessing t(11;18)/API2-MALT1 would be considered after failure to remission by H. pylori eradication.

Aims: The anaplastic lymphoma kinase gene (ALK) has attracted considerable attention as a potential molecular target in non-small-cell lung cancer (NSCLC). However, it is unclear whether ALK alterations are acquired during the metastatic progression of NSCLC. Methods and results: ALK status and ALK expression were evaluated in a series of 67 primary NSCLCs and their corresponding metastatic lesions using fluorescence in-situ hybridization and immunohistochemistry. ALK rearrangement was detected in 7.5% (5/67) of the primary tumours and in 9.0% (6/67) of the metastases (P

Purpose: To compare the diagnostic performance of a diffusion-weighted imaging (DWI) dataset and a gadofluorine M-enhanced imaging dataset for identifying lymph node (LN) metastases in a rabbit rectal cancer model. Materials and Methods: VX2 carcinomas were injected into the rectum of 26 rabbits. Four weeks later, T2-weighted imaging (T2WI), pre-T1WI, DWI, and post-T1WI were performed. Two radiologists independently reviewed the DWI set (T2WI, pre-T1WI, DWI) and the gadofluorine M set (T2WI, pre- and post-T1WI) and recorded their confidence scores for LN metastasis on a per-LN basis. Receiver operating characteristic (ROC) analysis was performed to compare the area under the ROC curve (Az) of the two imaging sets. Histopathologic results were used as the reference standard. Results: The Az and sensitivity of the gadofluorine M set were comparable to those of the DWI set (Az, for reader 1, 0.849, 0.829, P = 0.571; for reader 2, 0.923, 0.876, P = 0.212; sensitivity, for reader 1, 97%, 97%; for reader 2, 97%, 92%, P = 0.304). The specificity of the former was greater than that of the latter (for reader 1, 65%, 53%, P = 0.0003; for reader 2, 81%, 68%, P = 0.01). Conclusion: Gadofluorine M-enhanced images provided greater specificity than DWI for identifying LN metastases, whereas the Az and sensitivity of the former were comparable to those of the latter. J. Magn. Reson. Imaging 2012;35:1179-1186. © 2012 Wiley Periodicals, Inc.

J Oral Pathol Med (2012) 41: 384–388 Background: Leukoplakia of the lateral tongue is frequently associated with the risk of malignancy. Although incisional biopsy is accepted as a standard technique for evaluation, the possibility of underdiagnosis, and therefore missed diagnosis of malignancy, remains at all times. The aim of this study was to determine the rate of underdiagnosis by incisional biopsy for leukoplakia of the lateral tongue and to elucidate the underlying cause of for underdiagnosis. Methods: Twenty-two patients with leukoplakia in the lateral tongue who had undergone excisional biopsy for suspicion of malignancy were included in the study. Pathology was reviewed and classified into ‘no dysplasia,’‘dysplasia,’ and ‘carcinoma’. Underdiagnosis was defined as a change of diagnosis to a graver classification following excisional biopsy. To analyze the factors contributing to underdiagnosis, incisional and excisional biopsy specimens were re-evaluated. Results: Of the 22 patients with leukoplakia of the lateral tongue, 59.1% had coexistent malignancy, including nine squamous cell carcinomas and four verrucous carcinomas. Incisional biopsy resulted in underdiagnosis in 73.3% of the cases. Underdiagnosis was attributable to three common errors, which were mis-selection of sampling site within a large area of leukoplakia, error in pathology specimen preparation owing to small specimen size, and superficial biopsy frequently associated with punch biopsy. Conclusion: Leukoplakia of the lateral tongue is highly coexistent with malignancy, and incisional biopsy frequently leads to underdiagnosis. Therefore, complete excision with adequate margin is warranted for leukoplakia of the lateral tongue, preferably under general anesthesia, which could be performed with minimal morbidity and function preservation.

The purpose of this study was to compare differences of the psychological burdens between young male transsexuals and age-gender matched non-transsexuals with standardized psychiatric rating scales in Korea. A total of 43 biologically unrelated young male transsexuals and 49 age-gender matched non-transsexuals participated in the study. All subjects completed Beck's Depression Inventory (BDI), Social Avoidance and Distress Scale (SADS), Self-Esteem Scale (SES) and Family Adaptability and Cohesion Evaluation Scale (FACES-III). The transsexuals showed significantly higher scores on the BDI (P < 0.0001) and SADS (P = 0.002) and lower scores on the SES (P < 0.0001) and Adaptability and Cohesion subscales (P = 0.016 and P < 0.0001, respectively) of the FACES-III than those of the non-transsexuals. The present study found young male transsexuals may be potentially vulnerable to develop psychiatric and familial problems in comparison with non-transsexuals, at least in Korea, although methodological limitations exist. Further well-designed researches should be launched to confirm this preliminary study.

Objectives It has been suggested that oxidative injuries have an important role in the pathogenesis of Alzheimer's disease (AD). In this study, we assess whether the plasma levels of albumin, bilirubin, and uric acid would be altered in the AD patients compared to those of the healthy controls. Furthermore, we tried to find the correlations between plasma antioxidant levels and the cognitive function in AD patients. Methods The plasma albumin, bilirubin, and uric acid levels were measured by standard methods in 101 AD patients and 101 healthy controls. The Korean version of the Mini Mental Status Examination (MMSE-K) was used to evaluate the cognitive functions of AD patients. Results A significant reduction in the albumin, bilirubin, and uric acid levels in the AD group was found compared to those of the control group. The scores of MMSE-K showed the positive correlation with albumin level in the AD group after adjusting confounding factors such as body mass index, gender and age. Conclusion This study showed that oxidative injuries could be involved in the pathogenesis of AD, as well as indicating that some antioxidant might be associated with the cognitive functions in AD. Copyright © 2006 John Wiley & Sons, Ltd.

Primary adrenal lymphoma is rare, but clinically important. We report a unique case of adrenal lymphoma which showed extensive cystic change mimicking a pseudocyst. Seventy-three-year-old man visited our hospital for healthcare check-up, and was found to have a large adrenal cystic mass. He was received adrenalectomy on the impression of an adrenal pseudocyst. On gross examination, the mass was a unilocular cyst with no solid mass formation. Microscopically, the cyst wall had no epithelial lining, but was infiltrated by some atypical large lymphoid tumor cells. The cystic space was filled with coagulative necrotic material with the tumor cell shadow. The most of the tumor cells expressed leukocyte common antigen, CD20, PAX5, Ki-67, and Epstein-Barr virus (EBV)-encoded RNA, which was consistent with EBV-positive diffuse large B-cell lymphoma of the elderly. No extra-adrenal involvement was observed in imaging studies. We concluded that primary adrenal lymphoma should be considered as a rare but important cause of adrenal cysts.

Twenty-two Korean inpatients with delirium were administered prospectively a flexible dose of quetiapine. The delirium rating scale-revised-severity 98 (DRS-R-98) and clinical global impression scale-severity (CGI-s) scores were assessed at the time of pre- and post-treatment. The DRS-R-98 and CGI-s scores were significantly reduced by 57.3% and 55.1%, respectively. Quetiapine was effective and safe for the treatment of patients with delirium, and could be a useful alternative agent to classical antipsychotics in the treatment of delirium.

In this paper, we present a low-complexity sampling frequency-offset (SFO) estimation scheme suitable for the 3GPP long-term evolution (LTE) downlink system. First, a novel SFO estimation method for a pilot-aided orthogonal frequency division multiplexing system is proposed providing a good performance with reduced complexity. To achieve low complexity, the proposed estimation scheme uses a central conjugate-symmetric primary synchronisation signal specified in the LTE standard, which eases the SFO estimation at the receiver. For performance evaluation, we derive the mean square error expression of the proposed frequency estimation scheme. Simulations show that the proposed frequency estimation scheme can detect the SFO with higher accuracy and much lower complexity, compared with the conventional estimation schemes. Copyright © 2014 John Wiley & Sons, Ltd.