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Background: Cervical cancer continues to threaten women's health worldwide, and the incidence of cervical adenocarcinoma (AD) is rising in the developed countries. Previously, we showed that glucose-regulated protein 58 (Grp58) served as an independent factor predictive of poor prognosis of patients with cervical AD. However, the molecular mechanism underlying the involvement of Grp58 in cervical carcinogenesis is currently unknown. Methods: DNA microarray and enrichment analysis were used to identify the pathways disrupted by knockdown of Grp58 expression. Results: Among the pathway identified, the WNT signaling pathway was one of those that were significantly associated with knockdown of Grp58 expression in HeLa cells. Our experiments showed that β-catenin, a critical effector of WNT signaling, was stabilized thereby accumulated in stable Grp58 knockdown cells. Membrane localization of β-catenin was observed in Grp58 knockdown, but not control cells. Using a transwell assay, we found that accumulated β-catenin induced by Grp58 knockdown or lithium chloride treatment inhibited the migration ability of HeLa cells. Furthermore, an inverse expression pattern of Grp58 and β-catenin was observed in cervical tissues. Conclusions: Our results demonstrate that β-catenin stability is negatively regulated by Grp58 in HeLa cells. Overexpression of Grp58 may be responsible for the loss of or decrease in membranous β-catenin expression in cervical AD. [ABSTRACT FROM AUTHOR]

Background: Intracranial osteomas are uncommon lesions that usually arise from the inner table of the cranium. There are few reports in the literature of intracranial osteomas with meninges attachment and without direct relation with the skull bone; these osteomas were mostly attached with dura. We report a rare osteoma with falx attachment. Case: A 64-year-old woman presented with a 3-month history of intermittent tinnitus and dizziness. The scout film of petrous bone computed tomography scan revealed a high-density lesion in the frontal area. Magnetic resonance imaging showed a 2.5-cm mass attached to the surface of the falx in the right frontal parasagittal area. The patient underwent right frontal craniotomy, and a bony hard mass was found located in the right frontal parasagittal region extra-axially, with its medial surface attached to the falx. It could not be broken down by the cavitron ultrasonic surgical aspirator or even the cutting loop and was detached from the falx and removed in one piece. Histopathological examination showed a nodule with bony trabeculae and bone marrow tissue, compatible with osteoma. The postoperative course was uneventful, and the patient was discharged from the hospital with no neurological deficits one week after operation. Conclusions: This is the first case report in the English literature of an intracranial osteoma arising from the falx. Because of their slow growth and their locations in silent brain areas, intracranial osteomas are usually diagnosed incidentally. Surgical resection is the primary treatment choice [ABSTRACT FROM AUTHOR]

Objectives: The prognosis in infants with brain tumors has hitherto been very poor. The purpose of the study was to collect and analyze information regarding the clinical presentation, diagnosis, and management of these patients and to assess the eventual prognosis regarding survival and response to treatment. Materials and methods: This study retrospectively reviewed the records of 22 infants with brain tumors at our institution between November 1995 and October 2009. Their medical records were retrieved for age at diagnosis, presenting features, location, histology, surgical procedures, adjuvant treatment, recurrence, and survival. Results: The patients included 18 boys and four girls. The median age at diagnosis was 3 months with a range of antenatal diagnosis at 36 weeks of gestation up to 11.9 months. The group included four patients with definite congenital tumors presented in the perinatal period. The common presenting signs included increased head circumference, seizure, and vomiting. Over half of the tumors were histologically benign; however, medulloblastoma/primitive neuroectodermal tumor is the most frequent tumor type, accounting for six patients. Surgical resection was attempted in 18 patients, and three of them died in early postoperative period. Cerebrospinal fluid diversion was required in 11 patients, and seven of these patients needed VP shunting. Four patients received adjuvant chemotherapy, but one of them subsequently received salvage radiotherapy. Conclusion: Because of the expandability of the skull, brain tumors in infants may have protean manifestations. Although pathology categorization was quite a variable in our study, three quarters have tangibly survived after current therapeutic modalities. [ABSTRACT FROM AUTHOR]

Cardiac myxoma is the most common primary tumor of the heart. The existence of apoptosis in cardiac myxoma has been demonstrated. The purpose of this investigation was to elucidate the pathway of apoptosis and the cell cycle in cardiac myxomas. This study had 2 parts: investigation of a cultured cardiac myxoma cell line and the analysis of data from 20 patients with cardiac myxoma that was surgically excised. Apoptosis signal transduction was determined by assessing DNA fragmentation, Fas ligand (FasL), Fas, tumor necrosis factor-α (TNF-α), caspase-3, and terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) assay through immunohistochemical stain, quantitative reverse transcriptase— polymerase chain reaction (RT-PCR), and Western blot analysis. The patient population consisted of 12 (60%) women and 8 (40%) men with a mean age of 46 years (range = 32-64 years). All cases of myxoma were sporadic myxomas rather than familial. Clinical presentations included asymptomatic (26%), dyspnea (44%), stroke (9%), chest pain (9%), and fever (11%). All myxomas were located in the left atrium. Pathological scores for inflammation, cellularity, calcification, and thrombosis were not related to myxoma location or clinical events. In cardiac myxoma, apoptosis documented by TUNEL (70.9% ± 17.6%) and the caspase-3 (66.5% ± 32.5%) final common pathway is characterized by the extrinsic Fas/ FasL dependent pathway (positive stained 70.9% ± 19.2%; 26.0% ± 17.2%, respectively), but not the intrinsic pathway. The RT-PCR and Western Blot analysis (Fas/FasL, TNF-α, caspase-3, and apoptosis) of the cardiac myxoma and cultured cardiac myxoma cells confirmed the immunochemical results. The extrinsic Fas/FasL-dependent apoptosis pathways in cardiac myxomas were proved by both RNA and protein levels. [ABSTRACT FROM PUBLISHER]

We investigated whether the intensity of thymidylate synthase (TS) staining in tissue samples obtained from gastric cancer (GC) patients undergoing gastrectomy could predict response to 5-FU-based adjuvant chemotherapy after gastrectomy. Clinicopathological features of 124 patients with histologically proven GC who underwent radical gastrectomy were retrospectively reviewed. Tissue samples obtained from these patients were immunohistochemically stained for assessing TS expression. We arbitrarily classified the TS staining results as low (<20% cytoplasmic immunostaining) and high (≥20% cytoplasmic immunostaining) TS expression. The clinicopathological features of the low TS expression group patients were typically similar to those of the high TS expression group patients. However, multivariate forward stepwise logistic regression analysis revealed that low TS expression was independently associated with females and responders to 5-FU-based adjuvant chemotherapy. The median follow-up duration for the 124 GC patients who had undergone curative resection was 41.3 months. The GC patients who showed poor tumor differentiation and high TS expression had short disease-free survival (DFS) and overall survival (OS). Low TS expression is significantly associated with female GC patients and responders to 5-FU-based adjuvant chemotherapy. It predicts longer DFS and OS in selected GC patients treated with 5-FU-based adjuvant chemotherapy after curative resection. The results suggest that prospective assessment of TS staining intensity in tissue samples obtained from GC patients undergoing gastrectomy would be useful to predict the patients who would be benefited from 5-FU-based adjuvant chemotherapy after gastrectomy. [ABSTRACT FROM AUTHOR]

Background: A variety of high-throughput techniques are now available for constructing comprehensive gene regulatory networks in systems biology. In this study, we report a new statistical approach for facilitating in silico inference of regulatory network structure. The new measure of association, coefficient of intrinsic dependence (CID), is model-free and can be applied to both continuous and categorical distributions. When given two variables X and Y, CID answers whether Y is dependent on X by examining the conditional distribution of Y given X. In this paper, we apply CID to analyze the regulatory relationships between transcription factors (TFs) (X) and their downstream genes (Y) based on clinical data. More specifically, we use estrogen receptor α (ERα) as the variable X, and the analyses are based on 48 clinical breast cancer gene expression arrays (48A). Results: The analytical utility of CID was evaluated in comparison with four commonly used statistical methods, Galton-Pearson's correlation coefficient (GPCC), Student's t-test (STT), coefficient of determination (CoD), and mutual information (MI). When being compared to GPCC, CoD, and MI, CID reveals its preferential ability to discover the regulatory association where distribution of the mRNA expression levels on X and Y does not fit linear models. On the other hand, when CID is used to measure the association of a continuous variable (Y) against a discrete variable (X), it shows similar performance as compared to STT, and appears to outperform CoD and MI. In addition, this study established a two-layer transcriptional regulatory network to exemplify the usage of CID, in combination with GPCC, in deciphering gene networks based on gene expression profiles from patient arrays. Conclusion: CID is shown to provide useful information for identifying associations between genes and transcription factors of interest in patient arrays. When coupled with the relationships detected by GPCC, the association predicted by CID are applicable to the construction of transcriptional regulatory networks. This study shows how information from different data sources and learning algorithms can be integrated to investigate whether relevant regulatory mechanisms identified in cell models can also be partially re-identified in clinical samples of breast cancers. Availability: the implementation of CID in R codes can be freely downloaded from http:// homepage.ntu.edu.tw/~lyliu/BC/. [ABSTRACT FROM AUTHOR]

Adenomatoid tumors are benign mesothelial neoplasms most commonly found in the male and female genital tracts. Extragenital adenomatoid tumors are rare, most of them being solitary tumors. To our knowledge, only one case of multiple extragenital adenomatoid tumors, involving the liver and peritoneum, has been reported to date. Here we report another case of multiple extragenital adenomatoid tumors involving the mesocolon and omentum. A 47-year-old woman presented with a delayed menstrual period. Ultrasonography revealed a left adnexal mass, and surgical resection was attempted at a local hospital. The patient was transferred to our hospital without resection due to the intraoperative finding of multiple peritoneal tumors. At our hospital, an 8.0×7.5×6.0 cm tumor at the mesocolon of the sigmoid colon and three omental nodules measuring up to 2.5×2.0×1.7 cm were resected. Grossly, they were well circumscribed, gray-tan and elastic with small cystic spaces. Microscopically, they were composed of tubules and anastomosing channels lined by flattened or cuboidal cells with bland nuclei. Immunohistochemically, the tumor cells were positive for pan-cytokeratin AE1/AE3, vimentin, cytokeratin 5/6 and calretinin. The postoperative course was uneventful, and the patient was well 10 months after the operation. Despite their rarity, adenomatoid tumors should be included in the differential diagnosis of multiple intra-abdominal tumors. [ABSTRACT FROM AUTHOR]

Abstract Object  The coexistence of spinal arteriovenous malformation (AVM) and a familial cerebral cavernous hemangioma (CCH) is extremely rare. Methods  A 9-year-old boy suddenly developed severe paraplegia and urinary dysfunction. Spinal magnetic resonance imaging (MRI) scan revealed a cervical and upper thoracic intramedullary lesion. Due to acute neurological dysfunction, the patient underwent emergency surgical exploration. An intramedullary vascular lesion was found and excised. Pathologically, AVM was noted. After the surgery, the boy was ambulatory with left lower limb stiffness. MRI scan of the brain revealed multiple cerebral cavernous hemangioma. Symptomatic multiple CCH in his mother and grandmother were also noted. Conclusions  We concluded that the presence of spinal AVM should be suspected if the patient with familial CCH develops the signs of space-occupying lesion of the spinal cord, facilitating early diagnosis of the spinal AVM. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma (SCC), the most common primary malignant tumor of the conjunctiva, has a variable clinical presentation and immunohistochemical profile. Abundant cell cycles exist, including MIB-1 (Ki67 antigen), p16, p53, and p63, within the conjunctiva SCC. This investigation first reports the expressions of cell cycle markers in SCC. A retrospective study was conducted between December 1976 and June 2004, comprising 13 consecutive patients with conjunctiva SCC who were treated with surgical excision. Detailed clinical parameters were also reviewed. Overexpression of MIB-1, p16, p53, and p63 genes were studied by immunohistochemistry. Genechip containing 39 subtypes was used to elucidate human papillomavirus (HPV). The study group contained 13 (100%) men, with a mean age of 68±18 years and follow-up period of 20±17 months. The sample included four (33%) SCC located in the left eye and two (17%) recurrent SCC. Overexpression of the p53 and p63 was considerably higher than that of the p16 (P<0.01). HPV DNA was not detected in any of the 13 cases. This work first examined the immunohistochemical overexpression of cell cycle (MIB-1, p16, p53, and p63) in SCC. This investigation then showed that the expression of cell cycles in SCC was associated with key tumor clinicopathological features. This approach can help distinguish the potential roles of cell cycle in the development of SCC. [ABSTRACT FROM AUTHOR]

Purpose: We conducted a pilot trial to evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in gestational trophoblastic tumours (GTTs). Methods: Patients with placental site trophoblastic tumour (PSTT), high-risk GTT (World Health Organisation score ≥8, disease onset at postpartum or greater than 6 months after antecedent pregnancy), metastatic GTT, recurrent/resistant GTT after chemotherapy, or post-molar GTT with unexplained abnormal β-hCG regression and patients undergoing re-evaluation after salvage treatment were enrolled. PET was undertaken within 1 week after computed tomography (CT). Clinical impacts of additional PET were determined on a scan basis. Results: A total of 14 patients were recruited. Sixteen PET scans were performed, with one patient having three serial studies. Benefits of additional PET were seen in 7 of 16 (43.8%) scans; these benefits included disclosure of chemotherapy-resistant lesions (n=2), exclusion of false-positive CT lesions (n=1), detection of an additional lesion not found by conventional imaging (n=1) in high-risk GTT at the start of primary chemotherapy, and confirmation of complete response to treatment for PSTT or to salvage therapy for recurrent/resistant GTT (n=3). On the other hand, in two instances there were false-negative PET findings, six scans yielded no benefit, and one showed an indeterminate lesion. Conclusion: Our preliminary results suggest that 18F-FDG PET is potentially useful in selected patients with GTT by providing precise mapping of metastases and tumour extent upfront, by monitoring treatment response and by localising viable tumours after chemotherapy. A larger study is necessary to further define the role of 18F-FDG PET in GTT. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effects of albendazole on rabbits infected with larvae of Angiostrongylus cantonensis by histopathological and magnetic resonance imaging (MRI) techniques.Methods: Male rabbits were infected with 400 A. cantonensis larvae and treated with albendazole (5 mg/kg/day) for 2–14 days on day 5, 10, 15 or 20 post-infection.Results: Although there were pathological changes in the brains, MRI revealed unremarkable findings in the untreated group. However, the treated rabbits exhibited eosinophilic meningitis, choroid plexus inflammation, meningeal congestion, encephalitis, perivascular cuffing and meningitis, and were also found to have abnormal signal intensities on brain MR images in the 20 day post-infection treated group.Conclusions: Pathological changes in the brains of the treated rabbits are more severe than those without albendazole treatment, suggesting that the drug may not be very suitable for the treatment of cerebral angiostrongyliasis. [ABSTRACT FROM AUTHOR]

Lipoblastoma/lipoblastomatosis is an uncommon benign lipomatous tumor affecting mainly infants and children. It presents as a painless mass located frequently in upper and lower extremities. The present study was conducted to characterize the clinicopathologic features of lipoblastoma/lipoblastomatosis in a Chinese population. A retrospective survey of 16 cases of pathologically confirmed lipoblastoma/lipoblastomatosis from 1988 to 2002 was performed. The available clinical information and histological sections were reviewed. The study involved 10 males and 6 females ranging in age from 5 to 49 months (median, 11.5 months). The patients presented with mass involving neck ( n=5), inguina ( n=3), feet ( n=2), arm ( n=1), leg ( n=1), thorax ( n=1), mesentery ( n=1), buttock ( n=1), and presacral region( n=1). The lesions were removed surgically. Histologically, the majority (11/16) of primary tumors were of diffuse type. Follow-up ranging from 5 to 125 months was available in 13 patients. Four patients experienced a recurrence of tumors in the neck ( n=2) and lower extremities ( n=2) 11–84 months after operation. The most common site of involvement of lipoblastoma/lipoblastomatosis in our series was the neck. A follow-up period of more than 3 years is recommended for patients with this condition. [ABSTRACT FROM AUTHOR]

The authors report a 12-year-old girl who presented with a 2-year progressive painless thoracic scoliosis. Her previous development had been normal with no significant past history of illness. MRI revealed a thoracic ganglioneuroma, which was confirmed by surgical pathology. Ganglioneuroma might cause progressive spinal deformity mimicking adolescent idiopathic scoliosis. A careful preoperative survey is mandatory for patients diagnosed with scoliosis with a rigid or rapidly progressive curve. The authors recommend a combination of neurosurgery and orthopedic spine surgery to treat this condition. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The optimal postoperative management of pediatric intracranial ependymomas is controversial. We analyzed clinical prognostic factors for their influence on outcome in such children. Our retrospective series included 15 with supratentorial and 28 with infratentorial tumors. Twenty ependymomas were grade II, and 23 were anaplastic. Complete resection was performed in 18 patients, incomplete resection in 19, and stereotactic biopsy in 6. Radiotherapy was done in 31 patients and chemotherapy in 13. The surviving patients have been followed 8–232 months (median: 69 months). The median survival time was 30 months, and 5-year overall survival and progression-free survival rates were 53.9% and 45.9%, respectively. By tumor site: supratentorial, 56.6% and 50.9%; infratentorial, 52.3% and 42.5%. Multivariate analysis identified complete resection (5-year progression-free survival, 71.8%) and age <3 years old as significant favorable and adverse prognostic features (relative risk, 2.59; 95% CI, 1.05–6.38), respectively. Twenty-six children relapsed 1–107 months after diagnosis (median: 12 months). Relapses were local in 22 cases, and combined local and distant in three cases. Only one of 15 patients with supratentorial tumors developed isolated spinal metastasis. Failure at the primary site is the major obstacle to improve cure rates. The extent of surgical resection and age were the only statistically significant prognostic factors. [ABSTRACT FROM AUTHOR]

Cardiac hamartomas are very rare and are demarcated masses of enlarged, hypertrophied, mature myocytes and collagen tissue. Cardiac hamartomas are generally circumscribed in the right ventricle or atrium, but not reported in the crista terminalis (CRT). The CRT is crucial in electrophysiology, is related to arrhythmogenesis, and is targeted by radiofrequency catheter procedures. Previous works only described the benign natures of prominent CRT using non-invasive methods. This study describes an unusual cardiac hamartoma originating from the CRT and extending toward the tricuspid valve. Microscopically, this hamartoma comprised dense collagen and adipose tissue, mixed with hypertrophy, but with disarrayed cardiomyocytes. An irregular gap junction, connexin43, was demonstrated in this cardiac hamartoma. [ABSTRACT FROM AUTHOR]

To assess the cerebrovascular responses to short breath holding of cerebral gliomas using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI). Six patients with a low-grade glioma and one patient with a high-grade glioma were studied using T2*-weighted echo planar imaging (EPI) during repeated periods of 15-second or 20-second breath-holding. Tumor vascularity was evaluated using dynamic susceptibility contrast perfusion MRI. Increases in BOLD signal intensity during repeated breath-holding were consistently identified in patients' normal appearing gray matter, comparable with those in healthy adults. Absence of significant BOLD signal enhancement was noted both in low-grade and high-grade gliomas, which is either due to overwhelming hypoxia in a tumor, inadequacy or absence of hypercapnia-induced vasodilatation of tumor vessels, or both. Breath-hold regulated decreases in BOLD signals occurred only in the high-grade glioma, which is most likely due to the hypercapnia-induced steal effect that redistributes blood flow from tumor regions with unresponsive neovasculature to surrounding normal tissue. BOLD MRI during short breath holding can disclose differential cerebrovascular response between normal tissue and cerebral glioma. J. Magn. Reson. Imaging 2004;19:160–167. © 2004 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) involving the thyroid is very rare. It can be easily confused with far more common benign goiters or thyroid neoplasms. We report on a 5-month-old female patient presenting with progressive enlargement of an anterior neck mass. This patient underwent left subtotal thyroidectomy following which a diagnosis of isolated LCH involving the thyroid gland was confirmed. A course of chemotherapy was administered, and oral thyroxine replacement was initiated. Eighteen months after this treatment, the patient remained in complete remission. Following a thorough review of the literature, as best we are aware, this patient is the youngest individual suffering LCH who has been reported in the literature. In conclusion, isolated LCH of the thyroid is rare, and its diagnosis can be challenging for a clinician and typically requires appropriate awareness. Local excision is the treatment of choice, and prolonged follow-up is recommended. [ABSTRACT FROM AUTHOR]

The article focuses on the magnetic resonance imaging (MRI) findings in the brains of rabbits infected with Angiostrongylus cantonensis. In this study MRI and histological techniques were used to observe the changes in the brains of seven rabbits infected with the third-stage larvae of A. cantonensis. Changes were monitored by MRI from day 0 to 207 postinfection. The author of this study discusses the clinical features of the infection.

Only three cases of clitoral schwannoma have been reported in the English language literature, with none of them being a plexiform schwannoma. Here we report the first plexiform schwannoma of the clitoris. A 41-year-old woman without neurofibromatosis presented with a 2×2 cm, slowly growing, painless tumor of the clitoris. Simple excision of the tumor was performed, and pathological examination revealed a plexiform schwannoma. No evidence of recurrence was noted after 2 years of follow-up. Despite its rarity, a schwannoma should be included in the differential diagnosis of a clitoral enlargement or mass. Our case, despite its unique plexiform growth pattern, has clinical features similar to those of other reported cases of clitoral schwannoma. [ABSTRACT FROM AUTHOR]

A letter to the editor concerning the case of a patient in his mid-70s diagnosed to have pituitary oncocytoma with metastatic malignant melanoma is presented.

The article presents a discussion of the study concerning breast cancer metastasized to the scalp mimicking alopecia areata. A case of a 55-year-old woman who presents two slowly enlarging asymptomatic alopecic areas is offered. An overview of the woman's histological examination and prescriptions is provided.

Presents information on a case study regarding primitive neuroectodermal tumor of the brain in a girl with Turner syndrome diagnosed after 4 years of growth hormone therapy. Clinical condition of the patient; Histopathology of Turner syndrome; Effect of growth hormone therapy on serum concentrations of IGF-1.