Cancer Research and Treatment

Natural Killer ( NK ) Cell cytotoxicity According to the Expression of c-erbB-2 Protein in Human Gastric Cancer Cells: Byeong Woo Park, Kang Sup Shim, Sung Hoon Noh, Coong Bai Kim, Kyung Shik Lee; J Korean Cancer Assoc. 1995;27(1):1-8.

Abstract PDF: Although there is still controversy to the relationship between c-erbB-2 protein expression and prognosis of the gastric carcinoma, there were many reports about the poor prognosis with the expression of c-erbB-2 in gastric carcinoma. The mechanisms underlying this phenomenon are not known. However several possibilities such as acquired resistance to 5-Fluorouracil(5-FU) and resistance to the host immune system were suggested. So we performed this study to evaluate whether c-erbB-2 expression can alter the natural killeriNK) cell cytotoxic activity. Using single cell suspensions from primary gastric cancer tissues and malignant ascites due to stomach cancer, the immunohistochemical reactivity to c-cerB-2 protein was examined and we performed the tests for NK cell cytotoxic activity. The c-erbB-2(+) cancer cells were significantly more resistant to NK cell cytotoxic activity than c-erbB-2( ) cancer cells. However there was no significant difference in the resiatance to NK cell cytotoxic activity according to their immunohistochemical staining intensities. These results suggest that the resistance to the NK cel1 cytotoxicity may be one of the possi- ble mechanisms of the poorer prognosis of the c-erbB-2(+ ) gastric cancers.

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Synergistic Antitumor Effects of 5-Fluorouracil ( 5-FU ) and Alpha-interferon 2a Gastric Cnancer Cells: Sam Yong Kim, Sang Jun Park, Jong Suk Kim, Jee Young Choi, Hwan Jung Yun, Eui Gun Chun, Deog Yeon Jo, Chin Sun Bae; J Korean Cancer Assoc. 1995;27(1):8-18.

Abstract PDF: Many in vitro studies or clinical trials reported synergistic effect of the combination of 5-FU and alpha-interferon 2a(IFNa-2a) in patients with colorectal cancer, urinary bladder cancer, and esophageal cancer. There have been few reports on the effects of the combination of 5-FU and IFN against gastric cancer ce11 lines. This study was conducted to investigate the com- bined cytotoxic effects of 5-FU or cisplatin with IFNa-2a against two gastric cancer cell lines. SNU-1 and SNU-l6 cell lines were treated with a serial concentrations of 5-FU plus IFNa-2a (5000: 1, molar ratio) and cisplatin plus IFNa-2a (400: 1, molar ratio). Cytotoxicity was determined using a tetrazolium-based colorimetric (MTT) assay. The combination effect of two drugs was evaluated by the median effect principle after Chou et aL Calculation of Assay-AUC was done after Park et aL In SNU-1 cell line, combination of 5-FU and IFNa-2a showed a synergistic effect (combination index, CI<1). Assay AUC of 5-FU was markedly reduced com- parable to clinically achievable-AUC in all combinations. In SNU-16 cell line, combination of 5- FU or cisplatin with IFNa-2a showed no synergism (CI> 1). But inhibitory concentration (IC ) value was markedly reduced. So 5-FU or cisplatin activity were markedly enhanced by IFNa- 2a, especially at low doses.

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Prognostic Significance of Proliferating Cell Nuclear Antigen ( PCNA: Ho Yeong Lim, Joo Hang Kim, Hyun Cheol Chung, Hyo Dong Um, Jin Hyuk Choi, Byung Soo Kim, Dong Hwan Shin, Jae Kyung Roh, Byung Soo Kim; J Korean Cancer Assoc. 1995;27(1):18-28.

Abstract PDF: Proliferatina cell nuclear antigen(PCNA) is known to be closely correlated with DNA synthesis and cell proliferation. Proliferative activities of tumors have recently been consid- ered as one of important prognostic factors in a variety of human cancers. A total of 195 gastric carcinomas was evaluated with immunohistochemical study, using an- tibody(PC 10) with special reference to the correlation between PCNA expression and progno- sis. PCNA expression was assessed semi-quantitatively based on the proportion of tumor cells with immunostained nuclei. There was no significant correlation between PCNA expression and clinicopathological variables such as age, sex, tumor site, size, histologic grade, tumor stage, or the presence of lymph node metastases. To analyse survival, we evaluated disease-free survival and overall survival according to the extent of PCNA expression. No significant correlations between PCNA expression and both disease-free survival and overall survival were found. In conclusion, PCNA expression assessed by semi-quantitative PCNA grading system was not a significant prognostic factor in gastric carcinoma.

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End Results of Surgical Treatment of 354 Patients with Gastric Adenocarcinoma: Kyung Suk Chung, Sung Ha Moon, Hyun Wook Shin, Young Cheol Lee, Joo Seop Kim, Bong Wha Chung, Jae Jung Lee, Chul Jae Park, Young Cheol Jeon, Myung Seok Lee, Woo Joong Kim; J Korean Cancer Assoc. 1995;27(1):28-35.

Abstract PDF: The surgical results of 354 patients with gastric adenocarcinoma treated at the Department of Surgery, Kangnam Sarced Heart Hospital, Hallym University from l984 to 1993 were report- ed. The survival rate of the 354 patients was compared with reference to categories of prognostic factors(univariate analysis) and significant factors affecting survival were identified by multivariate analysis using the Cox's proportional hazard model. The resection rate was 93.5% and the operative mortality within 1 month was 2.5%. The 5- year survival rates were 49.2% for the entire group of patients, 52.0% for patients who under-went resection, 72.3% for patients who underwent curative resection, and 18.4% for patients who underwent palliative resection. The 5-year survival rates according to the TNM stage were 85.4% for stage I, 56.0% for stage II, 38.2% for stage III, and 10.3% for stage IV. Univariate analyses showed a significant difference in survival in relation to age, primary tumor factor(T), reaional lymph node factor(N), distant metastasis factor(M), macroscopic type, size of tumor, type of operation, TNM stage and curability of surgery. Multivariate analysis using the Coxs proportional hazard model in a stepwise fashion identified a final set of three significant variab1es: curability of surgery(P=0.0002), TNM stage(P=0.0007), and macroscopic type(P=0.0008). These results suggest that continuing efforts to increase rate of less advanced cancers and curative resection with systematic lymph node dissection in advanced cancers are necessary for an improvement of the end results of surgical treatment.

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Studies of Antioxidant Enzyme Activity in Tissue from Human G . I Cancer: Suen Woo Back, Chung Yong Kim, Young Don Min, Sung Hwan Kim, Cheun Gyu Park, Byung Lae Lee; J Korean Cancer Assoc. 1995;27(1):35-44.

Abstract PDF: The free radical-mediated oxidations of biologic molecules, membranes, and tissues are now accepted to be related with cancer, aging and other variety of pathologic events. Natural de- fence mechanisms against oxygen free radical damage include superoxide dismutase(SOD) which converts superoxide to H,Ocatalase, and glutathion peraxidase which decomposes H202. Many studies have been made on the activities of antioxidant enzymes in tumor. To evaluate the relationship between GI cancer and antioxidant enzyme, we measured SOD and catalase in tissues from cancer patients. The following relations of specific activities in tissues from cancer and normal were found: catalase 60.31+- 8.05 U/mg protein to 60.84 +- 11.93 U/mg protein in stomach cancer patients, 67.52 +- 9.9l U/mg protein to 65.16+- 2.69 U/mg protein in rectal cancer patients(P > 0.05): Cutn SOD 1.53+-0.38 U/mg protein to 1.49+-0.49U/mg protein in stomach cancer patients 1.88+-0.09U/mg protein to 1.89+-0.20 U/mg protein in rectal cancer patients(P>0.05): Mn SOD 0.32 +- 0.10 U/mg protein to 0.50+-0.08 U/mg protein in stomach cancer patients 0.26+-0.05 U/mg protein to 0.36+ 0.05 U/mg protein to 0.36+-0.05 U/mg protein in rectal cancer patients(P<0.01). In Dot-blot, Cutn SOD mRNA densities were not changed in cancer tissues compaired with normal tissues, but, Mn SOD mRNA densities were decreased in cancer tissues compaired with normal tissues. In conclusion, decrease of Mn SOD activities results from decrease of Mn SOD mRNA in GI cancer patients.

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Leucovorin , 5-Fluorouracil and Cisplatin ( LV - FP ) Chemotherapy for Advanced Colorectal Cancer: Young Jin Yuh, Young Hyuck Im, Yoon Koo Kang, Bong Seog Kim, Hyung Gun Kim, Tae Yong Son, Sang Goo Lee, Eun Mee Cheon, You Cheoul Kim, Chang Min Kim, Weon Seon Hong, Jhin Oh Lee, Tae Woong Kang; J Korean Cancer Assoc. 1995;27(1):44-52.

Abstract PDF: The biochemical modulation of 5-fluorouracil(5-FU) by leucovorin has been demonstrated to enhance the activity of 5-FU in patients with advanced colorectal cancer and the synergism between 5-FU and cisplatin is well known in advanced gastrointestinal tract cancers. We conducted a phase II trial to evaluate the effect of a combination of leucovorin, 5-FU, and cisplatin(LV-FP) in patients with advanced colorectal cancer. LV-FP regimen consisted of leu- covorin 20 mg/m/day IV in day 1-5, 5-FU 1,000 mg/m/day continuous IV. infusion in day 1-5, and cisplatin 20 mg/m/day IV in day 1-5. The regimen was repeated every 3 weeks. Among 46 patients with histologically confirmed advanced colorectal adenocarcinoma, 31 patients had measurable lesion(s) with median age of 55 years(22-70 years). 27 patients had previous histo- ry of chemotherapy and l9 were previously untreated. There was no complete respanse. 11 patients responded partially to the regimen to make the response rate 35%(l1/31). The median time to progression was 16 weeks (2-44 weeks), and the median survival time was 42 weeks(l+~80 weeks). There was no difference in response rates between the previously treated and the previously untreated. Hematologic toxicities were mild and non-hematologic toxicities were also tolerable. There was no treatment-related mortality. These results indicate that the LV-FP regimen is safe and effective in advanced colorectal adenocarcinoma.

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Correlation of Tumor DNA Ploidy , Axillary Lymph Node Changes with Other Prognostic Factors in Breast Cancer: Hong Chan Lee, Pah Jong Jung, Young Hyeh Ko; J Korean Cancer Assoc. 1995;27(1):52-61.

Abstract PDF: Flow cytometric DNA analysis has been applied as an important factor for decision of postoperative therapeutic regimen and prediction of prognosis of breast cancer. Sinus histiocytosis had been recognized as a better prognosic factor in axillary lymph nodes than negative sinus histiocytosis. It represents not only the presence of metastases, but also their immunologic potential and cell mediated immunity against the tumor. This study examined DNA ploidy pattern, S-phase fraction and sinus histiocytosis in axillary lymph nodes of breast cancer in 131 patients who underwent operation at the Department of Surgery, Hanyang University Hospital during the period of January 1990 through February 1993. On the basis of these datas, we analysed the correlation of tumor DNA ploidy and axillary lymph node changes with other prognostic factors which are TNM status, histologic grade and estrogen receptor in breast cancer. Authors obtained the following results; 1) In 131 patients, aneuploidy was 63(48.1%) and high S-phase fraction was 89(68%) 2) Incidence of aneuploidy and high S-phase fraction was increased according to the aggravation of T factor, N factor and poor histiologic grade. The rate of negative estrogen receptor was high in aneuploidy and high S-phase fraction group. 3) Among 102 patients, 53(50.1%) had positive sinus histiocytosis, 49(49.9%) had negative sinus histiocytosis. The positive rate of sinus histiocytosis in axillary lymph nodes was highly related with negative axillary lymph node metastases and small size of tumor and it was lower in aneuploidy and high S-phase fraction. 4) Among the patients as a whole postoperative early recurrence were present in 8 cases, they had poor TNM staging and high correlation to aneuploidy, high S-phase fraction and sinus histiocytosis seem to be useful prognostic factors. And additional follow up studies for survival is required.

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Carcinoma in Choledochal Cyst: Sun Whe Kim, Seon Hee Kim, Yong Hyun Park; J Korean Cancer Assoc. 1995;27(1):61-69.

Abstract PDF: The incidence of carcinoma in choledochal cyst is much higher than that of normal population. The mechanism of carcinogenesis in choledochal cyst is not clear, though reflux of pancreatic juice and stasis of bile appears to be important factors. To study the clinical characteristics of carcinoma in choledochal cyst and to present the rationale that resection is the choice of surgery in choledochal cyst, we reviewed 8 cases of carcinoma in choledochal cyst. The risk of carcinoma in choledochal cyst was 13.1%(GB cancer; 2 cases, CBD cancer; 5 cases, periampullary cancer; 1 case). The sex ratio(M:F= l: 1) and mean age(41 yrs) were intermediate between choledochal cyst(l:3, 36 yrs) and other bile duct cancer(2:1, 59 yrs). All patients had abdominal pain and 4 cases had weight loss which was rare in patients with choledochal cyst only. Five cases were type I and 3 cases were type IVa by Todani type. Anomalous pancreaticobiliary ductal union could be confirmed in 3 cases. Radical operations were possible in one case of GB cancer who received cholecystectomy and cyst excision, and in 2 cases of common bile duct cancer who received Whipples operation. Four patients who had previous history of biliary operation 1 month to 4 years before, received only palliative operation. The patient with periampullary cancer discharged without operation due to multiple liver metastasis. All patients expired between 3 months to 13 months after diagnosis of cancer except 2 patients: one patient who underwent cholecystectomy and cyst excision due to early GB cancer, has been alive for 5 years and one patient who underwent pailliative cystojejunostomy has been alive with disease for 3 months. In conclusion, the risk of carcinoma in choledochal cyst is very high and the prognosis is very poor, so the possibility of cancer association should always be considered and eariy excisional therapy is recommended for those who are diagnosed as choledochal cyst.

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Discrepancies between the Biochemical and Immunohistochemical Assays of the Progestrone Receptor : Correlations with Classical Prognostic Factors in Breast Carcinoma: Dae Yeon Kim, Se Hwan Han, Dong Young Noh, In Ae Park, June Key Chung, Kuk Jin Choe; J Korean Cancer Assoc. 1995;27(1):69-77.

Abstract PDF: Breast cancer specimens from 77 patients were assayed for the presence of progesterone receptors (PR) utilizing the biochemical assay (Dextran Coated Charcoal) and immunohistochemical assay (ICA). The PR status of these patients were evaluated in respect to age and size of the tumor, axillary lymph-node metastasis, and cell differentiation according to the each method. The number of PR positive tumor was 23 cases (29.9%) in DCC and 42 cases (54.5%) in PR-ICA. The concordance of both assays is 0.304. There was no correlation between PR status and the age of patients in both assays. There was increase of PR expression in smaller tumor, but that was significanfin only ICA (P<0.05). The relationship between axillary lymph- node metastasis and PR expression was not proven by ICA but there was significant increase of PR positive ratio in lesser axillary lymph-node metastasis with DCC method (P<0.05). The relationship between TNM stage and PR expression was not proven by ICA method but there was significant increase of PR positive ratio in early TNM stage with DCC method (P<0.05). The relationship between histologic grade and PR expression was not observed. In this study, the results of ICA showed higher expression rate than DCC method. The ICA was correlated with the size of tumor, while the DCC assay was correlated with the axillary lymph-node metastasis and stage.

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VP-16 and Cisplatin Combination Chemotherapy in Small Cell Lung Cancer: Jae Seok Kim, Hyuk Chan Kwon, Sung Jin Bae, Myung Hwan Noh, Won Tae Chung, Hyo Jin Kim, Chang Woon Kang, Jong Seong Kim; J Korean Cancer Assoc. 1995;27(1):77-84.

Abstract PDF: Objectives
Despite recent advances in chemotherapy, the treatment outcome of advanced non-small cell lung cancer(NSCLC) remains poor and NSCLC is still the predominant source of cancer-related mortality in worldwide. Thus, we evaluated the efficacy and safety of a combination chemotherapy with mitomycin C, vinblastine, and cisplatin(MVP) in advanced NSCLC patients in Korea. Methods; Cisplatin was infused intravenously at a dose 20 mg/m from 1st to 5th day and mitomycin C 10 mg/m and vinblastine 6 mg/m were given intravenously on day 1. This treatment schedule was repeated every 3 weeks. Results: Among 94 evaluable patients, overall response rate was 44% including 4% of complete response. Squamous cell carcinoma responded better than adenocarcinoma. The median time to progression was 24 weeks and the median survival time was 42 weeks. Statistically significant survival advantage was observed in responder group(60 weeks vs. 36 weeks). The toxicities of this regimen were mild and well tolerated. Conclusion: In advanced NSCLC, MVP combination chemotherapy is relatively effective and safe.

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The Effect of Combination Chemotherapy with Mitomycin C , Vinblastine , and Cisplatin ( MVP ) in Pastients with Advanced Non - Small Cell Lung Cancer: Sang Goo Lee, Young Hyuck Im, Choon Taek Lee, Hyung Gun Kim, Tae Young Son, Young Jin Yuh, Eun Mee Cheon, Yoon Koo Kang, Young Whang Kim, Jhin Oh Lee, Tae Woong Kang; J Korean Cancer Assoc. 1995;27(1):84-92.

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VACOP-B ( VP-16 , doxorubicin , cyclophosphamide , vincristine , prednisone , and bleomycin ) Chemotherapy for Non - Hodgkin's Lymphoma: Jun Young Kil, Jee Young Choi, Hwan Jung Yun, Eui Gun Chun, Deog Yeon Jo, Sam Yong Kim; J Korean Cancer Assoc. 1995;27(1):92-101.

Abstract PDF: Background
VACOP-B(VP-16, doxorubicin, vincristine, prednisone, and bleomycin), a regi- men emphasizing weekly treatment and brief duration (12weeks), has been reported to be ef- fective for the treatment of aggressive non-Hodgkin's lymphoma. We assessed the efficacy and the toxicity of VACOP-B treatment on an outpatient basis in patients with non-Hodgkin's lym- phoma. Patients and Methods: Between August 1990 and August 1994, 25 patients with non-Hodgkin's lymphoma were treated with VACOP-B regimen on an outpatient basis. 23 of the 25 patients (92%)had intermediate-or high-grade lymphomas. Of the 23 evaluable patients, six received prior chemotherapy or radiation therapy. Results: Among the 23 evaluable patients, 19(76%) achieved a complete response and three (12%) achieved partial respones. With a medinan follow-up of 24 months, survival ranged 2~44 + months. The acturial 3 year survival was 54%. Out of the 25 patients, eight (32%) experienced a marked leukopenia (<1,000/mm(3)), of whom seven rmuired hospitalization due to infection. Non-hematologic toxicities were mild; grade I or II toxicities were noticed (mucositis 36%: peripheral neuropathy 68%). Two died of the toxicity related to the chemotherapy(infection1 Lower stage, complete response rather than partial response were associated with a longer survivaL Conclusion: These results indicate that VACOP-B is effective, well tolerated, and feasible on an outpatient basis in the treatment of non-HodRkin's lymphoma. The use of hemopoietic growth factors such as granulocyte-colony stimulating factor or granulocyte-macrophage-colo- ny stimulating factor might circumvent the leukopenia and facilitate delivery of chemotherapy at full doses.

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Nitric Oxide Synthesis in Murine Skin Cancers: Chang Yeol Yim, Chang Hwan Lee, Soo Mi Choi, Wan Hee Yoo, Sung Joong Lee, Seong Hee Lim, Myung Hee Sohn; J Korean Cancer Assoc. 1995;27(1):101-111.

Abstract PDF: Nitric oxide(NO) is a major cytotoxic effector molecule of activated macrophages. Although the antitumor activity of NO produced by activated macrophages was demonstrated in in vitro experiments, the in vivo role of tumor infiltrating macropheges in tumor growth is currently uncertain. It is also unknown that tumor infiltrating macrophages produce NO, and thereby contribute either a host antitumor immune defense mechanism or a promoting mechanism of in vivo tumor growth by suppressing immune function. The purpose of the current study was to evaluate whether the NO synthesizing pathway is activated in in vivo growing tumor tissue, and thereby the produced NO inhibits tumor growth using various murine skin tumor models. Further experiments were designed to test whether tumor infiltrating macrophages are the major source of NO produced by the in vivo growing tumor tissue. Freshly diesociated murine skin tumors were found to have much higher levels of nitric axide secretion into culture medi- um than long-term cultured tumor. Immunomagnetic depletion of macrophages from freshly dissociated tumor cells using anti-Mac-1 antibody decreased NO production(17.5+-1.5 vs 5.0+-1.1 uM nitrite). Addition of the nitric oxide synthase inhibitor N-monomethyl-L-arginine(MLA) resulted in a dose-dependent decrease in nitric oxide synthesis in freshly dissociated tumor. There was a reciprocal relationship of NO synthesis with tritiated thymidine incorporation in these cultures. Strong iron-dithiol-dinitrosyl and heme-nitrosyl electron paramagnetic resonance signals were observed in freshly dissociated, but not long-term cultured tumor cells. Inhibition of NO synthesis using in vivo MLA administration resulted in a trend of increased growth rate of RD-995 murine skin cancer. This study demonstrates the role of macrophage NO synthesis as a host defense against tumor in vivo.

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Cyto - Melecular Conparison between Primary Squamous Cell Line from Bladder: Joong Shin Kang, Soo Sang Sohn, Dage Kwang Kim, Sung Ik Chang; J Korean Cancer Assoc. 1995;27(1):111-121.

Abstract PDF: To evaluate which cyto-molecular genetic evolutionary patterns take place during the in vitro establishment of permanent squamous cell carcinoma cell line of urinary bladder, cytomolecular genetic follow up was performed on primary culture for two weeks and on cancer cell line after contineued culture for three years in vitro. Near-diploid cells present on primary culture and near-hypertriploid or hypotetraploid cells, in contrast, present on cancer cell line. Chromosomal gains or losses are random from primary cancer to cell line. There are two kinds af structural cytogenetic abnormalities through progress in culture time. One is maintaining abnormal clone from original cancer to derived cancer cell line. Others are cytogenetic alteration during progessing culture time; Increasing and decreasing abnormal clones are coexisted in both grouy. Activation of oncogenes are different from primary cancer to cancer cell line. In conclusion, there are genetic alterations through progressing from primary cancer to cancer cell line. Due to these alterations, cancer ce11 1ines don't substituted for primary cancer and can not be availabe for using materials to choose production on monoclonal antibody and theraputic test.

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A Monocolnal Antibody P1 Against Leukocyte Common Antigen: Kyeong Cheon Jung, Sang Yoon Kim, Cheung Seog Park, Seong Hoe Park, Sang Kook Lee; J Korean Cancer Assoc. 1995;27(1):121-130.

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Reversal Effect of Antihistamines on Multidrug Resistance in Adriamycin - and Vincristine - resistant L1210 Variants: Jae Ryong Kim, Sung Yong Kim, Jeong Hee Kim; J Korean Cancer Assoc. 1995;27(1):130-138.

Abstract PDF: Intrinsic or acquired antitumordrug resistance in cancer cells is one of the major obstacles in cancer chemotherapy. Especially multidrug resistance(MDR) refers to the phenomenon where-by cells previously exposed to a single drug become resistant, simultaneously, to a range of structually and functionally unrelated agents. It is very important to overcome the drug- resistance in cancer cells for the success of chemotherapy. In order to isolate an effective chemasensitizer to overcome the drug resistance, we exam- ined the reversal effects of nine antihistamines on multidrug resistance in an adriamycin or a vincristine-resistant L1210(L1210AdR or L1210VcR) sublines, which show typical multidrug resistant phenotypes. The in vitro partial restoration of adriamycin sensitivity in L1210AdR by treatment of nontoxic doses of antihistamines was observed in astemizole, buclizine, megitazine, cetirizine, and terfenadine, in the order of their effectiveness(high to low). The sensitivity of L1210AdR to adriamycin was enhanced 13 fold when 1 uM of astemizole was present, and 8 fold in the presence of 30 uM buclizine. Astemizole and buclizine enhanced also the sensitivity to vinblastine(1160 fold and 933 fold), dactinomycin(complete reversal and 9 fold), or vinblastine (30 fold and 5 fold) in L1210AdR. However, the sensitivity to the same drugs in Ll210VcR was slightly increased in the presence af 1 uM astemizole or 30 uM buclizine. From these results, astemizole or buclizine may be used as a chemosensitizer during cancer chemotherapy. The mechanism by which astemizole or buclizine can reverse the drug resistance in L1210AdR or L1210VcR will be studied.

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Idiopathic Thromborcytopenic Purpura - like Syndroma in a Patient with Gastric Adenocarcinoma: Seong Hin Hong, Joon Ho Song, Seok Jung, Seon Hoo Kim, Jae Who Park; J Korean Cancer Assoc. 1995;27(1):138-144.

Abstract PDF: Idiopathic thrombocytopenic purpura(ITP)-like syndrome is a very rare paraneoplastic syndrome which is caused by autoimmune mediated platelet destruction. Thrombocytopenia in malignant tumor is usually known to be caused by several mechanisms including marrow replacement with tumor, marrow hypoplasia secondary to chemotherapy, platelet consumption due to activation of the coagulation cascade and the mechanism of autoimmune mediated platelet destruction has been also described. While most cases are documented in lymphopro- liferative disorders, it is extremely rare in solid tumor. We experienced a case of thrombocytopenia which could not be explained by usual mechanisms in a patient with gastric adenocarcinoma. In the case, ITP-like syndrome was suspected because no evidence of DIC was faund and all trials of platelet replacement were failed because of refractory response. As expected, the patient showed positive response to anti-platelet antibody, and spontaneous remission was achieved by administration of high dose immunoglobulin and prednisone with chemotherapy simultaneausly. We did not splenectomy, because platelet number was maintained well with above therapy. We report a case of ITP-like syndrome in gastric adenocarcinoma patient and so far as can be determined there has not been reported.

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A Case of Exogastric Growing Giant Gastric Leiomyoblastoma with Fistula: Kyu Jin Lee, Dae Hwang Ju, Sang Hyun Rho, Hyeong Kweon Kim, Seon Hee Choi, Hyeong Seok Oh, Yun Sik Yang, Yeon Jae Cheong; J Korean Cancer Assoc. 1995;27(1):144-151.

Abstract PDF: Liomyoblstoma, which has first proposed by Stout in 1962, is a rare disease that has a benign clinical course. But about 8-13% of cases change to malignancy. In complicated case, hemorrhage, necrosis, fistula formation can occur. A case of exogastric growing giant leiomyoblastoma with fistula manifested as hamate- mesis is presented. A 61-year old male patient suffering from massive hematemesis and epigastric discomfort for 1 month was proved to have large gastric leiomyoblastoma which had com- municating fistula into the gastric lumen by gastrofibroscopy and abdominal CT scanning. At operation, the mass was originated at lesser curvature of the stomach and located under pos- terior wall of the stomach and the transverse mesocolon waa protruded by the mass. The easily bleeding, multi-pedunculated mass was resected and diagnosed as leiomyoblastoma by Masson-trichrome and Vimentin stain. He is good health without evidence of disease, 2 months after operation.

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Primary Malignant Mesenchymoma of the Liver : A Possibility of Malignant Counterpary of Mesenchymal Hamartoma: Hyuck Sang Lee, Ji Uk Kim, Hye Kyung Lee, Yang Won Nah; J Korean Cancer Assoc. 1995;27(1):151-159.

Abstract PDF: The authors experienced a case of malignant mesenchymoma of the liver in a 6-year-old girl The patient is perfectly well without any evidence of recurrence or metastasis 14 months after undergoing right trisegmentectomy af the liver. This case is unique in that the tumor has the components of mesenchymal hamartoma intermixed with undifferentiated sarcomatous elements. The histologic findings in the present case seem to provide a clue that may substantiate the contention that malignant mesenchymoma arise from malignant transformation of mesen- chymal hamartoma.

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Assessment of Cellular Immunity to Autologous Breast Cancer using Sikn Window Test: Ki Hyuk Park, Soo Jung Lee, Min Chul Chim, Koing Bo Kwun, Dong Sug Kim; J Korean Cancer Assoc. 1995;27(1):159-165.

Abstract PDF: The biologic behavior of human breast cancer reflects on interaction between the intrinsic aggressive potential of the cancer and tumor-retarding cell mediated immunity(CMI). In an attempt to obtain information regarding specific cellular responses to breast cancer, Black and Leis introduced the use of cryostat section of autoiogous breast cancer tissue as target in skin window test(SWT). In order to evaluate the CMI and stimulating ability of PSK to CMI, we performed SWT and Multitest CMI accoding to stage. These findings provide that SWT is an additional aid in evaluation of CMI and immunotherapy snd may eerve as a guide to the individulal therapy.

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