Cancer Research and Treatment

Expression in Matrix - Metalloproteinases ( MMP-2 , MMP-9 ) in Gastric Cancer as new Targets for Biotherapy: Hyun Cheol Chung, Jae Yong cho, Sun Young Rha, Joon Oh Park, Joong Bae Ahn, Choong In Lee, Nae Choon Yoo, Joo Hang Kim, Jae Kyung Roh, Sung Hoon Noh, Jin Sik Min, Byung Soo Kim, Ho Yeong Lim, Jin Hyu Choi; J Korean Cancer Assoc. 1995;27(6):897-907.

Abstract PDF: The proteolytic processes are thought to be the critical point in tumor invasion and metastasis, mainly by matrix-metalloproteinases (MMPs) and serine proteases. We measured the activities of MMP-9 and MMP-2 in the 120 normal and cancer tissue samples from the same patients using gelatin zymography. Inactive MMP-9(92 kD) was expressed in 73.3% of the normal and 87.5% of the cancer tissues, respectively (p=0.009), while active MMP-9(82 kD) was expressed in 24.2% and 53.3%, respectively (p=0.0001). Inactive MMP-2 (72kD) was expressed in 33.3% of the normal and 55.0% of the cancer tissues, respectively (p=0.001), while active MMP-2(62kD) was expressed in 4.2% and 31.7%, respectively (p=0.0001). In Tl state, only frequency of expression and enzymatic activity of the active MMP-2(62kD) were increased, while from T2 stage, the expression and the activation of the both MMP-9 and MMP-2 were increased as the cancer progressed. The expression frequency of the MMP-9 was more common than of the MMP-2. The co-expression rate of the active forms (82 kD, 62 kD), activites of 82 kD and 62 kD, and the activation rates of the both MMPs were increased as the cancer invades and metastasizes to distant lymph node areas. In conclusion, MMP-2 activation was the main causes of the increased MMPs activity during the Tl phase of the gastric cancer, while production and activation of the both MMP-9 and MMP-2 were increased as the cancer progressed. Therefore, we suggest that the different expression and activation of the MMPs in the gastric cancer progression can be a potential therapeutic target in gastric cancer biotherapy.

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Clinical Analysis of Cancer of the Gastric Remnant: Doo Hyun Yang, Nam Poo Kang; J Korean Cancer Assoc. 1995;27(6):907-916.

Abstract PDF: Gastric remnant carcinoma was defined as cancer developing in the remnant mucosa more 5 years after surgery for benign gastroduodenal diseases or malignant lesions. To evaluate retrospectively the surgical treatment of patients with gastric remnant carcinoma following gastrectomy for benign and malignant gastroduodenal diseases, we reviewed 10 cases operated on at the Dept. of general surgery, chonbuk national university hospital between 1990 and 1994. The 10 cases accounted for l.96% of all operative cases for gastric cancer in the same period. Of the 10 cases, 5 were first operated on for adenocarcinoma and other 5 for peptic ulcer. Cancer arising in the gastric remnant was most commonly found in aged men. Patients group whose initial diseases were malignant appeared remnant carcinoma in shorter period after operation compared to patients group whose initial ones were benign. Carcinoma was developed on anastomois site totally after Billroth I reconstructian and evenly appeared on anastomosed and remnant sites after Billroth II reconstruction. Unfortunately the prognosis of gastric remnant carcinoma must be said poor in general, however, patients in stage I can sufficiently expect to survive for a long period. So, the significance of strict postoperative follow-up is recommended irrespective of the nature(benign or malignant) of the initial disease, esp, in early post-operative period.

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Prognostic Significances of p53 Protein and Other Prognostic Factors in Hepatocellular Carcinoma Patients: Gui Tark Hong, Dong Wook Choi, Jong Inn Lee, Nam Sun Paik, Nan Mo Moon, Seung Sook Lee; J Korean Cancer Assoc. 1995;27(6):916-924.

Abstract PDF: Hepatocellular carcinoma(HCC) is the one of most frequent cancers in Korea,and the mortality rate from HCC is highest in this country all over the world, probably due to high hepatitis B virus infection rate and extremely poor progonosis. Established prognostic factors in HCC are presence of venous invasion, multiplicity and curative resection, but we do not know all about prognosis in curatively resected cases. So, we studied p53 protein expression in Korean HCC patients, which is independent prognostic factor in breast cancer and lung cancer. We performed immunohistochemistry using Pab 180l, which is monoclonal antibody for p53 protein in 39 HCC patients, who underwent curative liver resection in Korea Cancer Center Hospital. Positive expression rate of p53 protein was 26 %. The p53 protein expression seemed to be higher in HCC patients with poor prognostic factors such as vein invasion, absence of encapsulation, and multiplicity, but they did not reach the stastistical significance. And slightly better survival rates were shown in p53 negative protein group, but no significant difference was detected(p=0.593). In conclusion, we could not detect the prognostic significance of p53 protein expression in curatively resected HCC patients, but we think that more extensive study will be needed in more patients using diverse antibodies to mutant p53 protein.

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Intrahepatic Recurrence after Transhepatic Arterial Chemoembolization in Hepatocellular Carcinoma: Tae Yong Moon, Byung Soo Kim, Suck Hong Lee, Hak Jin Kim, Sung Yup Lim, Bong Sig Koo; J Korean Cancer Assoc. 1995;27(6):924-929.

Abstract PDF: Purpose
We have investigated the annual frequency of recurrent intrahepatic tumors and the doubling time of regrowing tumors after transhepatic arterial chemoembolization (TAE) to know the proper time for subsequent TAE. Materials and Methods: Among cases in which a previous TAE was performed, 28 cases showed definite intrahepatic recurrence and 7 cases showed a regrowing tumor in the follow-up liver CT scan and/or hepatic angiography. Resnlts: The annual frequency of intrahepatic recurrence in the 28 tumors was 71.4% (20/28) within one year and 100% within 6 years. The mean doubling time of 7 regrowing tumors was 68.3 days. Conclusion: We concluded that periodically repeated TAE is needed for further treatment of the recurrent and regrowing tumors.

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The Significance of Serum CA 19-9 Level Change after Biliary Drainage Procedures in Pancreatic and Biliary Tract Cancer: Hyun Kag Kim, Chang Hee Lee, Baek Yeol Ryoo, Sook Hyang Jung, You Cheoul Kim, Chang Min Kim, Jhin Oh Lee, Taik Koo Yun, Young Soo Do, Byung Hee Lee; J Korean Cancer Assoc. 1995;27(6):929-936.

Abstract PDF: Although CA 19-9 has been widely used as a tumor marker for the diagnosis of pancreatobiliary cancers, the pattern of CA l9-9 level change after biliary drainage has not been well characterized. Because biliary drainage procedures are frequently employed for the temporary or palliative measures in biliary obstruction, the precise understanding on the change of CA 19-9 level after biliary drainage may be very helpful for the follow-up evaluation of those cases. We prospectively analyzed the serum CA 19-9 level before and after percutaeous transhepatic biliary drainage (PTBD) and biliary stent in patients with pancreatic, biliary tract cancer and common bile duct stone. Serum CA 19-9 level was initially measured by radioimmunoassay in 69 patients with be nign and malignant pancreatobiliary diseases. In 22 of 69 patients, PTBD and/or the insertion of biliary stent were performed and serial checks of CA 19-9 levels were followed. The elevation of serum CA 19-9 level was highly associated with pancreatobiliary cancers, especially in the cases with biliary obstruction, and in the CBD stones complicated with acute cholangitis. The serum CA 19-9 levels in most cases were significantly decreased by PTBD. There was the trend that the decrease after PTBD in biliary tract cancer was more prominent than that of pancreatic cancer. The elevation of serum CA 19-9 level was highly associated with the presence of biliary obstruction in pancreatobiliary cancers. Because the biliary drainage procedures significantly decrease serum CA 19-9 level, this can not be used for the marker of cancer pragression after biliary drainage procedures.

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Immunohistochemically Observed p53 Overxpression in Gallbladder Carcinomas: Young Cheol Lee, Jung Weon Shim, Hae Kyung Ahn, Joo Seop Kim, Chang Sig Choi; J Korean Cancer Assoc. 1995;27(6):936-940.

Abstract PDF: p53 mutations have been known to occur frequently in human cancers, but there have been only a few reports about p53 mutations in gallbladder cancer. Authors observed overexpression of p53 proteins, and investigated the clinical and pathologic features in 12 patients of the gallbladder carcinoma. Immunohistochemical staining for p53 proteins was done by anti-human monoclonal antibody(PAb [80]; pharmingen, CA), and p53 overexpression was found in 75%(nine cases) of 12 resected specimens. When 9 cases of p53 ovrexpression according to extent of involvement were classified, 5 cases belonged to mild ones, 1 case to moderate and 3 cases to severe. And when they were classified according to intensity, 3 cases belonged to mild ones, 2 cases to moderate and 4 cases to severe. Probably invasion depth of tumor and extent of differentiation were not related with p53 overexpression. Further study will be necessary why gallbladder carcinoma has higher positivity for p53 proteins.

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A Clinical Study of 14 Cases of Male Breast Cancer: Kuy Hee Her, Dong Young Noh, Ik Jin Yun, Woo Chul Noh, Han Kwang Yang, Kuk Jin Choe; J Korean Cancer Assoc. 1995;27(6):940-948.

Abstract PDF: Male breast cancer is uncommon disease accounting for approximately 1% of all breast cancers. Its rarity may prevent many physicians from seeing its natural history, cause, pathologic features, and pragnosis. Compared with female breast cancer, breast cancer in men accurs in older age groups, manifests in a more advanced state, and produces higher incidence of central location and ulceration. A clinical study was performed to the 14 cases of male breast cancer patients at the department of surgery, Seoul National university in a 14-year span, from Jan. 1981 to Dec. 1994. The results were as fallowings; 1) Prevalent age group was 8th decade(35.7%) 2) Their most common symptom was palpable mass(85.7%) 3) Five patients(35.7%) visited hospital over 1 year had passed 4) There were nine tumors(64.3%) situated in the left breast and eleven tumors(78.6%) were circumareola located 5) According to the TNM staging system, 6 cases(42.9%) were advanced(over stage III) stage breast cancer 6) Curative resections were performed in ten patients(71.4%) the procedures were 2 cases of Radical Mastectomy, 4 cases of Modified Radical Mastectomy, 4 cases of Simple Mastectomy and Axillary node dissection 7) Postoperative adjuvant therapies including multimodality approach were performed in 7 cases of the patients 8) Nine patients were expired, 6 were died of recurrences or metastases of the breast cancer and 3 were the other causes, the median survival period was 44 months. We observed that male breast cancer were detected older and far advanced. So early detection and treatment are important to promote the survival of the male breast cancer patients

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The Effect of High - dietary - iron and Desferoxamine on Mammary Adenocarcinoma of the Rats Induced by N-methyl-N-nitrosourea: Kwang Hwa Park, Kwang Gil Lee; J Korean Cancer Assoc. 1995;27(6):948-961.

Abstract PDF: Iron is one of the essential elements involved in various biologic phenomena in the cell, particularly essential for cellular growth and proliferation. But excessive accumulation of iron is known to be associated with the increased incidence of cancer; chelation of iron by desferoxamine is known to suppress the neoplastic growth. Normally the absorption of the dietary iron is for the amount just enough for the deficient fraction; however, it has been suggested that persistent and excessive dietary intake of iron causes overloads of iron in the body. In mammary cancer, which is thought to be related to diet, excessive iron intake is thought to influence the development and growth of tumor. This study was attempted to investigate the influence of excessive iron intake on the development and growth of breast cancer induced by N methyl-N-nitrosourea(MNU) in Sprague Dawley rats. The incidence, the size, mitotic activities, PCNA index and histopathologic findings of the MNU induced breast cancer were studied between high-dietary-iron and the normal-dietary-iron groups. The effect of iron deficiency induced by desferoxamine on mammary adenocarcinoma was also studied. The results of this study showed no difference in the development and growth of breast cancer between the normal-dietary-iron and high-dietary-iran groups after MNU injection, with regard to tumor size, mitotic figures, PCNA index and histopathologic findings. The breast cancers of desferoxamine group did not show any difference in incidence, tumor size, and PCNA index; they showed lower mitotic figures and lower histologic grades. The measurement of the iron contents of the tumor tissue showed no statistically significant difference among normal-dietary-iron, high-dietary-iron and normal-dietary-iron with desferoxamine groups. Normal-dietary-iron with desferoxamine group consistently showed low hematocrit value. In summary of above findings, excessive iron intake does not seem to have a significant effect on the incidence and growth of the breast carcinoma of rats induced by MNU. The low histologic grade and low mitotic figures seen in breast tumors of normal-dietary-iron with desferoxamine group is thought to be the result of inhibition of DNA synthesis related with chelation of iron.

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Inhibitory Effect of Transforming Growth Fasctor-β1 on Cellular Proliferation and c-myc Expression in Choriocarcinoma Cell Line: Sa Jin Kim, Jin Woo Kim, Jong Gu Rha, Guisera Lee, Seung Kyu Song, Sung Eun Namkoong; J Korean Cancer Assoc. 1995;27(6):961-968.

Abstract PDF: Modulation of cellular proliferation and c-myc oncogene expression after treatment of human choriocarcinoma cell line(BeWo) with trsnsorming growth factor-￥a1(TGF-￥a1) have been investigated by MTT [3-(4,5-dimethylthiaxol-2-yl)-2, 5-diphenyltetrazolium bromide] assay and Northern blotting analysis, respectively. TGF-￥a1 inhibited BeWo cell growth in a dose dependent manner at concentrations of 0.00110 ng/mL. When BeWo cells were exposed to 10 ng/ml of TGF-￥a1,c-myc was repressed after 4hr and completely aboiished at 24hr of stimulation. These results show that TGF-￥a1 may play an antiproliferative effect on BeWo cell growth via c-myc gene product. In vitro analysis of cellular and molecular alterations in BeWo cells in this study may aid in elucidating the mechanism of action of TGF-￥a1 on human choriocarcinoma tissues in vivo.

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Clinical Trial of Concomitant Thermo - Chemotherapy in Cervix Cancer Patients: Hong Seok Jang, Sei Chul Yoon, Su Mi Chung, Mi Ryeong Ryu, Yeon Shil Kim, Jong Sup Park, Sung Eun NamKoong, Seung Jo Kim, Kyung Sub Shinn; J Korean Cancer Assoc. 1995;27(6):968-978.

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Immunohistochemical Evaluation of Estrogen and Progesterone Receptor content in Endometrial Carcinoma: Geong Sin Lee, Mee Young Sol, Sun Kyung Lee; J Korean Cancer Assoc. 1995;27(6):978-986.

Abstract PDF: This study was done to evaluate formalin-fixed, paraffin-embedded material by performing immunohistochemical stains for estrogen receptor(ER) and progesterone receptor(PR) in a series of primary endometrial carcinoma. The endometrial carcinomas used were composed of 49 cases of endometrioid adenocarcinomas, 2 cases of adenoacanthomas, 2 cases of secretory carcinomas, 1 case of adenosquamous carcinoma, and 1 case of clear cell carcinoma. The ER and PR content in the carcinomas were divided into three categories according to the percentage of positive cells and the intensity of nuclear staining. Significant negative correlation was found between ER or PR category of endometrial carcinoma and nuclear grade of carcinoma, and significant positive correlation was found between categories of ER and PR in carcinomas. No significant correlation was found between ER or PR category of carcinoma and age distribution of patients with endometrial carcinoma. The results of this study indicated that immunohistochemical analysis of sex steroid receptor status on formalin-fixed and paraffin embedded tissue offers an excellent alternative to the standard biochemical or fresh frozen section procedures.

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Radiation Therapy of Carcinoma of the Cervical Stump: Seung Jae Huh, Won Dong Kim, Yong Chan Ahn, Sung Whan Ha, Il Han Kim, Charn Il Park; J Korean Cancer Assoc. 1995;27(6):986-990.

Abstract PDF: We have reviewed 19 cases of cervical stump cancer treated at the Seoul National and Soonchunhyang University Hospital from 1983 to 1993. Patients were treated with external beam radiation and/or intracavitary radiation. Median follow up period is 39 months. The absolute disease free, and overall survival rate for all patients are 51% and 70%, respectively. Six pelvic failures and two distant metastasis were observed. Recurrences were more common in external radiotherapy only or external radiotherapy plus colpostat application group than in the external radiotherapy plus tandem and colpostat treatment group. The grade 2 complication rate was 21%(4/l9) but there were no life threatening complications. Radiation therapy is effective for the treatment of cervical stump cancer.

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Neoadjuvant Chemotherapy with 5-Fluorouracil and Cisplatin for Locally Advanced Head and Neck Cancer: Ji Hoon Park, Hwan Suk Choi, Jeong Hee Kim, Si Young Kim, Hwi Joong Yoon, Kyung Sam Cho, Seong Eon Hong, Dong Mok Ryu, Hoe Young Ahn; J Korean Cancer Assoc. 1995;27(6):990-1002.

Abstract PDF: Background
The prognosis for patients with locally advanced head and neck cancer remains poor. In recent years, attempts at improving the poor survival rates have frquently focused on the initial use of chemotherapy followed by subsequent standard local therapy with surgery and radiation. Methods: Twenty-seven patients with previously untreated, locally advanced (stage III or IV) head and neck cancer were treated with 2 or 3 cycles of combination chemotherapy consisting of 5-fluorouracil infusion and cisplatin followed by operation or radiotherapy between January,1988 and March,1994. Results: 1) After the neoadjuvant FP chemotherapy, sixteen of 27 patients(59.2%) demonstrated an objective response, with one(3.7%) achieving a complete clinical response(CR) and fifteen(55.5%) a partial response(PR). After the definitive local therapy(DLT:operation or radiation therapy), 12(44.4%) patients had a CR and 12(44.4%) achieved PR, respectively with 88.8% overall response rates. 2) Twelve patients received operation and 15 patients received radiotherapy after the neoadjuvant chemotherapy. Among 12 patients who received operation, seven(58%) patients achieved curative resection with surgery and five(33%) patients a complete remission, seven patients(46.7%) a partial remission with radiotherapy. 3) The overall median survival of total 27 patients was 31 months. The median survival of the responders (median:54 months) to FP chemotherapy was not significantly prolonged compared with nonresponders(median:23 months). 4) Time to disease progression of the responders to definite local therapy was 19 months. 5) Leukopenia and thrombocytopenia were observed in 48%(grade I-III) and l0%(grade I- II) respectively. Nausea and vomiting were observed in all patients, but easily controlled. Alopecia, diarrhea, stomatitis and nephrotoxicity were observed infrequently. There were no treatment related fatalities. Conclusion: Neoadjuvant FP chemotherapy in patients with locally advanced head and neck cancer was tolerable, but did not improve the response rate and overall survival compared with previous other reports. The phase III randomized controlled prospective studies are warranted for the verification of this study

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Radiotherapy of Squamous Cell Carcinoma of the Oral Tongue: Young Ho Kim, Do Hoon Oh, Charn Il Park, Kwang Hyun Kim; J Korean Cancer Assoc. 1995;27(6):1002-1008.

Abstract PDF: Fifty-one patients with squamous cell carcinoma of the oral tongue were seen at Seoul National University Hospital between 1981 and 1989 and analyzed. Thirty-four patients were treated with radiotherapy alone and 17 patients with surgery and radiation therapy. Of the 34 patients receiving radiotherapy alone, 18 patients were treated with external beam irradiation alone, 11 patients with electron boost using intraoral cone(IOC) and external beam irradiation, 3 patients with interstitial implant and external beam irradiation, and 2 patients with IOC, interstital implant, and external beam irradiation. The overall 5-year survival rates(YSR) were 41.8%. The 5-YSR in stage I+II in radiotherapy(RT) alone group were 38.7% and in surgery plus radiation(OP+RT) group 81.8%(p=0.03). The 5-YSR in stage III+IV in RT alone group were 0.0% and in OP+RT group 53.3%(p=0.03). The five-year local control rates were 35.3%. The 5-year local control rates in stage I+II in RT alone group were 33.6% and in OP+RT group 61.1(p=0.04). The 5-year local control rates in stage III+IV in RT alone group were 11.1% and in OP+RT graup 53.3%(p=0.03). In RT alone group, The 5-year local control rates in stage I+II were 40.0% for patients treated with external beam irradiation only and 31.3% for patients treated with IOC or interstitial implant(p=0.68). In ealry stage(Stage I and II) oral tongue cancer, curative radiotherapy with IOC or interstital implant would be a treatment of choice and surgery reserved for salvage of radiotherapy failure. In advanced stage(Stage III and IV), surgery and postoperative radiotherapy are recommende as a treatment of choice.

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Expression of CD4 Molecules on Human Bone Marrow Cells and Lymphoma / leukemia Cell Lines: Tae Jin Kim, Doo Hyun Chung, Kyeong Cheon Jung, Sun Shin Kim, Jang Hee Hahm, Kuhn Kuk Lee, Seong Hoe Park; J Korean Cancer Assoc. 1995;27(6):1008-1017.

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Multidrug Resistance ( MDR 1 ) Gene Expression in Adult Acute Leukemia : Espression of P-glycoprotein and MDR 1 mRNA and its implication on clinical outcome in adult: Hyeoung Joon Kim, Ik Joo Chung, Jae Sung Seo, Keyong Sang Choi, Moo Rim Park, Kang Woo Baek, Youl Bae; J Korean Cancer Assoc. 1995;27(6):1017-1030.

Abstract PDF: Resistance to multiple chemotherapeutic agents is mainly related to the production of P- glycoproteins, a transmembrane drug efflux pump that is encoded by the multidrug resistance(MDR) gene, MDR I. To investigate whether MDR 1 could be involved in clinical resistance to chemotherapy in adult acute leukemias, We have analyzed prospectively 39 samples from 32 patients(27 at presentation, 5 after relapse) with acute leukemia for the evaluation of overexpression of MDR 1 mRNA and P-glycoprotein by using polymerase chain reactions(PCR) and flow cytometric assay, respectively. The induction rate of first complete remission differed between MDR 1 mRNA-positive and negative groups(37% v 84%, respectively; p=0.02). The survival rate(Kaplan-Meier method) in MDR 1 mRNA negative group was significantly higher than that in MDR 1 mRNA positive group(p=0.02). These results suggest that PCR assay of MDR 1 mRNA is a convenient method to detect expression of MDR 1 gene, and it may be a prognostic factor in the treatment of acute leukemia.

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Effects of 12-O-Tetradecanoylphorbol-13-Acetate on CD18 and Myeloperoxidase Genes Expression in HL-60 cells: Kyu Lim, Jong Nam Lee, Kwang In Kweon, Myung Sun Lee, Gi Ryang Kweon, Wan Hee Yoon, Sang Tae Kwak, Byung Doo Hwang; J Korean Cancer Assoc. 1995;27(6):1030-1040.

Abstract PDF: The CD18(￥a-subunit of integrin) is essential for expression of structural and functional CD11/CD18(￥a/￥a-subunit) complexes on the cell surface, and myeloperoxidase plays a role in the bacteriocidal action of granulocytes. Effects on CD18 and myeloperoxidase genes expression have been investigated during TPA-induced differentiation of HL-60 cells. CD18 mRNA was induced at 24 hr and myeloperoxidase mRNA was rapidly reduced at 12 hr. The level of CD18 mRNA was induced and myeloperoxidase was reduced in proportion to concentration of TPA. TPA-induced CD18 mRNA was slightly decreased and myeloperoxidase mRNA was no effect in cells treated with cycloheximide, respectively. On the other hand CD18 mRNA was completely reduced by actinomycin D pretreatment. TPA-dependent stimulation of CD18 gene and repression of myeloperoxidase gene were completely restored by staurosporin pretreatment. These results suggest that phosphorylation of a protein is a crucial step for the induction of CD18 mRNA and the repression of myeloperoxidase during TPA-induced differentiatian of HL-60.

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Antiemetic Effect of Granisetron in Cisplatin - Induced Nausea and Vomiting: Seock Ah Im, Hee Jung Choi, Ki Youl Seo, Ki Youl Seo, Jin Hyuk Choi, Soon Nam Lee; J Korean Cancer Assoc. 1995;27(6):1040-1048.

Abstract PDF: Cisplatin is an highly effective agent against a variety of cancers but produces the most severe nausea and vomiting compared with other chemotherapeutic agents. Recently the role of 5-HT,(serotonin) in cisplatin induced nausea and vomiting was introduced and serotonin receptor antagonists seem to be as effective as corticosteroids in preventing cisplatin-induced emesis. From October 1994 to August 1995, we evaluate antiemetic effect of granisetron, a selective 5-HT, receptor antagonist, in 20 patients (M:F=11:9) who receiving their first course of combination chemotherapy containing high dose cisplatin(100 mg/§³). Granisetron 3 mg was given intravenous infusion before 100 mg/§³ of cisplatin infusion. In first 24 hours after chemotherapy, complete response achieved in 18 of 20 patients(90%). First episode of vomiting developed at 31.5¡¾20.3 hours after cisplatin infusion. For delayed emesis, on second day, complete response achieved in ll of 18 patients (61%), major response in 4 of 18 patients (22%), minor response in 3 patients (17%) and from third to seventh day, complete response achieved in 8 of 18 patients (44%), major response in 7 of 18 patients (39%), minor response in 3 patients (17%). Most commonly reported adverse effect of granisetron was headache. In conclusion, granisetron was an effective antiemetic agent in preventing cisplatin induced acute emesis but not so effective in delayed emesis. For better control of delayed emesis, new combination antiemetic therapy should be investigated.

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A Comparative Study of Intravenous granistron Versus Intravenous / Oral Ondansetron in the Prevention of Nausea and Vomiting Associated with Moderately: Joon Oh Park, Hyun Cheol Chung, Yong Seok Yoon, Woong Chol Kang, Sang Hak Lee, Heui Cheul Chung, Jae Yong Cho, Sun Young Rha, Chong In Lee, Nae Choon Yoo, Joo Hang Kim, Jae Kyung Roh, Jin Sik Min, By; J Korean Cancer Assoc. 1995;27(6):1048-1061.

Abstract PDF: Nausea and vomiting are common and the most distressing side effects of cancer chemotherapy. As these symtoms can cause emotional instability and malnutrion from poor oral intake, which further lead to decrease the effect of chemotherapy, it is important to prevent emesis adequately and effectively. Ondansetron is a selective 5-HT, receptor antagonist and is reported to be effective in preventing cisplatin-induced emesis, Granisetron is a potent and the most selective 5-HT, receptor antagonist currently available. We conducted a prospective, randomized, open, single center, parallel group study to compare the antiemetic effect and safety of granisetron versus ondansetron in patients receiving moderately emetogenic chemotherapy. Form December l994 to May 1995, 65 consecutive patients who planned to receive moderately emetogenic chemotherapy(80 to 100 mg/§³ of cisplatin or 40 mg/§³of doxorubicin) were enrolled in this study. Granisetron was administered intravenously prior to chemotherapy at a dose of 3mg, and up to two doses of granisetron could be administered as rescue therapy within the first 24 hour period. Ondansetron 8 mg was given intravenously prior to chemotherapy followed by 2 more doses at 8 and 16 hours after chemotherapy. Finally, we evaluated 63 patients(32 receiving granisetron and 31 receiving ondansetron). In the first 24 hours after chemotherapy, complete and major response were achieved in 78.1 % of patients receiving granisetron and 74.2 % of patients receiving ondansetron(P=0.7163). There were also no differences in the control of delayed nausea and vomiting between two groups(56.3% vs 45.2%, P=0.3826). There were no differences in percentages of patients who received rescue therapy across the treatment groups: 3I.5% for granisetron vs. 45.2% for ondansetron during the study(P=0.3803). During the first 24 hours following chemotherapy, there were no differences in time to first episodes of nausea(granisetron 14 hours 20 minutes vs ondansetron 13 hours) and vomiting(granisetron 20 hours vs ondansetron 19 hours 20 minutes) between two groups. There were no significant adverse effects or toxicities with these antiemetics. We concluded that single dose granisetron was as effective in prophylaxis of emesis induced by moderatly emetogenic chemotherapy as triple doses of ondansetron and oral maintainence combination. For the non-responders to granisetron, combination of granisetron with other antiemetics of different action mechanism or maintainence granisetron trials are warranted.

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Germline Mutation of BRCA1 Gene in Korean Breast and Overian Cancer Patients: Jae Hwan Oh, Dong Young Noh, Kuk Jin Choe, Soon Beom Kang, Lee Su Kim, Man Su Ro, Nam Sun Paik, Dae Hyun Yang, Se Min Oh, Soon Nam Lee, Jae Gahb Park; J Korean Cancer Assoc. 1995;27(6):1061-1070.

Abstract PDF: We analyzed germline mutations of the BRCAl gene in 29 Korean breast cancer patients, which included ¨c 10 breast cancer patients with family history of breast or ovarian cancer, ¨e 7 early onset breast cancer patients without family history of breast or ovarian cancer(1ess than 40 years old at diagnosis) and ¨e 12 breast cancer patients without family history of breast or ovarian cancer(more than 40 years old at diagnosis), and 1 hereditary ovarian cancer patient. One nonsense mutation at codon 1815 encoding a truncated protein was detected in a breast cancer patient with family history of ovarian cancer. One missense mutation at codon 1630 was detected in a group of breast cancer patients without family history(more than 40 years old at diagnosis), but still not determined whether it was polymorphism or not. Three polymorphisms were detected, which included 2 cases of silent mutation and a case of missense mutation. In early onset breast cancer group and a familial ovarian cancer patient, there was no detected mutation. We confirmed a germline BRCAl gene mutation in one Korean patient of hereditary breast-ovarian cancer family.

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Extraskeletal Mesenchymal Chondrosarcoma of Thigh with Metastasis to Pancreas : A case report and literature review: g Hun Byun, Jin Hyoung Kang, Jung Ah Kim, Hoon Kyo Kim, Kyung Shik Lee, Eun Deok Chang; J Korean Cancer Assoc. 1995;27(6):1070-1077.

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Malignant Melanoma of the Cecum , Unknown Origin: Jin n Yeo, Nam Il Kim, Jung Soo Kim, Hae Myung Jeon, Seung Jin Yoo, Jae Sung Kim, Eun Jung Lee; J Korean Cancer Assoc. 1995;27(6):1077-1083.

Abstract PDF: Malignant melanoma is a relatively rare disease in Korea. But its incidence is increasing. The potentiality of malignant melanoma to metastasize to all parts of the body is well known. An often-unsuspected complication is metastasis to the gastrointestinal tract, which leads to bowel obstruction or intussusception. The most common symptoms in patients with gastrointestinal metastasis are vomiting, abdominal pain and abdominal distension. We experienced a case of malignant cecal melanoma presenting as adult intussusception. The primary origin was not found. We managed by right hemicolectomy with DTIC chemotherapy.

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Localized Fibrous Tumor of the Pleura with a Very Prominent Small Cell Component - A case report -: Gil Hyun Kang, Jong Ok Kim, Bym Kyung Kim, Dae Young Kang, Kun Young Kwon; J Korean Cancer Assoc. 1995;27(6):1083-1089.

Abstract PDF: Localized fibrous tumors are rare neoplasms that most often involve the pleura The histogenesis is still controversial: specialized submesothelial or fibroblastic origin. The incidence has not been clearly linked to asbetos exposure. We experienced a case of solitary fibrous tumor of the pleura with a very prominent small cell component in a 68-year-old male. The mass was found in the right chest incidentally on routine chest X-ray. On chest CT, a well-circumscribed homogeneous low density mass was attached to the right parietal pleura and measured 10 x 9 x 7 cm in dimension. On operation, the mass was attached to the upper parietal pleura and focally adhered to the right upper lobe. Grossly, the mass was ovoid, firm, and encapsulated by a thin translucent glistening membrane, and measured 13,5x 9x 7cm in dimension. The cut surface was mostly grayish-yellow, firm, and focally variegated with hemorrhage, necrosis, cystic change, and myxoid area. Microscopically, irregular aggregates of small round cells predominated and were admixed with cellular spindle cell areas, dense collagenous areas, and angiofibroma-like areas. It also showed focal necrosis and mitosis of 1/10HPF. On immunohistochemical staining, vimentin was positive, but cytokeratin, EMA, LCA, chromogranin, and NSE were negative. Electron microscopy showed fusiform to round tumor cells with scanty cytoplasm in close apposition to focal collagen. The nuclei were euchromatic or heterochromatic. The cytoplasm contained a small amount of organelles. Focal primitive intercellular junctions were identified.

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