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Background Mesenchymal stemlike cells (MSLCs) have been detected in many types of cancer including brain tumors and have received attention as stromal cells in the tumor microenvironment. However, the cellular mechanisms underlying their participation in cancer progression remain largely unexplored. The aim of this study was to determine whether MSLCs have a tumorigenic role in brain tumors. Methods To figure out molecular and cellular mechanisms in glioma invasion, we have cultured glioma with MSLCs in a co-culture system. Results Here, we show that MSLCs in human glioblastoma (GBM) secrete complement component C5a, which is known for its role as a complement factor. MSLC-secreted C5a increases expression of zinc finger E-box-binding homeobox 1 (ZEB1) via activation of p38 mitogen-activated protein kinase (MAPK) in GBM cells, thereby enhancing the invasion of GBM cells into parenchymal brain tissue. Conclusion Our results reveal a mechanism by which MSLCs undergo crosstalk with GBM cells through the C5a/p38 MAPK/ZEB1 signaling loop and act as a booster in GBM progression. Key Points 1. MSLCs activate p38 MAPK-ZEB1 signaling in GBM cells through C5a in a paracrine manner, thereby boosting the invasiveness of GBM cells in the tumor microenvironment. 2. Neutralizing of C5a could be a potential therapeutic target for GBM by inhibition of mesenchymal phenotype.

Retroperitoneal liposarcoma is an infrequent, locally aggressive malignancy. We report two cases of huge retroperitoneal liposarcomas. The presence of a palpable abdominal mass was a common symptom of the two patients. Preoperative imaging study showed huge retroperitoneal tumors. Both patients underwent complete surgical resections, and a negative microscopic margin was achieved in both cases. The histopathologic diagnosis was a well-differentiated retroperitoneal liposarcoma. Neither of the two patients developed a recurring tumor during the 1.5 years of follow-up.

Various anastomosis techniques have been introduced for the safe pancreaticoenterostomy. Objective In the present study, we developed an experimental animal model for simple pancreaticojejunostomy and evaluated the feasibility, safety, and efficacy of this technique.Ten dogs were studied.The dogs underwent the simple approximation ("docking") method for pancreaticojejunostomy and were re-explored on the 30th post-operative day.After excision of the remnant pancreas with the jejunal segment of the pancreaticojejunostomy, the degrees of fibrosis in the remnant pancreas were analyzed according to the patency of the pancreaticojejunostomy.There were no mortalities and clinically significant complications. The patency of pancreaticojejunostomy remained in six cases and was obliterated in four cases. It was noted that obliterated pancreaticojejunostomy accompanied cases with more dilated pancreatic ducts (3.1 ± 0.4 mm vs. 5.5 ± 0.6 mm, P = 0.008). The grade of pancreatic fibrosis was significantly correlated with the obliterated pancreaticojejunostomy (P = 0.038) and the size change of the remnant pancreatic duct (P = 0.040).The suggested simple pancreaticojejunostomy method is easy and shows no evidence of significant pancreatic fistula. However, the potential risk of dysfunction in the remnant pancreas limits its possible clinical applications. The meticulous duct-to-mucosa pancreaticojejunostomy is highly preferred to manage the remnant pancreas following pancreaticoduodenectomy.

Purpose: To determine the rate of mortality for uveal melanoma in the Korean population and assess whether it correlates with cytogenetic data, and clinical and histopathological factors. Methods: A retrospective review of medical files from 33 uveal melanoma patients who underwent enucleation at Yonsei University, Seoul, Korea, between January, 1994 and December, 2009 was performed. Dual-colour fluorescence in situ hybridization was performed using centromeric probes for chromosome 3 and 8 in archived patient tissues. Results: The mean age of patients was 53.2 years (range; 29–78), and the mean largest basal diameter was 11.8 mm (range; 6.0–18.1). Of the 20 tissue blocks with available cytogenetic data, there was monosomy 3 in seven (35%) and polysomy 8 in four (20%). The presence of monosomy 3 (p

Malakoplakia is an uncommon but distinctive type of chronic granulomatous inflammation that occurs most commonly in the genitourinary tract, especially the urinary bladder. Most patients have associated conditions characterized by some degree of immunosuppression, as seen in solid-organ transplants, autoimmune diseases requiring steroid use, chemotherapy, chronic systemic diseases, alcohol abuse and poorly controlled diabetes. We report an unusual case of the renal malakoplakia that involved the perirenal space, extending to the descending colon in a 65-year-old Korean woman with secondary adrenal insufficiency and diabetes mellitus.

The prevalence of multi-drug resistant tuberculosis (MDR-TB), which is resistant to isoniazid and rifampin, has been increasing in Korea. And the side effects of 2nd line anti-tuberculosis medications, including drug-induced hepatitis, are well known. Although prothionamide (PTH) is one of the most useful anti-TB medications and although TB medication-induced acute hepatitis is a severe complication, there are only a few published case reports about prothionamide induced hepatitis. In this case report, a 22 year old male was diagnosed with pulmonary MDR-TB and was administered 2nd line anti-TB mediations, including PTH. Afterwards, he had a spiking fever and his liver enzymes were more than 5 times greater than the upper limit of the normal range. He was then diagnosed with drug-induced hepatitis by liver biopsy. His symptoms and liver enzyme elevation were improved after stopping PTH. Accordingly, we report this case of an association between PTH and acute hepatitis.

1 Department of Pathology, Severance Hospital, Seoul, Korea Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis) is a rare disease characterized by lymphadenitis with fever. It is self-limited within one to four months, and is generally diagnosed by an excisional biopsy of the affected lymph node. Kikuchi-Fujimoto disease has a wide variety of nonspecifi c symptoms and it is sometimes misdiagnosed as malignant lymphoma, lymph node tuberculosis, or systemic lupus erythematosus. Because clinical course and treatment of this disease differ from those of others, Kikuchi-Fujimoto disease must be included in differential diagnosis of enlarged lymph node. In this report, we discribed a case of 24-year-old male patient who visited the clinic complaining of fever, petechiae, and enlarged lymph node. He was diagnosed as Kikuchi-Fujimoto disease and immune thrombocytopenic purpura.

Churg-Strauss syndrome is a rare primary vasculitis called allergic granulomatosis angiitis. There is a substantial overlap of symptoms or signs between different vasculitides, so that a diagnosis of any vasculitis can be determined by a combination of clinical symptoms and laboratory tests. We report a case of a 54-year-old woman who had bronchial asthma, eosinophilia, peripheral polyneuropathy, pulmonary infiltrate, maxillary sinusitis, and extravascular eosinophilic infiltration on skin biopsy. So she was diagnosed as having Churg-Strauss syndrome, but she was antineutrophil cytoplasmic antibodies-negative on immunologic study. She had fever and showed cardiac involvement that was presented as cardiomegaly and pulmonary edema at chest radiography and left ventricular hypertrophy on electrocardiography. After steroid therapy, general condition and skin manifestation were rapidly improved.

Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.