Primary intraosseous odontogenic carcinoma (PIOC) is a carcinoma arising within the jaws, putatively developing from remnants of odontogenic epithelium. We describe a case of PIOC arising from odontogenic cyst affecting the left posterior mandible of 72-year-old Korean man. Clinical examination showed a symptom-free hard mass. There was no evidence of ulceration, and there was no pain or bleeding. The overlying mucosa was intact and no regional lymph nodes were palpable. Clinical and radiological studies for other distant primary sites were negative. Radiographically, the tumor showed multilocular radiolucency with a noncorticated, ill defined border surrounding an impacted third molar tooth. Histology exhibited sheets or islands of nonkeratinizing malignant epithelial cells with minimal clear cell component in continuity with begin or dysplastic cyst lining epithelium. Immunostaining for PCNA and p53 protein showed a higher percentage of positive cells and more intense staining in the carcinomatous tissues than in the benign and dysplastic lesions.

Ficus carica L. (common fig), one of the first plants cultivated by humans, originated in the Mediterranean basin and currently grows worldwide, including southwest Asia and South Korea. It has been used as a traditional medicine for treatment of metabolic, cardiovascular, and respiratory diseases as well as hemorrhoids and skin infections. Its pharmacological properties have recently been studied in detail, but research on the anti-cancer effect of its latex has been only been studied on a limited basis on several cell lines, such prostate cancer, breast cancer, and leukemia. In this study, we investigated the anti-cancer activity of the latex of Ficus carica L.and its underlying mechanism in FaDu human hypopharynx squamous carcinoma cells. (See Ed. note above) We confirmed through SDS-PAGE analysis and gelatinolytic activity analysis that the latex of Ficus carica contains cysteine protease ficin. Our data showed that the latex inhibited cell growth in a dose-dependent manner. In addition, the latex treatment markedly induced apoptosis in FaDu cells as determined by FACS analysis, elevated expression level of cleaved caspase-9, -3 and PARP (poly (ADP-ribose) polymerase), and. increased the expression of Bax (pro-apoptotic factor) while decreasing the expression of Bcl-2 (anti-apoptotic factor). Taken together, these results suggested that latex containing the ficin inhibited cell growth and induced apoptosis by caspase and the Bcl-2 family signaling pathway in FaDu human hypopharynx squamous carcinoma cells. These findings point to the potential of latex of Ficus carica to provide a novel chemotherapeutic drug due to its growth inhibition effects and induction of apoptosis in human oral cancer cells.

Acinic cell carcinoma is a well-differentiated, low-grade tumor that accounts for 1-3% of salivary gland tumors. Among the variant of acinic cell carcinoma, papillary cystic variant of acinic cell carcinoma is much more rare and it is known to be difficult to diagnose and has a poor prognosis. In this paper, we report a case of 58 - year - old man diagnosed as papillary cystic variant of acinic cell carcinoma and the characteristics of the lesion by integrating the recent cases of papillary cystic variant of acinic cell carcinoma. This study emphasizes the need for long-term studies and further investigation of papillary cystic variants of acinic cell carcinoma.

소화관에서 주로 발생하는 반지세포암은 대부분은 위에서 발생하며, 담낭에서 원발성으로 발생하는 경우는 극히 드물어 지금까지 국내에서는 1예만 보고되고 있다. 본 증례는 58세의 남자가 5일 전부터 발생한 상복부 통증을 주소로 내원하여 복부 전산화단층촬영과 복부 자기공명 담췌관 촬영술에서 담낭 결석을 동반한 담낭염 및 담관 결석으로 진단되었다. 내시경 역행 췌담관 시술을 시행하여 담관석을 제거한 후 복강경하 담낭절제술을 시행하였다. 절제된 담낭의 조직검사에서 반지 세포암으로 진단되어, 항암 치료 및 방사선 치료를 시행받았으나, 1년 후 전이성 병변 및 복수가 진행되어 현재 보존적 치료 중이다. 이에 저자들은 담낭염으로 오인된 담낭의 원발성 반지세포암 1예를 경험하여 문헌고찰과 함께 보고한다.

To compare functional Chinese cabbage(‘Amtak’ baechu; F1 hybrid cultivar between Brassica rapa and B. perkinensis, AB) with general Chinese cabbage (‘Chunkwang’ baechu; general spring cultivar, CB), two kinds of kimchi(ABK and CBK) prepared with AB and CB cultivar were fermented at 10°C for 10 days. Their fermentative characteristics and anti-proliferative activities against mouse carcinoma cell lines were investigated. General kimchi(CBK) showed mature pH on the 6th day of fermentation, whereas functional kimchi(ABK) reached pH on the 9th day. CBK also exhibited acidity of mature stage on the 6th day, but ABK reached mature acidity on the 9th day. Although ABK and CBK were salted in the same condition, ABK had lower salinity than CBK, throughout the fermentation time. The highest total bacterial and lactic bacterial counts of CBK showed on the 8th day of fermentation, but ABK showed the highest total bacterial and lactic bacterial counts on the 10th day. The texture of ABK was harder than CBK for fermentation time. This seems to be corrleated with the slower fermentation rate of ABK. ABK showed significantly higher anti-proliferative activity (54.6% cell viability of control) in B16BL6 at 1,000 μg/mL. ABK was also higher in anti-proliferative activity than CBK throughout the fermentation time. However, there was no significant difference in the anti-proliferative activity of ABK between the fermentation times. In conclusion, fermentation of ABK showed a better texture, due to the slow fermentation rate and more anti-proliferative activity against mouse carcinoma cell line than those of CBK.

Carcinoma ex pleomorphic adenoma (Ca ex PA) is an uncommon malignant tumor. It is an aggressive salivary carcinoma, arising from a primary or recurrent benign pleomorphic adenoma (PA). The most common clinical presentation of Ca ex PA is a firm mass in the parotid gland. Here we report a case of Ca ex PA, arising from a recurrent benign PA in the right parotid gland, in a 70-year old female patient. The lesion was first diagnosed as a PA and a superficial parotidectomy was performed. Re-operation was performed for recurrent PA. The second recurrence was diagnosed as Ca ex PA.

Abnormal HLA-G expression occurs in various diseases such as melanoma, renal cell carcinoma, asthma, and classic Hodgkin’s lymphoma. The purpose of this study was to determine whether HLA-G gene is linked with oral squamous cell carcinoma (OSCC). To investigate the possible link with susceptibility to OSCC, 54 OSCC patients and 120 healthy controls were enrolled in this study. HLA-G 14bp insertion/deletion polymorphism is in 3'-untranslated region of HLA-G gene. HLA-G 14bp insertion/deletion polymorphism was analyzed using the polymerase chain reaction (PCR) method. For the analysis of genetic data, SPSS18.0 program was used. Logistic regression models were performed for odds ratio (OR), 95 percent confidence interval (CI), and p value. There was a significant difference in distribution allele between OSCC patients and control subjects (OR=0.018, 95% CI=0.002- 0.131, p<0.001). Our results suggest that HLA-G 14bp insertion/deletion polymorphism may be linked with susceptibility to OSCC in the Korean population.

Anthriscus sylvestris (L.) Hoffm. is a perennial herb found widely distributed in various regions of Korea, Europe, and New Zealand. The root of A. sylvestris have been extensively used in the treatment for antitussive, antipyretic, cough remedy in Oriental medicine, but the physiologically active function of the leaf of A. sylvestris is as yet unknown. In this study, we investigated the anti-cancer activity and the mechanism of cell death of water extracts of leaf of Anthriscus sylvestris (WELAS), on human FaDu hypopharyngeal squamous carcinoma cells. Our data showed that WELAS treatment inhibited cell viability in a concentration- and time-dependent manner. In addition, the treatment of WELAS markedly induced apoptosis in FaDu cells, as determined by the viability assay, DAPI stain and FACS analysis. WELAS also increased the proteolytic cleavage of procaspase-3, -9 and PARP (poly(ADP-ribose) polymerase). In addition, exposure to WELAS decreased the expression of Bcl-2 (an anti-apoptotic factor), but increased the expression of Bax (a pro-apoptotic factor), suggesting that mitochondria-dependent apoptotic pathways are mediated in WELAS-induced apoptosis. Taken together, these results indicate that water extracts of leaf of A. sylvestris inhibits cell growth and induces apoptosis via the mitochondrial-dependent apoptotic pathway in FaDu human hypopharyngeal squamous carcinoma cells. Therefore, we propose that the water extracts of leaf of A. sylvestris is a novel chemotherapeutic drug, having growth inhibitory properties and induction of apoptosis in human oral cancer cells.

The fruit of Kochia scoparia Scharder is traditionally used as a medicinal ingredient to treat allergic skin diseases and inflammatory diseases in China, Japan and Korea. Recently, several studies reported that K. scoparia had potential for the cytotoxicity of human cancer cells. To investigate the anti-cancer effect of K. scoparia on oral cancer and to determine the specific type of cell death induced by MEKS treatment. We investigated the anti-cancer effects of K. scoparia, methanol extract (MEKS) in HSC4 human oral cancer cells. We examined the effects of MEKS on the proliferation rate, cell cycle arrest, 7-AAD-ANNEXIN V double stain, reactive oxygen species (ROS) generation and activation of apoptosis and necroptosis-associated proteins in HSC4 cells. MTT assay results demonstrated that MEKS decreased the proliferation rates of HSC4 cells in a dose-dependent manner with an IC50 value of 45.3 μg/ml. MEKS at 50 μg/ml significantly increased the sub-G1 DNA contents of HSC4 cells to 84.8%, versus untreated cells. However, the activation of apoptosis-associated proteins such as cleaved caspase 3, cleaved caspase 8, cleaved caspase 9 and cleaved Poly (ADP-ribose) polymerase (PARP) did not detect. The level of Bax protein markedly increased in MEKS-treated HSC4 cells. In addition, the cell viability of the DPQ pre-treated HSC4 cells with MEKS treatment was significantly greater than that of MEKS treated-cells. These results suggest that MEKS inhibits cell proliferation and induces necroptosis in oral cancer cells and that MEKS may have potential chemotherapeutic value for the treatment of human oral cancer.

Anthricin (Deoxypodophyllotoxin), a naturally occurring flavolignan, has well known anti-cancer properties in several cancer cells, such as prostate cancer, cervical carcinoma and pancreatic cancer. However, the effects of Anthricin are currently unknown in oral cancer. We examined the anticancer effect and mechanism of action of Anthricin in human FaDu hypopharyngeal squamous carcinoma cells. Our data showed that Anthricin inhibits cell viability in a dose- and time-dependent manner (IC50 50 nM) in the MTT assay and Live & Dead assay. In addition, Anthricin treated FaDu cells showed marked apoptosis by DAPI stain and FACS. Furthermore, Anthricin activates anti-apoptotic factors such as caspase-3, -9 and poly (ADP-ribose) polymerase (PARP), suggesting that caspase-mediated pathways are involved in Anthricin- induced apoptosis. Anthricin treatment also leads to accumulation of the pro-apoptotic factor Bax, followed by inhibition of cell growth. Taken together, these results indicate that Anthricn-induced cell death of human FaDu hypopharyngeal squamous carcinoma cells is mediated by mitochondrial-dependent apoptotic pathway. In summary, our findings provide a framework for further exploration on Anthricin as a novel chemotherapeutic drug for human oral cancer.

Background: Cisplatin is a well-known platinum-containing anti-cancer drug against bladder, ovarian, lung and testicular cancer. However, the potential effects and molecular targets of cisplatin in human mucoepidermoid carcinoma (MEC) are not fully understood. Here, we investigated the apoptotic effect and underlying mechanism of cisplatin in human MEC cells. Methods: The potential effects of cisplatin were evaluated by trypan blue exclusion assay, Western blotting, 4’-6-diamidino-2-phenylindole (DAPI) staining, live/dead assay and immunocytochemistry. Results: Cisplatin suppressed cell growth and enhanced expression of cleaved PAPR in MC3 and YD15 cells. Cisplatin caused morphological change of nuclei and increased the number of ethidium homodimer-1-stained cells. In addition, cisplatin commonly increased Bax activation in both cells, while other Bcl-2 family proteins were not affected. Conclusions: These results suggest that cisplatin might induce apoptosis by activating Bax protein, which would provide baseline data for development of effective treatment strategy against MEC.

An FDA approved drug for the treatment of type II diabetes, Troglitazone (TRO), a peroxisome proliferator–activated receptor gamma agonist, is withdrawn due to severe idiosyncratic hepatotoxicity. In the search for new applications of TRO, we investigated the cellular effects of TRO on YD15 tongue carcinoma cells. TRO suppressed the growth of YD15 cells in the MTT assay. The inhibition of cell growth was accompanied by the induction of cell cycle arrest at G0/G1 and apoptosis, which are confirmed by flow cytometry and western blotting. TRO also suppressed the expression of cell cycle proteins such as cyclin D1, cdk2, cdk4, cyclin B1, cdk1(or cdc2), cyclin E1 and cyclin A. The inhibition of cell cycle proteins was coincident with the up-regulation of p21CIP1/WAF1 and p27KIP1. In addition, TRO induces the activation of caspase-3 and caspase-7, as well as the cleavage of PARP. Further, TRO suppressed the expressions of Bcl-2 without affecting the expressions of Bad and Bax. Overall, our data supports that TRO induces cell cycle arrest and apoptosis on YD15 cells.

As a result of development in medical diagnostic technology, the incidence of double primary cancer is increasing. In case that one primary cancer was identified by pathologic finding and has suggestive multiple metastatic lesions of the cancer, it is often difficult that the lesions are considered as another synchronous primary malignancy, not as metastasis of primary cancer. Here, we report a rare case of synchronous double primary renal cell carcinoma that was diagnosed initially as metastatic duodenal adenocarcinoma. A 66-year-old man presented with a palpable abdominal mass. Abdominal computed tomography showed duodenal wall thickening and hypervascular masses in the liver and left kidney. Esophagogastroduodenoscopy revealed an ulcerative lesion in the duodenal bulb, and endoscopic biopsy identified moderately-differentiated adenocarcinoma. We regarded the findings as duodenal adenocarcinoma with metastasis to liver and kidney. So he was treated with fluoropyrimidine-based chemotherapy for the diagnosis of duodenal adenocarcinoma with liver and renal metastases. After 10 months, he developed a right forearm mass. Morphological and immunohistochemical analysis of an incisional biopsy of the forearm mass were consistent with a diagnosis of metastatic renal cell carcinoma. Even when there is a pathologically confirmed malignancy, clinicians must consider the possibility of synchronous double primary malignancy in metastatic lesions.

췌장의 파골세포양 거대세포 미분화 암종은 그 발생 빈도는 드물지만 높은 악성도를 가지는 외분비 췌장암이다. 췌장 의 파골세포양 거대세포 미분화 암종은, 복부 전산화단층촬 영에서 괴사와 출혈을 동반한 낭성 및 고형 종괴의 소견을 보이며, 다른 췌장의 낭성 종양과 감별이 필요하다. 현재까 지 명확하게 정립된 치료법은 없으며, 조기 진단 및 종양의 완전 절제만이 생존률 향상을 가져온다고 보고되고 있다. 본 증례는 58세 남성 환자에서 발생한 췌장의 파골세포양 거대 세포 미분화 암종이 수술 및 항암치료에도 불구하고 연조직 전이로 진행하여 사망한 1예로 문헌고찰과 함께 보고한다.

Kodamaea ohmeri, previously known as Pichia ohmeri or Yamadazyma ohmeri, is an ascosporogenous yeast that belong to the Saccharomycetaceae family, and it is a rare yeast-form fungus recently identified as an etiological agent of fungemia, endocarditis, urinary tract infection and peritonitis in immunocompromised patients. This paper presents a case of K. ohmeri fungemia in a 70-year-old man with carcinoma of the ampulla of Vater. After receiving endoscopic retrograde cholangiopancreatography (ERCP) for releasing obstruction of ampulla of Vater by insertion of the biliary stent, he was pyrexial with a temperature of 38.5°C. Two set of blood samples were obtained from a peripheral vein for culture. The pathogen was identified as K. ohmeri using the Vitek YST card (bioMérieux, France) and was confirmed by the sequencing of the D1/D2 domains of the 26S rRNA gene and the internally transcribed spacer region. The minimal inhibitory concentrations of the antifungal agents were as follows: amphotericin B 0.5 μg/mL; fluconazole 2 μg/mL; voriconazole ≤ 0.12 μg/mL; fluocytosine ≤ 1 μg/mL. According to the Clinical and Laboratory Standard Institute recommended breakpoint for Candida spp, the isolate was susceptible to fluconazole, amphotericin B, voriconazole, and flucytosine. This is the first report of the isolation of K. ohmeri in the patient with a gastrointestinal neoplasm following ERCP.

This study was performed to investigate the correlation between the primary squamous cell carcinoma in oral cavity (POSCC) and paired metastatic oral squamous cell carcinoma in cervical lymph node (MOSCC) via immunohistochemical staining with Ki-67 and p53. The subjects included ten patients (20 specimens) who were diagnosed with OSCC with metastatic lymph nodes from 2010 to 2015 and surgically treated involving neck dissection in Kyungpook National University Hospital. Twenty specimens were stained immunohistochemically with Ki-67 and p53. The degrees of immunostaining by Ki-67 and p53 was evaluated as 0 (no positive cells), weak (1~25% positive cells), moderate (26-50% positive cells) and strong (>50% positive cells). Despite the strong tendency, there was no statistically significant result between expressions of Ki-67 and p53 in POSCC or MOSCC. We found that high expression of Ki-67 was significantly correlated with poor degree of differentiation. Our results suggest that expression of Ki-67 may be a predictable factor for degree of differentiation of POSCC and MOSCC.

OSCC is currently the most common malignancy of the head and neck, affecting tens of thousands of patients per year worldwide. Natural flavonoids from plants are potential sources for novel anti-cancer drugs. Icariin is the active ingredient of flavonol glycoside, which is derived from the medical plant Herba Epimedii. A metabolite of icariin, icariside II exhibits a variety of pharmacological actions, including anti-rheumatic, anti-depressant, cardiovascular protective, and immunomodulatory functions. However, the exact mechanism causing the apoptosis-inducing effect of icariside II in OSCC is still not fully understood. In the present study, we assessed the anti-cancer effect of icariside II in OSCC cell lines by measuring its effect on cell viability, cell proliferation, and mitochondria membrane potential (MMP). Icariside II treatment of OSCC cells resulted in a dose- and time-dependent decrease in cell viability. Hoechst staining indicated apoptosis in icariside II-treated HSC cells. Icariside II inhibited cell proliferation and induced apoptosis in HSC cells, with significant increases in all present parameters in HSC-4 cells. The results clearly suggested that icariside II induced apoptosis via activation of intrinsic pathways and caspase cascades in HSC-4 cell lines. The collective findings of the study suggested that Icariside II is a potential treatment for OSCC; in addition, the data could provide a basis for the development of a novel anti-cancer strategy.

Human DEK gene on chromosome 6p encodes a 43kD nuclear phospoprotein that was originally identified as part of a fusion protein found in a subset of acute myeloid leukemia carrying a t(6;9) translocation. Although DEK upregulation has been described in a number of human malignancies and was significantly associated with high histologic grade, lymph node metastasis and/or advanced clinical stage, no previous report has evaluated the expression of DEK protein and its clinical significance in oral squamous cell carcinoma (OSCC). Our aims were to determine DEK expression in tissue samples of normal oral mucosa and OSCC by immunohistochemistry, to analyze the correlation between DEK expression and clinicopathological parameters, and to evaluate the value of DEK as a prognostic marker for patient’s survival. Ten normal oral mucosa, 10 epithelial dysplasia, and 60 OSCC samples were studied by immunohistochemistry. DEK expression tended to increase through the full thickness of epithelium in the dysplastic mucosa when compared with those in normal oral mucosa. High expression of DEK protein (score ≥ 2) was found in 68.3% of OSCC cases. Statistical analysis revealed that DEK overexpression in OSCC was positively correlated with high histologic grade (p=0.001), lymph node metastasis (p=0.003), and advanced clinical stage (p=0.039). In the Kaplan-Meier survival analysis, DEK overexpression was significantly associated with decreased overall survival in patients with OSCC (p=0.019). Our results suggest that DEK overexpression may be a reliable marker to predict the clinical outcome in OSCC.

급성 췌장염 중에 1차 검사에서 원인이 불명확한 경우 급성 특발성 췌장염이라고 하며 그 중 종양에 의한 것은 비교 적 드물지만 진단이 늦어질 경우 예후가 좋지 않아 먼저 의심하는 것이 매우 중요하다. 본 증례는 급성 특발성 췌장염 환자에서 악성종양을 의심하고 적극적으로 추적관찰하던 과정에서 초음파내시경상 이상소견이 확인되었고, 적절한 시기에 수술을 결정하여 췌관내유두상점액종양 관련 침습 암을 진단한 경우이다. 따라서 원인이 불분명한 췌장염에 대해 악성종양을 의심하는 것이 필요함을 강조함과 동시에 초음파내시경의 추적관찰이 진단에 도움이 된 실제 사례를 보고함으로써 앞으로의 진료 및 의사결정에 유익할 것으로 보여 문헌과 함께 보고하는 바이다.

cording to histopathological characteristics. One is composite tumor, and the other is collision tumor. Composite tumor is a lesion showing the combined histopathological characteristics of two or more previously recognized tumor and/or cysts of different categories. Two constituent parts are mixed with each other, and histological transition is often observed. On the other hand, collision tumor is a lesion showing the independent histopathological characteristics of two or more previously recognized tumor and/or cysts of different categories. Two constituent parts are separated each other by connective tissue, and histological transition is not observed. Their origin is still unclear. In this study, a collision tumor was reported. 77-year old woman was referred to CNUH with a neck mass in right submandibular area. Incisional biopsy was carried out, and the patient was diagnosed as collision tumor of squamous cell carcinoma and neurofibroma. After reviewing studies reporting collision tumor from head and neck area, formation of a collision tumor was most frequent from a cervical area and average age is 59.6. A collision tumor commonly lead to misdiagnosis, and the prognosis is not always transparent. The variety symptom of collision tumor has to be kept in mind in the diagnosis and treatment of the lesions in head and neck area.