Thymidylate synthase (TS) is an enzyme that catalyzes an important DNA biosynthesis process. The gene expression of TS has not been reported in non-small-cell lung cancer (NSCLC) patients. To clarify the correlation between TS mRNA levels and clinicopathological features of NSCLC, we examined 70 Stage I and II NSCLC patients for intra-tumoral expression of TS using TaqMan reverse transcription polymerase chain reaction (RT-PCR) assay and immunohistochemistry methods. We also investigated the TS promoter 28 bp polymorphism in 48 cancer tissues using PCR amplification of genomic DNA. Lung cancer tissue showed higher TS mRNA levels than normal lung tissue (Mann-Whitney U-tests; p ‫؍‬ 0.0020). Further, TS mRNA expression was correlated with immunohistochemical TS expression (p ‫؍‬ 0.029). We obtained 2 different DNA fragments, which indicated triple-repeat (3R) and double-repeat (2R) type alleles. Cancer tissues with the 3R/3R genotype showed significantly higher TS mRNA levels as compared to those with other genotypes (p ‫؍‬ 0.0019). The TS genotype was also correlated with immunohistochemical TS expression ( 2 test; p ‫؍‬ 0.0079). The disease-free survival of the low TS mRNA level group was significantly better than those with high TS mRNA levels (log-rank test; p ‫؍‬ 0.010), however, there were no significant differences found by immunohistochemical evaluation (p ‫؍‬ 0.34) or TS genotype analysis (p ‫؍‬ 0.11). A multivariate analysis revealed that high TS mRNA levels independently contributed to disease-free survival. The quantitation of TS mRNA levels is clinically more sensitive and useful for determining the prognosis of Stage I and II NSCLC patients than an immunohistochemical evaluation. © 2003 Wiley-Liss, Inc. Key words: thymidylate synthase; non-small-cell lung cancer; disease-free survival; real-time RT-PCR; DNA polymorphism; immunohistochemistryThymidylate synthase (TS) is an enzyme that catalyzes the methylation of fluorodeoxyuridine monophosphate (dUMP) to deoxythymidine monophosphate (dTMP), which is an important process for DNA biosynthesis. 1-3 Recent studies have demonstrated that the prognosis of cancer patients is significantly related to TS intra-tumoral immunohistochemical expression and mRNA levels. 4 -6 In non-small-cell lung cancer (NSCLC) patients, TS expression shown by immunohistochemical staining is considered to be an important prognostic indicator to determine survival, 6 however, TS mRNA levels have not been reported. To clarify the correlation between TS mRNA levels and clinicopathological features of NSCLC, we examined Stage I and II NSCLC patients for intra-tumoral expression of TS using real-time reverse transcription polymerase chain reaction (RT-PCR) assay and immunohistochemical methods.The TS gene has a unique tandem repeated sequence in the 5Ј-untranslated region and the number of repeats has been found to be polymorphic. 7 The presence of the triple vs. double 28 base pair (bp)-sized repeat was shown to enhance gene expression in in vitro and in vivo studies. 7,8 We investi...

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Our findings indicate that the intermediate-term oncologic outcomes after VATS thymectomy for early-stage thymoma are as favorable as outcomes after open thymectomy. Further follow-up is still required to evaluate the long-term outcomes after VATS thymectomy.

We report a case of foreign accent syndrome (FAS) without aphasia. The patient was a right-handed, 44-year-old woman, a native Japanese. Disposition and inversion of pitch accents and appearance of unnecessary stress accents made her speech sound foreign, like that of a Korean. MRI demonstrated an infarction in the middle fifth of the posterior lateral aspect of the left precentral gyrus. Limited motor cortex damage causes FAS without dysarthria, apraxia of speech, or aphasia.

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The prognosis of patients with differentiated thyroid cancer is relatively fair, with a 10-year survival rate above 80%. One of the important prognostic factors is cancer invasion to the airway. For the last 25 years we have been performing combined resection of the trachea and larynx and have reported a relatively good 10-year survival (67.7%) and improved quality of life (QOL). However, operative complications associated with the procedure, especially insufficiency of the anastomosis and bleeding from large vessels, are life-threatening. Of 40 patients who underwent resection of the trachea, insufficiency of the anastomosis occurred in 4 and subsequent massive bleeding from carotid artery due to neck infection in 2. Tracheal resection should be carried out carefully by avoiding insufficiency. We have concluded that combined resection is a good treatment choice for survival and good QOL when performed for local control in patients with differentiated thyroid cancer.

Our trial regarding the choice of total or partial thymectomy in thoracoscopic surgery for thymomas yielded acceptable results that warrant further investigations into long-term survival and recurrence after longer-term observation of patients undergoing these procedures.

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