objective: A high intake of fat in the diet plays a crucial role in promoting obesity and obesity-related pathologies, and especially visceral obesity is closely associated with obesity-related complications. Because adipose tissue is anatomically associated with lymph nodes, the secondary lymphoid organ, we hypothesized that fat tissue-derived factors may influence the cellularity of lymphoid tissue embedded in fat. Methods and Procedures: Mesenteric and inguinal lymph nodes were isolated from obese mice fed a high-fat diet and control mice fed a regular diet. T-cell population, activation state, and the extent of apoptosis were determined by flow cytometric analysis or terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) assay. Results: The weight of mesenteric lymph nodes and the total number of lymphoid cells in the obese mice significantly decreased compared with those in the control mice; however, no change was observed in the weight of inguinal lymph nodes. The numbers of CD4 + and CD8 + T cells in the mesenteric lymph nodes of obese mice significantly decreased compared with those of the control. Enhanced T-cell activation and apoptosis were observed in the mesenteric lymph node cells of the obese mice. The treatment of lymph node cells with free fatty acids, oxidative stress, and chylomicrons, which are obesity-related factors, resulted in lymph node T-cell activation and apoptosis. Discussion: These results suggest that visceral fat accumulation with a high-fat diet can cause the atrophy of mesenteric lymph nodes by enhancing activation-induced lymphoid cell apoptosis. Dietary fat-induced visceral obesity may be crucial for obesity-related immune dysfunction.

This study reviews the clinical outcome and prognosis of patients with malignant mixed müllerian tumors (MMMTs) of the ovary treated with optimal cytoreductive surgery, leaving no residual disease, and platinum-based chemotherapy. Ten patients diagnosed with MMMT of the ovary after complete surgical staging from February 1993 to February 2004 at Asan Medical Center in Korea were studied retrospectively. All ten patients were treated with optimal cytoreductive surgery, leaving no gross residual disease. Seven patients received ifosfamide/cisplatin chemotherapy, and the remaining three patients received other platinum-based combination chemotherapy. Demographic data, pathologic findings, treatments, and survival time were reviewed. Of the ten patients, two were scored at FIGO stage IIC, seven were at stage IIIC, and one was at stage IV. The median survival time of all ten patients was 46 months. The overall survival rate was 60.0% at 1 year, 40.0% at 2 years, and 20.0% at 5 years. Platinum-based combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of ovarian MMMT.

The objective of this study was to review the clinical outcome and prognosis of patients with primary peritoneal carcinoma (PPC) treated with cytoreductive surgery and combination chemotherapy. We retrospectively reviewed the charts of 27 patients with histologically confirmed PPC, treated between March 1990 and February 2004 at Asan Medical Center, South Korea. The review included demographic data, pathologic findings, treatments, and outcomes. The mean age of the 27 patients was 57.5 +/- 7.2 years, and the rate of optimal cytoreduction was 70.4%. Seven patients had stage IIIB, 17 had stage IIIC, and 3 had stage IV; all patients received adjuvant chemotherapy. There were 4 patients with progressive disease, 5 partial responders, and 15 complete responders; the remaining 3 patients were nonevaluable. At the time of the review, 10 patients were alive without evidence of disease, 3 were alive with disease, and 14 had died from disease. The median overall survival time was 41 months, and the overall 5-year survival rate was 18.1%. Patients who had optimal cytoreduction had a longer median survival (42 months) than those who had suboptimal cytoreduction (10 months; P < 0.05). Combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of patients with PPC.