Detection of Epstein-Barr Virus DNA in Oropharynx by Polymerase Chain Reaction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Epstein-Barr virus (EBV) is a human herpes virus which causes infectious mononucleosis and is associated with such human cancers as Burkitt's Lymphoma, Hodgkin's disease, non-Hodgkin's disease, and nasopharyngeal carcinoma. However, the role of EBV as a causative factor in other head & neck tumors is not fully elucidated. This study analyzed the detection rate of Epstein-Barr virus (EBV) in the throat washing samples from pateints with head and neck tumors and non-malignant diseases, as well as from normal subjects. MATERIALS & METHODS: The throat washing samples were collected from 49 patients of head & neck tumors, 52 patients of non-malignant diseases (pharyngitis and tonsillitis) and 24 normal subjects. The EBV DNA was detected by using the EBV (BNRF1)-specific primers & Polymerase Chain Reaction (PCR). RESULT: The EBV DNA was detected in 25 (51%) of the 49 throat washing samples from patients with tumors, as well as 3 (60%) of 5 samples from patients with nasopharyngeal carcinoma, and 22 (50%) of 44 samples from patients with head and neck tumors. The throat wasing samples from 52 patients with non-malignant diseases and 24 samples from healthy subjects were also examined. EBV was detected in 17 (32.7%) of 52 patients with non-malignant diseases and 3 (12.5%) of 24 samples from healthy subjects. CONCLUSION: These data indicate that the EBV may be related to non-malignant diseases and head and neck tumor.

Expression of the p53 Protein and Detection of HPV by ISH in Sinonasal Inverted Papilloma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The p53 protein is a 53 kD phosphoprotein. It is also one of the early recognition markers of malignancy and can be used to predict the aggressive behaviors of tumor. The human papilloma virus (HPV) is a species-specific, epitheliotrophic, double-stranded DNA virus. The purpose of this study was to evaluate the expression rate of p53, and to investigate whether a correlation exists between the rate of recurrence and the severity of lesion. We also investigated whether p53 expression rate and HPV affect recurrence and carcinogenesis of inverted papilloma. MATERIALS AND METHODS: Twenty-two cases of the inverted papilloma and 6 cases of squamous cell carcinoma arising in the inverted papilloma were used for the study. We used immunohistochemical staining for p53 and performed the molecular study of HPV DNA with in situ hybridization (ISH) on the paraffin embedded materials. RESULTS: 1) The overall expression rate of p53 was 39% (11/28). A significant correlation was observed between p53 protein accumulation and the severity of the lesion (p=0.0015). 2) Seven of 11 patients who tested positive for p53 showed recurrence, whereas two of the 12 patients who tested negative for p53 showed recurrence. There was a correlation between the rates of p53 expression and recurrence (p=0.029). 3) The HPV was detected in four cases (13%) of inverted papilloma. There was no statistical significance between HPV and the rate of recurrence(p=0.147). CONCLUSION: The results demonstate that p53 mutations and HPV may play a role in the oncogenesis of inverted papilloma.

Immunohistochemical Study between Extracellular Matrix Protein Tenascin and T Lymphocytes Distribution in Cholesteatoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Components of extracellular matrix protein play a crucial role in morphogenesis and epithelial cell differentiation. Protein is highly conserved during evolution and is expressed in a variety of tissues, and the amount of T and B lymphocytes are significantly higher in cholesteatomatous tissue than in the external auditory canal skin. We examined the spatiotemporal expression and distribution of extracelluar matrix protein tenascin and lymphocytes of cholesteatomatous tissue and normal external auditory canal skin. MATERIAL AND METHODS: The biopsy specimens of cholesteatomatous tissue and external auditory canal skin were obtained during middle ear surgery. Monoclonal mouse antibodies against tenascin, CD4 helper cell and CD8 cytotoxic/suppressor T cells were used. RESULTS: The results are as follows: 1) The expression of tenascin was significantly increased in cholesteatomatous tissue compared to that in normal external auditory canal skin. 2) As the expression of T lymphocytes increased, the expression of tenascin increased significantly (p<0.05, r=0.832). 3) As the expression of Langerhans' cells increased, the expression of tenascin increased significantly (p<0.05, r=0.788). CONCLUSION: These results suggest that the change in the composition of the extracelluar matrix protein and lymphocyte in cholesteatomatous tissue may play an important role in the pathogenesis of cholesteatomatous otitis media.

Effect of Diazepam on the Catecholamine Response to Endotracheal Intubation in Multiple Trauma Patients

BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed. METHODS: The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05. RESULTS: 1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I. CONCLUSION: It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.

Characteristics of the Immortalized Human B-cells by Epstein-Barr Virus

Human lymphoblastoid B-cell lines immortalized by Epstein-Barr virus (EBV) were established from peripheral blood of patients with acute myeloblastic and chronic lymphocytic leukemia and chronic fatigue syndrome. The sera of patients with acute myeloblastic and chronic lymphocytic leukemia did not show antibodies to Epstein-Barr viral capsid antigen (VCA), but serum of a patient with chronic fatigue syndrome disclosed antibodies to VCA (IgG, IgM), and EBNA was demonstrated in peripheral blood mononuclear cells by polymerase chain reaction. The established cell lines were mature B-cell phenotypes with polyclonal proliferation in early passage and no evidence for commitment to other lineages. The immortalized cells by EBV were designated as CSUP-1 and CSUP-2 (from acute myeloblastic leukemia, FAB classification M2 and M1), CSUP-3 (from chronic lymphocytic leukemia) and CSUP-4 (from a patient with chronic fatigue syndrome). The CSUP-1, 2, 3, and 4 grew in suspension forming clumps with a doubling time of 38 to 49 hours. Colony formation was not recognized in plate. By light and electron microscopic examination, the immortalized cells showed features of lymphoblastoid to plasmacytoid lymphocytes, and multinucleated giant cells. The lymphoblastoid cells showed scanty cytoplasm with poorly developed organelles. Immunophenotypic analyses of CUSP-1, 2, 3, and 4 with monoclonal antibodies by flow cytometry showed B-cell phenotype with polyclonal proliferation in early passage. Epstein-Barr virus nuclear antigen was confirmed in the extracted DNAs from immortalized cells by polymerase chain reaction. DNA analysis showed a normodiploid stemline with a DNA index of 1.12. The established cells were strongly reactive for CD10, CD30 (Ki-1) in early passage, and bcl-2 and c-myc onco-protein in early and late passage. Karyotypic analysis of CSUP-1, 2, 3 and 4 showed 46, XY or 46, XX. No tumorigenesis in heterotransplanted SCID mouse was recognized. This immortalized cells by EBV should be a valuable cell lines to study the pathogenesis of EBV-related malignant lymphoma.

Expression of p53 and Epidermal Growth Factor Receptor in the Oral and Oropharyngeal Squamous Cell Carcinomas / 대한이비인후과학회지

The prognostic significance of the squamous cell carcinomas of the oral and oropharynx have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histologic characteristics. For determining prognostic indicators, the authors performed immunohistochemical staining of p53 and epidermal growth factor receptor(EGFR) in 29 cases of squamous cell carcinomas of the oral and oropharynx. The expression rate of p53 was 51.7%, that of EGFR was 96.6%, and overexpression rate of EGFR was 41.4%, however there were no statistical significance between the reactivity of EGFR, p53 and clinicopathological features such as primary stage, nodal stage, clinical stage, death and histologic grade.

The Effect of Audiant Bone Conductor Implantation / 대한이비인후과학회지

Audiant bone conductor(ABC) can be beneficial to patients with conductive hearing loss and sensorineural hearing loss. We have implanted ABC for 3 patients with bilateral conductive hearing loss and 2 patients with unilateral profound sensorineural hearing loss. And we evaluated the hearing gain in these patients except 1 case who did not return for follow up. The preoperative average air conduction threshoulds at the three speech frequencies 500, 1000 and 2000Hz, SRT, SD scores were 48.3dB HL, 47.5dB HL, 95% respectively and 19.1dB HL, 20dB HL, 95% postoperatively in 2 patients with bilateral conductive hearing loss. The preoperative average air conduction threshoulds at the three speech frequencies 500, 1000 and 2000Hz, SRT, SD scores were no response, no response, 0% respectively and 42.5dB HL, 51.3dB HL, 60% postoperatively in 2 patients with sensorineural hearing loss.

Variation of pH and Electrolyte in Nasal Secretum / 대한이비인후과학회지

BACKGROUND: Airway secretions partly arise from the interstitial fluid and partly from the secretory activities of respiratory epithelium and submucosal gland. The flow of water across the tracheobronchial epithelium is likely to be an important determinant of the efficiency of mucociliary clearance. Water movement across the epithelium is thought to follow active ion transport passively by means of the osmotic gradients created. OBJECTIVES: The aim of this study was to determine whether Na, K, and Cl are transported actively by the epithelium of nasal mucosa and to evaluate an effect of the tracheostomy on changes of pH and electrolytes in nasal secretum. MATERIALS AND METHODS: pH and Na, K, and Cl values were estimated in 35 samples (20 tracheostomized patients and 15 normal persons) of nasal secretum and plasma. RESULTS: On 15 normal persons, Mean pH value was 7.43, Na 143.2, K 4.2 and Cl 109.1(mEq/L) in plasma and Mean pH value was 7.81, Na 139.7, K 11.5 and Cl 127.5(mEq/L) in nasal secretion. On 20 tracheostomized patients, pH 7.49, Na 140.2, K 3.8, and Cl 108.7(mEq/L) in plasma were estimated, and pH 7.88, Na 128.5, K 12.0, and Cl 121.5(mEq/L) were estimated in nasal secretum. In nasal secretum pH, K, and Cl were higher than in plasma by +0.39, +8.2 and +12.8(mEq/L) respectively, while Na was lower -11.6(mEq/L). We had the same result on normal persons as on tracheostomized patients. The results show that pH, K and Cl were higher in nasal secretion and Na was lower than in plasma. CONCLUSION: Significant difference of pH and electrolyte values in nasal secretion was not observed between normal person and tracheostomized patient.

The Incidence of Epstein-Barr Virus Nuclear Antigen in Sporadic Non-Hodgkin's Lymphomas of Korean / 대한암학회지

PURPOSE: It's well known that the Epstein-Barr virus (EBV) is associated with endemic Burkitt's lymphoma and B cell lymphomas in immunocompromised individuals, and undifferentiated carcinoma of the nasopharynx. A clonotypic proliferation of EBV has been demonstrated in the neoplastic cells of these malignancies, suggesting a causative role of EBV in the tumorigenesis. More recently, it was identified that EBV has been linked to Hodgkin's disease and B or T-cell non-Hodgkin's lymphomas (NHLs) without preexisting immunodeficiency. MATERIAL AND METHOD: To determine the immunophenotype and incidence of EBV infection in sporadic NHLs of Korea, We investigated 90 cases of NHLs through immunohistochemistry and polymerase chain reaction, respectively. RESULTS: Sixty-nine of 90 (77%) of NHLs are of B-cell type, 18 of 90 (20%) of NHLs are of T-cell type and 3 out of 90 (3%) of NHLs are undefined lineage by immunohistochemistry. EBV genome was detected in 7 out of 69 (10%) B-cell lymphomas, 5 out of 18 (28%) T-cell lymphomas and 1 out of 3 (33%) non-B and non-T cell lymphomas by polymerase chain reaction. The male/female ratio of EBV-positive NHLs was 2.25:1. There are no prominent differences in age distribution and tumor localization between EBV- positive groups and negative groups. CONCLUSION: EBV positivity in T-cell NHLs is rather higher than in B-cell NHLs and this finding suggests that there is inter-relation association between EBV and T-cell NHLs, although the exact nature of this association remains to be established.

An Immunohistochemical Study on the Expression of the Bauhinia Purpurea in the Reed-Sternberg Cells

The diagnosis of Hodgkin's disease is based on the morphologic identification of Reed-Sternberg (RS) cells and its variants in paraffin-embedded sections. The origin of RS cells remains a subject of controversy, and cells resembling RS cells are observed in some non-Hodgkin's lymphoma of T-cell lineage. In this study, eighteen cases of Hodgkin's disease (3 nodular sclerosis, 6 diffuse lymphocyte predominance, and 9 mixed cellularity) were studied with peanut agglutinin(PNA), anti-Leu-M1(CD15), LN2(CD74), Ber-H2(CD30) and bauhinia purpurea (BPA) by the avidin-biotin-peroxidase complex(ABC) method in paraffin-embedded sections. RS cells and their variants revealed positive reactions with one or more of the reagents in all examined cases. BPA staining was positive in 17 of 18 cases (94.4%), PNA staining was positive in 9 of 18 cases (50.0%), Leu MI was positive in 7 of 18 cases(38.9%), Ber-H2 was positive in 11 of 18 cases (61.1%), and LN2 was positive in 8 of 18 cases(44.4%). The staining properties of examined markers were recognized as paranuclear, diffuse cytoplasmic and cellular membranous patterns, but LN2 disclosed diffuse cytoplasmic staining in the positive cells. BPA also showed dense cytoplasmic staining reaction with macrophage-histiocytes. BPA reactivity was not affected by fortnalin fixation or paraffm embedding. Thirty six cases of non-Hodgkin's lymphomas(IO T-cell and 26 B-cell type) were also examined. The neoplastic cells of those cases did not stain positive with BPA, PNA, and Leu-Mi, but stained positively with LN2 in 3 cases of T-cell lymphomas and 14 cases of B-cell lymphomas, and BeT-H2 in T-cell lymphomas. In conclusion, to facilitate the detection of RS cells and related variants in paraffm sectionse of Hodgkin's disease, BPA can be used as a useful marker because of its high-detection rate, reproducible staining pattem, and resistance to fixative.

The clinical study of the temporal bone fractures / 대한이비인후과학회지

No abstract available.

Effects of Anesthesia and surgery on Blood Sugar Level in Children / 대한마취과학회지

The effects of ether and halothane anesthesia, and surgery on blood sugar level in children were studied in twelve patients, Six patients were anesthetized with ether and other six patients with halothane. Blood samples were taken two times through a catheter in the external jugular vein after intravenous injection of pentothal 6 mg/kg and succinylcholine 1mg/kg during the anesthesia and. surgical procedure. Blood sugar was measured with the orthotoluidine method. The mean value of blood sugar in the ether group was elevated significantly from 68 mg/100 inl to 92. 2 mg/100 ml and also in the halothane group it was elevated' from 68. 8 mg/l00 ml to 81 mg/100 ml, with a significant difference that the blood sugar level was higher in the ether group than in the halothane group. Results were also compared with the hyperglycemic response to different types of surgery. The value of blood sugar under general anesthesia during intra-abdominal, body surface and other surgery was measured. The hyperglycemic response to intra-abdominal surgery was the largest and the next was in other surgery, and in body surface surgery it was smallest, so it was shown there is a relationship between the degree of trauma and the rise in blood sugar.