The Usefulness of Cytokeratin Immunohistochemistry in Detection of Lymph Node Micrometastases in Neck Dissection Specimens / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis in head and neck cancer patients is one of the most important prognostic factors. The previous studies have shown that the detection of occult micrometastases using immunohistochemical method is superior compared to the routine hematoxylin-eosin stain. The aim of this study was to document the rate of missed occult micrometastases on routine hematoxylin-eosin stain. MATERIALS AND METHOD: Sixty-nine tumors from the patients with squamous cell carcinoma of the head and neck were included. Immunohisto-chemical staining was performed using Pancytokeratin AE1/AE3 antibody. The number of lymph nodes examined was 1710 (mean per patient:24.8;range:one to 66). RESULTS: Of 69 tumors studied, 14 lymph nodes had occult metastases detected by the immunohistochemical method. On review by pathologist, the lymph node metastases were confirmed in 4 of 14 lymph nodes, whereas even on hematoxylin-eosin stain. Hematoxylin-eosin stain was not sufficient to detect occult micrometastases in 10. CONCLUSION: Because immuno-histochemical method enhanced the detection rate of occult micrometastases in cervical lymph nodes of head and neck squamous cell carcinoma patients, it is recommended for routine diagnostic use in every patient, in whom the lymph nodes show negative for metastasis on routine hematoxylin-eosin stain.

Analysis of Proteoglycan Gene Messages in Human Nasal Mucosa and Nasal Polyp using Dot Blot Hybridization / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been suggested that the formation and growth of nasal polyp require the remodeling of extracellular matrix. Proteoglycans (PGs) are the major components of the extracellular matrix that maintain the integrity of the structural tissues The leucine-rich repeat PGs include lumican, decorin and biglycan, all of which have many important biologic activities in various pathologic conditions, including the remodeling of the extracellular matrix. Therefore, these small-PG families may be involved in the formation and growth of nasal polyp. MATERIALS AND METHODS: Surgical specimens of nasal polyps and the normal nasal mucosa were assessed for mRNA expressions coding for lumican, decorin and biglycan using the reverse transcription-polymerase chain reaction,which was followed by dot blot hybridization. RESULTS: Lumican, decorin and biglycan mRNAs were expressed in all tissue samples examined. Semi-quantitative dot blot hybridization revealed that the levels of the lumican and biglycan messages are lower in the nasal polyp tissues than in the nasal mucosa. The decorin messages in the nasal polyp were expressed at levels similar to those in the nasal mucosa. CONCLUSION: These results suggest that lumican, decorin and biglycan may be important components of the extracellular matrix in the nasal mucosa. Considering the function of these PGs, the normal levels of decorin associated with low levels of biglycan and lumican may play a role in the pathogenesis of nasal polyposis.

Clinical Experience of Chronic Recurrent Parotitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic recurrent parotitis has been considered as an ascending infection from the oral cavity, but its causes remain unknown. Although conservative mechanical and medical measures are usually effective in controlling the acute exacerbations of this disease, surgical treatment may become necessary when the infection become too frequent or severe for episodic treatment. This study was designed to evaluate the etiology and pathology, and to analyse the outcome of surgery. MATERIALS AND METHODS: A retrospective study was conducted on nine patients who were managed by surgery(seven patients: superficial parotidectomy, two patients: total parotidectomy) after failure with all conservative measures. The age distribution was from 25 to 72 years, with the mean of 44 years. RESULTS: Of nine patients, the numbers of recurrence were 1-5 times (with the average of three times). Duration of illness ranged from one to 42 years, with a mean of 12 years. Conservative treatments preceding surgery included parotid gland massage, sialogogues, repeated use of antibiotics, and Stensens duct probing in all patients. The disease persisted in all the patients despite these measures, but following parotidectomy (superficial: 7 patients, total: 2 patients), all had complete resolution of the disease. Two patients developed transient facial weakness (House-Brackmann grade II) postoperatively without permanent sequelae. Other complications included seroma in two patients, facial deformity in two patients, Freys' syndrome in one patient, and salivary fistula in one patient. CONCLUSION: Chronic recurrent parotitis, when deeply severe, causes significant. When all the conservative medical management fail, parotidectomy can be offered as the last resolution.

A Case of Spontaneous Chyle Leakage Presenting as Supraclavicular Swelling / 대한이비인후과학회지

A chyle leakage occurs due to injuries m the thoracic duct or the accessory lymphatic channels in the neck or the upper chest. The most common causes of chyle leakages are trauma and neoplasm, and spontaneous chyle leakages are infrequently en- countered. There are few cases of spontaneous chyle leakage reported in the literature. Recently, we experienced a case of spontaneous chyle leakage presenting as supraclavicular swelling following severe coughing. We report this case with a review of literature.

Expression of Antimicrobial Defensin Peptides of the Human Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Defensin, an antimicrobial peptide, is an important component of the innate immune response, particulary at mucosal surface. The present study was undertaken to investigate the expression of defensin in inferior turbinate mucosa and nasal polyp. MATERIALS AND METHODS: Expression of beta-defensin 1, 2 and alpha-defensin 5, 6 mRNA was investigated by RT-PCR and dot blot hybridization. Immunohistochemistry was utilized for detection of alpha-defensin 1, 2, 3 in tissue section. RESULTS: beta-defensin 1 mRNA was expressed in all tissue samples, with not so significantly different levels of expression. beta- defensin 2 mRNA was detected in patients with chronic sinusitis, but not in patients with normal mucosa. Its expression level was significantly higher in nasal polyp than in turbinate mucosa. alpha-defensin 5, and 6 mRNA were not expressed in any tissue but alpha-defensin 1, 2 and 3 were detected in all tissue samples obtained from patients with chronic sinusitis. CONCLUSION: The results suggest that beta-defensin 1 may play a constitutive role in the nasal defense while alpha-defensin 1, 2, 3 and beta-defensin 2 may be induced in response to local infection or inflammation.