Studies on Relationships between Inflammatory Cell, Cytokines and Clinical Features in Pediatric Otitis Media with Effusion / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Retension of inflammatory cells and cytokines in the middle ear cleft can result in ongoing chronic otitis media with effusion. This study aims to investigate the role of these inflammatory cells and cytokines in the middle ear effusion (MEE) of children with otitis media with effusion. MATERIALS AND METHOD: We analyzed 46 pediatric middle ear effusion samples for IL-6, IL-10, TNF-alpha and inflammatory cells and tried to elucidate the relationship between the concentration of these cytokines, inflammatory cells and clinical features. RESULTS: 1) The concentration of TNF-alphain MEE from children younger than 2 years was significantly higher than the levels of children older than 2 years (p<0.05). 2) The concentration of TNF-alpha in MEE of preoperative medication group was significantly lower than the levels of non-medication group (p<0.05). 3) The concentration of IL-6 in MEE of the ears with hearing threshold poorer than 35 dB was significantly higher than the levels of the ears with hearing threshold better than 35 dB (p<0.05). CONCLUSION: The results showed that TNF-alpha and IL-6 are intimately involved in the inflammatory cascade of the middle ear and suggest regulation of these cytokines as possible sites of future therapeutic intervention in otitis media with effusion.

Treatment of Methicillin-Resistant Staphylococcus Aureus(MRSA) Otorrhea in Pediatric Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection has been increasing. There are problems with children with MRSA otorrhea in visiting otolaryngology clinics, since systemic vancomycin or teicoplanin injection can cause systemic side effects in children and admission and medical costs are higher. In this study, we used the conventional antibiotics orally and topically for the treatment of otorrhea by MRSA infection to compare the therapeutic effects of conventional antibiotics with the systemic vancomycin or teicoplanin. The author also tried to determine the timing of systemic vancomycin injection for the control of MRSA otorrhea. MATERIALS AND METHOD: Twenty-eight pediatric patients with MRSA otorrhea were treated with either conventional antibiotics (20 patients) topically and orally or systemic vancomycin or teicoplanin injection (8 patients). The use of vancomycin or teicoplanin injection was indicated when otorrhea didn't stop despite of 3-4 weeks of conventional treatment and when referred from local clinics, and in case of cholesteatoma, when it came as a result of complication of middle ear disease. RESULTS: The average therapeutic period for the conventionally treated group was 24.7 days. On the other hand, the average period was 12.3 days and 9.8 days for the systemic vancomycin and teicoplanin injection group, respectively. CONCLUSION: The conventional antibiotics treatment, topically or orally applied for the treatment of MRSA otorrhea in children, has advantages in relation to time and economy, although the average therapeutic period was longer than the treatment with systemic vancomycin or teicoplanin injection. The author suggests the usage of conventional antibiotics for 3 weeks prior to the use of systemic vancomycin injection.

Prognostic Significance of Expression of Glutathione S-Transferase-pi and Multidrug Resistance-Associated Protein in Nasopharyngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For the treatment of nasopharyngeal carcinoma (NPC), radiation therapy is a primary option. Because of distant metastasis and the high incidence of a locoregional failure following radiotherapy, the combined treatment modality with chemotherapy is applied, although resistance to chemotherapy makes chemotherapy less effective. The Cisplatin-based chemotherapy has been widely used in the field of nasopharyngeal cancer. The Cisplatin resistance is known to be caused by the multidrug resistance-associated protein (MRP), which is one of the drug-export pumps and the glutathione S-transferase (GST)-pi which catalyzes the conjugation of the GSH (glutathione) and the cisplatin. The aim of this study is to determine the predictive value of GST-pi and MRP upon the response to cisplatin in nasopharyngeal carcinoma. SUBJECTS AND METHOD: We analyzed tumor tissues from 49 cases of paraffin block specimens which were diagnosed with NPC and treated at Chonnam National University Hospital. The immunohistochemical study for the GST-pi and the MRP was performed with paraffin block specimens of nasopharyngeal cancers. RESULTS: In the GST-pi, the relationship between the early stage (64.3%) and the advanced stage (91.4%) was statistically significant (p=0.020). The expression of the GST-pi and the MRP had no relationship with the clinical factor, the response to chemotherpy and the survival rate. CONCLUSION: Because the expression of the GST-pi and the MRP in the nasopharyngeal carcinoma could not predict the response to chemotherapy. So the efforts to find the predictive value of the chemotherapy are needed.