Ki-67 Index in the Head and Neck Squamous Cell Carcinomas and Tumor Adjacent Epithelia / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Prognostic information is essential for the evaluation, judgement and optimal treatment of patients with head and neck squamous cell carcinoma. To evaluate the biological behavior of the malignancy, in particular, the proliferative activity of tumor cells were analyzed by proliferative markers, such as the Ki-67 index, PNCA and AgNOR. We performed this study to draw correlations between clinical findings and histopathologic prognostic factors using the Ki-67 index in the tumor tissues and the tumor adjacent epithelia. MATERIALS AND METHODS: The Ki-67 index of tumor tissues and the tumor adjacent epithelia from 24 patients with head and neck squamous cell carcinoma were analyzed using immunohistochemical methods. The relationships between the Ki-67 index in tumor tissues and tumor adjacent epithelia and several host and tumor factors were analyzed. RESULTS: The median Ki-67 index was higher in the tumor tissues than in the tumor adjacent epithelia (p<0.001). The ki-67 index of tumor tissues or tumor adjacent epithelia was not correlated with any host or tumor factor except N stage with tumor of interval to any treatment failure among the five variables which includes Ki-67 index, T stage, N stage, AJCC stage and age. Media interval to any treatment failure was shorter in groups with a high Ki-67 index than in groups with a low Ki-67 index of tumor tissue, but this result was statistically insignificant. CONCLUSION: The Ki-67 index was of little values in prognosis. However, among the various markers such as, the Ki-67 index, T stage, N stage, AJCC stage and age, the Ki-67 index of tumor tissue was the most significant predictor of interval to any treatment failure.

Expression of p53, mdm-2, nm23 and TGFalpha in Primary and Second Primary Cancers in Multiple Head and Neck Cancers / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Development of second primary cancer is an important biological characteristic of head and neck squmaous cell carcinoma. In the past, the development of second primary cancer has been explained by the field cancerization theory. However, recent reports support the common common clonal origin theory. Common clonal origin theory states that following the initial transformation, the progeny of the transformed clone spread through the mucosa and gives rise to the geographically distinct but genetically related tumor. The objective of this study is to compare the expression pattern of p53, mdm-2, nm23 and TGFalpha which are proteins involved in the development, growth and metastasis of tumor in primary and second primary cancers of multiple head and neck cancer. MATERIALS AND METHODS: Expression of p53, mdm-2, nm23 and TGFalpha were analysed by immunohistochemical study of 12 paraffin embedded sections from 6 patients (3 synchronous tumors, 3 metachronous tumors) who were surgically treated for multiple head and neck cancer. RESULTS: p53, mdm-2, nm23 and TGFalpha were expressed in the same pattern in 3 patients (50%) of primary and second primary cancers. CONCLUSION: In our study, we observed the same expression patterns in 3 cases; however, it was difficult to conclude based on this result alone the clonality relationship between primary and second primary cancer. We suggest that further studies using molecular biological techniques are needed to identify the early genetic events of carcinogenesis.

p53 Mutation Patterns in Primary Head and Neck Squamous Cell Carcinomas and Their Metastatic Neck Nodes / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Analysis of molecular events that occur during the evolution of head and neck squamous cell carcinoma has discovered multiple genetic changes, such as chromosomal abnormalities, activation of oncogenes, and inactivation of tumor suppressor genes. The involvement of p53 gene at the advanced tumor stage including lymph node metastasis has been demonstrated in head and neck cancers. Although there is some evidences for the persistence of p53 mutation of lymph node metastasis in head and neck cancer, no systematic study has been carried out to elucidate the persistence of p53 mutations and together with intratumoral heterogeneity of p53 mutations in primary and metastatic head and neck cancers. The purpose of this study was to reveal the pattern and intratumoral heterogeneity of p53 mutations in primary head and neck squamous cell carcinomas and their metastatic lymph node. MATERIALS AND METHODS: In total 71 microdissected samples of primary tumors and their metastatic lymph nodes from 12 head and neck squamous cell carcinomas, exon 5 to 8 of p53 tumor supressor gene were analyzed by single strand conformational polymorphism and immunohistochemical study for the specimens. RESULTS: In eight of 12 cases, mutational inactivations were identified. Involved exons were five cases of exon 5, two cases of exon 8 and one case of exon 7. In all of eight cases, mutations were identical in the primary and all of its metastatic samples. In microdissected study to obtain tumoral clones, mutation of p53 showed identical kind of p53 mutation for both primary and metastatic samples. CONCLUSION: p53 mutations of primary and metaststic head and neck squamous cell carcinomas showed identical kind of p53 mutation with intratumoral heterogeneity.

Clinical Experience of Acute Mastoiditis in Recent 10 Years / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Acute mastoiditis is an acute inflammatory disease of the mastoid process but it has declined dramatically in the postantibiotic era. However, contrary to the benefits of broad-spectrum antibiotics, resistant and unusual pathogens may cause this disease entity. Recently, in our hospital, antibiotic resistant and atypical pathogens such as Actinomyces, Mycobacterium tuberculosis were on the increase. In this paper we would like to discuss optimal diagnosis and treatment for acute mastoiditis. PATIENTS AND METHODS: Thirteen patients with mastoititis were treated in our hospital in the last 10 years. All of them were reviewedretrospectively. RESULTS: Eight patients recovered after treating with intravenous antibiotics with or without myringotomy and the rest were managed surgically. Among the 5 who received surgical treatments, one developed chronic otitis media and one developed cholesteatoma 3 years later. CONCLUSION: Surgical intervention was indicated for cases that accompanied complications. It would be important to be aware of any unusual pathogens in the management of acute mastoiditis which does not respond to empirical antibiotics therapy.

Expression of Fos Protein in Brainstem Vestibular Nuclei of Rat-II. Sinusoidal Acceleration Stimulation- / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fos, the protein product of c-fos gene, has been known to be rapidly expressed in neurons following various external and internal stimuli and this protein expression has been used as a neural activation marker in many fields. This experiment was performed to examine the afferent pathway of the lateral semicircular canals following sinusoidal acceleration. MATERIALS & METHODS: To stimulate the lateral semicircular canals, animals received rotary stimulation for 90 minutes with 2.0Hz sinusoidal acceleration. Thirty minutes after stimulation, the subjects were sacrificed and their brainstems were processed for immunohistochemistry to detect Fos expression. RESULTS: Fos proteins were strongly expressed in the superior, dorsal medial vestibular and inferior vestibular nuclei. However, there was no expression in the lateral and ventral portion of medial vestibular nuclei. CONCLUSION: This finding suggested that the afferent pathway from peripheral vestibular end-organ can be successfully mapped by detection of Fos expression and Fos is an useful neural activity marker in the vestibular system.

Noise Induced Expression of 72kD Heat Shock Protein in Rat Saccule / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Heat shock protein (HSP) is an intracellular protein, expressed for cell protection under stressful condition. Expression of HSP was found in cochlear after noise stimulation. The vestibular end organs, especially saccule, have been known to be damaged by loud sound because of its anatomical and embryological vicinity with the cochlea. In this study, we observed the function of HSP72 that it is indeed expressed in rat saccule following noise stimulation. MATERIALS AND METHODS: Experimental animals were exposed to noisy environment at 100, 110 and 120 dB SPL for 90 minutes. Noise stimulation was transferred through a tone hook of behind-the-ear type hearing aid. Saccule was dissected and stained immunohistochemically and examined for expression of HSP under light microscope. RESULTS: Strong immunoreactivities were observed at type I and II hair cells of rat saccule which received noise of 120 dB for 90 minutes. Stronger imm-unoreactivities were found along the marginal areas of the saccule. CONCLUSION: These findings suggest that HSP72 are expressed in rat saccule following overthreshold noise and it could be presumed that HSP72 may have a protective role against noise trauma.

Mucosa-Associated Lymphoid Tissue Lymphoma of the Parotid Gland Mimicking Warthin's Tumor / 대한이비인후과학회지

The parotid tumor which presents as solid and cystic mass on computed tomography, shows hot uptake on technetium-99m scan and oxyphilic oncocytic cells and intermingled lymphocytes on fine needle aspiration usually suggests Warthin's tumor. We have treated a patient with such preoperative findings of Warthin's tumor. However, the pathologic diagnosis of the surgical specimen was mucosa-associated lymphoid tissue lymphoma.

Facial Nerve Graft in Parotid Malignancy / 대한이비인후과학회지

Surgical extirpation of parotid cancer frequently results in sacrifice of the facial nerve. In each case when sacrifice of nerve is necessary, immediate nerve repair with cable graft is preferred. However, controversy continues over the effects of postoperative radiotherapy on facial nerve graft function. Six patients with parotid cancer who had extensive resection with sacrifice of the seventh nerve and primary autogenous cable graft repair were reviewed. Five of six patients had good to excellent dynamic function. Three of four patient who were treated with postoperative radiotherapy had good to excellent function. Immediate nerve grafting should be used even when postoperative radiotherapy is planned.