Bacteriologic Evaluation of Peritonsillar Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Peritonsillar abscess (PTA) is a collection of pus lateral to tonsil and is located between the fibrous capsule of the palatine tonsil, usually at its upper pole, and the superior to the pharyngeal constrictor muscle. It frequently occurs as a complication of acute tonsillitis. Bacteriology including clinical characteristics in PTA were evaluated. SUBJECTS AND METHOD: Sixty-one patients with peritonsillar abscess, who visited National Medical Center from January 1997 through August 2001 were entered into the study. Each patient was asked to answer a questionnaire for clinical aspects of PTA. Needle aspirations were performed and pus was drained in all cases. Bacterial susceptibility to ampicillin, cephazoline, ciprofloxacin, erythromycin, tetracyclin, and vancomycin was tested on the ioslated bacteria. RESULTS: Among 61 cases, aerobes were isolated in 15 cases (24.6%) and anaerobes in 16 cases (26.2%). There was no significant difference in the culture positive rate of aerobes (p=0.767) and anaerobes (p=1.0) between antibiotics-medicated patients and nonmedicated patients. Among the cultured organisms, peptostreptococcus was the most common and the second most common was beta-hemolytic streptococcus. However, alpha-hemolytic streptococcus, an important pathogen considered in the previous study, was detected at 1.6%. CONCLUSION: Antibiotics medication was not a significant factor in culture positive rate in our study. Peptostreptococcus as an anaerobe and beta-hemolytic streptococcus as an aerobe were the major causes that contributed to the decreased state of peritonsillar abscess and culture positive rate of alpha-hemolytic streptococcus.

Expression of CD44s, v3 and v6 in Squamous Cell Carcinoma of the Head and Neck / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: CD44 is a transmembrane glycoprotein that mediates cell adhesion through binding to extracelluar matrix molecules such as hyaluronan. Multiple isoforms of CD44 are generated by alternative splicing of 10 separate exons (v1-v10). Some of them have been noted as markers for tumor metastasis and prognosis in several studies. We investigated whether CD44s, v3 and v6 may be a useful markers in the head and neck squamous cell carcinoma. MATERIALS AND METHOD: Paraffin embedded tissue sections, which was diagnosed as squamous cell carcinoma of the head and neck from 41 patients were stained immunohistochemically with monoclonal Ab of CD44s, v3 and v6. The results were compared with the primary tumor status, lymph node metastasis, histopathologic differentiation and survival. RESULTS: Various levels of immunoreactivities of the CD44s, CD44v3 and CD44v6 were detected dominantly in cancer cell membrane. The positive rate of CD44s, CD44v3 and CD44v6 were 59%, 66%, 71%, respectively. The decreased expression of CD44s and CD44v6 was significantly correlated to lymph node metastasis but was not affected by T-stage, histopathologic differentiation and survival. CD44v3 had no correlation with the T-stage, N-stage, pathologic differentiation nor survival. CONCLUSION: The expression of CD44s and CD44v6 in the head and neck squamous cell carcinoma may be a biologic marker for lymph node metastasis.

Clinical Study of the Hemangioma of the Head and Neck in Adult / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hemangiomas are the most common benign tumors in children, but are sometimes reported in adults. There are many reports about hemangioma in children, but rare in adults. We intended to identify the clinical manifestations of hemangiomas and their treatment modalities. MATERIALS AND METHOD: We reviewed medical records of 25 patients over 20 years old, who underwent operation and were diagnosed with hemangioma from 1985 to 1999. RESULTS: There were 12 males and 13 females with their age ranging from 20 to 65 years, and a peak incidence was observed in the third decade (44%). The diagnoses were classified depending on histopathologic findings, and they were cavernous hemangioma in 19 cases (76%), capillary hemangioma in 3 cases (12%) and mixed hemangioma (12%). The most prevalent site was tongue (36%), followed by nasal cavity (16%), parotid (12%) and buccal area (8%). All patients underwent surgical excision and radiation therapy was added in 2 cases. Postoperative recurrences were observed in 3 cases (14%). CONCLUSION: Unlike hemangiomas in children, hemangiomas in adults are less likely to undergo spontaneous involution and they rarely resolve. Therefore, the research recommends that more active interventions like excision should be considered rather than observation for adult hemangiomas.

The Expression Pattern and the Prognostic Value of p53, p21, and Bax Proteins in Oral Squamous Cell Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The wild-type p53 protein activates different tumor suppressor genes, leading to the Gl arrest following DNA damage. P21 and bax play a pivotal role in the regulation of apoptosis. The authors wanted to find out the relationship among p53, p21 and bax and the correlation between the staining results and dinicopathologic factors. We also assessed their influence on survival in the oral cavity cancer. MATERIALS AND METHODS: Paraffin embedded tissue sections were made from squamous cell carcinoma of oral cavity from 46 patients. Tissue sections were immunohistochemically stained for the expression of p53, p21 and bax. Results were then compared with the size of primary tumor, lymph node metastasis and histopathalogic diffrentiation. The probability of survival was calculated by the Kaplan-Meier method. RESULTS: Immunoreactivity of the p53 and p21 were detected dominantly in the nuclei at various levels, and immunoreativity of bax was detected in the cytoplasm, The positive rates of p53, p21, and bax were 54.4%, 58.7%, 26.1%, respectively. The positive rate of p53 and the negative rate of bax expression were significantly increased with T-stage but were not affected by N-stage and histopathologic differentiation. P21 had no correlation with the T-stage, N-stage nor with pathologic differentiation. In the multivariate analysis, neither the single oncoprotein nor the combinations of p53, p21, bax had influence on survival statistically. CONCLUSION: The bax protein and mutant p53 protein can be a biological marker for primary tumor progression.

The Study of Voice in Postmenopausal Syndrome / 대한이비인후과학회지

OBJECTIVES: We intended to evaluate the relationship between voice and the menopause, so we observed vocal symptoms and voice parameters in patients of postmenopausal syndrome compared with those in premenopausal women. MATERIALS AND METHODS: Forty postmenopausal and twenty premenopausal women were included in this study. Each woman was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The voices were recorded and analyzed by the Multi-Dimensional Voice Program and a Laryngograph. A statistical analysis of voice parameters was done by a paired-t-test. RESULTS: Vocal symptoms detected in the menopausal women were lowered pitch, voice fatigue, recurrent hoarseness, and loss of high tone. Jitter in postmenopausal group was significantly increased compared with the premenopausal group, but the fundamental frequency, shimmer, the Harmonics-to-noise ratio and the closing quotient showed no significant differences. There were no significant changes of voice parameters between menopausal patients with and without vocal symptoms. CONCLUSION: The change of voice may be objectively identified in postmenopausal women. In treating the postmenopausal symptoms, it may be required to take voice changes into consideration.