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.

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.

Possibility of Reciprocal Infections of Methicillin-Resistant Staphylococcus Aureus between Medical Personnel and Patients after Performing Middle Ear Surgery / 대한이비인후과학회지

BACKGROUND: The cases of Methicillin-Resistant Staphylococcus aureus(MRSA) infection after middle ear surgery, most of which are thought to be hospital acquired infection, are increasing recently in our hospital. MRSA infection is apt to be long lasting and to bring many complications because MRSA is resistant to aminoglycosides and cephalosporin as well as methicillin. There are many reports that medical personnel have a role to transmit that organisms to other patients. OBJECTIVES: To find and eradicate infection source and transmission route are both essential because medical personnel who contact MRSA infected patients can be a continuing transmission route. MATERIALS AND METHODS: Bacterial cultures from the noses and hands of medical personnel working in the department of Otolaryngology of Korea University Hospital were done and ribotyping through Southern blot technique was used to compare and prove an identical strain of MRSA organism between medical personnel and patients. RESULTS: As a result of ribotyping with EcoRI and HindIII, one distinct subtype(type I) was identified to be shared between medical personnel and patients. Among 30 medical personnel, 10 were carriers of MRSA. Seven MRSA isolates from these 10 medical carriers and 18 from 30 isolates of otorrhea shared the same type I ribotype. CONCLUSION: This finding reveals that MRSA transmission could occur between medical personnel and patients. Medical personnel should be aware of their possible role as a relay-stay of transmission of pathogenic organisms and should give efforts to prevent it.