Loss of Heterozygosity on Chromosome 3p, 9p, 17p in Oral & Oropharyngeal Squamous Cell Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Patients of oral and oropharyngeal squamous cell carcinoma in the comparable stage have diverse clinical courses and responses to similar treatment. Understanding the genetic alterations that occur in these neoplasms may help us understan4 their biology and behavior. Loss of heterozygosity (I.OH) correlates with inactivated tumor suppressor genes, and tumor suppressor genes are important in the development of oral and oropharyngeal squamous cell carcinoma. We invested LOH for the p53, p16, FHlT gene loci by PCR using microsatellite markers. MATERIALS AND METHODS: Specimens from 25 patients with oral and oropharngeal sqamous cell carcinomas were microdissected, and DNA was obtained from normal and tumoral tissues from paraffin embedded sections. PCR analysis was done with three primers, TP53 (17p13.1) for p53 gene and D9S165 (9p21) for p16 gene and D3S1067 (3p21.1-3p14.2) for FHIT gene. LOH was defined as reduction in the allelic ratio over 50%. RESULTS: LOH at the p53 locus was found in 6/17 of the informative cases (35%), and for the p16 locus, LOH was found in 4/13 of the informative cases (31%). For FHIT locus, LOH was found in 4/15 of the informative cases (27%). CONCLUSION: LOH on chromosome 3 (FHlT gene), chromosome 9 (p16 gene) and chromosome 17 (p53 gene) occurs in oral and oropharyngeal squamous cell carcinoma with high frequency suggesting that these tumor suppressor genes are involved in the development and progression of these carcinomas. There was no correlation behveen genetic alterations, age, pathologic stage, depth of invasion, cervical lymph node metastasis, recurrence and differentiation.

Effects of Peritonsillar Infiltration with Bupivacaine and Oral Dextromethorphan on Post-Tonsillectomy Pain / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Peripheral tissue or nerve injury often leads to post-injury pain hypersensitivity caused by peripheral and central sensitization. Central sensitization which plays a significant role is triggered by nociceptive afferent inputs and mainly results from N-methyl-D-aspartic acid (NMDA) receptor activation. If the afferent impulses are prevented from gaining access to the CNS or if NMDA receptor is blocked by antagonist, central sensitization will not develop and then less pain will result. Previous studies demonstrated that preoperative infiltration of local anesthetics or oral NMDA receptor antagonist could alleviate postoperative pain. We investigated the effects of peritonsillar infiltration with bupivacaine and oral dextromethorphan on post-tonsillectomy pain. MATERIALS AND METHODS: Forty consecutive patients were randomly allocated to one of four groups. Group I was bupivacaine-treated group, and group II was dextromethorphan-treated group. Group III was both bupivacaine and dextromethorphan-treated group, and group IV was control group. Pain scores were assessed using self-rating numeric rating scale ( NRS) at rest and on swallowing during the postoperative day 0, 1, 2, and 7. Doses of supplementary diclofenac administered postoperatively were also recorded. RESULTS: Group I, II, and III showed significantly lower NRS pain scores compared with control group at rest and on swallowing throughout the postoperative 7 days. Diclofenac doses were not statistically different among the four groups. CONCLUSION: Preoperative peritonsillar infiltration with bupivacaine and/or medication with dextromethorphan contributed to decrease the intensity of postoperative pain after tonsillectomy.