ABSTRACT
Adenoid cystic carcinoma (ACC) is rare malignant tumor that affects major and minor salivary gland, ceruminous glands, and occasionally excretory gland of the female genital tract. While ACC accounts for less than 1% of all head and neck malignancies and approximately 10% of all salivary neoplasm, this tumor is one of the most common malignancies of the submandibular and minor salivary glands. ACC is characterized by a slow rate of progression, a tendency for perineural invasion, and a high recurrence rate after intensive surgery and adjuvant radiotherapy. ACC is divided into 3 types according to a distinctive histologic pattern. It is well known that the histologic pattern of ACC correlates well with the grade of tumors and prognosis. There are no clear guidelines for the treatment of ACC, but recently a combination of surgery and postoperative radiotherapy has been recommended. The most significant prognostic factors are clinical stage and distant metastasis. We present two cases of ACC arising from external auditory canal with a review of literature.
Subject(s)
Female , Humans , Adenoids , Carcinoma, Adenoid Cystic , Ear Canal , Head , Neck , Neoplasm Metastasis , Prognosis , Radiotherapy , Radiotherapy, Adjuvant , Recurrence , Salivary Glands, MinorABSTRACT
Although chronic sinusitis is more often caused by the blockage of sinus ostia or the presence of an oroantral fistula, the disease is generally caused by dental problems. Although chronic maxillary sinusitis of dental origin is a rare entity when compared to sinus diseases of rhinogenic origin, it is extremely important to identify a dental etiology when it occurs. Chronic maxillary sinusitis of dental origin may be caused by the followings; chronic oroantral fistula (OAF), foreign bodies (dental fillings, teeth roots, parts of broken instruments, or packing materials) pushed through the root canal or OAF into the sinus, periapical granulomas or small inflammatory cysts of the molars and bicuspids, or large odontogenic cysts occupying total or subtotal space of the maxillary sinus. We report a case of unilateral subacute maxillary sinusitis associated with foreign body in the maxillary sinus. The foreign body in the maxillary sinus was dental Nu gauze. Dental Nu gauze helps to control bleeding and prevent pooling of wound fluid. Although endoscopic approach to chronic maxillary sinusitis of dental origin is a new, reliable method associated with less morbidity and lower incidence of complications, the operation was conducted mainly according to the Caldwell-Luc's method. Based on the findings of our case, we suggest that patient's dental problem history and dental state must be taken into consideration in cases where maxillary sinusitis is suspected.
Subject(s)
Bicuspid , Dental Materials , Dental Pulp Cavity , Foreign Bodies , Hemorrhage , Incidence , Maxillary Sinus , Maxillary Sinusitis , Molar , Odontogenic Cysts , Oroantral Fistula , Periapical Granuloma , Sinusitis , Tooth , Wounds and InjuriesABSTRACT
BACKGROUND AND OBJECTIVES: Acute tonsillitis is a clinical condition of gross tonsillar infection. Since previous studies focused on immunology of tonsils and group A beta-hemolytic streptococcus, we have not had sufficient clinical analyses of acute tonsillitis, such as predisposing factors and change of organism strains causing tonsillitis. This study aims to explain many factors that seem to be related to severe acute tonsillitis, such as age, sex, seasonal distribution, days from initial symptoms to visit, body temperature, symptoms, past history, duration of hospitalization, number of patients of culture positive group, culture organisms and antibiotic sensitivity of common organism strains. SUBJECTS AND METHOD: In this study, researchers clinically reviewed 283 patients who were hospitalized at the Chung-Ang University Hospital at any time from January 1993 to December 2002. Throat smear was done at the surface of inflammed tonsils. RESULTS: Among 283 cases, 125 cases yielded pus plug. Seven strains of bacteria were isolated in 115 culture-positive cases. There were significant differences between Group A (from January 1993 to December 1997) and Group B (from January 1998 to December 2002) regarding organism strains isolated. In both Group A and B, group A beta-hemolytic streptococcus was the most common organism that caused severe acute tonsillitis. However, in Group B, other organism strains, such as Pseudomonas aeruginosa and Enterococcus, increased in number and in their resistance to penicillin and cephalothin. The researchers found no predisposing factors that were related to severe acute tonsillitis. CONCLUSION: To sum up, this study demonstrates that we may reconsider the use of antibiotics such as penicillin and cephalothin for severe acute tonsillitis. This study calls for further studies about the change of organism strains that cause severe acute tonsillitis and about the predisposing factors that affect severe acute tonsillitis.
Subject(s)
Humans , Allergy and Immunology , Anti-Bacterial Agents , Bacteria , Bacteriology , Body Temperature , Causality , Cephalothin , Enterococcus , Hospitalization , Palatine Tonsil , Penicillins , Pharynx , Pseudomonas aeruginosa , Seasons , Streptococcus , Suppuration , TonsillitisABSTRACT
BACKGROUND AND OBJECTIVES: Recent studies have demonstrated overexpression of cyclooxygenase-2 (COX-2) in various cancers including head and neck cancers. COX-2, an inducible enzyme which catalyzes the formation of prostaglandins from arachidonic acid, is expressed in some cancers. We investigated the anti-tumor effect of selective COX-2 inhibitor, Meloxicam, on the human oral cavity squamous cell carcinoma xenografted in nude mice. MATERIALS AND METHOD: We inoculated the oral cavity cancer cell (KB cell) line subcutaneously into 30 athymic mice which were divided into 3 groups 1 week after inoculation. One group received no treatment whereas two other groups received selective COX-2 inhibitor, Meloxicam, 10mg/kg and 40mg/kg three times weekly for 3 weeks. We studied mean tumor volume, apoptotic index (TUNEL) and proliferative index (Ki 67) in the control and treated groups. RESULTS: Meloxicam induced apoptosis, suppressed cell proliferation with significant difference (p<0.01), and suppressed the xenografted tumor growth with significant difference (p<0.05) in the Meloxicam treated group. All tumor expressed COX-2. CONCLUSION: This result suggested that the selective COX-2 inhibitors suppressed the growth of human oral cavity squamous carcinoma and a further study will be needed for determination of the pharmacologic pathway and efficacy of selective COX-2 inhibitor for head and neck cancers.
Subject(s)
Humans , Mice , AnimalsABSTRACT
BACKGROUND AND OBJECTIVES: Inverted papilloma is a rare benign tumor of nasal epithelium associated with high recurrence rate and malignant potential. Its etiology is still uncertain, and the mechanism of proliferation has not yet been fully described. Among the various approaches for evaluating the proliferation activity, proliferating cell nuclear antigen (PCNA) has been introduced as another marker of cellular proliferation. The purpose of this study was to detect the quantify and compare cell proliferation in the human inverted papilloma, maxillary carcinoma, nasal polyp and hypertrophic turbinate mucosa, and to analyze the relationship between PCNA expression and clinicopathologic findings in human inverted papilloma. MATERIALS AND METHODS: The samples were obtained after surgical removal from 29 patients with inverted papilloma, 5 patients with maxillary squamous cell carcinoma, 15 patients with nasal polyp, and 10 patients with hypertrophic turbinate. The cell proliferation was assessed by immunohistochemical identification of the PCNA. RESULTS: The cell proliferation was significantly higher in the inverted papilloma and maxillary carcinoma than in the nasal polyp and hypertrophic turbinate. The cell proliferation in the inverted papilloma was greater when it was associated with dysplasia. CONCLUSION: The increased epithelial cell proliferation seems to be involved in the development of the inverted papilloma, and the high PCNA expression in the inverted papilloma may serve as a useful indicator to predict the malignant transformation.
Subject(s)
Humans , Carcinoma, Squamous Cell , Cell Proliferation , Epithelial Cells , Mucous Membrane , Nasal Mucosa , Nasal Polyps , Papilloma, Inverted , Proliferating Cell Nuclear Antigen , Recurrence , TurbinatesABSTRACT
The exact pathogenesis of nasal polyposis is unknown, but inflammation is thought to be an important factor in its development. CC chemokines and CC chemokine receptors on inflammatory cells influence the cells' migration to the inflammation sites. In an attempt to better understand the events of this migration, we performed an analysis of the CC chemokine receptors mRNA in nasal polyps, allergic inferior turbinate mucosa and hypertrophic inferior turbinate mucosa. The expression of CC chemokine receptor mRNA was measured with an RT-PCR in 20 samples of nasal polyps, seven samples of allergic inferior turbinate mucosa and six samples of hypertrophic inferior turbinate mucosa. The results showed the expression levels of CCR2, CCR3, CCR4, and CCR5 mRNA to be higher in the nasal polyps than in the mucosa taken from the allergic and hypertrophic inferior turbinates. CCR4 and CCR5 mRNA expressed more strongly than did CCR1, CCR2 and CCR3 mRNA (p<0.001). The number of infiltrating eosinophils correlated with the level of CCR3 mRNA expression (p<0.001).
Subject(s)
Chemokines, CC , Eosinophils , Inflammation , Mucous Membrane , Nasal Polyps , Receptors, CCR , RNA, Messenger , TurbinatesABSTRACT
The empty sella syndrome is applied to the abnormal extension into the sella turcica of an arachnoid diverticulum filled with CSF, which displace and compresses the pituitary gland. Such a diverticulum can erode the sellar floor and lead to CSF rhinorrhea through the sphenoid sinus. Recently we experienced a case of the spontaneous CSF rhinorrhea associated with the empty sella syndrome in a 55 year-old woman. The CSF leakage was repaired successfully by sublabial, transseptal, transsph-enoidal approach.
Subject(s)
Female , Humans , Middle Aged , Arachnoid , Cerebrospinal Fluid Rhinorrhea , Cerebrospinal Fluid , Cytochrome P-450 CYP1A1 , Diverticulum , Empty Sella Syndrome , Pituitary Gland , Sella Turcica , Sphenoid SinusABSTRACT
Vascular cell adhesion molecule-1 (VCAM-1) has been implicated in selective eosinophil recruitment characterizing allergic inflammation. To understand the events involved in selective eosinophil migration into allergic inflammatory sites, we performed quantitative analysis of VCAM-1 mRNA expression levels in the nasal mucosa of TDI-induced allergic rats. Expression levels of VCAM-1 mRNA from inferior turbinate were examined using competitive PCR in 35 allergic rats and 5 control rats and compared with infiltrated eosinophil counts. Quantity of VCAM-1 mRNA was more increased in allergy group than in the control group, especially in group sacrificed 3 hours to 4 days after provocation. Infiltrating eosinophils were correlated with the expression levels of VCAM-1 mRNA (p<0.01). These results suggest that VCAM-1 plays a predominant role in controlling antigen-induced eosinophil recruitment into the tissue, and that the induction of VCAM-1 expression on the endothelium at the site of allergic inflammation regulates eosinophil recruitment.
Subject(s)
Animals , Rats , Endothelium , Eosinophils , Hypersensitivity , Inflammation , Nasal Mucosa , Polymerase Chain Reaction , RNA, Messenger , Turbinates , Vascular Cell Adhesion Molecule-1ABSTRACT
BACKGROUND AND OBJECTIVES: Programmed cell death (apoptosis) is distinctive form of cell death manifested by characteristic chromatin condensation and DNA fragmentation, whose function is the deletion of cells in normal development, organogenesis, immune function, and tissue growth, but which can also be induced by pathologic stimuli. The purpose of this study was to analyze the relationship between apoptotic index and HPV, p53 and PCNA expression, and clinicopathological findings in laryngeal squamous cell carcinomas. MATERIALS AND METHODS: Fourty-one cases of laryngeal squamous cell carcinomas were analyzed for the detection of HPV DNA by in situ hybridization, the expression of p53 and PCNA by immunohistochemical technique, and detection of apoptotic bodies by in situ hybridization. RESULTS: HPV DNA was detected in 8 (19.51%), p53 was expressed in 26 (63.41%) out of 41 cases, and the PCNA expression rate was 48.39+/-21.06%. The average apoptotic index was 9.38+/-2.89, there was no relationship between apoptotic index and HPV and p53 expression (p>0.05). The apoptotic indices were 11.26+/-1.86, 8.17+/-2.55, and 4.32+/-2.41 in well differentiatied, moderately differentiatied and poorly differentiatied carcinoma, respectively. The histopathological differences were statistically significant (p<0.05). Also there was an inverse proportion between apoptotic index and PCNA expression. CONCLUSION: The apoptotic index was related to cellular differentiation regardless of HPV and p53 expression. Also these results suggest that the numbers of apoptotic bodies in the tumor tissues can make it possible to presume indirectly the malignant potentiality of the tumor and will help us to understand the biologic behavior of head and neck cancer.
Subject(s)
Apoptosis , Carcinoma, Squamous Cell , Cell Death , Chromatin , DNA , DNA Fragmentation , Head and Neck Neoplasms , In Situ Hybridization , Organogenesis , Proliferating Cell Nuclear AntigenABSTRACT
BACKGROUND: Human papillomavirus(HPV) is epitheliotrophic virus invading the anogenital tract and the upper aerodigestive tract. HPV produces a diversity of benign and malignant tumors. The wild-type p(53) gene participates in suppressing cell transformation while the mutant forms have tumorigenic potential. Alterations in the structure of p(53) gene represent one of the most common genetic changes associated with human cancers. OBJECTIVES: We evaluated the HPV infection and p(53) overexpression, and analyzed p(53) overexpression according to clinicopathological findings and HPV infection in laryngeal squamous cell carcinomas. MATERIALS AND METHODS: Thirty-nine cases of laryngeal squamous cell carcinomas and ten cases of laryngeal nodules were analyzed for the detection of HPV DNA by in situ hybridization technique and the detection of p(53) overexpression by immunohistochemical technique. RESULTS: 1) HPV DNA was detected in 10(25.6%), and p(53) overexpression was detected in 19(48.7%) out of 39 cases in laryngeal squamous cell carcinomas. 2) The p(53) overexpression was detected in 7(78%) out of 9 cases more than Brinkman index score 1000, and was detected in 12(40%) out of 30 cases less than 1000. 3) HPV positive cases showed 50% of p(53) overexpression whereas HPV negative cases showed 48% overexpression. CONCLUSION: HPV and p(53) gene were thought to be the etiological factors of laryngeal squamous cell carcinomas. The p(53) overexpression was related to smoking regardless of the histopathological findings and HPV infection.
Subject(s)
Humans , Carcinoma, Squamous Cell , DNA , In Situ Hybridization , Smoke , SmokingABSTRACT
The human papillomavirus(HPV) is a subfamily of the Papovaviridae family as a double stranded DNA virus, and HPV is the etiological agent of squamous cell papillomas in different anatomic regions including the skin and the mucous membranes of oral cavity, esophagus, respiratory and anogenital tracts. Inverted papilloma of the nasal cavity and paranasal sinuses is uncommon benign lesion, in which there is a inversion of the neoplastic epithelium into the underlying stroma. The local aggressiveness, high rate of recurrence, associated malignancy, and tendency of multicentricity have led to the advocation of radical removal of the tumor. The cause of sinonasal inverted papilloma remains unknown. However, the involved etiologic factors are thought to be smoking, allergy, environmental factors, HPV, and chronic infections. The purpose of this study was to detect HPV in sinonasal inverted papilloma, to examine the relationship between cellular dysplasia and recurrence of inverted papilloma, to examine the relationship between HPV and recurrence of inverted papilloma in forty two sinonasal inverted papillomas(inverted papilloma without dysplasia 30 cases, inverted papilloma with dysplasia 6 cases, inverted papilloma associated squamous cell carcinoma 5 cases, inverted papilloma transformed squamous cell carcinoma 1 case). For these purposes, paraffin-embedded tissues were subjected to polymerase chain reaction using type-specific primers pairs. Following results were obtained: 1) The HPV was detected in 5(12%) out of 42 cases of inverted papilloma, one contained human papillomvirus 6, two contained human papillomavirus 11, and two contained human papillomavirus 16. 2) The recurrence of inverted papilloma occurred in 1(16%) out of 6 cases exhibited dysplasia, in 3(10%) out of 30 cases not exhibited dysplasia. 3) The recurrence of inverted papilloma occurred in 2(66%) out of 3 cases positive for HPV, in 2(6%) out of 33 cases negative for HPV. In conclusion HPV was thought to be the etiological factor of sinonasal inverted papilloma. Also there was a relationship between HPV and recurrence of inverted papilloma. Further work is in progress to determine the possible mechanisms by which HPV induces oncogenesis in inverted papilloma.
Subject(s)
Humans , Carcinogenesis , Carcinoma, Squamous Cell , DNA Viruses , Epithelium , Esophagus , Human papillomavirus 11 , Human papillomavirus 16 , Hypersensitivity , Mouth , Mucous Membrane , Nasal Cavity , Papilloma , Papilloma, Inverted , Paranasal Sinuses , Polymerase Chain Reaction , Recurrence , Skin , Smoke , SmokingABSTRACT
BACKGROUND: Expression of mutant p53 has been observed in a variety of human cancers, including head and neck squamous cell carcinoma and carcinoma of breast, colon, esophagus, lung, stomach, liver, thyroid, etc. OBJECTIVES: To establish expression frequency of p53 and correlation between p53 expression and clinicopathologic data in squamous cell carcinoma of head and neck. MATERIALS AND METHODS: Fresh tissue samples were obtained from 66 patients with squamous cell carcinoma of head and neck undergoing biopsy or surgery. Expression of mutant p53 was evaluated by immunohistochemical staining with anti-p53 monoclonal antibody in 66 paraffin-embedded tissues of squamous cell carcinoma in head and neck. The studies consisted of 13 cases of oral carcinoma including tongue, 10 cases of pharyngeal carcinoma and 43 cases of laryngeal carcinoma. RESULTS: 1) The frequency of p53 expression in squamous cell carcinoma of head and neck was 48.5%((31/66). 2) The frequency of p53 expression by tumor site was 42.6%(6/13) in oral cavity, 60%(6/10) in pharynx and 44.2%(19/43) in larynx. 3) A positive relationship was seen between p53 expression and lymphnode metastasis, representing 69.2% p53 expression in metastasis group and 16.7% p53 in non-metastasis group. CONCLUSION: Author was suggested that p53 expression in squamous cell carcinoma of head and neck was related to tumor progression and metastasis.
Subject(s)
Humans , Biopsy , Breast , Carcinoma, Squamous Cell , Colon , Esophagus , Head , Larynx , Liver , Lung , Mouth , Neck , Neoplasm Metastasis , Pharynx , Stomach , Thyroid Gland , TongueABSTRACT
Systemic antibiotic therapy is widely used for prophylaxis in major head and neck surgery, but the efficacy of topical oral antibiotic therapy has not been fully investigated. Therefore we planned to study the efficacy of topical clindamycin gargle on oral flora. Thirty-six healthy adults(20 males, 16 females) were included in the study, and we tried with three oral-washing agents; 0.9% normal saline, 10% povidone iodine, and 75mg clindamycin in 52ml tap water. Samples of saliva were cultured for aerobic and anaerobic bacteria immediately before, immediately after, and at 1- and 4-hour intervals after, washing the mouth with a solution of either control(normal saline or povidone iodine) or clindamycin. Quantitative analysis demonstrated significant reduction of oral flora level after use of the topical antibiotic at the 1-, 4-, and 8- hour interval. It is postulated that topical clindamycin, by reducing concentrations of oral flora, may also reduce the incidence of regional infection following major upper aerodigestive tract surgery.
Subject(s)
Humans , Male , Anti-Bacterial Agents , Bacteria, Anaerobic , Clindamycin , Head , Incidence , Mouth , Neck , Povidone , Povidone-Iodine , Saliva , WaterABSTRACT
No abstract available.
ABSTRACT
No abstract available.
Subject(s)
Lithotripsy , Salivary Gland Calculi , Salivary Glands , ShockABSTRACT
No abstract available.