Laryngotracheal Stenosis in Burned Patients with Inhalation Injury: Analysis of Risk Factors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngotracheal stenosis (LTS) in burned patients with inhalation injury have features distinct from other stenosis after intubation or tracheotomy. However, the risk factors for LTS in burned patients with inhalation injury have not been thoroughly assessed. The aim of this study is to identify the risk factors for and evaluate the pattern of LTS in burned patients with inhalation injury. SUBJECTS AND METHOD: From May 2005 to April 2007, 227 burned patients with inhalation injury treated at the Hangang Sacred Heart Hospital, Hallym University Medical Center were investigated retrospectively. The risk factors analyzed for LTS in burned patients with inhalation injury were gender, age, duration of intubation, size of the endotracheal tube, previous tracheotomy, number of intubations, severity of inhalation injury. RESULTS: Among 81 patients who survived and could be followed up until the study period, 10 (12%) patients developed LTS. The stenosis involved the subglottis.cervical trachea (5), subglottis.cervical tracheal and glottis (1), glottis (4). According to Myer-Cotton classification, there were 6 (60%) patients with grade III, IV stenoses on subglottis.cervical trachea. The number of intubations and previous tracheotomy were found to be risk factors for the development of LTS in burned patients with inhalation injury. CONCLUSION: LTS by inhalation injury is usually shown on web at the anterior and posterior glottic areas or circumferential narrowing of the subglottis. Repeated endotracheal intubations and previous tracheotomy in patients with inhalation injury may increase the prevalence of LTS.

Functional Benefit after Modification of Radial Forearm Free Flap for Soft Palate Reconstruction

OBJECTIVES: To compare the velopharyngeal function, swallowing and speech of the conventional and modified radial forearm free flap (RFFF) for soft palate reconstruction. METHODS: Retrospective clinical study. Twenty-eight patients who underwent oropharyngeal reconstruction with RFFF were divided into two groups: 10 patients had conventional folded RFFF and 18 patients underwent modified method. RESULTS: The average speech intelligibility score in modified RFFF group was 8.0+/-2.4, and 6.2+/-2.2 in conventional RFFF group (P<0.05). The nasalance was 27.4+/-7.8% in modified group and 38.6+/-2.7% in conventional group during no nasal passage reading and 43.6+/-7.3% in modified group, 55.2+/-7.6% in conventional group during high nasal passage reading (P<0.05). The subjective swallowing functional score was 2.8 in modified group and 2.1 in conventional group. CONCLUSION: The speech assessment and nasalance demonstrate a more favorable outcome in modified group than conventional group.

Role of Hepatocyte Growth Factor and c-met Gene Expression in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The hepatocyte growth factor (HGF)/c-Met signal pathway may play various roles in carcinogenesis of several organs. However, studies about this pathway in head and neck cancers, especially oral cavity and oropharyngeal squamous cell carcinoma (SCC), are very rare. Our objectives are to evaluate the relationship between the mRNA and protein expression of HGF and c-met genes in oral cavity and oropharyngeal carcinomas. SUBJECTS AND METHOD: In this study, we examined the mRNA expression of HGF and c-Met by means of the immunohistochemistry (IHC) method and reverse transcription polymerase chain reaction (RT-PCR) in 40 cases of surgically resected oral cavity and oropharyngeal SCC and 10 cases of low grade dysplasia. RESULTS: Using RT-PCR, HGF mRNA amplification was detected in 67.5% and 10% of carcinoma and dysplasia. c-Met mRNA over-expression was detected in 57.5% and 20% of carcinoma and dysplasia. Using IHC, HGF and c-Met protein over-expression was detected in 55% and 62.5% in carcinoma, but not detected in dysplasia. CONCLUSION: These results suggest that HGF/c-Met signal pathway may be associated with the development of oral cavity and oropharyngeal SCC.

Clinical Analysis of Pharyngocutaneous Fistula after Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pharyngocutaneous fistula after total laryngectomy is one of the most common complication in the immediate postoperative period. The objective of this study is to evaluate the variable predisposing factors after total laryngectomy and to investigate the management of pharyngocutaneous fistula. SUBJECTS AND METHOD: One hundred fifty cases who had been performed total laryngectomy were investigated retrospectively. Fifteen of 150 cases (10.0%) developed pharyngocutaneous fistula after total laryngectomy. We analyzed clinical parameters such as age, sex, smoking, alcohol intake, DM (diabetes mellitus), hypertension, liver disease, postoperative hemoglobin, albumin etc. RESULTS: Smoking, DM, hypertension, postoperative hemoglobin, postoperative albumin were significant factors associated with pharyngocutaneous fistula. Nine patients were managed with conservative treatment and six patients underwent surgical reconstruction by using pectoralis major myocutaneous flap. The average duration of oral feeding was 30 postoperative days in conservative treatment group and 83 postoperative days in surgical intervention group. CONCLUSION: Pharyngocutaneous fistula may be preventable by correcting the predisposing factors. We must consider the initial size of fistula and the response of conservative treatment to determine methodology and timing of surgical management.

Histopathologic Changes of Tracheal Mucosa in Burned Patients with Inhalation Injury / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Inhalation injuries can produce a wide spectrum of negative clinical effects. Respiratory failure remains one of the leading causes of death in burned patients with inhalation injury. Despite advances in understanding of inhalation injury, few studies have focused on histopathologic findings of tracheal mucosa. The purpose of this study is to investigate histopathologic changes of tracheal mucosa in burned patients with inhalation injury. SUBJECTS AND METHOD: Tracheotomy was performed on 31 patients who was admitted to the Hospital center from May 2005 to March 2006. Thirty-one patients were divided into two groups : patients with inhalation injury (group I)(n=16), patients without inhalation injury (group II)(n=15). Tracheal mucosa were taken out during the tracheotomy. The tracheal mucosa were read blindly by one pathologist. RESULTS: Histopathologic examination showed the following finding in the tracheal mucosa of all patients in the group I : epithelial ulceration. Different findings were observed in the group I as time passed by after inhalation injury, such as interstitial edema, inflammatory cell infiltration, capillary dilatation, and increased fibrosis. No abnormal findings were observed in the tracheal mucosa in the group II. CONCLUSION: Inhalation injuries cause histopathologic damages to tracheal mucosa. The different histopathologic findings of tracheal mucosa that take place in time following inhalation injuries suggest to process an inflammatory reaction. The study in related to clinical features should be needed due to tracheal mucosa injury may produce respiratory complications.

Clinical Significance of the Expression of Galectin-3 in Thyroid Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Galectin-3 is a beta-galactoside binding protein, of which the major function is not fully elucidated in malignant tumor. However, galectin-3 is expressed in epithelial cells and contributes to the progression of cancer. Although galectin-3 is expressed in a variety of tissues and plays important roles in malignant transformation or tumor progression, the study on its expression related to clinicopathological parameters in thyroid tumor is rare. So, the present study aims to find out the clinical significance of galectin-3 in thyroid tumor. SUBJECTS AND METHOD: We assessed mRNA and protein expressions of the galectin-3 gene by means of the RT-PCR method and immunohistochemical staining in 100 cases of thyroid tumors (50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasia). The expression of galectin-3 is compared with the clinical prognostic factors of thyroid papillary cancer. RESULTS: Using RT-PCR, galectin-3 mRNA was detected in 41 (82%) in papillary carcinoma, 6 (60%) in follicular carcinoma, 8 (40%) in follicular adenoma and 9 (45%) in nodular hyperplasia cases. Using immunohistochemical staining, galectin-3 protein expressions were detected in 46 (92%), 7 (70%), 3 (15%) and 1 (5%). The expressions of the galectin-3 mRNA and protein were significantly recognized in thyroid papillary carcinoma. However, the galectin-3 mRNA and protein over-expression is not significantly correlated with the clinical prognostic factors of thyroid papillary carcinoma. CONCLUSION: These results suggest that galectin-3 expression may be associated with thyroid papillary carcinoma development.

Airway Management in Burn Patients with Inhalation Injury / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Respiratory failure remains one of the leading causes of death in burn patients with inhalation injury. Obtaining and maintaining a secure airway are both essential and challenging. Although different airway managements are performed in burn patients with inhalation injury, its exact indications and timing remain controversial. The purpose of this study is to define the principle of airway management in burn patients with inhalation injury. SUBJECTS AND METHOD: A retrospective study was performed on 177 burn patients with inhalation injury who were admitted to Hangang Sacred Heart Hospital at Hallym University Medical Center from July 2002 to June 2005. RESULTS: Severty-seven patients underwent mask O2 supply for initial airway management. A total of 77 patients survived. One hundred patients underwent endotracheal intubation for initial airway management. Of these, 42 patients underwent tracheotomy after endotracheal intubation. A total of 42 patients reported abnormal chest X-ray findings. Of these, 10 patients survived and had significant improvement in PaO2/FiO2 ratios within 3 days following tracheotomy. CONCLUSION: In most cases, laryngotracheal edema subsides within 72 hours, permitting short periods of airway management. Deterioration of respiratory function permits prolonged intubation and ventilator support. Although tracheotomy does not improve general condition, it offers some advantages in terms of pulmonary toilet, patient comfort and airway security. If patients show deterioration of respiratory function, tracheotomy should be performed earlier.

Motor Innervation of the Trapezius Muscle: The Intraoperative Motor Conduction Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In radical neck dissection, sacrifice of the spinal accessory nerve creates a definite deficit of the shoulder function. To demonstrate the presence of motor input from the spinal accessory and the cervical plexus to the trapezius muscle, intra-operative motor nerve conduction study was performed. SUBJECTS AND METHOD: Twenty-four patients were studied on completion of the operation. In each patient, the entire length of the spinal accessory nerve, the upper cervical plexus and some cervical plexus branches running to the trapezius were preserved independently. Compound muscle action potentials were measured for each part of the trapezius muscle on stimulation of the spinal accessory, C2, C3 and C4 nerves. RESULTS: By stimulating the spinal nerve, evoked responses were obtained from all 24 patients in the upper, middle and lower trapezius. C2 contributions were seen in 2 out of 24 patients, supplying all three parts of the muscle in 0. C3 contributions were seen in 11 out of 24 patients, supplying all three parts of the muscle in 8. C4 contributions were seen in 20 out of 24 patients, supplying all three parts of the muscle in 16. CONCLUSION: The spinal accessory nerve provides the most important and consistent motor input and C2, C3 and C4 also provide motor input to the trapezius muscle. But they were not consistently present and did not innervate all three parts of the trapezius muscle. Compared with other studies, it is interesting to note that C4 gives more consistent motor input to the trapezius muscle than other cervical branches.

Transoral Adenoidectomy with the Microdebrider under Transnasal Endoscopy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although there have been various methods to remove adenoid, it is still difficult to achieve complete adenoidectomy due to its unfavorable anatomic structure. The aim of this study was to introduce transoral adenoidectomy using a microdebrider under transnasal endoscopy and to evaluate its efficacy. MATERIALS AND METHOD: The subjects consisted of 80 patients with adenoid vegetation. Among them, 40 patients underwent adenoidectomy using the microdebrider and other 40 cases were performed using the adenoid curette via transoral approach. Preoperative and postoperative lateral skull radiographs were obtained and compared. Also, the amount of intraoperative bleeding, complications, postoperative symptom score, and the duration of operation were compared. RESULTS: There were no statistical differences in the intraoperative bleeding, subjective symptoms after surgery and postoperative complications. But, patients, who had been performed adenoidectomy using the transoral debrider under transnasal endoscopy, had better outcomes in the nasopharyngeal ratio and the shortest nasopharyngeal diameter in lateral skull radiographs. CONCLUSION: Transoral adenoidectomy using the microdebrider under transnasal endoscopy is an effective method for more complete adenoidectomy.

Expression of the Matrix Metalloproteinase-2/9 and Tissue Inhibitor of Metalloproteinase-2 Proteins with Heterozygosity of p53 Gene in Thyroid Tumors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mutations or overexpression of the p53 gene is believed to play an important role in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP) initiates the degradation of the extracellular matrix and consequently may play a role in the process of tumor invasion and metastasis. Although MMPs are known to be expressed in a variety of tissues and molecular studies in malignant tumor have shown the high frequency of loss of heterozygosity (LOH) in some specific regions, the study on the MMPs expression along with LOH on p53 gene related to clinicopathological parameters in thyroid tumors is very rare. MATERIALS AND METHOD: In this study, we examined the MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP) -2 expression in association with p53 gene LOH using immunohistochemical method and molecular polymorphic analysis in 100 cases of thyroid tumors (50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasias). LOH was examined at four p53 gene related microsatellite loci including TP53, D17S796, D17S5, D17S513. RESULTS: By immunohistochemistry, MMP-2 expression was detected in 37 (74%) papillary carcinomas, 4 (40%) follicular carcinomas, 5 (25%) follicular adenomas and 2 (10%) nodular hyperplasia cases. MMP-9 expression was detected in 35 (70%) papillary carcinomas, 4 (40%) follicular carcinomas, 4 (20%) follicular adenomas and 2 (10%) nodular hyperplasia cases. TIMP-2 expression was detected in 32 (64%) papillary carcinomas, 4 (40%) follicular carcinomas, 4 (20%) follicular adenomas and 1 (5%) nodular hyperplasia cases. By PCR-polymorphism study, p53 LOH was detected in 31 (62%) papillary carcinomas, 8 (80%) follicular carcinomas, 6 (30%) follicular adenomas and 0 (0%) nodular hyperplasia cases. The differences in MMP-2, MMP-9 and TIMP-2 expression rates and p53 LOH between malignant and benign tumors were statistically significant. Also, MMP-2, MMP-9, TIMP-2 expression and p53 LOH correlated well with higher tumor histologic grade. Also statistically significant correlation was found between p53 LOH and lymph node metastasis. The MMP-2 expression showed increased tendency of lymphatic emboli formation and lymph node metastasis, but there was not statistically significant. MMP-2 expression was well correlated with MMP-9 expression and p53 LOH, but there is no remarkable correlation of expression of MMP-2 and MMP-9 comparable to TIMP-2 expression. CONCLUSION: We concluded that the expression of MMP-2, MMP-9 and TIMP-2 with p53 LOH may contribute to the malignant transformation and poorly differentiated grade in thyroid tumors. Also, MMP-2 expression may be regulated by p53 gene.

A Case of Spindle Cell Carcinoma of Larynx / 대한이비인후과학회지

Spindle cell carcinoma is a rare variant of squamous cell carcinoma characterized histologically by a biphasic pattern with both squamous and spindle cell component. There is controversy in the histogenesis, biologic behavior, optimal treatment and prognostic factor for tumor. Treatment must be similar for squamous cell carcinoma. With a review of literature, we report a case of a 61-year-old male with spindle cell carcinoma in the larynx, which has been managed by wide excision of tumor and postoperative radiotherapy.

A Clinical Analysis of Recurrent Respiratory Papillomatosis and Detection of Human Papilloma Virus Using Polymerase Chain Reaction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recurrent laryngeal papillomatosis (RRP) have been divided into juvenile or aggressive forms, and adult or non-aggressive forms. This study attempted to characterize these two forms of RRP in our series and to detect human papilloma virus (HPV) using polymerase chain reaction (PCR). MATERIALS AND METHOD: Authors reviewed the records of 60 patients treated for RRP over a 16-year period from 1983 to 1999 at the Department of otolaryngology, Pusan National University Hospital. Clinical parameters included sex, age, chief complains, location and type of lesion, tracheotomy state, number of operation, aggressiveness, outcome of treatment and complications after operation. Twenty-three paraffinembedded tissues were selected to PCR using type-specific primer pairs. RESULTS: 1) Subglottic extension, tracheotomy, time of operation and aggressiveness were more common in juvenile form than the adult form. 2) The multiple type was also common in the adult form. 3) Non-aggressive and single types showed better response for treatment. 4) There are no significant differences of cure rate according to age and treatment modality, but preoperative alpha-interferon therapy showed more effective in the case of compromised airway. 5) HPV type 6, 11 in 10 cases(43.5%) were detected out of 23 cases. Most detected cases were non-improvement group. CONCLUSION: The significant difference of treatment results are found in comparison between aggressive and non-aggressive forms and alpha-interferon may be an effective therapy for aggressive respiratory papillomatosis. HPV subtype may be related to the prognosis factor.

Clinical Efficiency of Adenoidectomy Using Microdebrider / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Remnant adenoid tissue after adenoidectomy or immoderate procedure result in various complications such as bleeding, damage to the mucosa of posterior nasopharyngeal wall or orifice of Eustachian tube. The purpose of this paper is to compare conventional adenoidectomy with microdebrider-assisted adenoidectomy based on postoperative outcome and intraoperative effectiveness. MATERIALS AND METHOD: We performed a prospective study comparing thirty cases of adenoidectomy using conventional approach with fifteen cases of transoral microdebrider adenoidectomy using an indirect laryngeal mirror. Skull lateral radiographs and a symptom scale were used to evaluate preoperative and postoperative states. RESULTS: There was no significant difference in the improvement of symptoms and postoperative outcome between the conventional group and the microdebrider adenoidectomy group. However, it was found that more adenoid tissue could be removed in the microdebrider group. Postoperative nasopharyngeal endoscopic views revealed that microdebrider removed adenoid tissue precisely and preserved the posterior nasopharyngeal wall better when compared to the conventional group. CONCLUSION: Compared with the conventional procedure, adenoidectomy using the transoral microdebrider with an indirect laryngeal mirror was similar in achieving symptom improvement and postoperative outcomes, but removed more adenoid tissue with higher precision. From this study, we suggest that using microdebrider with indirect laryngeal mirror is another valuable method of adenoidectomy in the aspect of precision.

Expression of Vascular Endothelial Growth Factor and Platelet-Derived Endothelial Cell Growth Factor in Head and Neck Squamous Cell Carcinoma and It's Relation to Angiogensis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tumor angiogenesis is an essential process required for growth and metastasis in cancer. Vascular endothelial growth Factor (VEGF) and platelet-derived endothelial cell growth factor (PD-ECGF) are known to be angiogenetic factors. The objectives of this study were to measure the expression of VEGF, PD-ECGF and microvessel density (MVD) in head and neck squamous cell carcinoma (HNSCC) and compare them to normal larynx. We also evaluated relationships of VEGF, PD-ECGF and MVD to clinicopathologic findings in HNSCC. MATERIAL AND METHODS: The expression of VEGF, PD-ECGF and MVD were evaluated by immunohistochemical staining of 26 cases of HNSCC and 6 cases of normal larynx. RESULTS: The expressions of VEGF, PD-ECGF and MVD in HNSCC were significantly higher than in the normal control (p<0.05). MVD were significantly correlated with VEGF and PD-ECGF expressions in HNSCC (p<0.05). The VEGF, PD-ECGF expression and MVD correlated with many clinicopathologic findings in HNSCC. CONCLUSION: These results suggest that VEGF and PD-ECGF are involved in angiogenesis and are related to clinicopathologic findings of HNSCC. Furthermore, we propose that expressions of VEGF, PD-ECGF and MVD to be investigated more in the future as prognostic indicators of HNSCC.

The Effect of All-Trans Retinoic Acid on Culture of Aural Cholesteatoma Keratinocytes / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Retinoids have recently become an interest to clinicians because of their ability to inhibit migration and proliferation of the premalignant squamous cells, while enhancing growth and proliferation of normal cells. Aural cholesteatoma is defined as the state of hyperproliferative keratinocytes in the middle ear cavity. An in vitro investigation was undertaken to determine whether all-trans retinoic acid (t-RA) exhibits an inhibitory effect on cholesteatoma cell proliferation. METHODS: Cholesteatoma tissue was obtained during a middle ear operation, and the explant was cultured on six well-plates in a culture medium of Medium M-154 (Cascade Biologics Inc., USA) for one week. T-RA was then treated with 10M, 10M, 10M, 10M concentrations, respectively. The cholesteatoma explant cultures were observed daily, and topographic maps were constructed weekly to quantify the proliferation area. The explant culture area was estimated by Multiscan. RESULTS: In the absence of t-RA, the cholesteatoma explant culture area reached 401.5mm in four weeks. But with the administration of t-RA, the cultured area decreased proportionally to t-RA concentrations which reduced to 224.0 mm, 94.4 mm respectively in four weeks with 10M, 10M concentration of t-RA (p<0.05). CONCLUSIONS: This investigation showed that t-RA has a significant inhibitory effect on cholesteatoma proliferation. These results suggest that retionoids may have a role in controlling cholesteatoma disease.

Fibroblast Heterogeneity of Nasal Polyps in Non-Allergic and Allergic Rhinitis

BACKGROUND & OBJECTIVES: Some components of ground substances are known to be involved in developing nasal polyp. The fibroblasts are a major component of the ground substances in nasal polyp and have many immunologic roles. Heterogeneity of fibroblasts has been observed in other anatomical sites including the nasal mucosa. The aim of this study was to investigate the heterogeneity of fibroblasts of nasal polyps in non-allergic rhinitis and allergic rhinitis. MATERIALS & METHODS: Using the third passage of the fibroblasts taken from polyps of allergic and non-allergic patients, we measured the proliferating potential by comparing the cell growth in the culture system of fibroblasts and calculated the doubling time of the cell growth. We also compared the proliferating potentials between the two groups after stimulation with histamine or IL-4. RESULTS: Morphologic differences were examined by transmission electron microscopy. In the non-stimulated experiment, proliferation of fibroblasts was increased in the non-allergic polyp group (NAPG). When the fibroblasts were stimulated with histamine, the proliferation was not significantly changed on day 6 in both groups. When the fibroblasts were stimulated with IL-4, the proliferation was significantly increased in NAPG. Morphologic differences were demonstrated between the NAPG and the APG. CONCLUSION: The differences in cell proliferation potentials and morphological changes between both groups suggest that there is a heterogeneity of fibroblasts between them.

The Prevalence of Otitis Media with Effusion among Kindergarten and Elementary School Children in Song Buk, Seoul, Korea and Risk Factors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is the most common bacterial infection and the most frequent otologic indication for antimicrobial or surgical therapy in young children. It is also the leading cause of hearing disturbance in children. There have been few reports about the prevalence rate of OME in preschool children in Seoul. So, we investigated the prevalence of OME among kindergarten and elementary children in Song Buk Gu, Seoul, Korea. MATERIAL AND METHODS: Tympanometry and pneumatic otoscopic examination were performed on 3,364 children aged 3-7 years, from March to June of 1999. RESULTS: A total of 11.74% of the subjects had unilateral or bilateral OME. The prevalence rate of OME in 3 year-old children was 30.0% and that of 7 year-old children was decreased to 8.9%. The prevalence rate in March was 18.5% and that in June decreased to 6.5%. The majority of the cases were free of subjective symptoms, but some of significant symptoms were ear fullness, otalgia, tendency to increase the TV volume and autophonia. CONCLUSION: Significant risk factors are seasonal variation, age and the history of OME. There should be more attention paid to OME in children aged 7 years and younger, because its high prevalence and less symptoms.

The Transforming Growth Factor-beta1 Expression in Normal Laryngeal Mucosa, Laryngeal Dysplasia and Laryngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Transforming growth factor-beta1 (TGF-beta1) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by TGF-beta1 plays important roles in neoplastic progression. So expression of TGF-beta1 has been described in several tumors, but little is known about the role of TGF-beta1 in neoplastic progression of human larynx. The aim of this study was to investigate the role of TGF-beta1 in the neoplastic progression of human larynx. MATERIALS AND METHODS: We evaluated the expression of TGF-beta1 using immunohistochemical study in 6 cases of normal laryngeal mucosa, 6 cases of laryngeal dysplasia, 20 cases of laryngeal carcinoma. RESULTS: The results were as follows: 1) Normal laryngeal mucosa has no expression of TGF-beta1. 2) The expression of TGF-beta was 16.7% in laryngeal dysplasia, 50.0% in laryngeal carcinoma. CONCLUSION: The TGF-beta1 expression rate was correlated to the progression of laryngeal lesions when compared to normal laryngeal mucosa, laryngeal dysplasia and laryngeal carcinoma.

Allergic Rhinitis to Japanese Cedar in Cheju Island / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Abundance of Japanese cedars (JC) in Cheju Island has caused some of the island's residents to suffer from severe allergic symptom in the spring time. This study was carried out to verify the presence of JC allergic rhinitis (AR) in the island. Materials and Method: We performed a history survey, skin testing and nasal provocation test to JC and other common allergens for 170 residents who have symptom of AR. We also performed the same tests in 18 Japanese who had history of AR to JC and have lived in Korea more than 3 years. And as a control, skin tests were performed for 581 patients who live in Seoul. RESULTS: Positive reactions to JC were seen in 22.4% of the resident group. The prevalence rate was remarkable in the state capital of Cheju. These reactions were associated with conjunctivitis, dermatitis, asthma and food allergy. All the 18 Japanese patients were sensitive to JC. However, the allergic symptoms disappeared within 1 year after the move to Korea. And there were no patients sensitive to JC in the control subjects. Conclusions: We confirmed the presence of AR of JC in Cheju island. The distribution is comparatively coincided with JC and/or air pollution and this result indicate that environmental factors can be involved in the manifestation of the disease.

A Case of Relapsing Polychondritis Developed in Both Auricles / 대한이비인후과학회지

Relapsing polychondritis is a rare disease of unknown etiology. The disease is an immune disorder probably caused by autoimmunity. The characteristics are episodic with progressive inflammation of the cartilages of the body, most often of the ears, nose, costochondral junctions, joints, airway and cardiovascular system. Authors have recently experienced a case of relapsing polychondritis in a 28 year old man who had recurrent chondritis of both auricles. He did not have other involvement. The pathologic finding to the diagnosis was presented. We report this case with a review of the literature.