Tonsillar Squamous Cell Carcinoma Associated with Dermatomyositis: The First 2 Cases in Korea

Dermatomyositis (DM) is an autoimmune disorder with idiopathic myopathy and characteristic skin manifestations that one often accompanied by an internal malignancy. The association between dermatomyositis and malignancy has been reported several times, although tonsillar carcinoma is extremely rare not only in far eastern populations but also in caucasian populations. We report two cases of Korean patients with dermatomyositis associated with tonsillar carcinoma.

Toll-like Receptors 2 and 4 and Their Mutations in Patients with Otitis Media and Middle Ear Effusion

OBJECTIVES: Toll-like receptors (TLRs) detect microbial infections and they can directly induce innate host defense responses. TLR 2 has been shown to be primarily involved in the recognition of peptidoglycans and lipoteichoic acid of gram positive bacteria. TLR 4 recognizes lipopolysaccharides and lipoteichoic acids from both gram-negative and gram-positive bacteria. Both mutations lead a reduced capacity to elicit inflammation and they increase the risk for gram-positive and negative infections. This study was performed to investigate the expressions of TLR 2 and 4 and their mutations in patients suffering with otitis media and middle ear effusion. METHODS: Middle ear fluid samples were collected from 40 otitis media effusion (OME) patients who had ventilating tubesinserted. Bacteria in the effusion fluid were detected by standard bacterial culture. The secreted IgG, IgA and IgM were measured by Enzyme-linked immunosorbent assay. TLR 2 and 4 were assessed by performing RT-PCR. The genomic DNA from each patient was isolated from the middle ear fluid samples that were collected from 60 OME patients, and the presence of mutations was determined by performing restriction digestion and DNA sequencing analysis. RESULTS: Among the 40 middle ear fluid samples, bacteria were detected in 13 middle ear fluid samples. The amounts of IgM, IgA, and IgG were 151.20+/-60.94 ng/mL, 21.59+/-7.96 ng/mL and 11.55+/-16.98 ng/mL, respectively. TLR 2 and 4 were expressed in the middle ear fluid and the expression of TLR 2 was higher than that of TLR 4. However, there was no correlation between the expressions of TLR 2 and 4, and the concentration of immunoglobulin or the presence of bacteria (P>0.05). There ware no mutations of TLR 2 (Arg753Gln, Arg677Trp) and TLR 4 (Asp299Gly, Thr399Ile). CONCLUSION: TLR 2 and 4 were expressed in all the middle ear fluid samples of OME, but the mutations of TLR 2 and 4 were not detected. TLR 2 and 4 may play a vital role in the immunological responses of patients with OME.

The Short Stature in Children with Hypertrophy of Adenoid and Tonsil or Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There is little data to indicate that hypertrophy of adenoid and tonsil may cause short stature. However, there is no data relating short stature to allergic rhinitis in the Korean population. The aim of this study was to investigate the effect of hypertrophy of adenoid and tonsil and allergic rhinitis on children with short stature. SUBJECTS AND METHOD: One hundred and ninety-one children were included in the disease group, which consisted of three groups, allergic rhinitis only (n=83), hypertrophy of adenoid and tonsil only (n=67), and combintorial of allergic rhinitis and hypertrophy of adenoid and tonsil (n=41). There were 174 pediatric patients in the control group. Growth hormone levels, thyroid function and both wrist X-rays were checked on the children with short stature in order to exclude other chief medical problems causing short stature. For the purpose of evaluating the relationship between short stature and clinical factors, allergy parameters, eosinophil partition rate and total IgE levels were checked in the allergic rhinitis group, and the size of the adenoid and tonsil were checked in the adenoid and tonsil hypertrophy group. The relationship between the incidence of short stature and above clinical factors was evaluated. RESULTS: The incidence of short stature was significantly higher in each disease group than in the control. However, there was no statistically significant differences between each disease group. The above clinical factors were not associated with short stature. CONCLUSION: Hypertrophy in adenoid and tonsil and allergic rhinitis might be an independent cause of short stature.

A Case of Malignant Fibrous Histiocytoma on Nasal Dorsum / 대한이비인후과학회지

Soft tissue sarcoma of the head and neck is a rare and heterogenous group of malignant tumors. Especially, adult soft tissue sarcomas occur rarely in nasal cavity and paranasal sinus. They are, when poorly differentiated, termed as pleomorphic sarcoma, spindle cell sarcoma, or malignant fibrous histiocytoma (MFH) like tumor. The main stay of the treatment of adult soft tissue sarcomas is surgical resection with negative margin. Tumor grade, tumor size and extension of local infiltration are recognized prognostic factors, but classification of histologic type appears to have less prognostic significance. In case of uncontrolled locoregional disease, it often results in death due to intracranial extension. We report a case of a 68-year-old female with locoregional high grade pleomorphic sarcoma in the nasal cavity. This tumor was managed by wide local excision of tumor with negative margin.