A Case of Malignant Fibrous Histiocytoma of the Pterygopalatine Fossa / 대한이비인후과학회지

Although there are some reports of malignant fibrous histiocytoma arising from the head and neck region, there has been no reports on the case originating from pterygopalatine fossa. We experienced a case of 29-year old male patient who visited our hospital with complaints of trismus, periorbital swelling and altered sensation on the left zygomatic area. On physical examination, he showed hypertrophic left middle turbinate, retracted ear drum, and swollen posterior wall of the nasopharynx. On computed tomography, he also showed a low density lesion originating from pterygopalatine fossa. Based on these findings, he was diagnosed with malignant fibrous histiocytoma originating from pterygopalatine fossa. and underwent radical maxillectomy, marginal mandibulectomy, radical neck dissection, and tracheotomy.

Rate of Synthesis and Degradation of Lysozyme Protein by Retinoic Acid in Normal Human Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We considered two possible mechanisms that might be responsible for the increased accumulation of lysozyme in retinoic acid (RA)-deficient cultures, either increased lysozyme synthesis or decreased lysozyme degradation based on our previous data. This study was to determine whether the synthesis and decay rate of intracellular lysozyme in RA-sufficient cultures are different from those in RA-deficient cultures. MATERIALS AND METHOD: Passage-2 normal human airway epithelial cells were used. For synthesis rate of lysozyme, day 10 RA-deficient and RA-sufficient cultures, incubated over 6 hour period with 35S-methionine-cysteine and cell lysates, were collected. For decay rate, day 10 cultures grown in the presence or absence of RA were labeled with 35S-methionine-cysteine for 4 hours and the labeling media were then removed. Cell extracts were collected over 8 hours. Newly synthesized or labeled lysozyme was immunoprecipitated with anti-lysozyme antibody and separated by SDS-PAGE. RESULTS: Lysozyme synthesis rate in RA-sufficient cultures was higher than in RA-deficient cultures. In the RA-deficient cultures, the levels of newly synthesized lysozyme barely changed over the 8 hour post-labeling period. In contrast, in the RA-sufficient cultures, radiolabeled lysozyme levels decreased rapidly during the 8 hour post-labeling period, with a half-life of approximately 6 hours. CONCLUSION: Discrepancy in mRNA and protein of lysozyme in RA-deficient cultures is due to the increased stability of lysozyme protein in RA-deficient cultures.

Occult Neck Metastasis in Larynx and Hypopharynx Squamous Cell Carcinomas Confirmed with Simultaneous Bilateral Elective Neck Dissection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Neck metastasis is one of the most important prognostic factor in treating head and neck squamous cell carcinomas. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. However, occult metastasis rate confirmed with simultaneous bilateral elective dissection is rare. MATERIALS AND METHODS: Fifty patients (100 necks) who underwent surgery for laryngeal and hypopharyngeal squamous cell carcinomas as an initial treatment from 1992 to 1997 were evaluated. All had bilateral elective neck dissection at the time of surgery for the primary treatment. Charts and pathologic reports were reviewed. RESULT: Occult neck metastasis rate by primary site were as follows. Supraglottis ipsilateral 40% (8/20) contralateral 15% (3/20), glottis ipsilateral 18% (4/22), contralateral 0% (0/22), hypopharynx ipsilateral 88% (7/8), contralateral 25% (2/8). CONCLUSION: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Contralateral neck occult metastasis from glottic cancer was minimal.

Regulation of Mucin and Non-Mucin Secretions and Gene Expression by Triiodothyronine and Collagen Gel in Human Airway Epithelium / 대한이비인후과학회지

BACKGROUND AND OBJECTS: We have been interested in elucidating the role of hormones and growth factors in regulating differentiation and mucin and non-mucin secretions. Our purpose is to investigate the effects of each supplement contained in the culture medium for mucin and non-mucin secretions. MATERIALS AND METHODS: Individual factors were removed from the culture media of normal human tracheobronchial epithelial (NHTBE) cells grown in air-liquid interface cultures. The effects on the cell phenotype, mucin, lysozyme (LZ), and secretory leukocyte protease inhibitor (SLPI) secretion and gene expression were examined. RESULTS: Deletion of hydrocortisone, epinephrine, transferrin or amphotericin-gentamycin from the media had no reproducible effects; Deletion of insulin was incompatible with culture growth. Removal of triiodothyronine selectively increased mucin secretion, but did not affect the gene expression. However, MUC5AC mRNA levels were reproducibly increased, suggesting that the expressions of these two mucin genes were differentially regulated. LZ and SLPI secretion levels were not significantly affected by the deletion of triiodothyronine from the culture media. The LZ mRNA levels were increased in the absence of triiodothyronine whereas the SLPI transcript levels were not affected. Omission of the attachment substratum and the type 1 collagen gel resulted in a significant increase in all 3 secretory products. MUC2 and MUC5AC steady state mRNA levels were not consistently affected. In contrast, LZ and SLPI gene expressions were reproducibly increased. CONCLUSION: This study shows that individual factors in the epithelial environment can regulate the expression of specific secretory cell gene products in a highly selective manner.

A Case of Acute Labyrinthine Infarction by Vertebrobasilar Insufficiency / 대한이비인후과학회지

Acute labyrinthine infarction due to vertebrobasilar insufficiency results in acute vestibular and cochlear functional loss. It is very difficult to differentiate acute labyrinthine infarction from acute viral labyrinthitis, vestibulocochlear neuritis and sudden sensorineural hearing loss. Because its definite diagnosis criteria has not been yet established and confirmative diagnosis tool is limited, the diagnosis and appropriate treatment is more difficult. It is often misdiagnosed as a peripheral vestibular disorder because its clinical symptom is usually a form of dizzy attack with hearing impairment. We experienced a case of acute labyrinthine infarction due to vertebrobasilar insufficiency. We differentiated it from acute labyrinthitis and vestibulocochlear neuritis using ENG and diagnosed it by means of periodic ENG follow-up. Confirmative diagnosis was made by means of MR angiography. MR angiography shows non-opacification of right vertebral artery and focal stenosis of right basilar artery. We treated this patient with 500,000 unit of urokinase per day for 5 days and observed recovery of impaired vestibular and cochlear function.

Streptomycin Perfusion through the Round Window in Meniere's Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many local application methods have been developed for preventing vertigo attacks while preserving hearing loss. Among them, ototoxicity of aminoglycosides has been used for the treatment of Meniere's disease. The etiology and pathophysiology of Meniere's disease remain unknown, however, intratympanic aminoglycoside infiltration has proved to be a very effective treatment method for Meniere's disease. Therefore, currently, variable modalities of intratympanic aminoglycoside inflitration have been attempted in patients with Meniere's disease. We attempted to evaluate streptomycin perfusion for the control of vertigo with the preservation of hearing in patients with Meniere's disease. MATERIALS AND METHODS: Streptomycin powder was administered by filling up the round window niches in 15 patients with menere's disease from 1993 to 1996. Transmeatal approach was used for this technique and streptomycin infiltration was conducted for three consecutive days until patients developed spontaneous nystagmus or dizziness. RESULTS: 13 (83%) patients had no episodes of vertigo, and 2 patients had decreased vertigo attack. The preservation or improvement of hearing was reported in 87% of the patients. We observed that tinnitus disappeared in 33.3% of patients, and ear fullness in 40% of patient. After the operation, all of the patients reported to have no problems in daily activity. CONCLUSION: The streptomycin perfusion is a safe and simple procedure that is effective in controlling the vertigo, tinnitus and earfullness; however, futher further studies must be done on the preservation of hearing.