Multiple Primary Malignancies in the Head and Neck: A Clinical Review of 70 Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recent advances in medical management, along with increased life span, have contributed to the increased opportunity for detecting multiple primary malignancy (MPM). The purpose of this study was to evaluate the incidence and clinical characteristics of MPM in the head and neck region. SUBJECTS AND METHOD: We reviewed retrospectively the medical records of 984 patients with malignant tumors of head and neck who had been diagnosed histopathologically and treated between August 1985 to July 2005. RESULTS: Seventy patients (7.11%) were diagnosed as having MPM (double, n=66 ; triple, n=4). This group consisted of 67 men and 3 women (p<0.01). Twenty-five patients (36%) had synchronous double primary malignancy (SDPM) and 45 patients (64%) had metachronous double primary malignancy (MDPM). The hypopharynx was the most frequently involved site of the index tumor. The most common index tumors were squamous cell carcinoma histopathologically. Second primary malignancies were found in esophagus, stomach and lung. Fifty-five patients were found with first primary malignancy in head and neck, and 25 were with second primary malignancy. The patients with first and second primary malignancy in head and neck were 10 cases. The prognosis of SDPM (average of survival 11.1 months) was very poor. Patients with MPM have high cigarettes smoking and alcohol drinking habit. CONCLUSION: Patients with head and neck malignancies will require careful follow up for prevention, early detection, and the treatment of second primary malignancy.

Effect of Macrolide on the MUC4 Gene Expression in Human Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mucin gene expression and mucin secretion are highly increased by inflammatory airway diseases such as asthma, chronic bronchitis and rhinosinusitis. Macrolide antibiotics is considered one of the effective drugs inhibiting mucus secretion for chronic bronchitis and rhinosinusitis with nasal polyp. However, the anti-secretory effect of macrolide is not clear. This study was designed to investigate whether macrolide can suppress interleukin-1beta (IL-1beta)-induced MUC4 gene expression and mucin secretion in the cultured human nasal polyp epithelial cells and NCI-H292 epithelial cells. SUBJECTS AND METHOD: Nasal polyps were obtained from 20 patients with chronic rhinosinusitis with nasal polyp during endoscopic sinus surgery. We observed the effect of roxithromycin on the IL-1beta-induced MUC4 gene and mucin secretion by reverse transcriptase-polymerase chain reaction (RT-PCR) with enzyme-linked immunosorbent assay (ELISA) method. RESULTS: Roxithromycin attenuated the IL-1beta-induced MUC4 mRNA expression and mucin secretion with a dose dependent pattern in both of the cultured human nasal polyp epithelial cells and NCI-H292 epithelial cells. CONCLUSION: This result suggests that roxithromycin may be considered as an effective anti-hypersecretory agent for its down-regulation of the MUC4 gene.

A Study for the Effect of Stellate Ganglion Block on Herpes Zoster Oticus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Facial palsy of herpes zoster oticus has rapid onset, is usually severe in degree, and poorer in prognosis than Bell's palsy. In the past, herpes zoster oticus has usually been treated with acyclovir and steroid, but recently, applying stellate ganglion block for herpes zoster oticus has been recognized as an additional treatment that may improve facial palsy. This study was designed to evaluate the effect of stellate ganglion block on herpes zoster oticus. Subjects and METHOD : We reviewed retrospectively the medical records of 30 patients with herpes zoster oticus who were treated with acyclovir, steroid and stellate ganglion block between January 1995 and December 2004. The follow-up period was at least over than 6 months. RESULTS : All patients suffered from otalgia, vesicle, and facial palsy. The average degree of House-Brackmann classification on admission was 3.26 in the complete recovery patients and 4.61 in the incomplete recovery patients. Seventeen patients were completely recovered from facial palsy (56.7%), and 13 showed residual facial palsy 13 patients(43.3%). The poor prognosis may be related with early onset of facial palsy, high degree of House-Brackmann classification on admission and high degenerative ratio on electroneurography of facial nerve. CONCLUSION : The additional treatment of stellate ganglion block in herpes zoster oticus may not be effective on improving the complete recovery rate and prognosis.

Evaluation of Computed Tomography and Magnetic Resonance Imaging of Sinonasal Inverted Papilloma / 영남의대학술지

BACKGROUND: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.