A Case of Nonfunctioning Parathyroid Carcinoma / 대한이비인후과학회지

Parathyroid carcinoma is an uncommon endocrine tumor. Its usual clinical presentation is that of primary hyperparathyroidism with elevated serum calcium and parathyroid hormone levels. Nonfunctioning carcinoma of the parathyroid gland with normal serum calcium levels is very rare and more aggressive. Histologically, the neoplastic cells may be of variable size and shape but are usually uniform and not too dissimilar from normal parathyroid cells. There is a general agreement that a diagnosis of carcinoma based on cytologic detail is unreliable, and local invasion and metastasis constitute the only reliable criteria of malignancy. In both functional and nonfunctional carcinoma, early surgery has proven to be the only curative treatment approach whereas both chemotherapy and radiation therapy fail to produce systemic or regional benefit when used alone. En bloc excision of primary lesion with removal of any involved structures should be performed. This paper is a case report of a nonfunctioning parathyroid carcinoma and a review of the literature.

Expression of Human b-Defensin-1 mRNA in Human Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES:Antimicrobial peptides are cationic proteins that are found in a wide range of organisms. Recent reports suggest that human beta-defensin-1 (hBD-1), a prominent group of antimicrobial peptides, is an important component of the innate immune response, particularly at mucosal surfaces that are vulnerable to colonization by potential pathogens. Therefore, hBD-1 may participate in providing intrinsic nasal mucosal defense against microbial infections. The present study aimed to look for hBD-1 mRNA in apparently normal human nasal mucosa. MATERIALS AND METHODS: The expression of hBD-1 mRNA was investigated in the inferior turbinate tissues using reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization. RESULTS: The expression of hBD-1 mRNA was detected in these tissues. By in situ hybridization, hBD-1 mRNA was predominantly localized in superficial epithelial cells and submucosal glandular epithelium. CONCLUSION: These data suggest that nasal epithelia and submucosal glands may secrete hBD-1 and thus contribute to the mucosal defense of the nose.

Distribution Analysis of Goblet Cells in Atrophic Rhinitis and Rhinitis Sicca with Special Reference to Impression Cytology Findings / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The goblet cells secrete mucus in response to a wide variety of stimuli, playing an important role on increased nasal secretion. One of the main symptoms and signs in atrophic rhinitis and rhinitis sicca is a crust formation that fill up the nasal cavity, obstructing the nasal cavity. It has been suggested to be caused by mucosal atrophy and decreased nasal secretion. Nevertheless, distribution of goblet cells in both rhinitis has not been evaluated in the whole surface of inferior turbinate. The present study was to investigate the distribution density of goblet cells in the inferior turbinate of both rhinitis patients. MATERIALS AND METHODS: Impression cytology, using nitroscellulose membrane, was performed in inferior turbinates of normal control, rhinitis sicca and atrophic rhinitis patients. The membrane was fixed in the fixative and then stained with Alcian Blue. RESULTS: The membrane stained with Alcian Blue defined the whole distribution of goblet cells which was present in the medial surface of the inferior turbinate. In normal nasal turbinates, goblet cells were evenly distributed, and did not differ in their distribution density. In rhinitis sicca, goblet cells were irregularly distributed, showing a moth-eaten appearance in the anterior and mid-portion, whereas they gained the same distribution as the normal turbinate for the posterior portion. Atrophic rhinitis had a few number of goblet cells even in the mid-and posterior portion of the inferior turbinate. CONCLUSION: Impression cytology proves to be a reliable and efficient method for the evaluation of goblet cells distributed in the inferior turbinates. The present study demonstrated that goblet cells decreased in their number in inferior turbinates of both rhinitis, suggesting their major role in decreased nasal secretion.

The Ten Cases of Recurrent Pleomorphic Adenoma of Parotid Gland / 대한이비인후과학회지

BACKGROUND: The main cause of recurrent pleomorphic adenoma of the parotid gland is known to be incomplete surgical excision or accidental rupture of tumor pseudocapsule during surgery, which results in spillage of tumor cells into the wound. Recurrent pleomorphic adenoma of the parotid gland warrants consideration since there is a potential for the risk of malignant conversion. OBJECTIVES: We investigated clinical characteristics of recurrent pleomorphic adenoma of the parotid gland and analyzed the results of the treatment to establish surgical management modalities. MATERIALS AND METHODS: We examined retrospectively 10 cases of recurrent pleomorphic adenoma of the parotid gland and reviewed their clinical features, histopathologic findings, operative findings and postoperative outcomes. Six cases were female and four were male with the mean age of 45.8 years at the time of treatment. The average follow up period was six years and three months. RESULTS: Primary treatments included mass enucleation in seven cases and superficial parotidectomy in three cases. We performed total parotidectomy via anterior approach for all cases and limited neck dissection on level II was performed for six cases in whom the tumor spread was suspected. No patient experienced permanent facial nerve paralysis and tumor recurrence postoperatively except for two patients who died of lung metastasis despite radical tumor extiration and radiotherapy. CONCLUSION: Recurrent pleomorphic adenoma of the parotid gland is largely dependent on primary treatment. Recurrent tumors usually have multiple lesions, therefore total parotidectomy with limited neck dissection should be combined as a treatment modality and always been in mind the possibility of malignant conversion.