Effect of Triptolide and Cisplatin Combination on Apoptosis in AMC-HN4 Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cisplatin (CP) is a widely used agent for chemotherapy of head and neck squamous cell carcinoma but some tumor cell shows resistance to CP. Accordingly, it is necessary to seek a method to increase the sensitivity of tumor cell to CP. This study was conducted to investigate whether Triptolide (TP) is effective in the inhibition of proliferating head and neck cancer cell and sensitizes cancer cells to CP. MATERIALS AND METHOD: To assess how the combination of TP and CP influence apoptosis of head and neck cancer cell, AMC-HN4 cells were treated with different concentrations of TP and/or CP. Then, their growth was analyzed by XTT assay and the degree of apoptosis was analyzed by flow cytometry. RESULTS: The combination of TP and CP increased suppression of the growth of tumor cells more significantly and enhanced apoptosis more than that of TP or CP alone, and suppressed expression of anti-apoptotic protein. CONCLUSION: This study showed that TP alone had antitumor activity in AMC-HN4 cells, and the combination of TP or CP also might sensitize head and neck cancer cell to CP by suppressing the expression of antiapoptotic protein.

Effect of Topical Antibiotics to Mouse Model of Acute Rhinosinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Administration of antibiotics is an essential modality to treat acute rhinosinusitis. Although intranasal inoculation of antibiotics does not have definite bioavailability, it is a very effective method to treat acute rhinosinusitis. We made a mouse model of rhinosinusitis by inoculation of Streptococcus pneumoniae and administrated time-dependent antibiotics or concentration-dependent antibiotics as a topical manner and investigated their effectiveness. SUBJECTS AND METHOD : Fifty 10-week old male C57BL/6 mice were employed for acute rhinosinusitis model. Mice were inoculated with Streptococcus pneumoniae, and from the 6th to 10th day, we made the negative control group by inoculation of normal saline (Group I), the antibiotics group by inoculation of cefmenoxime & vancomycin (Group II), the ofloxacin & tobramycin group (Group III), and the positive control group (Group IV). On the 11th day, all mice were sacrificed and the effectiveness of antibiotics was evaluated by comparison of nasal lavage colony count and neutrophil count of the sinonasal tissue. RESULTS : Minimum bactericidal concentration (MBC) of each antibiotics was cefmenoxime 20 microgram/ml, ofloxacin 80 microgram/ml, tobramycin 25 microgram/ml, vancomycin 12.5 microgram/ml. By nasal lavage, antibiotics inoculation group (Group II, III) had more decreased bacterial growth than the positive control, and it was statistically significant (p=0.037). Comparision between the group administrated with concentration-dependent antibiotics and time-dependent antibiotics, clusters of neutrophil decreased in two groups compared to positive control revealed that the group administered with concentration-dependent antibiotics had fewer clusters of neutrophil than the group administered with time-dependent antibiotics, and it was statistically significant. CONCLUSION : Local inoculation of concentration dependent antibiotics could be a more effective way to treat acute rhinosinusitis induced by Streptococcus pneumoniae than time dependent antibiotics.

A Mouse Model of Chronic Rhinosinusitis Induced by Streptococcus Pneumoniae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A mouse has a great potential to be used in studying genetics and inflammatory process of the rhinosinusitis. The aim of this study was to observe effects of experimentally induced chronic rhinosinusitis on histopathology of the sinonasal mucosa in a mouse and to develop a chronic form of rhinosinusitis. MATERIALS AND METHOD: Thirty five, six-week old male C57BL/6 mice were used as follows: 7 normal controls without intervention, 7 Sham operated controls, 7 animals with ostial obstruction alone using Merocel, 7 animals implanted with Merocel plus 106 colony forming unit (CFU)/mL of Streptococcus pneumoniae and 7 animals implanted with Merocel plus 10(8) CFU/mL of S. pneumoniae. Six weeks after intervention, the animals were sacrificed and serially sectioned at 1 mm intervals and stained with Hematoxylin and Eosin. RESULTS: Increased epithelial thickness, goblet cell hyperplasia, epithelial disarray and inflammatory infiltration were observed in the experimental sinuses packed with Merocel alone or Merocel with bacterial inoculation, especially at the nasal septal area. However, there were no significant differences between the Merocel only inserted group and Merocel and bacteria inoculated group. CONCLUSION: Maxillary sinus ostial obstruction or ostial obstruction with S. pneumoniae inoculation induced chronic rhinosinusitis in C57BL/6 mice as indicated by the histologic change. This study could be used as a model of chronic rhinosinusitis for further study.

The Relationship between Modified Mallampati Grade, Tonsillar Grade and Apnea-Hypopnea Index / 수면정신생리

OBJECTIVES: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. METHODS: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI) : control (n=24), and patients with sleep apnea (n=70). RESULTS: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p< 0.05) CONCLUSION: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.

Continuous infusion of 5-FU and Leucovorin mixture (LF) for metastatic gastric cancer refractory to prior 5-FU bolus regimen / 대한내과학회지

BACKGROUND: Most patients with gastric cancer have metastatic disease at first diagnosis and need palliative chemotherapy. Unfortunately, the response duration of the first line chemotherapy is usually short and most patients need the second line therapy during their disease process. The action mechanism of continuous infusion of 5-FU is different from bolus 5-FU and we can expect that among patients who failed on bolus 5-FU, some patients will achieve response to infusional 5-FU. So, we planned to evaluate the efficacy and safety of leucovorin and infusional 5-FU as a second line regimen for the metastatic gastric cancer refractory to regimen containing bolus 5-FU. METHODS: Patients with recurred or metastatic gastric cancer unresponsive to regimen containing bolus 5-FU were entered into this study. The mixture of 5-FU 1,000 mg/m2/day and leucovorin 50 mg/m2/day was infused continuously for four days and this treatment was repeated by every three weeks. RESULTS: From March, 1996 to July 2001, 25 patients were enrolled in this study. One patient showed a partial remission, 9 stable disease and 15 progressive disease. The overall response rate was 4%. The median time to progression was 73 days and the median duration of overall survival was 140 days. Among total of 92 cycle chemotherapy, leukopenia, granulocytopenia and thrombocytopena of WHO grade 3 or 4 were observed in 7.6%, 12.0% and 14.1%, respectively. Stomatitis, nausea or vomiting of WHO grade 3 or 4 were 13.1%, 5.4%, respectively. Neutropenic infection occurred in two patients. CONCLUSION: The LF regimen was well tolerated with minimal toxicities and showed low effect as the second line chemotherapy for the patients with gastric cancer.

A Case of Central Diabetes Insipidus in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Central diabetes insipidus is caused by the insufficient secretion of vasopressin and has been reported in great variety of disorder of brain tumor, systemic infiltrative disease such as histiocytosis, amyoidosis and vasculitis, leukemia, and other autoimmune diseases. But there has been reported only 3 cases of systemic lupus erythematosus (SLE) associated with central diabetes insipidus. The exact pathophysiologic process of pituitary gland involvement in SLE has been unknown, although there are some evidence that vascular impairment and autoantibodies to pituitary gland may be contributory factors. Here, we report a case of central diabetes insipidus complicated by neuropsychiatric systemic lupus erythematosus.