Sublingual Immunotherapy in Asian Children: 2-Year Follow-Up Results

BACKGROUNDS: House-dust mites are the main cause of allergic rhinitis in Asia, for which immunotherapy (SLIT) is a currently accepted treatment. However, few studies have evaluated the efficiency of SLIT on Asian children with allergic rhinitis for a period longer than one year. The aim of this study was to investigate the efficacy and safety of SLIT for Asian children with allergic rhinitis due to house-dust mites over a 2-year period. MATERIALS AND METHODS: This study included 65 patients who had allergic rhinitis due to Dermatophagoides pteronyssinus and Dermatophagoides farinae. All patients were treated with SLIT (Staloral(R)). Symptom scores and quality of life were evaluated by using questionnaires over two years. The medication score was assessed monthly by a diary medication card and serologic tests were evaluated before and two years after the start of treatment. Adverse effects and dropout rates were also investigated. RESULTS: All nasal and non-nasal symptoms and quality of life were significantly improved after two years of treatment. Furthermore, the total medication score decreased significantly and the serologic tests showed a significant change two years after the start of SLIT. Although minor adverse effects were reported, no systemic reactions were observed. The dropout rate was 40%. CONCLUSION: SLIT is an efficient and safe therapeutic tool for a period of two years in Asian children with allergic rhinitis to house-dust mites.

Clinical Behavior of Papillary Thyroid Carcinoma Smaller than 1.5 cm / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: With the increasing use of high resolution sonography and fine needle aspiration biopsy, the proportion of newly diagnosed thyroid papillary carcinomas have increased. However, it is not entirely clear whether microcarcinomas detectable by the above technology the should be considered a threshold for risk evaluation. The purpose of this study is to evaluate the clinical behavior of papillary carcinomas smaller than 1.5 cm. SUBJECTS AND METHOD: A retrospective chart review was conducted for 181 patients who underwent surgery for thyroid cancer and was proven to have papillary carcinoma smaller than 1.5 cm in size from 1997 to 2006. The patients were divided into 3 groups according to cancer size. The patient's gender, age, surgical method, pathology, initial neck node and neck recurrence was analyzed by chi-square test, analysis of variance (ANOVA) test and multinomial logistic regression analysis. RESULTS: Progressively increasing frequency of signs of tumor aggressiveness (multifocal, bilateral, extracapsular spread) was observed with increasing size. The rate of lymph node metastasis increased also, but it did not reach a significant value. Despite the increasing rate of aggressiveness and lymph node metastasis, there was no significant difference in recurrence between these groups. CONCLUSION: Although the long term outcome does not seem to directly depend on tumor size in these small thyroid cancers, a progressing frequency of aggressiveness with increasing cancer size at presentation is evident.

A Case of Spindle Cell Carcinoma Originating from the Maxillary Sinus / 대한이비인후과학회지

Spindle cell (sarcomatoid) carcinoma of the upper respiratory tract is a rare malignancy, and its diagnosis, treatment, and prognosis still remain controversial. Histopathologic examination of this uncommon tumor shows surface epithelialcarcinoma and an underlying spindle-shaped proliferation. In the head and neck region, it is found predominantly in the larynx and oral cavity. To our knowledge, spindle cell carcinoma of the paranasal sinus has been rarely reported. We report a 57-year-old woman with a spindle cell carcinoma originating from the maxillary sinus. She was treated with surgery and post operative radiotherapy. After 8 months of close follow-up, she shows no sign of recurrence or distant metastasis. We offer this case and a review of the related literature in an effort to increase awareness of this rare malignancy.