Human Rhinovirus-induced Proinflammatory Cytokine and Interferon-beta Responses in Nasal Epithelial Cells From Chronic Rhinosinusitis Patients

PURPOSE: Asthma exacerbation from human rhinovirus (HRV) infection is associated with deficient antiviral interferon (IFN) secretion. Although chronic rhinosinusitis (CRS), an inflammatory upper airway disease, is closely linked to asthma, IFN-beta responses to HRV infections in human nasal epithelial cells (HNECs) from CRS patients remain to be studied. We evaluated inflammatory and antiviral responses to HRV infection in HNECs from CRS patients. METHODS: HNECs, isolated from turbinate tissue of 13 patients with CRS and 14 non-CRS controls, were infected with HRV16 for 4 hours. The HRV titer, LDH activity, production of proinflammatory cytokines and IFN-beta proteins, and expression levels of RIG-I and MDA5 mRNA were assessed at 8, 24, and 48 hours after HRV16 infection. RESULTS: The reduction in viral titer was slightly delayed in the CRS group compared to the non-CRS control group. IL-6 and IL-8 were significantly increased to a similar extent in both groups after HRV infection. In the control group, IFN-beta production and MDA5 mRNA expression were significantly increased at 8 and 24 hours after HRV16 infection, respectively. By contrast, in the CRS group, IFN-beta was not induced by HRV infection; however, HRV-induced MDA5 mRNA expression was increased, but the increase was slightly delayed compared to the non-CRS control group. The RIG-I mRNA level was not significantly increased by HRV16 infection in either group. CONCLUSIONS: HRV-induced secretion of proinflammatory cytokines in CRS patients was not different from that in the non-CRS controls. However, reductions in viral titer, IFN-beta secretion, and MDA5 mRNA expression in response to HRV infection in CRS patients were slightly impaired compared to those in the controls, suggesting that HRV clearance in CRS patients might be slightly deficient.

Treatment Outcomes of Squamous Cell Carcinoma of the Buccal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma of the buccal mucosa (BMSCC) has been known to have poor prognosis characterized by a high locoregional failure rate. The purpose of this study is to assess the current treatment outcome and to estimate the prognostic factors in patients with BMSCC. SUBJECTS AND METHOD: We retrospectively reviewed the medical records of 20 patients who were diagnosed and treated for BMSCC between August 1996 and May 2008. Potential prognostic factors including age, gender, stage, histologic grade, treatment modality were evaluated. RESULTS: The 5-year overall survival and failure-free survival rate were 47% and 42%, respectively. The 3-year overall survival rate in the early staged carcinoma (stage I and II) was 76%, and in the advanced staged carcinoma (stage III and IV), 38% (p=0.022). Patients who had surgery as initial treatment or well differentiated cancer achieved better overall survival rates (p=0.003, p=0.018). Forty-five percent of patients had treatment failure during follow-up. The univariate analysis showed that clinical stages and histologic grades are the two most important prognostic factors responsible for treatment failure. CONCLUSION: The 5-year survival rate of BMSCC was 47%. The strong influence of disease stage on prognosis emphasizes the importance of early diagnosis of BMSCC and aggressive treatment for patients with poorly/moderated differentiated cancer.

Predictive Factors of Level II Lymph Node Metastasis in N1b Papillary Thyroid Carcinoma Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cervical lymph node (LN) metastases are common in papillary thyroid carcinoma (PTC) and cervical neck dissection (ND) is frequently performed to improve regional control of the disease. However, there is a controversy as to the extent of lateral cervical ND. In the present study, we examined the diagnostic accuracy of ultrasonography (US) or CT and the predictive factors of level II LN metastases in PTC patients with clinically positive lateral neck nodes. SUBJECTS AND METHOD: We retrospectively analyzed 78 patients who underwent thyroidectomy and lateral ND including level II LN between August 1998 to June 2008. To identify predictive factors of cervical node metastases to level II, diverse factors were analyzed. RESULTS: The most common site of metastasis was level IV (83.3% of cases). The accuracy of diagnostic imaging in the detection of level II metastasis revealed sensitivity of 89.4%, and specificity of 93.5%. The results of the univariate analysis showed that the presence of level II metastases was significantly associated with the location of primary tumor (p<0.001), number of metastatic LN (p=0.001), and great size of metastatic LN (p=0.010). In addition, the multivariate analysis showed that the location of primary tumor and number of metastatic LN were an independent risk factor for the presence of level II metastasis. CONCLUSION: Preoperative imaging was accurate for detecting the presence of level II LN metastasis. Patients with upper lobe tumor and multiple metastatic LN have a higher risk of harboring metastatic disease at the level II. We suggest that routine dissection of the level II LN may not be necessary for patients with no evidence of diagnostic imaging and predictive factors of level II LN metastasis.