Cloning of a Family of Serine Protease Genes Expressed in German Cockroach(Blattella germanica) and Possibility as Allergens / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The serine protease allergens have been known as one of the most important inhalent allergens of insects as well as house dust mites. There is no known serine protease allergen of German cockroach, which is a well-known etiological agent of allergic diseases. We identified the serine protease genes of cockroach, Blattella germanica, and examined its possibility as an allergen. MATERIALS AND METHOD: We have isolated three partial genes, Bg3, Bg5 and Bg6, of serine protease from the Blattella germanica cDNA library using the degenerate oligonucleotide PCR primers specific for the conserved regions. RESULTS: The genes, Bg3, Bg5 and Bg6, were composed of 396 bp 131 amino acids, 513 bp 170 amino acids, and 410 bp 136 amino acids, respectively. Northern hybridization analysis indicated that the size of Bg5 and Bg6 transcripts was approximately 0.7 kb. The gene, Bg5, was also identified as a multiple gene by the Southern blot analysis. The gene, Bg3, showed significant homology to trypsin-like serine protease of various insects. The deduced amino acids sequence of the gene Bg5 was matched to the mite group III allergen as well as various species of insect serine protease sequences. The gene Bg6 also showed high homology to the amino acids sequences of insect serine proteases and mite group III allergens. Three Blattella germanica serine protease gene fragments revealed close genetic relationships with Dermatophagoides farinae group III allergen in the phylogenetic analysis. CONCLUSION: The high homology and close phylogenetic relationship raise the possibility of three serine protease genes as being an allergen of German cockroach.

Laser Salvage Surgery for Recurrent Glottic Cancer after Radiotherapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Salvage surgery for recurrent glottic cancer after radiation failure has been reported in the literature as a treatment for total laryngectomy and partial laryngectomy (vertical partial laryngectomy, supracriocoid partial laryngectomy) in selected cases. Also, CO2 laser cordectomy has also been reported as a successful primary treatment for early glottic cancer. However, salvage laser surgery for recurrent glottic cancer has been rarely reported. Our experience of transoral laser cordectomy on recurrent glottic cancer after radiotherapy is reported. SUBJECTS AND METHOD: Twelve patients with early recurrent glottic cancer after full-course radiotherapy (rT1a, n=4 ; rT1b, n=1 ; rT2, n=7) underwent laser cordectomy between October, 2002 and January, 2005. According to the European Laryngological Society Classification, they were found to have two type III, one type IV, and eight type V performed. One patient underwent type II at one side and type III at the other. Surgery in all the cases were performed at one stage with curative intent. RESULTS: The mean follow-up interval was 30 months (range 17-44 months) with five out of 12 cases (42%) having local recurrence. Four of the five cases with local recurrence underwent total laryngectomy. Three cases were salvaged while one had additional recurrence. The other one was under palliative treatment. The local control rate was 58%, overall survival and disease specific survival rate was 100%. The mean hospitalized period was 6.4 days (range 2-26 days) after surgery, and tracheotomy was performed in four cases (duration : 3-20 days). There was no postoperative aspiration pneumonia and nasogastric tube was not performed in any of the cases. CONCLUSION: Transoral laser microsurgery may be a feasible salvage method for recurrent glottic cancer to gain oncologic and functional results, and could be used as an organpreserving procedure with curative intent in selected cases.

Expressed sequence tags analysis of Blattella germanica

Four hundred and sixty five randomly selected clones from a cDNA library of Blattella germanica were partially sequenced and searched using BLAST as a means of analyzing the transcribed sequences of its genome. A total of 363 expressed sequence tags (ESTs) were generated from 465 clones after editing and trimming the vector and ambiguous sequences. About 42% (154/363) of these clones showed significant homology with other data base registered genes. These new B. germanica genes constituted a broad range of transcripts distributed among ribosomal proteins, energy metabolism, allergens, proteases, protease inhibitors, enzymes, translation, cell signaling pathways, and proteins of unknown function. Eighty clones were not well-matched by database searches, and these represent new B. germanica-specific ESTs. Some genes which drew our attention are discussed. The information obtained increases our understanding of the B. germanica genome.

A Case of Neurilemmoma of the Brachial Plexus / 대한이비인후과학회지

Neurilemmoma is a benign, solitary tumor which may occur from the nerve sheath of the peripheral, sympathetic and cranial nerves. Although it occurs most frequently in the head and neck region, especially in the acoustic nerve and the vagus nerve, the neurilemmoma of the brachial plexus is rare. We have experienced a case of neurilemmoma in the brachial plexus. Surgical excision was performed by anterior supraclavicular approach. The mass was removed completely, sparing the nerve function. We report this case with literature review.

Changes in Resonance Frequency and Length of External Auditory Canal in Relation to Age / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: With the currently available diagnostic procedure, hearing impaired children are diagnosed at an early age and hearing aids are fitted soon thereafter. Thus, appropriateness of using available correction methods for adult ears and ear models for determining and predicting hearing aid characteristics for these children need to be examined. The objectives of this study are to create a database of resonance frequency and length of external auditory canal (EAC) in all age groups and to adjust the peak frequency response of hearing aid system to take account of the changing resonance peak frequency as child gets older. MATERIALS AND METHOD: We studied 437 ears with no age limitation. We measured rear ear unaided response (REUR) with Rastronics frequency response analyzer and external ear canal length using silastic tube under microscopic or otoscopic finding. Statistical analyses were performed to determine age differences. RESULTS: Ear canal length increased with age, and an adult value was achieved by the age of 14 years. Resonance frequency decreased with age, and reached to an adult value by the age of 9 years. There was significant relationship between ear canal length and resonance frequency. CONCLUSION: Alteration in resonance frequency with age may have practical implications by affecting the insertion gain of hearing aid system in children. The data may be used as useful adjustment factors to correct the current hearing aid system in children.

A Case of Metastatic Hepatocellular Carcinoma of the Ethmoid Sinus / 대한이비인후과학회지

Hepatocellular carcinoma usually metastasizes to lung, breast, lymph node, GI tract, bone, kindey, and adrenal gland. Up to now, only few cases of hepatocellular carcinoma presenting as a metastatic ethmoid sinus tumor could be found in the literature. If a patient with hepatocellular carcinoma complains epistaxis, and if expansile, osteolytic, and hypervascular lesions are observed in a radiologic examination, nasal cavity and sinus tumor should be confirmed through biopsy. We report, along with the review of appropriate literature, a case of histollogically confirmed metastatic hepatocellular carcinoma of the ethmoid sinus of a 56 year old man.

Neurotologic Analysis of Cerebellopontine Angle Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The authors performed seven removal operations cerebellopontine angle tumor, six of which were acoustic neuroma. The purpose of this research is to analyze different cases of cerebellopontine angle tumor, determine their clinical characteristics, and evaluate the efficacy of various surgical approaches. MATERIALS AND METHODS: We performed neurotological analysis of both clinical characteristics and the results of each surgical approach for seven patients who have been treated for cerebellopontine angle tumor. RESULTS: The most frequent symptom was the complaint of hearing disturbance, where the mean PTAs measured were 66 dB, and the mean speech discrimination score was 35%. The average size of tumors measured by MRI was 3.9 cm. The following surgical approaches were used: translabyrinthine in 4 cases, modified translabyrinthine in 2 cases, transcochlear in one case. Complete removal of the tumor was possible in six patients. Facial nerve was preserved anatomically in six patients, and hearing preservation was possible in one patient for whom we performed the modified translabyrinthine approach. CONCLUSION: Early diagnosis and treatment is important in order to improve the facial nerve function after the operation. The modified translabyrinthine approach is worth performing for hearing preservation.

Effect of cisplatin on sodium-dependent hexose transport in LLC-PK-1 renal epithelial cells

Cis-dichlorodiammine platinum II (Cisplatin), an effective chemotherapeutic agent, induces acute renal failure by unknown mechanisms. To investigate direct toxic effects of cisplatin on the renal proximal tubular transport system, LLC-PK-1 cell line was selected as a cell model and the sugar transport activity was evaluated during a course of cisplatin treatment. Cells grown to confluence were treated with cisplatin for 60 min, washed, and then incubated for up to 5 days. At appropriate intervals, cells were tested for sugar transport activity using alpha-methyl-D-(14C)glucopyranoside (AMG) as a model substrate. In cells treated with 100 micrometer cisplatin, the AMG uptake was progressively impaired after 3 days. The viability of cells was not substantially changed with cisplatin of less than 100 micrometer, but it decreased markedly with 150 and 200 micrometer. In cisplatin-treated cells, the Na+/-dependent AMG uptake was drastically inhibited with no change in the Na+/-independent uptake. Kinetic analysis indicated that Vmax was suppressed, but Km was not altered. The Na+/-dependent phlorizin binding was also decreased in cisplatin-treated cells. However, the AMG efflux from preloaded cells was not apparently retarded by cisplatin treatment. These data indicate that the cisplatin treatment impairs Na+/-hexose cotransporters in LLC-PK-1 cells and suggest strongly that defects in transporter function at the luminal plasma membrane of the proximal tubular cells constitute an important pathogenic mechanism of cisplatin nephrotoxicity.

A Case of Verrucous Carcinoma of Maxillary Sinus / 대한이비인후과학회지

Verrucous carcinoma is a rare variant of squamous cell carcinoma that is more often seen in the oral cavity and larynx, but extremely rare in the paranasal sinus. In establishing the diagnosis, close cooperation is required between the clinician and pathologist, since the lesion appears obviously malignant on clinical examination but on pathologic study it may be reported as hyperplastic or papillomatous or as hyperkeratotic benign squamous epithelium. Verrucous carcinoma should be treated by surgical excision because there is evidence to suggest that the lesion may become more aggressive after radiotherapy and surgery gives better survival rates than radiotherapy. We experienced a case in which the patient presented with a history of right nasal obstruction and intermittent facial pain for about 4 months and was ultimately diagnosed as having verrucous carcinoma of maxillary sinus. Caldwell-Luc's operation was performed. We report this case with a review of the literature.

Analysis of Treatment in the Patients with Non-Hodgkin's Lymphoma of the Head and Neck / 대한이비인후과학회지

BACKGROUND: The patients with non-Hodgkin's lymphoma(NHL) of the head and neck was treated with radiotherapy traditionally, but the results were not satisfactory. Although chemotherapy or combined chemotherapy and radiotherapy was tried recently, prognostic factors and treatment of choice has not been described yet. OBJECTIVES: We performed this study to investigate the prognostic factors of NHL and the differences of treatment outcomes among chemotherapy, radiotherapy and combined therapy for NHL of the head and neck. MATERIALS AND METHOD: The subjects are 50 patients with NHL localized in the head and neck, who were treated at Kosin University Gospel Hospital from January 1988 to January 1996. We analyzed clinical datas retrospectively. RESULTS: Five year overall survival rate was 41% in the patients whose primary lesion was Waldeyer's ring and 78.3% in patients who present with primary lesion in cervical node(p<0.05). Five year overall survival rate of chemotherapy, radiotherapy, and combined therapy was 50.8%, 20%, 77% respectively(statistically not significant). These results suggest that location of primary site, pathologic type and response rate to treatment may be significant prognostic factors on univariate analysis(p<0.05). CONCLUSION: Combined chemotherapy and radiation therapy are more effective for the patients with NHL presenting in the head and neck.