No abstract available.
Cholesteatoma, Middle Ear* ; Lymphocytes*

The effects of chimeric monoclonal antibodies (cMAbs), prostaglandin E, (PGE,), and indomethacin (INDO) on antibody-dependent cellular cytotoxicity (ADCC) against human squamous cell carcinoma of head and neck (SCCHN) cell line were examined. Using the PCI-50 SCCHN cell line as target and normal human peripheral blood mononuclear cells as effector, ADCC was enhanced by the treatment of cMAbs (1.25 p,g/ml), but was inhibited by exogenous PGE (5 X 10' M). The effects of cMAb and PGE were dose-dependent. Maximal suppression of activity occured when PGE was present during the entire 4-hr 'Cr-release assay period, whereas pretreatment of effector cells with PGE had minimal inhibitory effect after washing. These results indicate that decreased ADCC seen with SCCHN targets treated with PGE is related to post-binding events, such as binding of effector and target cells. Pre-treatment of effector cells with INDO (1 ug/ml) resulted in restoration of NK activity which was inhibited by PGE. Our in vitro results suggest that INDO can increase tumor cell killing by the reversal of the suppression for many imrnune functions by PGE.
Antibodies, Monoclonal ; Antibody-Dependent Cell Cytotoxicity ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Homicide ; Humans* ; Indomethacin ; Neck* ; Prostaglandins E

BACKGROUND: Some authors recommend the surgical correction at early childhood in the selected cases of unilateral atresia as well as bilateral atresia. It has been enabled due to the improvement of imaging technique and it gives cosmetic satisfaction and biaural hearing. OBJECTIVES: The authors laid emphasis on the timing of canaloplasty in unilateral atresia, stage of canaloplasty, and postoperaitve hearing results. MATERIALS AND METHODS: A retrospective review of surgical results of congenital aural atresia from 1983 to 1995 in Seoul National University Hospital was performed. RESULTS: Forty four patients had unilateral atresia and 16 patients had bilateral atresia. Age range at the time of surgery was from 5.3 years to 14.6 years: average age was 8.1 years. Otoplasty was performed in 22 ears by plastic surgeons. It took precedence over canaloplasty in 17 ears. The endaural anterior approach through incision from temporal area to cavum cocha was performed in these cases. Meatal stenosis was the most common postoperative complication, but it has been decreased since the introduction of modification of anterior approach. The surgical attempts to improve hearing could not be performed in 14 ears due to various reasons. The audiologic follow-up period in the remaining 60 ears ranged from 1 year 9 months to 8 year 8 months(mean, 3 year 8 months). By analyzing final air conduction level, it was possible to attain 30 dB or better in 18(30%) of 60 cases and 40 dB or better in 36(60%) of 60 cases. CONCLUSION: The authors recommend the surgical correction at early childhood in unilateral atresia. and the otoplasty should be performed at first and it seems to be better in view of early audiologic rehabilitation that canaloplasty would be performed before the stage of elevation of rib cartilage graft. Meatal stenosis can be reduced by modification of anterior approach.
Cartilage ; Constriction, Pathologic ; Correction of Hearing Impairment ; Ear ; Follow-Up Studies ; Hearing ; Humans ; Postoperative Complications ; Retrospective Studies ; Ribs ; Seoul ; Transplants

This study was conducted to evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer which is notorious for its poor prognosis and severe surgical morbidity with functional deficits. Medical records of 62 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV(AJCC, 1992), were retrospectively reviewed. Neoadjuvant chemotherapy showed an overall response rate of 87% and a complete remission(CR) rate was 67% following chemotherapy and radiation therapy. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Thirteen of 30 patients were able to preserve their larynges for more than three years by chemotherapy and radiation. This regimen appeared to be as effective as radical surgery with postoperative radiation therapy without comprise of survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and figure out the best treatment option for patients who are partially or non-responsive to chemotherapy.
Carcinoma, Squamous Cell ; Drug Therapy* ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Medical Records ; Prognosis ; Radiotherapy* ; Retrospective Studies ; Treatment Failure

Liver tissuses obtained from 5 human fetuses between 11 weeks and 23 weeks of gestation during the high activity of hepatic hemopoiesis were observed with transmission electron microscope using continuous series of thin sections. The objective of present study was to evaluate ultrastructures of megakaryopoietic cells, the migration of extravascular megakaryocyte into the sinusoidal lumen and the relevence between a migrated megakaryocyte and a Kupffer cell. Immature megakaryocytes were usually observed between growing hepatic laminae and within hepatic sinusoids. A megakaryoblast contained numerous polyribosomes, rather large mitochondria, short tubular elements of rough endoplasmic reticulum and small granules. Moreover, demarcation tubules and a few small specific granules were observed in immature megakaryocytes. The nucleus was mononuclear but frequently indented. With maturation, the nuclei were multilobulated. In the cytoplasm, in contrast to the decrease in polyribosomes and rough endoplasmic reticulum, the numerous specific granules and well -developed demarcation membrane system were predominant. Thereafter cytoplasmic zonation was observed clearly in maturing and mature megakaryocytes. Some megakaryocytes passed through the sinusoidal lining epithelium and into the hepatic sinusoids. The cell to cell interaction was often found as adhesion between migrated megakaryocyte and Kupffer cell, and erythroblasts within megakaryocyte (emperipolesis). These results suggest that intravascular megakaryopoiesis in addition to extravascular megakaryopoiesis occurs to produce platelet during the human fetal liver.
Blood Platelets ; Cell Communication ; Cytoplasm ; Emperipolesis ; Endoplasmic Reticulum, Rough ; Epithelium ; Erythroblasts ; Fetus* ; Humans* ; Liver ; Megakaryocyte Progenitor Cells ; Megakaryocytes* ; Membranes ; Mitochondria ; Polyribosomes ; Pregnancy ; Thrombopoiesis

OBJECTIVES: Sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment for allergic rhinitis. This study aimed to investigate the efficacy and adverse effects of SLIT in Korean patients with allergic rhinitis caused by house dust mites. The treatment compliance and the patient satisfaction with SLIT were also assessed. METHODS: The patients who were sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farinae and who started SLIT between November 2007 and July 2008 were included in this study. The symptom questionnaires, which included items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance, were obtained before and 6 months after SLIT. The patient satisfaction and the adverse effects were also investigated. RESULTS: One hundred forty-two patients started SLIT and 98 of them continued SLIT for 6 months or more. Ninety-two of the 98 patients completed the questionnaires. The duration of receiving SLIT was 9.8 months on average (range, 6 to 13 months). All the symptoms of allergic rhinitis were improved with SLIT. Forty-five percent of the patients were satisfied for SLIT, while 12% were unsatisfied. The incidence of adverse effects was 12% during maintenance therapy, although it was 48% during the up-dosing phase. The drop-out rate of SLIT was 31.0%. CONCLUSION: The subjective symptoms were improved with SLIT in Korean patients with allergic rhinitis for house dust mites. Yet the drop out rate was high despite of the symptomatic improvement.
Compliance ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Eye ; Humans ; Immunotherapy ; Incidence ; Nasal Obstruction ; Nose ; Patient Satisfaction ; Pyroglyphidae ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing ; Surveys and Questionnaires

BACKGROUND: The epithelial-myoepithelial carcinoma(EMC) of major and minor salivary glands is a low grade malignancy which shows frequent local recurrence. OBJECTIVES: The aim of this study was to define the clinical feature and treatment outcome of EMC of major and minor salivary glands. MATERIALS AND METHODS: Nine cases of EMC of major and minor salivary glands were reviewed retrospectively. RESULTS: The clinical course varied from slowly growing painless mass to the mass associated with facial nerve paralysis, bleeding or bone desutruction. Local recurrence was observed in 3 cases(33%) at 3, 10 and 11 months after primary resection, but no metastasis to periglandular, cervical lymph nodes or distant site occurred in our series including three recurrences. One of three recurrent patients died due to local extension of the tumor. Other two patients with recurrent tumors were successfully treated with revision operation and survived more than 2, 6 years without disease, respectively so far. Preoperatively these tumors were usually regarded as benign salivary gland tumor in CT scan except for the cases showing bone destruction. Atypical cells on fine needle aspiration cytology/frozen biopsy coupled with benign looking CT finding suggested low grade malignancy in which case EMC should be considered a differential diagnosis. Pathologic diagnosis was frequently confused with other high grade carcinoma rather than low grade carcinoma or benign tumor. This resulted in unnecessary postoperative radiotherapy, but clinically aggressive recurrent cases recurred despite radiotherapy. No malignant cells were found in clinically enlarged lymph nodes, and we have to retain positve attitude toward surgical management of advanced or recurrent EMC keeping in mind that recurrent tumor may inherit different tumor bilogy. CONCLUSION: Although epithelial-myoepithelial carcinoma is a rare salivary gland tumor, otolaryngologists should be aware of its existence because this low grade malignancy can cause diagnostic confusion during workup and also frequently be misdiagnosed as other high grade salivary malignancy in clinically aggressive form.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential ; Facial Nerve ; Hemorrhage ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paralysis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salivary Glands* ; Salivary Glands, Minor ; Tomography, X-Ray Computed ; Treatment Outcome*

BACKGROUND: Despite recent advances in radiation therapy and chemotherapy, surgical procedures remain the primary modality of head and neck cancer therapy. Adequate surgical resection frequently requires the removal of significant amounts of tissue. In addition to the prolongation of life, the restoration of a functional aerodigestive tract is the primary concern of the reconstructive surgeon. OBJECTIVE: With the above in mind, we have evaluated our experience with head and neck reconstruction using various flaps. MATERIALS AND METHODS: The medical records of 95 patients who underwent 112 reconstructive surgeries in the head and neck area from 1983 to 1996 in Seoul National University Hospital were reviewed. Results were evaluated with emphasis on the functional aspect and postoperative course. RESULTS: Successful transfer using PMMC flaps were achieved in 100%, 93% in skin defect and oral/oropharyngeal defect, respectively. In pharyngoesophageal reconstruction, free and visceral flaps had higher success rates and lower complication rates than pectoralis major myocutaneous(PMMC) flaps(75% vs. 64%, 64% vs. 25%). The average completion time to oral intake in pharyngoesophageal reconstruction was within 2 weeks using free and visceral flaps, but within 29 days using PMMC flaps. CONCLUSIONS: PMMC flap is still a workhorse for head and neck reconstruction. Reconstruction with PMMC flap is adequate for skin, oral or oropharyngeal reconstruction, but inadequate for pharyngoesophageal reconstruction especially for circumferential defect. Those patients reconstructed with visceral flaps were able to tolerate oral feedings sooner and were less likely to have local complications than those with PMMC flaps. Thin myocutaneous flaps such as platysma flap can be used for myomucosal defect of oral cavity as adequately as free flaps.
Drug Therapy ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Head* ; Humans ; Life Support Care ; Medical Records ; Mouth ; Myocutaneous Flap ; Neck* ; Seoul ; Skin

BACKGROUND AND OBJECTIVES: Airway problems frequently occur in neonatal patients requiring intensive care due to high prevalence of intubation history and congenital conditions that are linked to craniofacial or upper aerodigestive tract anomalies. However, many investigations on airway disorders have examined large populations of hospitalized children without focusing on those treated in the intensive care unit (ICU). Here we present the clinical features and outcomes in infants hospitalized with airway-related problems at the neonatal ICU. SUBJECTS AND METHOD: A total 69 patients were studied from May 2005 to December 2012, with each examined by an otolaryngologist while in neonatal ICU (NICU) for possible airway problems. Descriptive analysis was used in evaluating illnesses suffered and subsequent upper airway treatments. Factors associated with tracheostomy were identified by multivariate analysis. RESULTS: The median age of infants was 30 days (range, 1-237 days), with a male-to-female ratio of 1.38. The median gestational age was 35⁺³ weeks, and the mean birth weight was 2.35±0.89 kg. Overall, 40 patients had histories of intubation (median duration, 36 days; range, 1-204 days). The most common diagnosis in the upper airway exam was laryngomalacia (n=12), followed by subglottic stenosis (n=10) and micrognathia (n=8). Tracheostomy was performed in 38 patients (55.1%). In multivariate analysis, intubation history was identified as the only variable demonstrating a significant independent association with tracheostomy (p=0.006). CONCLUSION: Upper airway problems in NICU patients are due to a variety of disorders. Precise diagnosis and treatment is achievable through bedside and intraoperative assessments. Patients with a history of intubation are at increased risk of tracheostomy.

BACKGROUND AND OBJECTIVES: Mass-forming lesions involving the skull base are challenging to otolaryngologists in many ways. For one, the most important differential diagnosis of a skull base lesion is to rule out the malignant neoplasm, however, nonneoplastic lesions, such as infection or nonspecific inflammatory lesions of the skull base can mimic a malignant process. This study evaluates the clinical manifestations, progression and therapeutic results of fibrosing inflammatory pseudotumors of the skull base. MATERIALS AND METHODS: We analyzed eight cases of non-neoplastic mass-forming lesions involving the skull base. RESULTS: In most cases, malignant lesions were initially suspected during diagnostic work-up, but subsequent histologic examinations revealed that these lesions consisted of inflammatory cells and fibrosis without neoplastic cells. The most common manifestations were pain and other various neurologic symptoms related to the involved anatomic sites. All cranial nerve malfunctions except for the olfactory and the spinal accessory nerves were observed in our case studies. No patient in our case studies developed any separate lesion outside of the head and neck region. As these lesions are usually characterized as being hypointense on T2 weighted images unlike the other common skull base malignancy, MRI can offer some clues for preoperative differential diagnosis of pseudotumor from malignancy. After the pathologic diagnosis, most of the patients were treated with extended oral steroid medication, with initial doses of 60-100 mg/day of prednisolone. It was difficult to relate the responsiveness to steroid therapy with the histologic degree of sclerosis/fibrosis or chronicity of the disease in our cases. CONCLUSION: A fibroinflammatory lesion of the skull base is a rare disease, but, otolaryngologists should be aware of this disease in order to avoid confusion in decision making for the management of skull base lesions.
Accessory Nerve ; Cranial Nerves ; Decision Making ; Diagnosis ; Diagnosis, Differential ; Fibrosis ; Granuloma, Plasma Cell* ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Prednisolone ; Rare Diseases ; Skull Base* ; Skull*