BACKGROUND AND OBJECTIVES: Surgery with postoperative radiotherapy has been the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, the prognosis still remains dismal. To increase survival rate and organ preservation rate, alternative approach is needed. Incorporating the taxane regimen into the treatment of HNSCC, the new treatment strategy of sequential therapy has been introduced. The purpose of this study is to determine the efficacy of neoadjuvant chemotherapy, followed by concurrent chemoradiotherapy for the HNSCC. SUBJECTS AND METHOD: Between January 2001 and June 2005, 19 patients with HNSCC were treated with neoadjuvant chemotherapy, followed by concurrent chemoradiotherapy. The sites of primary tumors were hypopharynx in eight patients, oropharynx in six patients, and larynx in five patients. Neoadjuvant chemotherapy included 70 mg/m2 of docetaxel on day 1, 70 mg/m2 of cisplantin on day 2 and 800 mg/m2 of 5-fluorouracil on day 2-4. The cycles were repeated every three weeks. Concurrent chemoradiotherapy starts after two cycles of neoadjuvant chemotherapy. Radiation dose was 200 cGy/dayx5/week with a total of 6,000-7,000 cGy, and the concurrent chemotherapy of 20 mg/m2 of docetaxel or 20 mg/m2 of cisplantin was given weekly. RESULTS: The median follow-up was 21 months. The overall 2-year survival rate was 70.1% and the 2-year organ preservation rate was 59.4%. The survival rate and organ preservation rate of larynx cancer patients were higher than those of hypopharynx and oropharynx cancer patients, but it was not statistically significant (p=0.09, 0.16). The patients of the lower stage showed higher survival rate and organ preservation rate, but it was not statistically significant (p=0.19, 0.48). The most common Grade 3 or 4 toxicities of neoadjuvant chemotherapy were leukopenia, anorexia, nausea and vomiting, whereas the most common Grade 3 or 4 toxicities during concurrent chemoradiotherapy were mucositis, stomatitis, and leukopenia. One patient died due to sepsis during treatment. CONCLUSION: Neoadjuvant chemotherapy with three combined regimens followed by concurrent chemoradiotherapy might be effective treatment modality for HNSCC. Further studies with large number of patients and longer follow-up will be needed.
Anorexia ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Drug Therapy* ; Fluorouracil ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Hypopharynx ; Laryngeal Neoplasms ; Larynx ; Leukopenia ; Mucositis ; Nausea ; Neck* ; Neoadjuvant Therapy ; Organ Preservation ; Oropharyngeal Neoplasms ; Oropharynx ; Prognosis ; Radiotherapy ; Sepsis ; Stomatitis ; Survival Rate ; Vomiting

BACKGROUND/AIMS: In clinical practice, among the technique to detected Helicobacter pylori (H. pylori) infection, IgG serological test is noninvasive, safe, quick, widely available, and inexpensive. We studied that whether the titers of anti-H. pylori IgG antibody were correlated with endoscopic finding, and the degree of microscopic gastric damage and H. pylori density in dyspeptic patients. METHODS: Gastric biopsy specimens were obtained in 109 patients with H. pylori infection undergoing upper gastric endoscopy. The titers of serum IgG antibodies to H. pylori were measured by enzyme immunoassay. Macroscopic gastric damages and histologic grades were scored by the Sydney system. RESULTS: Endoscopic findings showed no significant association with H. pylori antibody titers (p=0.111). There was significant correlation between H. pylori antibody titers and lymphocyte infiltration (p=0.002), neutrophil infiltration (p=0.002), H. pylori density (p=0.0001), respectively. There was no significant correlation between H. pylori antibody titers and atropy (p=0.142), intestinal metaplasia (p=0.368), respectively. CONCLUSIONS: H. pylori antibody titer has significant association with the H. pylori density, neutrophil and lymphocyte infiltration. The serological test using EIA method is a useful in detecting H. pylori infection and it may be used as a predictor for the H. pylori density and degree of inflammation.
Antibodies ; Biopsy ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Inflammation ; Lymphocytes ; Metaplasia ; Neutrophil Infiltration ; Neutrophils ; Serologic Tests

BACKGROUND: There are several reports on outbreaks of V. paraphaemolyticus enteritis, however, these are only complicated cases or microbiologic surveillance in marine environment. We experienced an outbreak associated with eating flavored crabs and investigated the magnitude of the outbreak on a large scale located in Inchon. METHOD: We took medical history and stool cultures from patients with diarrhea, visited the Inha University Hospital from September 14 to September 30, 1998. Pulsed-field gel electrophereis of isolates from stool culture performed to identify the relation. We counted the number of diarrheal patients visited the emergency rooms of 5 other general hospitals and 9 private clinics in Inchon from August 16 to September 30, 1998. We bought 6 crabs and 2 flavored crabs at a nearby market and cooked 6 crabs flavored at our hospital. Cultures from the flavored crabs stored at a refrigerator were done daily for consecutive 5 days. RESULTS: The outbreak began on September 5 and ended on September 29, 1998. The numbers of patients visiting ERs of 6 general hospitals and private clinics during outbreak were estimated 1,033 and 4,530, respectively. All 8 crabs revealed Vibrio spp., but identification up to species level was not possible. Pulsed-field gel electrophoresis of 12 isolates showed different patterns and suggested different sources. CONCLUSION: In 1998, an outbreak estimated more than 5,000 patients of V. parahaemolyticus enteritis occurred in Inchon, Korea. Because the magnitude of food-associated enteritis is enormous, that surpass the number which we assumed from clinical practice, early report and prompt investigation of such cases are necessary.
Diarrhea ; Disease Outbreaks ; Eating ; Electrophoresis, Gel, Pulsed-Field ; Emergency Service, Hospital ; Enteritis* ; Hospitals, General ; Humans ; Incheon* ; Korea* ; Vibrio parahaemolyticus* ; Vibrio*