Sonography-guided OK-432 sclerotherapy for benign thyroid cysts.

CONCLUSION: Sonography-guided OK-432 sclerotherapy is effective and safe, and offers a useful alternative treatment for benign thyroid cysts in selected patients. OBJECTIVE: To review the results of sonography guided OK-432 sclerotherapy for benign thyroid cysts. PATIENTS AND METHODS: The details of 20 patients who registered at our institute from December 2002 through August 2006, with recurrent cystic thyroid nodules after two or more aspirations, and who were cytologically negative for malignancy, were reviewed. All cases received OK-432 injections at a concentration of 0.05 mg/ml with sonography. When treatment results were unsatisfactory, the procedure was repeated up to three times at approximately 4 week intervals (mean number, 2.05). RESULTS: Five of the 20 cases were excluded for various reasons. Eleven of the remaining 15 cases (73.3%) showed good responses (<10 mm in diameter), whereas the other 4 patients showed poor responses. All patients tolerated the therapy well, and no significant morbidity or complication occurred among patients treated by OK-432 sclerotherapy.

Differential expression of human beta defensin 2 and human beta defensin 3 in human middle ear cholesteatoma.

OBJECTIVES: The purpose of this study was to investigate the differential expressions of human beta defensin (hBD) 2 and hBD-3 in human middle ear cholesteatoma epithelium. METHODS: The expressions of hBD-2 and hBD-3 were analyzed by quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blotting, and immunohistochemical staining. Samples were obtained from 10 patients who underwent middle ear surgery for middle ear cholesteatoma. RESULTS: Real-time RT-PCR and Western blot analysis showed that the messenger RNAs and proteins of hBD-2 and hBD-3 were higher in the cholesteatoma epithelium than in normal external auditory canal skin. In cholesteatoma epithelium, hBD-2 and hBD-3 activities were present in the upper granular layer and in the prickle cell layer, but in the normal skin they were poorly expressed in all layers. CONCLUSIONS: Increased expressions of hBD-2 and hBD-3 in cholesteatoma epithelium suggest that cholesteatoma, a chronic inflammatory state of middle ear keratinocytes, may induce an innate immune response. That the induction of hBD-2 was found to be more intense than that of hBD-3 in cholesteatoma epithelium implies that hBD-2 is the major effector in terms of chronic epithelial inflammatory responses.

Overexpression of placenta growth factor in human middle ear cholesteatoma.

CONCLUSIONS: The expression and localization of placenta growth factor (PlGF) within cholesteatoma were defined. The authors propose that PlGF is an angiogenic growth factor in cholesteatoma, and participates in the neoangiogenesis of cholesteatoma. OBJECTIVES: Middle ear cholesteatoma is characterized by the presence of a keratinizing squamous epithelium with hyperproliferative features. Such growth can only be supported by abundant blood vessels. Because proliferating tissues require an enhanced blood supply, angiogenesis appears to be a prerequisite for the expansion of cholesteatoma. This study aimed to analyze the presence of PlGF as an angiogenic growth factor in human cholesteatoma. MATERIALS AND METHODS: Tissue samples from human cholesteatoma and normal auditory meatal skin were obtained from patients during surgery for cholesteatoma of the middle ear. PlGF mRNA expression was quantified by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). PlGF was localized by immunohistochemical staining. Western blotting was used for detection of PlGF protein. RESULTS: Expression of PlGF mRNA was significantly elevated in the epithelium of cholesteatoma compared with normal auditory meatal skin. PlGF was detected on cholesteatoma by Western blotting. PlGF was detected in the suprabasal layer of cholesteatoma using immunohistochemical study, but was not detected in normal auditory meatal skin.

Expression of cathelicidin in human salivary glands.

BACKGROUND: Salivary secretions play a critical role in maintaining oral health via innate host defense mechanisms and secretion of secretory IgA. One of the antimicrobial peptides, LL-37, is the only cathelicidin protein that has yet been identified in humans. Cathelicidins are a family of peptides thought to provide an innate defensive barrier against a variety of potential microbial pathogens. OBJECTIVES: To examine the expression of cathelicidin in human salivary glands and to investigate up-regulation of cathelicidin in inflammatory conditions. DESIGN: Reverse transcriptase-polymerase chain reaction and immunohistochemical staining were performed on 20 salivary gland tissues, 10 from normal salivary glands and 10 from glands with chronic sialadenitis. RESULTS: Cathelicidin messenger RNA transcripts were detected in the tissues from the normal salivary glands and the glands with chronic sialadenitis. The level of cathelicidin messenger RNA in glands with chronic sialadenitis was significantly increased compared with that in normal salivary glands. Cathelicidin protein was expressed in the glandular epithelium of the normal salivary glands and the glands with chronic sialadenitis. CONCLUSION: The results indicate that cathelicidin might play an important role in innate host defense of human salivary glands.

The usefulness of cytokeratin immunohistochemistry in detection of lymph node micrometastasis in neck dissection specimens.

OBJECTIVE: Our study was designed to find out the rate and the characteristics of micrometastasis in cervical lymph nodes using immunohistochemical staining. STUDY DESIGN AND SETTING: From 69 patients, 1710 lymph nodes negative for metastasis on hematoxylin-eosin stain, were examined. Immunohistochemical stain was performed using pan-cytokeratin AE1/AE3 antibody. RESULTS: In 13 cases, occult lymph node metastasis was detected by immunohistochemical method. On retrospective review of the hematoxylin-eosin stain by the pathologist, lymph node metastasis was detected in 4 of 13 patients. CONCLUSIONS: Because the immunohistochemical method enhanced the detection rate of occult micrometastasis in cervical lymph nodes of head and neck squamous cell carcinoma patients, it may be recommended for routine diagnostic use in patient with negative for a lymph node metastasis on routine hematoxylin-eosin stain.

T3 supraglottic cancer: treatment results and prognostic factors.

OBJECTIVE: A retrospective study was performed in order to analyze the treatment results and prognostic factors in patients with T3 supraglottic carcinoma and to differentiate between the treatment results obtained for T3 transglottic carcinoma and T3 pure supraglottic carcinoma. MATERIAL AND METHODS: Thirty-two patients who underwent surgery with or without postoperative radiation therapy between 1990 and 2000 were studied. Neck dissection was performed in 27 patients and 24 received postoperative radiation therapy. RESULTS: The 3-year overall survival rate was 81.7%. The 3-year overall survival rates for T3 pure supraglottic carcinoma and T3 transglottic carcinoma were 91.7% and 73.2%, respectively (p < 0.05). Univariate analysis revealed a prognostic significance for vocal cord fixation. T3 transglottic carcinoma was significantly correlated with vocal cord fixation. CONCLUSIONS: We suggest that surgery, either alone or in combination with postoperative radiation therapy, provides acceptable cancer control and survival rates for patients with T3 supraglottic carcinoma. Vocal cord fixation detected during preoperative fiberoptic laryngoscopy is a significant prognostic factor. T3 transglottic cancer needs more aggressive management.

Recurrent plunging ranula treated with OK-432.

A 36-year-old man was admitted who had a 2-month history of swelling of the right submandibular area and the right side of the mouth floor. He had undergone operations for right plunging ranula with a lesion on the floor of the mouth twice 7 years ago. Under fluoroscopic guidance, the contents of the cyst were aspirated as much as possible and injected with the same amount of OK-432 solution (Picibanil 0.1 mg; 10 ml) twice with 3-week intervals. Examination after 6 weeks showed that the cystic mass seen before therapy had disappeared completely, and no recurrence was encountered after 1 year. We here report a case in which a successful sclerotherapy with OK-432 for recurrent plunging ranula after surgery was performed.

A hybrid carcinoma of epithelial-myoepithelial carcinoma and adenoid cystic carcinoma in maxillary sinus.

Hybrid carcinoma of the salivary gland is a very rare entity that has been described only in the parotid and palate. The occurrence of a hybrid carcinoma of maxillary sinus has not been reported. The diagnosis of hybrid carcinoma is important particularly when the components of tumor have different biologic behaviors. Diagnosis and treatment require a high index of suspicion, especially when the tumor is an epithelial-myoepithelial carcinoma, pathological effort to look for a more aggressive accompanying tumor, and proper oncologic treatment. We describe a case of 26-yr-old woman with a hybrid carcinoma composed of epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component (cribriform pattern) in the right maxillary sinus with a brief review of the relevant literature.