Cyclooxygenase-2 expression in Warthin's tumour.

OBJECTIVES: To determine whether cyclooxygenase-2 (COX-2) is overexpressed in Warthin's tumours, and to characterize its pattern of expression. METHODS: Twenty-one paraffin-embedded Warthin's tumour specimens were analysed by immunohistochemical staining for expression of human COX-2. Semi-quantitative analysis of the staining was performed. RESULTS: In all of the specimens, we found that there was overexpression of COX-2 within the epithelial component of the tumours, with no expression in the lymphoid components. There was also overexpression of COX-2 in the salivary duct system of normal parotid tissue. CONCLUSIONS: Our results suggest that COX-2 is up-regulated in the epithelial component of Warthin's tumours. Our findings support the hypothesis that Warthin's tumours originate from heterotopic ductal epithelial cells of the parotid gland. The role of COX-2 expression in the pathogenesis of Warthin's tumours remains to be determined.

Microbiology of chronic suppurative otitis media in Singapore.

The objective of the study was to study the microflora and the antibiograms of patients with chronic suppurative otitis media (CSOM) in Singapore. Ninety patients with CSOM were prospectively studied. They had chronic ear discharge and had not received antibiotics for the previous five days. Swabs were taken, and cultured for bacteria. Antibiotic testing was done using modified Kirby Bauer disk diffusion method. In addition to the usual antibiotics, the three most common topically available antibiotics (chloramphenicol, gentamicin and neomycin) were tested. There were 135 positive cultures for organisms from the 90 patients. The most common causal organisms isolated were Pseudomonas aeruginosa (33.3%) and Staphylococcus aureus (33.3%) followed by coagulase negative Staphylococcus (21.1%). Fungi accounted for 8.8% of isolates while 6.6% were anaerobes. Of the three antibiotics commonly available as topical eardrops, gentamicin has the highest susceptibility rate (82.6%), followed by neomycin (67.8%) and chloramphenicol (62.8%).

Head and neck cancer after foreign body ingestion.

INTRODUCTION: Ingestion of a foreign body is a common occurrence in our population. We present 2 cases that illustrate an unusual outcome of an otherwise usual occurrence. CLINICAL PICTURE: Two patients who presented with a history of ingestion of fish bones were worked up. The radiological findings were suspicious of a foreign body and both underwent examination under general anaesthesia. The endoscopic findings were normal. After further evaluation for persistent calcifications with computed tomography, a thyroid malignancy was found in the first patient and tongue cancer in the second patient. TREATMENT: The first patient underwent elective hemithyroidectomy and the second underwent wide excision of the tumour with neck dissection. OUTCOME: Both recovered uneventfully with regular follow-up in the outpatient clinic. CONCLUSION: There should be a high index of suspicion in patients with persistent calcifications.