Tumor size measured by preoperative ultrasonography and postoperative pathologic examination in papillary thyroid carcinoma: relative differences according to size, calcification and coexisting thyroiditis.

Ultrasonography (US) is a useful diagnostic modality for evaluation of the size and features of thyroid nodules. Tumor size is a key indicator of the surgical extent of thyroid cancer. We evaluated the difference in tumor sizes measured by preoperative US and postoperative pathologic examination in papillary thyroid carcinoma (PTC). We reviewed the medical records of 172 consecutive patients, who underwent thyroidectomy for PTC treatment. We compared tumor size, as measured by preoperative US, with that in postoperative specimens. And we analyzed a number of factors potentially influencing the size measurement, including cancer size, calcification and coexisting thyroiditis. The mean size of the tumor measured by preoperative US was 11.4, and 10.2 mm by postoperative pathologic examination. The mean percentage difference (US-pathology/US) of tumor sizes measured by preoperative US and postoperative pathologic examination was 9.9 ± 19.3%, which was statistically significant (p < 0.001). When the effect of tumor size (≤10.0 vs. 10.1-20.0 vs. >20.0 mm) and the presence of calcification or coexisting thyroiditis on the tumor size discrepancy between the two measurements was analyzed, the mean percentage differences according to tumor size (9.1 vs. 11.2% vs. 9.8%, p = 0.842), calcification (9.2 vs. 10.2%, p = 0.756) and coexisting thyroiditis (17.6 vs. 9.5%, p = 0.223) did not show statistical significance. Tumor sizes measured in postoperative pathology were ~90% of those measured by preoperative US in PTC; this was not affected by tumor size, the presence of calcification or coexisting thyroiditis. When the surgical extent of PTC treatment according to tumor size measured by US is determined, the relative difference between tumor sizes measured by preoperative US and postoperative pathologic examination should be considered.

Detection of pneumolabyrinth after temporal bone trauma using computed tomography.

CONCLUSION: Pneumolabyrinth is a very rare condition, even in otic capsule disrupting (OCD) fracture. Hearing was not always impaired, even in cases with OCD fracture. The co-existence of pneumocochlea, regarded as a risk factor for total hearing loss, was extremely rare in cases of pneumolabyrinth. OBJECTIVES: The purposes of this study were to analyze the radiological and clinical features in patients with pneumolabyrinth and to overcome the diagnostic pitfalls encountered during pneumocochlea detection. MATERIALS AND METHODS: The temporal bone computed tomographies (TBCT) of 402 patients diagnosed with temporal bone fracture along with their clinical records were retrospectively reviewed. RESULTS: Only six patients (7% of those with OCD fractures or 1.5% of those with temporal bone fracture) were found to have pneumolabyrinth. Locations of the pneumolabyrinth were in the vestibule in all six cases and three of them showed air densities both in the cochlea and semicircular canal. The size of the air density in the vestibule was 5.38 ± 4.56 mm(2) at the axial view and 6.57 ± 5.67 mm(2) at the coronal view. The mean minimal Hounsfield unit (HU) of air density area in the vestibule was -968.1 ± 22.94 at the axial view and -941 ± 16.88 at the coronal view. Patients with pneumocochlea eventually developed total hearing loss.

Intracochlear Bleeding Enhances Cochlear Fibrosis and Ossification: An Animal Study.

The aim of this study was to investigate the effects of intracochlear bleeding during cochleostomy on cochlear inflammatory response and residual hearing in a guinea pig animal model. Auditory brainstem response threshold shifts were greater in blood injected ears (p<0.05). Interleukin-1ß, interleukin-10, tumor necrosis factor-α and nitric oxide synthase 2, cytokines that are related to early stage inflammation, were significantly increased in blood injected ears compared to normal and cochleostomy only ears at 1 day after surgery; with the increased IL-1ß being sustained until 3 days after the surgery (p<0.05). Hair cells were more severely damaged in blood injected ears than in cochleostomy only ears. Histopathologic examination revealed more extensive fibrosis and ossification in blood injected ears than cochleostomy only ears. These results show that intracochlear bleeding enhanced cochlear inflammation resulting in increased fibrosis and ossification in an experimental animal model.

Association of p21-activated kinase-1 activity with aggressive tumor behavior and poor prognosis of head and neck cancer.

BACKGROUND: This study investigated the role of p21-activated kinase (PAK)-1 in progression of head and neck squamous cell carcinoma (HNSCC). METHODS: We examined PAK isoforms and explored whether PAK activation enhanced in vitro invasion of the HNSCC cell line. We analyzed the relationship between PAK1 expression and various clinicopathological features and investigated the effect of PAK1 overexpression on survival in 119 patients with HNSCC. RESULTS: PAK1 and PAK2 are predominantly expressed in HNSCC cells and patient tissues. Particularly, PAK1 makes the dominant contribution to increase in cell migration and invasion. There was a statistically significant correlation between PAK1 overexpression and aggressive cancer behavior. Moreover, PAK1 seemed to be a prognostic factor for overall and disease-specific survival in patients. Interestingly, enhancement of PAK1 expression was found in the invasive front of cancer. CONCLUSION: PAK1 is associated with the aggressive tumor behavior and poor prognosis of head and neck cancer.