Neutrophil-to-lymphocyte ratio associates with nutritional parameters, intratumoral immune profiles, and clinical outcomes of pembrolizumab in head and neck squamous cell carcinoma.

BACKGROUND: The relationship between the tumor-immune microenvironment and systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), is unclear. METHODS: We examined the characteristics of systemic inflammatory markers and tumor immune microenvironments in relation to treatment outcomes in 29 consecutive patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) who received pembrolizumab, using 14-marker multiplex immunohistochemistry and image cytometry. RESULTS: NLR ≥4.5 (high NLR) at pretreatment status significantly correlated with short overall survival (OS) and progression-free survival-2 (PFS2) and malnutrition status. High NLR in peripheral blood was significantly correlated with low lymphoid cell and high tumor-associated macrophage counts in tissues, especially myeloid-to-lymphoid cell ratios, suggesting an association between circulating and intratumoral immune complexity profiles. CONCLUSIONS: This study suggests a link between NLR in circulating blood, systemic nutritional status, and immune composition within the tumor.

A Case of Esophageal Submucosal Abscess Originating from a Peritonsillar Abscess.

We report the case a 54-year-old male patient who was admitted to our hospital with a sore throat and evidence of a high inflammatory reaction. Computed tomography revealed a peritonsillar abscess extending from the inferior right tonsil to the cervical esophagus, and thickening of the esophageal wall. The pharyngeal abscess was drained through an intraluminal incision in the mesopharynx. Culture of the abscess fluid showed growth of Streptococcus constellatus, one of the organisms of the Streptococcus milleri group. We diagnosed the patient as having phlegmonous esophagitis secondary to peritonsillar abscess. The inflammation was judged to have extended to the submucosal space of the esophagus from the pharyngeal mucosal space. Since the inflammation was contained within the esophageal wall and did not progress to mediastinitis, critical symptoms did not appear and the patient improved through conservative management with antibiotics

Laryngeal stenosis in a patient with severe congenital neutropenia.

OBJECTIVES/HYPOTHESIS: We report the first case of laryngeal stenosis with granuloma in a patient with severe congenital neutropenia (SCN). STUDY DESIGN: Case report and retrospective review. METHODS: Review of medical records. RESULTS: A 6-year-old female who was diagnosed with SCN presented with a cough and wheezing. An endoscopic study revealed laryngeal stenosis with granuloma. Tracheotomy and direct laryngoscopy were performed under general anesthesia, and administration of granulocyte colony-stimulating factor was started. The laryngeal granuloma disappeared 3 weeks later, and the tracheal stoma was closed. CONCLUSIONS: Presence of a laryngeal lesion should be considered in SCN patients with persistent airway symptoms.

K(+)-Cl(-) cotransporter 1 (KCC1) negatively regulates NGF-induced neurite outgrowth in PC12 cells.

Potassium chloride cotransporters (KCCs) mediate electroneutrally-coupled transport of K(+) and Cl(-), and play crucial roles in various cell functions including regulation of cell volume and homeostasis of cellular Cl(-)content. Four isoforms of KCCs (KCC1, 2, 3, and 4) have been identified. KCC1 is ubiquitously expressed, whereas KCC2 is mainly expressed in neuronal cells of central nervous system. KCC3 is highly expressed in heart, skeletal muscle, kidney, lung and placenta. KCC4 is mainly expressed in epithelial cells. In this study, we investigated roles of KCCs in NGF-induced neurite outgrowth of rat pheochromocytoma PC12 cells. The most abundantly expressed isoform in PC12 cells was KCC1. Inhibition of KCCs using [(dihydronindenyl)oxy] alkanoic acid (DIOA), an inhibitor of KCCs, enhanced the NGF-induced neurite outgrowth of PC12 cells in a dose-dependent manner. Treatment of PC12 cells with NGF significantly decreased mRNA expression of KCC1, whereas other isoforms, KCC2-4, showed no changes in their mRNA expression in response to NGF treatment. Knockdown of KCC1 using small interfering RNA (siRNA) enhanced the NGF-induced neurite outgrowth. These results suggest that KCC1 negatively regulates the NGF-induced neurite outgrowth of PC12 cells.