抗人喉癌单克隆抗体对荷瘤裸鼠放射免疫定位显像的观察

目的 用喉癌裸鼠模型研究抗人喉癌单克隆抗体的免疫导向作用，为诊断和治疗提供依据和方向。方法 用高效碘标法标记三株混合抗人喉癌单克隆抗体（ＭｃＡｂＬＣ）经腹腔注入人喉癌裸鼠模型体内，用单光子发射计算机断层（ＥＣＴ）扫描显像并测定肿瘤、血液和组织单位质量浓集的放射性占注入总放射性的百分比（％ＩＤ／ｇ）和肿瘤与主要器官组织的放射性比值（Ｔ／ＮＴ）。结果 单克隆抗体在一定时限内能够选择性的浓集在移植瘤组织     

喉癌单克隆抗体三株混合应用检测喉癌组织及血清中喉癌相关抗原

为探讨喉癌相关抗原在喉癌组织及血清中的表达，采用自己研制的抗人喉癌单克隆抗体（ＭｃＡｂ）三株混合应用，分别以ＡＢＣ免疫组化法及ＥＬＩＳＡ双抗体夹心法对喉癌组织及血清中喉癌相关抗原进行检测。结果表明混合ＭｃＡｂ应用可使喉癌组织中喉癌相关抗原检出率由单一ＭｃＡｂ的８０．０％～８６．６％提高至９７．７％。喉癌患者血清中喉癌相关抗原水平明显高于正常对照组（Ｐ＜０．０１），且血清中喉癌相关抗原水平与临床分型、分期密切相关，随着肿瘤范围扩大，血清中喉癌相关抗原水平呈上升趋势。抗人喉癌混合ＭｃＡｂ特异性较高，敏感性较好，可以作为喉癌早期诊断、监测病情变化、判断预后的肿瘤标记物。     

突发性耳聋患者的局部脑血流断层显像研究

本研究旨在探讨局部脑血流（ｒＣＢＦ）断层显像与突发性感音神经性耳聋（简称突聋）的关系和临床价值。方法：对１０例正常志愿者,１９例传导性耳聋及３１例突聋患者在治疗前行ｒＣＢＦ显像并对比分析其显像特点,与同期ＣＴ对照,随访ｒＣＢＦ显像阳性的突聋患者６～１２月并再次行ｒＣＢＦ显像。结果：①突聋组ｒＣＢＦ显像阳性率（８０．６％）明显高于传导性聋组（５．３％）和正常组（０％）,其突聋组病灶与正常组织的放射性比值（Ｔ／ＮＴ）（０．５９６８±０．０９８２）明显低于传导性聋（０．９８０９±０．０２９１）和正常组（０．９９０８±０．０３１１）（均Ｐ＜０．０１）;而后两组间ｒＣＢＦ显像阳性率和Ｔ／ＮＴ值无显著性差异（Ｐ＞０．０５）;②ＣＴ对突聋的病灶位于颞横回检出率明显低于ｒＣＢＦ显像（Ｐ＜０．０１）;③突聋患者的Ｔ／ＮＴ值与耳聋的程度有较高的相关性;④ｒＣＢＦ显像呈缺血性改变的突聋患者预后（８１．８２％）优于梗塞性改变者（２１．４３％）（Ｐ＜０．０１）;⑤ｒＣＢＦ断层显像与临床预防观察有较高的一致性（９１．７％）。结论：ｒＣＢＦ断层显像对突聋的病灶检出明显高于ＣＴ,对突聋的诊断和鉴别诊断及预后有重要的临床价值     

喉癌引流淋巴结淋巴细胞在喉癌动物模型体内的分布

用氚标胸腺嘧啶核苷（￣３Ｈ－ＴｄＲ）标记人喉癌引流淋巴结淋巴细胞，转输入皮下接种人喉癌瘤系ＰＨＣ＿３的裸鼠体内，检测各脏器及肿瘤内的放射性强度而计算出标记细胞的分布百分率。结果发现转输后第１天３０．７％的标记细胞位于肝脏，肺、脾及肾也有少量分布。以后分布量逐周减少，到第４周末肝脏中仍有４．３％分布。而肿瘤中则始终只有极少量标记细胞存在。结果提示人喉癌引流淋巴结淋巴细胞对人喉癌没有专嗜性，不能聚集到肿瘤局部。活化淋巴细胞对肿瘤的杀伤机制除了直接接触杀伤外，还可能有更复杂的间接杀伤机制存在。     

喉癌相关抗原免疫电镜的定位研究

目的研究喉癌混合单克隆抗体相关抗原的定位,为喉癌的早期诊断及导向药物治疗奠定理论基础。方法采用三株喉癌单克隆抗体ＬＣ９、ＬＣ１１、ＬＣ１２混合对９０例病理证实的喉癌组织切片（病理Ⅰ级４９例,Ⅱ级４１例）、１４例喉癌前病变及１０例正常喉粘膜进行免疫组化染色（ＡＢＣ法）光镜观察,同时采用ＬＳＡＢ法对９例新鲜喉癌组织细胞行免疫过氧化物酶标记电镜包埋前染色,对混合单克隆抗体相应抗原进行超微结构的定位观察。结果喉癌组织中喉癌相关抗原检出率（９７．７％）与正常喉粘膜相比明显增高（Ｐ＜０．０１）;混合单克隆抗体相应抗原主要定位于细胞膜性结构,即细胞膜、核膜、线粒体膜和内质网膜。结论混合喉癌单克隆抗体具有良好的特异性,带有药物的单克隆抗体可通过膜性结构来攻击癌细胞,达到治疗作用。混合单克隆抗体检测的相关抗原均分布于细胞膜和／或细胞浆中,细胞核无着色。     

喉癌引流淋巴结淋巴细胞在喉癌动物模型体内的分布

用氚标胸腺嘧啶核苷（＾３Ｈ－ＴｄＲ）标民人喉癌引流淋巴结淋巴细胞，转输入皮下接种人喉癌瘤系ＰＨＣ３的裸鼠体内，检测各脏器及肿瘤内的放射性强度而计算出标记细胞的分布百分率。结果发现转输后第１天３０．７％的标记细胞位于肝脏，肺、脾及肾也有少量分布。以后分布量逐周减少，到第４周末肝脏有４．３％分布。面肿瘤中则始终只有极少量标记细胞存在。结果提示人喉、癌引流琳巴结淋巴细胞对人喉癌没有专嗜性，不能聚集到肿瘤     

喉癌组织雄激素受体测定及其意义

采用葡聚糖包被活性炭的放射性配体饱和分析技术（ＤＣＣ法）测定３３例喉癌组织中雄激素受体（ＡＲ）含量，并进行Ｓｃａｔｃｈａｒｄ饱和曲线分析。发现在喉癌组织中存在较高水平的ＡＲ，含量在３～１６．９ｆｍｏｌ／ｍｇ。ｐｒｏ之间（平均为１０±３．９ｆｍｏｌ／ｍｇ．ｐｒｏ），解离常数（Ｋｄ）为１．７×１０－９Ｍ。提示喉癌是类固醇性激素依赖性肿瘤；喉癌组织中ＡＲ对雄激素的超常需求，可能是ＡＲ含量增高并引起肿瘤恶性增殖的结果。用抗雄激素的内分泌疗法治疗喉癌可有一定疗效。     

维甲酸对人喉鳞癌裸鼠移植瘤的治疗观察

目的　寻求有效的喉癌辅助治疗方法,研究全反式（ａｌｌｔｒａｎｓ） 维甲酸（ ｒｅｔｉｎｏｉｃ ａｃｉｄ,ＲＡ）在体内的抗肿瘤作用。方法　利用人喉鳞癌瘤系ＰＨＣ３ 制造裸鼠喉癌模型（ 裸鼠１６ 只, 实验治疗组和对照组各８ 只） ,观察ＲＡ治疗荷喉癌裸鼠的疗效,并在光镜及透射电镜下观察ＲＡ 作用后肿瘤组织显微及超微结构,免疫组化检测肿瘤细胞ｃｍｙｃ 蛋白的阳性率。结果　治疗组肿瘤生长明显受到抑制,抑制率达５０％ 以上（ Ｐ＜ ０．０５）。光镜及透射电镜观察发现,ＲＡ 治疗组裸鼠移植人喉癌细胞有一定程度的良性趋向分化。免疫组化检测肿瘤细胞ｃｍｙｃ 蛋白的阳性率,治疗组（３４．０ ％ ±１０．６％ ） 与对照组（６０．５％ ±１５．２ ％） 相比差异有显著性（ Ｐ＜ ０．０１）。结论　维甲酸对裸鼠移植人喉癌有生长抑制及诱导分化作用,且与ｃｍｙｃ 癌基因及蛋白的调控有关。     

喉癌单克隆抗体三株混合应用检测喉癌组织及血清中喉癌相关…

为探讨喉癌相关抗原在喉癌组织及血清中的表达，采用自己研制的抗人喉癌单克隆抗体（ＭｃＡｂ）三株混合应用，分别以ＡＢＣ免疫组化法及ＥＬＩＳＡ双抗体夹心法对喉癌组织及血清中喉癌相关抗原进行检测。结果表明混合ＭｃＡｂ应用可使喉癌组织中喉癌相关的的检出率由单一ＭｃＡｂ的８０．０％￣８６．６％提高至９７．７％。喉癌患者血清中喉癌相关抗原水平明显高于正常对照组（Ｐ〈０．０１），且血清中喉癌相关抗原水平与临床分型     

喉癌中染色体9p21区域D9S319座位的杂合性丢失研究

为发现和定位新的抑癌基因提供线索和依据，应用聚合酶链反应检测了５４例喉癌（包括３例原位癌）组织中染色体９ｐ２１区域Ｄ９Ｓ３１９座位的ＤＮＡ微卫星多态标记的杂合性丢失（ｌｏｓｓｏｆｈｅｔｅｒｏｚｙｇｏｓｉｔｙ，ＬＯＨ）。结果：２例可提供信息的原位癌病例中ＬＯＨ频率为２／２，４４例可提供信息的浸润期喉癌病例中ＬＯＨ频率为６６％（２９／４４）。研究表明，在染色体９ｐ２１区域存在与喉癌发生发展密切相关的抑癌基因，该区域抑癌基因失活是喉癌发生发展的早发事件     

A Decrease in Maxillary Sinus Pressure,as Seen in Upper Airway Allergy or Infection,Results in an Increase in Upper Airway Nitric Oxide Levels

The paranasal sinuses are connected to the nasal cavity via small osties. Ostial occlusion, caused by mucosal swelling, will result in a slowly increasing negative pressure inside the sinus cavity. In parallel, the oxygen content in the sinus will decrease, resulting in the development of relative hypoxia. Hypoxia is a powerful inducer of nitric oxide (NO) synthase, and inducible NO synthase has been shown to be present in considerable amounts in the upper airways, including the sinuses. The present study was designed to investigate whether a reduction in sinus pressure would affect upper airway NO production. Thirteen healthy volunteers were investigated. A pressure chamber was used to lower the ambient pressure to-4.9 kPa. NO was sampled from one nostril or via a drainage tube inserted into the maxillary sinus before, during and after the hypobaric exposure. When the pressure was decreased, NO levels increased from 256 &#45 15 to 316 &#45 19 ppb ( n =13, p <0.001). The NO levels remained elevated (282 &#45 21 ppb; p <0.05) when measurements were repeated 20 min after leaving the chamber. The nasal airway resistance (V2 tot ) also increased as a result of the chamber session (from 16 &#45 2° before to 21 &#45 3° after; p <0.05). An increase in NO levels was also found when the experiments were repeated with NO sampled directly from the maxillary sinus (225 &#45 6 before and 265 &#45 9 ppb after; n =6, p <0.001). For control purposes the nasal analyses were repeated again, this time under hyperbaric conditions (+4.9 kPa). This resulted in a slight decrease in the NO levels (from 273 &#45 22 to 241 &#45 17 ppb; n =10, p <0.001), but there was no change in the nasal airway resistance. We conclude that a reduction in sinus pressure, as seen in upper airway allergy or infection, may result in an increase in upper airway NO production.     

One‐stop neck lump clinic: phase 2 of audit. How are we doing?

One‐stop neck lump clinic: phase 2 of audit. How are we doing? Regular monitoring and audit of a service are integral to ensuring maintenance of efficiency and standards. This is particularly important where the quality of the service is operator dependent, as is the case in the clinical diagnosis of neck lumps and fine needle aspiration cytology. The one‐stop neck lump clinic has now been running in the department for more than 20 months. A previous article described the results of the first phase audit carried out at 6 months and had identified a waiting time to be seen that was longer than that recommended by the British Association of Otorhinolaryngologists, Head and Neck Surgeons. Measures were implemented to reduce this waiting time and a second audit was carried out after another 10 months with the aims of assessing if modification of the means of referral reduces waiting time and if the outcomes of clinical performance in phase 1 could be maintained or improved. We discuss the results of phase 2 in the audit spiral.     

Physiologische Grundlagen einer Hörprothese

Zusammenfassung Im Bemühen, eine Hörprothese zu entwickeln, die ein Sprachverständnis erlaubt, erscheint es zumindest fürs erste am zweckmäßigsten, durch künstliche elektrische Reizung des Hörnerven die natürlichen Verhältnissen so gut als möglich zu imitieren. Der normale Hörnerv enthält etwa 30000 Nervenfasern, die sich qualitativ gleich, quantitativ jedoch unterschiedlich verhalten, wobei über die Eigenschaften der von den ÄHZ kommenden Spiralfasern im Augenblick sichere Aussagen nicht möglich sind (siehe 2.3). Die quantitativen Unterschiede zwischen den einzelnen Hörnervenfasern beziehen sich auf deren Frequenzabstimmung, Frequenzselektivität, Schwellen, Intensitätsfunktionen und — wichtig insbesondere für das Vorhaben einer künstlichen elektrischen Reizung — in Zeitunterschieden in den Aktivitätsmustern, die durch Laufzeitunterschiede auf der Basilarmembran bedingt sind (2.3). Diese Zeitunterschiede in der Aktivität einzelner Fasern liegen im Bereich mehrerer ms (2.3.6; 2.3.7). Die durch Schallreize im normalen Hörnerven ausgelösten Aktionspotentiale haben überdies einen probabilistischen Charakter, d. h. ihr Auftreten ist keineswegs streng determiniert. Es versteht sich von selbst, daß man bei künstlicher, elektrischer Reizung nicht alle verbliebenen Nervenfasern selektiv reizen kann. Somit wird eine Reizelektrode immer eine Gruppe von Nervenfasern erregen müssen. Bei jeder denkbaren elektrischen Reizung wären alle Fasern im Reizbereich einer Elektrode synchron und streng deterministisch aktiviert, was einen außerordentlich ernstzunehmenden Unterschied zu natürlichen Verhältnissen darstellt (3.2).Um die Zahl der zum Sprachverständnis mindestens notwendigen Reizkanäle abzuschätzen, wird man, in Ermangelung anderer experimenteller Daten, von psychoakustischen Untersuchungen an Normalhörenden auszugehen haben. Diese haben gezeigt, daß das Gehör neben einer außerordentlichen Fähigkeit verschiedene Tonhöhen zu unterscheiden, andererseits die Fähigkeit besitzt, bestimmte Frequenzgebiete zu sogenannten Frequenzgruppen zu integrieren. Die in eine solche Frequenzgruppe fallende Schallenergie wird zu einem einheitlichen Höreindruck verarbeitet. Es scheint also sinnvoll, die für einen Prothesenbau notwendige Zusammenfassung von Gruppen von Fasern des Hörnerven in verschiedene Reizkanäle entsprechend diesen Frequenzgruppen vorzunehmen (3.1). Demnach müßte der Sprachbereich in 15 Reizkanäle aufgeteilt werden, was wiederum, wenn man in der Cochlea reizen will, 1,2 mm Abstand von Kanal zu Kanal erlauben würde. Dabei müßte der Reizerfolg sauber auf die einzelnen Kanäle beschränkt bleiben, d.h. eine optimale Kanaltrennung erreicht werden. In Anbetracht der groben Abweichungen der neuronalen Aktivität vom normalen Verhalten, die bei künstlicher, elektrischer Reizung unvermeidlich sind, ist freilich unsicher, ob die angegebene Zahl ausreichen würde. Andererseits ist es in Anbetracht der zu erwartenden Stromverteilung im Sprachbereich kaum vorstellbar, mehr als die angegebene Zahl von Kanälen realisieren zu können.Was die Kodierung der Schallparameter innerhalb eines Elektrodenkanals betrifft, wird vorgeschlagen, die Frequenzkodierung nach dem Ortsprinzip optimal auszunutzen, und im Hinblick auf die Periodizitätsanalyse und die Lautheitskodierung sich soweit als möglich den natürlichen Verhältnissen anzunähern (3.3). Dabei wären Laufzeitunterschiede zwischen den Kanälen und der probabilistische Charakter der neuronalen Entladungen soweit als möglich einzuführen, um die Dominanz eines periodicity pitch zu vermeiden.Eine für Sprachverständnis ausreichende Prothese ist auch nur denkbar, wenn eine Prothese die zur Sprachübertragung notwendige Übertragungskapazität besitzt. Ergebnisse der Kanal-Vocoder-Technik zeigen, daß Sprache noch mit 1500 bit/s befriedigend übertragen werden kann. Eine Abschätzung der möglichen Leistungsfähigkeit einer 15-kanaligen Prothese (3.4), basierend auf der Zahl der möglichen unterscheidbaren Unterschiedsstufen der Hörempfindung, ergibt, daß diese Übertragungskapazität knapp erreicht werden könnte. Allerdings ist damit noch nicht gesagt, daß das Zentralnervensystem die angebotene Information auch im Sinne einer Phonemanalyse auswertet und damit für ein Sprachverständnis maximal ausschöpft. Nur für diesen Fall wäre ein Sprachverständnis zu erwarten.Als Reizort erscheint in erster Linie die Cochlea (5.1) geeignet. Für den Fall einer Degeneration der primären afferenten Fasern des Hörnerven ist aufgrund physiologischer Überlegungen auch der Nucleus cochlearis ventralis (5.5) interessant, allerdings würde so nur der ventrale Anteil der Hörbahn stimuliert. Doch besitzen auch andere Reizorte spezifische Vorteile (5.2–5.4).Theoretische Überlegungen (6.1) und experimentelle Messungen an implantierten Elektrodensätzen (6.3) zeigen, daß die Forderung der Kanaltrennung nur schwer zu erreichen sein wird. Deswegen wird der dynamische Bereich (im Hinblick auf Veränderung des Reizstromes) eines nach den obigen Kriterien konstruierten Reizkanals auf maximal 3 dB zu beschränken sein, so daß Erregungsausbreitung auf weitere Bereiche der Cochlea durch Ansteuerung von mehreren Reizkanälen zu imitieren wäre.Die Chancen, eine Prothese zu verwirklichen, die befriedigendes Sprachverständnis auf der Basis einer quasinatürlichen Reizung des Hörnerven erlaubt, wird von uns in Anbetracht der geschilderten mannigfaltigen Schwierigkeiten als sehr niedrig angesehen. In Anbetracht des großen Nutzens, der andererseits eventuell resultieren könnte, halten wir die Erforschung des Problems jedoch für angebracht.Es wird von uns vorgeschlagen, auch zu untersuchen, ob sich für eine prothetische Versorgung vorverarbeitete Sprache besser eignet (7.). Für Prothesen, die ein Sprachverständnis nicht anstreben, halten wir eine Implantation in die Cochlea für überflüssig. Hier erscheint uns die Implantation von Reizelektroden am runden Fenster (Douek et al., 1977; Fourcin et al., 1978; s. a. 1. und 7.) wegen des geringeren Risikos der überlegenere Weg.Die zitierten eigenen Arbeiten der Autoren wurden mit Unterstützung der DFG durchgeführt (DFG-K1 219).     

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF‐C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty‐two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow‐up was 2 years after radiotherapy. Expression of VEGF and VEGF‐C was evaluated by immunohistochemistry of formalin‐fixed, paraffin‐embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF‐C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF‐C (P < 0.001). In addition, the expression of VEGF‐C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF‐C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF‐C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.     

Limited Surgery for Cancer of the Larynx and Hypopharynx: Options and Consequences

We reviewed surgical options for laryngeal preservation (limited surgery) in laryngeal and hypopharyngeal cancers and the consequences of the options. Of 44 patients with laryngeal cancer, 11 (25%) received limited surgery and 33 (75%) received total laryngectomy. The survival rates were 91% for the limited surgery group and 73% for the total (radical) surgery group. Of 31 patients with hypopharyngeal cancer, 7 (23%) received limited surgery and 24 (77%) received total laryngopharyngectomy. The survival rates were 53% for the limited surgery group and 40% for the total (radical) surgery group. The survival rates associated with limited surgery were thus better than those for total (radical) surgery for cancers of both the larynx and hypopharynx. This was attributed to the limited surgery group comprising well-selected patients with confined lesions. Organ preservation surgery should be technically simple, reliable in terms of its functional impact and, above all, should not jeopardize the patient's survival. Supracricoid subtotal laryngectomy with cricohyoidoepiglottopexy or cricohyoido-pexy has great potential for laryngeal preservation and will become the major limited surgery modality for treating cancer of the larynx. Limited surgery, however, needs to be performed with great care and is indicated only for very well-selected patients with cancer of the hypopharynx.     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Cervical Reflex Induced by Click Stimuli in Cats

We studied click-evoked potentials in the anterior horn of the spinal cord in 17 cats. A concentric needle electrode was inserted into the anterior horn of the spinal cord at levels C3-C6. Potentials evoked with 105 dB SPL clicks were recorded with a peak latency of 4.89-5.10 ms only at the C3 level. These responses were observed 45-60 dB SPL above the auditory brainstem response (ABR) threshold, and no potentials were evoked by stimulation of the contralateral ear. Average was performed 100 times with changes in stimulation frequency of 1-20 Hz. The amplitude of the potentials decreased with increasing stimulus frequency, but there were no changes in ABRs. The responses disappeared after destruction of the medial vestibulospinal tract at the obex level, but ABRs were still recorded. The spinal nucleus of the accessory nerves was located in the anterior horn of the spinal cord at levels C1-C6, and the sternocleidomastoid muscle motoneurons were found at levels C1-C3. The click-evoked potentials recorded in this study reflect responses of the spinal nucleus of accessory nerves through the vestibulospinal tract to click stimulation. The responses have the same characteristics as vestibular-evoked myogenic potentials that can be recorded using surface electrodes over the sternocleidomastoid muscles of humans.     

A simple objective evaluation and grading for facial paralysis outcomes

Matrix metalloproteinase (MMP)-2 and -9 degrade type IV collagen, which is one of the major components of the basement membrane in normal tissue and expressed in the surroundings of the cancer nest in squamous cell carinoma. The degeneration of type IV collagen is an essential step in the metastasis to lymph nodes and distant organs. In this study, we examined MMP-2 and -9 levels of cancer tissue and serum obtained from patients with head and neck squamous cell carcinoma (HNSCC) in order to evaluate the relationship between the clinicopathologic features and MMPs. We examined the production of MMP-2 and -9 in cancer tissue homogenates of 73 patients who had HNSCC and the serum MMP levels of 16 patients with HNSCC and 8 healthy volunteers. We also studied the localization of MMP-2 in the carcinoma using an immunohistochemical approach. The concentrations of MMP-2 and -9 in the tissue homogenates and serum were measured by means of a sandwich enzyme immunoassay using a monoclonal antibody. Immunohistochemical analyses were performed with monoclonal antibody to MMP-2. The concentration of MMP-2 in the tumor tissue homogenates was unrelated to tumor size, but that in patients with lymph node metastases was significantly higher than in those without lymph node metastases. The concentration of MMP-9 was unrelated to lymph node metastasis and tumor size. The levels of both MMP-2 and -9 in serum were unrelated to lymph node metastasis. Immunohistochemistry indicated that MMP-2 was mainly expressed in cancer cells. Because MMP-2 degrades type IV collagen, the level of MMP-2 in carcinomas may be a useful indicator of the degree of invasion and metastasis.     

A case of cortical deafness and anarthria

The nasal epithelium protects the underlying tissue from damage. Epithelial cell growth is controlled by epidermal growth factor (EGF) and is possibly affected by toxic proteins, e.g. eosinophil cationic protein (ECP). The aims of this study were to examine nasal fluid epithelial cell counts and their relations to EGF, eosinophils and ECP in 23 patients with seasonal allergic rhinitis and 20 healthy controls. Nasal fluid epithelial cell counts were lower in patients than in controls. EGF levels did not differ between patients and controls, and correlated with epithelial cell counts in controls but not in patients. Eosinophils and ECP were higher in patients than in controls, but did not correlate with epithelial cell counts. The role of growth factors, such as EGF, in regulating epithelial cells merits further study.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.