扁桃体Kaposi’s肉瘤

已证实免疫抑制与Ｋａｐｏｓｉ＇ｓ肉瘤的发生发展有密切关系。艾滋病患者继发的恶性肿瘤中９５％为Ｋａｐｏｓｉ’ｓ肉瘤和淋巴瘤,但最初表现在扁桃体的Ｋａｐｏｓｉ’ｓ肉瘤则几乎未见报道。该文报告２例年轻成年男性ＨＩＶ阳性的Ｋａｐｏｓｉ’ｓ肉瘤,其主要症状为咽...     

与HIV相关的上呼吸道、消化道鳞状细胞癌

回顾１９８５～１９９４年间在纽约皇家医疗中心和长岛大学医院确诊且资料完整的上呼吸道、消化道鳞状细胞癌（ＳＣＣ）５３９例，将ＳＣＣ伴有人类免疫缺陷病毒（ＨＩＶ）感染列为一组，ＳＣＣ不伴ＨＩＶ感染列为对照组，对每个病人的年龄、性别、致癌因素（吸烟、饮酒）、ＨＩＶ感染、肿瘤部位、临床分期及治疗进行统计学分析处理，结果：４．５％（２４／５３９）病人伴有ＨＩＶ感染，且ＨＩＶ感染病人年龄明显低于无ＨＩＶ感染者（Ｐ＜０．０１），２１．３％小于４５岁，仅０．８％大于４５岁（Ｐ＜０．０１）；两组肿瘤的部位分布没有…     

艾滋病的耳鼻咽喉表现

目的总结艾滋病患者在耳鼻咽喉的临床表现.方法10例艾滋病的临床资料回顾性分析.结果10例艾滋病患者,有卡波氏肉瘤8例,颈部肿块8例,皮肤、口腔咽喉黏膜溃疡4例,上呼吸道梗阻行气管切开术2例,单侧慢性化脓性中耳炎者1例.结论艾滋病患者以咽喉、口腔部卡波氏肉瘤及黏膜溃疡出现最早,应引起高度警惕及重视.     

杆菌性血管瘤病:获得性免疫缺陷综合征的一种新病症

自1981年确认获得性免疫缺陷综合征(AIDS)以来,以前罕见的感染和新生物已变得日益普遍,杆菌性血管瘤病(BA)在1983年以前的文献中尚无描述,现在,就与人类免疫缺陷病毒(HIV)感染有关的皮肤表现而言,它仅次于卡波济氏肉瘤(KS)而居第二位。2例HIV携带者,因鼻中隔不愈合性或进行性溃疡在耳     

与爱滋病相关的喉部卡波济肉瘤

爱滋病（AIDS)是一种获得性免疫缺陷综合征,系人类免疫缺陷病毒（HIV）感染引起,卡波济肉瘤（Kaposi's sarcoma,KS)可作为HIV感染的肿瘤（AKS）,是爱滋病相关特征性疾病之一,约40％位于头颈部。现将1997年8月至1999年10月在赞比亚麦纳索科（Maiasoko)军医院授外工作中收治的AKS6例报道如下。     

无神经病学表现的人类免疫缺陷病毒阳性患者耳神经学和听觉脑干反应的表现

人类免疫缺陷病毒（ＨＩＶ）感染的神经病学表现（非晚期并发症）主要与ＨＩＶ在疾病早期的中枢神经系统（ＣＮＳ）定位有关。诱发电位（视觉、听觉和躯体党）和神经耳科学测试已证明在显示ＨＩＶ所致的亚临床ＣＮＳ功能紊乱方面十分敏感。本研究旨在通过脑干诱发电位（Ａ...     

爱滋病患者的口腔、咽及鼻部的早期表现

关于爱滋病(即获得性免疫缺陷综合征Ac-quired immunodeficiency syndrome,AIDS)的病因、流行病学及诊断标准已日趋明确。爱滋病的主要临床表现,如机会性感染、卡波肉瘤(KS)等亦已得到世人的共识。     

16例HIV感染者耳鼻咽喉科表现（摘要）

１６例ＨＩＶ感染者耳鼻咽喉科表现（摘要）范献良１９８９年８月～１９９１年８月在坦桑尼亚工作的２年间遇到在耳鼻咽喉科就诊的ＨＩＶ感染者１６例，报告如下。一、临床资料：１６例中男７例，女９例，除１例为３岁儿童外，其余都在１９～４０岁之间，平均２７．３岁；...     

艾滋病与卡波氏肉瘤

艾滋病是人类免疫缺陷病毒引起的一种获得性免疫缺陷综合征。HIV病毒进入人体后 ,侵入体内各种细胞 ,最主要的靶细胞是 T4 淋巴细胞 ,当 T4 淋巴细胞减少 ,人体免疫系统严重破坏 ,产生免疫缺陷 ,容易遭受某种机遇性感染和引起一些不常见肿瘤 ,如卡波氏肉瘤 (Kaposis sarcoma,KS)及 B细胞淋巴瘤。笔者于 1996年 6月至 1999年 6月在非洲博茨瓦纳首都玛丽娜公主医院及佛朗西医院工作期间 ,发现艾滋病卡波氏肉瘤17例 ,报告如下。1　临床资料。本组 17例 ,男 7例 ,女 10例 ,年龄 18～ 38岁 ,平均年龄 2 8.5岁 ,均为黑色人种。发现 HIV阳性为…     

7例HIV感染者耳鼻咽喉表现(摘要)

近年来 ,性传播疾病患者有所增加 ,尤其在非洲地区艾滋病发病率较高 ,但发生于口腔及咽喉部者较少见 ,首诊于耳鼻咽喉科的患者更为少见。 2 0 0 0年 8月～ 2 0 0 1年 10月我在援喀麦隆医疗队工作的 14个月间遇到的耳鼻咽喉科就诊的 HIV感染者 7例 ,为提高耳鼻咽喉科医师对本病的认识 ,现报道如下。7例中男 2例 ,女 5例 ,除 1例为 3岁儿童外 ,其余均在 19～ 4 0岁之间 ,均为黑色人种。 3例出现耳部表现 ,其中耳廓带状疱疹 2例 ,化脓性中耳炎 1例。咽喉部表现者 4例 ,其中卡波济肉瘤 2例 ,1例分布于软硬腭、舌根和咽弓 ,另 1例分布于软腭及…     

Primary Kaposi’s sarcoma of the nasal cavity not associated with AIDS

Kaposi’s sarcoma (KS) is an unusual vascular tumor characterized by multiple reddish blue nodules, which usually present on the skin of the lower and upper extremities. KS may also involve mucosal sites, lymph nodes and visceral organs. During the last two decades, with the large increase in the incidence of this tumor associated with the acquired immune deficiency syndrome (AIDS), there have been increasing number of cases with KS presenting on the skin or mucosa of the head and neck. A review of the literature revealed that only six cases of primary KS of the nasal cavity have previously been published and only one of them presented in a patient not associated with AIDS. We report the case of a 59-year-old woman who presented 4 years ago with nasal obstruction and intermittent minor epistaxes. Physical examination revealed the presence of a fleshy tumor arising from the left nasal septum, which was excised. Histological examination of the tumor showed morphological and immunohistochemical features of KS. A complete physical and laboratory examination revealed no other pathological findings. The patient received no further treatment and 4 years later, she is in excellent condition. In the present study, we report the second case where the primary manifestation of the KS was in the nasal cavity in a patient with an adequate immune system.     

Oropharyngeal kaposi sarcoma in related persons negative for human immunodeficiency virus

OBJECTIVES: Kaposi sarcoma (KS) is a vascular tumor that can affect the mucosa of the upper aerodigestive tract. Although KS is the most common malignancy in patients with acquired immunodeficiency syndrome, it is rare in immunocompetent persons. We describe an unusual presentation of KS in 2 related individuals and describe our attempts to determine whether oropharyngeal KS is associated with human herpesvirus 8 (HHV-8). METHODS: All relevant clinical and surgical information, including information on tumor histopathologic and human immunodeficiency virus (HIV) serologic tests, was abstracted from the patient charts and electronic databases. HHV-8 immunohistochemistry was performed on paraffin-fixed specimens. RESULTS: Both patient 1 and patient 2 (the nephew of patient 1) were referred for workup of a tonsillar mass that was pathologically confirmed to be KS. In each case, HIV serologic testing was negative, and a screening immunologic workup, including a quantitative natural killer cell count, a B- and T-lymphocyte count, and immunoglobulin analysis, also yielded findings that were within normal limits. Immunohistochemistry performed on 1 pathological specimen showed positive staining for the presence of HHV-8, the etiologic agent of KS. CONCLUSIONS: The presence of oropharyngeal KS in 2 related HIV-negative individuals supports a role for genetic factors in susceptibility to KS, a common exposure to an infectious agent such as HHV-8, or both. Whereas most KS cases in industrialized countries are associated with immunodeficiency, clinical and laboratory data do not suggest that either of the patients described in this report are immunodeficient. Their susceptibility to KS may be secondary to a subtle inherited defect in host resistance to HHV-8, or another unknown factor.     

Kartagener's syndrome. A blinded, controlled study of cilia ultrastructure

We investigated respiratory mucosa cilia ultrastructure in patients homozygous for the gene for Kartagener's syndrome (KS) and patients apparently phenotypic for KS who had bronchiectasis and sinusitis but without situs inversus. Parents, as obligate carriers of the recessive KS gene, were also evaluated among other control groups. The four patients with KS had significantly fewer cilia outer dynein arms than normal subjects or parents of patients with KS. Two of five patients apparently phenotypic for KS demonstrated distinctive ultrastructural changes. No other subjects demonstrated explicit ultrastructural abnormalities. Internal control specimens showed that the number of outer dynein arms was consistent within a subject compared with variation between subjects. The outer dynein arm serves as a dependable ultrastructural marker. Carriers of KS do not demonstrate distinctive morphologic cilia abnormalities. Not every patient with chronic bronchiectasis and sinusitis demonstrates abnormal cilia ultrastructure.     

Characterization of a chemotactic defect in patients with Kartagener syndrome

Kartagener syndrome (KS) is an autosomally inherited recessive condition characterized by situs inversus, bronchiectasis, and chronic sinusitis. Ciliary dynein, the mechanochemical force generator in ciliary movement, is deficient in patients with KS. We examined blood samples from two patients and tissue biopsy specimens from five patients and found: (1) no significant defect in neutrophil or monocyte chemotaxis in response to formylpeptide chemoattractant; (2) no alterations in centriolar structure, but significantly more centriole-associated microtubules in KS neutrophils and monocytes than in control leukocytes; and (3) a marked reduction in KS fibroblast chemotaxis in response to fibronectin compared with control fibroblasts. The significance of these cellular defects in KS is described.     

Is there a relation between mastoid aeration and Körner’s septum?

The purpose of this study is to investigate the prevalence of Körner’s septum (KS) in temporal bones with varying degrees of pneumatization and to evaluate any relationship between the degree of pneumatization and the presence of KS. Data were obtained retrospectively from 356 temporal bone high-resolution computed tomography of 178 patients who underwent tympanoplasty. Mastoid bone pneumatization was classified as aerated, diploic and sclerotic. The presence of Körner’s septum was also investigated. The relationship between the presence of Körner’s septum and the type of mastoid pneumatization was assessed. KS was encountered in 98 out of total 356 ears. Prevalence of KS was not statistically different between aerated (31%, n = 36), diploic (24.7%, n = 27) and sclerotic mastoids (26.9%, n = 35; p > 0.05). In conclusion, there is no relationship between the presence of KS and the degree of pneumatization. The presence of KS does not necessarily corroborate the presence of poor pneumatization.     

基于NK公式和KS公式预测ICL术后早期拱高的一致性研究

目的 探讨基于CASIA OCT的NK和KS公式预测有晶状体眼人工晶体术后拱高的一致性。 方法 前瞻性病例研究。选取植入ICL矫正中高度近视患者25例(50眼)。采用CAISA OCT分析术后1 d、1周、1个月拱高(Vault)变化情况以及NK、KS公式的预测拱高值和实际拱高值的差异以及一致性。各时间点拱高变化数据采用单因素重复测量方差分析。NK、KS公式预测拱高值和各时间点拱高差异采用配对t检验分析。NK、KS公式预测拱高值和各时间点一致性采用Bland-Altman分析。拱高与眼前节各参数之间采用多元线性回归进行分析。 结果 术后拱高随着时间的增加变低。术后1天和1周的拱高差异为(122.22±81.03)μm(P<0.001),术后1 d和1个月拱高差异为(169.04±84.20)μm(P<0.001),术后1周和1个月拱高差异为(46.83±45.70)μm(P<0.001)。NK公式预测值和术后第1天测出的实际拱高有统计学差异(P=0.001)。KS公式预测值和术后第1天和第1个月测出的实际拱高有统计学差异(P=0.013,P=0.009)。NK、KS公式预测值和术后第1周一致性最高。术后拱高和前房宽度、晶状体矢高以及角到角距离相关。NK公式的拱高预测值与术后第1天的拱高数值一致性要低于KS公式的拱高预测值与术后第1天的拱高预测值,与术后第1周、第1个月的拱高数值一致性要高于KS公式。 结论 ICL术后早期拱高随着时间的增加有降低的趋势。CASIA OCT的两种预测公式的术后拱高与术后第1周时的拱高一致性最高。NK公式能比较准确地预测术后拱高实际值,且NK公式在术后早期预测拱高方面要优于KS公式。     

Normal sense of smell in Kallmann syndrome. A case report

BACKGROUND: Kallmann's syndrome (KS) was first mentioned in 1944 as an association of anosmia and hypogonadotropic hypogonadism. Causes are multiple genetic defects the most common of which is the x-linked KS appearing mostly in men. However, autosomal dominant and autosomal recessive forms have also been described. PATIENT: We present a case of KS with normosmia (male, 39 years of age). All symptoms of hypogonadotropic hypogonadism were present. RESULTS: Psychophysical olfactory testing revealed left-sided anosmia with right-sided normosmia which was confirmed by electrophysiological measures of olfactory function. Magnetic resonance imaging indicated aplasia of the left olfactory tract and bulb, whereas the right-sided structures appeared to be normal. CONCLUSIONS: As indicated in this case with lateralized anosmia and contralateral normosmia, overall olfactory function strongly depends on the "best" nostril. Therefore, in many clinical situations, lateralized olfactory testing appears to be extremely important.     

Kaposi's sarcoma and community-acquired immune deficiency syndrome

Kaposi's sarcoma (KS), or idiopathic multiple hemorrhagic sarcoma, has heretofore been considered an indolent disease of the elderly, which also occurs in immunosuppressed hosts. Within the last two years, an epidemic of a community-acquired immune deficiency syndrome (AIDS) and disseminated KS has been reported in various population groups across the United States. The head and neck manifestations of KS in AIDS and our experience at UCLA are reviewed. Of 45 patients with AIDS, 18 (40%) had initial disease in the head and neck region. Most commonly, dermal lesions (44%), oropharyngeal lesions (39%), and cervical lymphadenopathy (33%) were noted. One patient had coexistent lymphoma. Six patients (33%) died of opportunistic infections. Head and neck lesions often herald more extensive disease. Early recognition of AIDS is important for complete patient evaluation as well as for personal safety.     

Ultrastructural abnormalities of the cilia in human nasal epithelia

Nasal mucosal cilia were observed with electron microscope in 14 patients with immotile cilia syndrome (ICS), 9 with nasal papilloma (NP), 23 with sinobronchial syndrome (SB), 2 with sinusitis combined with dextrocardia (SC), 1 with Kartagener's syndrome (KS), and 5 normal controls (C). Abnormalities such as complex cilia, cilia with abnormal axonemes and cilia with randomly oriented central microtubules were frequently found in the groups of ICS (8.1%) and NP (10.4%) while less in other groups: SB (4.9%), SC (5.3%), KS (4.7%) and C (3.9%). The percentage of cilia with defective dynein arms (DA) was the highest in the ICS group (94.0%), followed by the groups of SC (53.7%), SB (47.5%), NP (41.2%), C (35.8%) and KS (33.3%). The ICS group was found to be the largest in the number of defective DA per a cilium (4.1), followed by the groups of NP (1.0), SB (0.6), SC (0.7), KS (0.4) and C (0.4). Increased rates of defective DA were also recognized in cilia of tracheal mucosa and flagella of sperm in 7 patients with ICS examined. In conclusion, neither abnormal cilia nor defective DA of cilia are specific findings for ICS. However, when we observe these findings in high percentage in nasal mucosa as well as in other organs, we may define this condition as ICS.     

Retroviruses in Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS)

The ultrastructure of Kaposi's sarcoma (KS) of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS) was examined electron microscopically. The tumour consisted of pleomorphic vascular endothelial structures and spindle cell formations. The KS cells contained characteristically numerous multivesicular bodies, a large number of tubuloreticular structures and abundant Weibel-Palade bodies in their cytoplasm. Virus particles, 100-120 nm in diameter, were observed budding from the plasma membrane or as free particles already separated from the plasma membrane. Many mature virions manifested a dense cylindrical-shaped core. These virus particles and the human T-cell lymphotropic retroviruses subgroup HTLV-III are ultrastructurally identical. This report is based on recent immunological research.