Bong-Jae Lee

Prediction of prognosis using standardized uptake value of 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography for nasopharyngeal carcinomas

PURPOSEnTo evaluate the prognostic significance of 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography ([(18)F]FDG-PET) at diagnosis by calculating maximal standard uptake values (SUV(max)) in patients with non-disseminated nasopharyngeal carcinoma (NPC) receiving concurrent chemo-radiotherapy (CCRT).nnnMATERIALS AND METHODSn[(18)F]FDG-PET was performed in 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT. [(18)F]FDG uptake by primary tumors and neck nodes was measured with the SUV(max).nnnRESULTSnComplete response occurred in all 41 patients. The ten patients who presented with any component of treatment failure had a significantly higher SUV(max) than the remaining patients. The median SUV(max) of all patients was 6.48 (range: 2.31-26.07). Patients having tumors with high [(18)F]FDG uptake (median or greater) had a significantly lower 3-year disease free survival (DFS) rate than patients with lower tumor [(18)F]FDG uptake (less than median) (51% vs 91%, P=0.0070). Patients with an SUV(max) below 8 had a higher DFS than patients with an SUV(max) of 8 or greater.nnnCONCLUSIONn[(18)F]FDG uptake, as measured by the SUV(max), may predict DFS in CCRT-treated NPC. High [(18)F]FDG uptake may be useful for identifying patients requiring more aggressive treatment.

Prognostic Value of Tumor 18F-FDG Uptake in Patients with Untreated Extranodal Natural Killer/T-Cell Lymphomas of the Head and Neck

Although 18F-FDG PET has been used to monitor patients with lymphoma, its usefulness has not been determined in patients with extranodal natural killer/T-cell lymphoma (ENKTL). Therefore, we evaluated whether pretreatment 18F-FDG uptake was a predictor of survival in patients with ENKTL of the head and neck. Methods: Pretreatment staging work-ups, including whole-body 18F-FDG PET, were performed on 21 patients with previously untreated head and neck ENKTL. Fourteen patients received combined chemoradiotherapy (n = 14), and 7 received chemotherapy or radiotherapy alone. We assessed the relationship of maximum standardized uptake value (SUVmax) of the tumor to disease-specific survival (DSS) and to clinical parameters, including sex, age, Ann Arbor stage, performance status, International Prognostic Index score, presence of B symptoms, lactate dehydrogenase level, local tumor invasion (LTI), and lymph node involvement. Results: Mean tumor SUVmax was 5.5 and was significantly higher in patients with elevated lactate dehydrogenase level, LTI, or poor response to initial therapy (P < 0.05). All 5 nonresponders to therapy had an SUVmax greater than 5.5, whereas 11 of 16 responders (69%) had an SUVmax less than or equal to 5.5 (mean SUVmax, 8.4 vs. 4.5). Univariate analysis showed that an International Prognostic Index score greater than or equal to 2, LTI, and SUVmax category were significant predictors of 3-y DSS, although only the SUVmax category remained an independent determinant of DSS on multivariate analysis (P = 0.023). Conclusion: High tumor 18F-FDG uptake was closely associated with local tumor invasion, contributing to unfavorable treatment and survival outcomes in patients with ENKTL of the head and neck.

Natural Course of Retention Cysts of the Maxillary Sinus: Long‐Term Follow‐Up Results

Objectives: Retention cysts of the maxillary sinus are an incidental finding on radiographs. These cysts usually appear as rounded, dome‐shaped, soft tissue masses, most often on the floor of the maxillary sinus. The aim of this study was to investigate the long‐term natural course of retention cysts of the maxillary sinus.

Tutoplast-Processed Fascia Lata for Dorsal Augmentation in Rhinoplasty:

OBJECTIVE: Tutoplast-processed fascia lata (TPFL) is a commercially available homograft, which has been successfully used as human graft tissue for physical support procedures. The present report evaluates the use of TPFL in rhinoplasty. STUDY DESIGN AND SETTING: The study involved a retrospective analysis of rhinoplasty cases using TPFL. The study population consisted of 69 patients (52 male and 17 female) and a minimum follow-up of 12 months. RESULTS: TPFL was used as a smoothening graft after correction of deviated and hump noses, as a major dorsal contouring graft for saddle or flat noses, and in secondary rhinoplasty following silicone implant complications. TPFL alone was used in 41 cases and in combination with other material in 28 cases. The only complication was major resorption in three cases, with two being secondary rhinoplasty patients. CONCLUSION: TPFL alone or in combination with other materials can be used as a dorsal augmentation material in rhinoplasty. TPFL was particularly useful for correction of dorsal irregularities and in cases requiring a minimal amount of augmentation.

Organized hematoma of the maxillary sinus

OBJECTIVE: Organized hematoma of the maxillary sinus can develop by means of organization of hematoma in the unaerated maxillary sinus. To our knowledge, this is only the second article describing organized hematoma in the maxillary sinus. MATERIAL AND METHODS: We have observed eight cases of organized hematoma of the maxillary sinus recently and here we describe the clinical features (using CT scans and medical records), radiologic characteristics and pathologic findings. RESULTS: The patients comprised five males and three females (mean age 58 years), all of whom had a history of frequent epistaxis. They also complained of nasal obstruction, hyposmia, headache and swollen cheeks. Rhinoscopy revealed obliterated nasal cavities due to bulging lateral walls. CT scans showed soft-tissue densities expanding the maxillary sinus into the nasal cavity. The treatment modalities used (applied either alone or in combination) were Denkers operation, Caldwell-Lucs operation and endonasal endoscopic surgery, and the outcomes were successful. CONCLUSION: Organized hematoma should be included in the differential diagnosis when patients have frequent epistaxis and an expansile mass in the maxillary sinus.

Organized Hematoma of the Maxillary Sinus: CT Findings

OBJECTIVEnOrganized hematoma of the maxillary sinus is rare. It occurs by organization of the hematoma in an unaerated maxillary sinus. The purpose of this study was to evaluate the CT features of this lesion.nnnCONCLUSIONSnOrganized hematoma should be included in the differential diagnosis when patients have recurrent epistaxis and an expansile mass in the maxillary sinus.

Detection of rhinovirus in turbinate epithelial cells of chronic sinusitis.

Background In contrast to the well-established association of rhinovirus (RV) with acute sinusitis, little is known about the role of RV infections in the pathogenesis of chronic sinusitis. Therefore, we assayed the nasal cavity mucosae of chronic sinusitis patients lacking signs of acute viral infection for the presence of RV. Methods Nasal lavage fluids and turbinate epithelial cells from 39 sinusitis patients and 27 control subjects were tested. Turbinate epithelial cells were collected using a Rhino-probe mucosal curette. Picornavirus was assayed by an initial reverse-transcription polymerase chain reaction (PCR), and picornavirus-positive samples were assayed by nested reverse-transcription PCR to detect RV. Results All lavage fluids from both groups, as well as control epithelial cells, were negative for picornavirus. In contrast, 8 of 39 (21%) epithelial cell samples from sinusitis patients were positive for picornavirus. RV-specific nested-PCR revealed that all eight of these samples were positive for RV. Conclusion The detection of RV in the turbinate epithelial cells of chronic sinusitis patients suggests that RV may be important in the pathogenesis of chronic sinusitis.

Levocetirizine inhibits rhinovirus-induced ICAM-1 and cytokine expression and viral replication in airway epithelial cells

Levocetirizine inhibits the production of intercellular adhesion molecule (ICAM)-1 and secretion of interleukin (IL)-6 and IL-8, which may have beneficial effects on the pathophysiologic changes related to human rhinovirus (HRV) infection. We investigated the effects of levocetirizine on rhinovirus infection in primary human nasal epithelial cells (HNEC) and A549 cells. Cells were treated with different concentrations of levocetirizine, ranging from 0.5, 5 or 50nM, either starting at the time of infection and continuing thereafter, or beginning 24h before infection and continuing thereafter. Levocetirizine treatment inhibited the HRV-induced increase in ICAM-1 mRNA and protein levels, as well as the HRV-induced expression of IL-6 and IL-8 mRNA and protein levels. Viral titer, as measured by culture in MRC-5 cells, was reduced by levocetirizine. Levocetirizine treatment also reduced the increased nuclear factor-kappa B (NF-kappaB) expression seen with HRV infection. Levocetirizine inhibited the expression of Toll-like receptor (TLR)3 mRNA and protein levels. These findings indicate that, in HNEC and A549 cells, levocetirizine inhibits HRV replication and HRV-induced upregulation of ICAM-1, IL-6, and IL-8, TLR3 expression and NF-kappaB activation. The results of this study suggest that levocetirizine may have a possible clinical application in the treatment of airway inflammation caused by HRV infection.

Organizing hematoma of the maxillary sinus

Objective The study aims to elucidate the clinical features and surgical results of OHMS (organizing hematoma of the maxillary sinus). Study Design and Setting We performed a chart review of 20 patients undergoing surgery for maxillary sinus lesions and pathologically diagnosed with OHMS between January 1990 and December 2005. Results The most common complaint was frequent epistaxis (70%). Paranasal CT scans showed unilateral expansile maxillary opacification, heterogeneous enhancement, bony destruction (25%), and focal calcification (15%). Treatment consisted of a sublabial approach combined with endonasal endoscopic surgery (50%), endonasal endoscopic surgery alone (45%), and Denkers operation (5%). All patients had a successful outcome without recurrence. Conclusion Conservative surgical approaches such as sublabial or endonasal endoscopic surgery alone or in combination lead to excellent outcomes without recurrence. We propose the term “OHMS” to better describe this rare pathology. Significance Our report is the largest series of OHMS to date.

Clinical features and prognostic model for extranasal NK/T‐cell lymphoma

The clinical features of extranodal natural killer (NK)/T‐cell lymphoma (ENKL) that originates in extranasal sites are less well defined than those of ENKL that originates in nasal sites. Therefore, we compared the clinical characteristics and prognoses of patients with nasal ENKL and patients with extranasal ENKL.