Howard S McGuff

Setup and characterization of a human head and neck squamous cell carcinoma xenograft model in nude rats

OBJECTIVE: To develop and characterize a new head and neck cancer animal model. STUDY DESIGN: A human head and neck squamous cell carcinoma (HNSCC) xenograft model in nude rats was established via subcutaneous inoculation of a human-origin HNSCC cell line, SCC-4. The tumor was evaluated for growth characteristics, pathologic features by hematoxylin-eosin (HE) staining, and immunohistochemistry of epidermal growth factor receptor (EGFR). 2-[18F] fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET) imaging characteristics were studied too. RESULTS: A new HNSCC animal model was successfully established. Tumor sizes reached about 1 cm3 on day 15 after tumor cell inoculation. HE staining pathology has confirmed that this tumor is a typical SCC. EGFR immunohistochemistry demonstrated this tumor model to be strongly EGFR positive. 18F-FDG PET study has shown that 18F-FDG accumulated in tumors. CONCLUSIONS: This study has demonstrated that this tumor model is an appropriate HNSCC tumor model for animal studies on HNSCC.

Leiomyosarcoma of the larynx : Case report

Leiomyosarcoma involving the larynx is extremely rare and may be difficult to diagnose. Likewise, because of the rarity of this lesion, little information exists with regard to long-term follow-up or optimal management. Reported here is a review of the literature and a case report of a patient with leiomyosarcoma of the larynx treated by surgery alone with 5 years of follow-up.

Securing meshed split-thickness skin grafts with 2-octylcyanoacrylate.

Meshed split-thickness skin grafts (STSGs) secured with 2-octylcyanoacrylate (2-OCA) were compared with meshed STSGs secured by suture and bolster (S&B). The 2 techniques were compared for graft survival, foreign-body giant cell response, inflammatory response, appearance, texture, and application time. Sixteen 2.5 × 2.5 cm meshed STSGs were harvested from the dorsa of 2 pigs for a total of 32 grafts. On each pig 8 grafts were sprayed with 2-OCA, and the other 8 were secured with S&B. Evaluations were performed on postoperative days 14, 24, 48, and 56. Biopsy specimens were obtained on postoperative days 14 and 56. There were no significant differences in percent survival, foreign-body giant cell response, inflammatory response, and appearance between control and study grafts. The average time to apply the 2-OCA onto a graft was 3 seconds, compared with 8 minutes for S&B application. 2-OCA provides a quick and reliable means of securing meshed STSGs and would be especially useful in areas where it is difficult to use S&B, such as total maxillectomy defects.

Rhinoscleroma: A Case Report and Update on Medical and Surgical Management

Objectives: Rhinoscleroma is a chronic, progressive, granulomatous infection caused by Klebsiella rhinoscleromatis. The bacteria can infect the upper and/or lower airways, with the sinonasal cavity being affected 95%-100% of the time. We present the case of a 42-year-old Hispanic man who presented with Stage 3 rhinoscleroma, resulting in nasopharyngeal, glottic, and subglottic stenosis. Methods: The patient was taken to the operating room for direct microlaryngoscopy. A posterior cordotomy of the left vocal fold and laser radial incisions/dilation of the subglottis were performed along with topical application of Mitomycin-C. Results: Biopsies of the nasopharygeal and subglottic lesions showed inspissated mucin with foamy histiocytes, gram negative bacilli, and acute and chronic inflammation with fibrosis. Cultures were positive for Klebsiella rhinoscleromatis, sensitive to gatifloxacin. These pathological findings were consistent with Stage 3 rhinoscleroma. The patient was treated with a 6-month course of gatifloxacin. Purulent rhinorrhea and airway difficulties were improved at 6 weeks and resolved at 6 months. Conclusion: We report a case of synchronous rhinoscleromatous lesions. A combination treatment of surgical laser debridement, Mitomycin-C and long-term fluoroquinolones appears to be effective in treating this condition. There are 3 stages of rhinoscleroma and with prompt recognition and early treatment, the natural history of the disease can be halted. The advantages of fluoroquinolones over traditional antibiotic treatment for this condition (tetracycline) include low incidence of side effects, once daily dosing and concentration within the macrophages, the region of bacterial replication. When surgical treatment is necessary, stenosis can be effectively managed with CO2 laser treatments and Mitomycin-C.