Nozomi Nomi

Immunohistochemical detection of cervical lymph node micrometastases from T2N0 tongue cancer

Conclusions These results indicate that extensive, multiple cervical micrometastases occurred from an early stage in patients with T2N0 tongue cancer. The presence of micrometastases suggests the necessity of preventive neck dissection for Level I–IV nodes as a radical treatment. Objective Cervical lymph node metastases occur with a relatively high frequency in patients with T2N0 squamous cell carcinoma of the tongue, and control of the metastases greatly influences the prognosis of patients. In this study, micrometastases in the cervical lymph nodes were investigated to clarify the necessity and required extent of preventive neck dissection. Material and methods We investigated micrometastases in 24 subjects who had previously been diagnosed with T2N0 tongue cancer. We performed immunostaining with anti-cytokeratin antibody cocktail AE1/AE3 of sections of 401 paraffin-embedded lymph nodes obtained from these patients. Results Micrometastases were observed in 14 patients (58%) and were most abundant in Level II nodes (n=11; 46%). Micrometastases were observed in the Level IV nodes of 3 patients (13%), and upstaging to pN2b occurred in 7 patients (29%).

Th17 cells contribute to nontypeable Haemophilus influenzae-specific protective immunity induced by nasal vaccination with P6 outer membrane protein and α-galactosylceramide.

Nasal vaccination is an effective therapeutic means of preventing upper respiratory infection. Recently, nasal vaccination with P6 outer membrane protein of nontypeable Haemophilus influenzae (NTHi) and alpha‐galactosylceramide (α‐GalCer) was reported to induce NTHi‐specific protective immunity. The present study investigated the role of the Th17 cells induced by nasal vaccination. Mice were immunized with P6 and α‐GalCer, and their P6‐specific immune responses were examined. Cytokine‐producing cells were analyzed by flow cytometry, and expression of cytokines in P6‐specific CD4+ T cells was determined by reverse transcription‐polymerase chain reaction. Bacterial challenges were performed with live NTHi. To examine the role of Th17 cells, bacterial clearance was also evaluated after interleukin (IL)‐17 neutralization. P6‐specific nasal wash immunoglobulin (Ig) A and serum IgG were increased after immunization with P6 and α‐GalCer. Specific IgA‐producing cells increased markedly in the nasal passages (NPs) of the immunized mice. In addition to P6‐specific Th1 and Th2 cells, IL‐17‐producing Th17 cells were induced in the NPs and spleen. Bacterial clearance was enhanced by nasal vaccination. Interestingly, impaired NTHi clearance was shown after IL‐17 neutralization. These findings suggest that nasal vaccination with P6 and α‐GalCer is an effective regimen for the induction of NTHi‐specific protective immunity in the upper respiratory tract. In addition to antigen‐specific secretory‐IgA, specific Th17 cells induced by nasal vaccination contribute to protection against NTHi.

Expression of bone morphogenic protein in sinonasal inverted papilloma with new bone formation.

Inverted papilloma (IP) is a common benign tumor in the nose and sinus. Osteogenesis in sinonasal IP is extremely rare; to date, only five cases of IP with new bone formation appear in the literature. In addition, the mechanism of osteogenesis in IP remains unclear. Here, we describe three cases of IP with new bone formation and an investigation into a possible role for bone morphogenic protein (BMP) in osteogenesis. Of three patients with sinonasal IP with new bone formation, two were treated by endoscopic sinus surgery and one was followed up with watchful waiting. Tumor tissues were subjected to immunohistochemistry to detect BMP expression. The patients were successfully treated surgically and showed no evidence of recurrence postoperatively. Follow-up examination is ongoing. Immunohistochemically, the tumors expressed BMP-4 but not BMP-2 or BMP-7. ESS could be successfully used to achieve complete removal of the sinonasal IPs with new bone formation. BMP-4 might be associated with new bone formation in the tumor.

Correlation between anti-survivin antibody and survivin mRNA expression in head and neck cancer patients

Abstract Conclusions: Survivin may act as a major cancer antigen in head and neck cancer, and the present study revealed a link between systemic anti-survivin antibody responses and survivin expression in cancer tissues in patients with head and neck cancer. Objectives: Survivin is highly expressed in cancer cells, but is expressed at low levels or not at all in normal tissues. Little is known about the relationship between survivin expression and antibody responses to survivin in patients with head and neck cancer. Methods: Anti-survivin antibody responses in sera of head and neck cancer patients were investigated by enzyme-linked immunosorbent assay. The expression of survivin mRNA in the cancer tissues from larynx and hypopharynx was examined by quantitative RT-PCR. Results: Sera from 42 of 55 patients (76.4%) were positive for anti-survivin. High levels of anti-survivin were detected in patients in the advanced stage of disease. Most cancer tissues, but not normal adjacent tissues, expressed survivin mRNA, and a significant correlation between the levels of anti-survivin antibody in the serum and survivin mRNA in cancer tissues was detected.

Wegener's Granulomatosis with Extensive Bone Abnormalities Mimicking Fungal Sinusitis

Abnormalities of the underlying bone of the paranasal sinuses have sometimes been shown in Wegeners granulomatosis (WG). We describe an interesting case of WG with extensive bone abnormalities in the sinuses mimicking fungal sinusitis. A 30-year-old woman presented with intermittent unilateral epistaxis. Biopsy was performed for the granulation tissue in the right nasal cavity, and she was diagnosed as having WG. Computed tomography (CT) revealed a ring-like calcification, mimicking a fungus ball, in the right maxillary sinus. Endoscopic sinus surgery was performed to confirm the diagnosis. A spherical bony structure, surrounded by granulation tissue, was identified in the maxillary sinus. The wall of the “bony ball” was fragile, like an egg shell. No fungus was found in the sinus. Thus, the extensive bone abnormalities were due to WG.