• Title/Summary/Keyword: oropharynx

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A Case Report of Synchronous and Metachronous Quintuple Primary Malignant Tumors (동시성 및 이시성 5중 원발암의 증례 보고)

  • Jung Hyeon Lee;Hye ki Cho;Dong Kee Jang;Hyoun Woo Kang;Jae Hak Kim;Yun Jeong Lim;Jun Kyu Lee
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.36-39
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    • 2018
  • Multiple primary cancer is defined as two or more malignant neoplasms in a single individual. The incidence of multiple primary cancer is likely to increase due to earlier and accurate diagnosis and prolonged life span. Above all, the incidence of quintuple primary malignant tumors is reportedly extremely rare. Herein, we present a case of 65-year-old who had quintuple primary cancers of the liver, rectum, nasopharynx, oropharynx and hypopharynx.

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Serogroup and Antimicrobial Resistance of Streptococcus pneumoniae Isolated from Oropharynx in Children Attending Day Care Center (유아원 소아의 구인강에서 분리된 폐구균의 혈청군과 항균제 내성에 관한 연구)

  • Kim, Kyung Hyo;Lee, Jong Eun;Whang, Il Tae;Ryu, Kyung Ha;Hong, Young Mi;Kim, Gyoung Hee;Lee, Keun;Kang, Eun-Suk;Hong, Ki-Sook
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.346-353
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    • 2002
  • Purpose : Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. Methods : From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. Results : The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. Conclusion : The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.

A Case of Massive Empyema Caused by Streptococcus constellatus and Anaerobic Bacteria for Mental Retardation (정신지체환자에서 발생한 Streptococcus constellatus와 혐기성 균에 의한 거대 농흉 1예)

  • Kim, Kyeong-Hyun;Kim, Se-Hyun;Heo, Jeong-Won;Lee, Sang-Hoon;Han, Seon-Sook;Lee, Seoung-Joon;Kim, Woo-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.476-479
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    • 2011
  • The Streptococcus milleri group, which also includes S. anginosus, S. intermedius and S. constellatus, is found in the oropharynx, upper respiratory tract, gastrointestinal tract, and urogenital tract mucosa. Bacteria in the Streptococcus milleri group are associated with bacteremia and abscess formation. Most of the reports of of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions. Predisposing factors that have been associated with S. milleri group empyema include mucosal disturbances (sinusitis, periodontal disease, enteric disease), preceding to pneumonia, thoracic surgery, malignancy, neurological disease, alcohol abuse, and also diabetes mellitus. We report on a 42-year-old man with mental retardation. He who suffered from dyspnea and a fever that he had developed for over 14 days. S. constellatus and anaerobic bacterias (Prevotella buccae and Micromonas micros) were cultured. The patient was treated with the drainage of pleural effusion and clindamycin and levofloxacin.

Three-dimensional analysis of pharyngeal airway change of skeletal class III patients in cone beam computed tomography after bimaxillary surgery

  • Kwon, Young-Wook;Lee, Jong-Min;Kang, Joo-Wan;Kim, Chang-Hyen;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.9-13
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    • 2012
  • Introduction: To evaluate the 3-dimensional changes in the pharyngeal airway of skeletal class III patients after bimaxillary surgery. Materials and Methods: The study sample consisted of 18 Korean patients that had undergone maxillary setback or posterosuperior movement and mandibular bilateral sagittal split osteotomy setback surgery due to skeletal class III malocclusion (8 males, 10 females; mean age of 28.7). Cone beam computed tomography was taken 1 month before and 6 months after orthognathic surgery. Preoperative and postoperative volumes of the nasopharyngeal, oropharyngeal, and laryngopharyngeal airways and minimum axial areas of the oropharyngeal and laryngopharyngeal spaces were measured. Moreover, the pharyngeal airway volume of the patient group that had received genioplasty advancement was compared with the other group that had not. Results: The nasopharyngeal and laryngopharyngeal spaces did not show significant differences before or after surgery. However, the oropharyngeal space volume and total volume of pharyngeal airway decreased significantly (P<0.05). The minimum axial area of the oropharynx also decreased significantly. Conclusion: The results indicate that bimaxillary surgery decreased the volume and the minimum axial area of the oropharyngeal space. Advanced genioplasty did not seem to have a significant effect on the volumes of the oropharyngeal and laryngopharyngeal spaces.

Extrapulmonary Small Cell Carcinoma - a Case Series of Oropharyngeal and Esophageal Primary Sites Treated with Chemo-Radiotherapy

  • Sahai, Puja;Baghmar, Saphalta;Nath, Devajit;Arora, Saurabh;Bhasker, Suman;Gogia, Ajay;Sikka, Kapil;Kumar, Rakesh;Chander, Subhash
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7025-7029
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    • 2015
  • Background: The optimal sequence and extent of multimodality therapy remains to be defined for extrapulmonary small cell carcinoma because of its rarity. The purpose of our study was to assess the response to neoadjuvant chemotherapy followed by chemoradiation/radiation in patients with extrapulmonary small cell carcinoma. Materials and Methods: Four consecutively diagnosed patients were included in this study. The primary tumor site was oropharynx in three patients and esophagus in one. The patients with the limited disease were treated with chemotherapy followed by concurrent chemoradiation (n=2) or radiotherapy (n=1). The patient with the extensive disease with the primary site in vallecula was treated with chemotherapy and palliative radiotherapy to the metastatic site. Results: The median follow-up was 22.5 months (range, 8-24 months). Three patients with the limited disease (base of tongue, n=2; esophagus, n=1) were in complete remission. The patient with the extensive disease died of loco-regional tumor progression at 8 months from the time of diagnosis. Conclusions: The combination of chemotherapy and radiotherapy is the preferred therapeutic approach for patients with extrapulmonary small cell carcinoma. Induction chemotherapy followed by concurrent chemoradiation or radiation provides a good loco-regional control in patients with limited disease.

Oral and Pharyngeal Cancer Among the Arab Population in israel from 1970 to 2006

  • Zini, Avraham;Nasser, Nasser;Vered, Yuval
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.585-589
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    • 2012
  • Background: Israeli Arabs are considered as a developing society characterized by poverty and high levels of smoking among men. The purpose of this study was to describe their incidence, mortality and survival rates for oral and pharyngeal cancer between the years 1970-2006. Studies such as this in the Arab world, where the population is almost the same as the Arab population in Israel, are rare. Methods: The incidence and survival data were derived from all relevant registered data at the National Cancer Registry. The group of lesions included cancer of the lips, tongue, buccal mucosa, floor of the mouth, salivary glands, gums, palate and pharynx. Morphological description was according to WHO classification. Results: Most diagnosed patients were male. The mean age was 54.4 years, and mean years of survival were 3.83. The oropharynx was the most common site (28.3%) while the palate was the least frequent (3.12%). Squamous cell carcinoma (SCC) was the most common histological feature (66.3%), while basal cell carcinoma (BCC) was the least (3.9%). The overall 5 years survival rate was 59.4%, this being highest for BCC (82.1%), while SCC was significantly lower (56.2%) (p<0.001). Lip cancers survived better than other sites. Conclusions: Data from this society are similar to other developing societies in the majority of the results. The incidence of oral and pharyngeal cancer is lower among the Arab population, in comparison to the Jewish population in Israel.

Investigation of the effects of miniscrew-assisted rapid palatal expansion on airflow in the upper airway of an adult patient with obstructive sleep apnea syndrome using computational fluid-structure interaction analysis

  • Hur, Jae-Sik;Kim, Hyoung-Ho;Choi, Jin-Young;Suh, Sang-Ho;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.353-364
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    • 2017
  • Objective: The objective of this study was to investigate the effects of miniscrew-assisted rapid palatal expansion (MARPE) on changes in airflow in the upper airway (UA) of an adult patient with obstructive sleep apnea syndrome (OSAS) using computational fluid-structure interaction analysis. Methods: Three-dimensional UA models fabricated from cone beam computed tomography images obtained before (T0) and after (T1) MARPE in an adult patient with OSAS were used for computational fluid dynamics with fluid-structure interaction analysis. Seven and nine cross-sectional planes (interplane distance of 10 mm) in the nasal cavity (NC) and pharynx, respectively, were set along UA. Changes in the cross-sectional area and changes in airflow velocity and pressure, node displacement, and total resistance at maximum inspiration (MI), rest, and maximum expiration (ME) were investigated at each plane after MARPE. Results: The cross-sectional areas at most planes in NC and the upper half of the pharynx were significantly increased at T1. Moreover, airflow velocity decreased in the anterior NC at MI and ME and in the nasopharynx and oropharynx at MI. The decrease in velocity was greater in NC than in the pharynx. The airflow pressure in the anterior NC and entire pharynx exhibited a decrease at T1. The amount of node displacement in NC and the pharynx was insignificant at both T0 and T1. Absolute values for the total resistance at MI, rest, and ME were lower at T1 than at T0. Conclusions: MARPE improves airflow and decreases resistance in UA; therefore, it may be an effective treatment modality for adult patients with moderate OSAS.

Update of Head and Neck Cancer Staging in the 8th Edition Cancer Staging Manual of the American Joint Committee on Cancer (두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판)

  • Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.9-15
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    • 2017
  • The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

Retropharyngeal Abscess and Acute Descending Necrotizing Mediastinitis by a Traumatic Perforation of Pharynx (외상에 의한 인두천공 후 발생한 후측인두부농양 및 급성하행 괴사성 종격동염 1례)

  • Han, Kyung In;Jung, Dae Gun;Kim, Eugene;Oh, Chang Kyu;Hur, Jae Kyun
    • Pediatric Infection and Vaccine
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    • v.13 no.1
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    • pp.78-84
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    • 2006
  • Retropharyngeal abscess and descending necrotizing mediastinitis is a potentially life-threatening condition that rarely develops following trauma to the oropharynx in children. We describe a case of a 17-month-old girl with a retropharyngeal abscess that extended to the posterior mediastinum, producing an acute descending necrotizing mediastinitis and pyopneumothorax. Culture of blood and pleural pus yielded Streptococcus pyogenes. The patient underwent repeated drainage and debridement, was treated with antibiotics and recovered. This report aims to review the retropharyngeal abscess with descending necrotizing mediastinitis in children and to highlight the fact that minor pharyngeal trauma, although not significant at first, should be observed with suspicion for serious potential complications.

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Genetic and biological characteristics of recent Korean isolates of avian influenza virus subtype H9N2

  • Acharya, Madhav Prasad;Kwon, Hyuk-Joon;Kim, Il-Hwan;Lee, Youn-Jeong;Kim, Jae-Hong
    • Korean Journal of Veterinary Research
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    • v.52 no.4
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    • pp.223-230
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    • 2012
  • The worldwide distribution and continuing genetic mutation of avian influenza virus (AIV) has been posed a great threat to human and animal health. A comparison of 3 isolates of AIV H9N2, A/chicken/Korea/KBNP-0028/00 (H9N2) (KBNP-0028), A/chicken/Korea/SNU8011/08 (H9N2) (SNU 8011) and an inactivated oil vaccine strain A/chicken/Korea/01310/01 (H9N2) (01310), was performed. The former 2 AIVs were isolated from field cases before and after the application of an inactivated H9N2 vaccine in 2007, respectively. The antigenic relationship, viral shedding, tissue tropism and genetic analysis were examined. The comparison of virus shedding from the cloaca and the oropharynx revealed that both isolates were more frequently isolated from the upper respiratory tract (90~100%) 1 day post inoculation (DPI) compared with isolation 5 DPI from gastrointestinal tracts (10~60%). Moreover, the isolate KBNP-0028 were recovered from all organs including bone marrow, brain and kidneys, indicating higher ability for broad tissue dissemination than that of SNU 8011. KBNP-0028 replicated earlier than other strains and with a higher titer than SNU 8011. In full-length nucleotide sequences of the NA gene and a partial sequence of the HA gene of SNU 8011, we found that there might be significant changes in tissue tropism, virus replication and genetic mutation in AIV H9N2 isolates.