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OBJECTIVE The present study seeks to estimate the potential of multifrequency tympanometry in the diagnosis of primal otologic disorder in children with adenoid hypertrophy (AH). STUDY DESIGN Prospective observational study. SETTING Tertiary pediatric institution. PATIENTS One hundred thirty-one children presenting consecutively at the otolaryngology clinic were divided on the basis of AH into 98 patients and 33 controls. INTERVENTIONS Middle ear status was assessed using pneumatic otoscopy, standard, and wide band tympanometry. MAIN OUTCOME MEASURES Tympanogram type/intratympanic pressure, and resonance frequency (RF) were correlated with each other as well as with a set of clinical parameters. Receiver operating characteristic analysis was employed to reveal the diagnostic value of RF. RESULTS Mean RF declined in chronic otitis media with effusion by 43.25% (p

In the present study, we evaluated the expression of JUNB and CXCR4 in circulating tumor cells (CTCs) of lung cancer patients and investigated whether these proteins have prognostic clinical relevance. Peripheral blood from 30 patients with non-small-cell lung cancer (NSCLC) was filtered using ISET membranes, and cytospins from 37 patients with small-cell lung cancer (SCLC) were analyzed using confocal and VyCAP microscopy. Both JUNB and CXCR4 were expressed in the vast majority of lung cancer patients. Interestingly, the phenotypic patterns differed between NSCLC and SCLC patients; the (CK+/JUNB+/CXCR4+) phenotype was present in 50% of NSCLC vs. 71% of SCLC patients. Similarly, the (CK+/JUNB+/CXCR4–) was present in 44% vs. 71%, the (CK+/JUNB–/CXCR4+) in 6% vs. 71%, and the (CK+/JUNB–/CXCR4–) phenotype in 38% vs. 84%. In NSCLC, the presence of ≥1 CTCs with the (CK+/JUNB+/CXCR4+) phenotype was associated with worse progression-free survival (PFS) (p = 0.007, HR = 5.21) while ≥2 with poorer overall survival (OS) (p < 0.001, HR = 2.16). In extensive stage SCLC patients, the presence of ≥4 CXCR4-positive CTCs was associated with shorter OS (p = 0.041, HR = 5.01). Consequently, JUNB and CXCR4 were expressed in CTCs from lung cancer patients, and associated with patients’ survival, underlying their key role in tumor progression.

In the COVID-19 era, extreme measures of social distancing have contained the spread of common viral respiratory infections, which are involved in the pathogenesis of Adenotonsillar Hypertrophy (ATH), and Chronic Otitis Media with Effusion (COME), the two commonest chronic ENT diseases of childhood. This study examines the lockdown effect on the number of procedures performed for these two conditions.The consecutive charts of 650 and 195 children being operated respectively for ATH and COME during the quarantine (05/2020-02/2021) and unrestrained (05/2019-02/2020) periods were retrospectively reviewed. Surgical treatment of ankyloglossia, performed in 103 patients during the same periods was employed as a control procedure.Adenotonsillectomies and tympanostomies significantly decreased in the lockdown phase by 52% (P 0.001) and 74% (P 0.001), respectively, whereas control procedure counts increased by 25%. In terms of seasonal variation, ATH-related surgeries were significantly reduced during the winter season of the pandemic by 73% (P 0.001), in comparison with the corresponding months of the unrestrained period. School-aged children received significantly fewer operations for ATH (-59%) than preschoolers (-42%), as a result of the lockdown (P = 0.044).When the child's exposure to respiratory pathogens is minimal, as in the case of lockdown, a noticeable decline occurs in the incidence of ATH and COME indicated for surgical treatment. Chronic low-grade inflammation, boosted by repetitive viral infections seems to underlie both conditions. Timely, effective isolation measures might reverse the disease process and keep the child away from the Operating Room.

Objectives/Hypothesis: Invasive squamous cell carcinomas (SCC) of the larynx, like most solid tumors, are surrounded by a reactive stroma, in which cancer associated fibroblasts (CAFs) are the predominant cell type. This mesenchymal reaction may affect cancer progression multiply. The proinflammatory enzyme cyclooxygenase-2 (COX-2) has been correlated with head and neck cancer. This study aims to explore the impact of epithelial and stromal COX-2 expression on SCC behavior. Study Design: Retrospective case review study performed in a tertiary health center institution. Methods: Double immunohistochemistry of COX-2 and the CAF marker α-smooth muscle actin (α-SMA) was utilized in 97 laryngeal cancer patients. Follow-up data were collected in 52 cases. Results: Low COX-2 immunostaining in cancer cells was associated with advanced grade (P = .044) and shorter recurrence-free period (P = .035). CAF expression was positively correlated with the grade of the infiltrating tumor (P = .030). Conclusions: In laryngeal SCCs, COX-2 may exert its deleterious effect by alterations in the tumor microenvironment. CAF-derived, COX-2-mediated paracrine influences on malignant cells possibly facilitate cancer progression. Overlooking the stromal remodeling could account for unsuccessful treatments of epithelial neoplasms. Laryngoscope, 2009

Invasive squamous cell carcinomas (SCC) of the larynx, like most solid tumors, are surrounded by a reactive stroma, in which cancer associated fibroblasts (CAFs) are the predominant cell type. This mesenchymal reaction may affect cancer progression multiply. The proinflammatory enzyme cyclooxygenase-2 (COX-2) has been correlated with head and neck cancer. This study aims to explore the impact of epithelial and stromal COX-2 expression on SCC behavior.Retrospective case review study performed in a tertiary health center institution.Double immunohistochemistry of COX-2 and the CAF marker alpha-smooth muscle actin (alpha-SMA) was utilized in 97 laryngeal cancer patients. Follow-up data were collected in 52 cases.Low COX-2 immunostaining in cancer cells was associated with advanced grade (P = .044) and shorter recurrence-free period (P = .035). CAF expression was positively correlated with the grade of the infiltrating tumor (P = .030).In laryngeal SCCs, COX-2 may exert its deleterious effect by alterations in the tumor microenvironment. CAF-derived, COX-2-mediated paracrine influences on malignant cells possibly facilitate cancer progression. Overlooking the stromal remodeling could account for unsuccessful treatments of epithelial neoplasms.

Squamous cell carcinomas (SCCs) of the larynx are sequelae of hyperplastic and dysplastic lesions. Epidermal growth factor receptor (EGFR) is found frequently overexpressed in SCCs of the head and neck, although its regulatory role is not fully elucidated. Conversely, retinoid X receptor alpha (RXRalpha) mediates the reversing effects of retinoids on head and neck carcinogenesis. We examined the expression of EGFR in relation to the progress of laryngeal tumorigenesis and how this association is modulated by concurrent RXR presence.A retrospective study.A basic research anatomy laboratory, operating within a tertiary care institution.Tissue samples from 129 patients with premalignant or malignant laryngeal lesions.Paraffin-section immunohistochemistry.EGFR immunoreactivity in relation to histopathology progression, in both the presence and absence of RXR immunoexpression.EGFR was upregulated along the epithelial deterioration toward neoplasia (p.001) but was unaffected by tumour grade. In RXRalpha-positive cases, a markedly stronger induction of EGFR occurred with malignant transformation compared with the epithelia immunonegative for the nuclear receptor.This study suggests that RXRalpha confers to squamous cells a shielding effect against excessive mitogenic stimulation, which might be EGFR dependent. RXR-positive patients manifesting resistance to anti-EGFR agents could benefit from rexinoid administration.