Th1 Th2, Tc1 Tc2 cells of patients with otolaryngological diseases

ABSTRACTCytokines are important regulatory mediators secreted by T cells and other immunoactive cells. Based on the cytokine synthesis patterns, CD4 T cells can often be classified into at least two populations with different immune regulatory functions. The Th1 cells, producing interleukin (IL)-2 and interferon (IFN)-γ, are often associated with cell-mediated immune responses such as delayed type hypersensitivity (DTH), whereas Th2 cells, secreting IL-4, IL-5 and IL-13, usually provide B cell help and enhance allergic reactions. Naïve CD8 T cells, similar to CD4 T cells, can differentiate into at least two subsets of cytolytic effector cells with distinct cytokine patterns. The Tc1 cells secrete a Th 1 - like cytokine pattern, including IL-2 and IFN-γ. The Tc2 cells produce Th2 cytokines, including IL-4, IL-5 and 11—10. There is increasing evidence that Th1/Th2 and Tc1/Tc2 cytokine imbalance has been of patho- genetic importance in various diseases, such as allergic and autoimmune diseases. The present review article focuses on the evidence that the imbalance of Th1/Th2 and Tc1/Tc2 cytokines plays an important role in various otolaryngological diseases, such as Kimura's disease, Wegener's granulomatosism, acute perceptive hearing loss and Meniere's disease. It is concluded that the predominance of Th 1 or Th2 and Tc1 or Tc2 cells may contribute to the mechanism in the pathogenesis of these otolaryngological diseases

Brain Abscess as a Rare Complication of Primary Extranodal Nasal-type Natural Killer/T-cell Lymphoma

We present the case of a 58-year-old Japanese woman with a natural killer T (NK/T)-cell lymphoma complicated by brain abscess. NK/T-cell lymphomas represent a rare type of lymphoma derived from either activated NK cells or, rarely, cytotoxic T cells. They are aggressive Epstein-Barr virus (EBV)-associated lymphomas that involve mainly the nasal cavity. Brain abscess associated with primary extranodal nasal-type NK/T-cell lymphoma is extremely uncommon: to our knowledge, this is the first reported case of this lymphoma with brain abscess as the initial clinical manifestation. Endoscopic surgery was performed for definitive diagnosis under intraoperative navigation system. Chemotherapy followed by radiotherapy was performed and was effective: 72 months later the tumor has not recurred. Recommendations of endoscopic management for diagnosis and treatment of this rare neoplasm are discussed

Serum Concentrations of Eosinophil Cationic Protein and Eosinophils of Patients with Kimura's Disease

ABSTRACTBackground: To clarify the role of eosinophils in the pathogenesis of Kimura's disease and the values of measuring serum levels of eosinophil cationic protein (ECP) for monitoring disease activity might be very important, but there are few reports about this matter.Methods: A total 14 serum and 7 tissue samples from patients with Kimura's disease were studied. The concentrations of ECP and cytokines (interleukin-4 (IL-4), granulocyte-macrophage colony-stimulating factor (GM-CSF), and interleukin 5 (IL-5)) in sera from patients with Kimura's disease were measured by enzyme-linked immunosorbent assay (ELISA). The density of eosinophils and the degree of activation of eosinophils in the tissue were also studied immunohistochemically.Results: The concentration of ECP in sera from patients with Kimura's disease was significantly higher than that in the control group (p<0.05). At the time of the remission, a significant decrease of ECP was observed. In interfollicular areas, most infiltrated eosinophils were positive for EG2 antibody (64.0-94.0%) and the mean percentage of EG2-positive eosinophils was 75.7%. The concentrations of IL-4, gM-CSF, and IL-5 in sera from patients with Kimura's disease were within normal ranges or below the detectable level in all sera examined.Conclusions: Our findings suggest that eosinophils play an important role in the pathogenesis of Kimura's disease and ECP may be used as an additional parameter of disease activity

Case Report Carbon Ion Beam Radiotherapy for Sinonasal Malignant Tumors Invading Skull Base

Objective. To evaluate the treatment outcome and prognostic factors in patients with sinonasal malignant tumors invading skull base. Study Design and Setting. A retrospective clinical study at the Yamagata University School of Medicine. Subjects and Methods. Three patients with sinonasal malignant tumors invading skull base were presented in present study. All patients were treated with carbon ion beam radiotherapy. The prescribed dose to the center of the clinical target volume was 64.0 GyE/16 fractions over 4 weeks at 4.0 GyE/fraction per day. Results. All patients completed carbon ion beam radiotherapy without an interval. The mean observation period was 39.6 months (range: 11-54 months). There were no local or regional recurrences in all cases; however, one patient had a metastasis in distant organs. Regarding the complications, visual loss was observed in one eye of one patient whose optic nerve was entirely involved by the tumor and field of carbon ion beam radiotherapy. Radiation induced brain injury was observed in two patients; however, these patients do not complain about neurological abnormality and had no treatment for radiation induced brain necrosis. Conclusions. Carbon ion beam radiotherapy for sinonasal malignant tumors invading the skull base showed therapeutic effectiveness

EVALUATION OF PERIVENTRICULAR HYPODENSITY IN ADULT HYDROCEPHALUS WITH CT CISTERNOGRAPHY AND XENON-ENHANCED CT

Metrizamide CT cisternography and Xeon enhanced CT were employed to evaluate the periventricular hypodensity (PVH). CT cisternography was performed on adult cases with suspected communicating hydrocephalus, of which 43 cases showing ventricular reflux were investigated. In those cases in which significant transition of metrizamide into the area of PVH was followed after the ventricular reflux and stasis, the shunt operation was effective. The PVH disappeared post-operatively. However, in cases with PVH in which the metrizamide penetration did not occur, the PVH did not disappear post-operatively and clinical improvement was not detected. Xenon-enhanced CT was performed in six cases. Three cases exhibited communicating hydrocephalus, in which the area of PVH was not enhanced by metrizamide with CT cisternography. The other cases demonstrated acute high pressure hydrocephlaus. The PVH in the former cases was neither enhanced by Xenon nor metrizamide, while the latter was enhanced significantly. Studies suggested that the reversible PVH was the result of an abnormally increased transition of cerebrospinal fluid through the ependymal layer, while the irreversible PVH resulted from the axonal destruction or demyelination of the periventricular white matter