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ABSTRACT: Adenocarcinoma of the prostate (CAP) is a rare diagnosis in men younger than 50 years of age; this age group accounts for less than 0.1% of all patients with prostatic cancer. Left supraclavicular lymphadenopathy (LSCL) as the presenting symptom of metastatic CAP is even rarer. No cases of CAP presenting as LSCL in men younger than 45 years have been reported in the literature. Here we report a 42-year-old male with the uncommon presentation of CAP as LSCL. In adult males with persistent LSCL, even if younger than 45 years, measurement of serum prostate specific antigen is warranted at the time of initial presentation, and the lymph node biopsy should be subsequently stained for prostate specific antigen immunohistochemically. These examinations are crucial to establish a definitive diagnosis of CAP and, in turn, to institute appropriate management and achieve the best possible outcome.
Journal of the Chinese Medical Association 12/2011; 74(12):570-3. · 0.79 Impact Factor
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ABSTRACT: Varicella zoster virus (VZV) infection of the head and neck region may present with various clinical symptoms, involving different entities and different routes of viral spreading. We present a case of VZV infection of the pharynx and larynx with multiple cranial nerve (CN) neuropathies (CN VII, VIII, IX, and X) of a 52-year-old woman who complained of the sudden onset of hoarseness, odynophagia, dysphagia, and hearing loss in the left ear, followed by left-side facial weakness lasting for 1 week. Endoscopic examination revealed multiple mucosal erosions over the oropharynx, with extension upward to the nasopharynx and downward to the mucosa overlying the epiglottis, arytenoid, and vocal cord. All of these lesions tended to lateralize to the left side, suggesting a VZV infection diagnosis; this was confirmed by polymerase chain reaction on eruptional exudates, as well as serologic examination.
The Laryngoscope 07/2011; 121(8):1627 - 1630. · 1.75 Impact Factor
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Canadian Medical Association Journal 05/2011; 183(11):1276-9. · 8.22 Impact Factor
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ABSTRACT: The incidence of head and neck cancers in patients with an initial presentation of deep neck infection is unclear and may be underestimated. Thus, the aim of this study was to assess the incidence of head and neck cancers initially manifested as deep neck infection. Also, the possible risk factors and pathophysiology are discussed. This study was a retrospective medical chart review in a tertiary referral center. A total of 81 consecutive patients admitted with a diagnosis of deep neck infection over a 46-month period were analyzed. The demographic data, physical examinations, laboratory findings, radiographic studies, and pathology report were analyzed. Among the 81 deep neck infection patients, head and neck cancers were histologically demonstrated in four patients (4.9%) with the initial symptom of a painful neck mass. The incidence of head and neck cancer initially manifested as deep neck infection was found to increase in patients aged over 40 years (6.7%; 3/45 vs. 2.8%; 1/36). A detailed history of all patients with deep neck infection should be taken. Furthermore, endoscopic examination, thyroid examination and routine pathological examination should be performed, especially in those aged over 40. Also, careful explanation to the patient and his/her family about the possibility of underlying head and neck cancer (incidence 1-5%) may be needed. If the neck swelling diminishes, but does not disappear completely after full course of antibiotics, repeated fine needle aspiration, endoscopy, or image study should be considered.
Archives of Oto-Rhino-Laryngology 05/2011; 269(2):585-90. · 1.29 Impact Factor
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ABSTRACT: Cromolyn sodium (cromolyn) effectively inhibits both antigen- and exercise-induced asthma when used as an aerosol. Intranasal cromolyn is also recommended for preventing and treating allergic rhinitis. By inhibiting the degranulation of sensitized mast cells, cromolyn reduces the release of mediators that trigger inflammation and the allergic response. The precise pharmacologic activity of cromolyn has not been fully elucidated. This study evaluated the effect of cromolyn on isolated rat's trachea. The following assessments of cromolyn were performed: (1) effect on tracheal resting tension, (2) effect on contraction caused by 10(-6) M of methacholine as a parasympathetic mimetic, and (3) effect of the drug on electrically induced tracheal contractions. The results indicated cromolyn could inhibit electrical field stimulation-induced spike contraction when the preparation was increased to 10(-4)M. Adding cromolyn at doses of ≥10(-8) M did not elicit a relaxation or contraction response to 10(-6) M of methacholine-induced contraction. It alone had a minimal effect on the basal tension of the trachea as the concentration increased. This study indicates cromolyn had no cholinergic or anticholinergic effect and high concentrations of cromolyn might actually inhibit parasympathetic function of the trachea. Inhibiting parasympathetic function of the trachea through stabilizing the presynaptic nerve by cromolyn may be responsible for protecting patients against antigen- and exercise-induced asthma.
Allergy & rhinology (Providence, R.I.). 04/2011; 2(2):e46-50.
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New England Journal of Medicine 08/2010; 363(9):864. · 53.30 Impact Factor
