MyMedR

Beta haemolytic streptococcal carriers among normal schoolchildren

Chen ST, Dugdale AE, Puthucheary SD

Trop Geogr Med, 1972 Sep;24(3):257-64.

PMID: 4636100

Matched MeSH terms: Nasopharynx/microbiology

Sarcocystis infection in an Orang Asli: the second human case from Malaysia

Kutty MK, Mohan Das A, Dissanaike AS

Southeast Asian J. Trop. Med. Public Health, 1975 Sep;6(3):400-1.

PMID: 816009

The second case of Sarcocystis infection in man is reported from an aborigine girl. It was an incidental finding at autopsy and two cysts were seen in the muscle of the oropharyngeal region. The cysts and zoites were similar to those in the previous case reported from Malaysia.

Matched MeSH terms: Nasopharynx/parasitology

Serological markers in the diagnosis of histopathological types of nasopharyngeal carcinoma

Sam CK, Prasad U, Pathmanathan R

Eur J Surg Oncol, 1989 Aug;15(4):357-60.

PMID: 2547665

The titres of IgA against Epstein-Barr virus, viral capsid antigens and the titres of IgG against early antigen were found to be useful markers for the diagnosis of different histopathological types of nasopharyngeal carcinoma.

Matched MeSH terms: Nasopharynx/pathology

Fulltext Clonal proliferations of cells infected with Epstein-Barr virus in preinvasive lesions related to nasopharyngeal carcinoma

Pathmanathan R, Prasad U, Sadler R, Flynn K, Raab-Traub N

N Engl J Med, 1995 Sep 14;333(11):693-8.

PMID: 7637746 DOI: 10.1056/NEJM199509143331103

BACKGROUND: The Epstein-Barr virus (EBV) is consistently detected in patients with nasopharyngeal carcinoma. To determine whether EBV infection is an early, initiating event in the development of this malignant tumor, we screened nasopharyngeal-biopsy samples, most of which were archival, for preinvasive lesions, including dysplasia and carcinoma in situ. Preinvasive lesions were found in 11 samples, which were tested for the presence of EBV.
METHODS: EBV infection was detected with in situ hybridization for EBV-encoded RNAs (EBERs) and by immunohistochemical staining for latent membrane protein 1 (LMP-1). The larger samples were also tested for the EBV genome with the use of Southern blotting. The expression of specific EBV RNAs was determined by the amplification of complementary DNA with the polymerase chain reaction.
RESULTS: Evidence of EBV infection was detected in all 11 tissue samples with dysplasia or carcinoma in situ. EBERs were identified in all eight samples tested, and LMP-1 was detected in all six of the tested samples. Six of the seven samples tested for the EBV termini contained clonal EBV DNA: Transcription of the latent EBV gene products, EBV nuclear antigen 1, LMP-1, LMP-2A, and the BamHI-A fragment, was detected in most of the samples. Viral proteins characteristic of lytic lesions were not detected.
CONCLUSIONS: Preinvasive lesions of the nasopharynx are infected with EBV. The EBV DNA is clonal, indicating that the lesions represent a focal cellular growth that arose from a single EBV-infected cell and that EBV infection is an early, possibly initiating event in the development of nasopharyngeal carcinoma. Preinvasive lesions contain EBV RNAs that are characteristic of latent infection but not the viral proteins that are characteristic of lytic infection. The detection of the EBV-transforming gene, LMP-1, in all the neoplastic cells suggests that its expression is essential for preinvasive epithelial proliferations associated with nasopharyngeal carcinoma.

Matched MeSH terms: Nasopharynx/pathology*; Nasopharynx/virology

Fulltext Ureaplasma urealyticum and Mycoplasma hominis isolation from cervical secretions of pregnant women and nasopharyngeal secretions of their babies at delivery

Chua KB, Ngeow YF, Ng KB, Chye JK, Lim CT

Singapore Med J, 1998 Jul;39(7):300-2.

PMID: 9885690

A prospective study was carried out at the University Hospital, Kuala Lumpur to determine the cervical carriage rate of Ureaplasma urealyticum and Mycoplasma hominis among healthy pregnant women at delivery and the incidence of nasopharyngeal colonisation among their infants.

Matched MeSH terms: Nasopharynx/microbiology*

Fulltext Colonization and transmission of Ureaplasma urealyticum and Mycoplasma hominis from mothers to full and preterm babies by normal vaginal delivery

Chua KB, Ngeow YF, Lim CT, Ng KB, Chye JK

Med J Malaysia, 1999 Jun;54(2):242-6.

PMID: 10972036

A prospective study was carried out among pregnant women and their newborn babies in the University Hospital, Kuala Lumpur from January 1996 to June 1997. The maternal cervical colonization rates of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) were found to be 57.5% and 15.8% respectively while the isolation rates from nasopharyngeal secretions of the newborns were 50.8% for UU and 6.6% for MH. The overall transmission rates were 88.4% for UU and 42.1% for MH. There was no significant difference in the transmission rates of either organism from mothers to their respective newborn babies by the maturity of pregnancy. In preterm babies, the nasopharyngeal isolation rates of UU and MH were not influenced by the babies' gestational age and birth weight nor by the maternal history of abortion or parity. However, there was a tendency for UU to persist in the nasopharyngeal secretion of preterm babies especially those of birth weight below 2 kg. None of the babies contaminated with mycoplasmas at birth developed respiratory symptoms during six to eight weeks of follow-up.

Matched MeSH terms: Nasopharynx/microbiology*

Fulltext Endoscopic coagulation of sphenopalatine artery for posterior epistaxis

Prepageran N, Krishnan G

Singapore Med J, 2003 Mar;44(3):123-5.

PMID: 12953724

To present our experience of endoscopic electrocoagulation of sphenopalatine artery for persistent posterior epistaxis despite conservative measures.

Matched MeSH terms: Nasopharynx/blood supply*

Fulltext Intranasal Use of Quicklot in a Patient with Uncontrollable Epistaxis

Gurdeep S, Harvinder S, Philip R, Amanjit K

Med J Malaysia, 2006 Mar;61(1):112-3.

PMID: 16708748

A 60-year-old man who presented with nasopharyngitis developed uncontrollable epistaxis following a punch biopsy of the nasopharynx. QuickClot was successfully used to arrest the haemorrhage under general anaesthesia after the usual methods employed to secure haemostasis failed. The haemostatic plug was successfully removed a week later after control of the infection. This case represents the first reported intranasal use of QuickClot. We describe our experience and a literature review on this haemostatic agent.

Matched MeSH terms: Nasopharynx/injuries*

Epstein-Barr virus DNA detection in the diagnosis of nasopharyngeal carcinoma

Yap YY, Hassan S, Chan M, Choo PK, Ravichandran M

Otolaryngol Head Neck Surg, 2007 Jun;136(6):986-91.

PMID: 17547993

OBJECTIVES: This study examines the presence of Epstein-Barr virus (EBV) in nasopharyngeal carcinoma (NPC) by using polymerase chain reaction (PCR).

STUDY DESIGN: Eighty-six postnasal biopsy samples and 71 fine-needle aspirate samples of neck masses were obtained from patients who were clinically suspect for NPC. Genomic DNA was extracted from the samples, and EBNA1, EBNA2, and LMP genes of EBV were detected by PCR. PCR results were compared with NPC histopathology findings.

RESULTS: The sensitivity of PCR to detect EBNA1 (97.14%), EBNA2 (88.57%), and LMP (91.43%) genes of EBV in nasopharyngeal biopsy samples were higher than those in fine-needle aspirate samples.

CONCLUSION: Detection of EBV by PCR in tissue obtained from nasopharyngeal biopsy and fine-needle aspirate samples of neck masses is a relatively inexpensive, reliable, and accurate method of diagnosing NPC. Detection of EBV genes is on par with histopathological examination (HPE) and superior to fine-needle aspirate cytology.

SIGNIFICANCE: PCR is an ideal tool for suggesting NPC and guiding the diagnostic workup in occult primary tumors, facilitating earlier diagnosis and reducing morbidity and mortality.

Matched MeSH terms: Nasopharynx/pathology

Fulltext Extramedullary plasmacytoma in the maxillary sinus

Megat Shiraz MA, Jong YH, Primuharsa Putra SH

Singapore Med J, 2008 Nov;49(11):e310-1.

PMID: 19037537

Extramedullary plasmacytoma is a rare malignant plasma cell tumour. We report an extremely aggressive case of extramedullary plasmacytoma of the right maxillary sinus, which had metastasised to the brain and rib. A 56-year-old man presented with recurrent epistaxis and acute anaemia. Nasendoscopy revealed a medialised medial wall of the right maxilla and a mass occupying the whole nasopharynx. Magnetic resonance imaging revealed a right maxillary tumour with extension to the ipsilateral nasal cavity, nasopharynx, right sphenoid and ethmoidal sinuses. There was an extra-axial brain metastasis. There were metastases to the right parietal region and left eighth rib. Histopathology examination of the maxillary mass revealed abundant plasma cells with kappa-chain restriction. He was planned for four cycles of chemotherapy. Unfortunately, in view of the advanced stage of disease, he succumbed to his disease during the first cycle of chemotherapy.

Matched MeSH terms: Nasopharynx/pathology

Fulltext Increase in tumour-infiltrating lymphocytes with regulatory T cell immunophenotypes and reduced zeta-chain expression in nasopharyngeal carcinoma patients

Yip WK, Abdullah MA, Yusoff SM, Seow HF

Clin Exp Immunol, 2009 Mar;155(3):412-22.

PMID: 19220831 DOI: 10.1111/j.1365-2249.2008.03793.x

The pathological significance of the mechanisms of tumour immune-evasion and/or immunosuppression, such as loss of T cell signalling and increase in regulatory T cells (T(regs)), has not been well established in the nasopharyngeal carcinoma (NPC) microenvironment. To evaluate the T(reg) immunophenotypes in tumour-infiltrating lymphocytes (TILs), we performed a double-enzymatic immunostaining for detection of forkhead box P3 (FoxP3) and other markers including CD4, CD8, and CD25 on 64 NPC and 36 non-malignant nasopharyngeal (NP) paraffin-embedded tissues. Expression of CD3 zeta and CD3 epsilon was also determined. The prevalence of CD4(+)FoxP3(+) cells in CD4(+) T cells and the ratio of FoxP3(+)/CD8(+) were increased significantly in NPC compared with those in NP tissues (P < 0.001 and P = 0.025 respectively). Moreover, the ratio of FoxP3(+)/CD25(+)FoxP3(-) in NPC was significantly lower than that in NP tissues (P = 0.005), suggesting an imbalance favouring activated phenotype of T cells in NPC. A significant negative correlation between the abundance of FoxP3(+) and CD25(+)FoxP3(-) cells (P < 0.001) was also identified. When histological types of NPC were considered, a lower ratio of FoxP3(+)/CD25(+)FoxP3(-) was found in non-keratinizing and undifferentiated carcinomas. Increased CD4(+)FoxP3(+)/CD4(+) proportion and FoxP3(+)/CD8(+) ratio were associated with keratinizing squamous cell carcinoma. A reduced expression of CD3 zeta in TILs was found in 20.6% of the NPC tissues but none of the NP tissues. These data provide evidence for the imbalances of T(reg) and effector T cell phenotypes and down-regulation of signal-transducing molecules in TILs, supporting their role in suppression of immune response and immune evasion of NPC.

Matched MeSH terms: Nasopharynx/immunology

Fulltext Detection of novel respiratory viruses from influenza-like illness in the Philippines

Furuse Y, Suzuki A, Kishi M, Galang HO, Lupisan SP, Olveda RM, et al.

J Med Virol, 2010 May;82(6):1071-4.

PMID: 20419824 DOI: 10.1002/jmv.21763

Several novel viruses have been recently identified in respiratory samples. However, the epidemiology of these viruses in tropical countries remains unclear. The aim of the present study was to provide an overview of the epidemiology of novel respiratory viruses, including human metapneumovirus, human bocavirus, new subtypes of human coronavirus (NL63 and HKU1), KI virus, WU virus, and Melaka virus in the Philippines, a tropical country. Nasopharyngeal aspirates from 465 patients with influenza-like illness were collected in 2006 and 2007. Reverse transcription polymerase chain reaction (RT-PCR) and PCR were performed to detect viruses from culture-negative specimens. Human metapneumovirus, human bocavirus, human coronavirus HKU1, KI virus, and WU virus were detected for the first time in the Philippines; Melaka virus was not found.

Matched MeSH terms: Nasopharynx/virology*

Prognostic factors in patients with nasopharyngeal carcinoma treated in Hospital Kuala Lumpur

El-Sherbieny E, Rashwan H, Lubis SH, Choi VJ

Asian Pac J Cancer Prev, 2011;12(7):1739-43.

PMID: 22126556

BACKGROUND: Nasopharyngeal carcinoma is the third most common cancer among men in Peninsular Malaysia. However, no information is available about the prognostic factors. The objective of this study was to identify factors with an influence on outcome in patients treated in Hospital Kuala Lumpur.

METHODS: A total of 159 patients with non-metastatic nasopharyngeal carcinoma treated during 2002-2003 in Hospital Kuala Lumpur were included in this study. All received radiotherapy. Fifty three patients were treated with radiotherapy alone, while 106 patients received combination chemotherapy. Overall survival and local recurrence-free survival were analyzed using the Kaplan-Meier method and univariate analysis was performed using the log-rank test.

RESULTS: This study found out that 5-year overall survival and 5-year local recurrence-free survival rates were 58.6% and 54.2% respectively. The stage specific 5-year overall survival rates were: Stage I, 100%; Stage II; 93.3%, Stage III, 62.7%; Stage IVA, 42.2%; and Stage IVB, 40.6%. On univariate analysis, gender (p<0.05), T-classification (p<0.001), N-classification (p<0.05), stage (p<0.05) and cranial nerve involvement (p<0.001) were found to be significant prognostic factors for 5-year overall survival, while gender (p<0.05) and N-classification (p<0.05) were significant prognostic factors for 5-year local recurrence-free survival.

CONCLUSION: The overall survival rate of patients for this study was low. The patient factor that significantly affected 5-year overall survival was gender, while disease factors were stage, T-classification, N-classification and cranial nerve involvement.

Matched MeSH terms: Nasopharynx/pathology

The nasopharynx in infants with cleft lip and palate

Rajion ZA, Al-Khatib AR, Netherway DJ, Townsend GC, Anderson PJ, McLean NR, et al.

Int J Pediatr Otorhinolaryngol, 2012 Feb;76(2):227-34.

PMID: 22136741 DOI: 10.1016/j.ijporl.2011.11.008

The purpose of this study was to use three-dimensional computed tomography data and computer imaging technology to assess the skeletal components of the naso-pharyngeal area in patients with cleft lip and palate and to quantify anatomical variations.

Matched MeSH terms: Nasopharynx/anatomy & histology; Nasopharynx/radiography*

Fulltext Genome sequence of an unclassified pleosporales species isolated from human nasopharyngeal aspirate

Ng KP, Yew SM, Chan CL, Soo-Hoo TS, Na SL, Hassan H, et al.

Eukaryotic Cell, 2012 Jun;11(6):828.

PMID: 22645233 DOI: 10.1128/EC.00133-12

Pleosporales is the largest order in the fungal class Dothideomycetes. We report the 36,814,818-bp draft genome sequence and gene annotation of UM1110, a Pleosporales isolate associated with unclassified genera that is potentially a new fungal species. Analysis of the genome sequence led to the finding of genes associated with fungal adhesive proteins, secreted proteases, allergens, and pseudohyphal development.

Matched MeSH terms: Nasopharynx/microbiology*

Fulltext Nasopharyngeal carcinoma presented with right upper limb weakness: a case report

Zamzuri, Z., Mohd Adham, S.Y., Mohamad Saufi, A., Azian, A.A., Mohamed Azril, M.A., Azlina, A.R.

International Medical Journal Malaysia, 2012;11(2):58-61.

MyJurnal

Nasopharyngeal carcinoma (NPC) is a malignant neoplasm arising from the mucosal epithelium of the
nasopharynx, mainly within the lateral nasopharyngeal recess or Fossa of Rosenmuller. Distant metastasis to the cervical spine is the least common site in the vertebral system. This is a case of a 37-year-old lady with stage IV C nasopharyngeal carcinoma with local extension to the cervical spine who presented with right upper limb weakness.

Matched MeSH terms: Nasopharynx

Velopharyngeal and choanal stenosis after radiotherapy for nasopharyngeal carcinoma

Hussein J, Tan TS, Chong AW, Narayanan P, Omar R

Auris Nasus Larynx, 2013 Jun;40(3):323-6.

PMID: 22652485 DOI: 10.1016/j.anl.2012.05.004

Choanal stenosis is a well recognized late complication of radiotherapy for nasopharyngeal carcinoma. However velopharyngeal stenosis post radiotherapy for nasopharyngeal carcinoma is rare. We present here a case of bilateral choanal stenosis and velopharyngeal stenosis in a patient treated with radiotherapy for nasopharyngeal carcinoma. A 58-year-old woman presented to our otolaryngology clinic with a one year history of nasal obstruction. She was diagnosed to have nasopharyngeal carcinoma 12 years ago for which she received radiotherapy. Clinical examination revealed bilateral choanal stenosis and velopharyngeal stenosis. Treatment of choanal stenosis and velopharyngeal stenosis is challenging due to high incidence of recurrence and patients frequently require multiple procedures. The patient underwent a transnasal endoscopic excision of velopharyngeal scar tissue and widening of posterior choana using Surgitron®, mitomycin-C applied topically to the surgical wound and bilateral stenting under general anesthesia. The stents were kept for two weeks, and 3 years post operation velopharyngeal aperture and posterior choana remained patent. As illustrated in this case velopharyngeal stenosis can occur after radiotheraphy and should not be overlooked. Combine modality of transnasal endoscopic excision of velopharyngeal scar tissue, widening of choanal stenosis with Surgitron® followed by the application of mitomycin-C and stenting has been shown to be an effective option.
Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Nasopharynx/physiopathology*; Nasopharynx/surgery

Fulltext Submandibular mass as a rare presentation of advanced nasopharyngeal carcinoma

Mohamad I, Kosha MY

Malays Fam Physician, 2013;8(3):40-2.

PMID: 25893058 MyJurnal

Cervical lymphadenopathy is a common presentation of nasopharyngeal carcinoma (NPC). It can be present in the classical location of the level II or VI lymph nodes or at any other levels of the lymph nodes in the neck. NPC should be suspected when a patient presents with cervical lymphadenopathy and conductive hearing loss. A thorough endoscopic assessment of the nasopharynx should be performed to rule out this radiotherapy-curable disease at its early stage.

Matched MeSH terms: Nasopharynx

Fulltext Outbreaks of enterovirus D68 in Malaysia: genetic relatedness to the recent US outbreak strains

Ng KT, Oong XY, Pang YK, Hanafi NS, Kamarulzaman A, Tee KK

Emerg Microbes Infect, 2015 Aug;4(8):e47.

PMID: 26421270 DOI: 10.1038/emi.2015.47

Matched MeSH terms: Nasopharynx/virology

Fulltext Nasopharyngeal Bacterial Carriage in the Conjugate Vaccine Era with a Focus on Pneumococci

Devine VT, Jefferies JM, Clarke SC, Faust SN

J Immunol Res, 2015;2015:394368.

PMID: 26351646 DOI: 10.1155/2015/394368

Seven-valent pneumococcal conjugate vaccine (PCV7) was included in the UK national immunisation program in 2006, and this was replaced by thirteen-valent PCV in 2010. During this time, the carriage of vaccine-type Streptococcus pneumoniae decreased but pneumococcal carriage remained stable due to increases in non-vaccine-type S. pneumoniae. Carriage studies have been undertaken in various countries to monitor vaccine-type replacement and to help predict the serotypes, which may cause invasive disease. There has been less focus on how conjugate vaccines indirectly affect colonization of other nasopharyngeal bacteria. If the nasopharynx is treated as a niche, then bacterial dynamics are accepted to occur. Alterations in these dynamics have been shown due to seasonal changes, antibiotic use, and sibling/day care interaction. It has been shown that, following PCV7 introduction, an eradication of pneumococcal vaccine types has resulted in increases in the abundance of other respiratory pathogens including Haemophilus influenzae and Staphylococcus aureus. These changes are difficult to attribute to PCV7 introduction alone and these studies do not account for further changes due to PCV13 implementation. This review aims to describe nasopharyngeal cocarriage of respiratory pathogens in the PCV era.

Matched MeSH terms: Nasopharynx/immunology*; Nasopharynx/microbiology*

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