Head and neck squamous cell carcinomas (HNSC C) show diverse clinicopathological features and are mostly linked with poor outcome. In this study, we tested if the expression of tumor growth, cell cycle and basement membrane anchorage related biomarkers allow prognostic and clinicopathological stratification of HNSCC. Archived HNSCC samples from 226 patients included into tissue microarrays (TMA) were tested using immunohistochemistry. Histopathological evaluation and the analysis of immunostaining for EGFR, Ki67, p53, p16 ink4 and Collagen XVII proteins were carried out in digital whole slides. Statistical evaluation was carried out using Pearson's Chi-square test and Kaplan-Meier survival analysis. In the tested cohort, hypopharyngeal cancers had the least favorable, and glottic cancers had the most favorable prognosis. High Ki67 positive tumor cell fractions were associated with significantly worse prognosis and elevated rate of lymph node metastasis. Both Ki67 and EGFR expression correlated significantly with the tumor localization. Ki67 index was the highest in the hypopharyngeal region and it proved to be the lowest in the glottic region. EGFR expression was the highest in the oral cavity and the lowest in the glottic region. The survival rate of patients with p16 ink4

Infections in the neck layers and spaces are potentially life-threatening diseases causing further complications, like mediastinitis, airway obstruction, or sepsis. Despite of the need for a conservative approach, they still regularly require surgical intervention. Records of 17 patients with severe neck infections that were treated by wide external incision and open wound management were retrospectively analyzed. The aim of the study was to clinically characterize these most serious neck infections. The most common presenting symptoms were neck pain and tense neck mass (94-94%) regularly with fever (65%), always accompanied by a marked elevation of C reactive protein level (average 192 uG/l). These findings were constant and very similar among both the deep neck infection and necrotizing fasciitis cases. More than half of the patients (53%) had at least one systemic co-morbidity. The parapharyngeal space was most commonly affected (83%), but extended disease involving more than two major neck regions was found in 13 cases (76%). Dental (29%) was the most common primary infection, followed by peritonsillar abscess (23%), Microbiological results showed a wide variety of corresponding bacteria. Mediastinitis was developed in three cases (18%), and airway obstruction requiring tracheostomy in two cases (12%). All the patients survived. Severe neck infections are a heterogenous group of diseases regarding to the primary site of infection, microbiology, localisation and host reaction. However, rapidly developed, painful, tense neck mass with a highly elevated CRP level should always alert for an extended or phlegmonous process in the layers or spaces of the neck.

A Wegener-granulomatosis a kis és közepes átmérőjű erek granulomaképződéssel járó nekrotizáló gyulladása. Sú-lyosság és klinikai megjelenés szempontjából a betegség igen széles skálát mutat. A gyorsan halálhoz vezető sziszté-más kórforma és a csak egy szervre lokalizálódó betegség ennek a skálának két végpontján foglal helyet. A diagnózis felállítását segíti az antineutrofi l citoplazmatikus antitest kimutatása és az érintett szerv jellegzetes szövettani elvál-tozásának igazolása. Sajnos, sok esetben a klinikai gyanút sem a hisztológia, sem az autoantitest-vizsgálat nem tá-masztja alá. Ezért -valamint azért is, mert sokszor a később generalizálttá váló betegség is hosszú ideig csak egy szerv érintettségét mutatja -ismernünk kell az egyes szervrendszerek részéről mutatkozó klinikai tüneteket. Ez lehetővé teszi a korai diagnózist és a terápia időben történő megkezdését. Orv. Hetil., 2013, 154, 1083-1095. Kulcsszavak: Wegener-granulomatosis, nekrotizáló vasculitis, ANCA, immunszuppresszív kezelés, scleritis Wegener's granulomatosisWegener's granulomatosis is a necrotizing infl ammation of small and medium size vessels with granuloma formation. It is a very heterogeneous disease in respect of severity and clinical manifestation. While it can be a rapidly progressive disease with fatal ending, there are forms limited only to one organ. Diagnosis is supported by the positivity of antineutrophil cytoplasmatic antibody and the presence of the typical histological fi ndings. Unfortunately, these examinations cannot confi rm clinical suspicion relatively frequently. In addition, there may be only symptoms related to one single organ for a long time at the beginning of the disease and, therefore, one have to be aware of the clinical signs and symptoms of the different organ systems. This may allow us to make an early diagnosis and start treatment in time. Orv. Hetil., 2013, 154, 1083 Történeti áttekintésA nekrotizáló vasculitist először 1866-ban Kussmaul és Maier írta le, ez a polyarteritis nodosa volt [1].Friedrich Wegener az 1930-as években írt először egy olyan betegről, aki a későbbi terminológiával élve Wegener-granulomatosisban (WG) szenvedett. 1939-ben írta le a betegséget, mint önálló entitást [2].