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Background and Objectives : Adenotonsillar hypertrophy is the most common disorder in pediatric otolaryngology, which should be suspected as a possible cause of obstructive sleep apnea syndrome (OSAS). In the past, most of the adenotonsillectomy were performed because of recurrent infection, but now OSAS is the most common indication in many centers. Materials and Method : A review of 1,945 adenotonsillectomy performed between 1990 and 1998 is presented. We classified into two categories of indication for adenotonsillectomy and analyzed changing trends of indication for adenotonsillectomy. Results : Although recurrent infection remains the predominant indication for surgery, there has been a rise in OSAS as a significant indication from 13.67% in 1990 to 24.26% in 1998. Conclusion : An increase has occurred in the percentage of adenotonsillectomy performed for OSAS due to adenotonsillar hypertrophy. This trend promises to continue as physicians become increasingly aware of the prevalence and seriousness of adenotonsillar hypertrophy as a cause of sleep apnea.
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Branchial cleft cyst is rarely encountered congenital neck disease. It is commonly believed that the branchial anomaly is persistance of remnant of the embryologic branchial apparatus. Among the patients visited Kyung Hee Medical Center with neck mass and inflammatory sign from January, 1980 to Aprial, 1994, we reviewed 26 cases of branchial cleft cysts confirmed by histopathologic findings with retrospective study on clinical aspects. The results are as follows: 1) There was no sex difference(14 male and 12 female), and most common between 2nd and 4th decade(21 cases, 80%). 2) Palpable mass was most common complaint(21 cases). In physical exam, the mass was non-tender, mobile and soft in most cases(over 80%). 3) The most common lesion site was anterior triangle in 15 cases. Along the SCM level, 21 cases were in upper 1/3, 2 cases in middle 1/3 and 3 cases in lower 1/3. 4) According to Bailey's classification, type II were 20 cases(76.9%), type I 5 cases(19.2%) and type III 1 case. 5) Among 28 cases, fistulous tract was found in 6 cases: one was complete type and 5 were incomplete type. 6) Among 26 cases before operation, 10 cases were diagnosed as branchial cleft cyst, 6 cases tuberculosis, 3 cases parotid tumor and 2 cases thyroglossal duct cyst. 7) Type of lining epithelium in histopathologic finding was stratified squamous epithelium in 22 cases(84.6%), mixed type in 4 cases(15.4%).
Background : and objective : Mahuangbujaseshintang(MBST) and soshihotang (SST) have been used for treatment of chronic disease of respiratory tract. It is necessary to clarify the mechanism of anti-allergic effects and to standardize the extracts. Materials and methods : The effects of MBST and SST were evaluated on histamine release in rat mast cells ex vivo. Several hours after administration of the extracts. Mast cells were stimulated by DNP-ascaries and histamine contents were measured. Time course structural change of the cells was examined by dynamic study. In order to evaluate the effect of the extracts on the nasal patency. Acoustic rhinometry was performed after administering of leukotriene D4 to both nasal cavities of guinea pig(GP). We examined the effects of the extracts with double-blind study, and also studied change of nasal patency after challenge of antigen by acoustic rhinometry in patients with allergic rhinitis. Results : MBST at 4 hr and SST at 3 hr after oral administration remarkably inhibited histamine release from rat mast cells in a dose-dependent manner. MBST-treated GPs failed to show bi-phasic phenomena which indicated to reduce nasal volume at the time of early and late phases in allergic inflammation. Both groups of patients who took MBST and SST for 1 week or 2 weeks showed significant decreased symptom severity index (SSI) from treatment week 2 (p$lt;0.05). The percent volume change after challenge of the antigen was decreased in 31 patient who took the extracts for 2 weeks. Conclusion : We can conclude that the herb medicine of MBST and SST may be effective for allergic rhinitis. (J Asthma Allergy Clin Immunol 20: 619-626, 2000)
Background and Objectives: Nasal polyposis is a chronic inflammatory disease characterized histologically by edematous fluid with sparse fibrous cells, few mucous glands and proliferation of stromal and epithelial cells. There have been many studies done separately about epithelial cells, fibroblasts, and other inflammatory cells in nasal polyps. However, there is no usable study model for the cell-to-cell interaction. Therefore, we tried to make a new model for the study of nasal polyp by coculture of epithelial cells and fibroblasts. Subjects and Method: Nasal polyp was collected during endoscopic sinus surgery. Almost half of them were used for epithelial cell culture and the remaining portion was used for fibroblast culture in the same polyp. Using a transwell insert fibroblasts were placed in the bottom and epithelial cells were placed on the insert respectively. RNA were isolated both from cpithelial cells and fibroblasts of 12,24, and 48 hours' coculture. The expressions of IL-8,IL-6, and eotaxin from coculturcd cells were compared with cells that were cultured alone by semiquantitative RT-PCR. Results: IL-8 was highly expressed in fibroblasts than in epithelial cells, especially in cocultured cells. The expression of IL-6 in fibroblasts was much higher than in epithelial cells, especially in cocultured fibroblasts. Eotaxin is weakly expressed in fibroblasts but not in epithelial cells. Conclusion : These findings indicate that cocultured cells show different expression of the mRNA of various cytokines compared with cultured cells alone. And this coculture system may be more ideal than the mono-cell culture system for the study of cell-to-cell interactions and to reveal the pathogenesis of oasal polyposis.