In Vitro Allergen Challenge Upregulates the Expression of Local Vascular Endothelial Adhesion Molecules in the Nasal Mucosa of Allergic Rhinitics

이봉재,김재호,이인철 대한비과학회 1995 Journal of rhinology Vol.2 No.2

Background : The increases of inflammatory cells in the nasal lavages and the mucosal tissues hours after antigen challenge in the allergic rhinitics propose the possibility of the corresponding increase of vascular endothelial adhesion molecules. The purpose the this study is to investigate the effect of allergen challenge on the expression of adhesion molecules and their temporal pattern of expression in the nasal mucosa of allergic rhinitis. Materials and Methods : The inferior turbinate mucosae were taken from 6 patients with perennial allergic rhinitis and cultured in the RPMI 1640 media with relevant antigen(D.farinae) for 0, 1, 2, 4, 6, 12, 24, and 48 hours. The proportion (%) of mucosal vessels expressing endothelial adhesion molecules such as ICAM-1, E-seletin, and VCAM-1 was obtained from the specimens immunostained with ABC-AP method. Results : The expression of E-selectin, with minimal at baseline, was significantly upregulated 1hour after culture with antigen, reached peak at 4 hour (38.3%), and then returned to baseline at 24 hour. The baseline expression of ICAM-1 was most prominent (48%). The incubation of allergic mucosa with antigen increased the ICAM-1 expression slowly until reaching to the peak level (77%) at 12 hour , and the level was maintained as long as 48 hours. Unlike E-selectin or VCAM-1, ICAM-1 was also expressed on the epithelial cells, especially in the basal cell layer. Conclusion : The expression of E-selectin showed a characterisctic of rapid induction and decline in the allergic nasal mucsoa. The prominent expression of ICAM-1 on the epithelial cells as well as on the vascular endothelial cells suggests the active role of ICAM-1 in the extravasation of inflammatory cells and also in the transepithelial migration into the nasal secretion.

비폐색 개선을 위한 비중격 수술 시 High Septal Deviation은 반드시 교정되어야 하는가?

한성준,오훈,박용균,민상기,신지호,이원욱,김진일,김현직 대한비과학회 2016 Journal of rhinology Vol.23 No.2

Background and Objectives: High dorsal deflection of the nasal septum around cartilage or the perpendicular plate is technically difficult to correct. The objective of this study was to assess whether correction of high septal deviation during septoplasty is necessary to improve nasal airflow. Patients and Surgical Method: Twenty-one patients with high septal deviation around the septal cartilage or the perpendicular plate were included in this study. In order to improve nasal obstruction, septoturbinoplasty was performed, but high septal deviation was not corrected. Subjective and objective improvements were evaluated using the visual analogue scale and acoustic rhinometry 1 month before and 3 months after surgery. Results: After correction of nasal septum deviation except high septal deviation and reduction of turbinate mucosal volume, postoperative nasal volume and minimum cross-sectional area were significantly increased. Subjective symptom scales for nasal obstruction, rhinorrhea, sneezing, and posterior nasal drip were considerably improved after limited septoturbinoplasty in patients who still had high dorsal deflection of the nasal septum. Conclusion: Our findings suggest that limited septoturbinoplasty without excessive resection of high dorsal deflection of the nasal septum can improve nasal airflow and reduce subjective symptoms, including nasal obstruction.

수술 후 잔존한 연소성 비인강 혈관섬유종에 감마나이프 수술로 치료한 1예

설정훈,김창훈,현동우,구용철 대한비과학회 2012 Journal of rhinology Vol.19 No.2

Juvenile nasophayngeal angiofibroma (JNA) is a histologically benign but highly vascular, agressively expansile lesion that occurs exclusively in prepubescent or pubescent males. Traditional treatmemt strategy of JNA has included open surgical approaches for majority of tumors. However, radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of postoperative residual JNA with gamma knife radiosurgery.

The Similarity of Biomarkers Level between Direct Nasal Fluid and Nasal Lavage Fluid in Allergic Rhinitis Patients

김재순,한수진,박정민,김성완,은영규,권오은 대한비과학회 2021 Journal of rhinology Vol.28 No.2

Background and Objectives: Biomarkers of allergic rhinitis (AR) have been studied; however, little is known regarding their practical application in the diagnosis of AR. Previous studies collected samples using saline lavage, nasal brushing, or nasal biopsy. To utilize nasal fluid as a diagnostic tool, we need to standardize the method of sample collection. Therefore, this study aimed to evaluate the difference in concentration of biomarkers depending on the method of nasal fluid collection. Materials and Method: Forty-five AR patients who had greater than moderate AR symptoms and who had positive results on skin prick test and serum-specific IgE tests were enrolled in this study. Nasal fluid was collected using the direct method or saline lavage method. The concentration of each biomarker was analyzed using enzyme-linked immunosorbent assay and the values compared. Results: Nasal fluid samples were collected directly from 14 patients and were collected via saline lavage in 31 patients. No significant differences were found in the median value of each biomarker between the two methods of nasal sample collection. Conclusion: Nasal fluid collection method does not significantly affect biomarker concentration Background and Objectives: Biomarkers of allergic rhinitis (AR) have been studied; however, little is known regarding their practical application in the diagnosis of AR. Previous studies collected samples using saline lavage, nasal brushing, or nasal biopsy. To utilize nasal fluid as a diagnostic tool, we need to standardize the method of sample collection. Therefore, this study aimed to evaluate the difference in concentration of biomarkers depending on the method of nasal fluid collection.Materials and Method: Forty-five AR patients who had greater than moderate AR symptoms and who had positive results on skin prick test and serum-specific IgE tests were enrolled in this study. Nasal fluid was collected using the direct method or saline lavage method. The concentration of each biomarker was analyzed using enzyme-linked immunosorbent assay and the values compared.Results: Nasal fluid samples were collected directly from 14 patients and were collected via saline lavage in 31 patients. No significant differences were found in the median value of each biomarker between the two methods of nasal sample collection.Conclusion: Nasal fluid collection method does not significantly affect biomarker concentration.

진피지방이식을 이용한 2차 융비술 1예:2년간의 추적 결과

김준모,서문선,서범석,김석화 대한비과학회 2006 Journal of rhinology Vol.13 No.2

Many allograft materials have been used for performing augmentation rhinoplasty. But in cases involving complications such as infection, inflammation and foreign body reaction, these should be removed and replaced with an autograft material which is more suitable for revision surgery. Frequently, the use of autograft materials, including bone and cartilage, are restricted by many limitations such as unavailability, insufficiency in volume, and resorption. By using the dermofat, however, we achieved good surgical results in revision rhinoplasty from the aspect of volume and donor site morbidity. Thus, we report this case with a review of the literature.

성인에서 폐쇄성 수면 무호흡을 동반한 거대 설편도 비대 1례

한현주,이동준,모지훈,이상준 대한비과학회 2016 Journal of rhinology Vol.23 No.1

Obstructive sleep apnea is characterized by repeated episodes of obstructive apnea and hypopnea. Lingual tonsillar hypertrophy causing obstructive symptoms is a rare disease in adults. Recently, we experienced a case of obstructive sleep apnea due to massive lingual tonsillar hypertrophy. The patient had tonsillectomy as a child and underwent adenoidectomy three years prior to the current presentation due to snoring and sleep apnea. However, symptoms did not improve and were recently aggravated. The upper airway evaluation and polysomnography revealed excessive lingual tonsillar hypertrophy and severe obstructive sleep apnea. An enlarged lingual tonsil was successfully removed using a Coblator. No recurrence was observed, and the obstructive sleep apnea was resolved postoperatively.

Megadose Steroids and Intranasal Optic Nerve Decompression in the Treatment of Traumatic Optic Neuropathy

전시영,김천규,정태기,황의기 대한비과학회 1999 Journal of rhinology Vol.6 No.2

Background and Objectives:Traumatic optic neuropathy (TON) is a relatively rare complication associated with closedhead injury. However, it represents an extremely poor prognosis, and its management remains controversial. We present thetreatment results of 15 patients with immediate and complete TON who were treated with megadose steroids (MDS), and, incases where MDS produced no response, intranasal optic nerve decompression (OND). Patients and Methods:The diagnosisof TON was based on evidence of the following:complete loss of vision, absence of direct pupillary light reflex and intact consensualresponse. All of the patients underwent high resolution CT scans of the orbit and received a complete neuro-opthalmologicexamination. MDS was started immediately after the diagnosis. If no response occurred by 48 hours, an intranasal ONDwas conducted. Results:Two of the 15 patients exhibited improved vision after treatment with MDS, and six of the remaining13 patients who were unresponsive to MDS demonstrated improved vision after OND. Overall, eight out of the 15 patients experiencedimproved vision. Conclusion:This study is uncontrolled, but suggests that our protocol of MDS and, in cases wherethis produced no response, OND may be an effective and valid treatment modality for patients with immediate complete TON,which is generally believed to represent an extremely poor prognosis regardless of treatment.

진균의 단핵구 유래 수상세포의 활성화와 Th 면역반응에 미치는 영향

신승헌,예미경,한바다 대한비과학회 2010 Journal of rhinology Vol.17 No.2

Background and Objectives:The mucosal immune response depends on the surveillance network established by dendritic cells (DC) localized within the respiratory epithelium. Fungi have been increasingly recognized as important pathogens in respiratory diseases. We hypothesized that DCs play a central role in the immune response against airborne fungi. Materials and Methods:Monocyte-derived DCs were developed by incubating monocytes with interleukin-4 (IL-4) and granulocyte-macrophage colony-stimulating factor. DCs were stimulated with Alternaria alternata and Aspergillus nigra for 24 hours and then co-cultured with CD4-positive lymphocytes for 6 days. Levels of IL-6 and tumor necrosis factor-α (TNF-α) were measured to determine activation of the DCs, and levels of TNF-α, IL-5, and interferon-γ (INF-γ) were measured to determine Th polarization. DC migration was induced with conditioned media from nasal polyp epithelial cells stimulated with fungi. Results:Alternaria and Aspergillus activated DCs with enhanced production of cytokines. When activated DCs were co-cultured with CD4-positive lymphocytes, Th2 cytokine and IL-5 production was significantly increased by Alternaria. DC migration was significantly increased by conditioned media from cells that were activated with Alternaria. Conclusion:Airborne fungi induced different immune responses depending on the fungi. Alternaria strongly induced DC migration and a Th2 immune response.

후각 기능에 대한 선별검사로서 자가 측정 후각 설문지(Scent Survey for Screening Test)의 임상 실행 가능성

양영수,최혜랑,조재훈,홍석찬,김진국 대한비과학회 2018 Journal of rhinology Vol.25 No.1

Background and Objectives: The scent survey for screening (SSS) test is a subjective olfactory questionnaire devised for this study. We demonstrated the correlation of the SSS test with other olfactory tests and the efficacy of the SSS test as an olfactory screening test compared to KVSSII. Subjects and Method: A total of 363 patients who visited our ORL outpatient department underwent the SSS test, VAS, and KVSS I and II. The patients were divided into two groups, a group with normal olfactory function and a group with olfactory dysfunction according to the KVSS II test. In each group, the correlations between the olfactory tests were studied, and the cutoff value of the SSS test as a screening test was investigated. Results: There was positive correlation between CCSIT and KVSS I, II, T, D, and I tests and the SSS test in the total group and in the olfactory dysfunction group (p<0.05). The identification test in the KVSS II showed the highest positive correlation. While the cut-off value of normal olfactory function in the KVSS II is 28, the SSS test showed the highest specificity and sensitivity of 74 under an ROC curve. Conclusion: The SSS test showed very high correlation with other olfactory tests, especially in an olfactory dysfunction group. This result indicates that the SSS is appropriate as a screening test to select people with olfactory disorder.

양측 비강에 다발성으로 발생한 거대 골수외 형질세포종 1예

김영효,장태영,김재은 대한비과학회 2012 Journal of rhinology Vol.19 No.2

A 52-year-old patients suffering from nasal stuffiness had necrotic, ulcerative polypoid mass in both nasal cavity. CT and MRI revealed bilateral polypoid mass with bony invasion in left maxillary anterior and posterior wall, left pterygopalatine fossa and right central skull base. The patient was diagnosed as plasmacytoma by histologic examination. To rule out multiple myeloma, several additive studies such as bone scan, bone marrow biopsy, urine Bence-Jons protein, serum protein electrophoresis, peripheral blood smear were performed and all results were negative. The patient was transferred to department of hemato-oncology and got 2 times of chemotherapy consisting of cyclophosphamide and dexamethasone and radiotherapy (5400 cGy / 30 fractionation). A month after the completion of chemoradiotherapy, the sized of mass decreased significantly without evidence of progression.