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.

Late Metastatic Renal Cell Carcinoma Recurrence Presenting as a Maxillary Sinus Mass 12 Years after Nephrectomy: Case Report and Literature Review

주연희,전영진,조현진,김상욱 대한비과학회 2021 Journal of rhinology Vol.28 No.1

Metastasis to the sinonasal cavity is rare. Late recurrence, such as metastasis developing 10 years or more after nephrectomy, is even more rare. We present a rare case of late metastatic renal cell carcinoma (RCC) in the maxillary sinus after nephrectomy and discuss reported sinonasal metastatic RCC cases. A 64-year-old man presented with left nasal obstruction for the previous one year. He had undergone right nephrectomy to treat RCC 12 years prior. Paranasal sinus computed tomography and magnetic resolution imaging revealed a 4.6-cm-diameter mass exhibiting delayed contrast enhancement that filled the left maxillary sinus and the nasal cavity. Histologically, clear cell RCC was diagnosed. We resected the maxillary sinus tumor to resolve the nasal obstruction for palliative symptom relief. There has been no evidence of recurrence to date, 3 years postoperatively. When a patient with a history of RCC presents with a hypervascular paranasal sinus mass, metastatic RCC should be considered, despite history of nephrectomy. It is important to make an appropriate treatment plan depending on extent of metastases and location of the metastatic tumor.

실라스틱 이식물을 이용한 위축성 비염의 치료 1예

이재용 대한비과학회 2005 Journal of rhinology Vol.12 No.1

두통, 좌측 안검 하수, 시력 저하를 주소로 내원한 Tolosa-Hunt Syndrome 1례

문명기,양병욱,홍석진,이경철 대한비과학회 2016 Journal of rhinology Vol.23 No.2

Cavernous sinus syndrome (CSS) is defined as the involvement of two or more of the third, fourth, fifth (V1, V2) or sixth cranial nerves or involvement of only one of them in combination with a neuroimaging-confirmed lesion in the cavernous sinus. Some cases of CSS are attributed to Tolosa-Hunt syndrome (THS), an idiopathic inflammatory disease of the cavernous sinus. THS is characterized by painful ophthalmoplegia due to granulomatous inflammation in the cavernous sinus. THS is a diagnosis of exclusion that requires a vigorous series of differential diagnoses, and corticosteroid therapy is known to dramatically resolve clinical findings of THS. We report a case of a patient with painful ophthalmoplegia associated with vision loss, which was suspected to be THS. This patient followed a relatively typical clinical course of THS on steroid pulse therapy. We emphasize the differential diagnosis of THS, its presentation, and treatment.

상악동 후비공 용종 111예의 치료 성적

송형용,정유삼,유명상,왕종환,이봉재 대한비과학회 2010 Journal of rhinology Vol.17 No.2

Background and Objectives:Antrochoanal polyp (ACP) is a benign maxillary sinus polyp that originates from the mucosa of the maxillary sinus, passes through the sinus ostium, and extends into the choana. Surgical methods employed in the treatment of antrochoanal polyp are simple avulsion, Caldwell-Luc operation, osteoplastic maxillary sinus operation, and endonasal endoscopic removal. In this study, we evaluated the clinical presentation of ACP and compared its surgical outcomes. Materials and Methods:We retrospectively reviewed 111 patients who were treated for ACP between January 1995 and May 2008, and analyzed clinical features, radiologic findings, and surgical results. Results:The study group consisted of 111 patients (65 males, 46 females) with a mean age of 20.0 years (range, 4 to 70). Sixty-one cases were accompanied by sinusitis (20 with unilateral sinusitis, 41 with bilateral sinusitis). Endoscopic sinus surgery (ESS) was used to treat 95 cases, and the external approaches of Caldwell-Luc operation or osteoplastic maxillary sinus operation were applied in 12 and four cases, respectively. Among those who received ESS, ACP recurred in 16 cases, whereas none of the patients who received the external approach showed recurrence. Conclusion:Endoscopic sinus surgery is a good alternative method for the treatment of ACP. If the antral part of ACP cannot be removed completely, an external approach such as Caldwell-Luc operation or osteoplastic maxillary sinus operation for pediatric patients may be considered to prevent recurrence.

흡연이 비용종 상피세포와 섬유아세포에서 MMP-9, TIMP-1, VEGF의 발현에 미치는 영향

안윤숙,김준모,왕종환,장용주 대한비과학회 2009 Journal of rhinology Vol.16 No.2

Background and Objectives:It has been known that MMP-9, TIMP-1, and VEGF play an important role in the formation of nasal polyps (NPs). The aim of this study is to investigate the effect of smoking on the expression of MMP-9, TIMP-1 and VEGF in the epithelial cells and fibroblasts of NPs. Materials and Methods:The epithelial cells and fibroblasts of NPs obtained from 10 patients who underwent endoscopic sinus surgery were cultured and used. The prepared CSE concentrations were 5%, 1%, 0.5% and 0.1%. In the control group, cells were cultured for 9 hours in the media containing 1 ml of AEGM and DMEM/F-12K. In the CSE group, cells were treated with 5%, 1%, 0.5% and 0.1% CSE for 9 hours. After washing with PBS, cells were cultured in medium for 24 hours. ELISA was performed to measure the secretion of MMP-9, TIMP-1 and VEGF proteins and real-time PCR was performed to assay their mRNAs. Results:The production of MMP-9, TIMP-1 and VEGF proteins did not change significantly in comparison with the control group in epithelial cells and fibroblasts after exposure to CSE. Conclusion:These results suggest that CSE does not appear to have an effect on the expression of MMP-9, TIMP-1 and VEGF for developing and growth of nasal polyposis. Background and Objectives:It has been known that MMP-9, TIMP-1, and VEGF play an important role in the formation of nasal polyps (NPs). The aim of this study is to investigate the effect of smoking on the expression of MMP-9, TIMP-1 and VEGF in the epithelial cells and fibroblasts of NPs. Materials and Methods:The epithelial cells and fibroblasts of NPs obtained from 10 patients who underwent endoscopic sinus surgery were cultured and used. The prepared CSE concentrations were 5%, 1%, 0.5% and 0.1%. In the control group, cells were cultured for 9 hours in the media containing 1 ml of AEGM and DMEM/F-12K. In the CSE group, cells were treated with 5%, 1%, 0.5% and 0.1% CSE for 9 hours. After washing with PBS, cells were cultured in medium for 24 hours. ELISA was performed to measure the secretion of MMP-9, TIMP-1 and VEGF proteins and real-time PCR was performed to assay their mRNAs. Results:The production of MMP-9, TIMP-1 and VEGF proteins did not change significantly in comparison with the control group in epithelial cells and fibroblasts after exposure to CSE. Conclusion:These results suggest that CSE does not appear to have an effect on the expression of MMP-9, TIMP-1 and VEGF for developing and growth of nasal polyposis.

후향적 방법을 통한 후각장애환자의 임상적 특성및 Steroid 효과 분석

최성호,김선태,박형민,문광하,정주현,차흥억 대한비과학회 2016 Journal of rhinology Vol.23 No.1

Background and Objectives: Olfactory dysfunction is a common sensory disorder, but there are currently no standard diagnostics or therapeutic methods. We analyzed the effects of systemic steroid therapy in patients with olfactory dysfunction. Materials and Method: We analyzed patients who visited our ENT department with olfactory dysfunction for 3 years. We reviewed their charts and classified the patients according to age, sex, etiology of olfactory dysfunction, degrees of olfactory dysfunction and the effect of systemic steroid therapy. Results: The mean age was 44.3 years old and there were 50 males and 55 females; 55 patients had inflammatory disease and 50 patients had non-inflammatory disease. The distribution of degrees of olfactory disorder according to cause was not significantly different (p=0.120). In 105 patients, 20% experienced improvements after systemic steroid therapy, and the response of systemic steroid therapy was better among patients with inflammatory causes. In cases of inflammatory disease, there was a larger amount of severe hyposmia patients, and their response to systemic steroid therapy was significant (p=0.015). Patients with mild and moderate hyposmia were more responsive to systemic steroid therapy than patients with severe hyposmia (p=0.382). Conclusion: In cases of hyposmia due to inflammatory disease, systemic steroid therapy with proper operative management may increase therapeutic effects.

양측성 음향비강통기도검사를 이용한 알레르기성 비염 환자에서의 비강유발검사에 대한 비중격만곡증의 영향 평가

김영효,장태영 대한비과학회 2011 Journal of rhinology Vol.18 No.1

Background and Objectives:We aimed to evaluate the effects of septal deviation on patient symptoms and acoustic rhinometry measurements in patients with allergic rhinitis and to determine which side of the septum is the better choice. Materials and Methods:The bilateral nasal provocation test with acoustic rhinometry was performed on patients with septal deviation and allergic rhinitis (Group A, n=25) and in patients with allergic rhinitis alone (Group B, n=26). Fifteen to 60 minutes after provocation, the change in symptoms as measured by the visual analogue scale, the change in total nasal volume (TNV) and minimal cross-sectional area (MCA) were compared between the concave and convex septal sides. The degrees of change in TNV and MCA were also compared between the groups. Results:Group A had higher basal values and more changes in nasal obstruction than did Group B. Changes in TNV and MCA were most prominent after 30 minutes on both sides, without significant differences. By summing the sides together, we were able to obtain more stable results without paradoxical increase. Conclusion:Septal deviation itself has little effect on the result of nasal provocation in patients with allergic rhinitis. By summing the parameters of acoustic rhinometry from both nasal cavities, clinicians can achieve more stable results.y

Mast Cells and Allergic Rhinitis

조중생 대한비과학회 1998 Journal of rhinology Vol.5 No.2

That mast cells play a role in acute allergic inflammation by releasing various inflammatory mediators, including histamine,leukotrienes (LT), such as LTC4 and LTD4, and prostaglandins (PG), such as PGD2, is well known. Additionally, mast cellscontribute to the development of allergic inflammation also through the release of multifunctional cytokines. The incidence ofintraepithelial mast cells (IEMC) is found to be greater in nasal mucosa exposed to an allergen, and the cells are thought to play animportant role in producing the immediate allergic reaction. Lamina propira mast cells (LPMC) are known to be the dominantsource of TH2 cytokine and are responsible for development of the late phases of an allergic reaction They may upregulate theexpression of adhesion molecules on the endothelial cells and induce basophil and eosinophil recruitment. Based on these considerationit can be proposed that mast cell is a initiating cell of allergic reaction in target organ and IEMC and LPMC havecapacity to make major contribution to both immediate or late phase reaction of allergic rhinitis.

인두 편도 절제 수술을 받은 환자의 연령 변화

이은정,김지훈,황혜진,김민기,강민석,김경수 대한비과학회 2017 Journal of rhinology Vol.24 No.1

Background and Objectives: Controversy remains regarding whether the age at which patients undergo adenoidectomy is increasing or decreasing. Thus, the aim of this study was to analyze patient age at adenoidectomy over the past 30 years. Subjects and Method: Retrospective analysis of adenoidectomy patients treated between 1984 and 2013 who were confirmed to have adenoid hypertrophy on physical examination and radiologic findings was performed. Patients were divided into three groups by decade, the 1980s, 1990s, and 2000s. The numbers of patients, mean/median age, maximum age, and sex ratio were analyzed for each group. Results: A total of 2,450 patients were enrolled, including 466 cases in the 1980s, 946 in the 1990s, and 1,038 in the 2000s. The mean age of patients was 7.38 years in the 1980s, 8.16 in the 1990s, and 8.37 in the 2000s and has significantly increased since the 1990s (p<0.05). Conclusion: The mean age of patients who underwent adenoidectomy has increased over the past 30 years. Therefore, adenoid hypertrophy needs to be considered in children of all ages who visit otorhinolaryngologic departments.