Changes of Nasal Airflow Sensitivity in Patients with Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal patency may be considered to have two aspects, the resistance to airflow and the sensation of airflow. Although the sensation of nasal airflow has received little attention from clinicians until now, it is likely to be of great importance in clinical practice. However, there are only a few studies that assess the sensation of nasal airflow in patients complaining of nasal obstruction. The aim of this study is to compare the airflow sensitivity of the nose in chronic sinusitis patients with normal controls and to determine the relationship between the airflow sensitivity and the radiologic staging of sinusitis, the presence of polyps, and the status of turbinate mucosa. MATERIALS AND METHOD: All patients had bilateral chronic sinusitis. We assessed the stages of sinusitis by OMU-CT. We also assessed the presence of polyps and the status of inferior and middle turbinate mucosa by endoscopic examination. We measured threshold velocities at five different sites of each nasal cavity by an apparatus delivering a pulsing jet of air at varying velocities. RESULTS: The threshold velocity of nasal airflow at all test sites were higher in sinusitis patients than in normal subjects. There were no significant differences in nasal airflow sensitivity between radiologic staging groups, whereas there were significant correlation between the airflow sensitivity in nasal mucosa and the presence of polyps or status of turbinate mucosa. CONCLUSION: The results suggest that decreased sensation of nasal airflow may contribute to the sensation of nasal obstruction in patients with chronic sinusitis.

Effect of ozone on nasal allergic responses in ovalbumin-sensitized rats / 천식및알레르기

Background and objectives: A large body of evidence suggests that ozone plays an important role in the development of respiratory allergy. However, the mechanisms by which ozone may interact with airway responses to allergen are not clear. The aim of this study was to determine whether ozone enhances the nasal inflammatory responses to allergen challenge in ovalbumin-sensitized rats and whether ozone has an effect on the allergic sensitization process. METHOD: Twenty-seven Wistar rats were divided into five groups : control group (group 1), group exposed to 0.3 ppm ozone for 3 days (6 hr/day) (Group 2), group challenged by allergen in ovalbumin-sensitized rats (group 3), group exposed to ozone followed by allergen challenge in ovalbumin-sensitized rats (group 4), and group exposed to 0.3 ppm ozone for 6 hours at intervals of 3 days during allergen sensitization (group 5). To induce the allergic rhinitis in groups 3, 4, and 5, rats were immunized intraperitoneally with ovalbumin-Al(OH)3 gel solution, followed by intranasal nebulization of 0.1% ovalbumin solution. Nasal lavage fluid (NLF) was obtained immediately after the last exposure and then Evans blue dye was infused via the femoral vein. The concentration of protein and total cell counts in NLF and the amount of extravasated Evans blue dye in nasal mucosa were measured. RESULTS: Ozone exposure significantly increased the concentration of protein and total cell counts in NLF and Evans blue extravasation compared to the control group. Allergen challenge in sensitized rats increased total cell counts in NLF and Evans blue extravasation although the differences between this group and the controls did not reach statistical significance. The combination of ozone exposure and allergen challenge caused significant increase in total cell counts in NLF and Evans blue extravasation compared to groups 2 and 3. However, there were no significant differences in Evans blue extravasation, concentrations of protein and total cell counts in NLF between groups 3 and 5. CONCLUSION: Ozone may enhance the nasal inflammatory responses to allergen in patients with allergic rhinitis.

Increased vascular permeability and reduced neutral endopeptidase activity in rat nasal mucosa after ozone exposure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Exposure to ozone has several effects on the respiratory tract, including airway inflammation and hyperresponsiveness. It has been suggested that these were associated with decreased NEP (neutral endopeptidase) activity. The purpose of this study is to investigate whether ozone exposure increases the vascular permeability in nasal mucosa, and if the vascular permeability is increased, whether it is associated with decreased NEP activity. MATERIALS AND METHODS: Twenty Wistar rats were divided into four experimental groups: control group (group 1), phosphoramidon pretreated group (group 2), ozone exposure (3 ppm for 30 minutes) group (group 3), and phosphoramidon + ozone exposure group (group 4). Sixty minutes after ozone exposure or 10 minutes after phosphoramidon pretreatment, capsaicin (100microgram/kg) was injected via femoral vein. Immediately, nasal lavage fluid was obtained and Evans blue dye was infused via femoral vein. Five minutes later, rats were sacrificed and nasal mucosa was taken. We measured the amount of extravasated Evans blue dye in nasal mucosa, and the concentration of albumin in nasal lavage fluid. RESULTS: Evans blue extravasation were significantly increased in groups 2, 3, and 4 when compared with group 1 (p<0.05), and in group 4 when compared with group 3 (p<0.05). Albumin concentration in nasal lavage fluid was increased in groups 2, 3, and 4, compared with group 1. But, there were no statistically significant differences. CONCLUSION: These results suggest that ozone increases the vascular permeability of nasal mucosa, and this is partially associated with decreased NEP activity after ozone exposure.

Traumatic Optic Neuropathy: The Comparison of Visual Outcome by Treatment Modalities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Traumatic optic neuropathy (TON) is a rare but potentially devastating complication of blunt head trauma. However, the optimal management for the TON is still an open question. In this report, we compared the visual outcome of TON treated with corticosteroids and optic nerve decompression (OND) with those treated with corticosteroids alone. PATIENTS AND METHODS: A total of 32 cases with TON due to blunt head trauma was followed over 6 months at the Chungnam National University Hospital. Twenty-two cases were treated with megadose corticosteroids and eleven cases were treated by surgical decompression of the optic canal combined with corticosteroids. For the purpose of analysis, visual acuity was converted into logMAR (logarithm of the minimum angle of resolution) units. Improvement was measured as the difference in visual acuity between the initial and final visual-acuity units (improvement in logMAR=post-treatment logMAR-initial logMAR). This value was then used to determine the percentage of improvement as the proportion of the visual acuity lost, using 20/13 (logMAR=0.18) as perfect vision (Improvement %=Improvement/{0.18-initial logMAR}). RESULTS: Patients whose initial vision was better than no light perception (NLP) showed better improvement rate (64%) compared with patients whose initial vision was NLP (17%). Vision improved in eight of the steroid-treated groups (38%) and in four of the steroid-OND groups (36%). There were also no significant differences in the improvement or the percentage of improvement in the visual acuity between two groups. CONCLUSION: As might have been expected, patients with initial NLP in both groups attained significantly lower final visual acuities than those who initially had some vision. However, there were no significant differences in the improvement or the percentage of improvement in the visual acuity between two groups. That is, no clear benefit was found for optic canal decompression surgery. But the limitation of this study was that it was difficult to conclude that surgical decompression is not necessary in the treatment of TON. A prospective randomized controlled clinical trial will be needed.

Esophagus, Stomach & Intestine; A Case of Primary Malignant Melanoma of the Esophagus / 대한소화기내시경학회지

Primary malignant melanoma of tbe esophagus is extremely rare and its incidence is below 0.1%. The tumor is polypoid and tend to be large, which is covered with false membrane, friable, hemorrhagic, and necrotic. Hematogenous and lymphogenic metastasis are common. Resection of the tumor with an anastomotic procedure seems to be the treatment of choice, and postoperative irradiation may be useful. But, despite these measures, prognosis is poor, with a 5-year survival of 4.2%. We report a case of 58-year-old man with primary malig- nant melanoma of the epophagus, and review of the literature in presented related studies.

A Case of Esophageal Ucerations in Behcet's Disease its Endoscopic Finding / 대한소화기내시경학회지

Behcet's disease is a chronie inflammatory symptom complex consisting of recurrent oral ulcer, genital ulcer, ocular lesion or skin lesion. Intestinal involvement in Behcet's disease most commonly affects the ileocecal region in the patient with gestrointestinal symptoms, But esophageal involvement in Behcet's disease is very uncommon, most commonly affects the midesophagus with localized ulcerative lesion. A 38-Year-old woman with refractory and recurrent oral and genital ulcer was admitted because of aggravation of pharyngodynia and dysphagia. Gastrofiberscopic examination showed multiple, small sized ulcers on oral cavity and mid-to-distal esophagus. She was treated with steroid.

A Case of Lymphangiomas of the Esophagus and Sigmoid Colon / 대한소화기내시경학회지

Lymphangiomas are benign tumors of lymphatic vessels, which can occur anywhere the lymphatics exist. The lymphangioma of the esophagus is exceedingly rare. Seven cases had reported in the world and there is no case report about the lymphangioma of the esophagus in our country. So we present one case of lymphangiomas that coexist in esophagus and sigmoid colon. This kind of case don't have been reported yet.