Antibacterial Effect of Lidocaine in Mouse Model of Acute Rhinosinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was performed to verify the antibacterial effect of lidocaine against common bacterial pathogens which causes acute bacterial rhinosinusitis in vitro, and also to evaluate in vivo effects in the nasal cavity of mice with an acute rhinosinusitis induced by Streptococcus pneumoniae inoculation. MATERIALS AND METHOD: The initial cultures of Streptococcus pneumonia, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Hemophilus influenza were done in Mueller-Hinton broth and the subsequent culture in 5% sheep blood agar (SBA). Minimal inhibitory concentration (MIC) was obtained by making culture broth to a turbidity of McFarland No 0.5 overnight by having it diluted by 1:200 times, and medicating 100 microL lidocaine in each culture. It was cultured for 24 hours at 36degrees C and analyzed spectrophotometrically. Minimal bactericidal concentration (MBC) was obtained by the same work as MIC and was followed by the subculture in 5% SBA to obtain the minimum concentration of no growth. Two percent concentration of lidocaine, MBC of S. pneumoniae was used for in vivo study. Thirty-six experimental mice (C57BL6/J) were divided: the control Group I contained only broth inoculation, Group II S. pneumoniae inculation and Group III to VI varying concentrations of lidocaine inoculation in different intervals and exposure time. On the 6th day, nasal lavage was done and mucosal neutrophil count was sought by dissecting the mice head by selecting three sections of anatomicallynd same site and 4 randomly selected places from each section. RESULTS: MIC and MBC values of S. pneumoniae were 1%, 2%, K. pneumoniae 2% and 2%, P. aerusinosa 2% and 4%, S. aureus 2% and 4%, H. influenzae 0.25%, and 1%, respectively. Mucosal neutorophils revealed a more statistically significant increase in Group II than all other groups followed by Group V, VI, III, and IV. The nasal lavage showed larger colony count in Group II, III, and V than those of other groups without any statistical meaning. CONCLUSION: This study enabled us to find out the MIC and MBC of lidocaine on various pathogens, the causes of an acute rhinosinusitis in vitro. It also showed that an acute rhinosinusitis is developed by using S. pneumoniae in vitro and that the longer the exposure time and higher the exposure frequency of lidocaine, the greater were antibacterial effects.

The Relationship between Nasal Septal Deviation and Inferior Turbinate Hypertrophy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the correlation of nasal septal deviation and coexistent inferior turbinate hypertrophy of both side. It also focused on proportional relationships between nasal septal deviation and each compartment of inferior turbinate hypertrophy. MATERIALS AND METHOD: PNS CT of 106 patients treated during the period from September, 2001 to July, 2002 at the Keimyung University Dongsan Medical Center were reveiwed retrospectively to measure nasal septal deviation angle and inferior turbinate hypertrophy. Using PACS (picture archiving and communicating system), we measured the thickness of medial and lateral mucosal, conchal bone by 0.1 mm unit. Each measurement was compared according to the degree of septal deviation angle and its correlation to the co-existent turbinate hypertrophy was analyzed. RESULTS: Inferior turbinates of the concave side were more hypertrophied when compared with the convex side (p<0.05) and its medial mucosa and conchal bone thickness were also increased more in the concave side (p<0.05). However, in view of correlations, there was no statistically significant relationship between septal deviation angle and the degree of hypertrophy of medial, lateral mucosa and conchal bone of inferior turbinate. CONCLUSION: Although it is a common belief that the nasal septal deviation may cause inferior turbinate hypertrophy of the concave side, there is a possibility of another explanation for this phenomenon, such as the developmental theory.

Hypocalcemia after Thyroidectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Incidence of hypocalcemia after thyroidectomy varies from 5.4 to 83%, and permanent hypocalcemia from 0.5 to 8%. The purpose of this study was to determine incidence and risk factors for the development of hypocalcemia and permanent hypocalcemia after thyroidectomy. MATERIALS AND METHOD: The medical records were reviewed for 130 patients who underwent thyroid surgery at the Department of Otolaryngology, Dongsan Medical Center, Keimyung University from January 1998 to June 2002. The subjects were reviewed according to sex, various thyroid diseases, unintentional removal of parathyroid gland, autotransplantation of parathyroid gland and various surgical modality that would affect postoperative hypocalcemia. Hypocalcemia was defined as a serum calcium level under 8.0 mg/dl on at least two consecutive measurements regardless of symptoms. Permanent hypocalcemia was defined for cases in which hypocalcemia persisted more than 6 months after thyroidectomy. RESULTS: Among 130 patients, 43 patients (33.1%) had hypo-calcemia and 9 patients (6.9%) permanent hypocalcemia. Factors significantly predictive of postoperative hypocalcemia in univariate analysis included malignancy (p < 0.001), extensive operation (total thyroidectomy, total thyroidectomy with neck dissection)(p < 0.001) and unintentional removal of parathyroid gland (p < 0.001). Independant risk factors on multivariate analysis were malignancy (p=0.027) and unintentional removal of parathyroid gland (p=0.048). CONCLUSION: Our study showed that the incidence of hypocalcemia after thyroidectomy was 33.1% and permanent hypocalcemia 6.9%. Our study found malignancy, extensive surgery, unintentional removal of parathyroid gland to be statistically significant risk factors. Hypo-calcemia can be kept to a minimum by profound knowledge of anatomy of thyroid and parathyroid gland, meticulous surgical technique and delicate autotransplantation of parathyroid gland.