The Correlation Study between the Specific IgE for Staphylococcus Aureus Exotoxin and Nasal Mucus Culture in Chronic Rhinosinusitis with Nasal Polyposis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp. MATERIALS AND METHOD: Nasal polyp and serum were obtained from 30 patients who underwent endoscopic sinus surgery for CRSwNP and 10 control turbinate mucosae were used. Nasal culture was done for each patients. Specific IgE levels for S. aureus exotoxin A (SEA), S. aureus exotoxin B (SEB), and toxic shock syndrome toxin 1 (TSST-1) were measured using ImmunoCAP method in nasal tissue and serum. The patients were divided into three groups : A, nasal polyp (+)/culture (+) ; B, nasal polyp (+)/culture (-) ; C, nasal polyp (-)/culture (-). RESULTS: The culture for S. aureus was 27% in CRSwNP when compared to 10% in control. The specific IgE for S. aureus in serum was significantly expressed in nasal polyp (30%) compared to control (0%). Also the Group A showed a significant high rate of specific IgE (63%) compared to Group B (18%) and Group C (0%) in serum. In nasal polyp tissue, the specific IgE has showed no specific difference between nasal polyp (7%) and control (10%). However, it was also increased in Group A (25%), compared to Group B (0%) and Group C (11%). CONCLUSION: Our results demonstrated that there was a correlation between nasal polyp and specific IgE levels to S. aureus exotoxin. These results suggest that S. aureus exotoxin can act as a traditional allergen and induce the inflammatory reaction in CRSwNP. Background and Objectives : Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp.

Morphological Changes of Endolymphatic Sac after Gentamicin Injection to Chick Embryo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Gentamicin, which is known to have potential toxic effect to the inner ear, causes functional disturbance by destroying the inner ear at a concentration above a certain level. The purpose of this study was to identify morphological changes in the endolymphatic sac after gentamicin injection using chick embryo and the degree of changes according to different concentration of gentamicin. MATERIALS AND METHOD: The same breed of chicken (Gallus domesticus) was chosen and artificial growth incubator was used to germinate the eggs. Increasing the concentration of gentamicin at the same rate (10, 20, 30, 40 mg/ml), we injected it into the yolk sac of chicken and observed the morphological changes in the embryonic sac by light microscope. RESULTS: As the concentration of gentamicin increased, the size of the endolymphatic sac increased and the thickness and contour of sac wall changed. Especially, the inner membrane thinned down greatly. CONCLUSION: In this research, we confirmed that endolymphatic sac is affected by gentamicin in proportion to its concentration. Especially, considering that inner membrane epithelial cells play an important role in the absorption of endolymph, we suggest that the ototoxicity of gentamicin causes the disturbance in the absorption of endolymph, which may cause endolymphatic hydrops.

A Case of Adenocarcinoma of the Larynx / 대한이비인후과학회지

The larynx is a rare site for an adenocarcinoma. This case presents adenocarcinoma of epiglottis, a rare malignant neoplasm of the larynx. A 74-year-old man was presented with throat discomfort that began 4 months ago and neck mass for 1 month ago. The laryngeal telescopic finding revealed centrally ulcerative fungating mass on the laryngeal surface of epiglottis. A biopsy of the neoplasm pathologically characterized the lesion as adenocarcinoma. An adenocarcinoma of the larynx is a highly lethal neoplasm and has worse prognosis than squamous cell carcinoma of the larynx. We treated with the conservative surgery and bilateral neck dissection. There is no evidence of recurrence at 18 months after the initial treatment.

One Case of Downbeat Nystagmus with Compression of Vestibulocochlear Nerve by Vertebral Arteries

A case is reported of downbeat nystagmus associated with compression of the root of vestibulocochlear nerve by vertebral arteries, which was revealed by magnetic resonance imaging. Chief complain of the patient was positional vertigo, which aggrevated at left decubitus position. Downbeat nystagmus was increased in left Dix-hall pike test. Tetsuo et al, reported downbeat nystagmus with compression of dolichoectatic vertebral arteries to the medulla oblongata and surgical neurovascular decompression of the dolichoectasia reverses the progression of symptoms if permanent neurologic damage has not already occurred.

The Design of Subjective Visual Vertical and Horizontal Measurement Method in Normal Peoples

BACKGROUND AND OBJECTIVES:Subjective visual vertical and horizontal presented as test that evaluate otolithic organ. However, was not discussed about condition that is factor influencing in examination or position at examination. Therefore, we wished to evaluate effect of subjective visual vertical and horizontal in each test condition and find repletion item. MATERIALS AND METHOD:Measured subjective visual vertical and horizontal dividing by gender and three age group to 45 normal persons. Do so that there may be axis of rotation of 0.3x0 cm size candlepin on center of screen and lower part of screen to 18 inch LCD monitor at subjective visual vertical. Do so that may be center of screen and left middle at subjective visual horizontal and gave change length and axis of rotation of candlepin. Measured subjective visual vertical and horizontal each 3 times in standing, sitting, supine position in darkroom. RESULTS:There are no statistical differences in each positions and distinction of gender and axis of rotation. But there are statistical differences in age groups. CONCLUSION:Difference in age groups means that examination method or control of number of test, preliminary education of patients, assistance need rather than is caused change or abnormality of otolithic organ. Therefore, is thought to be representative test that evaluate function of otolithic organ as clinical test.

Clinical Analysis of the Dizzy Patients in a Department of Emergency Medicine

BACKGROUND AND OBJECTIVES: The patient presenting to the emergency department with the complaint of dizziness is one of the most common as well as most challenging problems confronting the emergency physician today. Dizziness is a vague symptom of disease ranging from serious to benign. The differential diagnosis and proper management of dizziness in a department of emergency medicine are the most important things. We undertook this study to evaluate the character and clinical analysis of the dizzy patients and to discuss the significance and necessity of primary care in a department of emergency medicine. MATERIALS AND METHOD: From September 1999 to October 2003, we sampled the 1,371 dizzy patients who visited the Emergency Department(ED). Of these patients, the 650 patients performed electronystagmography(ENG) and rotatory chair test were selected, except for the patients with loss of consciousness, known psychiatric disease or direct brain injury. RESULTS: The 650 patients were attributed to acute peripheral vestibulopathy in 88.5% (575 patients) of patients, benign paroxysmal positional vertigo in 9.5% (62 patients) of patients, central origin in 1.4% (9 patients) of patients, other organic origin in 0.6% (4 patients) of patients. In a retrospective analysis of patients with central origin, the symptoms estimated at central origin, for example, persistent headache, were found. CONCLUSION: The exact diagnosis and management for the dizzy patients in a department of emergency medicine require the primary physician's concern and understanding for dizziness.