Role of the TAS2R38 Bitter Taste Receptor Gene Single Nucleotide Polymorphism in Patients With Taste Disorders / 대한이비인후과학회지

Background and Objectives@#Several studies have shown that three single nucleotide polymorphisms (SNPs) in the TAS2R38 gene demonstrate a strong association with the ability to sense the bitter taste of phenylthiocarbamide (PTC) in. We have previously reported about TAS2R38 genotypes in normal volunteers. The aim of this study was to investigate the role TAS2R38 gene plays in taste disorder by examining SNPs in the TAS2R38 gene in taste disorder patients.Subjects and Method Ninety-four patients with taste dysfunction from multiple etiologies were enrolled. The genotypes were defined by identifying SNPs on the TAS2R38 gene. The proportion of different TAS2R38 genotypes in the group was compared with that in the normal volunteers of our previous study. The whole mouth taste threshold tests were performed and the thresholds were compared among the three different genotypic groups. @*Results@#The proportion of each diplotype in taste disorder patients were as follows: PAV/ PAV 36.2% (34/94), PAV/AVI 34.0% (32/94), and AVI/AVI 29.8% (28/94). The proportion of AVI/AVI type was higher in the group than in the normal volunteers (p=0.031). The detection and recognition thresholds of all four basic tastes were increased in the order of PAV/PAV, PAV/AVI, and AVI/AVI genotypes. @*Conclusion@#The proportion of AVI/AVI homozygous was significantly higher in taste disorder patients than in the normal volunteers. Our findings suggest that the genotypes of TAS2R38 may represent one of the risk factors responsible for the development of taste disorders.

Effect of Manuka Honey on Transforming Growth Factor Beta-1-Induced Extracelluar Matrix Production in Nasal Polyp Derived Fibroblasts / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Manuka honey has anti-microbial, anti-inflammatory, and anti-proliferative action with a high concentration of methylglyoxal compound. It is also effective in killing Staphylococcus aureus biofilm and effective for the acute exacerbation of chronic rhinosinusitis. The aim of this study was to determine the anti-fibrotic effect of manuka honey in nasal polyp fibroblasts.MATERIALS AND METHOD: Primary nasal fibroblasts were isolated from nasal polyps and treated with transforming growth factor-beta 1 (TGF-β1). To determine the anti-fibrotic effect of manuka honey, fibroblasts were pre-treated with various concentration of the honey. Reverse transcription-polymerase chain reaction and western blot analysis were then performed to determine α-smooth muscle actin (α-SMA), collagen type I, and matrix metalloproteinase-9 (MMP-9) messenger ribonucleic acid (mRNA) expression and protein production in nasal polyp fibroblasts. Phosphorylated Smad (pSmad) 2/3 and phosphorylated adenosine monophosphate-activated protein kinase (pAMPK) were then determined by western blotting.@*RESULTS@#TGF-β1 stimulation increased α-SMA, collagen type I, and MMP-9 mRNA expression and protein production in nasal polyp fibroblasts. Manuka honey effectively suppressed α-SMA, collagen type I, and MMP-9 mRNA expression and protein production. Its inhibitory role on TGF-β1 induced myofibroblast differentiation and its extracellular matrix production was associated with Smad2/3 and AMPK pathway.@*CONCLUSION@#Manuka honey can inhibit TGF-β1 induced myofibroblast differentiation, collagen type I, and MMP-9 production in nasal fibroblasts. These results suggest that manuka honey might be a useful candidate for the inhibition of nasal polyp formation if further studies in vivo were accompanied.

A Case of Cholesteatoma of Maxillary Sinus

Cholesteatoma is common disease entity within the middle ear cavity but is rarely found in the paranasal sinuses, especially the maxillary sinus. We experienced a case of cholesteatoma of the maxillary sinus without history of previous trauma or operation. The patient was not improved by functional endoscopic sinus surgery. The mucosa of the maxillary sinus was removed through the Caldwell-Luc approach, and heavy saline irrigation was performed. After reoperation, the postoperative period was uneventful, and there was no sign of recurrence on endoscopic examination.

Effect of Manuka Honey on Transforming Growth Factor Beta-1-Induced Extracelluar Matrix Production in Nasal Polyp Derived Fibroblasts / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Manuka honey has anti-microbial, anti-inflammatory, and anti-proliferative action with a high concentration of methylglyoxal compound. It is also effective in killing Staphylococcus aureus biofilm and effective for the acute exacerbation of chronic rhinosinusitis. The aim of this study was to determine the anti-fibrotic effect of manuka honey in nasal polyp fibroblasts. MATERIALS AND METHOD: Primary nasal fibroblasts were isolated from nasal polyps and treated with transforming growth factor-beta 1 (TGF-β1). To determine the anti-fibrotic effect of manuka honey, fibroblasts were pre-treated with various concentration of the honey. Reverse transcription-polymerase chain reaction and western blot analysis were then performed to determine α-smooth muscle actin (α-SMA), collagen type I, and matrix metalloproteinase-9 (MMP-9) messenger ribonucleic acid (mRNA) expression and protein production in nasal polyp fibroblasts. Phosphorylated Smad (pSmad) 2/3 and phosphorylated adenosine monophosphate-activated protein kinase (pAMPK) were then determined by western blotting. RESULTS: TGF-β1 stimulation increased α-SMA, collagen type I, and MMP-9 mRNA expression and protein production in nasal polyp fibroblasts. Manuka honey effectively suppressed α-SMA, collagen type I, and MMP-9 mRNA expression and protein production. Its inhibitory role on TGF-β1 induced myofibroblast differentiation and its extracellular matrix production was associated with Smad2/3 and AMPK pathway. CONCLUSION: Manuka honey can inhibit TGF-β1 induced myofibroblast differentiation, collagen type I, and MMP-9 production in nasal fibroblasts. These results suggest that manuka honey might be a useful candidate for the inhibition of nasal polyp formation if further studies in vivo were accompanied.

Clinical Characteristics of Patients Receiving Sinonasal Surgery after Neurologic Evaluation

The Effects of Olfactory Training with Intranasal Corticosteroid Spray in Korean Patients with Olfactory Dysfunction

The Predictive Factors of Olfactory Changes after Endoscopic Sinus Surgery

Olfactory dysfunction is one of the most common complaints of patients with chronic rhinosinusitis. Patients who suffer from olfactory dysfunction report a negative effect on their overall quality of life. Chronic rhinosinusitis-related olfactory impairment is the most treatable form of olfactory disorder; however, outcomes after endoscopic sinus surgery (ESS) are challenging to predict. Previous studies have documented a wide range in overall improvement after ESS. The purpose of this study is to review the factors that predict changes in olfaction after ESS.

Anti-Inflammatory Effects of Chamaecyparis Obtusa Essential Oil on Peripheral Blood Mononuclear Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The biological activity in antibacterial and antioxidative action of essential oils (EOs) have been investigated. In this study, we tried to evaluate the effects of Chamaecyparis obtusa EOs on producing chemical mediators by peripheral blood mononuclear cells (PBMCs). SUBJECTS AND METHOD: PBMCs from healthy volunteers were stimulated with lipopolysaccharide (LPS) and phytohaemagglutinin (PHA) in the presence of varying concentrations of EOs. Cytotoxic effects of EOs were measured using an aqueous cell proliferation assay kit and supernatants were analyzed using enzyme-linked immunosorbent assay. Tumor necrosis factor-α (TNF-α), interleukin-5, and interferon-γ (INF-γ) protein levels were measured to determine the anti-inflammatory effects of essential oil. RESULTS: EOs were found to have cytotoxic effects on PBMCs at levels of over 1%. EOs not only could induce PBMCs to produce chemical mediators, but it also significantly inhibited the LPS induced TNF-α and INF-γ productions as well as the PHA induced INF-γ production. CONCLUSION: EOs had cytotoxic effects at high concentrations and modulated chemical mediator productions from PBMC. These data suggest that EOs could be used to treat immunologic or inflammatory diseases.

Fungal Sinusitis: a Retrospective Analysis of Operated 298 Cases at a Single Medical Center, 2005–2015 / 대한의진균학회지

BACKGROUND: Many articles have reported an increased prevalence of fungal sinusitis in otherwise healthy individuals, although invasive fungal sinusitis is a well-documented disease in immunocompromised patients. OBJECTIVE: This study aimed to analyze the linear trend of changes in clinical characteristics of fungal sinusitis from 2005 to 2015. METHODS: Of the 3198 patients who underwent endoscopic sinus surgery between 2005 and 2015, 298 cases that were pathologically confirmed to be fungal sinusitis were retrospectively analyzed by reviewing their medical records. RESULTS: From 2005 to 2015, the mean age of fungal sinusitis patients showed increasing trend. The number and the proportion of fungal sinusitis cases in FESS (functional endoscopic sinus surgery) patients showed increasing trend. The percentages of fungal sinusitis patients with hypertension, allergic rhinitis, and septal deviation also showed increasing trend for eleven years. There were no statistical relationship between the direction of septal deviation and affected sinuses. CONCLUSION: Fungal sinusitis had increased from 2005 to 2015. The age and comorbidities such as hypertension, allergic rhinitis, and septal deviation in fungal sinusitis patient had also increased.

Changes in Etiologies and Clinical Characteristics of Operated Unilateral Sinus Diseases: Comparison Study between 2005 and 2015

BACKGROUND AND OBJECTIVES: A considerable proportion of sinus diseases is associated with a unilateral lesion. Unilateral paranasal pathological lesions require precise preoperative diagnosis and histopathological assessment. This study aimed to analyze the changes in etiologies and clinical characteristics of operated unilateral sinus diseases between 2005 and 2015. SUBJECTS AND METHODS: Two hundred eighteen operated cases with unilateral sinus disease in 2005 and 2015 were reviewed to retrospectively analyze the etiologies and clinical characteristics. RESULTS: In 2015 compared with 2005, the proportion of unilateral sinus disease and patient age were increased. The proportions of patients with allergic rhinitis and hypertension were significantly increased in 2015. The leading cause of unilateral sinus lesions was nasal polyp, followed by fungus, tumor, mucocele, anatomical variation, odontogenic sinusitis, and foreign body. This ranking did not change between 2005 and 2015. The number of patients with fungal sinusitis was significantly increased in 2015. The direction of nasal septal deviation had no statistically significant relation with unilateral sinus disease. CONCLUSION: This comparison study of unilateral sinus disease between 2005 and 2015 showed that the proportion of fungal sinusitis, patient age, and patients with underlying disease were increased.

Comparison of Manuka, Kanuka, and Black Locust Honey on the Production of Chemical Mediators by Peripheral Blood Mononuclear Cells

BACKGROUND AND OBJECTIVES: Honey has various biological and pharmacological activities and has been used as treatment against various inflammatory diseases. The aim of this study was to compare the anti-inflammatory characteristics of manuka, kanuka, and black locust honey. MATERIALS AND METHOD: Peripheral blood mononuclear cells (PBMCs) from healthy human volunteers were isolated and then stimulated with lipopolysaccharide (LPS) with or without pre-treatment of various concentrations of honey for 72 hours. The cytotoxic effects of honeys were measured using an aqueous cell proliferation kit, and the supernatants were analyzed for interleukin-5 (IL-5), IL-10, interferon-γ (INF-γ), and tumor necrosis factor-α (TNF-α) using an enzyme-linked immunosorbent assay. RESULTS: Samples of 1% manuka and kanuka honey were found to have cytotoxic effects on PBMCs. Honey itself enhanced the production of IL-10 and TNF-α production. Manuka and kanuka honeys suppressed LPS-induced IL-10 and INF-γ production, while black locust honey only suppressed IL-10 production from PBMCs. CONCLUSION: Honeys had immunomodulatory properties of both immunostimulatory and immunosuppressive effects on PBMCs. Different honeys might have different immune modulatory functions due to their different components.

The Relationship between Snoring Noise and Hearing Impairment in Snorers and Their Spouses / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Snoring is a condition that affects a large percentage of population and is associated with various medical and social complications. However, there are only few published reports investigating the effects of chronic snoring exposure on hearing. In the present study, we examined whether there is an association between chronic snoring noise exposure and noise induced hearing impairment not only in snorers but also in their spouses. Subjects and MethodZZSixty snorers and 27 spouses under the age of 55 were recruited. All participants had more than 5 years of exposure to snoring. Questionnaire for snoring and pure tone audiometry were conducted. Subjects were classified into normal hearing group and hearing impairment group. SUBJECTS AND METHOD: Sixty snorers and 27 spouses under the age of 55 were recruited. All participants had more than 5 years of exposure to snoring. Questionnaire for snoring and pure tone audiometry were conducted. Subjects were classified into normal hearing group and hearing impairment group. RESULTS: Forty percent of snorers and 25.9% of spouses had hearing impairment. The snorers with hearing impairment had longer duration of snoring than the snorers with normal hearing. However, there were no statistical differences in loudness of snoring between the two groups. In the spouse group, there were statistical differences in loudness of exposed snoring and in duration of snoring exposure between the hearing impairment group and the normal hearing group. CONCLUSION: The result of this study indicated that chronic exposure to snoring noise may be associated with hearing impairment in snorers and their spouses. But in the snorers, further studies are required to identify the factors other than snoring noise associated with hearing impairment.

Comparison of Salt Taste Threshold and Salt Intake between Hypertensive and Normotensive Group / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Salt-taste threshold can influence salt appetite, and is thought to be another marker of sodium intake. Many studies have found an association between sodium intake and blood pressure. The aim of this study was to compare the salt-taste threshold and salt intake between hypertensive and normotensive groups. SUBJECTS AND METHOD: One hundred twenty volunteers (51 men and 69 women) who did not take antihypertensive medications were evaluated. First, a questionnaire, which included questions regarding demographic information and preference of salty taste, was conducted, and 24-hour ambulatory blood pressure was checked. Then salt taste threshold was measured by assessing the ability of the subjects to discern the taste of salt in graded solutions of saline. Lastly, 24-hour urinary sodium was measured in a 24-hour urine collection. RESULTS: The salt taste threshold and taste preference for salt were slightly higher in hypertensive group. There was slightly higher salt intake measured as 24-hour urinary sodium in the hypertensive group, compared with the normotensive group. However, there were no significant differences in salt taste threshold, preference of salty taste, and salt intake between the normotensive and the hypertensive groups. CONCLUSION: The threshold of salt taste was not related to sodium intake and hypertension status. These results suggest that the development of hypertension depends on the complex interaction of factors such as genes and environmental factors rather than sensory factors like taste threshold and taste preference.

Dietary Supplements and Postoperative Bleeding

There is a wide variety of dietary supplements on the market that are taken by patients of all walks of life. Unfortunately their use is self-prescribed and patients rarely view them as medication reveal their use to hospital staff. Garlic has been reported to inhibit platelet aggregation and may interact with anticoagulants and antiplatelet agents. Other alternative supplements have also been associated with potential increased bleeding, including ginkgo biloba, ginger, ginseng, and omega-3 fatty acid. It is essential for surgeons to be apprised of all substances ingested by patients, so they can identify potential adverse effects and drug interactions.

Correlation Analysis between Anthropometric Measurement and the Results of Seep Questionnaires in Patients with Obstructive Sleep Apnea

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing and affects quality of life. Several questionnaires have been developed for screening OSA. The aim of this study was to compare the anthropometric measurements of OSA patients using sleep questionnaires as a tool to screen patients with OSA. MATERIALS AND METHOD: This study enrolled 126 adult OSA patients. All subjects underwent overnight polysomnography (PSG) and were measured for body mass index (BMI), neck circumference, waist circumference, and tonsil size. Patients were screened using the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire (Berlin Q), and STOP questionnaire (STOP Q). Correlation and multiple regression analyses were conducted to determine the predictive value of the anthropometric measurements of OSA patients. RESULTS: ESS, Berlin Q, and STOP Q results were associated with apnea hypopnea index (AHI), minimal oxygen saturation of PSG and BMI, neck circumference, waist circumference, and hip circumference of OSA patients. However, facial contour did not significantly influence the results of sleep questionnaires. CONCLUSION: Some anthropometric characteristics are associated with sleep questionnaire results. Not only sleep questionnaires, but also anthropometric data can be used as predictive tools of OSA.

The Effect of Physical Characteristics on Sleep Disturbance and Cardiovascular Complications in Obstructive Sleep Apnea Patients: The Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is a common yet an under-diagnosed sleep related breathing disorder associated with many adverse health outcomes. OSA is commonly associated with cardiovascular disorders that include coronary artery disease, heart failure, hypertension, cardiac arrhythmias and stroke. The aim of this study was to investigate the physical characteristics of OSA patients as a screening test for sleep apnea associated cardiovascular disease. SUBJECTS AND METHOD: One hundred twenty-six adult OSA patients were enrolled in this study. All subjects underwent an overnight polysomnography (PSG) and were determined body mass index (BMI), neck circumstance, waist circumstance, tonsil size, etc. Cardiovascular events, such as hypertension, cardiovascular accident, myocardial infarction, and angina were analyzed. The correlation and multiple regression analysis were conducted to find influential and predictive factors of cardiovascular complications of OSA. RESULTS: PSG findings, apnea-hypopnea index (AHI), minimal oxygen saturation, and oxygen desaturation index were associated with BMI, neck circumstance, and waist circumstance. Tonsil size was also associated with AHI and oxygen desaturation index. However, PSG results were not associated with cardiovascular accidents of OSA patients. Hypertension was associated with tonsil size, angina was associated with Mallampati score and cardiovascular accident was associated with tonsil size. CONCLUSION: Although we cannot find the statistical relation between PSG results and cardiovascular disease, tonsil size and Mallampati score influenced the risk of cardiovascular accident.

Differences in Taste Thresholds According to Sex and Age Groups in Korean / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of the study was to compare the gustatory function between age-matched men and women in Korean subjects. SUBJECTS AND METHOD: Healthy non-smoking volunteers without smell and taste disorders were investigated. Thirty-nine men and women of the same age group were evaluated for gustatory function. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. The electrical taste thresholds were measured using an electrogustometer for four different sites in the oral cavity, i.e., both sides of anterior and posterior tongue. RESULTS: Female subjects had lower mean values of detection and recognition thresholds for all of the four tastes than male subjects, although these results did not reach statistical significance except for the detection threshold for salt and the recognition threshold for quinine. In electrogustometry, thresholds in the posterior tongue of glossopharyngeal nerve area were significantly higher for men than women. CONCLUSION: Men had higher taste threshold than women of the same age category. For additional information on the effects of gender and aging on taste thresholds, further studies including a large number of well-controlled subjects are essential.

The Effect of Omnaris(R) on the Inflammatory Reaction and Mucin Gene Expression from Nasal Polyp Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Glucocorticoids are a potent anti-inflammatory agent. The au-thors conducted this study to investigate the effect of Omnaris(R) on suppression of inflammation induction and mucin gene expression in nasal polyp epithelial cells. SUBJECTS AND METHOD: Primary nasal polyp epithelial cells were stimulated by 5 ug/mL of streptococcal enterotoxin B (SEB) and lipopolysaccharide (LPS). To determine the effects of Omnaris(R), cells were pretreated with 200, 100, 10, 1 ng/mL of Omnaris(R). The anti-inflammatory effect of epithelial cells were confirmed by measuring interleukin (IL)-6, IL-8, and granulocyte-macrophage colony stimulating factor (GM-CSF), and mucin gene expressions were determined by real time PCR for MUC4, MUC5AC, MUC5B, MUC8. RESULTS: SEB and LPS enhanced the production of IL-6, IL-8, and GM-CSF from nasal polyp epithelial cells. The increased cytokine levels were significantly suppressed by Omnaris(R) at 100 and 10 ng/mL. The expressions of MUC4, MUC5AC, MUC5B, MUC8 mRNA, and MUC4 mRNA were increased by SEB and LPS, respectively. The increased expression of these mucin genes were significantly suppressed by 100, 10, and 1 ng/mL of Omnaris(R). CONCLUSION: Omnaris(R) significantly suppressed the production of chemical mediators and mucin gene expression, which indicated that Omnaris(R) is effective in improving and treating inflammatory diseases in the nasal cavity.

Effects of Fungi and Eosinophils on Mucin Gene Expression in Rhinovirus-Infected Nasal Epithelial Cells

PURPOSE: Fungi, rhinoviruses (RVs), and eosinophils are associated with upper respiratory diseases. We evaluated the effects of fungal stimulation and eosinophil co-culture on the expression of mucin genes in RV-infected nasal polyp epithelial cells. METHODS: Nasal polyp epithelial cells were obtained from chronic rhinosinusitis patients. Cultured epithelial cells were stimulated with Alternaria and Aspergillus with or without RV-16 infection. The epithelial cells were co-cultured with eosinophils for 16 h. MUC4, MUC5AC, MUC5B, and MUC8 mRNA expressions in the epithelial cells were quantified using real-time RT-PCR. To determine the underlying mechanism, nuclear factor-kappaB (NF-kappaB), activator protein-1 (AP-1), and mitogen-activated protein kinase (MAPK) inhibitors were used to inhibit mucin gene expression. RESULTS: Fungi and RV-16 induced mucin gene expression in nasal polyp epithelial cells. However, there was no synergistic increase in mucin gene expression, with the exception of MUC4 mRNA expression stimulated by 25 microg/mL Aspergillus. When RV-16-infected epithelial cells were stimulated with fungi and then co-cultured with eosinophils, MUC4, MUC5B, and MUC8 mRNA expressions increased. Mucin gene expression was inhibited by NF-kappaB inhibitors. CONCLUSIONS: RV-16, airborne fungi, and eosinophils may exacerbate the inflammatory process in nasal mucosal diseases by enhancing mucin gene expression.

The Effect of Aging on Taste Thresholds in Korean / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The sense of taste is one of the most important human senses and plays a critical role in an individual's food preferences and the nutritional status. Proper gustatory function in older people is important for quality of life and enjoyment of food. The objectives of this study was to investigate the effect of aging on taste thresholds in Korean subjects. SUBJECTS AND METHOD: One hundred sixty normal volunteers without smell and taste disorders were investigated. Each subject was given a questionnaire for age, sex, status of smoking and medication. Then, a whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. RESULTS: Older subjects (over 50 years) showed worse taste sensitivity compared with younger subjects (age 20-29 years). The detection thresholds of all four basic tastes and the recognition threshold of salty taste of elderly participants were significantly higher than those of young participants. CONCLUSION: Gustatory sensitivity was found to decrease with age. Especially, older subjects appeared to have a reduced perception of salt, which can alter eating habits, such as intake of more salty foods. Our data can provide preliminary normative values for future investigation of chemosensation in the Korean population.