Histopathologic Characteristics of Chronic Sinusitis with Asthma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic sinusitis has been closely related to bronchial asthma. Patients with both sinusitis and asthma have showed somewhat different mucosal appearance and pathology, compared to those without asthma. We investigated histopathological features of these patients. SUBJECTS AND METHOD: 19 sinusitis patients with asthma who had undergone endoscopic sinus surgery from April, 1995 through September, 1997, and 53 patients without asthma who had undergone surgery from January, 1997 through July, 1997 were evaluated. We compared the following 7 parameters of sinus mucosal histopathology between the asthma and non-asthma group by reviewing histopathological slides: basement membrane thickening, goblet cell hyperplasia, subepithelial edema, submucous gland formation, eosinophilic infiltration, lymphocyte infiltration, polymorphonuclear leukocyte infiltration. We also compared preoperative disease extent, evaluated by degree of polyposis and OMC CT findings, and presence of allergy, which might affect the sinus mucosal pathology. RESULTS: There revealed no statistical difference between two groups on presence of allergy, preoperative polyposis, and OMC CT scores. However, the asthma group showed significant basement membrane thickening, goblet cell hyperplasia, and eosinophilic infiltration, which was statistically significant. No difference was found between subepithelial edema, submucous gland formation, lymphocyte infiltration, and polymorphonuclear leukocyte infiltration. CONCLUSION: Significant histopathological features such as basement membrane thickening, goblet cell hyperplasia, and eosinophil infiltration characterized chronic sinusitis with asthma; however, there were no differences owing to the presence of allergy or the extent of preoperative disease. Adequate preoperative management, close attention during surgery and careful follow-up would be necessary.

The clinical characteristics of dizzy patients with normal vestibular function tests

BACKGROUND AND OBJECTIVES : Dizziness is a very common complaint in every day practice. The prevalence of dizziness ranges from 1.8 % in young adults to 30% in the elderly. The sensitivity of vestibular function tests is limited. It was reported that the sensitivity of electronystagmography for diagnosing peripheral vestibular disorders was variable, ranging from 46 to 74%. The objective of this study is to analyse the causes and clinical characteristics of dizzy patients who show normal vestibular function tests. MATERIALS AND METHODS : From January 1999 to June 2001, 375 dizzy patients with normal vestibular function tests(mean age, 49.7 years; range, 8 to 79 years) were assessed with the medical records and typed questionnaires about dizziness. RESULTS : Dizzy patients with normal vestibular function tests were attributed to an unknown cause in 20.0% of patients, benign paroxysmal positional vertigo in 19.5%, migrainous dizziness in 11.7%, psychogenic dizziness in 10.4%, Meniere's disease in 9.6% and vertebrobasilar insufficiency in 7.2%. CONCLUSION : Dizzy patients with normal vestibular function tests can be evaluated by careful history taking and combined multidisciplinary approach with neurologist, psychiatrist and cardiologist and strict diagnostic criteria are necessary.

Effect of Neurotrophins and Depolarization on Survival of Spiral Ganglion Neurons in Dissociation Cell Culture / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several neurotrophic factors have been shown to play an essential trophic role in the development, maintenance and regulation of neuronal function. Specific neurotrophins are currently used in clinical trials for the treatment of some neurodegenerative diseases. The purposes of this experiment were twofold. Firstly, we aimed to determine the trophic effects of BDNF, NT-3, and 25 mM K+ on auditory neurons in dissociated cultures of early postnatal spiral ganglia. Secondly, we tried to collect pure neural cells after dissociating the spiral ganglions using the immunomagnetic sorting method with one of neuronal surface antigens. MATERIALS AND METHODS: Dissociated spiral ganglion cell cultures were pre-pared from cochleae of Sprague Dawley rats of 5-6 days old, and maintained in a neurobasal medium with modified N2 supplements. BDNF (50 ng/ml), NT-3 (50 ng/ml), and 25 mM K+ were added to the cultures, respectively. These cells were grown during the time course (24hr, 48hr, 72hr, 98hr) and stained with NF-200 to identify survival of spiral ganglion neurons. Immunomagnetic cell sorting for separation of spiral ganglion neurons in dissociated cells was carried out using the MiniMACS Separating System. Magnetically separated cells were analysed by flow cytometry. RESULTS: Survival of the auditory neurons in the dissociated cells was significantly increased by addition of BDNF, NT-3, and 25K. The effect of 25 mM K+ on neuronal survival showed the highest in the experimental conditions. BDNF dramatically increased the neurite length compared with those under other conditions. After immunomagnetic sorting in dissociated cultures, spiral ganglion neurons were shown to contain 50% of the fluorescently labeled positive cells. CONCLUSIONS: Neurotrophins (BDNF, NT-3) and depolarization by 25 mM K+ were essential trophic factors for postnatal auditory neurons and BDNF stimulated neuritogenesis in cultured spiral ganglion neurons. The immunomagnetic cell sorting method is not appropriate for collecting pure neural cells from the dissociated cells of spiral ganglia (50% purity).

Soft Palate Reconstruction with a Superior-Constrictor Advancement-Rotation Flap(SCARF) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reconstruction of the soft palate after tumor resection is a difficult surgical procedure because of the requirements of the dynamic functional velopharynx. The ideal technique should be simple, reliable, sensate, dynamic and fast, and should be performed transorally or transcervically. Many methods such as obturators, loco-regional flaps, and free flaps have been devised to reconstruct the soft palate but none meets all this criteria. Superior-constrictor advancement-rotation flap (SCARF) is a dynamic local myomucosal flap to achieve circumferential closure of the velopharynx and reestablish its valvular sphincteric function and this satisfies all the criteria mentioned above. We evaluated the validity of SCARF for reconstruction of the soft palate after tumor resection. MATERIALS AND METHODS: From 1998 to 1999, three patients underwent a SCARF reconstruction of the velopharynx after 30% to 70% of the soft palate had been resected. All patients were evaluated after wound healing with regard to subjective satisfaction and objective parameters such as speech-language evaluation and videofluoroscopic study. RESULTS: All patients reestablished velopharyngeal competence without significant phonatory or deglutitive disability. There was no donor site complication. CONCLUSION: We could functionally reconstruct the defect of soft palate (maximum 70%) after tumor resection with SCARF. The SCARF reconstruction of the soft palate was simple, fast, reliable and performed transorally without any significant donor site morbidity.