Expression of Midkine mRNA in Human Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A heparin-binding polypeptide called midkine is a family of secreted growth/differentiation cytokines and has a role in tumor growth by enhancing endothelial proliferation, vascular density and angiogenesis. In this respect, midkine may be involved in the pathogenesis of nasal polyposis. The aim of the present study is to evaluate the expression of midkine mRNA in the human nasal mucosa and polyps. MATERIALS AND METHOD: The total RNA was isolated from freshly disected inferior turbinate of patients who underwent rhinoplasty and from nasal polyps of chronic rhinosinusitis patients. The expression and distribution of midkine mRNA was investigated by reverse transcriptse- polymerase chain reaction (RT-PCR) and in situ hybridization. The midkine mRNA expression in nasal mucosa and polyps were semi-quantitatively evaluated by Southern blot hybridization. RESULTS: The expression of midkine mRNA was identified in both normal inferior turbinate and nasal polyp. Histochemistry of in situ hybridization revealed that midkine mRNA in normal inferior turbinate was intensely expressed in the surface epithelium, submucosal glands, vascular endothelium, and inflammatory cells scattered in submucosal tissues. Midkine mRNA was expressed in the nasal polyps, many inflammatory cells and newly formed vascular endothelium, but not in the newly formed glandular epithelium. In semi-quantitative southern blot hybridization, midkine mRNAs did not have different expression levels between inferior turbinate and nasal polyps. CONCLUSION: These results indicate that midkine mRNA is innately expressed in human nasal mucosa, playing a role in nasal physiology. Also, the results show that midkine may be involved in the pathogenesis of nasal polyps via angiogenesis, tissue growth, and inflammatory process.

Analysis of Proteoglycan Gene Messages in Human Nasal Mucosa and Nasal Polyp using Dot Blot Hybridization / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been suggested that the formation and growth of nasal polyp require the remodeling of extracellular matrix. Proteoglycans (PGs) are the major components of the extracellular matrix that maintain the integrity of the structural tissues The leucine-rich repeat PGs include lumican, decorin and biglycan, all of which have many important biologic activities in various pathologic conditions, including the remodeling of the extracellular matrix. Therefore, these small-PG families may be involved in the formation and growth of nasal polyp. MATERIALS AND METHODS: Surgical specimens of nasal polyps and the normal nasal mucosa were assessed for mRNA expressions coding for lumican, decorin and biglycan using the reverse transcription-polymerase chain reaction,which was followed by dot blot hybridization. RESULTS: Lumican, decorin and biglycan mRNAs were expressed in all tissue samples examined. Semi-quantitative dot blot hybridization revealed that the levels of the lumican and biglycan messages are lower in the nasal polyp tissues than in the nasal mucosa. The decorin messages in the nasal polyp were expressed at levels similar to those in the nasal mucosa. CONCLUSION: These results suggest that lumican, decorin and biglycan may be important components of the extracellular matrix in the nasal mucosa. Considering the function of these PGs, the normal levels of decorin associated with low levels of biglycan and lumican may play a role in the pathogenesis of nasal polyposis.

Microscopic Partial Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conventional tonsillectomy with the naked eye has posed problems in obtaining a good surgical field and in minimizing damage to the adjacent tissue. Tonsillectomy using an operating microscope offers outstanding illumination and visualization of the surgical field, thereby reducing the incidence of complications associated with tonsillectomy. The objective of this study was to compare the surgical methods of the conventional and the microscopic tonsillectomies, and to evaluate the usefulness and effectiveness of the microscopic tonsillectomy. MATERIALS AND METHODS: Two hundred children between the ages of five and ten who received tonsillectomy between June 1995 and August 1998 at Korea University Hospital were divided into two groups,' one group underwent tonsillectomy using an operating microscope (Group 1, n=100) and the other group underwent tonsillectomy using the conventional dissection and snare technique (Group 2, n = 100). Duration of surgery, post-operative healing period, amount of intra and post-operative hemorrhage, post- operative pain score, and the incidence of post-operative cicatrical pharyngeal stenosis were compared between the two groups. RESULTS: There was no statistically significant diference in operating time and post-operative healing period between the two groups, but cicatrical pharyngeal stenosis due to post-operative scarring was more common in the group that underwent conventional tonsillectomy. The amount of hemorrhage both intra and post-operatively, and post-operative pain was significantly decreased in the microscopic tonsillectomy group. CONCLUSION: The widespread use of operating microscope in otolaryngological surgeries allows this technique to be applied to tonsillectomy with few problems. This technique affords decreased intra-operative bleeding, less post-operative complications, and decreased post-operative pain compared with conventional techniques. We believe that microscopic tonsillectomy is a safe, elegant and effective procedure that represents a new concept in tonsil surgery.

Expression of Antimicrobial Defensin Peptides of the Human Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Defensin, an antimicrobial peptide, is an important component of the innate immune response, particulary at mucosal surface. The present study was undertaken to investigate the expression of defensin in inferior turbinate mucosa and nasal polyp. MATERIALS AND METHODS: Expression of beta-defensin 1, 2 and alpha-defensin 5, 6 mRNA was investigated by RT-PCR and dot blot hybridization. Immunohistochemistry was utilized for detection of alpha-defensin 1, 2, 3 in tissue section. RESULTS: beta-defensin 1 mRNA was expressed in all tissue samples, with not so significantly different levels of expression. beta- defensin 2 mRNA was detected in patients with chronic sinusitis, but not in patients with normal mucosa. Its expression level was significantly higher in nasal polyp than in turbinate mucosa. alpha-defensin 5, and 6 mRNA were not expressed in any tissue but alpha-defensin 1, 2 and 3 were detected in all tissue samples obtained from patients with chronic sinusitis. CONCLUSION: The results suggest that beta-defensin 1 may play a constitutive role in the nasal defense while alpha-defensin 1, 2, 3 and beta-defensin 2 may be induced in response to local infection or inflammation.

Modeling Hemodialysis Patient`s Quality of Life / 기본간호학회지

The purpose of this study is to develop and test a nursing model which can be applied to prediction of the quality of life for the patient receiving hemodialysis. A hypothetical model was constructed on Johns & Meleis's empowerment model framework which has 3 constructs (stress, resource, empowerment). 6 Factor(perceived stress, self-esteem as personal resource, perceived social support as social resource, perceived fertigue, perceived health status & self efficacy as empowerment) were selected to predict the quality of life of receiving hemodialysis patients. 4 Factors(self-esteem, perceived social support, perceived health status & self efficacy) had direct effects on the quality of life significantly. Self-esteem had indirect effect on the quality of life via perceived health status significantly. Perceived social support had indirect effect on the quality of life via self-efficacy significantly. Perceived stress ha no direct and indirect effect on the quality of life significantly. Revised model from hypothetical model showed better fit to the data by eliminating unsignificant path. From results of this study we suggest that to improve quality of life of hemodialysis patient nurses provide nursing interventions which improve self-esteem, perceived social support, self-efficacy & perceived health status.

Clinical Experience with Doxazosin toward the Influence on Blood Pressure and Serum Lipid Parameters

This study was designed to assess the antihypertensive efficacy and overall tolerance of doxazosin in patients with mild-to-moderate essential hypertension. Doxazosin was administered in once-daily dose from 1 to 3mg to 97 patients both in a general hospital and a local clinic in rural area. These patients are composed of three groups. One group has 49 Patients treated with doxazosin monotherapy, another group with 31 patients treated with doxazosin as well as other antihypertensive drugs combined and a third group is composed of 17 patients with renal insufficiency n addition to hypertension. The patients in the third group with renal insufficiency had 2.5mg/dl-5.0mg/dl in serum creatinine. Results are as follows : 1) The study sample is composed of 37 males (38.1%) and 60 females (61.9%) with mean age 51.4 years. Among three subasmples no statistically significant difference is observed in age, sex, mean body weight and heigh at 0.05 error level. 2) A total of 47 patients (48.5%) of the 97 patients have completed twelve-week doxazosin antihypertensive treatment. At a mean dose of 4.4+/-0.4mg at twelfth week, 37 patients (78.7%) responded to doxazosin therapy. Twenty-nine(61.7% patients achieved "excellent" blood pressure control(mean sitting DBP of < or =90mmHg), and 8 patients (17.0%) showed "good respone" (10mmHg or more DBP reduction from baseline). Whereas remaining 10 patients (21.3%) showed only "fair response" (5-9mmHg DBP reduction) or "failed"(0-4mmHg DBP reduction). In doxazosin monotherapy group thirteen(68.4%) of nineteen patients showed "excellent" or "good response" at a mean dose of 4.8mg/day. Combination therapy group with eighteen patients showed 100% therapeutic success. This group had fourteen(77.8%) "excellent" and four(22.2%) "good respinse" at a mean daily dose of doxazosin 3.9mg. Renal insufficiency group with ten patients showed six(60.0%) "excellent" and four (40.0%) "failure"cases at a mean daily dose of 4.6mg. 3) The mean baseline sitting blood pressures of doxazosin monotherapy group were 175/109 whose blood pressure at twelfth week were 150/94 at a mean daily dose of 4.8mg. The baseline blood pressure of combined therapy group 180/111 were reduced to 145/91 at twelfth week at a mean daily dose of 3.9mg. Those of renal insufficiency group were 177/112 and 156/98 respectively at a mean doxazosin daily dose of 4.6mg. 4) Of the 97 study cases, adverse effect were reported in 19.6%. The most prevalent adverse effects were dizziness(11.3%), blurred vision(9.3%), headache(5.2%), most of which were mild or moderate and disappeared with or were tolerated on continued therapy. But three cases(3.1%) had to refrain from doxazosin administration due to blurred vision, dizzines, and headache. 5) The change of lipid analysis between before and after treatment in the monotherapy group with doxazosin showed 3.8% decrease of total cholesterol and 4.6% increase of HDL cholesterol and 11% increase of triglycerides, which were not statistically significant. In the combination therapy group 0.4% decrease of total cholesterol, 24.1% decrease of HDL cholesterol and 44.3% increase of triglycerides were observed. In the renal insufficiency group 4.9% decrease of total cholesterol, 22.1% decrease of HDL cholesterol, 0.1% decrease of triglycerides were observed. But all these findings have limitation in generalization due to small number of sample and a short period of observation. 6) Laboratory chemistry test results revealed no apparent treatment-related abnormalities.

An epidemiological note on the taeniasis in Korea

The present study was undertaken to evaluate the prevalence rate of Taenia spp. infection and distribution of taeniasis caused by T. solium among Koreans in several localities in Korea during the period from 1977 to 1980. A total of 1,946 stool specimens collected from students and inhabitants of Chungcheong Bug Do and Gyeongsang Nam Do were examined by cellophane thick smear method. Among them, 40 persons were detected as Taenia egg positive cases. The overall positive rate of Taenia spp. shows 2.1 percent. The prevalence rate of male (2.3 percent) is relatively higher than that of female (1.4 percent). In order to observe the distribution of Taenia solium infection, the whole worms or a part of proglottids of Taenia spp. were collected from the stools of egg positive cases by normal defecation or anthelmintic treatment. For the species identification, expelled proglottids were examined microscopically by the number of branches of the uterus, presence of a vaginal sphincter or the accessory ovarian lobe etc. Among 199 egg detected cases in this study 59 (39.1 percent) out of 151 cases in Seoul, 12(40.0 percent) of 30 cases in Gyeongsang Nam Do and 2 (25.0 percent) from 8 taeniasis cases in Cheju Do were infected with T. solium. But none of T. solium infection was found from 10 egg positive cases in Chungcheong Bug Do. As a whole, the composition of species shows 36.7 per cent of T. solium infection and 55.8 percent of T. saginata infection, and in 7.5 per cent the species were not identified.