ABSTRACT
BACKGROUND AND OBJECTIVES: Vasointestinal peptide (VIP) is an important neurotransmitter involved in the regulation of mucus secretion, but the relationship of VIP and mucin genes is not clear. This study was designed to investigate the effect of VIP on MUC2/5AC genes expression and mucin secretion in human airway epithelial cells. MATERIALS AND METHOD: The mRNA levels of MUC2/5AC genes and mucin secretion were determined by RT-PCR and the immunoblot method in cultured human airway NCI-H292 epithelial cells. RESULTS: VIP (10-6-10-10 M) induced MUC2/5AC gene expression and mucin secretion in a reverse dose-dependant manner. The maximum expression of mRNA and mucin secretion level of MUC2/5AC was 10-10 M of VIP. Actinomycin D inhibited the VIP-mediated MUC2/5AC gene expression and mucin secretion, but cycloheximide did not. Budesonide attenuated the VIP-mediated MUC2/5AC genes expression and mucin secretion. RU-486, a glucocorticoid receptor antagonist, restored the inhibitory effect of budesonide. CONCLUSION: These results suggest that VIP regulates MUC2/5AC gene expression and secret mucin by transcriptional regulation, and that budesonide inhibits the VIP-mediated MUC2/5AC genes expression and mucin secretion through the glucocorticoid receptor.
Subject(s)
Humans , Budesonide , Cycloheximide , Dactinomycin , Epithelial Cells , Gene Expression , Mifepristone , Mucins , Mucus , Neurotransmitter Agents , Receptors, Glucocorticoid , RNA, Messenger , Vasoactive Intestinal PeptideABSTRACT
BACKGROUND AND OBJECTIVES: Mucus hypersecretion is a hallmark of many respiratory inflammatory diseases such as asthma, bronchitis and sinusitis. While the current therapeutic pharmacological approaches to reducing mucus hypersecretion are limited, clinical studies have suggested that glucocorticoids reduce mucus secretion in patients with airway disease. However, the effect of glucocorticoids on mucus hypersecretion is not clear. Recently, we observed that IL-1beta induces MUC2 gene expression and mucin secretion in a previous experiment. This study was designed to investigate the effects of budesonide on the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion. MATERIALS AND METHOD: We observed the steady state mRNA level of MUC2/5AC genes using RT-PCR and mucin protein using immunoassay method in cultured human airway NCI-H292 epithelial cells. RESULTS: Budesonide attenuated IL-1beta-mediated MUC2/5AC gene expression as well as mucin secretion. The attenuated effect of budesonide was in a dose-dependent pattern. This attenuated effect of budesonide was blocked by glucocorticoid receptor antagonist, RU-486. CONCLUSION: This result suggests that budesonide suppresses the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion via blockage of glucocorticoid receptor.
Subject(s)
Humans , Asthma , Bronchitis , Budesonide , Epithelial Cells , Gene Expression , Glucocorticoids , Immunoassay , Interleukin-1beta , Mifepristone , Mucins , Mucus , Receptors, Glucocorticoid , RNA, Messenger , SinusitisABSTRACT
BACKGROUND: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.
Subject(s)
Adult , Female , Humans , Male , Acoustics , Nasal Cavity , Polyps , Prospective Studies , Rhinometry, Acoustic , SinusitisABSTRACT
BACKGROUND: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.
Subject(s)
Adult , Female , Humans , Male , Acoustics , Nasal Cavity , Polyps , Prospective Studies , Rhinometry, Acoustic , SinusitisABSTRACT
Radicular cyst is the most common inflammatory odontogenic abnormality which is associated with the crown of unerupted or developing maxillary and/or mandibular teeth. There have been many reported cases where radicular cysts were removed by means of enucleation through Caldwell-Luc's approach. However, there has been only a few reports about marsupialization of radicular cyst. In patients, who are old, aged and immunocompromised are intolerable to complete enucleation and are prone to pathologic fractures and postoperative complications, marsupialization is the only alternative method. For the first time in Korea, we encountered a 64-year old immunocompromised female patient with a large infected radicular cyst which was managed by marsupialization with wide inferior meatal antrostomy under transnasal endoscope and obtained successful results.
Subject(s)
Female , Humans , Middle Aged , Crowns , Endoscopes , Fractures, Spontaneous , Immunocompromised Host , Korea , Postoperative Complications , Radicular Cyst , ToothABSTRACT
BACKGROUND AND OBJECTIVES:Extranasal approach has been emphasized treatment of choice in inverted papilloma of nasal cavity and paranasal sinuses until several years ago. However, nowadays conservative transnasal endoscopic surgery is done in properly selected cases of inverted papilloma. The aim of this study was to compare the long-term outcomes of transnasal endoscopic and extranasal surgical management of inverted papilloma. MATERIALS AND METHODS: Among 33 patients who were pathologically diagnosed as inverted papilloma from January 1990 to August 1997, we reviewed the medical records and CT scans of 25 patients who underwent surgical treatment and were available for the follow up at least more than 2 years, retrospectively. RESULTS: Thirteen patients were treated via transnasal endoscopic approach and twelve patients by extranasal approach. According to Skolnik(1966)'s stage classification, 20 patients showed stage T3. Eleven patients of them were treated via transnasal endoscopically and 9 patients extranasally. Four minor postoperative complications, such as epiphora, septal perforation, vestibular pain and facial parasthesia, were noted in extranasal approach group. One case(7.7%) recurred in conservative transnasal endoscopic surgery group during mean 38 months follow up period. However, no recurrence was found in extranasal approach group during mean 60 months follow up period. CONCLUSION: If endoscopic surgery is performed by experienced surgeons in adequately selected patients, conservative transnasal endoscopic surgery can be considered as an alternative surgical modality in inverted papilloma of nasal cavity and paranasal sinuses.