Clinical Characteristics of Allergic Rhinitis According to Allergic Rhinitis and Its Impact on Asthma Guidelines

OBJECTIVES: The Allergic rhinitis and its impact on asthma (ARIA) guidelines were suggested for use to classify allergic rhinitis (AR). However, few studies have been performed in Asians. The objective of this study is to identify the clinical characteristics of AR in Korean patients according to the ARIA guidelines. METHODS: For the study, 610 patients who had been diagnosed with allergic rhinitis at Seoul National University Bundang Hospital and 545 patients who had been diagnosed with allergic rhinitis at 3 local clinics were included. All the patients were categorized into 4 groups, such as the mild intermittent, mild persistent, moderate-severe intermittent and moderate-severe persistent groups. The patients were given a questionnaire on allergic rhinitis-related symptoms and they underwent blood tests, including the blood eosinophil count and the serum total IgE level. RESULTS: The most prevalent type was the moderate-severe persistent group (34.7%), and the moderate-severe intermittent group (17.1%) was the rarest. There were significant differences among the 4 groups for olfaction (P<0.001), self-awareness of rhinitis (P=0.013), a previous history of AR (P<0.001), self-awareness of asthma (P=0.001) and allergic conjunctivitis (P<0.001). On the allergy laboratory tests, there was a significant difference between the groups for the eosinophi count (P=0.004). The number of blood eosinophil was more in the persistent groups than in the intermittent groups. CONCLUSION: According to the ARIA guidelines, the moderate-severe persistent group was the most prevalent for Korean patients. Blood eosinophilia and olfactory dysfunction were the most severe in the moderate-severe persistent group.

The management of rhinitis and sinusitis

No abstract available.

The Effect of Tonsillectomy and Adenoidectomy on Nasality in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillar and adenoid hypertrophy is one of the common causes of nasal obstruction, mouth breathing, snoring and sleep apnea in children. Tonsillectomy and adenoidectomy (T & A) could relieve these symptoms but may also cause voice changes after the operation. The aim of this study was to evaluate the voice changes objectively by nasometric and acoustic rhinometric analyses. MATERIALS AND METHODS: Thirty-eight patients who underwent T & A and twenty-two control children who had no sinonasal or tonsillar hypertrophy problems were selected. A visual analogue scale was used for determining the subjective nasality changes and nasometric analyses were used to determine the objective nasalance differences. Acoustic rhinometry was used to measure the nasopharyngeal volume changes and the removed adenoid tissue were directly measured. Data were collected prior to the operation, and on the second, 7th and 14th days after the operation. Data were compared and analyzed statistically. RESULTS: The volume of removed adenoid tissue was not statistically related with the subjective nasality changes which increased significantly after T R. A. Nasalance in the patient group increased significantly after the operation compared to that in the control group. The voiume of nasopharynx increased significantly after adenoidectomy, but it had a minimal statistical correlation with the volume of the removed adenoid tissue. CONCLUSION: Nasometric and acoustic rhinometric tests can serve as objective tools for evaluating the subjective nasality changes after T 5z A.

Measurement of Nasal Trigeminal Pungency Threshold: Comparison between Normals and Patients with Decreased Sense of Smell

BACKGROUND AND OBJECTIVES: In order to measure the level of nasal trigeminal pungency threshold and to evaluate the interaction between olfactory and trigeminal nerves, we measured olfactory thresholds and trigeminal pungency thresholds using 1-butanol in 40 normal people and in 46 patients with decreased sense of smell by non-sinonasal origin. MATERIALS AND METHODS: Two-alternative forced-choice modified ascending method of limit (CCCRC test) was used for the measurement of olfactory and pungency thresholds, using 1-butanol plastic squeezable bottles successively threefold diluted by distilled water as stimulus, while distilled water as blank. RESULTS: There was a statistically significant difference in pungency threshold between normals (2.18+/-1.5 dilution step) and patients (1.11+/-1.0 dilution step)(p<0.001). CONCLUSION: The pungency thresholds of hyposmics and anosmics are higher than those of normals, which suggests that a loss or decrease of olfactory sensation is accompanied by a simultaneous decrease of trigeminal chemosensitivity.

A Case of Allergic Mucin Sphenoiditis without Fungus

Allergic fungal sinusitis is characterized by eosinophilic allergic mucin with fungal hyphae in histopathologic aspect. "Allergic mucin sinusitis without fungus" or "Allergic fungal sinusitis-like syndrome" is a new term used to describe patients who have clinical and histopathologic features of allergic fungal sinusitis but fail to demonstrate fungi in histopathologic sections or cultures of sinus tissue. In this study, we report on a case of allergic mucin sinusitis which involved only sphenoid sinus of the left side in a 31 year old female.

Occupational asthma and rhinitis caused by curry powder / 천식및알레르기

Curry powder is widely used in various dishes. It is a mixture of 20-50 kinds of natural spices made from the leaves and seeds of plants. Although there have been some reports of allergy caused by inhalation of spices in western countries, while there are no reports of occupational allergy caused by spices in our country. We report a patient with rhinitis and asthma induced by exposure to spice dusts in a curry industry. A 32-year-old man developed rhinorrhea, sneezing and coughing three years prior to visiting our hospital. Since 10 years ago, he has been involved in grinding and mixing spices in a curry industry. Total peripheral eosinophil count was 400/mm3 and serum total IgE level was 163 IU/ml. Allergy skin-prick test showed positive responses to mugwort (3+), D. farinae (3+) and celery (3+), while serum specific IgE detected by RIA (DPC, LA, CA) showed all negative results. Skin-prick test to four kinds of spice extractscelery seed, fennel, cumin and coriander-showed strong positive responses. Bronchoprovocation test with celery seed extract (1:10 v/v) showed an early asthmatic response. Specific IgE and IgG4 antibodies to celery seed and the other three spices were detectable by ELISA. IgE-ELISA inhibition test using each spice antigen showed significant inhibitions. In conclusion, IgE-mediated mechanism may be involved in the pathogenesis of curry powder-induced bronchoconstriction in an exposed worker. Further studies will be needed to investigate the role of specific IgG4 in pathogenesis of bronchoconstriction in curry powder-induced asthma.

The Prevalence of Nasal Septal Deformities among Children in Kindergarten and First Grade in Anyang and Kunpo Cities

Nasal septal deformity (NSD) is a common nasal disorder, but its prevalence among children has not been reported in Korea. The aim of this work was to study the prevalence of NSD among children in kindergarten and first grade in Anyang and Kunpo cities and to evaluate whether the occurrence of NSD in children was affected by school activity or correlated with sex. We examined 1,646 nasal septa of 1,491 students (average age : 7.5 years ; range : 6.3-8.9 years) at three elementary schools and 155 children (average age : 6.5 years ; range : 5.9-7.1 years) at two public kindergartens. The overall prevalence of NSD was 13.6%. A significant difference in prevalence was found between male and female children and between male and female firstgraders. No difference was found between the children in kindergarten and the children attending first grade and between male and female children in kindergarten. The most common type of NSD, based on the Mladina's classification, was type 1, followed by types 2 and 5.

Mucin Secretion and MUC1 mRNA Expression in the Cultured Secretory Cells of the Rat Nasal Epithelium

The upper respiratory system is lined with epithelium (mucosa) of the pseudostratified ciliated columnar type that produces mucus as a secretion. The major constituent of mucus is mucin, a glycoprotein of distinct physical and biochemical properties that exists in various organs. The aim of this study was to analyze the biochemical and molecular biological conditions affecting mucin secretion in cultured secretory cells of the upper respiratory mucosa. Rat nasal epithelial cells were cultured in four conditions differing in culture matrix : 1) plastic surface (PL), 2) thick collagen gel (TG), 3) thin collagen gel (GC), and 4) collagen gel coated membrane (CO). In each group, cell proliferation patterns, gel lysis and ciliary regeneration were observed, and attachment efficiency and confluence day were recorded. After confluence, mucin in the culture media was tagged with [3H]-glucosamine and analyzed by elution through Sepharose CL-4B column. The expression of MUC1 in cultured cells was analyzed by RT-PCR. In PL and GC, attachment efficiency was less than 2.2%. The shape and size of each cell in active proliferation was not regular. Confluence was observed on culture day 21 (range : 15-24). In TG and CO, attachment efficiency was more than 10.0% and the shape and size of each cell in active proliferation was regular in a compact fashion. Eight days (range : 7-11) were needed for confluence. After elution through column, mucin was detected in TG and CO but not in GC and PL. MUC1 was expressed in TG and CO but not in GC and PL. In conclusion, a thick collagen gel matrix was essential in mucin secretion and MUC1 expression in cultured secretory cells of the rat nasal mucosa.

The Effects of Pregnancy Conditions on the Incidence of Nasal Septal Deformities in Neonates

BACKGROUND AND OBJECTIVES: To study the incidence of nasal septal deformities (NSD) in neonates and to identify pregnancy conditions related with NSD occurrence. MATERIALS AND METHODS: Prospective study of 131 women and their newborns. Incidences of neonatal NSD were looked for with a cotton wool test and through direct visual examination of the neonatal nasal cavity with an otoscope. Under study were arbitrary but possibly related factors of neonatal NSD : the mother's age, parity, medical history, the duration of total labor, the duration of second-stage labor, the delivery type, neonatal birth weight and gestational age. The contributions of these factors were analyzed statistically. RESULTS: The incidence of neonatal NSD as identified through otoscopic examination was 11.5%. All studied factors indicated no statistically significant relationship with neonatal NSD. CONCLUSION: Probable nasal trauma during pregnancy and delivery is likely not a factor in the occurrence of NSD in neonates.

MR Evaluation of the Olfactory Bulb in Normals and Patients with Decreased Sense of Smell*

To evaluate changes in olfactory bulb size in patients with reduced or no sense of smell, 23 normals and 20 hyposmics or anosmics were examined with nasal endoscopy, olfactory testing and magnetic resonance imaging (MRI) of the olfactory bulb. Olfactory testing consisted of a threshold test by bounded three-alternative forced-choice modified ascending method of limits (CCCRC test) and the step method using threefold dilutions of 1-butanol and an olfactory identification test using 32 natural odors familiar to Koreans. The MR evaluation involved the estimation of olfactory bulb size by using a 13 cm diameter general purpose surface coil with 3 mm T1-weighted MR coronal sections without interval. The cut areas of the olfactory bulb in MR coronal sections were measured with a Hope Graph Planimeter (model No. 9-003) after fivefold enlargement. The olfactory bulb was observed in three cuts of MR imaging in all subjects. In the measured area of the olfactory bulb, the anterior portion of the olfactory bulb was significantly smaller than the middle and posterior areas in normals, but hyposmics or anosmics showed decreased olfactory bulb area, especially in height, when compared with normals. There was good correlation between olfactory bulb area and olfactory threshold as well as olfactory identification in normals and patients. MR imaging can be a useful tool for patients with hyposmia or anosmia.

Comparison of Olfactory Threshold Tests:CCCRC Test versus Step Method / 대한이비인후과학회지

There are many variables that can be manipulated in the study of olfactory thresholds. They include the choice of odorant, the way to bring the stimulus to the subject's nose, number of trials, interval between trials, dilution method, environmental conditions, as well as psychophysical method. The focus of this study lay on how much differences were made by the psychophysical method, the sequence of presentations of stimuli that led to calculation of an index of sensitivity and how reliable the result of step method in olfactory threshold testing is. The olfactory threshold tests entailed comparison of procedures: 1) a procedure of two-alternative forced-choice(2AFC) testing by an ascending method of limits(CCCRC test), 2) a two-alternative forced-choice(2AFC) version of step method that used a computerized algorithm to calculate threshold on an ongoing basis throughout testing. As a result, mean concentration difference of 7.6-fold was achieved in the thresholds by the two procedures and inter-test correlation coefficient was 0.46. Estimation of threshold in the step method remained relatively constant after 10 trials to the end of the 30 test-trials without biases, which meant step method showed coherent data. Accordingly step method is suitable for olfactory threshold test despite of relatively long testing time.

A Case of Intranasal Meningoencephalocele / 대한이비인후과학회지

Meningoencephalocele is an ectopic protrusion of the meninges and a portion of the brain that retains connection with the CNS through a defect in the bony covering. It is a rare developmental anomaly that results from faulty closure of the embryonic neural tubes. Meningoencephalocele is usually classified into occipital, sincipital and basal types according to the location and among these, the basal type is less frequently encountered than other types. The authors have experienced a case of basal-type intranasal meningoencephalocele in 4 year-old male patient, which was removed successfully via bifrontal craniotomy and intranasal endoscopic approach, and the defect of skull base was repaired by inner table of the cranium and septal mucosa with good result.

Measurement of Olfactory Threshold in Normal Korean Adults with Combined Use of Bounded CCCRC Test and Step Method

The high variability of measured olfactory thresholds in humans reflects very broad range of sensitivity within and among individuals. This can be derived from the strongly compressive nature of olfaction, which makes it relatively hard to compare the size of two stimuli in odor sensation. However, we know that some portion of the variation is the result of extrinsic factors e.g. the method used to measure the olfactory threshold. For this reason, in order to address the bias and reliability of a psycophysical method, we combined the use of the CCCRC (Connecticut Chemosensory Clinical Research Center) test with the step method in 40 normal Korean adults twice a week for the evaluation of threshold. The measured thresholds showed high test-retest reliability and the threshold estimates remained consistent during the testing without trial-biases. Based on the results, we can conclude that a combined test using the CCCRC test and step method can be used in the measurement of olfactory threshold in a clinical context.

Lateral Sinus Thrombophlebitis Caused by Isolated Sphenoid Sinusitis

Lateral sinus thrombophlebitis is a very rare complication of paranasal sinusitis. This disease can result in a fatal outcome if not treated with proper antibiotics or surgical intervention. Recently, the authors came across a case of lateral sinus thrombophlebitis resulting from cavernous sinus thrombophlebitis complicated by isolated sphenoid sinusitis. Because of a severe and persistent headache, the case was initially admitted and managed as though the patient was suffering from Tolosa-Hunt syndrome. Hemifacial hypoesthesia, periorbital swelling and meiosis on the right side developed during tentative treatment. High resolution computed tomography showed isolated sphenoid sinusitis with partial bony dehiscence on the roof of left sphenoid sinus. Magnetic resonance images showed multiple thrombosis in the cavernous sinus, internal carotid artery, sigmoid sinus and lateral sinus on the right side. Antibiotics, thrombolytics and endoscopic surgical intervention of sinusitis prevented a fatal outcome in spite of remaining hemifacial hypoesthesia and ptosis on the right side.

A prevalence study of otitis media and related diseases in Korea in 1991 / 대한이비인후과학회지

No abstract available.

Dimension of lateral lamella of lamina cribrosa in ostiomeatal unit CT / 대한이비인후과학회지

No abstract available.

The clinical use of bronchoscopic laser surgery / 대한이비인후과학회지

No abstract available.

Effect of adenotonsillar hypertrophy on snoring in children / 대한이비인후과학회지

No abstract available.

Clinical analysis of cleft palate patients / 대한이비인후과학회지

No abstract available.

A case of cholesterol granuloma of the spenoid sinus / 대한이비인후과학회지

No abstract available.