The Effects of Intranasal Instillation of Stem Cell Factor in Mice with Experimentally-Induced Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The pathogenesis of allergic rhinitis has not been fully understood. The role of stem cell factor (SCF) in allergic airway inflammation has recently been identified. This study aimed to investigate the effect of intranasal instillation of SCF in mice with experimentally-induced allergic rhinitis. MATERIALS AND METHOD: Male BALB-c mice were intraperitonially sensitized to ovalbumin mixed with aluminum hydroxide and were challenged with aerosols of ovalbumin. Recombinant murine SCF was directly instilled to both nasal cavities. Sneezing and nose-rubbing act of the mice were checked by symptom scores. Nasal lavage fluid (NLF) was collected and histamine levels in the NLF were measured. The eosinophils in the inferior turbinate of the mice were counted at the coronal section of the skull. RESULTS: The symptom scores checked 1 hour after intranasal instillation of 50 nM SCF and 500 nM SCF were 29+/-8 (mean+/-S.D.) and 31+/-10, respectively. They were significantly different from those of the control group (18+/-5). Histamine levels of NLF collected 1 hour after intranasal instillation of 500 nM SCF were 3.62 1.8 nM and were significantly different from those of the control group (1.31+/-0.4 nM). The number of eosinophils in the inferior turbinate of mice counted 24 hours after intranasal instillation of 500 nM SCF was 17.6+/-3.2 and was significantly different from those of the control group (11.2+/-3.5). CONCLUSION: Stem cell factor may play an important role in the pathogenesis of allergic rhinitis.

Sclerotherapy for Craniofacial Venous Malformation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Venous malformations are one of the most common vascular anomalies, and are more frequently found in head and neck region. Various treatment options are available, and intralesional injection of sclerosant is the commonest primary treatment modality. We reviewed 20 cases of venous malformation treated with sclerotherapy at Seoul National University Hospital. MATERIALS AND METHODS: Twenty cases of venous malformation in head and neck were reviewed retrospectively, which had been managed with sclerotherapy from January 1991 to July 2001. The patients were treated at the department of otolaryngology-Head and Neck Surgery or plastic surgery of Seoul National University Hospital. Emulsion of Ethamolin and Lipiodol was used as a sclerosing agent. Some patients received surgical treatment after sclerotherapy. All of the patients received direct-puncture venography(Digital subtraction angiography) before sclerotherapy. Treatment results were evaluated by using MRI, angiography, or CT. If the reduction of volume of mass was more than 50 percent after sclerotherapy, we regarded the result as effective, if less than 50 percents, non-effective. Statistical analysis was done using SPSS10.0 for windows. RESULTS: Among twenty patients, there were eight males(40%), and twelve females(60%). Ages at the beginning of treatment ranged from six to thirty-eight years(mean age:20.6 years). The most common site of lesions was cheek(in 12 cases). Mass sizes(largest diameter) ranged from 2 cm to 20 cm. Nine cases were managed with both sclerotherapy and surgical excision, and eleven cases, only with sclerotherapy. Thirteen cases(65%) responded well to sclerotherapy(volume reduction>or=50%). There was no major complication. Tenderness, induration, swelling, and pain were reported as post-sclerotherapy complaints. Mild dyspnea occurred in one case, and the patient was managed at ICU shortly without fatal event. CONCLUSION: Sclerotherapy with or without surgical excision was an effective treatment modality for venous malformation, with minimal risk of major complications. There were no significant differences in the treatment results according to the initial size of the lesions.

Management of Pyriform Sinus Fistula with Chemocauterization / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A pyriform sinus fistula can cause a recurrent abscess in the neck. Complete excision is recommended but in many cases, surgery is complicated because of recurrent infection. Recurrence may result from failure to recognize, or inadequate excision of the tract. To avoid this, we attempted chemocauterization of the internal opening of the fistula tract with trichloracetic acid (TCA) on suspension laryngoscopy. MATERIALS AND METHOD: This was a 9-year review of 30 patients with pyriform sinus fistula. Medical history, diagnostic methods, operative findings and treatment results were analyzed with a review of the literatures. RESULTS: On suspension laryngoscopy, a fistula opening was found in the pyriform sinus of all patients, mainly on the left side. Except for two patients, 28 patients were managed by TCA chemocauterization. Of the five patients who had recurrent masses, three patients were successfully managed by simple excision and two patients were managed by repeated TCA cauterization with unobliterated internal openings. There was no serious intra- or postoperative complication. CONCLUSION: TCA cauterization is an appropriate first line treatment method for pyriform sinus fistula, especially for patients who have had recurrent neck abscess and undergone open drainage procedure. This method can be used to avoid morbidity of an open surgical procedure.

Clinical Findings of Recurrent Respiratory Papillomatosis and Preliminary Results of the Adjuvant Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the respiratory tract. RRP is usually divided into two groups by age of onset. We aimed to investigate the different clinical courses between the childhood-onset and the adult-onset RRP and review the effects of the treatments. MATERIAL AND METHOD: We retrospectively reviewed 44 patients with RRP who had been treated in our hospital over the last 13 years. We compared the clinical courses and intersurgical intervals of childhood-onset RRP with those of adult-type and evaluated the effect of the alpha-interferon (local injection) by comparing preadjuvant average surgical interval with postadjuvant surgical interval with a review of the literature. RESULTS: Childhood-onset RRP was most often diagnosed between 1 and 4 years of age. It was more widespread and it recurred more frequently than adult-onset RRP, often involving the trachea and necessitating the tracheostomy. Therefore, more frequent surgical interventions were needed in childhood-onset RRP (2.81/year) than in the adult-type (1.14/year). Adjuvant therapy (local injection of alpha-interferon) was applied to 10 patients. Seventy-five percent of the 8 patients (2 were excluded due to short duration of F/U period) showed complete response (CR) or partial resopnse (PR) and only two patients did not respond to alpha-interferon at all. CONCLUSION: Childhood-onset RRP is more aggressive and widespread than its adult counterpart and intralesional injection of alpha-interferon seems to have a potential of a safe and effective adjuvant therapy for RRP.