Pharmacological Management of Germinal Matrix-Intraventricular Hemorrhage

Germinal matrix-intraventricular hemorrhage (GM-IVH) is among the devastating neurological complications with mortality and neurodevelopmental disability rates ranging from 14.7% to 44.7% in preterm infants. The medical techniques have improved throughout the years, as the morbidity-free survival rate of very-low-birth-weight infants has increased; however, the neonatal and long-term morbidity rates have not significantly improved. To this date, there is no strong evidence on pharmacological management on GM-IVH, due to the limitation of well-designed randomized controlled studies. However, recombinant human erythropoietin administration in preterm infants seems to be the only effective pharmacological management in limited situations. Hence, further high-quality collaborative research studies are warranted in the future to ensure better outcomes among preterm infants with GM-IVH.

Triggered Electrooculography for Identification of Oculomotor and Abducens Nerves during Skull Base Surgery

Objective@#: Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. @*Methods@#: We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1–5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. @*Results@#: Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). @*Conclusion@#: This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

Temporal Volume Change of Cavernous Sinus Cavernous Hemangiomas after Gamma Knife Surgery

Cavernous hemangiomas occur very rarely in the cavernous sinus. This study aimed to evaluate the efficacy of Gamma Knife surgery (GKS) on cavernous sinus cavernous hemangioma (CSCH) and to analyze the temporal volume change. We retrospectively reviewed the clinical data of 26 CSCH patients who were treated with GKS between 2001 and 2017. Before GKS, 11 patients (42.3%) had cranial neuropathies and 5 patients (19.2%) complained of headache, whereas 10 patients (38.5%) were initially asymptomatic. The mean pre-GKS mass volume was 9.3 mL (range, 0.5–31.6 mL), and the margin dose ranged from 13 to 15 Gy according to the mass volume and the proximity to the optic pathway. All cranial neuropathy patients and half of headache patients showed clinical improvement. All 26 patients achieved mass control; remarkable responses (less than 1/3 of the initial mass volume) were shown in 19 patients (73.1%) and moderate responses (more than 1/3 and less than 2/3) in 7 patients (26.9%). The mean final mass volume after GKS was 1.8 mL (range, 0–12.6 mL). The mean mass volume at 6 months after GKS was 45% (range, 5–80%) compared to the mass volume before GKS and 21% (range, 0–70%) at 12 months. The higher radiation dose tended to induce more rapid and greater volume reduction. No treatment-related complication was observed during the follow-up period.GKS could be an effective and safe therapeutic strategy for CSCH. GKS induced very rapid volume reduction compared to other benign brain tumors.

Meckel's Diverticulum Diagnosed in a Child with Suspected Small Bowel Crohn's Disease / 대한소아소화기영양학회지

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

Analysis According to Characteristics of 18 Cases of Brachial Plexus Tumors : A Review of Surgical Treatment Experience

OBJECTIVE: Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons.METHODS: The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed.RESULTS: The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age.CONCLUSION: For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

Analysis According to Characteristics of 18 Cases of Brachial Plexus Tumors : A Review of Surgical Treatment Experience

OBJECTIVE: Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. METHODS: The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. RESULTS: The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. CONCLUSION: For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

Usefulness of Positron Emission Tomography-Computerized Tomography Uptake according to Early Gastric Cancer Gross Morphology

BACKGROUND/AIMS: The role of 18F-fluorodeoxyglucose (18F-FDG) PET-CT for early gastric cancer (EGC) was undetermined due to its low sensitivity. The aim of this study was to assess the usefulness of 18F-FDG PET-CT according to endoscopic classification of EGC. MATERIALS AND METHODS: We retrospectively reviewed 206 patients who had undergone PET-CT due to gastric cancer from June 2009 to June 2012. Among those patients, 120 including 65 patients who underwent gastrectomy were analyzed. RESULTS: According to endoscopic gross morphology, 50 (41.7%) patients were classified as EGC and 70 (58.3%) patients were classified as advanced gastric cancer (AGC). Compared with the EGC group, the AGC group showed significantly higher rate of positive 18F-FDG uptake of primary lesions (98.6% vs. 28.0%, P<0.001) and lymph nodes (50.0% vs. 6.0%, P<0.001), and higher standardized uptake value max of primary lesions (7.65+/-3.51 vs. 4.82+/-2.18, P=0.012). Among 65 patients who underwent gastrectomy, PET-CT positive lesions were found in patients with tumor size greater than 3 cm (86.4% vs. 9.5%, P<0.001), lesions detected by stomach CT (90.9% vs. 9.5%, P<0.001) and PET-CT lymph node positive lesions (4.8% vs. 31.8%, P=0.025). Among 31 patients with EGC, elevated types (type I and IIa) showed no difference of positive 18F-FDG uptake compared with flat or depressed types (IIb, IIc, and III) (55.6% vs. 31.8%, P=0.253). CONCLUSIONS: 18F-FDG PET-CT has positive detection rate for EGC greater than 3 cm and there was no differences of 18F-FDG PET-CT uptake rates between elevated types and flat or depressed types of EGC.

Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture

PURPOSE: To evaluate radiological and clinical results of the antegrade intramedullary prebent K-wire fixation for the 5th metacarpal neck fracture. MATERIALS AND METHODS: Between January, 2006 and December, 2009, 31 patients with displaced neck fracture of the fifth metacarpal who received antegrade intramedullary prebent K-wire fixation were included in this study. Radiological and clinical outcome evaluations were performed. RESULTS: All the fractures were completely united. In the oblique radiographs, the average of preoperative angulation was corrected from 38.9degrees to 4.4degrees. The average difference between postoperative and final follow-up was 1.2degrees. Clinical outcomes were satisfactory except for one patient who had sustained ulnar nerve dorsal branch injury during surgery. CONCLUSION: Antegrade intramedullary prebent K-wire fixation may be preferentially considered as one of the best ways to fix the displaced neck fractures of the fifth metacarpal.

Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years: A Case Report

Tuberculous infection of the ischium is a rare condition. It is recommended that antituberculosis chemotherapy is combined with surgical intervention. The patient in this case had an abscess on his right gluteal region and he had undergone an operation without antituberculosis chemotherapy. After eight years, an abscess recurred in the same area and he was treated with surgical resection. Antituberculosis chemotherapy was administered following histopathological confirmation of tuberculosis. At 1 year postoperatively, the patient had no pain and there was no evidence of recurrence.

Anti-cancer Activities of Ginseng Extract Fermented with Phellinus linteus

In the present study, the anti-cancer effects of ginseng fermented with Phellinus linteus (GFPL) extract were examined through in vitro and in vivo assays. GFPL was produced by co-cultivating ginseng and Phellinus linteus together. Ginsenoside Rg3, Rh1 and Rh2 are important mediators of anti-angiogenesis and their levels in GFPL were enriched 24, 19 and 16 times, respectively, more than that of ginseng itself through the fermentation. GFPL exhibited distinct anti-cancer effects, including growth inhibition of the human lung carcinoma cell line A549, and promotion of immune activation by stimulating nitric oxide (NO) production in Raw 264.7 cells. Further evidence supporting anti-cancer effects of GFPL was its significant prolongment of the survival of B16F10 cancer cell-implanted mice. These results suggest that the GFPL may be a candidate for cancer prevention and treatment through immune activation and anti-angiogenic effects by enriching Rg3, Rh1 and Rh2.

Total Hip Replacement Arthroplasty with the Mallory-Head System : Minimum 8-Year Follow-up Results

PURPOSE: The purpose of this study was to assess the clinical and radiographic results of total hip arthroplasty with using the double tapered Mallory-Head system. MATERIALS AND METHODS: The clinical and radiographic results of a consecutive series of 81 total hip replacements in 75 patients were reviewed at eight to twelve years (average: 9.8 years) postoperatively. The underlying diseases were avascular necrosis in 46 hips (57%), osteoarthritis in 12 hips (15%), RA in 9 hips (11%) and others. The clinical result was evaluated on the basis of the modified Harris hip score and the modified Merle d'Aubigne-Postel score. A radiographic analysis was also performed. RESULTS: The average modified Harris hip score was improved from preoperative 56 points to postoperative 92 points. The average modified Merle d'Aubigne-Postel score was 15 points at the latest follow up, and 55 hips (68%) were classified as having clinical grades of excellent or good results. One acetabular component was revised because of loosening, and one was revised because of recurrent dislocation. CONCLUSION: The clinical and radiological evaluations of the total hip replacements using the Mallory-Head system showed good results.

The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery

PURPOSE: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. MATERIALS AND METHODS: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. RESULTS: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. CONCLUSION: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

Osteochondromas of the Bilateral Tali / 대한족부족관절학회지

Benign and malignant tumors are found in the foot, although the incidence is low. The most common bone tumor in the foot is osteochondroma, which is thought to develop in bones that form through the process of enchondral ossification. In particularly, osteochondromas in the foot mostly occur in metatarsal bones and phalanges. It is seldom found in talus. It is usually confused with osteophyte or enthesis. We report an osteochondroma case confirmed by roentgenographical and pathological investigation, after removing the masses form bilateral tali of a 19-year-old male patient presented with bilateral ankle joint pain for three years.

A Case of Adult Intussusception of the Colon Caused by Cecal Neurofibroma in a Patient with Neurofibromatosis Type 1 / 대한소화기내시경학회지

Neurofibromatosis type 1 (NF-1) is an autosomal dominant hereditary disorder and it is characterized by neurofibromas and cafe-au-lait spots on the skin. NF-1 affects the gastrointestinal tract in 25% of the cases and the stomach and jejunum are the commonly involved sites. Yet the occurrence of colon NF is very unusual. Several cases of colon involvement of NF-1 have been reported on and their clinical manifestations were massive or occult bleeding, constipation and asymptomatic rectal or perianal nodules. There was a reported case of colon-to-colon intussusception via an isolated colonic neurofibroma. However, the best of our knowledge, there has been no reported case of colon-to-colon intussusception induced by NF-1. We encountered a case of NF-1 involving the cecum that resulted in colon-to-colon intussusception and secondary acute appendicitis. The patient showed the typical skin lesions and bony abnormalities of NF. We report on this case with a review of the literature.

Ciliary Beat Frequency in the Airways of Humans : Influences of Lidocaine, Age, Sex and Smoking

We measured the ciliary beat frequencies (CBFs) in respiratory ciliated epithelia obtained from the nasal cavity, trachea, and bronchus of 40 subjects during fiberoptic bronchoscopy, using a video-computerized analysis technique. The subjects were classified into various groups based on a range of parameters, including sex, age, history of smoking and whether or not a local anesthetic has been used and mean values of CBFs were analyzed between these groups. The ciliary beat of nasal epithelial cells was significantly faster than that of the trachea or bronchus (p=0.008). There were significant positive correlations between the CBFs at the nasal cavity and trachea (R2=0.467, p<0.001), nasal cavity and bronchus (R2=0.566, p<0.001), and trachea and bronchus (R2=0.541, p<0.001). Subjects older than 60 years of age had significantly slower CBFs at all three sites and than their younger counterparts (p<0.001). Neither sex nor smoking affected the ciliary motility at any site of the respiratory tract. There was no significant difference in the nasal CBFs between the anesthetized and non-anesthetized sides. In conclusion, this study can provide important clinical data on the CBFs of respiratory tracts in humans.

Effects of beta-toxin of Staphylococcus aureus and Neuraminidase of Streptococcus pneumoniae on Ciliary Activity of Nasal Ciliated Epithelial Cells

BACKGROUND AND OBJECTIVES: The in vitro effects of pneumococcal neuraminidase and staphylococcal beta-toxin on ciliary activity were investigated at different concentrations and lengths of exposure. MATERIALS AND METHODS: The ciliated epithelial cells were taken from the maxillary sinus mucosa of rabbits. Ciliary beat frequency (CBF) was measured at concentrations of 0.01, 0.1 and 1.0 U/mL of neuraminidase and 0.1, 1.0, 2.0, 5.0 and 10 U/mL of beta-toxin using a video-computerized analysis technique. The CBF was measured 2, 4, 6, 12, 24 and 48 hours after administration of the neuraminidase and beta-toxin. In the control group, normal saline was percutaneously applied to the right maxillary sinus. In the experimental group, 2 U/mL of beta- toxin was applied to the left maxillary sinus using the same technique. At 7 days, all of the mucosae were taken from the inferomedial wall of the maxillary sinus for light microscopy. RESULTS: There was no change in CBF during a 48-hour incubation at 0.01, 0.1 and 1.0 U/mL of neuraminidase. However, the CBF dropped significantly after an 8-hour incubation at 2.0 U/mL of beta-toxin (p<0.05, repeated measures ANOVA). No ciliary activity was observed after a 12-hour incubation at 10 U/mL of beta-toxin. The mucoid, purulent discharge was observed in the maxillary sinuses of the experimental group. Prominent epithelial disruption and infiltration of inflammatory cells into the epithelium and lamina propria were observed in the beta-toxin-applied group. CONCLUSION: The results of this study suggest that staphylococcal beta-toxin may reduce ciliary activity and induce sinusitis without occlusion of the natural ostium of the maxillary sinus in rabbits. This study provides another animal model of sinusitis for understanding the pathogenesis of sinusitis caused by bacterial exotoxins.

A Model of Human Nose and Paranasal Sinuses for the Study of Sinus Ventilation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The pathogenesis of chronic paranasal sinusitis has been gradually clarified, but there have been conflicting arguments on the ventilation of paranasal sinus. The aim of the present study is to establish an objective, quantitative and reproducible method for the investigation of the ventilation of paranasal sinuses. MATERIALS AND METHODS: With the axial images of high resolution computed tomography, a fine model of human paranasal sinus was made. The model was fitted with pressure sensors, and the pressure changes in the nasal cavity, frontal, maxillary and sphenoid sinuses were measured by pressure sensors and digital physiograph during nasopharyngeal respiration. RESULTS: Results demonstrated negative pressures compared to the atmospheric pressure during inspiration and positive pressures during expiration in the sinonasal cavities, and the highest and lowest pressures were measured in the nasal cavity. CONCLUSION: This study introduces another method for the investigation on the sinus ventilation through a model study. And this study model has demonstrated that the ventilation of paranasal sinuses depends on nasal respiration. Furthermore, the method is useful to evaluate the results of nasal and sinus surgeries in the case of an obstructed ostium, deviated septum or hypertrophied turbinates.

A Comparison of the Therapeutic Effects of Powder and Aerosolized Budesonide in the Treatment of Perennial Allergic Rhinitis

The aims of this study are to compare the efficacy and side effects of intranasal budesonide as a dry powder and as a freonpropelled pressurized aerosol in the treatment of perennial allergic rhinitis and to assess the difference in compliance with the powder and aerosol. The study design was a randomized, double-blind crossover between two treatment groups over a six-week period. Twelve patients with symptomatic perennial allergic rhinitis received 400 microgram of intranasal budesonide administered daily as two puffs/nostril/day of the drug delivered by a freon-propelled aerosol for the first three weeks and as one inhalation/nostril/day of the pure drug powder for the next three weeks. Fourteen adults with allergic rhinitis received the drug in the reverse sequence. Patients recorded daily symptoms on diaries, and, at each clinic visit, adverse effects were recorded. Compliance with the powder and with the aerosol was also evaluated. During the six weeks, there were significant improvements in symptoms in both treatment groups, and the differences in efficacy and compliance with the medication between the two groups were not significant. Adverse effects included headaches, epistaxis, and nasal dryness ; however, they were not serious and equally distributed in the two groups. We conclude that powder and aerosolized budesonide improve the symptoms of perennial allergic rhinitis significantly with little difference in efficacy, side effects, and preference.

A Comparison of the Therapeutic Effects of Powder and Aerosolized Budesonide in the Treatment of Perennial Allergic Rhinitis

The aims of this study are to compare the efficacy and side effects of intranasal budesonide as a dry powder and as a freonpropelled pressurized aerosol in the treatment of perennial allergic rhinitis and to assess the difference in compliance with the powder and aerosol. The study design was a randomized, double-blind crossover between two treatment groups over a six-week period. Twelve patients with symptomatic perennial allergic rhinitis received 400 microgram of intranasal budesonide administered daily as two puffs/nostril/day of the drug delivered by a freon-propelled aerosol for the first three weeks and as one inhalation/nostril/day of the pure drug powder for the next three weeks. Fourteen adults with allergic rhinitis received the drug in the reverse sequence. Patients recorded daily symptoms on diaries, and, at each clinic visit, adverse effects were recorded. Compliance with the powder and with the aerosol was also evaluated. During the six weeks, there were significant improvements in symptoms in both treatment groups, and the differences in efficacy and compliance with the medication between the two groups were not significant. Adverse effects included headaches, epistaxis, and nasal dryness ; however, they were not serious and equally distributed in the two groups. We conclude that powder and aerosolized budesonide improve the symptoms of perennial allergic rhinitis significantly with little difference in efficacy, side effects, and preference.

Changes Produced by Different Concentrations of Inflammatory Cytokines in the Proliferation and Ciliary Movement of Human Respiratory Epithelial Cells

The aim of this study was to determine the effects of cytokines IL-1beta, TNF-alpha, and TGF-beta on the proliferation and ciliary beat frequency (CBF) of human nasal epithelial cells (HNECs) in vitro. Subcultured HNECs were incubated in a medium containing recombinant human (rh) cytokines rhIL-1beta rhTNF-alpha and rhTGF-beta at concentrations of 0.01 ng/ml, 0.1 ng/ml, 1 ng/ml, 10 ng/ml, and 100 ng/ml. After a two-day incubation with these cytokines, daily cell proliferation was measured by MTT assay for six days. The CBF was measured at concentrations of 1 ng/ml of rhIL-1beta 10 ng/ml of TNF-alpha and 1 ng/ml of TGF-beta solutions. While rhIL-1beta inhibited proliferation of HNECs in concentration-dependent and time-dependent manners, rhTNF-alpha stimulated HNEC growth at concentrations ranging from 0.01 ng/ml to 10 ng/ml in concentration-dependent and time-dependent manners. In contrast, rhTGF-beta inhibited HNEC growth irrespective of concentration and incubation time. The CBF of the human nasal ciliated epithelial cells increased after the addition of rhIL-1beta and rhTNF-alpha The CBF increased progressively for four hours after the addition of rhIL-1beta and rhTNF-alpha The increased CBF continued for 24 hours and decreased after two days. However, no variation of the CBF was observed after the addition of rhTGF-beta regardless of concentration or incubation time. The results of this study suggest that during acute inflammation, IL-1beta TNF-alpha and TGF-beta may have important roles in the repair and defense mechanism of the human nasal epithelium by regulating the proliferation and CBF of nasal epithelial cells.