Two Cases of Jugular Phlebectasia / 대한이비인후과학회지

Anterior or lateral neck mass that appears on straining should be differentiated from laryngocele, jugular phlebectasia and superior mediastinal cysts or masses. The most common cause of aneck masses which that appears on straining is alaryngocele. The jugular phlebectasia may present itself in a similar manner, although it occurs rarely. The cause of the jugular phlebectasia is unclear. The diagnosis is made on a clinical basis and confirmed by the less invasive radiological technique. No treatment is indicated because of its self-limiting, benign condition. However, the surgical removal is needed for cosmetic purposes by a unilateral excision of the jugular vein. We experienced two cases of jugular phlebectasia, one anterior and the other internal. One case of The anterior jugular phlebectasia was successfully treated by surgical excision, and the other case of internal jugular phlebectasia was treated conservatively.

A Case of Multiple Dermoid Cyst of the Floor of the Mouth / 대한이비인후과학회지

A multiple dermoid cyst is a rare tumor in the floor of the mouth. It presents as abnormal cystic development in the midline as a result of displaced or enclaved embryonic epithelium during the midline closure of the first and second bilateral branchial arches. Dermoid cyst is classified inot three categories according to its histological type; dermoid, epidermoid, and teratoma. The treatment of choice is complete surgical excision and prognosis is excellent. We present a recently encountered case of a multiple dermoid cyst in the floor of the mouth; the cyst was removed using the intraoral approach.

The Changes of the Generation of Superoxide Free Radical and the Activity of Antioxidant Enzymes after Streroid Therapy in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An intranasal topical and a systemic steroid therapy produce clinical improvement in patients with nasal polyps, but the mechanisms of their action are not clear. Recently, reactive oxygen species such as oxygen free radicals were identified as the potent toxic agents in various pathologic conditions including nasal polyps. The purposes of this study were to reveal the steroid effect on the generation of oxygen free radicals and exmaine the activities of various antioxidant enzymes in human nasal polyps. MATERIALS AND METHODS: Forty patients who received endoscopic sinus surgery due to chronic paranasal sinusitis with nasal polyps were classified into four groups; Group I included 10 specimens with no medication, group II included 10 specimens with oral steroid medication, Group III included 10 specimens with intranasal topical steroid therapy, group IV included 10 specimens with both oral and intranasal topical steroid therapy. We measured the generation of oxygen free radicals and activity of antioxidant enzymes, (SOD, GSH-Px, and CAT) and compared each group using electrophotometric analysis. RESULTS: The generation of oxygen free radicals were lowered in group II, III, and IV, compared to group I. Group IV showed the lowest level in the generation of oxygen free radicals. The activities of SOD, GSH-Px, and CAT, which are specific scavengers of oxygen free radicals, increased significantly in groups II, III, and IV (p<0.05). CONCLUSION: These results suggest that oxygen free radicals may play an important roles in the formation of nasal polyps. The mechanism of steroid action in the treatment of polyps may be explained in the decreased generation of oxygen free radicals and the increased activity of antioxidant enzymes in some ways.

A Case of Tuberculosis of Thyroid Gland / 대한이비인후과학회지

Tuberculosis of the thyroid gland is extremely rare, with only a few reported cases in the recent literature. The diagnosis is based entirely upon the histological picture of the tubercle, which consists of aggregates of mononuclear epithelial cells, giants cells, and a border of lymphocytes. Tuberculosis may involve the thyroid gland in two main forms. One common form spreads to the thyroid as part of generalized dissemination, and the other one is focal or caseous tuberculosis of the thyroid, presenting as a nodule, thyroiditis, an abscess, or a carcinoma-like mass. The differential diagnosis from malignancy and other non tuberculous granulomatous lesion is impossible upon the clinical ground. Surgical intervention is essential in order to establish the definitive diagnosis and to exclude the possibility of tumors. We experienced a case of the tuberculosis of the thyroid gland presenting with palpable thyroid nodule in a 44 year-old female patient. She was clinically and biochemically euthyroid and her CT scans demonstrated multiple low density in both thyroid gland with strands in the subcutaneous fat layer. The mass was removed surgically and confirmed to be tuberculosis.

The Generation of Superoxide Radicals and Activities of Antioxidant Enzymes in Influenza A Virus-Induced Maxiliary Sinusitis of Rabbits / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Oxygen free radicals are generated markedly in various infected condition, and these molecular species were identified as potent pathologic agents. The activities of various antioxidant enzymes have close relationships to genereration and metabolism of oxygen free radicals. The purpose of this study was to investigate the changes in the generation of superoxide radicals and activities of antioxidant enzymes and to compare histopathological changes in influenza A virus-induced maxillary sinusitis. MATERIALS AND METHODS: The experimental viral infection was induced in New Zealand white rabbits by inoculating 0.3 ml of influenza A virus. Maxillary sinus mucosa were examined with a light microscope and the generation of superoxide radicals and activity of antioxidant enzymes were measured at the intervals up to 28 days after inoculation. RESULTS: The mucosal changes deteriorated and reached maximum at seven days after inoculation. The first day of inoculation, mononuclear phagocytes and neutrophils began to be found in subepithelial layer. We also found that capacity of oxygen generation increased about one and a half fold compared with the non-infected control group. The activity of SOD, GSH-Px and CAT, which are specific scavengers of oxygen radicals, peaked at three, five, and seven days after viral inoculation, respectively. CONCLUSIONS: These results suggest that oxygen free radicals play an improtant role in the histopathologic damage in the early stage of influenza A viral infection, and the activities of antioxidant enzymes are enhanced by the generation of superoxide radicals. It is also indicated that antioxidant enzymes may have a therapeutic potential for this viral infection and other conditions associated with free radicals.

Electron Microscopic Demonstration of Sialoglycoconjugates in the Sinus Mucosa of Rabbits after Inoculation of the Influenza A Virus

This study was conducted in order to observe ultrastructural changes in the expression of sialoglycoconjugates in maxillary sinus mucosa after inoculation of influenza A virus utilizing four different gold-labeled lectins : ckia amurensis (MAA), wheat germ agglutinin (WGA), sambucus nigra (SNA), and peanut agglutinin (PNA). A comparison of the affinities of these gold-labeled lectins demonstrated the varying distributions of sialoglycoconjugates in the ciliary layer and the granules in goblet cells. Examination of normal sinus mucosa labeled with four gold-labeled lectins showed the distribution of sialoglycoconjugates to be mainly in the ciliary layer and the granules in goblet cells and restricted to the surface of the cilia, microvilli and the secretory light granules. The application of an influenza A virus infection decreased the labeling intensity of gold-labeled MAA in the cilia and the secretory granules but not of WGA. SNA gold did not label the surface of the cilia and granules in either case. PNA gold particles, however, labeled the cilia and the secretory granules very weakly in normal sinus mucosa, but labeled moderately in cases of influenza A virus infection. These results suggest that the sugar residues of sialoglycoconjugates consist of Neu5Ac(alpha2, 3)Gal, GlcNAc, Neu5Ac. They also suggest that the sugar residues serve as a protecting factor or modulator against influenza A virus infection.

Changes of the Sialoglycoconjugates in the Maxillary Sinus Mucosa of theRabbits after Inoculation of Influenza a Virus / 대한이비인후과학회지

The present study was carried out in order to observe the changes in the expression of the sialoglycoconjugates of the rabbit sinus mucosa after inoculation of influenza A virus utilizing a biotin labeled lectins for light microscopy with four different lectins; Maackia amurensis(MAA), Wheat germ agglutinin(WGA), Sambucus nigra(SNA), and Peanut(PNA). A comparison of the affinity of these lectins demonstrated the different distribution of sialoglycoconjugates in the ciliary layer and goblet cells. The normal sinus mucosa stained with four types of lectins showed that the sialoglycoconjugates were mainly distributed in the ciliary layer and goblet cells. Moreover, the main sugar residues of the sialoglycoconjugates were figured out to be consisted of Neu5Ac(alpha2,3)Gal, GlcNAc and Neu5Ac. Influenza A virus infection decreased the staining intensity of the mucosa with MAA, but not with WGA. The staining intensity of PNA, however, was highly increased in the viral infected mucosa. These results suggest that Neu5Ac(alpha2,3)Gal sugar residues may be required as protecting factor or modulator for Influenza A virus infectivity.

Expression of Heat Shock Protein 70 in Influenza A Virus Induced Acute Maxillary Sinusitis of Rabbits / 대한이비인후과학회지

BACKGROUND: Heat shock proteins(HSPs) are released from the cells by temperature elevation or other stresses, including cytokines, hypoxia, inflammation or reactive oxygen species. These proteins likely play a role in cellular repair and survival mechanisms. OBJECTIVES: In order to elucidate the relationship between the HSP 70 and viral induced maxillary sinusitis. MATERIALS AND METHODS: The degree of HSP expression was evaluated in New Zealand white rabbits with maxillary sinusitis induced by inoculation of Influenza A virus(KOREA /1/ 80/H3N2) into the mucosa. The animals were serially sacrificed 1, 5, 7, 14, 21, 28th day after inoculation. The localization of the induced form of HSP 70 in the normal & infected maxillary mucosa were studied with immunohistochemical staining. RESULTS: The normal sinus mucosa did not show any staining for the HSP 70. As contrasted with the normal group, the mucosa of the first day after viral inoculation showed very light staining in the epithelial layer. The degree of immunoreactive staining was gradually increased up to the seventh day. Epithelial layer of the mucosa, cilia and submucosa were heavily stained at seventh day after inoculation, and then the degree was reduced at 14th day. The staining of the mucosa was completely disappeared at 28th day after viral inoculation. CONCLUSION: These results suggest that the HSP 70 was produced from acute stage of the infected mucosa by the Influenza A virus. Presumably, it is closely related to the inflammatory reaction in the mucosa of the maxillary sinus.