A Case of Cerebral Salt Wasting Syndrome after Surgical Excision of a Giant Acoustic Neuroma / 대한이비인후과학회지

Cerebral Salt Wasting Syndrome (CSWS) is defined as the development of extracellular volume depletion due to a dysfunction of the renal sodium transport system. Differentiation of CSWS from the Symdrome of Inappropriate Secretion of Antidiuretic Hormone in patients with intracranial disease is difficult because both syndromes include hyponatremia and concentrated urine with natriuresis. However, distinguishing between these two syndromes is very important because the treatment options differ. We report a 41 year-old Asian woman who presented initially with hyponatremia, and was finally diagnosed with CSWS after an operation for an acoustic neuroma. Based on this case, we discuss a possible mechanism and disclose insights about differential diagnosis thereof.

Expression and Distribution of Tumor Necrosis Factor-Alpha in Mice Cochlea Exposed to Noise / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recent studies have shown that inflammatory responses occur in the inner ear under various damaging conditions including noise-overstimulation.Identification of time-dependent expression patterns of pro-inflammatory cytokines during the response initiation should lead to rational therapeutic strategies that block the response and reduce the damaging sequelae. MATERIALS AND METHOD: We evaluated the time-dependent expression pattern of pro-inflammatory cytokines in noise-exposed mouse cochlea (white noise, 120 dB SPL, 3 hours) using immunohistochemistry and reverse transcriptase-polymerase chain reaction(RT-PCR). RESULTS: The most potent pro-inflammatory cytokine, the tumor necrosis factor-alpha (TNF-alpha), was up-regulated after noise exposure. Immunohistochemical analyses showed that the TNF-alpha expression was distinctively induced within the spiral ganglion and stria vascularis. RT-PCR showed that TNF-alpha was induced shortly after noise exposure and persisted upto seven days following noise exposure. CONCLUSION: Taken together, acoustic trauma induces cochlear inflammation and the data suggest that TNF-alpha may have some role in cochlea damage that occur following noise exposure.

A Case of Multiple Fungal Balls Involving the Isolated Three Sinuses

The fungal ball usually occurs in a single sinus, most frequently in the maxillary sinus, and multiple sinus localization has rarely been reported? Recently, the authors experienced a rare case of multiple fungal balls involving three sinuses that were not contiguous, the bilateral maxillary sinuses and right sphenoid sinus. The patient had a history of endodontic treatment. We report this rare case with a literature review.

Genetic Role in Allergic Rhinitis

Allergic rhinitis is an inflammatory disease of the nasal mucosa, induced by an IgE-mediated reaction following exposure to an allergen. Allergic rhinitis is a global health problem, with a prevalence of between 9-42% among the general population. While it is known that allergic rhinitis does not exhibit a Mendelian hereditary pattern, the disease does have a hereditary component. The development of allergic rhinitis entails a complex interaction between genetic predisposition and environmental exposure to different factors, of which the most important is the implicated allergen. Genetic studies about several atopic diseases, including allergic rhinitis, are now actively in progress, but most of the studies focus on asthma and adverse drug reactions. Current genetic studies of allergic rhinitis include family and twin studies, genome-wide linkage analyses, and candidate gene association studies. Also ongoing are studies to identify susceptibility genes and to understand factors influencing gene expression.

Proteomic Analysis of the Specific Protein Expression in Nasal Polyp / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal polyp is a non-neoplastic, chronic inflammatory disease of the nasal mucosa, with its pathogenesis still not well known. We used proteomics, an emerging technique to identify new biomarkers in biological tissue, to find new potential biomarkers of the nasal polyp. MATERIALS AND METHOD: The study materials consisted of 5 specimens of nasal polyp taken from 5 patients who underwent endoscopic sinus surgery and 5 cases of normal nasal mucosa of the inferior turbinate as control. We did the proteomic profiling using matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF MS). RESULTS: We detected about 500 protein spots. The selected twelve spots were analyzed. Six up-regulated proteins are annexin, keratin, actin, serpin 3, glutathion S-transferase P, and coactosins like protein. Six down-regulated proteins are two vimentins, two actins, fibrinogen, and hemoglobin subunit beta. CONCLUSION: We identified 12 proteins expressed in the nasal polyp by using proteomics. These proteins may be helpful in understanding the mechanism of the pathogenesis of nasal polyp, and may be used as basic data.

A Case of Petrosquamosal Sinus: A Rare Emissary Vein of the Temporal Bone / 대한이비인후과학회지

The petrosquamosal sinus (PSS) is a rare emissary vein of the temporal bone. This vein connects dural sinuses with external jugular venous system. This pathway has been known to regress during fetal and early postnatal life however, several cadavaricstudies have revealed that the PSS is a relatively common feature in human. The imaging diagnosis of the PSS, such as digital subtraction angiography or high resolution CT scan, has been rarely reported in humans. We report a case of PSS in a patient with cholesteatoma with a review of literature.

Cholesterol Granuloma of the External Auditory Canal / 대한이비인후과학회지

Cholesterol granuloma (CG) has been known to be a pathologic condition that is associated with many kinds of middle ear diseases. Histopathologically, it is characterized by foreign body giant cells and numerous clefts consistent with prior cholesterol crystals. It can occur in any pneumatized bone and can cause expansile changes in surrounding structures. The temporal bone is the most common site of CG, but presenting in the ear canal is rare. We report a case of CG in the external auditory canal with a review of literature.

Reference Range of Values of Peritoneal Equilibration Test and Changes in Peritoneal Kinetics in Korean Long-Term CAPD Patients / 대한신장학회잡지

PURPOSE: The aim of this study was to define the reference range of the peritoneal solute transfer in Korean CAPD patients and to investigate the change in peritoneal kinetics in long-term patients. METHODS: Routine PET was done 14 days after catheter break-in in 102 new CAPD patients and using our reference range of PET, the patients were categorized into 4 groups as described by Twardow- ski. In 35 long-term (>3 yrs) CAPD patients, D/Pcr, D/D0 glucose and drain volume in last follow- up (mean duration, 60+/-23 months) PET were compared with those in initial PET. RESULTS: Dialysate to Plasma creatinine ratio (D/ Pcr) at 0 hour, 2 hours and 4 hours was 0.045+/-0.062, 0.408+/-0.151 and 0.612+/-0.154, respectively. D/D0 glucose at 2 hours and 4 hours was 0.594+/-0.129 and 0.398+/-0.121, respectively. Peritoneal solute transfer rate in Korean patients was slightly lower than previously reported results in North American patients (P=0.08). Mean drain volume was 2360+/-270ml and mean residual volume was 436+/-178ml. Drain volume was well correlated with D/D0 glucose (positively, r=0.375, P<0.01) and D/Pcr (negatively, r=-0.345, P<0.01). There were no difference in peritoneal solute transfer, drain volume and residual volume according to sex, age, body surface area and diabetes. In initially high and high average trans- porters, solute transfer rate decreased significantly in followup PET. Out of 7 initially high transporters, 3 remained in high and 4 became high average transporters. Out of 12 initially high average transporters, 3 became low average transporters. Out of 8 initially low average transporters, 2 became high average transporters. And out of 8 initially low transporters, 2 became high average and 1 became high transporters. The number of episodes of perito- nitis do not significantly correlated with the changes of peritoneal solute transport rate. CONCLUSION: These data suggest that peritoneal solute transfer rate in Korean patients is slighthly lower compared with that in North American patients and in long-term CAPD patients the peri- toneal solute transport rate changed to centropetal directions (towards to mean) according to initial PET result.