Comparative Analysis of Endonasal Lateral Osteotomy and Percutaneous Lateral Osteotomy in Patients with Deviated Nose / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#The purpose of this study was to compare the effectiveness of percutaneous and endonasal lateral osteotomy for the correction of deviated nose.SUBJECTS AND METHOD: Medical records of 60 patients who underwent rhinoplasty to correct deviated nose were reviewed retrospectively. Patients with unilateral osteotomy, revision rhinoplasty, spreader graft, or who had no preoperative or postoperative photos were excluded from the study. The patients were categorized into two groups, which either had C-shaped deviation or I-shaped deviation. Preoperative and postoperative deviation angles were measured and their differences were analyzed according to the approach methods.@*RESULTS@#In the percutaneous approach group, 26 patients had C-shaped deviation and 10 patients had I-shaped deviation, whereas in the endonasal approach group, 17 patients had C-shaped deviation and 7 patients had I-shaped deviation. In the percutaneous approach, the deviation angle was statistically improved in the C-shaped deviation, but in the endonasal approach, it was statistically improved in the C-shaped and I-shaped deviation after surgery. In the C-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 5.2°±3.6° and 7.9°±5.3°, respectively, which showed significant difference. However, in the I-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 2.9°±1.3° and 2.9°±1.0°, respectively, with no significant difference.@*CONCLUSION@#The improvement of deviation angle following osteotomy may be different according to the approach methods for deviated nose. Endonasal approach was more suitable than percutaneous approach in the correction of I-shaped deviated nose.

Comparative Analysis of Endonasal Lateral Osteotomy and Percutaneous Lateral Osteotomy in Patients with Deviated Nose / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the effectiveness of percutaneous and endonasal lateral osteotomy for the correction of deviated nose. SUBJECTS AND METHOD: Medical records of 60 patients who underwent rhinoplasty to correct deviated nose were reviewed retrospectively. Patients with unilateral osteotomy, revision rhinoplasty, spreader graft, or who had no preoperative or postoperative photos were excluded from the study. The patients were categorized into two groups, which either had C-shaped deviation or I-shaped deviation. Preoperative and postoperative deviation angles were measured and their differences were analyzed according to the approach methods. RESULTS: In the percutaneous approach group, 26 patients had C-shaped deviation and 10 patients had I-shaped deviation, whereas in the endonasal approach group, 17 patients had C-shaped deviation and 7 patients had I-shaped deviation. In the percutaneous approach, the deviation angle was statistically improved in the C-shaped deviation, but in the endonasal approach, it was statistically improved in the C-shaped and I-shaped deviation after surgery. In the C-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 5.2°±3.6° and 7.9°±5.3°, respectively, which showed significant difference. However, in the I-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 2.9°±1.3° and 2.9°±1.0°, respectively, with no significant difference. CONCLUSION: The improvement of deviation angle following osteotomy may be different according to the approach methods for deviated nose. Endonasal approach was more suitable than percutaneous approach in the correction of I-shaped deviated nose.

Effect of Pyunkang-tang on Inflammatory Aspects of Chronic Obstructive Pulmonary Disease in a Rat Model

We investigated the anti-inflammatory effect of Pyunkang-tang extract (PGT), a complex herbal extract based on traditional Chinese medicine that is used in Korea for controlling diverse pulmonary diseases, on cigarette smoke-induced pulmonary pathology in a rat model of chronic obstructive pulmonary disease (COPD). The constituents of PGT were Lonicerae japonica, Liriope platyphylla, Adenophora triphilla, Xantium strumarinum, Selaginella tamariscina and Rehmannia glutinosa. Rats were exposed by inhalation to a mixture of cigarette smoke extract (CSE) and sulfur dioxide for three weeks to induce COPD-like pulmonary inflammation. PGT was administered orally to rats and pathological changes to the pulmonary system were examined in each group of animals through measurement of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in bronchoalveolar lavage fluid (BALF) at 21 days post-CSE treatment. The effect of PGT on the hypersecretion of pulmonary mucin in rats was assessed by quantification of the amount of mucus secreted and by examining histopathologic changes in tracheal epithelium. Confluent NCI-H292 cells were pretreated with PGT for 30 min and then stimulated with CSE plus PMA (phorbol 12-myristate 13-acetate), for 24 h. The MUC5AC mucin gene expression was measured by RT-PCR. Production of MUC5AC mucin protein was measured by ELISA. The results were as follows: (1) PGT inhibited CSE-induced pulmonary inflammation as shown by decreased TNF-α and IL-6 levels in BALF; (2) PGT inhibited the hypersecretion of pulmonary mucin and normalized the increased amount of mucosubstances in goblet cells of the CSE-induced COPD rat model; (3) PGT inhibited CSE-induced MUC5AC mucin production and gene expression in vitro in NCI-H292 cells, a human airway epithelial cell line. These results suggest that PGT might regulate the inflammatory aspects of COPD in a rat model.

Pyunkang-hwan (Pyunkang-Tang) ameliorates air pollutant-induced inflammatory hypersecretion of airway mucus and bleomycin- induced pulmonary fibrosis in rats.

OBJECTIVE: To investigate the effect of Pyunkanghwan (Pyunkang-tang) extract (PGT) on secretion of airway mucin in an experimental animal model involving hyperplasia of goblet cells and mucus hypersecretion, and to test its effects on bleomycin (BLM)-induced pulmonary fibrosis in vivo. METHODS: The protective activity of orally administered PGT was assessed in two rat pulmonary disease models. Effects on hypersecretion of pulmonary mucin in sulfur dioxide (SO2)-induced bronchitis in rats were assessed by quantifying the amount of mucus secreted and examining histopathology in the tracheal epithelium. In a rat model for BLMinduced pulmonary fibrosis, toxicity to the pulmonary system was examined by measuring levels of malondialdehyde and hydroxyproline, indicators of lipid peroxides and collagen, respectively, in lung tissue 28 days post-BLM treatment. Serial sections of lung tissue were stained with Masson trichrome to visualize collagen deposition. Effects of PGT on collagen synthesis were also assessed in vitro, in a cell culture model. RESULTS: PGT inhibited mucin secretion and normalized SO2-induced increased muco- substances in goblet cells. In the BLM- induced model, PGT decreased the characteristic histopathological features of lung fibrosis and inhibited fibrotic lesions, as indicated by decreased hydroxyproline content. PGT also inhibited the BLM-induced increase in malondialdehyde levels, demonstrating its protective effect against lipid peroxidation in cell membranes of the lung. In MLg 2908 mouse lung fibroblast cells, PGT decreased transforming growth factor (TGF)-ß-stimulated type I collagen synthesis. CONCLUSION: PGT can inhibit both hypersecretion of airway mucins and pulmonary fibrosis.

Apigenin Inhibits Tumor Necrosis Factor-alpha-Induced Production and Gene Expression of Mucin through Regulating Nuclear Factor-Kappa B Signaling Pathway in Airway Epithelial Cells

In the present study, we investigated whether apigenin significantly affects tumor necrosis factor-alpha (TNF-alpha)-induced production and gene expression of MUC5AC mucin in airway epithelial cells. Confluent NCI-H292 cells were pretreated with apigenin for 30 min and then stimulated with TNF-alpha for 24 h or the indicated periods. The MUC5AC mucin gene expression and mucin protein production were measured by reverse transcription - polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Apigenin significantly inhibited MUC5AC mucin production and down-regulated MUC5AC gene expression induced by TNF-alpha in NCI-H292 cells. To elucidate the action mechanism of apigenin, effect of apigenin on TNF-alpha-induced nuclear factor kappa B (NF-kappaB) signaling pathway was also investigated by western blot analysis. Apigenin inhibited NF-kappaB activation induced by TNF-alpha. Inhibition of inhibitory kappa B kinase (IKK) by apigenin led to the suppression of inhibitory kappa B alpha (IkappaBalpha) phosphorylation and degradation, p65 nuclear translocation. This, in turn, led to the down-regulation of MUC5AC protein production in NCI-H292 cells. Apigenin also has an influence on upstream signaling of IKK because it inhibited the expression of adaptor protein, receptor interacting protein 1 (RIP1). These results suggest that apigenin can regulate the production and gene expression of mucin through regulating NF-kappaB signaling pathway in airway epithelial cells.

Clinical Analysis of Result of Scar Revision According to Scar Hardness

Wound healing proceeds, fibroblasts play a major role in controlling the composition and amount of extracellular matrix and collagen metabolism. As the amount of collagen product is increased, the scar becomes more thicker and harder. Firmness of the scar can significantly influence the outcome of scar revision depending on the amount of collagen. This study aimed to classify the results of surgical scar revision according to the hardness of the scar and to compare histological differences and effectiveness in scar revision surgery between each classification. We selected subjects who had undergone scar revision and examined their scar pathology and surveyed the satisfaction levels of patients and Vancouver scar scale in each group. As the scar hardness increased from soft to hard, more collagen fiber bundle and elastic fiber tangling were noted. On the other hand, the satisfaction of patients was increased as the scar hardness was decreased from hard to soft. In this study, therefore, we concluded that as the scar becomes harder, the tangling of elastic fibers and the amount of collagen fiber bundles increase. Such patients revealed a robust collagen metabolism, and showed worse results of scar revision.

Self Induced Foreign Body Injection Patient: A Case Report

PURPOSE: In the past, laymen or beauty parlor employees commonly injected people with unproven foreign material such as paraffin, silicone, and cooking oil. We have treated a patient who injected foreign material into her face and neck. METHODS: For the last 20 years, a 43-year-old woman has been injecting herself in the face and neck with foreign material. There was no tenderness, erythema, pain, ulceration, or necrosis. However many visible, touchable subcutaneous masses were found. Her face was extremely ugly and disfigured by the foreign material. We could not recognize the boundary between her neck and mandible. The occipital scalp drooped extremely. Over the past 3 years, from February 2005 to October 2007, we performed 15 operations. RESULTS: We conducted a cephalometric facial analysis to compare preoperative and postoperative facial diameter. The patient's upper face diameter decreased from 67cm to 60 cm, the mid face diameter from 82cm to 59cm, the lower face diameter from 63 cm to 50cm, and the neck circumference diameter from 53cm to 44cm, respectively. The mid sagittal diameter decreased from 26 cm to 23cm. The total excised tissue weight was 4023.7 gram after 15 operations. CONCLUSION: Serial excision of face and neck masses in a patient who injected herself with foreign material resulted in a satisfactory outcome.

Cranioplasty Using Pericranial flap and Split-Rib Graft: Case Report

PURPOSE: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. METHODS: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. RESULTS: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. CONCLUSION: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.

Radiographic evaluation of alveolar bone profile of maxillary anterior teeth in Korean young adult / 대한치주과학회지

In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, guttapercha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest CW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was 3.5+/-0.7mm between two central incisor, and 2.8+/-0.6mm between central and lateral incisor. 2. Mean CW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were 3.9+/-0.2mm and 3.5+/-0.2mm between two central incisor, 3.0+/-0.2mm and 2.8+/-0.2mm between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.

Comparison of the depression and anxiety between the elderly in the home for the aged and those in the community / 영남의대학술지

This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.