Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model.

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Pro-inflammatory mediators and signaling proteins in the decidua of pre-eclampsia.

OBJECTIVE: To evaluate the role of CD68+ macrophages and inflammatory/signaling proteins in the decidua of singleton pregnancies with late-onset pre-eclampsia. PATIENTS AND METHODS: This study was designed as a prospective case-control study. Decidual tissue samples were obtained from twenty healthy pregnant women as a control group and twenty pregnant women with late-onset pre-eclampsia showing severe symptoms as the study group. We examined the abundance of CD68+ macrophages in both groups using flow cytometry. Protein and mRNA expression levels of inflammatory/signaling proteins, including inducible nitric oxide synthase, nuclear factor-κB inhibitor α, cyclooxygenase-2, and phosphorylated c-Jun N-terminal kinase, in the decidua of both groups were measured using Western blotting and Reverse Transcription-Polymerase Chain Reaction, respectively. Student's t-tests were performed for statistical analysis. RESULTS: The numbers of CD68+ macrophages were similar in the study and control groups (p=0.47). However, the levels of inducible nitric oxide synthase, nuclear factor-κB, cyclooxygenase-2, and phosphorylated c-Jun N-terminal kinase were significantly increased in the study group. Therefore, pro-inflammatory mediators and signaling proteins in the decidua during pre-eclampsia may be related to the pathogenesis of pre-eclampsia. CONCLUSIONS: Pre-eclampsia-induced alterations in the expression of inflammatory/signaling proteins in the decidua during singleton pregnancies may play a critical role in the pathogenesis of pre-eclampsia.

Plasmid curing resulted in improved heterologous gene expression in Leuconostoc citreum EFEL2700.

Leuconostoc citreum EFEL2700 isolated from kimchi was used as a host strain for genetic and metabolic engineering in our previous studies, but the cells of EFEL2700 contained a cryptic plasmid (P-cells). Thus, we created plasmid-free cells (F-cells) using the CRISPR/Cas9 system. In this study, we compared the microbial characteristics of P- and F-cells in terms of growth rate, biochemical properties, transformation efficiency, plasmid copy number and protein expression level. When the growth rate was measured in MRS medium at 30°C, no significant difference (P > 0·01) was observed. Biochemical properties, tested using an API 50CHL kit, showed no differences. Transformation efficiency of F-cells, measured using pCB4270, was higher (1·3 × 104 CFU per µg DNA) than that of P-cells (5·0 × 103 CFU per µg DNA). Copy number after transformation of pCBBgl was 4-fold higher for F-cells than for P-cells. When ß-glucosidase activity was assayed in the above experiment, F-cells showed 3·4-fold higher values than P-cells. In conclusion, this study demonstrates that plasmid curing in L. citreum EFEL2700 improves its characteristics as a gene expression host. SIGNIFICANCE AND IMPACT OF THE STUDY: Leuconostoc citreum EFEL2700 (P-cell) isolated from kimchi is a useful food-grade host for expressing heterologous genes. The presence of a cryptic plasmid is thought to limit efficient gene expression. In this study, we compared the microbial and genetic changes after plasmid curing in this strain. The plasmid-free strain showed improved levels of transformation efficiency, copy number and heterologous gene expression without alterations in phenotypes such as the growth rates and biochemical properties. The resulting strain of L. citreum EFEL2701 (F-cell) can be used as an efficient host for genetic engineering.

Prevalence of and factors related to latent tuberculous infection among all employees in a referral hospital.

SETTING: Referral hospital, South Korea. OBJECTIVE: To investigate the prevalence of and factors related to latent tuberculous infection (LTBI) among all hospital employees. DESIGN: A cross-sectional study of 479 health care workers (HCWs) undergoing LTBI screening. RESULTS: Overall prevalence of LTBI was 15.7%, 43.1% of whom initiated and completed LTBI treatment. Compared with HCWs without LTBI, those with LTBI were more likely to be older (P < 0.001), male (P = 0.003), work in low-risk departments (P = 0.013) and have more years of employment (P < 0.001). LTBI prevalence was highest in physicians (27.8%), followed by HCWs without patient contact (23.4%), nurses (8.3%) and other HCWs in contact with patients (6.9%). In multivariate analysis, compared with HCWs aged <20 years, those aged 40 years were 4.08 times more likely to have LTBI (P = 0.007). In addition, compared with HCWs working for <1 year, those working for 1-5 years or for 5 years were respectively 7.55 (P = 0.014) and 13.69 (P = 0.001) times more likely to have LTBI. CONCLUSIONS: Our results suggest that modified LTBI screening strategies, including HCWs with no patient contact and encouraging LTBI treatment participation, might be helpful in improving LTBI control in HCWs.

Anti-asthmatic effects of volatile organic compounds from Chamaecyparis obtusa, Pinus densiflora, Pinus koraiensis, or Larix kaempferi wood panels.

Asthma is a common chronic inflammatory disease in which lung airways narrow and produce extra mucus. Numerous medications, such as steroids, are used to prevent or control asthmatic symptoms, but side effects are associated with those medications. There are reports of anti-inflammatory, antibacterial, and antiparasitic effects of terpene, a volatile organic compound (VOC) in conifers. VOCs easily enter a gaseous form, and wood products are good sources of VOCs. However, only a few studies have been conducted on the effect on asthma of VOCs emitted by wood. In this study, we examined the effects of VOCs diffused from wood panels on ovoalbumin (OVA)-induced asthma in a mouse model. The mice were intraperitoneally sensitized with 10 µg of OVA with aluminum hydroxide on days 0, 7, and 14. From day 21 to day 26, the mice were challenged with 2% OVA intranasally for 30 min. For VOC treatment, asthma model mice were placed in polyacrylamide chambers containing wood panels of Chamaecyparis obtusa, Pinus densiflora, Pinus koraiensis, or Larix kaempferi. On day 27, serum, lung tissue, and bronchoalveolar lavage fluids were prepared for H&E staining, qRT-PCR, ELISA, and Diff-Quik staining, as appropriate. OVA treatment induced hypertrophy of the bronchiolar wall. The budesonide group and all four of the wood panel-exposed groups showed less thickening of the bronchiolar wall and downregulated transcriptional expressions of cytokines such as interleukin-4 (IL-4) and interleukin-13 (IL-13). The serum tumor necrosis factor-α (TNF-α) mRNA expression level was significantly decreased only in the C. obtusa group, but the serum IL-4 levels were decreased in all wood panel treatment groups. Diff-Quik staining of bronchoalveolar lavage fluids revealed a decrease in the number of granulocytes in all wood panel treatment groups. The results suggest that VOCs from C. obtusa, P. densiflora, P. koraiensis and L. kaempferi produce antiasthmatic effects by regulating the production of IL-4, IL-9, IL-13, TNF-α.

Efficacy and safety of non-invasive body tightening with high-intensity focused ultrasound (HIFU).

BACKGROUND: Noninvasive skin-tightening devices have become increasingly popular in response to increasing demand for improvements in skin laxity and tightening with minimal risk and recovery time. OBJECTIVE: We evaluated the efficacy and safety of HIFU for skin tightening in the face and body. METHODS: A total of 32 Korean subjects enrolled in this prospective clinical trial. The subjects were treated with HIFU to both cheeks, lower abdomen, and thigh. Skin elasticity was measured before and after treatment using a Cutometer (CT575, Courage and Khazaka® , Cologne, Germany). Three blinded, experienced dermatologists evaluated paired pre- and post-treatment (week 4 and 12) photographs according to the Global Aesthetic Improvement Scale (GAIS). Participants also completed self-assessments using GAIS. Subjects rated their pain on a numeric rating scale (NRS) immediately, 7 days, 4 weeks, and 12 weeks after treatment. RESULTS: Skin elasticity measured via a Cutometer was significantly improved 12 weeks after treatment at all treated sites (P<.05). Both IGAIS and SGAIS showed significant improvements 12 weeks after treatment. Immediately after treatment the mean NRS score was 3.00±1.586, but no pain was reported at 4 and 12 weeks post-treatment. No serious adverse effects were observed during the follow-up period. CONCLUSION: HIFU safely and effectively improves skin elasticity and clinical contouring of the face and body.

Donor site morbidities resulting from conchal cartilage harvesting in rhinoplasty.

OBJECTIVE: Conchal cartilage is frequently used in rhinoplasty, but donor site morbidity data are seldom reported. This study aimed to investigate the complications of conchal cartilage harvesting in rhinoplasty. METHODS: A retrospective chart review of 372 patients who underwent conchal cartilage harvesting for rhinoplasty was conducted. Data regarding patient demographics, types of nasal deformities, graft usage and complications were analysed. RESULTS: A total of 372 patients who underwent conchal cartilage harvesting for rhinoplasty were enrolled. The harvested conchal cartilage tissues were used in a variety of applications: tip graft, dorsal graft, septal reinforcement and correction of nostril asymmetry. Nine cases (2.4 per cent) with donor site morbidities were identified, including four cases (1.1 per cent) with keloids and five cases (1.3 per cent) with haematomas. CONCLUSION: Conchal cartilage harvesting is a safe and useful technique for rhinoplasty, with a low complication rate. However, patients should be informed about the possibility of donor site morbidities such as keloids and haematomas.

An Asian perspective on improving outcomes for nasal bone fractures by establishing specific treatment options.

OBJECTIVE: To report treatment outcomes of patients with different types of nasal bone fracture, following a tailored treatment protocol. DESIGN: The patterns and the severity of the fractures were determined by a preoperative facial photo and nasal bone computed tomography (CT) retrospectively. SETTING: A tertiary referral centre. PARTICIPANTS: We evaluated 129 patients who underwent surgery between March 2002 and January 2014. Patients were subjected to five different treatment methods depending on the severity of injury. MAIN OUTCOME MEASURES: Medical records were reviewed to assess rates of complications and revision surgery. Cosmetic and functional (the degree of nasal obstruction) outcomes were measured using the Likert scale from 1 (very dissatisfied, severe obstruction) to 5 (very satisfied, no obstruction). RESULTS: The mean elapsed time from injury to surgery was 14.9 days. The overall treatment failure rate, defined as a deformity that required revision, was 6.2%. The patient satisfaction scores for aesthetic and functional outcomes were 3.9 and 4.6 respectively. CONCLUSION: The prudent selection of patients with indication for closed reduction, and further specification of variable treatment options for the various degrees of nasal bone fracture, may be helpful in achieving an improved treatment outcome. LEVEL OF EVIDENCE: level IV.

Improved methods for evaluating pre-clinical and histological effects of subcutaneous fat reduction using high-intensity focused ultrasound in a porcine model.

BACKGROUND: Non-invasive body sculpting procedures are becoming increasingly popular. High-intensity focused ultrasound (HIFU) treatment is a non-surgical fat reduction procedure that permanently destroys unwanted abdominal fat. Despite its increasing popularity, evaluation methods for the procedure have not yet been fully developed. AIMS: The objective of this study was to develop evaluation methods for HIFU for non-surgical, permanent fat reduction in the anterior abdomen using a porcine model. METHODS: The abdomens of female pigs (Sus scrofa, n = 7) were treated with a HIFU device (SCIZER™ , Classys Inc, Seoul, Korea). We examined treatment effects using photography, ultrasound, gross and microscopic pathology, and serum lipid and liver function level analysis, carbon tracer test, and histological examination in order to determine the mechanism of action, efficacy, and safety of the procedure. RESULTS: HIFU treatment effectively reduced abdominal fat in a porcine model; it accurately treated the target subcutaneous fat layer and the subcutaneous fat was reduced effectively via ultrasonic measurement after HIFU treatment. On histological staining (H&E, toluidine blue, oil red O and immunohistochemistry), we found that subcutaneous fat reduction occurred effectively via accurate treatment of the targeted subcutaneous fat layer. On hematological assay, there were changes within normal range, and values remained stable after 48 h. Via carbon tracer test, the migration of activated macrophages was identified within the axillary lymph node (LN). PPAR-delta, a protein defined by immunohistochemistry staining, was overexpressed in the early stage on days 1 and 7, but a gradual decreasing pattern was confirmed. CONCLUSION: We successfully used a HIFU device for body contouring and fat reduction in a pre-clinical study. These results provide that the essential clues toward the effective evaluation, guiding selection of the appropriate diagnostic investigations.

Safety of transorally-inserted anvil for esophagojejunostomy in laparoscopic total gastrectomy.

BACKGROUND: To assess the safety of transorally-inserted anvil (TOA) for use during esophagojejunostomy (EJ) reconstruction during laparoscopic total gastrectomy (LTG). METHODS: Between March 2009 and December 2011, 39 consecutive open total gastrectomies (OTGs) and 36 LTGs using TOA for gastric cancer were comparatively evaluated. We investigated postoperative complications, using the Clavien-Dindo classification. To evaluate the effect of a learning period in using TOA for LTG, we also investigated shifts in the patterns of complications and changes in total operation time over the course of the study. RESULTS: The patient characteristics at baseline were not different between both groups, except for the extent of lymphadenectomy (P < 0.001) and depth of tumor invasion (P = 0.003). Multivariate analysis revealed that TOA usage elevated the occurrence of infectious complications significantly (OR = 3.32, P = 0.042), but was not associated with EJ-related complications. TOA usage did not need a learning period for the length of time required to complete the operation, or the likelihood of developing an EJ-related or infectious complication. CONCLUSIONS: TOA use for EJ during LTG is relatively simple and easy enough not to require a learning period for surgeons. This procedure did not elevated the occurrence of EJ-related complications compared to circular stapling in open surgery, but it does require special prevention efforts to avoid infectious complications.

Associations among SPARC mRNA expression in adipose tissue, serum SPARC concentration and metabolic parameters in Korean women.

OBJECTIVE: Secreted protein acidic and rich in cysteine (SPARC) is expressed in most tissues and is also secreted by adipocytes. The associations of SPARC mRNA expression in visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAT), serum SPARC concentration, and metabolic parameters in Korean women are investigated. DESIGN AND METHODS: This is a cross-sectional study. Fifty-eight women were recruited, of whom 15 women who underwent bariatric surgery for morbid obesity (BMI mean ± SD: 40.2±5.7 kg/m(2) ), 16 who underwent metabolic surgery for type 2 diabetes (BMI: 28.9±4.5 kg/m(2) ), and, as a control group, 27 who underwent gynecological surgery (BMI: 22.7±2.4 kg/m(2) ). Anthropometric variables, metabolic parameters, SPARC mRNA expression in adipose tissue, and serum SPARC concentration were measured. RESULTS: In all subjects, SPARC mRNA expression was significantly higher in SAT than in VAT. Serum SPARC concentrations (mean ± SE) in morbidly obese subjects, subjects with type 2 diabetes, and normal weight subjects were 267.3±40.2 ng/mL, 130.4±33.0 ng/mL, and 53.1±2.8 ng/mL, respectively. SPARC mRNA in SAT was significantly correlated with BMI, whereas SPARC mRNA in VAT was significantly correlated with BMI and VAT area. Serum SPARC concentration was significantly correlated with BMI, waist circumference, total adipose tissue area, and SAT area. After BMI adjustment, serum SPARC concentration was significantly correlated with fasting insulin concentration and HOMA-IR score. Multivariate regression analysis showed that BMI and HOMA-IR were independently associated with serum SPARC concentration. CONCLUSIONS: Serum SPARC concentration is significantly correlated with obesity indices and might be influenced by insulin resistance. These findings suggest that SPARC may contribute to the metabolic dysregulation associated with obesity in humans.

Reduction osteoplasty for treating pneumosinus dilatans of the maxillary sinus.

OBJECTIVE: To report a patient with maxillary pneumosinus dilatans and facial deformity treated by reduction osteoplasty and reconstruction. CASE REPORT: This study describes the successful management of facial deformity in a 17-year-old male with maxillary pneumosinus dilatans. The patient's facial deformity of the maxillary sinus, which had been slowly progressing over a 10-year period, was managed by reduction osteoplasty and reconstruction using the maxillary bone, conchal cartilage and Tutoplast-processed fascia lata via a sublabial approach. This treatment yielded satisfactory functional and aesthetic outcomes. CONCLUSION: As pneumosinus dilatans of the maxillary sinus is uncommon, there is no established surgical treatment protocol. This surgical technique was less invasive than other described procedures and revealed good cosmetic results.

Visualization of superluminal pulses inside a white light cavity using plane wave spatio temporal transfer functions.

In a white light cavity (WLC), the group velocity is superluminal over a finite bandwidth. For a WLC-based data buffering system we recently proposed, it is important to visualize the behavior of pulses inside such a cavity. The conventional plane wave transfer functions, valid only over space that is translationally invariant, cannot be used for the space inside WLC or any cavity, which is translationally variant. Here, we develop the plane wave spatio temporal transfer function (PWSTTF) method to solve this problem, and produce visual representations of a Gaussian input pulse incident on a WLC, for all times and positions.

Colour Doppler sonography of hepatic haemangiomas with arterioportal shunts.

OBJECTIVES: To determine the frequency of intratumoural flow and peritumoural hepatofugal portal flow using colour Doppler sonography (CDS) on hepatic haemangiomas with arterioportal shunt (APS), and to investigate possible factors that may affect the capability of CDS to depict such findings. METHODS: The study included 45 patients (35 men, 10 women; mean age, 56 years) with hepatic haemangiomas with APS on CT or MRI. Locating the tumour on greyscale sonography, the depth, size and echogenicity of the tumour were evaluated. CT or MR images were evaluated for fatty liver. CDS was performed to determine the presence of intratumoural flow and peritumoural hepatofugal portal flow. Differences in frequency of intratumoural flow and peritumoural hepatofugal portal flow according to the depth, size, echogenicity and fatty liver were evaluated by Student's t-test and Fisher's exact test. RESULTS: On CDS, intratumoural flow and peritumoural hepatofugal portal flow were found in 66.7% and 60%, respectively. The tumour depth was the significant variable that affected the capability of CDS to depict such findings. The frequencies of intratumoural flow and peritumoural hepatofugal portal flow were as high as 88% and 80% for shallow (≤30 mm) lesions, and they were 40% and 35% for deep (>30 mm) lesions (p=0.0012; p=0.0051). CONCLUSION: CDS can commonly depict intratumoural flow and peritumoural hepatofugal portal flow in patients with hepatic haemangiomas with APS. Therefore, CDS should be routinely performed when an incidental mass is encountered during the screening sonography, especially when the lesion is shallow.

Distortion free pulse delay system using a pair of tunable white light cavities.

Recently, a tunable bandwidth white light cavity (WLC) was demonstrated by using an anomalously dispersive intra-cavity medium to adjust a cavity linewidth without reducing the cavity buildup factor [G.S. Pati et al., Phys. Rev. Lett. 99, 133601 (2007)]. In this paper, we show theoretically how such a WLC can be used to realize a distortion-free delay system for a data pulse. The system consists of two WLCs placed in series. Once the pulse has passed through them, the fast-light media in both WLCs are deactivated, so that each of these now acts as a very high reflectivity mirror. The data pulse bounces around between these mirrors, undergoing negligible attenuation per pass. The trapped pulse can be released by activating the fast-light medium in either WLC. Numerical simulations show that such a system can far exceed the delay-bandwidth constraint encountered in a typical data buffer employing slow light. We also show that the pulse remains virtually undistorted during the process.

Removal of a nasal bone intraosseous venous malformation and primary reconstruction of the surgical defect using open rhinoplasty.

Primary intraosseous venous malformations are rare benign tumors that account for approximately 1% of all primary osseous tumors. They are rarely found in the midface. The authors report a case of an intraosseous venous malformation in a 28-year-old woman who presented with a bony lesion in the nasal bone. Treatment involved surgical excision via open rhinoplasty. Histopathology indicated an intraosseous venous malformation. 16 months postoperatively, there was no evidence of recurrence, the functional and cosmetic results were good, and the patient was satisfied with the treatment outcome.

Pancreatic ductal adenocarcinoma with intratumoral cystic lesions on MRI: correlation with histopathological findings.

The purpose of this study was to evaluate intratumoral cystic lesions of pancreatic ductal adenocarcinoma (PDAC) depicted on MRI, and to correlate these cystic lesions with their histopathological findings. This study included 12 patients (7 males and 5 females; mean age, 59 years) with intratumoral cystic lesions of PDAC detected on a retrospective MRI review. We reviewed the histopathological findings of the cystic lesions within PDACs and analysed the MRI findings, focusing on the appearance of the intratumoral cystic lesions, i.e. the size, number, margin and intratumoral location, and on the ancillary findings of PDAC, i.e. peripancreatic infiltration, upstream pancreatic duct dilatation and distal parenchymal atrophy. Intratumoral cystic lesions were classified as neoplastic mucin cysts (n = 7, 58%) or cystic necrosis (n = 5, 42%) according to the histopathological findings; they ranged in greatest dimension from 0.5 cm to 3.4 cm (mean, 1.7 cm). Seven patients had only one cystic lesion each, while the remaining five had multiple cystic lesions. Most of the neoplastic mucin cysts had smooth margins (n = 6, 86%) and eccentric locations (n = 6), whereas most cystic necroses had irregular margins (n = 4, 80%) and centric locations (n = 4). The most common ancillary findings of PDAC were peripancreatic infiltration, distal pancreatic atrophy and upstream pancreatic duct dilatation (92%, 75% and 58%, respectively). The intratumoral cystic lesions of PDACs on MRI were classified as either neoplastic mucin cysts with smooth margins and eccentric locations or cystic necroses with irregular margins and centric locations.

Removal of a metallic foreign body embedded in the external nose via open rhinoplasty approach.

Most metallic foreign bodies are inert, but they can cause chronic inflammatory reactions and be a source of infection. Identification and removal of foreign bodies from wounds is often necessary. The present report describes two cases of a foreign body embedded in the external nose. Each case was successfully treated by an open rhinoplasty approach. This approach is an effective and safe method for removal of foreign bodies in the external nose. It provides a good surgical field and a better cosmetic outcome than a conventional incision.