• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.69-72
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• 2008

Lymphomas of the nasal sinuses are relatively uncommon and represent less than 1% of all head and neck malignancies. Most common symptoms are nasal obstruction, epistaxis, rhinorrhea. We report a case of primary extranodal diffuse large B-cell non-Hodgkin's lymphoma in nasal sinuses accompanying with exophthalmos. A 70-year-old male patient was referred to our hospital with exophthalmos and severe septal deviation. We conducted endoscopic biopsy with septoplasty and biopsy result was diffuse large B-cell lymphoma. He received chemotherapy(R-CHOP) and radiotherapy. At follow-up, he remained free of disease.

• IMMUNE NETWORK
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• v.3 no.1
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• pp.61-68
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• 2003

Background: Fibroblast functions both as a structural element and as a vital immunoregulatory cell. Fibroblasts regulate inflammation through governing of chemokine expression. In order to elucidate the mechanisms by which the expressions of chemokines were regulated, the co-stimulatory effects of Th1 and proinflammatory cytokines were compared using nasal mucosal fibroblasts. Methods: Human nasal mucosa was obtained from surgery for septal deviation and the growth of fibroblasts was established. Fibroblasts from 4th to 6th passage were stimulated with various combinations of cytokines. To inhibit selected signaling pathways, fibroblasts were pretreated with cyclosporin A, wortmannin, staurosporine, and dexamethasone prior to the stimulation with cytokines. The supernatants were collected and chemokines were detected with a sandwich enzyme-linked immunosorbent assay. Results: $TNF-{\alpha}/IFN-{\gamma}$-induced production of RANTES was inhibited by all inhibitors used. MCP-1 was produced constitutively and $TNF-{\alpha}$-induced or $TNF-{\alpha}/IFN-{\gamma}$-induced production of MCP-1 was not inhibited by cyclosporin A or wortmannin, but by stauroporine or dexamethasone. All inhibitors used in this experiment inhibited $TNF-{\alpha}/IFN-{\gamma}$-induced or $IL-1{\beta}/IFN-{\gamma}$-induced production of MCP-2 in nasal mucosal fibroblasts. Although staurosporine or dexamethasone showed strong inhibitory effects, cyclosporin A or wortmannin did not inhibit the production of MCP-3 by $IL-1{\beta}/IFN-{\gamma}$ treatment. Conclusion: Chemokines were strongly induced by stimulation of cytokines in combination and showed different pattern of inhibition by the inhibitors. Therefore, it was assumed that cytokines acted on multiple pathways or on unknown pathways which converged to gene-specific transcription factors.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.289-294
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• 2008

Purpose: The nasal bone fracture is known as the most common facial fracture. Several authors reported the classification of nasal bone fracture. Stranc classified the type of nasal fractures based on a pattern of impaction and level of injuries. Stranc classification proposed here is based on careful clinical observation and relates to both treatment and prognosis. The aim of this study is to determine any predictive value to the preoperative classification of nasal fracture, using the description by Stranc and Robertson. Methods: We reviewed 310 patients with nasal bone fracture treated at our hospital for last two years. Results: Lateral impact type of nasal bone fracture predominated more than frontal impact in the ratio of 2.3:1. The most common type of Stranc classification was lateral impact plane I(48.4%). Male predominated more than female in the ratio of 3:1. The most frequent age group was first decade(27.1%), second decade in frontal impact(30.5%), first decade in lateral impact (30.7%). The most common etiology was violence (31.3%) followed by slip down(21.3%), and traffic accident(18.1 %).The most common associated fracture was orbital(22.9%) followed by zygoma(10%), and maxilla (6.1%). The most common complication was septal deviation(20.0%) in frontal impact, and nasal deformity (26.0%) in lateral impact. The incidence of nasal deformity in lateral impact(26.0%) was more higher than frontal impact(15.8%) Conclusion: By assessing the pathomechanics and resultant degree of injury to the nasal skeleton, a better understanding of the treatment plan and prognosis was obtained. Using this information, satisfactory informed patient consent can be obtained.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.19 no.2
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• pp.180-191
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• 2006

Objectives : The purpose of this clinical report was to investigate the general characteristics of the patients with nasal polyps and estimate the efficacy of the oriental medical treatment on nasal polyps. Methods : We performed a clinical analysis of 50 patients who visited Kabsan oriental clinic due to nasal polyps. We inquired into distribution of age, sex, operation history related to nose, grade of nasal polyps, efficacy of treatment, etc. Results and Conclusions : 1. The sex ratio was 2.3 : 1. The average age was 40.02 years. 2. In the nasal operation history, inexperienced patients were 35 cases and experienced patients were 15 cases. 3. In the region of nasal polyps, there were 35 cases of bilateral types of nasal polyps, which is mon than in unilateral types. In the number of nasal polyps, multicentric types of 26 cases were similar in the number with solitary type of 24 cases. 4. In the predisposing or concomitant diseases, chronic sinusitis was the most frequent followed by allergic rhinitis, chronic rhinitis, septal deviation chronic otitis media, asthma, tonsilitis and allergic dermatitis. 5. In the main symptoms, nasal obstruction was the most important. In the concomitant symptoms, patients had frequent rhinorrhea, smell disturbance, postnasal drip, headache, etc. 6. The average treatment period was 3,58 months and the average number of treatment was 12.94 sessions. 1. In the amount of herbal medicine, 2 and 3 Ji(劑) were the most. The most frequently used herbal medicine to treat was Hyangbujamogeuntanggagam(香附子茅根湯加減) 8. In the change of grade after treatment, Grade I was the most. In the efficacy of treatment, 'good' was the most, followed by 'excellent' and 'uneffective'.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.445-448
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• 2006

Purpose: The nose is the most prominent skeletal feature of the face and is thus prone to frequent injury. Closed reduction of nasal bone fractures can be performed under general or local anesthesia. However, the benefits and the drawbacks in either form of anesthesia chosen are seldom perceived by the surgeon. A retrospective study was performed to assess the differences in the outcome among the two groups subjected to surgery under different type of anesthesia and to introduce our method of local anesthesia and its adequacy. Methods: Two hundred and fifteen patients during a 2-year period were included in the study. 2% Lidocaine mixed with 1:100,000 epinephrine was injected on the anterior ethmoid nerve and the periosteum. Assessment factors included intra-operative adequacy of analgesia, post-operative analgesic requirement and functional and aesthetic outcome of surgery. Results: 19 patients were manipulated under general anesthesia and 196 patients were manipulated under local anesthesia on the anterior ethmoidal nerve and dorsal periosteum. No statistically signigicant variable in performance of surgery could be attributed to the mode of anesthesia employed(p > 0.05). Four patients experienced complications after reduction. One developed septal deviation and three nasal obstruction. But, no secondary operations were needed. Conclusion: Anterior ethmoidal nerve block and dorsal periosteal injection of 2% Xylocaine, combined with topical intranasal 4% lidocaine and epinephrine provided sufficient analgesia comparable to that of general anesthesia.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.11-18
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• 2022

Purpose: This study aimed to assess incidental abnormal findings in the paranasal sinuses and anatomical variations of the ostiomeatal complex (OMC) on magnetic resonance imaging (MRI) scans. Materials and Methods: MRI scans of 616 patients (mean age, 44.0±19.4 years) were evaluated. Prior to obtaining the MRI scans, a checklist of patients' clinical symptoms was filled out after obtaining their consent. The Lund-Mackay classification was used to assess the paranasal sinuses and OMC. The prevalence of abnormal findings and their associations with patients' age, sex, and subjective symptoms were analyzed by the chi-square test, independent-sample t-test, and analysis of variance. The level of significance was set at 0.05. Results: Abnormal findings in the paranasal sinuses were detected in 32.0% of patients, with a significantly higher prevalence in males (P<0.05), but no significant association with age (P>0.05). Epithelial thickening and retention cyst were the most common abnormal findings in the paranasal sinuses. According to the Lund-Mackay classification, 93% of the study population had normal sinuses (score<4). Concha bullosa and paradoxical concha were detected in 15.3% and 3.4%, respectively, with no significant association with the presence of septal deviation or Lund-Mackay classification (P>0.05). Conclusion: Considering the relatively high prevalence of abnormal findings in the paranasal sinuses, it appears that clinical symptoms alone are not sufficient to diagnose sinusitis. A more accurate strategy would be to assess radiographic images of the paranasal sinuses and use a classification system. Sinusitis should be suspected in patients receiving a high score in this classification.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.286-296
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• 1998

Different techniques for culturing respiratory epithelial cells have been developed to overcome the limitations of studies on in vivo and on bioptic material. Traditionally, culture systems are divided into organ cultures, explant cultures and dissociated cell cultures. The first two contain both epithelial and non-epithelial cells. However, in monolayer cultures of dissociated cells only epithelial cells are present, the effects observed are caused by a pure epithelial responses. The purpose of this study is to establish primary culture method of human nasal epithelium (HNEC) by monolayer culture of dissociated cells to evaluate the role of the epithelial cells in the allergic and non-allergic nasal inflammatory reactions. HNEC was prepared by primary culture method of monolayer culture of dissociated cells from human inferior nasal turbinate mucosa of septal deviation patients. Primary cultured cells were characterized by indirect immunofluorescence assay and transmission electron microscopy. The immunoreactivities of cytokeratin-pan and cytokeratin No. 8 were observed in cultured HNEC. However, the immnoreactivities of vimentin and von Willebrand factor were not observed in cultured HNEC. The tonofilaments and desmosome were observed in cultured HNEC. The cultured epithelial cells were identified to be pure nasal epithelial cells. The monolayer culture of dissociated cells could successfully be employed for further study to investigate the role of the epithelial cells in allergic or non-allergic nasal inflammatory diseases.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.64-67
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• 2005

Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.