Aspergillosis or actinomycosis is a very rare disease of paranasal sinuses. It is an infectious bacterial disease caused by actinomyces species, which is a gram-positive, anaerobic bacillus. Although actinomyces species are part of the normal flora commensal in the oral cavity or GI tract, they, in rare cases, they can invade the mucosa and form a fistula or an abscess once the mucous membrane is damaged by inflammation or trauma. Aspergillosis is a fungal infection, and the frequency of its outbreaks has been increasing because diagnostic techniques have been improved, and the use of antibiotic, steroid and anticancer medicines have increased as well as the growth of incidence of metabolic diseases. The diagnosis of Aspergillosis is to be confirmed by pathologic findings after surgery. Sulfur granules are histologically observed for actinomycosis, and 45° branched hyphae are to be found for Aspergillosis. This describes the first case reported in Korea where actinomycosis and Aspergillosis was diagnosed separately at each side of maxillary sinuses.
Abscess ; Actinomyces ; Actinomycosis* ; Aspergillosis* ; Bacillus ; Diagnosis ; Disease Outbreaks ; Fistula ; Gastrointestinal Tract ; Hyphae ; Incidence ; Inflammation ; Korea ; Maxillary Sinus* ; Maxillary Sinusitis ; Metabolic Diseases ; Mouth ; Mucous Membrane ; Paranasal Sinuses ; Rare Diseases ; Sulfur

Congenital unilateral lower lip paralysis (CULLP) is a rare condition characterized by inversion and absent depressive movement of the affected lower lip while moving the mouth, which is recognized when the infant cries. CULLP is a variation of facial paralysis caused by abnormal development of marginal mandibular nerve, hypoplasia of the depressor labii inferioris muscle or depressor anguli oris muscle. This report introduces two cases of congenital unilateral lower lip palsy, presenting a balancing technique involving the resection of the depressor labii inferioris on the non-affected side.
Facial Paralysis ; Humans ; Infant ; Lip* ; Mandibular Nerve ; Mouth ; Muscle Denervation ; Paralysis*

BACKGROUND AND OBJECTIVES: Recently, mandibular advancement device (MAD) has been used widely used for the treatment of obstructive sleep apnea (OSA) because it can effectively reduce the collapsibility of upper airway during sleep. Although MAD is widely prescribed by otorhinolaryngologists, several studies described its complications arising from the anterior placement of the mandible with long-term use. However, there is still a lack of studies on long-term complications in Korean patients. SUBJECTS AND METHOD: Retrospectively, we included a total of 57 OSA patients in the study. In this study, all enrolled OSA patients had used MAD over two years with more than 4 hours/day. Dental consulting and cephalometric analysis were conducted to identify the change of dental and skeletal findings at two different times (baseline and after 2 year). RESULTS: The dental findings showed that the overbite and overjet were significantly decreased. Additionally, the proclination of the lower incisors were increased significantly, whereas there was no significant change on the retroclination of the upper incisors. Three patients showed a change of malocclusion type. On the analysis of skeletal findings, we found a significant increase in the sella turcica central point-nasion-supramental point angle and a decrease in the subspinal point-nasion-supramental point angle. Moreover, the anterior lower facial height and anterior facial height were significant increased. CONCLUSION: Consistent with Western studies, our findings suggest that the long-term use of MAD could induce changes in dental and skeletal morphologies in Korean OSA patients. Therefore, clinicians should thoroughly evaluate potential changes in dental and skeletal morphologies when they prescribe MAD to patients with OSA.
Humans ; Incisor ; Malocclusion ; Mandible ; Mandibular Advancement* ; Methods ; Overbite ; Retrospective Studies ; Sella Turcica ; Sleep Apnea, Obstructive*

BACKGROUND AND OBJECTIVES: Many patients experience middle ear surgery via retroauricular approach. While not a main interest of the surgery, the change of the auricular shape after surgery has been a subject of complaint by some patients. In this study, we wanted to determine if a change in the auricular shape occurs after middle ear surgery and evaluate the possibility of using reconstruction of posterior auricular muscle as a treatment option for this kind of change. SUBJECTS AND METHOD: Forth patients who received middle ear surgery were enrolled in this study. Retroauricular incision and canal up mastoidectomy were carried out to all patients. The patients were separated into two groups randomly before surgery: one group that had the reconstruction of posterior auricular muscle during surgery, and the other that did not. The average of heights of the helix was compared. Also, patients were asked to fill out a questionnaire about auricular shape before and after surgery. RESULTS: The heights of helix increased about 1.6 mm after surgery; however, the difference of increment as a result of reconstruction of posterior auricular muscle was not statistically significant. Questionnaire about the change of auricular shape after surgery showed that only 8% patients had noticed about the change of auricular shape after surgery. CONCLUSION: Most patients have no complaint about auricular shape after middle ear surgery via retroauricular approach. The average of heights of the helix increases after middle ear surgery. However, the reconstruction of the posterior auricular muscle is not effective for reducing the observed increment of heights of the helix following middle ear surgery via retroauricular approach.
Ear Auricle ; Ear, Middle* ; Humans ; Methods

BACKGROUND AND OBJECTIVES: This study is aimed to investigate the efficacy of dexamethasone and methylprednisolone when used for Intratympanic steroid injection (ITSI) concurrent with systemic steroid as primary therapy. SUBJECTS AND METHOD: We undertook a retrospective study of 106 patients diagnosed with Idiopathic Sudden Sensorineural Hearing Loss at our institution. These patients were divided into the following groups based on their intratympanic steroid medications: Group 1 (which received dexamethasone for ITSI) and Group 2 (which received methylprednisolone for ITSI). The severity of pain after ITSI was also compared using Visual Analogue Scale. RESULTS: The therapeutic results of both groups showed no significant difference. The improvement of pure tone audiometry average threshold were 18.3±19.5 dB for Group 1 and 22.4±25.8 dB for Group 2, with no significant differences (p=0.402). The recovery rate according to Siegel's criteria were 34/70 (48.6%) and 18/36 (50.0%) respectively, with no significant differences (p=0.889). The degree of pain after ITSI were 1.51±1.06 and 3.92±1.63 for Group 1 and 2, respectively, showing significant differences (p<0.001). Again, there were no significant differences even when accompanying symptoms or severity of initial hearing loss were considered. CONCLUSION: There was no significant difference between efficacy of dexamethasone and methylprednisolone when used as primary therapy. Methylprednisolne caused more severe pain after ITSI, suggesting the choice of dexamethasone. Further studies are needed about the concentration of injected steroid.
Audiometry ; Dexamethasone ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Injection, Intratympanic ; Methods ; Methylprednisolone ; Retrospective Studies ; Steroids

Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease of the nasal and paranasal mucosa and it usually affects substantial impaired quality of life. CRS is a highly heterogeneous disease and currently defined as subgroups of patients based on nasal endoscopic findings, accompanied either by CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). However, clinical phenotypes does not adequately reflect the pathophysiologic diversity within patients with CRS. Thus, CRS was also classified according to the inflammatory endotypes, which defined as subtypes of disease with an immunologically different from others by the involvement of a specific molecule or cell. To date, it has been well known that CRSsNP patients characterized by a predominant T helper cell type 1 inflammatory response, whereas CRSwNP patients from Western driven by a T helper cell type 2 inflammation and increased eosinophil infiltration. Meanwhile, CRSwNP patients from Asian displayed a mixed T cell profile with a non-eosinophilic inflammation pattern. However, recent some studies have reported the new discoveries regarding immunologic different endotypes of CRSwNP, such as innate lymphoid cells and activated B-cell mediated immune response. Therefore, herein we describe concepts and new discoveries of immunologic endotype in patients with CRSwNP.
Asian Continental Ancestry Group ; B-Lymphocytes ; Eosinophils ; Humans ; Immunity, Innate ; Inflammation ; Lymphocytes ; Mucous Membrane ; Nasal Polyps* ; Phenotype ; Quality of Life ; T-Lymphocytes, Helper-Inducer

BACKGROUND AND OBJECTIVES: The management of external auditory canal (EAC) squamous cell carcinoma (SCC) is very difficult because the structure of the temporal bone is complicated. We aimed to analyze the surgical results of EAC SCC and propose a treatment protocol. SUBJECTS AND METHOD: Fifteen patients with EAC SCC who underwent operations between July 1984 and June 2001 were analyzed. We divided the patients into five classes according to the extent of tumor progression. In patients classified under Class I, the tumor involved the cartilaginous ear canal. Tumors of patients within Class II involved the bony ear canal or mastoid cortex. Tumors that involved the deep structures of the temporal bone but limited involvement of within the middle ear cavity were classified under Class IIIA. In Class IIIB, tumors involved the facial canal, the base of the skull, or mastoid air cells. In Class IIIC, tumors involved the cochlea, the medial wall of middle ear, dura, sigmoid sinus, or other structures such as the parotid gland, carotid canal, or petrous apex. We analyzed data concerning patients and tumors, surgical methods, and surgical outcomes. RESULTS: The number of patients classified under Class I, Class II, Class IIIA, Class IIIB and Class IIIC were 3, 3, 2, 1, and 6, respectively. Surgical approaches were local canal resection, partial temporal bone resection (TBR), subtotal TBR, and total TBR. Follow up period was 5 to 138 months with a mean (+/-SD) of 40 months (+/-37.5), and the five-year disease free survival rate was 40.6%. CONCLUSION: From this study, we suggest the treatment modality for the EAC SCC. We recommend a partial TBR for surgery of Class I or Class II EAC SCC cancers, a subtotal TBR for Class IIIA, and a total TBR when it is close to Class IIIB or Class IIIC.
Carcinoma, Squamous Cell* ; Clinical Protocols ; Cochlea ; Colon, Sigmoid ; Disease-Free Survival ; Ear Canal* ; Ear, Middle ; Follow-Up Studies ; Humans ; Mastoid ; Parotid Gland ; Skull ; Temporal Bone

BACKGROUND AND OBJECTIVES: Mucin hypersecretion is one of the main symptoms of inflammatory diseases in the respiratory tract. The authors previously reported that pleiotypic pro-inflammatory cytokine, interleukin (IL)-1beta, plays significant roles in the respiratory tract inflammation by inducing mucins (MUC2, MUC5AC, MUC8). However, the molecular mechanism for mucin hypersecretion in the respiratory tract is still unclear. MATERIALS AND METHOD: In order to understand the mechanisms of mucin hypersecretion in the airway epithelium, the differentially expressed proteins and genes in the lung mucoepidermoid carcinoma cell line (NCI-H292 cells), which were treated for 6 and 24 hours with IL-1beta (10 ng/ml), were identified using 2-dimensional polyacrylamide gel electrophoresis (2-D PAGE) proteomics and cDNA microarray analysis (8.6 K). RESULTS: In the 2-D PAGE, 8 differentially expressed proteins and 14 post-translational modification proteins were identified 6 and 24 hrs after the IL-1beta treatment. Microarray analysis identified a total of 413 genes (6.6%) in the 6-hour treatment group and 115 genes (2.0%) in the 24-hour treatment group that were regulated after the IL-1beta treatment. The differentially expressed genes that were regulated by the IL-1beta treatment were mostly found in the metabolic pathway rather than in the regulatory pathway. A comparison of the proteomic and microarray data showed that there was a large discrepancy between the protein expression and the gene expression levels. Among the genes encoding the proteins secreted in the airway, MUC5B was down-regulated but sialomucin CD 164, lysozyme, and the secretory leukocyte protease inhibitor (SLPI) were up-regulated. CONCLUSION: These results clearly show that the transcript levels have little value in predicting the extent of protein expression. Genomics and proteomics have different evaluation fields. Therefore, they may not provide all the information on the gene and protein profiles.
Carcinoma, Mucoepidermoid ; Cell Line ; Electrophoresis, Polyacrylamide Gel ; Epithelial Cells* ; Epithelium ; Gene Expression ; Genomics ; Inflammation ; Interleukin-1beta* ; Interleukins ; Lung ; Metabolic Networks and Pathways ; Microarray Analysis ; Mucins ; Mucus ; Muramidase ; Oligonucleotide Array Sequence Analysis ; Protein Processing, Post-Translational ; Proteomics ; Respiratory System ; Secretory Leukocyte Peptidase Inhibitor ; Sialomucins

BACKGROUND AND OBJECTIVES: Inner hair cells (IHCs) of the organ of Corti change the external sound stimulus into the electrical signal and transmit this signal to the auditory cortex through afferent nerve fibers. Outer hair cells (OHCs) control the sound transmission function of IHC. OHCs respond with a somatic shape change to alterations in their membrane potential and this electromotile response is believed to provide mechanical feedback to the basilar membrane. Efferent nerve fibers which arise from the superior olivary nucleus in the midbrain and transmit to OHCs through medial olivocochlear bundle use acetylcholine (ACh) as a neurotransmitter. The cholinergic response of OHCs' alpha-9 nicotinic ACh receptor increase the Ca2+ influx, which control OHCs' electromotility by changing a membrane potential. In this research, the effect of ACh on the K+ current in OHC of guinea pig was studied, and the change of OHC length by ACh was studied. MATERIALS AND METHODS: Using the extracted OHC from a guinea pig potassium currents induced by ACh were recorded using the whole-cell patch clamp technique. The change of OHC length when ACh was applied was observed. RESULTS: 1) ACh increases voltage-dependent K+ current in OHC. 2) In the condition, which Ca2+-dependent K+ current is blocked by removing Ca2+ from intra-cellular fluid, ACh has no effect on K+ current in OHC. 3) ACh increases OHC length. CONCLUSION: These experimental results show that ACh from the medial olivocochlear efferent system regulates mobility of OHC, increases the Ca2+-dependent K+ currents in OHC.
Acetylcholine* ; Animals ; Auditory Cortex ; Basilar Membrane ; Calcium ; Guinea Pigs ; Hair* ; Membrane Potentials ; Mesencephalon ; Nerve Fibers ; Neurotransmitter Agents ; Olivary Nucleus ; Organ of Corti ; Potassium Channels ; Potassium*

No abstract available.