It is known that early surgery between 6 and 24 months of age obtains better binocularity in infantile esotropia. We selected 59 patients who had infantile esotropia with onset before 6 months of age and underwent surgery at 10 years of age or less. Stereopsis was tested in 51 patients after surgery. Thirty four patients(66.7%) showed gross stereopsis. The patients who underwent surgery at 2 years of age or less, developed gross stereopsis in 80.8%. The patients who had their eyes aligned their eyes between 2 and 4 years of age, gross stereopsis was demonstrated in 64.3%, white the patients underwent surgery more than 4 years of age developed gross stereopsis in 36.3%. The younger the patients at the time of surgery, the greater the percentage of gross stereopsis was shown(p<0.05). Orthophoria(within +/-10 prism diopters) was seen in 81.3% of the patients underwent surgery at 2 years of age or less and in 59.3% of the patients underwent surgery more than 2 years of age(p>0.05). This study revealed that early surgery, before 2 years of age, yields better outcome for sensory fusion and good alignment.
Depth Perception ; Esotropia* ; Humans ; Telescopes

Knowledge about the mechanism and factors that influence olfaction in laryngectomees remains unclear. The aims of this study were to determine the effect of nasal airflow on olfactory ability, as measured by sniff alone and laryngeal bypass with sniff ; to evaluate varying olfactory abilities according to the status of the speech mechanisms in esophageal speakers (ES) and tracheoesophageal shunt speakers (TES) ; and to assess the relationship between speech acceptability and olfactory ability in laryngectomees. Two laryngectomee groups, consisting of ES and TES, and age-matched controls were analyzed through questionnaires, tests applying a Japanese T&T olfactometer to measure thresholds of odor detection and recognition, intravenous alinamin injection tests, and measures of speech acceptability. The findings that laryngeal bypass with sniff and the TES group demonstrated lower olfactory thresholds and shorter latent times than sniff alone and the ES group was informative about the importance of nasal airflow to the olfactory ability in laryngectomees. Furthermore, the close relationship found between olfactory threshold and speech acceptability showed that the ability to transport airflow through the nasal cavity during speech had a strong influence on olfactory ability in laryngectomees.
Asian Continental Ancestry Group ; Humans ; Nasal Cavity ; Odors ; Smell* ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: The basic principle of microdialysis is to mimic the function of a capillary blood vessel by perfusing physiologic liquid implanted into the target tissue. Amino acids are supposed to have functions for controlling the homeostasis of normal nasal mucosa and a role in the pathogenesis of allergic rhinitis. However, no studies have been conducted about the existence of amino acids in the nasal cavity. This study measures the concentration of 19 amino acids found in the nasal cavity of normal control and experimentally allergy-induced animal model in order to evaluate the difference in the concentration of amino acids between normal and allergic nasal mucosa. MATERIALS AND METHOD: An experimentally induced nasal allergy model was developed by intraperitoneal and intranasal sensitization with ovalbumin in Dunkin-Hartely guinea pigs according to a programmed protocol. A microdialysis probe was designed to be suitable to nasal mucosa using a Cuprophan hollow fiber (200 micrometer inner diameter, 300 micrometer outer diameter, 45 kDa molecular weight cut-off, Fitral, AN 69-HF). After verification of the probe, microdialysis was performed in the inferior turbinate submucosa of normal control (N=8) and experimental (N=8) groups. The concentration of 19 amino acids was analyzed using high performance liquid chromatography. Statistical analysis was performed using a student t-test. RESULTS: All 19 amino acids were validated at various concentrations in the nasal cavity. Glutamate (p=0.036) and GABA (p<0.001) concentrations were significantly higher in the experimental group than in the control group. CONCLUSION: The 19 amino acids measured existed in the nasal cavity at various concentrations, and the concentrations of glutamate and GABA were significantly higher in the allergy group than in the control group. The microdialysis technique is a powerful tool not only to measure endogenous substances for target organ chemistry but also to pharmacokinetically evaluate exogenous drug delivery processes in the nasal cavity.
Amino Acids ; Animals ; Blood Vessels ; Capillaries ; Chemistry ; Chromatography, Liquid ; gamma-Aminobutyric Acid ; Glutamic Acid ; Guinea Pigs ; Homeostasis ; Humans ; Hypersensitivity* ; Microdialysis* ; Models, Animal ; Molecular Weight ; Nasal Cavity ; Nasal Mucosa ; Ovalbumin ; Rhinitis ; Turbinates

BACKGROUND AND OBJECTIVES: This study was designed to compare the clinical outcomes according to surgical approach of extranasal, endonasal endoscopic, and a combined approach of the two, suggesting the indication of each surgical approach for excision of sinonasal inverted papilloma (IP). SUBJECTS AND METHOD: Fifty-six IP patients who had been operated at the department of Otorhinolaryngology, Pusan National University Hospital from January, 1995 to March, 2001 were retrospectively assessed. The patients were arbitrarily divided into three groups such as excision through extranasal approach (EEA), endonasal endoscopic excision (EEE), and EEE combined with Caldwell-Luc's approach (EEE+C-L) group. RESULTS: The most commonly affected sites by CT/MRI preoperatively was the nasal cavity followed in the decreasing order of frequency by maxillary, ethmoid, sphenoid, and frontal sinus. In the EEA group, the originated sites were the nasal cavity (2/6), maxillary (1/6), and frontal sinus (2/6). In the EEE group, the origin sites by operative findings were the nasal cavity (30/41), maxillary (5/41), sphenoid (3/41), and ethmoid (2/41) sinus. In the EEE+C-L group, eight cases (8/9) originated from the maxillary sinus. There were six cases associated with malignant tumors, five synchronous and one metachronous, treated combined with radiotherapy and/or chemotherapy. A total of eight cases recurred during the follow-up period. The recurrence rate was 16.6% (1/6) in EEA, 14.6% (6/41) in EEE and 10.1% (1/9) in EEE+C-L group, and there was no significant difference according to surgical approaches. CONCLUSION: EEE yielded a successful outcome only when the IP was limited to the originating sites of nasal cavity, medial and upper wall of maxillary sinus, ethmoid sinus, and sphenoid sinus. The complete removal of the tumor by EEE alone could not be achieved when the tumor was originated from the anterior, inferior, and posterolateral wall of maxillary sinus, requiring application of C-L's approach at the same time. EEA can be used with more benefits than EEE when the tumor is originated from the frontal sinus or when the mass tends to invade extensively.
Busan ; Drug Therapy ; Endoscopy ; Ethmoid Sinus ; Follow-Up Studies ; Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity ; Otolaryngology ; Papilloma, Inverted* ; Paranasal Sinuses ; Radiotherapy ; Recurrence ; Retrospective Studies ; Sphenoid Sinus

BACKGROUND AND OBJECTIVES: Mast cell is a key cell in the pathogenesis of allergic rhinitis. It is expected that apoptosis of mast cell is an important step that can lead to treatment of allergic rhinitis. Meanwhile, the cyclosporin A (CsA) is immunosuppresant agent to inhibit the action of various immune cells. The purpose of this study is to identify whether CsA directly induces apoptosis of mast cells in vitro. MATERIALS AND METHOD: After the culture of p815 cells, mouse mastocytoma cells, the cells were treated with 1 micrometer, 2 micrometer, 5 micrometer, and 10 micrometer CsA, and then LD50 of p815 cells were calculated by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide) assay. For identification of apoptosis of p815 cells, electrophoresis and flow cytometry after CsA treatment were done and morphological changes in light microscope was observed. We also quantified apoptotic cells by TUNEL assay and Hoechst stain. RESULTS: The LD50 of p815 cells is 9.87 micrometer after CsA treatment during 24 hours, 6.11 micrometer during 48 hours and 6.21 micrometer during 72 hours. With the higher concentration of CsA treatment, the greater effect on apoptosis of p815 cells was revealed. We observed laddering pattern for DNA fragmentation in electrophoresis. Nuclear fragmentation and chromatin condensation of p815 cells was observed under the light microscope. Results of flow cytometry were similar to the MTT assay results. Quantification of apoptotic p185 cells by TUNEL assay and Hoechst stain were calculated. CONCLUSION: Apoptosis of mast cells can be induced by CsA treatment in vitro.
Animals ; Apoptosis* ; Chromatin ; Cyclosporine* ; DNA Fragmentation ; Electrophoresis ; Flow Cytometry ; In Situ Nick-End Labeling ; Lethal Dose 50 ; Mast Cells* ; Mastocytoma ; Mice ; Rhinitis

BACKGROUND AND OBJECTIVES: The reports of normative measurements for inner ear structure using computer-based programs are rare. The purpose of this study was to measure the normative data of the Korean inner ear structures and establish the basic data for diagnosis of congenital inner ear anomaly. SUBJECTS AND METHOD: Temporal bone CT of 38 patients (16 men and 22 women) without apparent disease of middle and inner ear, fractures or major disorder such as seizure or tumor were retrospectively reviewed. Fifteen dimensions on axial views and 9 dimensions on coronal views were measured in PACS using pi-view program. The slice thickness of CT was 0.6 mm. RESULTS: From the axial view, the canal diameter of SSCC was 1.09+/-0.15 mm, the bony island width was 5.70+/-0.50 mm, the bony island width of LSCC was 3.99+/-0.58 mm, the cochlear upper turn width & height were each 5.63+/-1.07 and 3.03+/-0.65 mm. The vestibular aqueduct were observed 95.3%. From the coronal view, the cochlear height was 5.14+/-0.36 mm. The length of IAC was significantly longer in male than female (p<0.05) and the opening site of IAC was significantly wider in the left than the right (p<0.05). The upper turn of cochlea in good bone conduction (< or =10 B) had larger width and smaller height than those in poor bone conduction (>10 dB). CONCLUSION: We established the Korean normative measurements of the inner ear structures, which can be used for further diagnosis of the inner ear anomaly.
Bone Conduction ; Cochlea ; Diagnosis ; Ear, Inner* ; Female ; Humans ; Male ; Retrospective Studies ; Seizures ; Temporal Bone* ; Vestibular Aqueduct

BACKGROUND AND OBJECTIVES: The purpose of this study was to develop a subculturing technique that allows the formation of large amounts of normal human nasal epithelial (NHNE) cells without compromising the cells' ability to differentiate into secretory and ciliated cells. MATERIALS AND METHODS: Freshly isolated nasal epithelial cells, collected from normal inferior turbinates, were subcultured repeatedly in a serum-free medium on plastic culture dishes. The subcultured cells were tested for growth curve and electromicroscopic characteristics in air-liquid interface (ALI) cultures and for mucous secretory differentiation. RESULTS: The cultures grew rapidly during the first three passages, demonstrating a 20- to 40-fold expansion with each subculture. Ciliogenesis usually started on day 12 and the cultured cells formed cellular sheets exhibiting microvilli in the apical membrane, intracytoplasmic secretory granules, electron lucent, scant endoplasmic reticulum and complex tight junctions on the basolateral side. Passage-1 (P-1) and passage-2 (P-2) cells maintained their potential to differentiate into mucin-secretory and ciliated epithelial cells, and this potential was confirmed by immunocytochemistry with H6C5 and transmission electron microscopy. Although the number of NHNE cells on day 16 of culture decreased as the passage progressed from P-1 to P-3, the relative number of secretory cells did not significantly change. CONCLUSION: In conclusion, P-2 NHNE cell cultures retain the features of normal epithelium and are suitable for conducting many studies on upper airway cell biology.
Cell Culture Techniques ; Cells, Cultured ; Endoplasmic Reticulum ; Epithelial Cells* ; Epithelium ; Humans* ; Immunohistochemistry ; Membranes ; Microscopy, Electron, Transmission ; Microvilli ; Mucins ; Plastics ; Secretory Vesicles ; Tight Junctions ; Turbinates

BACKGROUND: Many head and neck surgeons preferred the radiotherapy as a first choice in treating early laryngeal carcinoma(T1, T2) to surgical operation because of the relatively high curability(80-90%), organ preservation and better quality of life. If radiotherapy failed, some surgeons perform total laryngectomy as salvage operation, but others prefer to perform partial laryngectomy, which is increasing in tendency. OBJECTIVE: To investigate the pattern of cancer invasion to the laryngeal cartilages using salvage laryngectomized cancer specimens which had recurred after radiotherapy. MATERIALS & METHOD: Preoperative computerized tomograpy images were retrospectively compared to postoperative salvage laryngectomized cancer specimens which had recurred after radiotherapy 13 cases from March, 1985 to February, 1994. RESULTS: 1) In laryngeal cacer recurred after radiotherapy, incidence of cartilage invasion was not in early supragolttic cancer. but all in advanced supraglottic cancer, and 3cases of 5 cases(60.0%) in early glottic cancer, 4cases of 5 cases(80.0%) in advanced glottic cancer. 2) The order of laryngeal cartilage invasion was the first thyroid cartilage(61.5%), the second arytenoid cartilage(30.7%), and the third cricoid cartilage(23.1%). 3) The diagnostic accuracy of preoperative CT scan for laryngeal cartilage invasion was 66.7% in thyroid cartilage, 55.6% in arytenoid cartilage, 55.6% in cricoid cartilage, and 100% in epiglottis. CONCLUSION: Selection of partial laryngectomy as salvage operation should be considered carefully.
Arytenoid Cartilage ; Cartilage ; Cricoid Cartilage ; Epiglottis ; Head ; Incidence ; Laryngeal Cartilages* ; Laryngectomy* ; Neck ; Organ Preservation ; Quality of Life ; Radiotherapy ; Retrospective Studies ; Thyroid Cartilage ; Thyroid Gland ; Tomography, X-Ray Computed

BACKGROUND: Tongue cancer comprises 10% of all head and neck cancer, and in spite of progress of therapeutic and diagnostic procedures in oncology, the prognosis of tongue cancer remains poor because of rich lymphatics of the tongue and high propensity of early subclinical lymph node metastasis. MATERIALS AND METHODS: Eighteen cases of tongue cancer specimens were sectioned serially and reviewed to investigate the correlations between macroscopic surface extension diameter and microscopic depth of invasion. And correlations between surface extension, muscular invasion and cervical lymph node metastasis of tongue cancer were studied. Furthermore, safety margin for glossectomy was also studied. RESULTS: The obtained results were as follows: 1) The macroscopic diameter of surface extension and microscopic depth of invasion of tongue cancer were correlated to each other (especially when the macroscopic diameter of surface extension was below 20 mm).2) Surface extension and muscular invasion were correlated independently with cervical lymph node metastasis. However, the 95% confidence index using the Cornfield method was too broad in order to draw a correlation among these three factors. 3) The safety margin was between 2.3mm and 13.5 mm. CONCLUSION: Macroscopic surface extension of tongue cancer serves as a valuable prognostic factor in predicting the depth of muscular invasion. Therefore, the safety resection depth can be estimated by the surface extension. In 12 cases of muscular invasions, relatively high prevalence of cervical lymph node metastasis were found, when compared to that of non-muscular invasive cancer. Therefore, muscular invasion itself is a very useful prognostic factor. But it is difficult to confirm the correlation between muscular invasion and cervical lymph node metastasis because of too broad CI.
Glossectomy ; Head and Neck Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Prevalence ; Prognosis* ; Tongue Neoplasms* ; Tongue*

BACKGROUND AND OBJECTIVES: Cancer cell line is the basic material of various cancer research. Diverse cancer cell lines from various head and neck regions are needed for biologic research of head and neck cancer. However, cell lines derived from head and neck cancer are not common. Recently, we have established and characterized a novel human squamous carcinoma cell line, PNUH-12, from the hypopharynx. MATERIALS AND METHODS:Among trials of twenty cases of head and neck cancer, we established only one specimen succeeded culture passage over 50. We characterized the cell line as follows: growth pattern and curve, morphology using phase contrast microscope and transmission electromicroscope, chromosomal anaysis, flow cytometric analysis, tumorigenecity by xenograft of cell line into nude mouse and morphological comparison, expression of cytokeratin, epithelial membrane antigen and vimentin, and P 53 mutation and its sequencing. RESULTS: PNUH-12 showed typical growth pattern of cancer cell line, representative morphological characteristics of squamous epithelial cell origin, multiple numerical and structural clonal abnormalities of chromosome, aneuploidy pattern of flow cytometry, and strong expression of cytokeratin. The formed tumor of nude mouse showed the identical histopathological phenotype (squamous cell carcinoma) of the original tumor of patient and similar morphology of PNUH-12. There was one point mutation of 78th base, C to G, in exon 7 of P53 gene. CONCLUSION: PNUH-12 can be a good control material and successufully bestowed to researchers for study of biology in head and neck cancer. There still needed more head and neck cancer cell lines from various regions and diverse cell types in future.
Aneuploidy ; Animals ; Biology ; Carcinoma, Squamous Cell* ; Cell Line* ; Epithelial Cells ; Exons ; Flow Cytometry ; Genes, p53 ; Head ; Head and Neck Neoplasms ; Heterografts ; Humans* ; Hypopharynx* ; Keratins ; Mice ; Mice, Nude ; Mucin-1 ; Neck ; Phenotype ; Point Mutation ; Vimentin