BACKGROUND AND OBJECTIVES: The frontal recess (FR) cells, including the frontal cell (FC), agger nasi cell (ANC), supraorbital ethmoid cell (SOC) and inter-frontal sinus septal cell (IFSSC), can interfere with the drainage system of the frontal sinus. We evaluated the relationship between the FR cells and the frontal sinusitis. SUBJECTS AND METHODS: All paranasal sinus CT scans performed from July 2004 through June 2005 were reviewed. Of the 675 scans reviewed, 317 patients (634 sides) were selected for data collection. Exclusion criteria included a clinical history of neoplasms, bony deformities, and extensive disease responsible for obscuring the bony anatomy. Similarly, CT scans with severe artifacts were also excluded. RESULT: FCs were present in 21.9% of the patients. According to the Bent's classification, the prevalence of each FC type was as follows; type 1 FC (13.6%), type 2 FC (3.2%), type 3 FC (1.9%) and type 4 FC (3.1%). Of the four types of FR cells, type 4 had a significant association with frontal sinusitis. The incidence of hyperpneumatized frontal sinus, ANC, SOC, IFSSC were significantly higher among patients with the FC than those without the FC (p<0.05). Patients without the ANC or with type 1 uncinate process, according to Stammberger's classification, displayed a higher frequency of frontal sinusitis (p<0.05). There was a statistically significant decrease in the frequency of frontal sinusitis among patients with hypopneumatized frontal sinus (p<0.05). CONCLUSION: In our series, the frontal sinusitis was influenced by each types of FC, attachment sites of uncinate process and the degree of frontal sinus pneumatization. Therefore, these anatomic variations in the frontal recess should be appropriately addressed during the surgical management of the frontal sinusitis.
Artifacts ; Congenital Abnormalities ; Data Collection ; Drainage ; Frontal Sinus ; Frontal Sinusitis ; Humans ; Incidence ; Prevalence

BACKGROUND: Monitoring the "depth of anesthesia" is an ongoing problem. To identify a useful parameter for determining the depth of anesthesia with enflurane, EEG data was obtained using a Physiolab 800. METHODS: Variations in EEG signals were measured and analyzed by the stage of anesthesia. EEG data was obtained from 15 patients during general anesthesia with enflurane. The EEG signal was acquired and analyzed in 5 steps (one day before anesthesia, during induction, during skin incision, at end of anesthesia, and one day after anesthesia). Fp1 electrode and the EEG data mainly from the forehead were used to determine the depth of anesthesia using EEG characteristics during enflurane anesthesia. All data were preprocessed by filtering, baseline correction and using the linear detrend method to reliable analyze of sample data in the surgical environment. Data obtained were transformed to frequency and power spectrum analysis was performed. RESULTS: alpha, beta, delta and theta waves were detected by frequency area separation and the trend of each wave was observed during each anesthesia stage. EEG data was slowed down and the theta wave ratio increased as the depth of anesthesia increased. Accordingly, spectral edge frequency (SEF) and median frequency (MF) were used as parameters to determine the depth of anesthesia. The frequencies of SEF and MF decreased during anesthesia and returned to the preanesthetic level after the cessation of anesthesia. CONCLUSIONS: Our results suggest that SEF and MF can contribute as useful parameters to determine the depth of anesthesia. Anesthetics not only affect the central nervous system, but also affect the autonomic nervous system. If the autonomic nervous system signals such as heart rate variability are taken into account, more reliable evaluations would be possible.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Autonomic Nervous System ; Central Nervous System ; Electrodes ; Electroencephalography* ; Enflurane ; Forehead ; Heart Rate ; Humans ; Skin ; Spectrum Analysis*

BACKGROUND AND OBJECTIVES: Before introducing transnasal endoscopic sinus surgery, surgical repair of the blowout fracture includes the transorbital approach with an external incision and/or the maxilloethmoidal approach. The advantages of the transnasal endoscopic technique include magnified direct visualization and easy access to the medial orbital walls. Gelfoam is a slowly absorbable material and is rigid enough to provide support where Silastic sheet is to be placed. The purpose of this study was to evaluate outcomes of transnasal endoscopic reconstruction with Gelfoam and Silastic sheet of medial orbital wall fracture. SUBJECTS AND METHOD: This study was a retrospective analysis 27 patients who underwent transnasal endoscopic reduction of blowout fracture from February 1999 to April 2004. The follow-up period was at least over than 12 months. RESULTS: The study population included 18 males and 9 female patients ranging from 13 to 54 years (mean, 33.3 years) of age. Twenty of 23 patients with diplopia showed a complete improvement of diplopia and 3 patients showed an incomplete improvement. All of 13 patients with limitation of ocular movement and 2 patients with enophthalmos revealed a complete resolution of their symptoms. There were no significant complications in all patients although ocular pain and epiphora were observed temporally after operation. CONCLUSION: Transnasal endoscopic reconstruction with Gelfoam and Silastic sheet for medial orbital wall fracture is a very successful technique that does not accompany major complications and has definite cosmetic advantage of causing no external scarring.
Cicatrix ; Diplopia ; Enophthalmos ; Female ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Lacrimal Apparatus Diseases ; Male ; Orbit* ; Retrospective Studies

BACKGROUND: Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. MATERIALS AND METHODS: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type III (53.7%) was the most frequent histological type. RESULTS: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. CONCLUSION: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.
Brain ; Female ; Humans ; Liver ; Lung ; Male ; Medical Records ; Nasopharyngeal Neoplasms* ; Neck ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Rare Diseases ; Recurrence ; Retrospective Studies ; Spine ; Survival Rate

OBJECTIVES: Excessive production of mucus results in plugging of the airway tract, which can increase morbidity and mortality in affected patients. In patients with diabetes, inflammatory airway disease appears with more frequent relapse and longer duration of symptoms. However, the effects of high glucose (HG) on the secretion of mucin in inflammatory respiratory diseases are not clear. Therefore, this study was conducted in order to investigate the effect and the brief signaling pathway of HG on MUC5B expression in human airway epithelial cells. METHODS: The effect and signaling pathway of HG on MUC5B expression were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), real-time PCR, enzyme immunoassay, and immunoblot analysis with specific inhibitors and small interfering RNA. RESULTS: HG increased MUC5B expression and epidermal growth factor receptor (EGFR) expression, and activated the phosphorylation of EGFR and p38 mitogen-activated protein kinase (MAPK). Pretreatment with EGFR inhibitor significantly attenuated the HG-induced phosphorylation of p38 MAPK, and pretreatments with p38 inhibitor or EGFR inhibitor significantly attenuated HG-induced MUC5B expression. In addition, knockdown of p38 MAPK by p38 MAPK siRNA significantly blocked HG-induced MUC5B expression. CONCLUSION: These findings suggest that HG induces MUC5B expression via the sequential activations of the EGFR/p38 MAPK signaling pathway in human airway epithelial cells.
Epithelial Cells* ; Glucose* ; Humans* ; Immunoenzyme Techniques ; Mortality ; Mucins ; Mucus ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Protein Kinases ; Real-Time Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; Recurrence ; RNA, Small Interfering

BACKGROUND AND OBJECTIVES: Recently, obesity has become one of the major health problems in our society. To overcome this problem, keeping a balance between food intake and energy expenditure is very important. Many natural substances including essential oils have been suggested for their potential effect on reducing weight. This study was performed to evaluate whether aroma inhalation of essential oil has a role in appetite regulation and works on the central nervous system through the olfactory stimulus. MATERIALS AND METHOD: Food intake was measured after 30 minutes of treatment with essential oil in overnight fasted Sprague-Dawley rats. In the control group, saline was used instead of essential oil. Changes in pro-opiomelanocortin (POMC) and neuropeptide Y (NPY) mRNA expression levels in the hypothalamus were measured following 30 minutes of treatment with geranium essential oil using real-time polymerase chain reaction. RESULTS: Of the seven essential oils, geranium significantly decreased the amount of food intake compared to the control group. Geranium essential oil significantly increased POMC mRNA expression in the hypothalamus, but did not change the NPY mRNA expression. The increased POMC mRNA expression was reversed by treatment with xylocaine, which blocks the olfactory perception. CONCLUSION: These results suggest that geranium essential oil has anorexic effect through the activation of POMC neurons in the hypothalamus via olfactory stimulus.
Appetite Regulation ; Central Nervous System ; Diethylpropion ; Eating ; Energy Metabolism ; Geranium ; Hypothalamus ; Inhalation ; Lidocaine ; Neurons ; Neuropeptide Y ; Obesity ; Oils, Volatile ; Olfactory Perception ; Pro-Opiomelanocortin ; Rats, Sprague-Dawley ; RNA, Messenger

BACKGROUND AND OBJECTIVES: Mucin gene expression and mucin production are highly increased during inflammatory airway disorders such as, asthma, chronic bronchitis and sinusitis. Cytokines, lipopolysaccharides and other inflammatory mediators are related with secretion and production of mucin. However, among of inflammatory mediators, the relation of leukotrienes and mucin genes expression is not clear. The aim of this study is to evaluate MUC2/5AC genes expression and mucin secretion through leukotriene receptor in human airway epithelial cells. SUBJECTS AND METHOD: The effect of Leukotriene D4 and leukotriene receptor antagonist, pranlukast hydrate (ONO-1078) on the regulation of MUC2/5AC gene expression and mucin secretion was observed in the human airway NCI-H292 epithelial cells. The mRNA levels of MUC2/5AC and the amount of mucin protein were determined by reverse transcription-polymerase chain reaction (RT-PCR) and immunoassay. RESULTS: Leukotriene D4 upregulated MUC2/5AC gene expression and mucin secretion on a dose dependent pattern. Pranlukast hydrate (ONO-1078, 100 micrometer) downregulated the leukotriene D4-mediated MUC2/5AC gene expression and mucin secretion. CONCLUSION: These results suggest that the leukotriene receptor system is one of the expression mechanisms of MUC2/5AC genes and mucin secretion.
Asthma ; Bronchitis, Chronic ; Cytokines ; Epithelial Cells* ; Gene Expression ; Humans* ; Immunoassay ; Leukotriene Antagonists ; Leukotriene D4 ; Leukotrienes ; Lipopolysaccharides ; Mucins* ; Receptors, Leukotriene* ; RNA, Messenger ; Sinusitis

This study describes the purification and characterization of type II restriction endonuclease of Helicobacter pylori in order to understand the DNA restriction and modification of H. pylori. H. pylori cell extract was subjected to polyethyleneimine treatment, salt precipitation, heparine-sepharose column chromatography, and fast protein liquid chromatography (FPLC) using Resource Q column and Mono Q column to purify the type II restriction endonuclease. Hpy51-I was characterized to recognize the sequneces 5`-GT(G/C)AC-3`, yielding 5-base 5` protruding ends. The restriction sequence was identical to that of Tsp 45 I. The enzyme exhibited its maximal activity in the presence of 10-20 mM LaCl, but was inhibited completely in the presence of more than 80 mM NaCl. The enzyme showed its maximal activity in the presence of 1-10 mM MgC1(2). The optimal pH and temperature for enzyme activity was pH 9.0 and 37 degrees C, respectively. MnC1(2) could not substitute for MgC1(2) in reaction mixture. And addition of j3-mercaptoethanol and bovine serum albumin in reaction mixture led to loss of enzyme activity of Hpy51-I. The whole cell extract of H. pylori strain 51 was confirmed to carry the enzyme activity for methylation of Hpy51-I-recognised sequence. Hpy51-I digested genomic DNAs of enteric bacteria to less than I kb while it could not cut the genomic DNAs of H. pylori isolates. In this study, the type II restriction enzyme (Hpy51-I) of H. pylori was identified and characterized its biochemical properties, demonstrating that Hpy51-I might be one of the barriers for preventing the introduction of foreign DNAs into H. pylori.
Chromatography ; Chromatography, Liquid ; DNA ; DNA Restriction Enzymes* ; Enterobacteriaceae ; Helicobacter pylori* ; Helicobacter* ; Hydrogen-Ion Concentration ; Methylation ; Polyethyleneimine ; Serum Albumin, Bovine