Nitric oxide (NO) signaling has been one of the most rapidly growing areas of study in biology. We know today that NO acts as a signal molecule in the nervous system, a weapon against infection, a regulator of blood pressure, and a gatekeeper of blood flow to different organs. However, much remains to be determined about the physiological and pathophysiological role of NO in the airways. NO appears to be co-localized to cholinergic innervation and involved in vasomotor and secretomotor control of the nasal mucosa. NO is present in exhaled air and appears to originate mainly from paranasal sinus epithelium. Moreover, immunohistochemical and in situ hybridization studies identify all three known isoforms of NO synthase in nasal mucosa. Inhaled endogenous NO in the airways is suggested as playing a role in host defense, and involved in the regulation of pulmonary function as an 'aerocrine.' However, the role of NO in airway inflammation is complicated and clearly has to be determined. The physiological role of NO in the nasal mucosa and its possible pathophysiological role in rhinitis are to be discussed.
Biology ; Blood Pressure ; Epithelium ; In Situ Hybridization ; Inflammation ; Nasal Mucosa* ; Nervous System ; Nitric Oxide Synthase ; Nitric Oxide* ; Protein Isoforms ; Rhinitis*

No abstract available.
Sinusitis*

Systemic corticosteroids currently represent the most effective treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), but their long-term use is constrained due to their detrimental side effects. Until recently, development of novel drugs for CRSwNP has been difficult partly due to the absence of a standard animal model of CRSwNP. Exotoxins of Staphylococcus aureus such as staphylococcal enterotoxin B (SEB), are well-known superantigens which can induce a strong immune response; there have been many studies on the association of staphylococcal enterotoxins and development of CRSwNP over the past two decades. Based on previous studies, we invented a mouse model of CRSwNP using SEB. Herein, we explain the protocol development for the mouse model, as well as identify histological and immunological similarities between this mouse model and humans. Furthermore, we describe a study that analyzed the risk factors for CRSwNP such as smoking, and also elaborate on a series of studies that searched for new potential drugs for CRSwNP, including resveratrol, anti-periostin antibody, topical hypoxia-inducible factors, and topical cyclosporine. Based on preceding studies, we have concluded that this mouse model might be a useful tool to investigate the pathophysiology and development of novel drugs for CRSwNP.
Adrenal Cortex Hormones ; Animals ; Cyclosporine ; Enterotoxins ; Exotoxins ; Humans ; Mice* ; Models, Animal ; Nasal Polyps* ; Risk Factors ; Smoke ; Smoking ; Staphylococcus aureus ; Superantigens

Allergic fungal sinusitis (AFS) is a benign, noninvasive form of fungal sinusitis. Histologically, AFS is characterized by allergic mucin, which consists of eosinophilic mucinous material with occasional laminar deposits of eosinophils. A diagnosis of AFS can be made when there is a demonstration of characteristic allergic mucin and an appearance of fungal hypae scattered within the mucin with no evidence of tissue invasion, or when fungi cultures yield positive results. Until now, no cases of AFS have been reported in Korea, though there have been many cases of mycetomas and a few cases of invasive fungal sinusitis. We present the first two cases of AFS in Korea. The patients demonstrated characteristic allergic mucin, fungal hypae scattered within the mucin, and no evidence of tissue invasion on histopathology. Nasal polyps, involvement of the unilateral sinuses, peripheral eosinophilia, an elevated total IgE, and hyperattenuated masses observed in the CT supported the diagnosis of AFS. The patients recovered and did not display recurrence after surgery and treatment with topical steroids and saline irrigation.
Diagnosis ; Eosinophilia ; Eosinophils ; Fungi ; Humans ; Immunoglobulin E ; Korea ; Mucins ; Mycetoma ; Nasal Polyps ; Recurrence ; Sinusitis* ; Steroids

Organized hematoma of the maxillary sinus is a rare clinical disease. We report a case of organized hematoma of the maxillary sinus presenting with acute sinusitis. This is the first article describing such a case. Included is a review of the literatures, highlighting the diagnostic signs of organized hematoma of the maxillary sinus.
Hematoma ; Maxillary Sinus ; Sinusitis

The korean society of otolaryngology has had and experience on intraining examination since 1992. We also had the fortieth annual board examination for specialist in 1997. But we have no evidence on the validity of these tests yet. The aim of this study is to examine the validity of the intraining examinations as a tool of formative evaluation, to present a personal progress index demonstrating constructive validity, and to examine the validity of the board examination as a tool of summative evaluation. We did statistic analysis on the consecutive personal scores of 1995 and 1996 intraining examinations, and 1997 written and oral board examinations. Analysis of the averages, standard deviations, distribution curves, and Wilcoxon singed rank test on the scores of 1995 and 1996 intraining examinations demonstrated the constructive validity. Chi-square test revealed that those who had low scores in intraining examinations of two consecutive years had low scores in 1997 board examinations and personal progress index demonstrated the predictive validity. Correlation and linear regression analysis demonstrated a strong correlation between 1997 written and oral board examination. Analysis of the averages, standard deviations, distribution curves, and Spearman rank correlation coefficient revealed that 1997 written board examination had higher concurrent validity than the that of oral examination.
Diagnosis, Oral ; Humans ; Linear Models ; Otolaryngology* ; Specialization

The expanded endonasal approach (EEA) to the ventral skull base provides endoscopic access from the frontal sinus to the second cervical vertebra. Potential advantages of the EEA include not only improved cosmesis but more importantly, the potential for reduced neurovascular manipulation. EEA is based on the principle of extracapsular dissection with full visualization of important neurovascular structures. There are significant risks of neural and vascular injury associated with EEA, and the reconstruction of dural defects is challenging. Experienced teams including rhinologists and neurosurgeons are needed for successful implementation of EEA. The surgical team must have adequate endoscopic skills to achieve hemostasis and address vascular emergencies. Advantages of having a skilled second surgeon to provide endoscopic visualization include dynamic adjustments of the endoscope to ensure the best view and avoid contact interference of instruments, second surgical opinions in complex anatomical areas, and maintenance of endoscopic views in cases of crisis such as vascular injury. Complications of the EEA such as neurovascular injury, cerebrospinal fluid leaks and infection are the same as those of open approaches. With the advent of the nasoseptal flap, problematic cases involving huge bony defects subsequent to the resection of skull base tumors have been greatly resolved.
Dietary Sucrose ; Emergencies ; Endoscopes ; Frontal Sinus ; Hemostasis ; Reconstructive Surgical Procedures ; Sella Turcica ; Skull Base ; Spine ; Surgical Flaps ; Vascular System Injuries

Small cell carcinoma commonly originates in the lung, with only about 4% of cases arising at extrapulmonary sites. Furthermore, small cell carcinoma of the sinonasal tract is extremely rare. In Korea, only 2 cases of primary sinonasal small cell carcinoma have been reported in the nasal cavity and the nasal septum, respectively. Recently, we have experienced a rare case of small cell carcinoma arising from the right maxillary sinus coexisting with a fungal ball lesion. Herein, we report this case with a review of the literature.
Aspergillosis ; Carcinoma, Small Cell* ; Fungi* ; Korea ; Lung ; Maxillary Sinus* ; Nasal Cavity ; Nasal Septum

No abstract available.
Neck*

OBJECTIVES: Postoperative wound healing status has not been considered in earlier studies on olfactory changes after surgery. This may be a factor accounting for the equivocal postoperative olfactory results. The aim of this study was to investigate postoperative olfactory results according to wound healing status. METHODS: Fifty patients who underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps with smelling disturbance were examined preoperatively, and at 6 months after surgery. Patients were divided into two groups according to postoperative Lund-Kennedy score: favorable and unfavorable wound healing. Preoperative ostiomeatal unit computed tomography (CT), such as Lund-Mackay score and olfactory cleft opacification score, clinical characteristics and olfactory function tests such as the butanol threshold test and cross-cultural smell identification test, and questionnaire responses were compared between the two groups. RESULTS: There were no differences in preoperative clinical characteristics between the favorable and unfavorable wound healing groups. The favorable wound healing group displayed greater improvement of olfactory results after surgery than the unfavorable wound healing group. Postoperative olfactory improvement patterns showed a hierarchy from subjective to objective improvement and from threshold to identification improvement. Patients who had postoperative favorable wound healing but showed no success of olfaction were characterized by more severe preoperative subjective symptoms and higher olfactory cleft opacification, especially in the upper part of olfactory cleft on preoperative CT scan. CONCLUSION: Wound healing status is an apparent risk factor for postoperative olfactory improvement. Moreover, preoperative opacification in the olfactory cleft may predict bad olfactory results after surgery, even in patients with favorable wound healing.
Accounting ; Humans ; Nasal Polyps ; Risk Factors ; Smell ; Wound Healing ; Surveys and Questionnaires