OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
Breast Feeding ; Cesarean Section ; Child ; Cohort Studies ; Delivery, Obstetric ; Female ; Humans ; Odds Ratio ; Pregnancy ; Prevalence ; Rhinitis ; Rhinitis, Allergic

Porcine epidemic diarrhea (PED) is a highly contagious enteric swine disease. The large economic impact of PED on the swine industry worldwide has made the development of an effective PED vaccine a necessity. S0, a truncated region of the porcine epidemic diarrhea virus (PEDV) spike protein, has been suggested as a candidate antigen for PED subunit vaccines; however, poor solubility problems when the protein is expressed in Escherichia coli, and the inherent problems of subunit vaccines, such as low immunogenicity, remain. Flagellin has been widely used as a fusion partner to enhance the immunogenicity and solubility of many difficult-to-express proteins; however, the conjugation effect of flagellin varies depending on the target antigen or the position of the fusion placement. Here, we conjugated flagellin, Vibrio vulnificus FlaB, to the N- and C-termini of S0 and evaluated the ability of the fusion to enhance the solubility and immunogenicity of S0. Flagellin conjugation in the presence of the trigger factor chaperone tig greatly improved the solubility of the fusion protein (up to 99%) regardless of its conjugation position. Of importance, flagellin conjugated to the N-terminus of S0 significantly enhanced S0-specific humoral immune responses compared to other recombinant antigens in Balb/c mice. The mechanism of this phenomenon was investigated through in vitro and in vivo studies. These findings provide important information for the development of a novel PED vaccine and flagellin-based immunotherapeutics.
Animals ; Diarrhea ; Escherichia coli ; Flagellin ; Immunity, Humoral ; In Vitro Techniques ; Mice ; Porcine epidemic diarrhea virus ; Solubility ; Swine ; Swine Diseases ; Vaccines, Subunit ; Vibrio vulnificus ; Vibrio

BACKGROUND AND OBJECTIVES: The skin prick test is a widely used test that uses three methods (allergen/histamine ratio method, erythema size method, and wheal size method) to interpret the results. However, there has been no comparison of these methods. The aim of this study is to compare the three different interpretation methods and define the relationship among them. SUBJECTS AND METHOD: A total of 139 patients who visited our allergy clinic complaining of nasal symptoms were enrolled. Three interpretation methods were used for defining positivity in the skin prick test, and their results were compared. The validity of each interpretation method was evaluated by total nasal symptom score. RESULTS: Positivity in the skin prick test was reported in 48.2% of patients according to the allergen/histamine ratio method and in 64.0% of patients according to the wheal size method and erythema size method. The proportion of subjects who showed a negative result with the allergen/histamine ratio method but positive results with the wheal size method or erythema size method was 15.8%. This group had a significantly higher total nasal symptom score, especially rhinorrhea and nasal obstruction, than subjects who showed negative results on all three methods. CONCLUSION: When diagnosing allergic rhinitis patients using the skin prick test, the wheal size method and erythema size method should be considered rather than the allergen/histamine ratio method.
Diagnosis ; Erythema ; Humans ; Hypersensitivity ; Methods* ; Nasal Obstruction ; Rhinitis, Allergic ; Skin Tests* ; Skin*

BACKGROUND AND OBJECTIVES: Hemangioma of the nasal cavity is an uncommon benign vascular tumor. This study aimed to analyze the clinical manifestations, radiologic findings, treatment modalities, and outcomes of intranasal hemangiomas. SUBJECTS AND METHOD: Retrospective reviews of the medical record were performed on 13 patients, who were treated for intranasal hemangioma from 2005 to 2014. RESULTS: Of the 13 patients identified, there were seven males and six females ranging from 11 to 80 years of age (mean age of 48.1+/-21.5). Epistaxis was the most common presenting symptom. Most common site of origin was the inferior turbinate. CT scans showed variable enhancement of the nasal mass without bony erosion. Preoperative diagnosis accuracy rate was 76.9%. The tumor was histopathologically classified as follows: capillary hemangioma (n=6, 46.1%), cavernous hemangioma (n=3, 23.1%), venous hemangioma (n=2, 15.4%), and mixed hemangioma (n=2, 15.4%). Endoscopic excisional surgery (n=11, 94.6%) and local excision (n=2, 15.4%) were performed for complete removal of the hemangioma. Preoperative selective embolization was performed on one patient. No evidence of recurrence after the surgery was observed. CONCLUSION: Intranasal hemangioma was usually found to occur in the inferior turbinate and the most common symptom was epistaxis. Capillary hemangioma was the most common type. Complete excision was recommended to prevent recurrence.
Diagnosis ; Epistaxis ; Female ; Hemangioma* ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Humans ; Male ; Medical Records ; Nasal Cavity ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Turbinates

BACKGROUND AND OBJECTIVES: We aimed to analyze the therapeutic effect of zinc, lipoprostaglandin E1 in addition to systemic steroid therapy on hearing improvement for the treatment of idiopathic sudden hearing loss. SUBJECTS AND METHOD: Retrospective medical chart reviews of 500 patients who had been diagnosed with unilateral idiopathic sudden hearing loss between May 2006 and April 2014 were performed. Then, we conducted a multiple linear regression analysis using the data of individual patients. RESULTS: Better hearing gain was associated with low tone hearing loss (p<0.001), better initial contralateral hearing (p<0.001), and the absence of dizziness (p=0.015). Patients who underwent intratympanic steroid treatment as salvage treatment showed a lower hearing gain (p<0.001). Zinc supplementation was effective for the treatment of patients with mild hearing loss (p<0.001). On the contrary, significant improvements in hearing gain were found in patients with profound hearing loss who were treated with an additional lipoprostaglandin E1 (p<0.001). CONCLUSION: An additional use of zinc and lipoprostaglandin E1 may enhance hearing improvement for the treatment of idiopathic sudden hearing loss.
Dizziness ; Hearing ; Hearing Loss ; Hearing Loss, Sudden* ; Humans ; Linear Models ; Retrospective Studies ; Zinc*

BACKGROUND AND OBJECTIVES: Epistaxis usually responds to conservative therapy such as nasal packing or electrocauterization. But sometimes more invasive techniques such as selective embolization is justified. We report our experience of 10 patients with selective endovascular embolization for refractory epistaxis. SUBJECTS AND METHOD: Ten patients were referred for selective arterial embolization for refractory epistaxis. Medical records were reviewed for clinical data, recurrence, and complication. RESULTS: Early rebleeding requiring treatment occurred in 1 patient (10%) and initial success rate of embolization was 90%. There was no major complication. Minor complications such as mild fever, groin pain, and voiding difficulty occurred in 2 patients (20%). CONCLUSION: Selective arterial embolization for refractory epistaxis is safe and effective for treatment of refractory intractable epistaxis.
Epistaxis* ; Fever ; Groin ; Humans ; Medical Records ; Nose ; Recurrence

Retrobulbar hematoma is a rare complication following septal surgery under general anesthesia. Symptoms and physical findings include temporary blindness, ophthalmoplegia, mydriasis, ptosis, proptosis and eyelid ecchymosis. Recently, we experienced a rare case of the right retrobulbar hematoma after septal surgery. At present, there is no literature about the occurrence of retrobulbar hematoma following septal surgery. We hereby present this case with an emphasis on the importance of prevention, identification and management of retrobulbar hematoma.
Anesthesia, General* ; Blindness ; Ecchymosis ; Exophthalmos ; Eyelids ; Hematoma* ; Mydriasis ; Ophthalmoplegia

BACKGROUND AND OBJECTIVES: Mucoceles usually occur as asymptomatic, dome-shaped, translucent cysts in the lower lip and oral cavity containing mucin. Mucoceles are usually associated with the minor salivary glands and are classified histologically into the extravasation type and the retention type. The objective of the present study was to establish the prevalence of these lesions according to age, gender, histologic type, and site of occurrence. SUBJECTS AND METHOD: We retrospectively reviewed the medical records from January 2008 to February 2013 pertaining to age, sex, clinical history, and other findings of 52 patients who underwent operation and confirmed as mucocele histologically. We re-evaluated all mucocele cases by an experienced pathologist. RESULTS: Of the 52 cases analyzed, 32 (61.5%) were females and 20 (38.5%) were males. Age ranged from 2 to 77 years (mean age 20.6 years), with 78.8% occurring between the ages of 0 and 30 years with peak incidences in the twenties for female patients and in the thirties for male (34%). There was a more predominance among women (61.5%). The lower lip was the site most frequently affected by the lesions (59.6%), whereas the lowest prevalence was observed for the soft palate (2%), and buccal mucosa (2%). Tongue (15.4%) and floor of mouth (21.2%) were not uncommonly affected sites. Histologically mucous extravasation type (96.2%) was more predominant than the retention type (3.8%). CONCLUSION: In this study, mucocele was found predominant in younger age groups, with the lower lip being the most frequently affected site. Histologically, the mucus extravasation type was the most common.
Female ; Humans ; Incidence ; Lip ; Male ; Medical Records ; Mouth ; Mouth Floor ; Mouth Mucosa ; Mucins ; Mucocele ; Mucus ; Palate, Soft ; Prevalence ; Ranula ; Retention (Psychology) ; Retrospective Studies ; Salivary Glands, Minor ; Tongue

BACKGROUND AND OBJECTIVES: Chronic rhinosinusitis with nasal polyps is an uncommon pathology in the pediatric population and a challenging problem to otolaryngologists. In this study, we aimed to assess the clinical characteristics and postoperative results of children who underwent sinus surgery due to nasal polyps. SUBJECTS AND METHOD: We retrospectively reviewed medical records of 45 pediatric patients who had sinus surgery from 2009 to 2012. We studied the relationship between clinical parameters and postoperative results. RESULTS: Forty-five patients (18 women and 27 men with an age range of 8 to 17 years) were treated surgically in our hospital. We found statistically significant correlation between the preoperative CT scores (p=0.043), the nasal obstruction symptom scores (p=0.032) and postoperative recurrence, but not between other parameters. CONCLUSION: In this study, prognostic factors affecting the postoperative outcome were preoperative CT score and nasal obstruction symptom score.
Child ; Endoscopy ; Female ; Humans ; Male ; Medical Records ; Nasal Obstruction ; Nasal Polyps ; Pediatrics ; Polyps* ; Prognosis ; Recurrence ; Retrospective Studies ; Sinusitis

With an increasing proportion of the elderly, dementia due to severe cerebral white matter change is frequently observed. Because these patients cannot express their symptoms effectively, the recognition of stroke can be delayed. In addition, clinical characteristics of their stroke might be different. We reported on three patients with severe leukoaraiosis, who exhibited altered consciousness after acute lacunar infarction in the corona radiata. This clinico-radiological discrepancy may have resulted from different susceptibility to ischemia in patients with severe white matter change.
Aged ; Cerebral Infarction ; Consciousness ; Dementia ; Dementia, Vascular ; Humans ; Ischemia ; Leukoaraiosis ; Stroke ; Stroke, Lacunar