BACKGROUND AND OBJECTIVES: The main treatment modality of sinonasal benign tumor is surgical resection, and the endoscopic intranasal approach has been commonly performed since the 1990s. The objective of this study was to evaluate the recurrence rates of different sinonasal benign tumors and to analyze the diverse approaches used in their surgical treatment. SUBJECTS AND METHOD: In 270 patients who were histopathologically diagnosed with sinonasal benign tumor during a period of 20 years, histopathologic type, treatment approach, interval between first treatment and recurrence, and recurrence rate according to treatment approach were analyzed. RESULTS: Recurrence rate was higher with the intranasal approach than with the extranasal approach in inverted papilloma and angiofibroma, but the differences were not statistically significant. The proportion of the intranasal approach during the latter 10 years was higher than that during the former 10 years. There was no significant differences between the recurrence rate during the former 10 years and that during the latter 10 years for both intranasal and extranasal approaches. CONCLUSION: Based on tumor location and stage and skill of the surgeon, the intranasal approach can replace the extranasal approach with no major changes in treatment outcome.
Angiofibroma ; Humans ; Methods ; Nasal Cavity ; Nose Neoplasms ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; Paranasal Sinuses ; Recurrence ; Treatment Outcome

PURPOSE: Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA. MATERIALS AND METHODS: Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed. RESULTS: Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA. CONCLUSION: The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.
Adult ; Aged ; Body Mass Index ; Female ; Humans ; Hypertension/complications/*epidemiology ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Sleep Apnea, Obstructive/complications/*epidemiology ; Waist Circumference

PURPOSE: Obstructive sleep apnea (OSA) is considered an independent risk factor for hypertension. However, it is still not clear which clinical factors are related with the presence of hypertension in OSA patients. We aimed to find different physical features and compare the sleep study results which are associated with the occurrence of hypertension in OSA patients. MATERIALS AND METHODS: Medical records were retrospectively reviewed for patients diagnosed with OSA at Severance Cardiovascular Hospital between 2010 and 2013. Males with moderate to severe OSA patients were enrolled in this study. Clinical and polysomnographic features were evaluated to assess clinical variables that are significantly associated with hypertension by statistical analysis. RESULTS: Among men with moderate to severe OSA, age was negatively correlated with hypertension (odds ratio=0.956), while neck circumference was positively correlated with the presence of hypertension (odds ratio=1.363). Among the polysomnographic results, the lowest O2 saturation during sleep was significantly associated with the presence of hypertension (odds ratio=0.900). CONCLUSION: Age and neck circumference should be considered as clinically significant features, and the lowest blood O2 saturation during sleep should be emphasized in predicting the coexistence or development of hypertension in OSA patients.
Age Factors ; Body Mass Index ; Female ; Humans ; Hypertension/*complications ; Male ; Neck/*anatomy & histology ; Odds Ratio ; Oxygen/*blood ; Retrospective Studies ; Risk Factors ; Sex Factors ; Sleep Apnea, Obstructive/*complications/diagnosis ; Waist Circumference

BACKGROUND AND OBJECTIVES: Allergy is a chronic disorder with undesirable consequences on the quality of life (QoL). The first aim of this study is to evaluate the impact of allergy on the QoL and to show the correlation between symptoms and categories of the QoL. The second purpose is to determine whether treatment with levocetirizine improves the QoL among allergic rhinitis patients. MATERIALS AND METHODS: A total of 412 allergic patients answered the questionnaire and its sensitivity was checked to validate its usefulness in asthma and allergic rhinitis patients. To evaluate the effect of applying levocetirizine for 1 month on the QoL among allergic rhinitis patients, a total of 94 subjects were assessed with the questionnaire and analyzed (paired t-test). To evaluate its effect on the symptoms of allergic rhinitis for the duration of 2 and 4 weeks, a total of 100 subjects were analyzed (repeated ANOVA) with the symptom questionnaire. RESULTS: Besides the physical symptoms, patients suffered from activity restriction, emotional problems, difficulty in being examined, and dissatisfaction with health status. The correlation between the questionnaire and the QoL was statistically significant. After treatment, the QoL and symptoms, except nasal congestion, were significantly improved. CONCLUSION: The questionnaire can be beneficial in assessing the QoL among allergic patients. Treatment with levocetirizine provides improvement in the QoL and lowers the symptoms score among allergic rhinitis patients.
Asthma ; Estrogens, Conjugated (USP) ; Humans ; Hypersensitivity ; Quality of Life* ; Rhinitis* ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Lysozyme, a major serous component of airway epithelial secretions, plays an important role in airway defense. However, little is understood about the regulation of its expression and the associated signaling pathway. The object of this study is to investigate the regulation of lysozyme expression, the downstream signaling pathway of lysozyme expression, and the related protein kinases under inflammatory conditions using the IL-1beta, which acts as a significant cytokine in many airway inflammations. MATERIALS AND METHODS: After the IL-1beta treatment of normal human nasal epithelial cells (NHNE), lysozyme mRNA expression was determined by RT-PCR. Expressed levels of ERK/p38 kinase were determined by Western blot analysis. RESULTS: IL-1beta treated NHNEcells had over-expressed lysozyme compared to the control group. Activated ERK/p38 kinase level showed marked increment by treating NHNE with IL-1beta. Lysozyme expression and ERK/p38 kinase levels decreased when inhibitors of ERK/p38 MAP kinases were added to the IL-1beta treated cells. Finally, expression of lysozyme and activated level of ERK/p38 MAP kinases decreased in a dominant-negative cell line even when treated with IL-1beta. CONCLUSION: From these results, we concluded that IL-1beta induces over-expression of lysozyme via ERK/p38 MAP kinase signaling pathways in airway epithelial cells.
Blotting, Western ; Cell Line ; Epithelial Cells* ; Humans* ; Inflammation ; MAP Kinase Signaling System ; Muramidase* ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Protein Kinases* ; RNA, Messenger

Major orbital complications after the endoscopic sinus surgeries are rare and of these, optic nerve injury is one of the most serious. This study was to undertaken to analyze 3 cases of optic nerve injury after endoscopic sinus surgery. The three cases included one patient with a loss of visual acuity and visual field defect, and two patients with total blindness. In all cases, no improvement of visual acuity was observed despite treatment. It is important to frequently check the location and direction of the endoscope during surgery to avoid optic nerve injury. In addition, surgeons must have a precise knowledge of the detailed anatomy through cadaver dissections, an ability to interpret the PNS CT scan and experienced procedural surgical skills.
Adult ; Blindness/etiology ; Endoscopy/*adverse effects ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Optic Nerve Injuries/diagnosis/*etiology/radiography ; Paranasal Sinuses/*surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Vision Disorders/etiology ; Visual Acuity ; Visual Fields

BACKGROUND AND OBJECTIVES: 15-lipoxygenase-1 (15-LO-1) is involved in the differentiation of human tracheobronchial epithelial cells. Here we investigated the relation between 15-LO-1 expression and the differentiation of normal human nasal epithelial (NHNE) cells. MATERIALS AND METHODS: NHNE cells, RT-PCR, Western blot analysis, and scanning electron microscopy (SEM) were used. RESULTS: In retinoic acid (RA)-sufficient culture media, 15-LO-1 expression in NHNE cells increased time-dependently, but its expression was undetectable in RA-deficient culture media. Moreover, in RA-deficient culture media, IL-4 time-dependently induced 15-LO-1 expression at a concentration of 1 ng/mL. In addition, MUC8 gene expression, a marker of mucociliary differentiation, was up-regulated by 15-LO-1, which was itself induced by IL-4. In SEM, the ciliated epithelium was observed with the treatment of IL-4. CONCLUSION: Our findings suggest that 15-LO-1 may be related to the differentiation of human nasal epithelium, and that it may mediate the mucociliary differentiation of NHNE cells.
Blotting, Western ; Cell Differentiation ; Cilia ; Culture Media ; Epithelial Cells* ; Epithelium ; Gene Expression ; Humans* ; Interleukin-4 ; Microscopy, Electron, Scanning ; Nasal Mucosa ; Tretinoin

BACKGROUND AND OBJECTIVES: In oral cavity cancer (OCC) cells, the effects of interleukin-4 (IL-4) are various according to the cell specificity. However, if IL-4 induces apoptosis on OCC cells, the mediator of this apoptosis is uncertain. Therefore, we investigated whether apoptosis of OCC cells occurs by IL-4 and whether 15-lipoxygenase-1 (15-LO-1) induced by IL-4 is the possible mediator of this apoptosis. MATERIALS AND METHODS: SCC 1483 cells were used. Flow cytometry and poly ADP-ribose polymerase cleavage were used to examine apoptosis. Western blot analysis and reverse transcription-polymerase chain reaction were used to measure 15-LO-1 protein and mRNA. RESULTS: The inhibition of cell proliferation by more than 50% was noted from 10 ng/ml of IL-4. At this dose, apoptosis was observed and this apoptosis was inhibited by 2.2 microM caffeic acid. 15-LO-1 expression was observed from the 8 hour treatment of IL-4 and apoptosis increased after the 24 hour treatment of IL-4. In this apoptosis, caspase cascade, cyclooxygenase-2, and non-steroidal anti-inflammatory drugs-activated gene-1 (NAG-1) were not involved. CONCLUSION: IL-4 induced apoptosis in SCC 1483 OCC cells and 15-LO-1 induced by IL-4 may mediate this apoptotic pathway.
Adenosine Diphosphate Ribose ; Apoptosis* ; Arachidonate 15-Lipoxygenase ; Blotting, Western ; Cell Proliferation ; Cyclooxygenase 2 ; Flow Cytometry ; Interleukin-4* ; Mouth Neoplasms ; Mouth* ; RNA, Messenger ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Extracellular purines and pyrimidines regulate various physiological responses via cell surface receptors known as purinoreceptors, and may exert autocrine or paracrine effects on ion transport, fluid transport, ciliary beat frequency and mucin secretion. This study aims to investigate the expression patterns of such purinoreceptors found in normal human nasal epithelial (NHNE) cells. MATERIALS AND METHOD: In RT-PCR, the mRNAs for several P2X (P2X3, P2X4, P2X7) and P2Y (P2Y1, P2Y2, P2Y4, P2Y6, P2Y11, P2Y12) receptors were identified in NHNE cells. Functional localizations of P2 receptors were investigated by measuring [Ca2+]i increases in a membrane-specific manner using a double-perfusion chamber. Absence of the responses of -Me ATP and 2MeS-ATP excluded functionally active P2X3, P2X4, and P2Y1 receptors as far as [Ca2+]i increase was concerned. RESULTS: Applications with ATP and UTP revealed that luminal membranes of NHNE cells express P2Y2 and P2Y6 receptors and basolateral membranes P2Y2 receptors. Expressions of P2Y2 and P2Y6 receptors in NHNE cells were further verified by the immunoblotting using specific antibodies. In addition, the results with BzATP indicated that the P2Y11 receptor may be present on the luminal side. CONCLUSION: The NHNE cells express functionally active P2Y2, P2Y6 and P2Y11 receptors in a membrane-specific pattern, which may play an important role in the control of mucin and fluid secretion in NHNE cells.
Adenosine Triphosphate ; Antibodies ; Calcium ; Epithelial Cells* ; Humans* ; Immunoblotting ; Ion Transport ; Membranes ; Mucins ; Nasal Mucosa ; Phenobarbital ; Purines ; Pyrimidines ; Receptors, Cell Surface ; Receptors, Purinergic P2Y1 ; Receptors, Purinergic P2Y2 ; Receptors, Purinergic* ; RNA, Messenger ; Uridine Triphosphate

BACKGROUND AND OBJECTIVES: To examine the MUC8 mRNA expression patterns according to the mucociliary differentiation of the normal human nasal epithelial (NHNE) cells, and to investigate the localization of the MUC8 proteins in the nasal polyps. MATERIALS AND METHODS: The passage-2 NHNE cells were cultured using an air-liquid interface technique and nasal polyp specimens. On the 2, 7, 14, and 28 days after confluence, the ciliated cells were counted using cytospin slide immunostaining using H6C5 and beta-tubulin, and the MUC8 mRNA levels were determined using real-time quantitative PCR. After synthesizing the polyclonal anti-MUC8 peptide antibodies, MUC8 immunostaining was preformed using the nasal polyps. The MUC8 mRNA and protein levels were determined with the NHNE cells treated with IL-1beta (10 ng/ml for 24 hours) using RT-PCR and Western blot analysis. RESULTS: The increasing pattern of the number of ciliated cells as well as the MUC8 gene expression level with increasing culture time in the NHNE cells was quite similar. MUC8 was expressed in the ciliated cells of the human nasal polyps. The MUC8 protein level as well as the mRNA level was up-regulated as a result of the IL-1beta treatment. CONCLUSIONS: This study indicates that the MUC8 protein is expressed in ciliated cells from the human nasal epithelial cells and is up-regulated by the IL-1beta treatment. These results suggest that the MUC8 gene and protein expression levels might be used as a ciliated cell marker in the human nasal epithelium.
Antibodies ; Blotting, Western ; Epithelial Cells ; Gene Expression ; Humans* ; Nasal Mucosa* ; Nasal Polyps ; Polymerase Chain Reaction ; RNA, Messenger ; Tubulin