Yang-Gi Min

Correlation between nasal obstruction symptoms and objective parameters of acoustic rhinometry and rhinomanometry

Acoustic rhinometry and rhinomanometry have been used to assess nasal airway patency objectively. We compared nasal obstruction symptoms before and after decongestion with several parameters of these objective tests. The patients assessed their nasal obstruction using a visual analogue scale (VAS). Cross-sectional areas and nasal resistance were measured by acoustic rhinometry and rhinomanometry before and after topical application of 1% phenylephrine solution in 32 patients with nasal obstruction symptoms. There was no significant correlation between the difference in the VAS and the difference in nasal resistance. There was also no significant correlation between the difference in the VAS and minimal cross-sectional area and cross-sectional areas at 3.3 cm (CA3.3), CA4.0 and CA6.4 from the nosepiece both in the wide and narrow sides and in both nasal cavities before and after nasal decongestion. It is concluded that rhinomanometry and acoustic rhinometry may have no diagnostic value in estimating the severity of nasal obstruction symptoms.

Histological and immunological features of non-eosinophilic nasal polyps

Objective The aim of this study was to investigate the his-toimmunological features of non-eosinophilic nasal polyps (NPs). METHODS Thirty patients with chronic rhinosinusitis and NPs were included in this study. NPs were grouped into eosinophilic and non-eosinophilic types according to the amount of eosinophils in the NPs. The amount of serum total IgE and peripheral blood eosinophils were measured. Basement membrane (BM) thickness was measured, along with the expression of chemokine receptor 5 (CCR5) and chemokine receptor 3 (CCR3) in NP lymphocytes. RESULTS Non-eosinophilic NPs comprised 66.7% of the total NPs included in this study. The amount of eosinophils in NPs was related to eosinophilia of the peripheral blood, but not to elevated serum IgE. BM was significantly thinner in non-eosinophilic than in eosinophilic NPs. Lymphocytes expressing CCR5 or CCR3 were less frequently found in non-eosinophilic than in eosinophilic NPs. CONCLUSION Histoimmunological characteristics of non-eo-sinophilic NPs differ from those of eosinophilic NPs; non-eosino-philic NPs may be featured by thinner BM and fewer CCR5- and CCR3-positive lymphocytes.

Changes of Nasal Function After Temperature-Controlled Radiofrequency Tissue Volume Reduction for the Turbinate

Objectives Temperature‐controlled and temper‐ature‐monitored radiofrequency tissue volume reduction (RFTVR) for the turbinate is a new treatment modality for nasal obstruction secondary to turbinate hypertrophy. We compared the nasal functions after the treatment of RFTVR and laser vaporizing turbinoplasty (LVT) using subjective symptom scores and objective tests.

Measurements of cross-sectional area of the nasal cavity by acoustic rhinometry and CT scanning

The authors aimed to evaluate the validity and characteristics of acoustic rhinometric tests by comparing the results with those of computed tomography (CT) of the nasal cavity. Cross‐sectional areas along the nasal cavity were measured by acoustic rhinometry (AR) and CT of the nasal cavity in 30 normal subjects.

Histologic Structure of Antrochoanal Polyps

The antrochonanal polyp (ACP) is defined as a maxillary sinus polyp that originates in the maxillary sinus, passes through the sinus ostia, and extends into the choana. The aim of this study was to compare the histologic findings of 40 cases of ACP with those of allergic and non-allergic nasal polyps, and so possibly to elucidate the pathogenesis of ACP. No allergy could be verified in any of the ACP patients. Inflammatory cell infiltration was significantly more severe in the ACP group than in the allergic polyp group. Eosinophilic infiltration was significantly less severe in the ACP group than in the allergic polyp group. Edema was not significantly different between the ACP, allergic, and non-allergic groups. In the ACP group, the presence of submucous glands was significantly less pronounced than in the ordinary nasal polyp groups. The fibrous type was present significantly more often than the infiltrative or granulating type in the ACP group. The histologic findings and clinical features of the ACP indicate that it has little causal relationship with nasal allergy but is all the more intimately associated with inflammatory processes. The paucity of submucous glands suggests that the ACP results from edematous hypertrophy of the respiratory epithelium rather than from distension of the glandular structures.

Adenoid Cystic Carcinoma of the Sinonasal Tract: Treatment Results

Objectives: Malignancies arising from the sinonasal tract, which includes the nose, paranasal sinuses, and nasopharynx, are uncommon. Although adenoid cystic carcinoma (ACC) is the second most common cancer occurring in the sinonasal tract, only few studies have been reported. This retrospective review was performed to identify the clinical features and treatment outcomes of sinonasal ACC.

Cytokine gene expression in nasal polyps

Nasal polyps are the most common mass lesion of the nasal cavity. Various pathogenetic mechanisms have been proposed. However, the cause is still largely unknown, and treatment methods have not been changed for several hundred years. In order to investigate the role of cytokines in the pathogenesis of nasal polyps, expression of cytokine messenger RNAs (mRNAs) in nasal polyps was investigated. We performed reverse transcriptase-polymerase chain reaction and Southern blot to examine gene expression of the cytokines interleukin (IL)-1ß, IL-6, IL-8, transforming growth factor (TGF)-ß, IL-4, IL-5, and interferon (IFN)-Γ and compared the results with the gene expressions of these cytokines in normal nasal mucosa. Nasal polyp tissues were obtained from 14 patients undergoing polypectomy for nasal obstruction. Among them, 4 patients suffered from associated perennial allergic rhinitis. The mRNAs of IL-4 and IL-5 (Th2 cytokines) as well as IFN-γ (Thl cytokine) were expressed in all of the nasal polyps obtained from the 14 patients, irrespective of the presence or absence of allergy, while 2, 0, and 4 of 6 normal turbinate mucosae expressed IL-4, IL-5, and IFN-γ mRNAs, respectively. The mRNAs of IL-1ß, IL-6, IL-8, and TGF-ß were expressed in 6, 1, 2, and 3 of 6 normal turbinate mucosae, respectively, while the mRNAs of these cytokines were expressed in all of the 14 polyp tissues except IL-6 mRNA, which was expressed in 13 nasal polyp tissues. There were no differences in the mean density ratios of each cytokine band on Southern blot between polyp tissues with allergy and those without allergy. These results suggest that many cytokines are produced in nasal polyps, that they may play important roles in the pathogenesis of nasal polyps, and that allergy per se may not play a fundamental role in the pathogenesis of nasal polyps.

Prevalence and risk factors of chronic sinusitis in Korea: results of a nationwide survey

From July through October 1991, a nationwide survey was conducted on the prevalence and risk factors of chronic sinusitis in Korea, using medical and family histories as well as physical examination. In all, 9,069 subjects were examined from 2,899 households residing in 60 different areas throughout the country. The overall prevalence of sinusitis was 1.01%. Case-control analysis was performed to determine possible risk factors for sinusitis. No significant differences were found in age groups or sexes. A significant geographic difference was seen in prevalence in the different provinces studied. Economic activity, crowding and allergy were significant risk factors. Other factors such as urban or rural residence, birth place, maternal and paternal age at birth, marriage, smoking history, education, social class, prior trauma, height and weight, and nasal septal deformities did not correlate with the occurrence of sinusitis.

Hypoxia-inducible Factor 1 Mediates Nasal Polypogenesis by Inducing Epithelial-to-Mesenchymal Transition

RATIONALE Nasal polyposis implies a refractory clinical course in case of chronic rhinosinusitis (CRS). Although hypoxia is believed to be associated with nasal polyposis, little is known about the mechanism underlying polypogenesis. OBJECTIVES To determine if hypoxia drives nasal polyposis by epithelial-to-mesenchymal transition (EMT). METHODS Immunoblotting, immunofluorescence, flow cytometry, and real-time polymerase chain reaction were performed to evaluate EMT and hypoxic markers in human nasal epithelial cells (hNECs) and in sinonasal tissues from patients with CRS with or without polyps. In addition, the effects of hypoxia-inducible factor (HIF)-1α inhibitors on nasal polypogenesis were investigated in a murine model. MEASUREMENTS AND MAIN RESULTS E-cadherin and α-smooth muscle actin (α-SMA) were down-regulated and up-regulated, respectively, in patients with polyps as compared with patients without polyps. Under hypoxia, hNECs transformed to a mesenchymal shape, and demonstrated representative changes in EMT markers; that is, mesenchymal markers (α-SMA, vimentin, and twist) increased but epithelial markers (E-cadherin and β-catenin) decreased. Mechanistically, E-cadherin level was recovered in hypoxia by silencing HIF-1α and decreased in normoxia by expressing HIF-1α. Furthermore, hypoxia was found to down-regulate PP2Ac phosphatase and up-regulate pSmad3, which led to α-SMA induction. In CRS sinonasal specimens, HIF-1α expression was found to correlate with E-cadherin loss and α-SMA expression. Finally, HIF-1α inhibitors suppressed nasal polypogenesis in a murine model. CONCLUSIONS hNECs undergo EMT during hypoxia and this process is critically mediated by HIF-1α and pSmad3. This study shows that hypoxia-induced EMT is likely to contribute to nasal polyposis in CRS, and suggests that HIF-1α be viewed as a therapeutic target for nasal polyposis.

Bronchial hyperresponsiveness in young children with allergic rhinitis and its risk factors

Background:  Subjects with allergic rhinitis but no clinical evidence of asthma have greater bronchial hyperresponsiveness (BHR), and several factors have been implicated as its determinants. However, studies in young children are lacking. The aims of this study were to evaluate the prevalence of BHR in young children with allergic rhinitis and to investigate its risk factors.