Soon Jae Hwang

Korea University, Seoul, Seoul, United States

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Publications (32)48.21 Total impact

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    ABSTRACT: The head shake sensory organization test (HS-SOT) is an expansion of the sensory organization test (SOT), which evaluates impairment of the patient's ability to apply vestibular input while actively moving the head. HS-SOTs has been proposed to increase the sensitivity of SOTs. The purpose of this study was to investigate the value of HS-SOTs in a healthy population with respect to age and compare the sensitivity of HS-SOTs with that of SOTs in the elderly population. One hundred two (n = 102) healthy subjects were divided into 3 age groups: the young adult group (between 20 and 39 yr), the adult group (between 40 and 59 yr), and the elderly group (between 60 and 79 yr). The subjects underwent SOTs and HS-SOTs. The equilibrium scores of HS-SOTs underwent more significant change than those of SOTs in the elderly group. The equilibrium score ratio SOT2/HS-SOT2 (HS-SOT during SOT condition 2) decreased by 4% more in the elderly group compared with that of the young adult group. The ratio of SOT5/HS-SOT5 decreased by 54% more in the elderly group compared with that of the young adult group. In the elderly, equilibrium scores of HS-SOTs changed more than those of SOTs. In addition, SOT5/HS-SOT5 demonstrated more sensitive changes in the elderly than SOT2/HS-SOT2 did.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 11/2011; 33(1):67-71. · 1.44 Impact Factor
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    ABSTRACT: Objectives The cell cycle must be involved in cell proliferation of the epithelium of middle ear cholesteatoma. Cyclins and cyclin-dependent kinase (CDK) complexes have important regulatory roles during cell cycle progression. Cyclin-CDK complexes are in turn regulated by the cyclin-dependent kinase inhibitors (CDKIs), which generally inhibit cell cycle progression. One of the important CDKI members is p27Kip1. The goal of this study is to evaluate the expression of p27Kip1 and Ki-67, a proliferation marker, in cholesteatoma and in the skin of the external ear canal.Methods The expressions of p27Kip1 and Ki-67 in cholesteatoma epithelium (n = 20) and ear canal epithelium (n = 7) were investigated by an immunohistochemical technique.Results In cholesteatoma epithelium specimens, the expression of p27Kip1 was observed from the parabasal layer to the granular layer, but not in the basal layer. Ki-67 was expressed dominantly in the basal and parabasal cell layers. Their expressions tend to be increased compared with their expressions in the normal ear canal skin. The expression pattern of the proliferation marker Ki-67 in the epithelial layers of two groups was inversely related to the expression of p27Kip1.Conclusions In cholesteatoma, the expressions of CDKI and Ki-67 were both increased in this study. The ability to inhibit proliferative activity was also increased in the cholesteatoma epithelium. The expression pattern of the proliferation marker Ki-67 in the epithelial layers was inversely related to the expression of p27Kip1. Not only is the proliferation activity increased, but also the ability to inhibit hyperproliferation is increased in the cholesteatoma epidermis. Despite increased proliferative activity in the cholesteatoma epidermis, epithelial cells still retain the capability to prevent cell cycle arrest by means of p27Kip1.
    The Laryngoscope 01/2009; 110(11):1898 - 1901. · 1.98 Impact Factor
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    ABSTRACT: To investigate the expression of messenger RNA (mRNA) of the gene for pigment epithelium-derived factor (PEDF) (OMIM *172860) and PEDF protein and to localize the PEDF protein in the nasal mucosa of patients with allergic rhinitis and of control subjects. Investigation of PEDF mRNA and PEDF protein expression in the nasal mucosa using reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemical staining. We used inferior turbinate mucosal samples from 10 patients with allergic rhinitis and 10 matched healthy control subjects. We extracted PEDF mRNA from the inferior turbinate mucosa samples and performed reverse transcription-polymerase chain reaction analysis. We used Western blotting to analyze differences in expression levels of PEDF protein between patients with allergic rhinitis and healthy controls, and the PEDF protein was localized immunohistochemically. The expression levels of PEDF mRNA and PEDF protein in the nasal mucosa were significantly increased in patients with allergic rhinitis compared with those in nonallergic controls. The PEDF protein was expressed in the epithelium and submucosal glands. We found that PEDF protein is expressed in the human nasal mucosa, and its expression is increased in allergic rhinitis. These results suggest a possible contribution of PEDF to the chronic inflammation of the nasal mucosa in allergic rhinitis.
    Archives of otolaryngology--head & neck surgery 11/2008; 134(10):1094-8. · 1.92 Impact Factor
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    ABSTRACT: To investigate the epidemiologic and microbiological characteristics of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infections in the otorrhea of chronic suppurative otitis media (COM) patients. Retrospective study of patients with newly identified MRSA infections from January 1998 through December 2006. A total of 2773 patients with a diagnosis of COM were included in this study. An antibiotic sensitivity test was performed for each isolate. The prevalence of MRSA in COM was 4.9 percent (137 of 2773 patients). The proportion of CA-MRSA rose from 0.7 percent in 1998 to 11.4 percent in 2006. However, the proportion of HA-MRSA did not change significantly, from 0.7 percent in 1999 to 1.3 percent in 2006. All of the CA-MRSA strains identified in our study were susceptible to trimethoprim/sulfamethoxazole (TMP/SMX). Rifampin susceptibility was also noted in 90 percent of the cases. CA-MRSA infections have risen dramatically in the past decade. CA-MRSA and HA-MRSA in COM differed in both clinical and microbiological aspects.
    Otolaryngology Head and Neck Surgery 10/2008; 139(3):395-8. · 1.73 Impact Factor
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    ABSTRACT: We compared the patterns of PAR-2 messenger RNA (mRNA) and protein expression in the nasal mucosa of subjects with and without allergic rhinitis. Biopsy specimens were obtained from 10 patients with allergic rhinitis and 10 normal controls. RNA was extracted from the nasal mucosa, and semiquantitative reverse transcription-polymerase chain reaction was performed for PAR-2. Tissue sections were immunostained for PAR-2 by use of specific antibody. The expression levels of PAR-2 mRNA in allergic rhinitis nasal mucosa were significantly up-regulated as compared with those in normal nasal mucosa. PAR-2 immunoreactivity was observed in the epithelium and submucosal glands in both normal controls and subjects with allergic rhinitis. Stronger immunoreactivity for PAR-2 was observed in allergic rhinitis nasal mucosa as compared with normal nasal mucosa. These results suggest that PAR-2 may be involved in allergic nasal inflammation.
    The Annals of otology, rhinology, and laryngology 08/2007; 116(7):554-8. · 1.21 Impact Factor
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    ABSTRACT: Recently, a selective COX-2 inhibitor was developed and used for reducing the levels of inflammation-inducing prostaglandin (PG) whilst not inhibiting the release of protective PG by COX-1. COX-1 may be the critical isoform required for the production of PG with a homeostatic function, whereas COX-2 may be the main contributor to PG production in inflammation. The purpose of this study was to investigate COX-1 and 2 expressions in experimental endotoxin-induced OME in rats and to quantify their temporal expressions. In a rat model, lipopolysaccharides (LPS) were inoculated into the middle ear cavity. Middle ear mucosa and temporal bone were samples at 0, 1, 3, 6, and 12h, and on days 1, 3 and 7 after instilling either LPS or sterile PBS. RT-PCR, Western blotting and immunohistochemical staining were performed to determine the expressions of COX-1 and COX-2. COX-1 mRNA and protein were detected in normal middle ear mucosa but their levels did not change after endotoxin instillation. However, COX-2 was not identified in normal middle ear mucosa, but COX-2 mRNA was maximally increased at 6h after endotoxin instillation and COX-2 protein was maximally increased at 12h. COX-2 expression, by immunohistochemical staining, was identified only at 12h after endotoxin injection. In this study, the basal expressions of COX-1 and COX-2 mRNA and protein in middle ear mucosa, as well as their regulations by endotoxin were investigated. COX-1 was not induced in middle ear mucosa by endotoxin whereas COX-2 was induced within 12h of stimulation. Our findings indicate that COX-2 inhibitor administration for the relief of inflammation should be considered within 12h of the initiation of an inflammatory process. These findings may provide an understanding of the mechanisms regulating PG formation in infection of the middle ear cavity.
    International Journal of Pediatric Otorhinolaryngology 02/2007; 71(1):101-6. · 1.35 Impact Factor
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    ABSTRACT: Congenital anomalies of the nasal septum besides septal deviation are very rare, and few cases of congenital defect of the vomer have been reported. We present a case of a 13-year-old boy who had a defect in the posteroinferior aspect of the nasal septum that was discovered incidentally during diagnostic work-up for chronic sinusitis. The patient had no history of maxillofacial trauma, drug abuse and had not previously undergone nasal surgery or cautery for epistaxis, and showed no evidence of systemic inflammatory disease. Based on the patient's history and laboratory findings, the septal defect is thought to be due to a congenital defect of the vomer bone.
    International Journal of Pediatric Otorhinolaryngology Extra 01/2007; 2(1):17-19.
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    ABSTRACT: To investigate the expression of peroxisome proliferator-activated receptor gamma (PPAR-gamma) messenger RNA and protein and to localize the PPAR-gamma protein in the nasal mucosa of patients with allergic rhinitis and control subjects. Prospective study. Tertiary academic institution. Patients Twenty patients with perennial allergic rhinitis and 20 matched nonallergic patients. Inferior turbinate mucosa samples were obtained from 20 patients with perennial allergic rhinitis and 20 matched nonallegic patients. Peroxisome proliferator-activated receptor gamma messenger RNA was extracted from the inferior turbinate mucosae, and then reverse transcription-polymerase chain reaction was performed. Western blot testing was used to analyze differences in PPAR-gamma protein expression levels between patients with allergic rhinitis and normal controls, and the PPAR-gamma protein was localized immunohistochemically. The expression levels of PPAR-gamma messenger RNA and protein in the nasal mucosa was significantly increased in patients with perennial allergic rhinitis compared with controls. Peroxisome proliferator-activated receptor gamma protein was expressed in the epithelium, infiltrating inflammatory cells, and submucosal glands. Peroxisome proliferator-activated receptor gamma is expressed in the human nasal mucosa and is up-regulated in perennial allergic rhinitis. These results suggest a possible contribution for PPAR-gamma in chronic inflammation of the nasal mucosa in perennial allergic rhinitis.
    Archives of Otolaryngology - Head and Neck Surgery 12/2006; 132(11):1196-200. · 1.78 Impact Factor
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    ABSTRACT: Allergic diseases have strong genetic backgrounds. Recently, a C-T polymorphism in the promoter region of CD14 has been associated with phenotypes of atopy in some populations. The aim of this study was to investigate the association of CD14/-159 polymorphism with total serum IgE levels and number of positive skin prick tests in Korean population with perennial allergic rhinitis. Prospective study. Deoxyribonucleic acid obtained from 164 children with perennial allergic rhinitis and 160 healthy controls were typed for the promoter polymorphism of CD14 gene at position -159 by restriction fragment length polymorphism analysis. Genotype frequencies, total serum IgE levels, and the number of positive skin tests for each genotype were compared. There were no significant differences in the CD14/-159 genotype frequencies between the allergic rhinitis group and the control group. In the skin prick test-positive population, the CC homozygotes were associated with higher serum total IgE levels and greater number of positive skin tests compared with subjects with CT and TT alleles (P<0.05). The results from the present study suggest that CD14/-159 polymorphism may play a role in the development of perennial allergic rhinitis in Korean children.
    International Journal of Pediatric Otorhinolaryngology 12/2006; 70(12):2081-5. · 1.35 Impact Factor
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    ABSTRACT: To evaluate the effectiveness of sucralfate in influencing throat pain, otalgia, analgesic requirement, bleeding, mucosal recovery, and incidence of postoperative bleeding in patients undergoing uvulopalatopharyngoplasty. A prospective double-blind randomized study. University-affiliated tertiary referral hospital. Eighty adult patients with obstructive sleep apnea syndrome requiring uvulopalatopharyngoplasty were recruited and randomly allocated into either a sucralfate treatment group or a control group. All patients underwent uvulopalatopharyngoplasty. Patients enrolled in the sucralfate group (n=40) were instructed to gargle the sucralfate suspension and then to swallow. Patients enrolled in the control group (n=40) were instructed to gargle placebo suspension at the same doses and schedule. Postoperative throat pain, otalgia, amount of analgesic required, degree of strength (defined as patients' general well-being and return to regular daily activities), percentage of mucosal covering, and postoperative bleeding. Throat pain and otalgia occurred significantly less often in sucralfate group, with less analgesic requirement and with rapid mucosal healing and early return to regular daily activities. There was no significant difference in episodes of postoperative bleeding between the 2 groups (P=.37). Although sucralfate therapy may not provide complete analgesia after uvulopalatopharyngoplasty, it may reduce the amount of analgesic required, thus preventing dose-related adverse effects from the analgesic agent. It can also significantly reduce the total number of days needed to return to normal daily activities (P=.41).
    Archives of Otolaryngology - Head and Neck Surgery 11/2006; 132(10):1082-5. · 1.78 Impact Factor
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    ABSTRACT: Allergic rhinitis is a chronic inflammatory disease with a genetic background, and IL-18 (formerly IFN-gamma-inducing factor) is a well-known pro-inflammatory cytokine. The aim of this study was to investigate whether the IL-18/-607 promoter polymorphisms were associated with allergic rhinitis in the Korean population. Prospective study. Deoxyribonucleic acid was obtained from the blood samples of 160 Korean children with allergic rhinitis and from 166 healthy controls. The IL-18/-607 polymorphism was analyzed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis. The frequency of the AC genotype of the IL-18/-607 gene polymorphism was significantly greater in allergic rhinitis patients than in controls (P<0.05). The A allele in the IL-18/-607 gene promoter region may be involved in the development of allergic rhinitis in the Korean population.
    International Journal of Pediatric Otorhinolaryngology 06/2006; 70(6):1085-8. · 1.35 Impact Factor
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    ABSTRACT: To investigate the up-regulation of chemokine ligand 20 (CCL20) in chronic rhinosinusitis mucosa and to localize the distribution of CCL20 in the human paranasal sinus mucosa. Prospective study. Tertiary academic institution. Ten patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis without nasal polyps and 10 normal control subjects. Messenger RNA was extracted from the sinus mucosa, and semiquantitative reverse transcriptase-polymerase chain reaction was performed. Immunohistochemical staining was used to localize the CCL20 protein. The expression levels of CCL20 messenger RNA level in chronic rhinosinusitis without nasal polyps were significantly increased compared with those in normal sinus mucosa. The expression of CCL20 protein was greater in chronic rhinosinusitis without nasal polyps mucosa and was localized to the epithelial and submucosal glandular cells. CCL20 is an inducible product of human paranasal sinus epithelium that may play a role in modulating mucosal immunity of the sinus mucosa.
    Archives of Otolaryngology - Head and Neck Surgery 06/2006; 132(5):537-41. · 1.78 Impact Factor
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    ABSTRACT: Epithelial cells can be called the first line of a defense barrier to microorganisms by the innate immune system. The antimicrobial peptides are the major participants of this system. Cathelicidins are a family of peptides thought to provide an innate defensive barrier against a variety of potential microbial pathogens. To evaluate the expression of the cathelicidin in recurrent throat infection. Reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical staining were performed for 10 palatine tonsil tissues with hypertrophy and 10 palatine tonsil tissues with recurrent throat infection. Cathelicidin mRNA transcripts were detected in recurrent throat infection. The expression levels of cathelicidin mRNA in recurrent throat infection was significantly higher compared with those in hypertrophic tonsils. Cathelicidin protein was localized on the tonsillar surface epithelium and inflammatory cells in the tonsillar crypt of recurrent throat infection patients. These results suggest that cathelicidin is one of antimicrobial peptides in the human palatine tonsils, and that cathelicidin may also play an important role in innate host defense of human tonsils.
    International Journal of Pediatric Otorhinolaryngology 04/2006; 70(3):487-92. · 1.35 Impact Factor
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    ABSTRACT: To evaluate the localization and expression of peroxidase proliferator-activated receptor (PPAR)gamma in cholesteatoma epithelium. Experimental study. Reverse-transcription polymerase chain reaction was performed on cholesteatoma tissues from 10 adult patients undergoing tympanomastoid surgery for middle ear cholesteatoma and on 10 samples of normal external auditory canal skin tissue. The expression levels of PPARgamma to glyceraldehyde-3-phosphate dehydrogenase transcripts were semiquantified by densitometry. We also characterized the cellular localization of the PPARgamma protein immunohistochemically. Ki-67 was also localized to compare the proliferative activity of cells in cholesteatoma epithelium and in normal external auditory canal skin. PPARgamma mRNA and protein were detected in normal external auditory canal skin and in cholesteatoma epithelium. The expression level of PPARgamma mRNA in cholesteatoma was significantly increased compared with that in normal external auditory canal skin. PPARgamma protein was expressed in cells mainly in the granular and prickle cell layers. However, the intensity of its expression was generally decreased in the parabasal layer of the cholesteatoma epithelium. Ki-67 was expressed in the nuclei of cells in the basal and parabasal layers, and a greater number of cells were Ki-67 immunopositive in cholesteatoma epithelium. PPARgamma is up-regulated in the cholesteatoma epithelium compared with normal external auditory canal skin. These results suggest that PPARgamma may play an important role in the pathogenesis of cholesteatoma.
    The Laryngoscope 02/2006; 116(1):58-61. · 1.98 Impact Factor
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    ABSTRACT: Objectives: Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. However, the presence of SP-A in the human paranasal sinus mucosa is not well known. The purpose of this study was to investigate the expression of SP-A protein in human paranasal sinus mucosa and to compare the expression of SP-A mRNA between normal paranasal sinus mucosa and paranasal sinus mucosa with chronic rhinosinusitis.Methods: Paranasal sinus mucosa samples from 10 patients who underwent surgery for chronic rhinosinusitis without polyps and 10 normal control subjects were used. Reverse transcriptase polymerase chain reaction was done to detect SP-A mRNA. The expression level of SP-A transcripts was semiquantified with desitometry. Cellular localization of SP-A was sought by using immunohistochemistry.Results:SP-A mRNA and protein were expressed in the human paranasal sinus mucosa. SP-A/GAPDH mRNA ratio in the paranasal sinus mucosa with chronic rhinosinusitis was greater compared with that in normal paranasal sinus mucosa (P < .05). Immunohistochemical staining revealed SP-A immunoreactivity in the epithelial cells and submucosal glands of paranasal sinus mucosa in both control subjects and chronic sinusitis patients. Stronger immunoreactivity was observed in chronic rhinosinusitis mucosa as compared with normal paranasal sinus mucosa.Conclusion: SP-A mRNA and protein are present in both normal and diseased human paranasal sinus mucosa. These results may provide potential targets for novel therapy of chronic rhinosinusitis.
    The Laryngoscope 01/2006; 116(2):328 - 330. · 1.98 Impact Factor
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    ABSTRACT: Salivary secretions play a critical role in maintaining the health of the oral cavity, which is the first gate of entry to the airways and thus is exposed to a variety of environmental insults. Surfactant protein A (SP-A) is a member of the collectin family and plays an important role in first-line airway defense. The objectives of this study were to examine the expression of SP-A messenger RNA and protein in human salivary glands and to investigate its up-regulation during inflammatory conditions. Reverse transcription-polymerase chain reaction was performed on salivary gland tissues from patients and a control group. The expression levels of SP-A to GAPDH (glyceraldehyde-3-phosphate dehydrogenase) transcripts were semiquantified by densitometry. We also characterized the cellular localizations of SP-A protein immunohistochemically. Tertiary academic institution. Ten patients with chronic sialadenitis and 10 patients with healthy salivary glands. Surfactant protein A messenger RNA and protein were detected in glands of patients who were healthy and in those with chronic sialadenitis. The expression levels of SP-A messenger RNA in the salivary glands of patients with chronic sialadenitis was significantly increased compared with those in healthy salivary glands. Immunohistochemical staining revealed SP-A immunoreactivity in the ductal epithelia of healthy salivary glands and in the salivary glands of those with chronic sialadenitis, and stronger immunoreactivity was observed in those with chronic sialadenitis tissues. Surfactant protein A is present in the salivary gland epithelium and is up-regulated in individuals with chronic sialadenitis. These results suggest that salivary gland SP-A may play an important role in the innate host defense of human salivary glands.
    Archives of Otolaryngology - Head and Neck Surgery 01/2006; 131(12):1108-11. · 1.78 Impact Factor
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    ABSTRACT: Oncostatin M is a multifunctional cytokine belonging to the interleukin-6 family of cytokines. It has been implicated as an important modulator of lower airway remodeling in the setting of asthma. However, there have been few studies regarding a similar role for the upper airway epithelium in the setting of allergic rhinitis. This study was undertaken to investigate the expression of oncostatin M mRNA and protein in normal and allergic rhinitis nasal mucosa and to localize the expression of the oncostatin M protein in allergic rhinitis. Inferior turbinate mucosa samples from 20 patients with perennial allergic rhinitis and 20 matched normal control subjects were obtained. Oncostatin M mRNA was extracted from the inferior turbinate mucosae, then reverse transcriptase-polymerase chain reaction was performed and analyzed semiquantitatively. Differences in expression levels of oncostatin M protein between samples from allergic rhinitis patients and normal control subjects were analyzed through Western blot, and oncostatin M protein was localized immunohistochemically. The expression levels of oncostatin M mRNA and protein were significantly upregulated in patients with allergic rhinitis mucosa. Oncostatin M protein was predominantly localized in the surface epithelium, infiltrating inflammatory cells, vascular endothelium, and submucosal glands and was more strongly expressed in the nasal mucosa of patients with allergic rhinitis than in normal control subjects. Oncostatin M is expressed in the human nasal mucosa and is upregulated in the setting of allergic nasal inflammation. These results suggest a possible contribution of oncostatin M in the remodeling of the nasal mucosa in allergic rhinitis.
    The Laryngoscope 01/2006; 115(12):2213-6. · 1.98 Impact Factor
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    ABSTRACT: Otosyphilis is a rare but important cause of sensorineural hearing loss and dizziness, because this hearing loss can be reversed by early diagnosis and aggressive treatment. Moreover, HIV may alter the course of otosyphilis and hasten the development of otosyphilis by reducing host cellular immunity. We report the case of a 35-year-old HIV-infected patient with bilateral fluctuating sensorineural hearing loss and bilateral total vestibular loss caused by otosyphilis. We include a discussion of the relationship between otosyphilis and HIV infection.
    Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 01/2006; 262(12):972-4. · 1.46 Impact Factor
  • The Journal of otolaryngology 11/2004; 33(5):332-4. · 0.50 Impact Factor
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    ABSTRACT: The primary mechanisms leading to mucus hypersecretion in chronic sinus inflammation are not well understood. This study aims to investigate the expression of MUC8 messenger RNA (mRNA) and protein and to compare between normal and chronically inflamed sinus mucosae in terms of the expression of MUC8 mRNA. Ten patients with chronic rhinosinusitis who were undergoing functional endoscopic sinus surgery were recruited for the study. Ten patients with no evidence of sinus disease were used as control subjects. RNAs were extracted from sinus mucosa, and semiquantitative reverse transcription-polymerase chain reaction was performed for MUC8. Localization of MUC8 protein was sought by immunohistochemical analysis. Messenger RNA encoding MUC8 was detected in human sinus mucosa. The level of MUC8 mRNA in chronic rhinosinusitis was significantly increased compared with that in normal maxillary sinus mucosa. We found more intense expression of MUC8 protein in the sinuses with chronic rhinosinusitis than in normal sinus mucosa. These results suggest that MUC8 may play an important role in the pathogenesis of sinus hypersecretion in chronic rhinosinusitis.
    The Annals of otology, rhinology, and laryngology 09/2004; 113(8):662-6. · 1.21 Impact Factor