Jin Hee Cho

Catholic University of Korea, Seoul, Seoul, South Korea

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Publications (38)37.76 Total impact

  • Article: Nasal pH in patients with chronic rhinosinusitis before and after endoscopic sinus surgery.
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    ABSTRACT: PURPOSE: Physiologically acidic nasal pH depends on intact nasal mucosal function. The aim of this study was to determine nasal pH in patients with chronic rhinosinusitis and to investigate the changes in pH related to mucosal healing after endoscopic sinus surgery. MATERIALS AND METHODS: Normal subjects and the patients with chronic rhinosinusitis who showed no recurrence after endoscopic sinus surgery were enrolled. Using a portable pH meter and a glass-tipped probe, nasal pH was measured in the inferior meatus in normal subjects and patients before and after surgery at 3months. RESULTS: The mean (±SD) nasal pH was 6.5±0.5 (5.9 to 7.3) in 19 normal subjects, and 6.7±0.6 (5.3 to 7.6) in 19 CRS patients before surgery, which showed no significant difference between the groups. The nasal pH values were in the range of 3.8-7.7 (mean±SD 5.7±0.9) at 3months after surgery, and significantly lower than the preoperative values in patients (P=.004). The patients showing pH lower than 6.0 accounted for 10.5% before surgery, but 68.4% after surgery. CONCLUSIONS: Normal nasal pH was in the slightly acidic range, and the mean nasal pH of patients with chronic rhinosinusitis fell within normal limits as well, which indicates that chronic rhinosinusitis may not disturb the electrolyte milieu of the nasal mucosa. The average nasal pH measured at 3months after endoscopic sinus surgery exhibited acidity of pH5.7. The factors causing a fall in nasal pH during the healing period after the sinus surgery remain to be elucidated.
    American journal of otolaryngology 05/2013; · 0.77 Impact Factor
  • Article: Bilateral modified nasoseptal "rescue" flaps in the endoscopic endonasal transsphenoidal approach.
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: For a wide exposure of skull base and preservation of septal mucosa, we have raised bilateral modified nasoseptal rescue flaps in the endoscopic endonasal transsphenoidal approach (EETSA) and evaluated the usefulness of these flaps elevation. STUDY DESIGN: Case series. METHODS: The study population comprised the patients who underwent EETSA with bilateral modified nasoseptal rescue flaps elevation between February 2009 and June 2012. We retrospectively reviewed patients' medical records. Patients underwent preoperative nasal evaluation using the Nasal Obstruction Symptom Evaluation (NOSE), Sino-Nasal Outcome Test (SNOT-20), and a visual analogue scale (VAS) to assess several nasal symptoms. Repeat testing was performed 6 months postoperatively. RESULTS: A total of 92 patients underwent the EETSA with bilateral modified nasoseptal rescue flaps elevation. A total of 17 patients had intraoperative cerebrospinal fluid (CSF) leakage. Three patients underwent extension of the modified nasoseptal rescue flap to a conventional nasoseptal flap. No patients underwent reoperation due to CSF leakage. There was no statistical difference between preoperative and postoperative total SNOT-20 and NOSE scores. According to the VAS, subjective olfaction function statistically worsened (P = 0.011) postoperatively. CONCLUSION: Bilateral modified nasoseptal rescue flaps elevation provided good exposure of the sellar floor, preserved the septal branch of sphenopalatine artery, and facilitated removal of sellar tumors. We could also preserve more septal mucosa by designing a novel incision and repositioning unused flaps to their original sites. Postoperative complications of the nasal cavity were thus minimized. We believe that this flap is very useful in a variety of settings during the EETSA. LEVEL OF EVIDENCE: 4. Laryngoscope, 2013.
    The Laryngoscope 04/2013; · 1.75 Impact Factor
  • Article: An acquired tufted angioma of the nasal cavity.
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    ABSTRACT: Tufted angiomas are benign vascular tumors that occur mainly in children younger than 5 years, involving the skin with subcutaneous plaques or in a nodular form. We experienced a rare tufted angioma in the nasal cavity. A 35-year-old woman visited our clinic because of frequent epistaxis. A mass was found in the left posterior nasal cavity, adjacent to the middle turbinate, and attached to the nasal septum. The mass was excised using endoscopy, under local anesthesia. The histopathological examination showed a cannon-ball distribution of the vasculature, compatible with a tufted angioma. This is the first tufted angioma in the English literature found in the nasal mucosa, so we report this case with a literature review.
    Auris, nasus, larynx 03/2013; · 0.58 Impact Factor
  • Article: Anatomical analysis of intraorbital structures regarding sinus surgery using multiplanar reconstruction of computed tomography scans.
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    ABSTRACT: This study aimed to investigate the anatomy of the intraorbital structures regarding to endoscopic sinus surgery and external frontal sinus surgery analyzing computer tomography (CT) scans. The CT scans of 100 patients were retrospectively evaluated. The anatomic relationships between the intraorbital structures and paranasal structures were measured using multiplanar reconstruction of the CT scan. The mean distances from the medial orbital floor (MOF) to the intraorbital structures were measured at the depth of the anterior ethmoid (AE), basal lamella (BL), and midportion of posterior ethmoid (PE) in the coronal planes respectively. The mean distances from the MOF to the medial rectus muscle and inferior rectus muscle at the depth of AE were approximately 8 mm and those distances in the BL and PE decreased rapidly. The mean distances from the MOF to the infraorbital nerve at the depth of the AE and BL were approximately more than 10 mm. The mean distances from the vertical axis, which passed through the MOF, to the superior oblique muscle and optic nerve at the depth of the PE were approximately 5 mm medially and 1 mm laterally. In addition, the mean distance from the midline to the trochlea of the superior oblique muscle was approximately 15 mm. Those measurements provide spatial information on the placements of the extraocular muscles within the orbit. The measurements will contribute to the avoidance of orbital complications during sinus surgery.
    Clinical and Experimental Otorhinolaryngology 03/2013; 6(1):23-9. · 0.92 Impact Factor
  • Article: Morphometric analysis of the infraorbital groove, canal, and foramen on three-dimensional reconstruction of computed tomography scans.
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    ABSTRACT: PURPOSE: This study aimed to investigate the anatomy of the infraorbital foramen (IOF), infraorbital canal (IOC), and infraorbital groove (IOG) with regard to surgical and invasive procedures using three-dimensional reconstruction of CT scans. METHODS: The CT scans of 100 patients were evaluated retrospectively. The morphology of the IOF, IOC, and IOG as well as their relationships to different anatomic landmarks was assessed in a three-dimensional model. RESULTS: The mean length of the IOC and IOG and the angle of the IOC relative to IOG were 11.7 ± 1.9, 16.7 ± 2.4 mm, and 145.5° ± 8.5°, respectively. The mean angles of the IOC relative to vertical and horizontal planes were 13.2° ± 6.4° and 46.7° ± 7.6°, respectively. In the relationships between the IOF and different anatomic landmarks, the mean distances from the IOF to supraorbital notch/foramen, facial midline, and infraorbital rim were 5.6 ± 3.1 mm laterally, 26.5 ± 1.9 mm laterally, and 9.6 ± 1.7 mm inferiorly, respectively. The mean distance from the IOF to anterior nasal spine (ANS) was 35.0 ± 2.6 mm, and the mean angle of the axis that passed the IOF and ANS relative to horizontal plane was 28.8° ± 4.1°. In addition, the mean soft tissue thickness overlying the IOF was 11.4 ± 1.9 mm. CONCLUSIONS: These results provide detailed knowledge of the anatomical characteristics and clinical importance of the IOF. Such knowledge is of paramount importance for surgeons when performing maxillofacial surgery and regional block anesthesia.
    Anatomia Clinica 02/2013; · 0.93 Impact Factor
  • Article: Anatomical analysis of nasal obstruction: Nasal Cavity of Patients Complaining of Stuffy Nose.
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: To evaluate the relationship between subjective symptoms of nasal obstruction and the corresponding nasal anatomical parameters using paranasal computed tomography (PNS CT). STUDY DESIGN: Retrospective chart review at a tertiary referral center. METHODS: We studied 277 patients who underwent evaluation by the Nasal Obstruction Symptom Evaluation scale and a visual analogue scale of nasal obstruction for preoperative evaluation; 197 patients with nasal obstruction who underwent septoplasty were enrolled in the study group, and 80 patients without nasal septal deviation and without nasal obstruction who underwent a trans-sphenoidal pituitary tumor operation were enrolled in the control group. A preoperative coronal CT image was used to calculate both nasal cavity cross-sectional areas and the septal deviation angle at the three levels (internal nasal valve, ostiomeatal unit [OMU], and choana). RESULTS: Differences between the study group and the control group were found in all nasal anatomical parameters at the internal nasal valve, OMU, and choana. In the study group, subjective nasal obstruction symptoms were correlated with the septal deviation angle and the nasal cavity cross-sectional area at the OMU and the choana levels. However, there was no correlation between subjective symptoms of nasal obstruction and anatomical factors at the nasal valve level (P < .05). CONCLUSIONS: Coronal PNS CT revealed a relationship between subjective nasal obstructive symptoms and anatomical factors at the middle and posterior nasal levels, especially in patients complaining of stuffy nose. When septoplasty is performed, we must pay attention to correction of middle and posterior nasal septal deviation. LEVEL OF EVIDENCE: 3.
    The Laryngoscope 02/2013; · 1.75 Impact Factor
  • Article: Nasalance change after sinonasal surgery: Analysis of voice after septoturbinoplasty and endoscopic sinus surgery.
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    ABSTRACT: Changes in nasalance caused by resonance change after endonasal surgeries have been reported in prior studies. In clinical practice, although patients often complain of a nasal voice just after surgery, their voices recover over time. The objective of this study was to evaluate the long-term nasalance changes before and after endonasal surgery. Patients who underwent sinonasal surgery at Yeouido St. Mary's Hospital between March 2009 and July 2011 were included in this study. We classified the subjects into three groups according to the surgeries they underwent: group 1, the septoturbinoplasty group; group 2, the endoscopic sinus surgery group; and group 3, the septoturbinoplasty and endoscopic sinus surgery group. We checked acoustic profiles, Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scores, and nasalance using a nasometer before and after the sinonasal surgery. When considering multidimensional voice program results, no observed parameters showed statistically meaningful changes before or after the operation in all three groups. GRBAS scales in all patients changed less than two scales postoperatively. Nasalance increased at 1 month after the operation in all groups. However, it returned to original levels with time: 3 months in group 2 and 6 months in groups 1 and 3. Sinonasal surgery can change the acoustic characteristics of the vocal tract and produce a significant increase in nasality in the early phase. However, after proper healing of the nasal cavity, nasality was observed to become similar to the preoperative level. Therefore, patients, especially voice professionals, do not need to be wary of voice changes after sinonasal surgery.
    American Journal of Rhinology and Allergy 01/2013; 27(1):67-70.
  • Article: What is the Relationship between the Localization of Maxillary Fungal Balls and Intranasal Anatomic Variations?
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    ABSTRACT: Although the mechanisms underlying the initiation and maintenance of inflammation in unilateral maxillary fungal balls (FBs) are poorly understood, the relationship between intranasal anatomy and maxillary FB is thought to play an important role. The aim of this study was to investigate the relationship between anatomic variations and FB. We enrolled 140 patients who were composed of 56 patients with FB, 56 patients with unilateral chronic rhinosinusitis (CRS), and 28 patients with no sinus disease. Computed tomography scans were retrospectively analyzed to identify and compare the associated nasal anatomic abnormalities. To measure the volume of the nasal cavity and middle meatus, computed tomography scans were reconstructed into three-dimensional images. The relatively larger volume of the middle meatus was associated with the localization of the FB in contrast with the CRS. However, the nasal-cavity volume, nasal valve area, and nasal septal deviation were not significantly associated with localization of FB. The mean volumetric and areal measurements such as nasal cavity, middle meatus, and nasal valve in FB-ipsilateral sides were not significantly different from those in contralateral sides as well as other groups. The middle meatus bears the major part of the inspiratory nasal airflow, and its volume may influence the occurrence of FB.
    Clinical and Experimental Otorhinolaryngology 12/2012; 5(4):213-7. · 0.92 Impact Factor
  • Article: Postoperative nasal symptoms associated with an endoscopic endonasal transsphenoidal approach.
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    ABSTRACT: Recent studies have indicated the usefulness of endoscopic endonasal transsphenoidal approach (EETSA). A few studies have reported on the postoperative nasal symptoms of patients who have undergone EETSA. Therefore, we adopted a rhinologic perspective to compare preoperative and postoperative nasal symptoms after performing a binostril, four-hand EETSA. Patients who were scheduled to undergo binostril, four-hand EETSA underwent preoperative nasal evaluation using the Nasal Obstruction Symptom Evaluation (NOSE), Sino-Nasal Outcome Test-20 (SNOT-20), and a visual analogue scale (VAS) to assess several nasal symptoms. Repeat testing was performed 6 months postoperatively. Paired Student's t tests were used to compare preoperative and postoperative scores. A total of 142 patients who underwent a binostril, four-hand EETSA were included in this study. We found no statistically significant differences between preoperative and postoperative NOSE, total SNOT-20 scores, or scores on the VAS for nasal obstruction, sneezing, rhinorrhea, snoring, or facial pain. However, VAS of olfactory change increased significantly after EETSA (p < 0.05). The binostril, four-hand EETSA would be a useful method because it permits operative manipulability and a wide visual field for skull base lesions. However, rhinologists must consider postoperative nasal symptoms and perform a proper preoperative examination, especially with regard to the olfactory function, and inform patients scheduled for EETSA of potential postoperative changes.
    Archives of Oto-Rhino-Laryngology 10/2012; · 1.29 Impact Factor
  • Article: Down-regulation of gelsolin may play a role in the progression of inverted papilloma through an antiapoptotic mechanism.
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    ABSTRACT: Gelsolin is an actin-binding protein with multiple cellular functions including apoptosis and is reported to be down-regulated in various cancers and premalignant lesions. The objective of this study was to identify gelsolin and caspase-3 expression in inverted papilloma (IP) and investigate the role of gelsolin in the progression of IP related to apoptosis. Specimens from 30 patients with nondysplastic IP were retrieved. The percentage of surface epithelium covered with squamous metaplastic epithelium was assessed. Immunohistochemically demonstrated gelsolin and caspase-3 expression were compared between IP and adjacent control mucosa. We analyzed the correlations among gelsolin expression, caspase-3 expression, and the degree of squamous metaplasia in IP. The degree of squamous metaplasia of surface epithelium was inversely correlated with gelsolin (r = -0.610; p < 0.001) and caspase-3 expression (r = -0.433; p = 0.017). Gelsolin expression in IP was significantly lower than that in the control when >50% of surface epithelium showed squamous metaplasia (p = 0.015). Caspase-3 also showed diminished expression when >50% of surface epithelium had undergone squamous metaplasia (p = 0.035). Gelsolin and caspase-3 expression showed no significant differences when the degree of squamous metaplasia was ≤50%. Gelsolin and caspase-3 expression levels in IP had a positive relationship (r = 0.557; p = 0.001). Progression of IP may be related to an insidious decrease in caspase-3-mediated apoptosis, and down-regulated gelsolin expression may be correlated with the decrease in apoptosis, especially in more highly progressed IP in which >50% of surface epithelium has undergone squamous metaplasia.
    American Journal of Rhinology and Allergy 05/2012; 26(3):177-82.
  • Article: The effect of topical FK506 (tacrolimus) in a mouse model of allergic rhinitis.
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    ABSTRACT: The management of allergic rhinitis (AR) encompasses education, pharmacotherapy, immunotherapy, and surgery. FK506 (tacrolimus) is an immunosuppressant that inhibits allergic reactions. The purpose of this study was to reveal whether FK506 treatment reduces allergic inflammation in an AR mouse model and to elucidate the mechanisms. Forty mice were divided into four groups: control, AR, FK (FK506), and dexamethasone (DEX). All mice except for the control group were sensitized by an i.p. injection of ovalbumin (OVA). After sensitization, the FK and DEX groups were treated with FK506 and DEX intranasally. All sensitized mice were challenged intranasally with OVA. Allergic symptoms and tissue eosinophil counts were recorded. Interleukin (IL)-5, interferon gamma, and IL-10 levels in nasal lavage fluid (NALF) and serum OVA-specific IgE levels were measured. T-bet, GATA-3, and Foxp3 mRNA expression in splenic mononuclear cells were determined by real-time polymerase chain reaction. In the FK group and DEX group, allergic symptoms, serum OVA-specific IgE, tissue eosinophil counts, IL-5 in NALF, and GATA-3 mRNAs expression decreased (p < 0.05), and IL-10 in NALF and Foxp3 mRNAs expression increased compared with the AR group (p < 0.05). No significant difference was observed between the FK group and the DEX group. These results suggest that topical FK506 may reduce allergic inflammation and have potency equal to DEX in the AR model. This mechanism may involve not only Th2 cells but also regulatory T cells. Additional studies are needed on FK506, but in the future, we can consider FK506 as an alternative to topical steroids in the treatment of AR.
    American Journal of Rhinology and Allergy 03/2012; 26(2):e71-5.
  • Article: Maxillary sinus squamous cell carcinoma with concurrent prolonged foreign body impaction.
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    ABSTRACT: Several elements in the maxillary sinus are reported to be carcinogenic. Also, foreign body reaction can cause cancer in any part of the body. We report a case of squamous cell carcinoma at the site in the maxillary sinus where a bullet splinter, analyzed as iron afterward, was inserted during the Korean War, approximately 60 years earlier.
    The Journal of craniofacial surgery 03/2012; 23(2):e124-6. · 0.81 Impact Factor
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    Article: A case of pituitary metastasis from breast cancer that presented as left visual disturbance.
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    ABSTRACT: Tumors that metastasize to the pituitary gland are unusual, and are typically seen in elderly patients with diffuse malignant disease. The most common metastases to the pituitary are from primary breast and lung cancers. We report a 65-year-old woman with pituitary metastasis from breast cancer who presented with recent-onset left progressive deterioration of visual acuity and visual field. The clinical diagnosis was made after brain and sellar magnetic resonance imaging showed a large sellar mass compressing the optic chiasm and invading the pituitary stalk. An otorhinolaryngology and neurosurgery team removed the tumor via a transsphenoidal approach, and this procedure obtained symptomatic relief. Postoperatively, metastasis from breast invasive ductal adenocarcinoma was confirmed histologically. We report this unusual case with a review of the relevant literature.
    Journal of Korean Neurosurgical Society 02/2012; 51(2):94-7. · 0.60 Impact Factor
  • Article: Role of the sphenoidal process of the septal cartilage in the development of septal deviation.
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    ABSTRACT: The sphenoidal process of the septal cartilage (SP) is a small strip of cartilage between the perpendicular plate of ethmoid bone and vomer. The present study was performed to evaluate the clinical significance of the SP in the development of nasal septal deviation. Prospective, controlled. Academic rhinologic practice. The authors examined 136 patients with nasal septal deviation. The length of SP was measured during septal surgery, and values were compared with the deviation angle. The distance between the anterior nasal spine (ANS) and the breakpoint of the suture line between the septal cartilage and the perpendicular plate of the ethmoid bone (ANS-PPE) and that from the ANS to the point where the choana meets the sphenoid sinus (ANS-CS) were determined and compared according to the age. The mean length of SP in patients with a deviated nasal septum was 25.90 ± 7.82 mm and decreased with age. The average deviation angles at the level of the ostiomeatal unit and nasal valve area were 8.28° ± 3.50° and 10.37° ± 4.38°, respectively. These angles increased with the length of SP (P < .01). The mean length of ANS-PPE showed a significant negative correlation with age. The mean length of ANS-CS had no correlation with age. SP was longer with increasing deviation angle in patients with nasal septal deviation. A long SP, a remnant cartilaginous tail of the nasal septum resulting from delayed ossification of the nasal septum, contributes to the exacerbation of septal deviation.
    Otolaryngology Head and Neck Surgery 01/2012; 146(1):151-5. · 1.72 Impact Factor
  • Article: A huge midline premaxillary cyst as a late complication of maxillary surgery.
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    ABSTRACT: A median palatal cyst is an uncommon nonodontogenic cyst, and patients usually present with a painless swelling or the sensation of a mass. The mass is typically a well-defined fixed swelling along the midline. The mass can cause slight elevation of the nasal floor or swelling and drainage from the hard palate. Surgical resection is usually recommended as a definite treatment.We treated a 30-year-old man with a premaxillary mass with nasal obstruction. He had undergone surgery on both the maxilla and the mandible to correct malocclusion 10 years earlier. A physical examination revealed elevated mucosa of the nasal floor, resulting in near-total obstruction of the nasal cavity, and the gingival mucosa over the upper incisors was also swollen. Preoperative computed tomographic scan demonstrated a midline nonenhancing round cystic lesion in the premaxillary area. Surgical excision was performed via a sublabial approach under general anesthesia, and his recovery after surgery was uneventful.
    The Journal of craniofacial surgery 09/2011; 22(5):1903-5. · 0.81 Impact Factor
  • Article: The Onodi cell: an obstacle to sellar lesions with a transsphenoidal approach.
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    ABSTRACT: The Onodi cell is the posterior-most ethmoid air cell and an important anatomical variant because of the intimate spatial relationship with the optic nerve, internal carotid artery, and sellar floor during sphenoid sinus surgery. The authors evaluated the incidence of Onodi cells, their clinical importance, and the association between preoperative radiological findings and surgical findings. Case series with chart review. Tertiary care medical center. The authors retrospectively reviewed the medical records of 162 cases, including preoperative paranasal sinus computed tomography (PNS CT) findings and the findings with the endoscopic endonasal transsphenoidal approach (EETSA). They evaluated the prevalence of Onodi cells and the clinical manifestations in the patients with these cells. They also examined the clinical significance of these cells during EETSA. Onodi cells were identified in the preoperative PNS CT of 53 patients, whereas Onodi cells were observed in 54 (33.3%) of the 162 patients at EETSA. The Onodi cells were bilateral in 23 patients and unilateral in 31. In all cases, the Onodi cells limited the exposure of the sellar floor. Only after removing these cells was the entire sellar floor exposed so that the tumors could be removed completely. Onodi cells were observed more frequently than in previous studies, and 98.1% of them were identified on preoperative PNS CT. When reviewing PNS CT images preoperatively, one needs to identify the presence of Onodi cells. The Onodi cells must be removed to completely resect tumors located in the sellar region during EETSA.
    Otolaryngology Head and Neck Surgery 08/2011; 145(6):1040-2. · 1.72 Impact Factor
  • Article: Immunomodulatory role of histamine H2 receptor in allergen-specific immunotherapy: a mouse model of allergic rhinitis.
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    ABSTRACT: The purpose of this pilot study was to investigate the effects of HR2 on allergen-specific immunotherapy in a mouse model of allergic rhinitis. An in vivo study using an animal model. Catholic Research Institutes of Medical Science. Fifty mice were divided into 5 groups: control, allergic rhinitis (AR), immunotherapy (IT), immunotherapy with HR2 agonist (HI), and immunotherapy with HR2 antagonist (HB). All mice except for the control group were sensitized with ovalbumin (OVA). After 1 week, mice in the IT, HI, and HB groups underwent immunotherapy by intradermal injections of OVA. During immunotherapy, the HI group was injected with HR2 agonist, whereas the HB group was injected with HR2 antagonist. All sensitized mice were challenged with intranasal OVA. After the final challenge, allergic behavior was evaluated. Interleukin (IL)-13, interferon-γ, IL-10, and transforming growth factor (TGF)-β levels in nasal lavage fluid (NALF), as well as OVA-specific IgE levels in serum, were measured. The number of eosinophils in lamina propria was evaluated. The levels of serum OVA-specific IgE and IL-13 in NALF were significantly increased in the HB group compared with the IT group (P < .05). Also, the tissue eosinophil counts were higher in the HB group than in the IT group (P < .05). HR2 antagonist impaired OVA-specific immunotherapy in mice. Although confirmation of this preliminary result is needed, these findings suggest that HR2 receptors may have inhibitory effects on immune tolerance. The authors suggest that application of this property could enhance the efficiency of allergen-specific immunotherapy.
    Otolaryngology Head and Neck Surgery 04/2011; 144(4):500-5. · 1.72 Impact Factor
  • Article: An anatomic study using three-dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal.
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    ABSTRACT: The pterygopalatine fossa (PPF) is accessed via the greater palatine canal (GPC) in an attempt to reduce bleeding during paranasal sinus surgery. This study aims to investigate the anatomy of the greater palatine foramen (GPF), GPC, and the PPF, with reference to PPF infiltration using three-dimensional reconstruction of computer tomographic (CT) scan measurements. The CT scans of 50 patients were retrospectively evaluated. The morphology of the GPF, GPC, and the PPF was assessed in a three-dimensional model. The thickness of the mucosa over the GPF was evaluated in the parasagittal plane. The mean length of the GPC was 13.8 ± 2.0 mm, and the mean height of the PPF was 21.0 ± 3.4 mm. The mean angles of the GPC in relation to the hard palate and the PPF were 67.4° ± 6.9° and 159.8° ± 7.1°, respectively. The GPF was 16.2 ± 1.3 mm lateral to the sagittal plane of the posterior nasal spine (PNS) and 6.1 ± 1.7 mm anterior to the coronal plane of the PNS. The mean volume of the PPF was 1039.9 ± 280.0 mm(3) . The mean thickness of the mucosa overlying the GPF was 10.7 ± 1.8 mm. We recommend that the PNS may be used as the bony landmark to locate the position of the GPF during PPF infiltration. The needle delivering the anesthetic should be bent 25 mm from the tip at a 45° angle, and a 1-ml injection of anesthetic should be administered in adults.
    Clinical Anatomy 03/2011; 24(5):576-82. · 1.29 Impact Factor
  • Article: Levocetrizine has anti-inflammatory effects against Toll-like receptor (TLR)3 through the inhibition of Toll-IL-1 receptor (TIR)-domain-containing adapter inducing IFN-beta (TRIF) and receptor-interacting protein (RIP).
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    ABSTRACT: To investigate the anti-inflammatory effect of levocetrizine (LCEZ) on the intracellular adhesion molecule-1 (ICAM-1) in human nasal epithelial cells stimulated by TLR3 and further analyze the anti-inflammatory mechanism of LCEZ in the MyD88-independent pathway before NF-κB is activated. A primary culture of human nasal epithelial cells (HNECs) was generated from nasal polyps. After stimulation of epithelial cells with LTA, double-stranded RNA (dsRNA), and LPS, reverse transcription-polymerase chain reaction (RT-PCR) was performed at 1, 6, and 24 h to clarify the optimal stimulation of ICAM-1 in HNECs. To investigate the anti-inflammatory effects of LCEZ, HNECs were pretreated with three different concentrations of LCEZ (500, 50, and 5 nM) for 2 h. HNECs were washed and then stimulated with dsRNA. At 1, 6, and 24 h after stimulation, the level of ICAM-1 was measured by RT-PCR and ELISA. Western blots for TRIF and RIP were performed. The level of ICAM-1 was significantly elevated by dsRNA. Pretreatment with LCEZ decreased the secretion of ICAM-1, which was observed in RT-PCR and Western blots but not in ELISA analyses. The expression of TRIF and RIP, measured by Western blot, was decreased by pretreatment with LCEZ. The activation of HNECs by TLRs (especially TLR3) could trigger an inflammatory process, which might be inhibited by LCEZ through the suppression of TRIF and RIP proteins.
    Auris, nasus, larynx 02/2011; 38(4):474-9. · 0.58 Impact Factor
  • Article: Toll-like receptor 2 gene polymorphisms in a Korean population: association with chronic rhinosinusitis.
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    ABSTRACT: To investigate the role of single-nucleotide polymorphisms (SNPs) in the gene encoding Toll-like receptor (TLR) 2 in Korean patients with chronic rhinosinusitis (CRS) and controls. A case-control study. Subjects (N = 214) were all adults (>20 years old) and were divided into patients with CRS (n = 106) and controls (n = 108). Five SNPs (rs1898830, rs3804099, rs3804100, R677W, and rs5743708) were selected and genotyped in a case-control study with the single-base-pair primer extension (SNaPshot) assay. The case-control study revealed that 2 SNPs in TLR2, rs3804099 (odds ratio [OR] = 2.88; 95% confidence interval [CI] = 1.17-7.09; P = .022) and rs3804100 (OR = 3.76; 95% CI = 1.42-9.96; P = .008), showed significant differences in minor allele frequency between CRS patients and controls. These 2 SNPs were correlated with CRS risk in Korean patients. Two SNPs in TLR2 may be associated with increased risk of CRS in Korean subjects.
    Otolaryngology Head and Neck Surgery 01/2011; 144(1):96-100. · 1.72 Impact Factor