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1.
Transplant Proc ; 50(1): 20-23, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29407309

RESUMO

BACKGROUND: Although cancer screening tests are not mentioned under brain-dead organ donor care guidelines in Korea, we assessed the level of prostate-specific antigen (PSA), an important prostate cancer marker, and performed prostate biopsies when needed in brain-dead organ donors. We believe that insisting on a screening test for cancer diagnosis in donors' organs is important. MATERIALS AND METHODS: Data were collected between January 2010 and July 2015 from Ajou University Hospital. We retrospectively analyzed the PSA levels and prostate biopsy results in 111 male brain-dead organ donors (mean age, 48.4 years). RESULTS: The mean PSA level was 7.395 ng/mL (range, 0.062 to 61.780; reference, 0 to 4 ng/mL). Ultrasonography or computed tomographic examination did not reveal prostate cancer, and a rectal examination was not performed. After checking the PSA levels, prostate biopsies were performed in 16 patients based on the recommendations of a urologist, and 4 patients (3.6% of 111) were diagnosed with prostate cancer. All cancers involved adenocarcinomas (acinar type) histopathologically. In 2 patients, the Gleason score was 6 (3 + 3), whereas the other 2 showed a score of 7 (3 + 4). Among the patients diagnosed with prostate cancer, 1 donated his liver and corneas, and the remaining 3 could not donate. CONCLUSION: Well-defined cancer screening tests are needed in Korea. Additionally, when the probability of organ transplantation-induced cancer metastasis is low or a recipient is at a high risk owing to not receiving organs, the law should allow organ donation even if prostate cancer is diagnosed in the donor.


Assuntos
Morte Encefálica/sangue , Detecção Precoce de Câncer/métodos , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Obtenção de Tecidos e Órgãos/métodos , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Idoso , Biópsia , Detecção Precoce de Câncer/normas , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Próstata/química , Próstata/patologia , Neoplasias da Próstata/patologia , República da Coreia , Estudos Retrospectivos , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos/normas
2.
Allergy ; 68(7): 862-9, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23751068

RESUMO

BACKGROUND: Since the recent establishment of a murine model of eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP), both the development of new drugs for treatment or prevention of eosinophilic CRSwNP and elucidation of their pathogenesis have been feasible. We investigated the therapeutic effects of resveratrol on CRSwNP and its mechanism of action using a murine model. METHODS: After induction of eosinophilic CRSwNP, the therapeutic effects of resveratrol were tested and compared with those of triamcinolone acetonide. Histopathologic changes were evaluated using hematoxylin and eosin for overall inflammation, Sirius red for eosinophils, and Masson's trichrome stain for collagen. The expression levels of the interleukin (IL)-4, IL-5, prostaglandin D synthase, and leukotriene C4 synthase genes were assessed by quantitative real-time PCR. Cyclooxygense-2 and 5-lipoxygense levels were evaluated by immunohistochemical staining and Western blot analysis. RESULTS: The degree of eosinophilic infiltration and subepithelial fibrosis was significantly decreased by administration of high-dose resveratrol, the potency of which was similar to that of triamcinolone acetonide. The expression levels of the IL-4, IL-5, prostaglandin D synthase, and leukotriene C4 synthase genes were significantly decreased by administration of low- or high-dose resveratrol. The production of 5-lipoxygenase was strongly inhibited by high-dose resveratrol. CONCLUSIONS: Resveratrol may be useful for the prevention of eosinophilic CRSwNP. A key mechanism of its action is believed to be its anti-inflammatory effect, particularly on eosinophils, by inhibiting the lipoxygenase pathway.


Assuntos
Eosinofilia/tratamento farmacológico , Pólipos Nasais/tratamento farmacológico , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Estilbenos/farmacologia , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Biópsia por Agulha , Western Blotting , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Esquema de Medicação , Eosinofilia/complicações , Eosinofilia/imunologia , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos BALB C , Pólipos Nasais/complicações , Pólipos Nasais/patologia , Distribuição Aleatória , Reação em Cadeia da Polimerase em Tempo Real , Valores de Referência , Resveratrol , Rinite/complicações , Rinite/imunologia , Medição de Risco , Sinusite/complicações , Sinusite/imunologia , Estatísticas não Paramétricas , Resultado do Tratamento
3.
Rhinology ; 49(3): 309-14, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21858261

RESUMO

BACKGROUND: Though mucosal cysts in the paranasal sinuses (PSMCs) are common findings on radiographic images, the nature of PSMCs and risk factors for the development of PSMCs have not yet been determined. The aim of this study was to evaluate the characteristics of PSMCs using brain magnetic resonance (MR) imaging. METHODOLOGY/PRINCIPAL: A total of 6831 subjects who underwent health checkup including brain MR imaging were included in this study. The characteristics of PSMCs, including their location, number and size, as well as the presence of obstruction of the sinus ostium and sinusitis, were analysed using brain MR images. Structured questionnaires and medical records were reviewed to evaluate the smoking status and comorbid medical conditions. RESULTS: The overall prevalence of PSMCs was 7.4% and was significantly higher in females than in males. PSMCs were most commonly found in the maxillary sinus, most of which were located unilaterally as a solitary cyst. Large cysts were associated with obstruction of the sinus ostium and subsequent sinusitis. Smoking was a single important risk factor for developing PSMCs. No significant associations were found between symptoms (nasal/respiratory) and the presence of PSMCs. CONCLUSIONS: The prevalence of PSMCs was 7.4% and decreased with age. Large cysts may lead to obstruction of the sinus and subsequent sinusitis. Smoking was an important risk factor for PSMCs, and the total amount of smoking correlated with cyst size. Most subjects were asymptomatic, and specific treatment was not performed.


Assuntos
Cistos/epidemiologia , Doenças dos Seios Paranasais/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Cistos/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/patologia , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia , Adulto Jovem
4.
Appl Clin Inform ; 1(2): 79-95, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-23616829

RESUMO

OBJECTIVE: In an effort to identify and characterize the environmental factors that affect the number of patients with acute diarrheal (AD) syndrome, we developed and tested two regional surveillance models including holiday and weather information in addition to visitor records, at emergency medical facilities in the Seoul metropolitan area of Korea. METHODS: With 1,328,686 emergency department visitor records from the National Emergency Department Information system (NEDIS) and the holiday and weather information, two seasonal ARIMA models were constructed: (1) The simple model (only with total patient number), (2) the environmental factor-added model. The stationary R-squared was utilized as an in-sample model goodness-of-fit statistic for the constructed models, and the cumulative mean of the Mean Absolute Percentage Error (MAPE) was used to measure post-sample forecast accuracy over the next 1 month. RESULTS: The (1,0,1)(0,1,1)7 ARIMA model resulted in an adequate model fit for the daily number of AD patient visits over 12 months for both cases. Among various features, the total number of patient visits was selected as a commonly influential independent variable. Additionally, for the environmental factor-added model, holidays and daily precipitation were selected as features that statistically significantly affected model fitting. Stationary R-squared values were changed in a range of 0.651-0.828 (simple), and 0.805-0.844 (environmental factor-added) with p<0.05. In terms of prediction, the MAPE values changed within 0.090-0.120 and 0.089-0.114, respectively. CONCLUSION: The environmental factor-added model yielded better MAPE values. Holiday and weather information appear to be crucial for the construction of an accurate syndromic surveillance model for AD, in addition to the visitor and assessment records.

5.
Int J Impot Res ; 20(6): 549-53, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18997807

RESUMO

Several reports have suggested a high incidence of erectile dysfunction (ED) among patients with obstructive sleep apnea syndrome (OSAS). The aim of this study was to investigate the correlation between OSAS and ED, or disease-specific quality of life (QOL) in patients with OSAS. In addition, we analyzed specific polysomnographic (PSG) parameters in predicting ED in OSAS patients. In total, 32 patients with OSAS and 27 normal controls were asked to complete the Korean versions of the International Index of Erectile Function questionnaire (KIIEF-5) and the Calgary Sleep Apnea Quality of Life Index (SAQLI). All patients then underwent a full-night in-laboratory PSG examination. Patients were diagnosed with OSAS if they had clinical symptoms suggestive of OSAS for at least 1 year and an apnea-hypopnea index (AHI) of more than 10 in PSG. Nineteen patients (59.3%) in the OSAS group showed ED, which was significantly higher than in the control group (8 patients, 29.6%, P=0.012). In addition, SAQLI scores worsened as AHI increased (r=0.327, P=0.011) and as the lowest oxygen saturation level decreased (r=0.420, P=0.001). ED was not significantly correlated with AHI (r=0.061, P=0.649); however, it was significantly correlated with the lowest oxygen saturation decreased (r=0.338, P=0.009). When the cutoff value for the lowest oxygen saturation level to predict ED was set at 77%, its positive predictive value was 88.9% (sensitivity=0.70, specificity=0.62). Thus, all male patients with OSAS should be screened for erectile dysfunction and more comprehensive consultation is needed, especially, if their lowest oxygen saturation levels are below 77%.


Assuntos
Disfunção Erétil/complicações , Qualidade de Vida , Apneia Obstrutiva do Sono/complicações , Adulto , Disfunção Erétil/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/metabolismo , Polissonografia , Apneia Obstrutiva do Sono/metabolismo , Inquéritos e Questionários
6.
Allergy ; 62(9): 1051-6, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17686108

RESUMO

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. METHODS: Methacholine bronchial challenges were performed in 4- to 6-year-old nonasthmatic children with allergic rhinitis (n = 83) and in healthy nonatopic controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Subjects were considered to have BHR when they had end-point concentrations of methacholine

Assuntos
Hiper-Reatividade Brônquica/epidemiologia , Hipersensibilidade Respiratória/epidemiologia , Rinite/epidemiologia , Alérgenos/efeitos adversos , Alérgenos/imunologia , Hiper-Reatividade Brônquica/sangue , Hiper-Reatividade Brônquica/imunologia , Hiper-Reatividade Brônquica/fisiopatologia , Testes de Provocação Brônquica , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina E/sangue , Masculino , Cloreto de Metacolina/farmacologia , Prevalência , Hipersensibilidade Respiratória/sangue , Hipersensibilidade Respiratória/imunologia , Hipersensibilidade Respiratória/fisiopatologia , Rinite/sangue , Rinite/imunologia , Rinite/fisiopatologia , Fatores de Risco , Testes Cutâneos
7.
Clin Exp Allergy ; 32(6): 921-7, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12047440

RESUMO

BACKGROUND: Allergic rhinitis is a known predictor and correlate of asthma incidence. However, it is not clear which patients with allergic rhinitis are at greater risk of the development of asthma. OBJECTIVE: The aim of this study was to investigate whether airway hypersensitivity and/or increased maximal response on the dose-response curve to methacholine would predict the development of asthma in subjects with allergic rhinitis. METHODS: One hundred and forty-one children with allergic rhinitis were prospectively studied for 7 years. At the initiation of the study, bronchial provocation test with methacholine using a stepwise increasing concentration technique was performed to measure PC(20) (provocative concentration causing a 20% fall in FEV(1)) and maximal response. Each subject was evaluated at least every 6 months and details of asthmatic symptoms or signs experienced during the intervening period were taken. RESULTS: Twenty of 122 subjects available for the follow-up developed asthma. Nine (19.6%) of 46 hypersensitive (PC(20) < 18 mg/mL) subjects developed asthma, compared with 11 (14.5%) of 76 normosensitive subjects (P = 0.462). Eight (32%) of 25 subjects without maximal response plateau developed asthma, compared with 12 (12.4%) of 97 subjects with maximal response plateau (P = 0.018). Score test for trend revealed a significant association between the level of maximal response (P = 0.007), but not the degree of methacholine PC(20) (P = 0.123), and the future development of asthma. CONCLUSION: An increased maximal airway response to methacholine is shown to be a better predictor for the future development of asthma in patients with allergic rhinitis, than airway hypersensitivity to methacholine.


Assuntos
Resistência das Vias Respiratórias/efeitos dos fármacos , Resistência das Vias Respiratórias/fisiologia , Asma/complicações , Asma/fisiopatologia , Broncoconstritores/farmacologia , Cloreto de Metacolina/farmacologia , Rinite Alérgica Perene/complicações , Rinite Alérgica Perene/fisiopatologia , Adolescente , Asma/epidemiologia , Testes de Provocação Brônquica , Criança , Proteção da Criança , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Volume Expiratório Forçado/efeitos dos fármacos , Volume Expiratório Forçado/fisiologia , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/efeitos dos fármacos , Coreia (Geográfico)/epidemiologia , Masculino , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Rinite Alérgica Perene/epidemiologia , Sensibilidade e Especificidade , Testes Cutâneos
8.
J Korean Med Sci ; 16(6): 697-701, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11748347

RESUMO

Multicenter Study on the Prevalence of Perennial Allergic Rhinitis and Allergy-Associated Disorders This study was aimed to determine the prevalence of perennial allergic rhinitis (PAR) using the skin test, radioallergosorbent test (RAST), or multiple allergosorbent test (MAST) and to clarify the clinical aspects of the patients diagnosed as having PAR by the questionnaire survey and rhinologic examination. The 71,120 subjects who had visited the 23 otolaryngology clinics at the randomly selected tertiary referral hospitals in Korea between November 1, 1999 and April 30, 2000 were studied. PAR was diagnosed when subjects complained of two or more associated symptoms and the skin test, RAST, or MAST using perennial inhalant allergens was positive. The questionnaire survey and rhinologic examination were performed in subjects with PAR. The prevalence of PAR was 3.93%. We could find no significant difference in the prevalence of PAR between the two sexes. However, there was a significant difference in the prevalence of PAR between the child and adult groups. The chief complaints were, in order of decreasing frequency, nasal obstruction, watery rhinorrhea, and sneezing. There was a family history of PAR in 40.2% of the subjects. The 39.6% of the subjects had associated allergic diseases, being atopic dermatitis most common. In conclusion, the prevalence of PAR in tertiary referral hospitals in Korea is 3.93%. Many subjects with PAR have family history and appear to be associated with other allergic diseases.


Assuntos
Dermatite Atópica/epidemiologia , Rinite Alérgica Perene/epidemiologia , Adulto , Criança , Dermatite Atópica/diagnóstico , Saúde da Família , Feminino , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Prevalência , Encaminhamento e Consulta/estatística & dados numéricos , Rinite Alérgica Perene/diagnóstico , Distribuição por Sexo , Testes Cutâneos , Inquéritos e Questionários
9.
Ann Otol Rhinol Laryngol ; 110(11): 1011-6, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11713910

RESUMO

This study aimed to determine the characteristics of ciliogenesis and the ciliary beat frequency (CBF) of cultured human nasal epithelial cells by means of an in vitro air-liquid interface (ALI) culture system. On the 14th, 21st, and 27th days of ALI culture, CBFs of cultured cells were measured with a video computerized analysis system, and the epithelial cell-collagen matrix complex was examined by scanning and transmission electron microscopy. Using a CBF distribution map, we calculated the proportion of ciliary beating area (CBA) on the cultured cells. On the 14th day, ciliated cells could be easily distinguished from other cells on scanning electron microscopy by their elongated cilia. Between the 14th and 27th days, the number of mature cilia increased, and after 27 days of air exposure, the cilia of each cell pointed to one direction. From the beginning of air-exposure culture until the 7th day, the number of secretory cells increased; however, from the 7th day to the 27th day, it decreased, and the number of ciliated cells increased. Total CBAs increased from the 7th day to the 21st day. The proportions of actively beating cells and the mean CBFs of beating cells among cultured epithelial cells increased with culture time. On the 21st day, the mean CBF of the cultured cells was similar to that of nasal ciliated cells in biopsy specimens (10.9 +/- 0.5 Hz versus 11.4 +/- 1.3 Hz), but until the 27th day, the CBF of cultured cells increased significantly (13.9 +/- 0.8 Hz). It is suggested that there may be some difference in CBF between nasal epithelial cells submitted to biopsy and nasal epithelial cells cultured by the ALI culture system.


Assuntos
Cílios/fisiologia , Depuração Mucociliar/fisiologia , Mucosa Nasal/citologia , Células Cultivadas , Cílios/patologia , Células Epiteliais , Humanos , Processamento de Imagem Assistida por Computador , Técnicas In Vitro , Microscopia Eletrônica de Transmissão e Varredura , Mucosa Nasal/patologia , Estatísticas não Paramétricas , Fatores de Tempo
10.
11.
Otolaryngol Head Neck Surg ; 124(3): 313-6, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11240998

RESUMO

Various saline solution formulae are frequently used in patients with rhinosinusitis. Osmolarity affects ciliary beat frequency (CBF); however, little is known about the effects of saline solutions on ciliary activity of nasal epithelial cells. The aim of this study was to assess whether CBF of normal turbinate mucosa is affected by hypertonic, isotonic, or hypotonic saline solution in vitro and whether histologic changes are associated with the alteration of ciliary movement. We assessed variations of CBF after exposure to 0.06%, 0.12%, 0.9%, 3.0%, or 7.0% saline solutions and histologic changes were examined by transmission electron microscopy. Isotonic and hypotonic solutions produced no ciliary slowing; however, ciliostasis was observed within a few minutes in 3.0% or 7.0% solution. The histologic changes demonstrated that the ciliary slowing might be attributed to epithelial damage by fluid transport toward the surrounding medium. In conclusion, hypertonic saline solutions decrease CBF and disrupt nasal epithelial cells in vitro.


Assuntos
Mucosa Nasal/efeitos dos fármacos , Solução Salina Hipertônica/farmacologia , Técnicas de Cultura de Células , Humanos , Soluções Hipotônicas/farmacologia , Soluções Isotônicas/farmacologia , Masculino , Microscopia Eletrônica , Depuração Mucociliar/efeitos dos fármacos , Mucosa Nasal/ultraestrutura , Fatores de Tempo
13.
Laryngoscope ; 111(1): 153-8, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11192885

RESUMO

OBJECTIVES: Temperature-controlled and temperature-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 ofRFTVR and laser vaporizing turbinoplasty (LVT) using subjective symptom scores and objective tests. STUDY DESIGN: Prospective, randomized clinical trial. METHODS: Twenty-four patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively evaluated from March 1999 to October 1999 at Seoul National University Hospital (Seoul, Korea). Sixteen patients were treated with RFTVR, and eight patients with LVT. The preoperative and postoperative nasal functions were investigated by visual analogue scale of symptoms, butanol threshold test, saccharine test, acoustic rhinometry, rhinomanometry, and ciliary beat frequency. RESULTS: At 8 weeks postoperatively, the severity and the frequency of nasal obstruction improved subjectively in 81.3% and 93.8% of RFTVR group and in 87.5% and 87.5% of LVT group, respectively. Significant improvement of nasal symptoms began from 2 to 3 days after the operation in the RFTVR group, whereas there was significant improvement of nasal symptoms at 8 weeks after operation in the LVT group. However, objective nasal functions including nasal volume and total nasal resistance were significantly improved at 8 weeks after surgery in both groups. Among patients reporting symptoms of hyposmia, 55.6% of RFTVR group and 63.6% of LVT group showed improved olfaction. Saccharin transit time and ciliary beat frequency were preserved after RFTVR CONCLUSION: RFTVR for the turbinate may be useful as an alternative approach for the treatment of chronic turbinate hypertrophy.


Assuntos
Ablação por Cateter , Obstrução Nasal/cirurgia , Nariz/fisiopatologia , Conchas Nasais/cirurgia , Acústica , Adulto , Resistência das Vias Respiratórias/fisiologia , Butanóis , Ablação por Cateter/instrumentação , Ablação por Cateter/métodos , Cílios/fisiologia , Feminino , Seguimentos , Humanos , Hipertrofia , Terapia a Laser/métodos , Masculino , Manometria , Depuração Mucociliar/fisiologia , Cavidade Nasal/patologia , Mucosa Nasal/fisiopatologia , Obstrução Nasal/patologia , Obstrução Nasal/fisiopatologia , Odorantes , Transtornos do Olfato/fisiopatologia , Satisfação do Paciente , Estudos Prospectivos , Reoperação , Sacarina , Limiar Sensorial/fisiologia , Olfato/fisiologia , Estatísticas não Paramétricas , Temperatura
14.
Laryngoscope ; 111(2): 246-50, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11210869

RESUMO

OBJECTIVES: This study was performed to investigate the changes in ciliary beat frequency (CBF) after treatment with Larginine in the human sinus mucosa and to determine the distribution of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in the healthy sinus mucosa. STUDY DESIGN/METHODS: CBF was measured in the sphenoid sinus mucosa of 12 patients who underwent trans-septal trans-sphenoidal hypophysectomy for the treatment of pituitary gland tumor. CBF was measured over 24 hours in Dulbecco's modified Eagle's medium (DMEM) after treatment with L-arginine, its inactive spatial isomer D-arginine, or an NOS inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME). DMEM without treatment with these materials was used as a control. Other pieces of the mucosa were exposed to L-NAME and its inactive spatial isomer D-NAME after preincubation with L-arginine. The specimens were immunohistochemically stained for iNOS and eNOS. RESULTS: CBF increased 24 hours after treatment with L-arginine as compared with control groups. CBF increased in proportion to the increasing concentrations of L-arginine. There was no significant change after treatment with D-arginine or L-NAME. CBF increased after treatment with L-arginine at 30 minutes and maintained for 24 hours. L-NAME inhibited the increase in CBF by L-arginine, but D-NAME showed no such effect. Immunoreactivity to both iNOS and eNOS was frequently observed in the ciliated epithelial cells and was stronger to eNOS than to iNOS. CONCLUSIONS: From the results of this study it is suggested that nitric oxide (NO) produced by iNOS and eNOS using L-arginine may increase CBF in the healthy sinus mucosa and that NO may have a regulatory function in ciliary motility in the human sinus mucosa.


Assuntos
Depuração Mucociliar/fisiologia , Óxido Nítrico Sintase/metabolismo , Óxido Nítrico/fisiologia , Mucosa Respiratória/enzimologia , Indução Enzimática/fisiologia , Humanos , Técnicas Imunoenzimáticas , Mucosa Nasal/enzimologia , Valores de Referência
15.
Laryngoscope ; 111(10): 1774-8, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11801944

RESUMO

OBJECTIVES: To introduce a new surgical technique for endoscopic removal of the antral portion of antrochoanal polyp (ACP) by powered instrumentation and to determine its efficacy by measures of relevant patient outcome. STUDY DESIGN: Prospective study in 28 patients undergoing endoscopic sinus surgery for ACP by our surgical technique. METHODS: Improvements of clinical symptoms and endoscopic and computed tomographic findings were evaluated postoperatively with a follow-up period ranging from 12 to 52 months. All symptom scores on a 100-mm visual analogue scale before operation were compared with those at the last visit after operation. Postoperative endoscopic and computed tomographic findings were graded using a three-point scale ranging from 0 to 2. In surgical technique, the antral portion of ACP was identified through the enlarged ostium under intranasal endoscopy and removed by a blade of powered instrumentation that was inserted through the canine fossa. RESULTS: Symptom scores were all significantly reduced postoperatively. All but one patient showed improvement in clinical symptoms and endoscopic and computed tomographic findings during the follow-up period. There were no major complications specific to this technique. CONCLUSION: Our technique provides an attractive alternative to other methods for removing the antral portion of an ACP and is associated with excellent outcomes and minimal morbidities.


Assuntos
Endoscopia , Neoplasias do Seio Maxilar/cirurgia , Pólipos Nasais/cirurgia , Pólipos/cirurgia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Pólipos Nasais/diagnóstico , Pólipos Nasais/patologia , Pólipos/diagnóstico , Pólipos/patologia , Complicações Pós-Operatórias/diagnóstico , Estudos Prospectivos , Instrumentos Cirúrgicos , Tomografia Computadorizada por Raios X
16.
Laryngoscope ; 110(12): 2085-8, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11129026

RESUMO

OBJECTIVES: To investigate the in vitro effects of staphylococcal beta-toxin on ciliary activity and the in vivo effects on sinusitis induction. STUDY DESIGN: The in vitro effects of staphylococcal beta-toxin on ciliary activity were investigated at different concentrations and exposure times. Experimental sinusitis was induced in rabbits with application of beta-toxin and confirmed 7 days later. METHODS: Ciliated epithelial cells were taken from the maxillary sinus mucosa of 10 rabbits. Five culture dishes from each rabbit were used for the experimental group, and one culture dish from each rabbit was used for the control group. In the experimental group, ciliary beat frequency (CBF) was measured at concentrations of 0.1, 1, 2, 5 and 10 U/mL of beta-toxin using a video-computerized analysis technique, while in the control group, culture medium containing no toxin was used. CBF was measured 1, 2, 4, 6, 8, 12, 24, and 48 hours after administration of beta-toxin. To induce experimental sinusitis, 2 U/mL of beta-toxin was percutaneously applied to the maxillary sinus of 10 rabbits without occlusion of the natural ostium, while normal saline was percutaneously applied to the right-side maxillary sinus of 4 rabbits in the control group. At 7 days, mucosal membranes were taken from the inferomedial wall of the maxillary sinus for light microscopic study. RESULTS: CBF dropped significantly after an 8-hour incubation at 2, 5, and 10 U/mL of beta-toxin. No ciliary activity was observed after a 24-hour incubation at 2 and 5 U/mL and a 12-hour incubation at 10 U/mL of beta-toxin. Mucoid, purulent discharge was observed in the maxillary sinuses of the beta-toxin-applied group. Prominent epithelial disruption and infiltration of inflammatory cells into the epithelium and lamina propria were observed in the beta-toxin-applied group. CONCLUSIONS: Staphylococcal beta-toxin may reduce ciliary activity and induce sinusitis without occlusion of the natural ostium of the maxillary sinus in rabbits This study provides another animal model of sinusitis for understanding the pathogenesis of sinusitis induced by bacterial exotoxins.


Assuntos
Toxinas Bacterianas/farmacologia , Cílios/efeitos dos fármacos , Sinusite Maxilar/microbiologia , Mucosa Nasal/citologia , Esfingomielina Fosfodiesterase , Staphylococcus aureus , Animais , Células Cultivadas , Cílios/fisiologia , Modelos Animais de Doenças , Células Epiteliais , Proteínas Hemolisinas , Coelhos
17.
Ann Otol Rhinol Laryngol ; 109(8 Pt 1): 726-30, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10961804

RESUMO

Platelet activating factor (PAF), a potent chemical mediator in inflammation and allergic reaction, has been thought to induce mucociliary inhibition and epithelial damage in the airway mucosa. However, several recent papers have reported that PAF may not readily damage the airway epithelium. The aim of this study was to elucidate the pathogenesis of PAF-induced epithelial damage in terms of ultrastructural changes. Sixteen micrograms of PAF (1 mL of 16 microg/mL) was administered into the maxillary sinuses of rabbits. The rabbits were divided into 2 groups according to time intervals, and the antral mucosa was taken 1 and 3 days after administration of PAF. The tissue was processed for routine transmission electron microscopy. No epithelial degeneration was observed other than platelet aggregation, red blood cell stasis, and swelling of the endothelial cells 1 day after administration of PAF. Migration of inflammatory cells into the perivascular connective tissue, infiltration of eosinophils into the subepithelial and intraepithelial spaces, and vacuolar degeneration of the epithelial cells with focal loss of cilia were seen 3 days after administration of PAF. In conclusion, PAF induced infiltration of eosinophils into the epithelium, and resulted in epithelial degeneration that varied according to the time interval. Our findings suggest that PAF may cause epithelial damage through a series of secondary events, probably due to cytotoxicity of eosinophils infiltrating the epithelium.


Assuntos
Seio Maxilar/efeitos dos fármacos , Seio Maxilar/patologia , Fator de Ativação de Plaquetas/farmacologia , Mucosa Respiratória/efeitos dos fármacos , Mucosa Respiratória/patologia , Animais , Microscopia Eletrônica , Coelhos
18.
J Korean Med Sci ; 15(3): 255-9, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10895964

RESUMO

Since the last decade, new insights into inflammatory processes have become possible by investigating the pattern of cytokines in acute and chronic sinus diseases. This review aims to update and discuss the findings of in vitro and in vivo studies concerning the role of cytokines in sinusitis and nasal polyposis. The proinflammatory cytokines interleukin-1beta, interleukin-6 and the neutrophil-chemoattractant interleukin-8 may play a major role in acute sinusitis, as shown in viral and allergic rhinitis. In chronic sinusitis interleukin-3 dominates the cytokine profiles, giving support to a variety of inflammatory cells. Interleukin-5 is a key protein in the pathogenesis of nasal polyposis. Activation and survival of eosinophils in nasal polyps are thought to be regulated by interleukin-5. Further investigation of cytokine expression patterns in inflammatory sinus diseases will lead to a better understanding of their pathogenesis and to a development of new therapeutic modality.


Assuntos
Citocinas/imunologia , Rinite/imunologia , Sinusite/imunologia , Doença Aguda , Doença Crônica , Humanos , Pólipos/imunologia
19.
Ann Otol Rhinol Laryngol ; 109(5): 484-7, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10823478

RESUMO

Macrolide antibiotics have a variety of actions along with antimicrobial action. To determine the effects of oral administration of clarithromycin (CAM) on rheological properties, we measured the spinability, dynamic viscoelasticity, and solid composition of human nasal mucus from 18 patients with chronic sinusitis before and after administration of CAM for 4 weeks. After administration of CAM, the spinability and percent solid composition of nasal mucus increased from 26.5 +/- 12.2 mm to 40.2 +/- 18.7 mm and 7.86% +/- 3.47% to 13.90% +/- 3.67% (p < .05), respectively, whereas the ratio of the viscosity to the elasticity (eta'/G') of nasal mucus after the administration of CAM decreased in all of the mucus samples. These results suggest that treatment with CAM may modulate the rheological properties of nasal mucus in patients with chronic sinusitis.


Assuntos
Antibacterianos/farmacologia , Claritromicina/farmacologia , Mucosa Nasal/efeitos dos fármacos , Sinusite/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/uso terapêutico , Doença Crônica , Claritromicina/uso terapêutico , Elasticidade/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Reologia/efeitos dos fármacos , Resultado do Tratamento , Viscosidade/efeitos dos fármacos
20.
Chest ; 117(2): 427-33, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10669686

RESUMO

STUDY OBJECTIVE: There is growing evidence that regular beta(2)-agonist use in patients with asthma is associated with decreased airway caliber and increased bronchial responsiveness. The aim of this study was to determine whether regular treatment with beta(2)-agonists induces changes in lung function and bronchial responsiveness in patients with primary ciliary dyskinesia. DESIGN: A randomized, double-blind, placebo-controlled, crossover study. PATIENTS: Nineteen children with primary ciliary dyskinesia. INTERVENTIONS: Subjects received inhaled salbutamol or identical placebo (2 x 100 microg qid) for periods of 6 weeks with a wash-out period of 4 weeks. MEASUREMENTS AND RESULTS: FEV(1) was measured before and 3 weeks and 6 weeks after salbutamol or placebo treatment. High-dose methacholine inhalation tests were performed before and 6 weeks after each treatment. The provocative concentration of methacholine producing a 20% fall in FEV(1) (PC(20)) and maximal airway narrowing (MDeltaFFEV(1)) was measured. No significant change in FEV(1) was observed during the salbutamol or placebo periods. No significant differences in the parameters of bronchial responsiveness (PC(20) and MDeltaFFEV(1)) were noted as the result of either salbutamol or placebo treatment. CONCLUSION: Our data have shown that salbutamol, inhaled regularly for 6 weeks, did not cause either a decline in lung function or an increase in bronchial responsiveness in subjects with primary ciliary dyskinesia.


Assuntos
Agonistas Adrenérgicos beta/administração & dosagem , Albuterol/administração & dosagem , Hiper-Reatividade Brônquica/induzido quimicamente , Broncodilatadores/administração & dosagem , Transtornos da Motilidade Ciliar/tratamento farmacológico , Medidas de Volume Pulmonar , Administração por Inalação , Adolescente , Agonistas Adrenérgicos beta/efeitos adversos , Resistência das Vias Respiratórias/efeitos dos fármacos , Albuterol/efeitos adversos , Hiper-Reatividade Brônquica/diagnóstico , Testes de Provocação Brônquica , Broncodilatadores/efeitos adversos , Criança , Estudos Cross-Over , Método Duplo-Cego , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Masculino
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