Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft

Relapsing polychondritis (RP) is an uncommon systemic disease that is characterized by episodic and progressive inflammation of the cartilaginous structures, which can be very debilitating and in some instances life-threatening. The pathogenic pathways of RP are largely unknown. However, several hypothesis have been suggested. We had an interesting case of aggravation of RP due to the infection. Graft cartilage on the nasal tip was affected by RP also. This case can give a clue of revealing the pathogenesis of RP. We introduce a case with a review of the literature.

Clinical Analysis of Characteristics of Patients Who Visit Otorhinolaryngology Clinic in Secondary General Hospital / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Common cold is an upper airway viral infection and can be managed by conservative treatment. According to the hospital referral system, mild diseases like common cold should be treated first at a primary physician clinic. However, now in Korea, visiting high-level hospitals for mild diseases is not impossible officially and even the rate of visiting high-level general hospital has increased in spite of the current hospital referral system. This study aimed to provide data of characteristics of patients who choose high-level hospitals for mild diseases like common cold. SUBJECTS AND METHOD: We conducted a survey targeting those who visit general hospitals for common cold. The questionnaire comprised of asking first choice of contact hospital, sex, age, awareness and use of antibiotics when visiting primary physician, medical examinations and duration of treatment, and reasons for thinking that general hospitals are superior to primary hospitals. Subjects were categorized according to their choice of first contact hospital with common cold, primary physician or general hospital. For each group, independent sample t-test and chi-square test were applied to variables. RESULTS: Among the variables for the two groups, statistical significances were found in age, duration of treatment and whether medical examinations were performed or not. CONCLUSION: Underestimation for primary physician and vague faith in medical examinations were most influential factors that lead patients with mild diseases to visit general hospitals. This study finds that programs for educating the public are necessary to make them understand that primary physician clinics are enough to treat common cold and that an institutional framework will be needed to support the hospital referral system.

The role of mapk and pkc-delta in phosphatidic acid-mediated intercellular adhesion molecule-1 expression

BACKGROUND: Phosphatidic acid (PA), an important second messenger, is involved in inflammation. Notably, cell-cell interactions via adhesion molecules play a central role in inflammation. This thesis show that PA induces expression of intercellular adhesion molecule-1 (ICAM-1) on macrophages and describe the signaling pathways. MATERIALS AND METHODS: Macrophages were cultured in the presence of 10% FBS and assayed cell to cell adhesion using HUVEC. For the gene and protein analysis, RT-PCR, Western blot and flow cytometry were performed. In addition, overexpressed cell lines for dominant negative PKC-delta mutant established and tested their effect on the promoter activity and expression of ICAM-1 protein by PA. RESULTS: PA-activated macrophages significantly increased adhering to human umbilical vein endothelial cell and this adhesion was mediated by ICAM-1. Pretreatment with rottlerin (PKC-delta inhibitor) or expression of a dominant negative PKC-delta mutant, but not Go6976 (classical PKC-alpha inhibitor) and myristoylated PKC-zeta inhibitor, attenuated PA-induced ICAM-1 expression. The p38 mitogen-activated protein kinase (MAPK) inhibitor blocked PA-induced ICAM-1 expression in contrast, ERK upstream inhibitor didn't block ICAM-1. CONCLUSION: These data suggest that PA-induced ICAM-1 expression and cell-cell adhesion in macrophages requires PKC-delta activation and that PKC-delta activation is triggers to sequential activation of p38 MAPK.

A Case of Schwannoma of the Nasal Cavity Mimicking Olfactory Neuroblastoma / 대한이비인후과학회지

Schwannoma is a benign, slowly growing nerve sheath tumor which can arise from any peripheral nerve containing schwann cells. The olfactory and optic nerves, the extentions of the central nerve system, are encased by glial cells and they lack of schwann cells. They do not give rise to schwannomas in the head and neck area. Therefore, it is generally known that schwannomas seldom occur in the nasal cavity occupied by the olfactory nerve. We have experienced a tumor that developed in the upper nasal cavity including the olfactory cleft and ethmoid sinus. Based on the location of tumor development, we initially diagnosed it as an olfactory neuroblastoma, and its biopsy results reported the tumor to be a schwannoma in the nasal cavity. The tumor was completely removed through craniofacial resection. We herein report a case of an olfactory schwannoma with a brief review of the literature in order to alert other clinicians to this rare tumor to expedite appropriate management.

Changes in Quality of Life after Adenotonsillectomy in Children with Sleep Disordered Breathing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sleep disordered breathing (SDB) comprises a spectrum of airway disorders that range from simple snoring to obstructive sleep apnea (OSA). In children, SDB can have an effect on the quality of life such as behavior, school performance, emotional distress and daytime function. We aim to verify changes in disease specific health related quality of life before and after adenotonsillectomy in children with SDB. SUBJECTS AND METHOD: Children aged 4 through 15 years old, a total of 50 (M:36, F:14) with symptoms of snoring, mouth breathing, sleep apnea and physical examination results demonstrating tonsil size of 3+ or greater, were included. To evaluate the quality of life in children, two standard questionnaires KOSA-18 (Korean Obstructive Sleep Apnea-18 Survey) and KOSA-6 (Korean Obstructive Sleep Apnea-6 Survey) were given to the parents of children to complete, preoperatively and postoperatively. RESULTS: There was significant improvement after adenotonsillectomy in the total score of KOSA-18 and KOSA-6. In KOSA-18 and KOSA-6, all domain scores showed improvement after surgery. CONCLUSION: Children with SDB who undergo adenotonsillectomy show significant improvement in the quality of life. Therefore, we suggest that surgical intervention could be recommended to improve the quality of life in children with adenotonsillar hypertrophy.

The Treatment of Pressure Sore Using Hydrogel and Hydrocolloid Dressing

Pressure sores are a common complication of hospitalized patients. However, It is often impossible to correct surgically because the general conditions of these patients are poor. It is known that the hydrogel has a powerful autolytic effect by providing moist environments and facilitates wound healing and hydrocolloid dressing is also known to promotes granulation tissue formation and epithelialization. The patients were treated with hydrogel(Purion gel(R), Coloplast A/S, Denmark) and hydrocolloid dressing (Comfeel Plus Transparent Dressing(R), Coloplast A/S, Denmark) after surgical debridement of pressure sores progressed to stage III(n=2) and IV(n=7). This combination treatment could facilitate to debride the nectrotic tissue and promote granulation tissue formation epithelialization simultaneously. We could achieve complete healing of pressure sores using the combination treatment without requiring surgical correction. In conclusion, hydrogel in combination with hydrocolloid dressing is effective in acheiving complete healing of progressed pressure sores.

Motor Innervation and Nerve Pathway of Glabellar Expression Muscles

We studied the motor innervation and the nerve pathway of glabellar expression muscles and a kind of glabellar skin wrinkles. Electric stimulation and surface tracing of the temporal and zygomatic branches of the facial nerve was performed using an electric nerve stimulator on both sides of 14 healthy volunteers. Micro- dissection of four cadaveric heads were also performed to confirm the results of nerve stimulation test. The corrugator supercilii muscle is innervated by the temporal branch of the facial nerve. The depressor supercilii muscle, the medial head of the orbicularis oculi muscle, and the procerus muscle are innervated by the zygomatic branch. The temporal branch to the corrugator supercilii muscles travels in a curvilinear pattern superior to the upper margin of the eyebrow. The zygomatic branch to the glabellar expression muscles travels in a curvilinear pattern inferior to the inferior orbital rim in the proximal portion and in a cobwebby pattern medial to the medial orbital rim in the distal portion. In cadaveric study, the zygomatic nerve branches off in the inferomedial orbital portion, and its fine branches enter into the procerus muscle, the depressor supercilii muscle, and the orbicularis oculi muscle. The surface pathway of the motor nerve to the glabellar expression muscles is described. We think that the zygomatic and temporal branches both should be blocked simultaneously to improve glabellar skin wrinkles completely.

Foot salvage procedure usng saphenous ven graftin schemc vascuar disease

Diabetic and nondiabetic vascular diseases cause significant foot problems and it frequently progress to osteomyelitis and amputation. Advances in vascular surgical techniques, including distal arterial bypass via synthetic grafts or autogenous vein grafting have opened the way for higher rate of limb salvage. We have experienced patients with ischemic vascular foot disease and combined skin ulceration and varing degree of soft tissue defect. In three patient with major vessel obstruction, we could preserve limb and avoid major amputation using greater saphenous vein graft with or without microvascular free tissue transfer.

W-Shaped Triple V-Y Advancement Flaps for the Correction of Secondary Cleft Lip Nasal Deformity

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.

A study on the evaluation of stress in the alcoholic patients

No abstract available.

Analysis of stress by korean social rcadjustment rating scale in peptic ulcer patients

No abstract available.