골수이식환자의 부비동 방사선 양성소견의 의의

윤성재,신창민,이혜령,허준영,김정수,김태훈,조인지 대한비과학회 2008 Journal of rhinology Vol.15 No.2

Background:Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). Objectives:The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. Materials and Methods:We reviewed the records of 203 patients who had received BMT in Kyungpook National University’s hospital from September 1998 to August 2006. Result:Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. Conclusion:Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis. Background:Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). Objectives:The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. Materials and Methods:We reviewed the records of 203 patients who had received BMT in Kyungpook National University’s hospital from September 1998 to August 2006. Result:Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. Conclusion:Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis.

만성 비-부비동염의 중증도에 대한 알레르기의 역할

류 찬,권용재,윤성문,이일로,강준명,장한성,원유성,윤희로 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.7

비부비동염의 보완대체의학 약물치료에 대한 최신 임상 연구 동향 -RCT 연구를 중심으로 -

장은하,민상연,김장현,Jang, Eun Ha,Min, Sang Yeon,Kim, Jang Hyun 대한한방소아과학회 2018 대한한방소아과학회지 Vol.32 No.3

Objectives The purpose of this study is to analyze clinical studies on effectiveness of herbal medicine in rhinosinusitis. Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on rhinosinusitis from the Pubmed in recent 10 years (from 2008 to 2018). Results 11 RCTs were reviewed. In 10 out of 11 studies showed that the herbal medicine may be effective in the treatment of chronic rhinosinusitis without nasal polyp and uncomplicated acute rhinosinusitis. However, inclusion and exclusion criteria, and outcome measures were varied among different studies. No serious adverse reactions were reported from the herbal medicine treatment. Conclusions The results of these trials showed that herbal medicine may be effective in the treatment of rhinosinusitis. Well-designed RCTs for domestic herbal medicine treatment on rhinosinusitis are needed to prove its efficacy clearly.

Association between a TGF<i>β</i>1 promoter polymorphism and rhinosinusitis in aspirin-intolerant asthmatic patients

Kim, Seung-Hyun,Park, Hae-Sim,Holloway, John W.,Shin, Hyoung-Doo,Park, Choon-Sik Bailliere Tindall,in association with the British 2007 Respiratory medicine Vol.101 No.3

<P><B>Summary</B></P><P><B>Background</B></P><P>Rhinosinusitis is highly associated with aspirin-intolerant asthma (AIA). The risk of aspirin intolerance is higher in people with rhinosinusitis than in those without it. Recently, the role of transforming growth factor <I>β</I>1 (TGF<I>β</I>1) in the pathogenesis of chronic rhinosinusitis has come under investigation. The goal of this study was to evaluate the association of <I>TGFβ1</I> gene polymorphism with an AIA phenotype in the Korean population.</P><P><B>Methods</B></P><P>A promoter polymorphism of the <I>TGFβ1</I> gene, TGF<I>β</I>1-509C>T, and a coding polymorphism (L10P), were genotyped in 203 patients with AIA, 324 patients with aspirin-tolerant asthma (ATA), and 456 normal controls (NC). Serum TGF<I>β</I>1 levels were determined by ELISA.</P><P><B>Results</B></P><P>The TGF<I>β</I>1-509C>T polymorphism was not significantly associated with the AIA phenotype; however, a significant association with the prevalence of rhinosinusitis in AIA (P=0.012), but not in ATA (P>0.05), was observed. When stratified by the presence of rhinosinusitis, the frequency of T allele carriers (CT or TT genotype) of TGF<I>β</I>1-509C>T was significantly higher in AIA (87.1%) compared to ATA (52.9%, P<0.001, OR=6.0, 95% CI=3.3–11.1). In addition, AIA patients carrying the TGF<I>β</I>1-509T allele showed a lower serum TGF<I>β</I>1 level compared to AIA patients carrying the TGF<I>β</I>1-509 CC genotype, especially when stratified by the presence of rhinosinusitis (P=0.002).</P><P><B>Conclusion</B></P><P>Our results show that the TGF<I>β</I>1 polymorphisms are not associated with the AIA phenotype in the Korean population, but may contribute to the development of the AIA phenotype with rhinosinusitis.</P>

부비동염 수술 후 시행한 뇌하수체 샘종 제거를 위한 경접형동 접근법의 임상 결과

김동섭(Dong Sup Kim),박찬순(Chan-Soon Park),김영일(Young Il Kim),김일섭(Il Sup Kim),성재훈(Jae Hoon Sung),양승호(Seung Ho Yang) 대한두개저학회 2019 대한두개저학회지 Vol.14 No.1

Background: Transsphenoidal surgery (TSS) is the mainstay of treatment for sellar and parasellar lesions. Nasal and paranasal sinus inflammation is considered a contraindication to TSS because of possible transcranial spread of infection. The objective of this study was to determine outcomes of TSS after operations for rhinosinusitis. Methods: Medical records and radiological findings of 8 consecutive patients who underwent TSS for pituitary adenomas following operations for rhinosinusitis were reviewed. Results: These patients consisted of 2 men and 6 women, with a mean age of 56.8 years (range, 34-74 years). Their presenting symptoms were visual defect (4 patients) and headache (4 patients) from neurosurgeon’s aspect. Rhinology examination revealed a preoperative Lund-Mackay score of 1 to 6 with involvement of sphenoid and ethmoid sinuses in 8 and 4 patients, respectively. Fungal infection was confirmed in 3 patients intraoperatively. The median interval between rhinosinusitis surgery and TSS was 55.8 days (range, 7-155 days). The median duration of antibiotics administration was 32.9 days (range, 9-84 days) after the rhinosinusitis surgery. Intraoperative tearing of suprasellar cistern and cerebrospinal fluid (CSF) leakage occurred in 5 patients during TSS for pituitary adenomas. Postoperative meningitis was noted in 2 patients and treated with further antibiotics administration. Conclusions: It is important to treat rhinosinusitis issues preoperatively for TSS. Intraoperative CSF leakage could increase the risk of postoperative meningitis in patients with rhinosinusitis even though it has been treated surgically and medically. Collaboration between rhinologist and neurosurgeon is mandatory for patients’ safety.

포도상 구균에 의해 유발된 급성 비부비동염 흰쥐 모델

김현성,전시영,안성기,김진평,박정제,정재호,성병기,강윤식 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.6

Background and Objectives:An experimental model of bacterial rhinosinusitis is essential to study the pathogenesis of rhinosinusitis.To our knowledge, there hasnt been an experimental model using rats for bacterial rhinosinusitis, where Staphylococcusaureus is directly inoculated to the rat nose. Staphylococcus aureus is also a predominantly isolated bacterial pathogen in theepisode of acute rhinosinusitis. The aim of this study was to develop a rat model of rhinosinusitis induced by Staphylococcus aureus,ATCC 25923. Subjects and Method:The infected Sprague-Dawley rats (4-6 week-old male) were applied intranasally with40 μl of Staphylococcus aureus, ATCC 25923, which corresponds to 108 colony-forming units per milliliter, which in turncorresponds to a No. 1 McFarland turbidity by spectrophotometer (VITEK, USA). After the 2nd, 5th, and 14th day, the ratswere killed respectively. Results:Nasal sinuses were then observed at low power field (×40) for changes in the amount ofinflammatory cell clusters in the sinus cavity. There were significant differences in the number of inflammatory cell clustersbetween the infected and control rats (p<0.05). The infected rats killed at the 5th day had significantly more inflammatory cellclusters within the sinus cavities (p<0.05). Conclusion:Staphylococcus aureus induces acute bacterial rhinosinusitis in rats asmeasured by increased inflammatory cell clusters. This study demonstrates the efficacy of a rat model of acute bacterial rhinosinusitis

만성 비부비동염의 중증도 평가시 Lund-Mackay 병기판정법의 임상적 의의

류 찬,정민교,이주형 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.8

Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis

Baek, Ji Hyeon,Seo, Hyun Kyong,Jee, Hye Mi,Shin, Youn Ho,Han, Man Yong,Oh, Eun Sang,Lee, Hyun Ju,Kim, Kyung Hyo The Korean Pediatric Society 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.7

Purpose: Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis. Methods: We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3-11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses ($IgG_1$, $IgG_2$, $IgG_3$, and $IgG_4$) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV), and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers ${\geq}0.35{\mu}g/mL$ or with a ${\geq}4$-fold increase were considered as positive responses. Results: The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. $IgG_1$ deficiency was observed in 1 patient and $IgG_3$ deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types. Conclusion: Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.

Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis

백지현,서현경,지혜미,신윤호,한만용,오은상,이현주,김경효 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.7

Purpose: Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis. Methods: We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3–11 years (mean age, 5.6 years), who had rhinosinusitis for >3months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses (IgG1, IgG2, IgG3, and IgG4) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV),and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers ≥0.35μg/mL or with a ≥4-fold increase were considered as positive responses. Results: The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. IgG1 deficiency was observed in 1patient and IgG3 deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types. Conclusion: Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.

비부비동염의 조직재형성

이흥만 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.6

Chronic rhinosinusitis is characterized by chronic inflammation of the nasal and paranasal mucosae and is currently classified into two major subgroups on the basis of the absence or presence of nasal polyps. A distinct set of inflammatory and remodeling factors has been found elevated in chronic rhinosinusitis. Transforming growth factor-β and matrix metalloproteinases are critical factors involved in the remodeling process. Transforming growth factor-β has been implicated as an important factor in remodeling processes involved in chronic rhinosinusitis, and serves as a main switch for different remodeling patterns in chronic rhinosinusitis.