Publications by authors named "Ki-Il Lee"

7 Publications

  • Page 1 of 1

Tolosa-Hunt Syndrome Misdiagnosed as Surgical Complication After Frontal Balloon Sinuplasty.

J Craniofac Surg 2021 Jan 28. Epub 2021 Jan 28.

Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea.

Abstract: Tolosa-Hunt syndrome (THS) is a rare benign disease caused by granulomatous inflammation in the craniofacial region. It is mostly idiopathic and generally presents with painful ophthalmoplegia, ipsilateral oculomotor paresis, and steroid responsiveness. There are few reports of THS after sinus surgery. Here, we present a case of THS in an adult immunocompetent patient with severe ophthalmic pain and diplopia after frontal balloon sinuplasty. The patient was initially misdiagnosed as having a surgical complication. The patient was treated with massive corticosteroid pulse therapy, and the symptoms resolved dramatically. There were no complications or recurrence in the 7-month follow-up period.
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http://dx.doi.org/10.1097/SCS.0000000000007483DOI Listing
January 2021

The effects of intermittent hypoxia on human nasal mucosa.

Sleep Breath 2021 Jan 2. Epub 2021 Jan 2.

Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea.

Purpose: Intermittent hypoxia (IH) is characterized by hypoxia-reoxygenation, reported to be a critical risk factor for obstructive sleep apnea (OSA). This experiment aimed to evaluate the direct effects of IH on the human nasal mucosa.

Methods: The direct effects of IH on the human nasal mucosa was evaluated by measuring the ciliary beat frequency (CBF) and expression levels of inflammatory cytokines (granulocyte-macrophage colony-stimulating factor, transforming growth factor-β, interleukin-6, and tumor necrosis factor-α). The normoxia group was exposed to a normoxic condition for 72 h. The IH group was exposed to 288 cycles of IH (1 cycle: hypoxia, 5 min; subsequent normoxia, 10 min) for 72 h. CBF was measured using an automated computer-based video image processing technique. Changes in the expression of cytokines were assessed by real-time reverse transcription-polymerase chain reaction (RT-PCR).

Results: The normoxia group revealed a persistent CBF pattern and a physiological range of inflammatory cytokines. However, the IH group showed a cyclic decrease in CBF and increased expression of inflammatory cytokines. Cytotoxicity assay indicated no difference in the survival rates between the two groups.

Conclusions: IH results in increased expression of inflammatory cytokines that adversely affects the mucociliary transport in the upper airway and, consequently, may result in airway inflammation.
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http://dx.doi.org/10.1007/s11325-020-02280-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778489PMC
January 2021

Columellar Wound Immediately After Open Rhinoseptoplasty Treated With Application of DuoDERM Extra Thin.

J Craniofac Surg 2021 Jan-Feb 01;32(1):e98-e99

From the Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.

Abstract: Most patients who undergo open rhinoseptoplasty do not develop any wound at the transcolumellar incision site. However, some patients require wound care immediately post-operation. Dressing is difficult to perform in the columellar region because of the location. Here, we report 2 cases of columellar wound as a complication of open rhinoseptoplasty. A patient developed mild wound dehiscence immediately after primary rhinoseptoplasty, whereas another developed partial columellar skin necrosis after the revision operation. We applied DuoDERM Extra Thin dressing (ConvaTec Group, Deeside, UK) for columellar wound and achieved healing. DuoDERM Extra Thin can be a simple and easy dressing material for immediate care of transcolumellar wounds.
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http://dx.doi.org/10.1097/SCS.0000000000006782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769182PMC
September 2020

Strain-Specific Differences in House Dust Mite (Dermatophagoides farinae)-Induced Mouse Models of Allergic Rhinitis.

Clin Exp Otorhinolaryngol 2020 Nov 15;13(4):396-406. Epub 2020 May 15.

Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea.

Objectives: Limited information is available regarding strain-related differences in mouse models of allergic rhinitis induced by Dermatophagoides farinae (Der f1). In this study, we compared differences between two mouse strains and determined the optimal dose of Der f1 for allergic rhinitis mouse models.

Methods: Forty-eight mice were assigned to the following six groups (n=8 per group): group A (control, BALB/c), group B (Der f1-sensitized BALB/c, 25 µg), group C (Der f1-sensitized BALB/c, 100 µg), group D (control, C57BL/6), group E (Der f1-sensitized C57BL/6, 25 µg), and group F (Der f1-sensitized C57BL/6, 100 µg). Allergic inflammation was induced with Der f1 and alum sensitization, followed by an intranasal challenge with Der f1. Rubbing and sneezing scores, eosinophil and neutrophil infiltration, and immunoglobulin, cytokine, and chemokine levels in the nasal mucosa and from splenocyte cultures were assessed.

Results: Rubbing and sneezing scores were higher in groups B, C, E, and F than in groups A and D, with a similar pattern in both strains (i.e., group B vs. E and group C vs. F). Serum immunoglobulin levels were significantly elevated compared to the control in groups B and C, but not in groups E and F. Eosinophil and neutrophil infiltration increased (all P<0.05) after the Der f1 challenge (groups B, C, E, and F) compared to the control (groups A and D) in both the BALB/c and C57BL/6 strains, without any significant difference between the two strains (group A vs. D, group B vs. E, and group C vs. F) (P>0.05). BALB/c mice (group B) showed a greater elevation of splenic interleukin (IL)-4 (P<0.01), IL-5 (P<0.01), and IL-6 levels (P<0.05) and nasal IL-4 mRNA levels (P<0.001) than the C57BL/6 mice (group E). Interestingly, mice treated with 100 µg Der f1 showed a weaker allergic response than those treated with 25 µg.

Conclusion: We found 25 µg to be a more appropriate dose for Der f1 sensitization. BALB/c mice are more biased toward a Th2 response and are a more suitable model for allergic rhinitis than C57BL/6 mice. This study provides information on the appropriate choice of a mouse model for allergic rhinitis.
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http://dx.doi.org/10.21053/ceo.2019.01837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669312PMC
November 2020

Cigarette smoke promotes eosinophilic inflammation, airway remodeling, and nasal polyps in a murine polyp model.

Am J Rhinol Allergy 2014 May-Jun;28(3):208-14

Department of Otorhinolaryngology, Dankook University College of Medicine, Chonan, South Korea.

Background: Exposure to cigarette smoking (CS) is a major risk factor for airway inflammation. However, little is known about the effects of CS exposure on eosinophilic rhinosinusitis with nasal polyps (ERSwNPs). Histopathological and molecular studies were performed to investigate its effects using a murine model of ERSwNPs.

Methods: Mice were assigned to one of the following four groups (n = 8 for each group): control group, CS exposure (CS group), ERSwNP (ERS group), and ERSwNPs exposed to CS (ERS + CS group). Histopathological changes were investigated using various stains, including hematoxylin and eosin for inflammation and polyp-like lesions, Sirius red for eosinophils, toluidine blue for mast cells, Alcian blue for goblet cells, and Masson's trichrome stain for collagen fibers. mRNA expression of cytokines from nasal mucosae was measured. Serum IgE and systemic cytokine levels were measured by enzyme-linked immunosorbent assays. The expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF) 1-alpha was evaluated by immunohistochemical staining.

Results: The ERS + CS group showed more severe symptoms, increased the number of polyp-like lesions, infiltration of eosinophils, goblet cell hyperplasia, and subepithelial fibrosis, compared with the ERS group. Additionally, mRNA expressions of IL-4 and IL-17A were up-regulated in ERS + CS group and higher levels of IL-4, IL-6, IL-17A, and interferon gamma from splenocytes were observed significantly in the ERS + CS group compared with the ERS group. In the ERSwNP murine model, exposure to CS enhanced the expression of VEGF and HIF-1-alpha in nasal epithelial cells.

Conclusion: Chronic exposure to CS aggravated eosinophilic inflammation and promoted airway remodeling and nasal polyp formation in a murine model of ERSwNPs. The underlying mechanism might involve up-regulated expression of VEGF and HIF-1-alpha.
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http://dx.doi.org/10.2500/ajra.2014.28.4055DOI Listing
April 2015

Seasonal Specificity of Seasonal Allergens and Validation of the ARIA Classification in Korea.

Allergy Asthma Immunol Res 2013 Mar 27;5(2):75-80. Epub 2012 Nov 27.

Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea.

Purpose: In Korea, tree pollens are known to be prevalent in spring, grass pollens in summer and weed pollens in autumn. However, few studies have revealed their seasonal specificity for allergic rhinitis symptoms. An ARIA (Allergic Rhinitis and its Impact on Asthma) classification of allergic rhinitis was recently introduced and its clinical validation has not been well proved. The aim of this study was to evaluate the seasonal specificity of seasonal allergens and to validate the ARIA classification with the conventional seasonal and perennial allergic rhinitis (SAR/PAR) classification.

Methods: Two hundred twenty six patients with allergic rhinitis were included in this study. The patients were classified according to the sensitized allergens and the ARIA classifications. A questionnaire survey was performed and the data on the seasonal symptom score, the severity of symptoms and the SNOT (sinonasal outcome test)-20 score was obtained and the data was analyzed and compared between the conventional SAR/PAR classification and the ARIA classification.

Results: Seasonal pollens (tree, grass, weed) were not specific to the pollen peak season and the patients' symptoms were severe during spring and autumn regardless of the offending pollens. More than 60% of the patients with SAR showed persistent symptoms and 33% of the patients with perennial allergic rhinitis (PAR) had intermittent symptoms, showing the lack of association between the SAR/PAR/PAR+SAR classification and the ARIA classification. The ARIA classification showed better association not only with the symptomatic score, but also with the SNOT-20 score, which showed better validity than the conventional SAR/PAR classifications.

Conclusions: Seasonal pollens were not specific to their season of prevalence in terms of the severity of symptoms, and the ARIA classification showed better representation of allergic symptoms and quality of life (SNOT-20 score) than did the SAR/PAR classification.
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http://dx.doi.org/10.4168/aair.2013.5.2.75DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579095PMC
March 2013

Analysis of the Development of the Nasal Septum according to Age and Gender Using MRI.

Clin Exp Otorhinolaryngol 2008 Mar 20;1(1):29-34. Epub 2008 Mar 20.

Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Dankook University, Cheonan, Korea.

Objectives: This study was designed to evaluate the normal development of the nasal septum in Koreans using sagittal MRI for the valuable clinical information on septal procedures.

Methods: Two hundred eighty patients who had their whole nasal septum visualized in the midline sagittal view were selected among the 3,904 patients with brain MRI from January, 2004 to December, 2006 at Dankook University Hospital. The patients who had a history of nasal septal surgery or nasal trauma were excluded. Following parameters are calculated and analyzed: lengths of bony and cartilage dorsum and septal cartilage-nasal bone overlap, total septal area, septal cartilage area and, the proportion of the cartilage area to septal area and the maximal harvestable cartilage for grafting were calculated using the PAC program.

Results: All the parameters were increased until adolescence. Thereafter, bony dorsal length, cartilage dorsal length, total dorsal length, total septal area and maximal harvestable cartilage for grafting have not changed significantly with age, while SC-NB overlap length, septal cartilage area, and proportion of the cartilage area to the total septal area were significantly decreased with age. The SC-NB overlap length was positively correlated with the septal cartilage area and the proportion of the cartilage area to the total septal area.

Conclusion: The small septal cartilage area and its proportion to the total septal area were significantly correlated with a short overlap length of the septal cartilage under the nasal bone. Septal procedures should be carefully performed in the elderly due to the risk of incurring saddle nose.
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http://dx.doi.org/10.3342/ceo.2008.1.1.29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671753PMC
March 2008