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Recently, in field of bridge construction, modular technology has been studied to reduce construction period. However, main stream of the study is limited to the pier, girder and deck of bridge, which are huge or main members. Studies on incidental facilities like concrete barrier is out of sight. Thus, in this study, connection system of concrete barrier was developed to apply to modular bridges and static experiment was performed in order to verify structural capability of proposed system. Variables of experiment are composed of bolt direction such as vertical and horizontal. The experimentation due to the designed variables was conducted by comparison with a standard concrete barrier, which is a traditional barrier. As a result, vertical joint way of the bolt showed nearly identical structural performance and healthy to standard specimen`s. it can be applied to modular bridges.

The objectives of the study were to analyze the clinical features of inverted papillomas (IP) associated with malignancy and to evaluate the correlation of tumor stage, survival and histolologic features. We conducted a retrospective review of 18 IP associated with malignancy patients. In addition, we compared histopathologic characteristics (tumor differentiation and malignant cell proportion) with clinical outcomes. Eleven of the tumors were present on the nasal cavity and 7 on the maxillary sinus. The rates of synchronous and metachronous malignancy were 10.1 and 1.1%, respectively. The disease-free survival rate was 83.3%. The tumors were staged as T1 (5/18), T2 (2/18), T3 (8/18), and T4 (3/18). According to the percentage of the malignant cell in the entire tumor tissue, 4 patients (22%) were in grade I, 4 patients (22%) were in grade II, 3 patients (17%) were in grade III, and 7 patients (39%) were in grade IV. There was no relationship between recurrence- and/or disease-free survival and histologic findings including tumor differentiation and malignant proportion. IP-associated malignancy tends to occur synchronously and have more favorable prognosis compared to other sinonasal malignancy. Furthermore, the proportion of malignant cell to IP and tumor stage seems not to affect the clinical outcome of IP-associated malignancy.

To investigate the hypocholesterolemic mechanism of barley in vivo, six-week-old C57BL/6J mice were fed a high-fat diet (HFD) or high-fat diet containing barley (HFD-B) for seven weeks. Total and LDL cholesterol concentrations were significantly reduced in the HFD-B group while fecal cholesterol and bile acid was increased. Real-time PCR and immunoblot analysis revealed the induction of FXR expression, which in turn suppressed the expression of ASBT and NPC1L1 in the HFD-B group compared with the controls. In the liver, the expression of HMG-CoA reductase was significantly reduced while LDL receptor expression was unaltered in the HFD-B group compared with the controls. Our data suggest that the hypocholesterolemic effects of barley are primarily the result of reduced dietary cholesterol uptake and bile acid resorption. Reduced expression of intestinal ASBT and NPC1L1 may play a key role in the regulation of dietary cholesterol and bile acid metabolism in mice consuming a diet containing barley.

Reduced-fat sausages were prepared by replacing pork back fat with barley flours of different particle sizes. Three barley flour fractions with different particle size were obtained by passing the ground barley material through a sieve. Fraction 1 and 2 had a higher water absorption index than other fraction and showed higher peak and final viscosities due to higher β-glucan content. Therefore, fraction 1 and 2 were used as a fat replacer in preparation of reduced-fat sausages. Response surface methodology was employed to optimize the formulation of reduced-fat sausage and the effects of fat content and barley flour paste concentration on the textural properties were analyzed simultaneously. Using a regression model, the optimum formulation of reduced-fat sausage was calculated. For fraction 1, calculated levels of fat content and paste concentration were 7.6 and 3.9%, and for fraction 2, levels were 6.7 and 6.9%, respectively.

쌀과 유산균을 이용한 곡류 발효 음료를 개발하기 위하여 김치로부터 현미 당화물에서산 생성이 우수한 유산균을 선발하였다. 선발된 균주는 L. mesenteroides로 동정되었으며, L. mesenteroides 310-12로 명명하였다. L. mesenteroides 310-12균주를 효소 처리한 현미 당화물 현탁액에 접종한 후 pH, 적정산도, 생균수의 변화를 경시적으로 측정하였다. 동시에 효소를 처리하지 않은 현미 분말 현탁액을 대조군으로 비교하였다. 당화물의 pH는 배양 9시간 이후 pH 3.63으로 급격히 감소한 후 배양 15시간에 pH 3.57로 완만하게 감소하였으나 대조군의 pH는 배양 3시간 후 pH 4.40에서 큰 변화가 없었다. 적정산도는 지속적으로 증가하여 배양 15시간에 0.40%에 도달하였으며, 유기산 함량은 젖산 0.077%, 초산 0.065%로 분석되었다. 생균수는 배양 12시간에 7.9 log CFU/g까지 급격히 증가하였으나 대조군에서 생균수의 증가는 매우 미미하였다. L. mesenteroides 310-12 균주로 발효시킨 현미 당화물에 몇 가지 식품 첨가물을 혼합하여 발효 음료를 제조한 후 4℃에서 보관하면서 pH, 적정산도 및 생균수의 변화를 조사하였다. 제조한 음료를 32일간 저장하였을 경우 pH는 큰 변화를 보이지 않았으나 적정산도는 점차 증가하여 저장 20일에 0.684%까지 증가한 후 감소하는 경향이었다. 생균수는 저장 25일에 7 log CFU/g까지 저장 기간이 증가함에 따라 점차 감소하였다.

Background It has been suggested that sinonasal inverted papilloma (IP) can progress to squamous cell carcinoma (SCC); however, mechanisms of malignant transformation are not fully understood. This study investigated alterations in the expression of cell cycle–related proteins in a multistep process of malignant transformation of IPs. Methods The expression of cell cycle–related proteins, including p53, p21, p16, and p63, was evaluated by immunohistochemistry in 21, 56, 7, and 18 cases of nasal polyps, IPs, IPs with dysplasia, and IPs with SCC, respectively. Furthermore, we determined the possible correlation between the expression of these proteins and clinicopathological variables in patients with IPs with SCC. Results Expression of p53 was found only in 8 of 18 IPs with SCC (44.4%). The frequency of p21 positivity was significantly higher in IPs with dysplasia (71.4%) and IPs with SCC (77.8%) compared with nasal polyps (0%) and IPs (12.5%). A p16 positivity was observed in 82.1% of IPs and 57.1% of IPs with dysplasia, whereas 83.3% of IPs with SCC showed an apparent loss of p16 protein expression. A p63 positivity was found in all specimens, but the percentage of positive cells was significantly increased in IPs with dysplasia and IPs with SCC compared with nasal polyps and IPs. There was no significant correlation between the expression of these proteins and clinicopathological variables, such as tumor stage, histological differentiation, and the proportion of malignant areas in patients with IPs with SCC. Conclusion Alteration of cell cycle–related proteins may contribute importantly to the malignant transformation from IP to SCC.

Sialectasis of Stensen's duct is an uncommon condition of the salivary gland featuring dilation of the parotid duct. Various surgical and non-surgical treatment modalities have been reported as treatment for Stensen's duct stenosis. In this report, a rare case of sialectasis with fusiform dilatation of the parotid duct is presented, which was corrected by a simple and easy surgical technique creating a new opening in the buccal mucosa.

Pneumolabyrinth is a very rare condition, even in otic capsule disrupting (OCD) fracture. Hearing was not always impaired, even in cases with OCD fracture. The co-existence of pneumocochlea, regarded as a risk factor for total hearing loss, was extremely rare in cases of pneumolabyrinth.The purposes of this study were to analyze the radiological and clinical features in patients with pneumolabyrinth and to overcome the diagnostic pitfalls encountered during pneumocochlea detection.The temporal bone computed tomographies (TBCT) of 402 patients diagnosed with temporal bone fracture along with their clinical records were retrospectively reviewed.Only six patients (7% of those with OCD fractures or 1.5% of those with temporal bone fracture) were found to have pneumolabyrinth. Locations of the pneumolabyrinth were in the vestibule in all six cases and three of them showed air densities both in the cochlea and semicircular canal. The size of the air density in the vestibule was 5.38 ± 4.56 mm(2) at the axial view and 6.57 ± 5.67 mm(2) at the coronal view. The mean minimal Hounsfield unit (HU) of air density area in the vestibule was -968.1 ± 22.94 at the axial view and -941 ± 16.88 at the coronal view. Patients with pneumocochlea eventually developed total hearing loss.

Dizziness and vertigo frequently occur after cochlear implantation (CI) surgery, particularly during the early stages. It could recover over time but some of the patients suffered from delayed or sustained vestibular symptoms after CI. This study used rat animal models to investigate the effect of unilateral cochleostomy on the vestibular organs over time. Twenty-seven Sprague Dawley rats underwent cochleostomy to evaluate the postoperative changes in hearing threshold, gain and symmetry of the vestibular ocular response, overall balance function, number of hair cells in the crista, and the c-Fos activity in the brainstem vestibular nucleus. Loss of vestibular function was observed during the early stages, but function recovered partially over time. Histopathological findings demonstrated a mild decrease in vestibular hair cells numbers. Increased c-Fos immunoreactivity in the vestibular nucleus, observed in the early stages after cochleostomy, decreased over time. Cochleostomy is a risk factor for peripheral vestibular organ damage that can cause functional impairment in the peripheral vestibular organs. Altered vestibular nucleus activity may be associated with vestibular compensation and plasticity after unilateral cochleostomy.

The use of precast concrete modular construction in the replacement and rebuilding of old structures has recently increased. However, the joints between modules in this type of construction exhibit special behavior that should be considered when analyzing the behavior of modular members. Both stability and serviceability should be studied; however, existing research has only addressed the former. Research regarding serviceability, involving deflection and crack development and propagation, is lacking. This study considers the difference in strength between on-site cast and precast segmental concrete to accurately evaluate the deflection of precast concrete flexural members with joints within the lapped splice. In addition, to reflect an initial crack, the deflection is calculated and evaluated by reflecting the effect of tension-stiffening and subsequently redefining the attached transmission lengths of the left and right sides of the cracked surface as a new cracked region. As a result of explicitly including joint behavior which is considered attached transmission length and characteristic by concrete strength, a more accurate calculation of deflection is developed.

OBJECTIVE: The aim of this study was to understand the prevalence and molecular genetic etiology of incomplete partition type III (IP type III) anomaly in Koreans. We also attempted to verify the prevalence of genomic deletions in the DFNX2 locus and to look for association between inheritance patterns and mutation type in East Asian IP type III subjects. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Subjects with IP type III anomaly and their biological mothers. INTERVENTIONS: Sanger sequencing, array-comparative genomic hybridization (aCGH), and PCR were performed. We also analyzed the type and inheritance of the causative genetic abnormality in East Asian DFNX2 patients. MAIN OUTCOME MEASURE: Mutation type and occurrence. RESULTS: We identified IP type III in 10 (4.8%) of 206 patients with an inner ear abnormality. We confirmed an etiologic homogeneity, DFNX2, of the IP type III in this Korean population. Two (20%) of the 10 DFNX2 carried a large genomic deletion affecting POU3F4, as proved by aCGH. PCR confirmed that the 2 deletions occurred de novo. Genetic alteration occurred de novo in 29.4% (5/17) of all reported Korean IP type III cases. From this study and literature review, we observed a striking difference of de novo occurrence rate (75% versus 12.5%, p = 0.032) between large genomic deletions and point mutations in East Asian population. CONCLUSIONS: Our data suggest that different POU3F4 mutations might show different recurrence rate in siblings of the IP type III families, especially in East Asian population. Genetic counseling should be provided accordingly.

This study is to evaluate the behavior of integral and segmental specimens through static and cyclic tests. Integral specimens were made with the same size to be compared with segmental specimens that were made by connected precast members. To evaluate its bending performance and serviceability, 1 integral and 3 segmental specimens were tested under static load. And 1 integral and 2 segmental specimens were tested under cyclic load, respectively. Different load ranges were considered in the cyclic tests to evaluate the safety and serviceability. The test results showed that under static loading, segmental specimens had about 94% of the integral specimen's maximum moment, averagely. Under cyclic loading, the segmental specimens showed that had enough safety in the range of higher than service load and enough serviceability. In conclusion, the maximum crack width (0.16mm) satisfied the allowable crack width (0.30mm) in the range of service load., {"references":["TRB. 2003, \"Prefabricated bridge elements and systems to limit traffic\ndisruption during construction,\" NCHRP Synthesis 324.","FHWA. 2005, \"Prefabricated bridge elements and systems in Japan and\nEurope,\" Report FHWA-PL-05-003.","Heung-bae Gil, \"Development of prefabricated bridge related domestic\nand foreign,\" Expressway & Transportation Research Institute, 2012.","Hyeong-teak Kang, Heung-bae Gil, il-geun Lee, \"Primary Research and\nConceptual Design of Prefabricated Bridge Elements and Systems on\nHighway,\" Expressway & Transportation Research Institute, 2007.","Sang-Yoon Lee, \"Major Differences between the Precast and Modular\nBridges,\" Korea Society of Civil Engineers, Vol.59 No.11 2011.","Korea Institute of Industrial Technology Evaluation and Planning,\n\"Modular bridge technology development and commercialization mid\nreport,\" 2012.07.","Shen Zhehao, \"Fatigue Life Evaluation of Loop Joint in Precast Concrete\nDeck Composite Bridge,\" 2005.","A. Azizinamini et al, \"Proposed Modifications to ACI 318-95 Tension\nDevelopment and Lap Splice for High-Strength Concrete,\" ACI\nStructural Journal, V.96, No.5, Nov-Dec 1999.","AASHTO. 2007. \"AASHTO LRFD Bridge design specifications,\" 4th\nEdition.\n[10] Korea Bridge Design & Engineering Research Center, \"Design Code of\nConcrete Bridge,\" 2012."]}

Recently in the field of bridges that are newly built or repaired, fast construction is required more than ever. For these reasons, precast prefabricated bridge that enables rapid construction is actively discussed and studied today. In South Korea, it is called modular bridge. Cross beam is an integral component of modular bridge. It functions for load distribution, reduction of bending moment, resistance of horizontal strength on lateral upper structure. In this study, the structural characteristics of domestic and foreign cross beam types were compared. Based on this, alternative cross beam connection types suitable for modular bridge were selected. And bulb-T girder specimens were fabricated with each type of connection. The behavior of each specimen was analyzed under static loading, and cross beam connection type which is expected to be best suited to modular bridge proposed., {"references":["Hyeong-Yeol Kim, Sang-Yoon Lee, Chang-Koo Kang, \"Introduction of\nPSC T-girder Bridge for Accelerated Construction\", KSCE Vol.58 No.10,\n2010.","Dong-Min Woo, \"Structural Capacity Evaluation of the Precast Cross\nBeam on Prestressed Concrete Girder Bridges\", Dankook University,\n2010.","Sang-Min Lee, \"A study on rational intermediate diaphragm design of\nskewed PSC girder bridge\", Yonsei University, 2006.","Ministry of Land, Transport and Maritime Affairs, \"Bridge Design\nManual\", the Republic of Korea, 2008","Korean Society of Civil Engineers, \"Bridge Design Specification\", 2005","AASHTO, \"Standard Specifications for Highway Bridges\", 2002.","AASHTO, \"LRFD Bridge Design Specifications\", 4nd Edition, 2007.","Expressway and Transportation Research Institute of Korea Expressway\nCorporation, \"Review the installation standards of 35m PSC beam\nbridge\", 2003","Abendroth, R. E. Klaiber, F. W., and Shafer, M. W., \"Diaphragm\nEffectiveness in Prestressed Concrete Girder Bridges\", Journal of\nStructural Engineering, ASCE, 1995.\n[10] Ministry of Construction and Transportation, \"Concrete Structural Design\nCriteria\", the Republic of Korea, 2008\n[11] Barr, P. J., Eberhard, M. O., and Stanton, J. F., \"Live-load Distribution\nFactors in Prestressed Concrete Girder Bridges\", Journal of Bridge\nEngineering, ASCE, 2001.\n[12] Zahrai, S. M., and Bruneau, M., \"Impact of Diaphragms on Seismic\nResponse of Straight Slab on Girder Steel Bridges\", Journal of Structural\nEngineering, ASCE, 1998."]}

Objective The purpose of this study was to evaluate the effect of furanone as a quorum sensing inhibitor with an antibiotic agent on experimentally induced Pseudomonas aeruginosa biofilm formation in an in vitro model. Materials and methods Bacterial cultures on agar plates and induction of biofilm formations were done in four different conditions; P. aeruginosa only (group 1), P. aeruginosa + ciprofloxacin (group 2), P. aeruginosa + furanone (group 3), and P. aeruginosa + furanone + ciprofloxacin (group 4). After biofilm formation on a silicone tympanostomy tube with P. aeruginosa was established, they were treated with ciprofloxacin, furanone, and ciprofloxacin with furanone respectively. All agar plates were processed for colony counts 1 day after incubation, and silicone tympanostomy tubes were observed using scanning electron microscopy 2 days after incubation. Any changes visualized on the biofilm lining the silicone tympanostomy tubes after treatment initiation were evaluated again 2 days after each treatment. Results There was no bacterial growth on the agar plate in group 4 compared to other groups and the formations of a biofilm on the surface of silicone tympanostomy tubes in group 4 were devoid. Little change to the original biofilm overlying the silicone tympanostomy tubes after each treatment was noted. Conclusion This study demonstrates that furanone may have a role as a QSI and can be helpful in preventing biofilm formation with ciprofloxacin in experimentally induced P. aeruginosa biofilms based on an in vitro model.

To describe a case of the atlantoaxial rotary subluxation (AARS) after tympanoplasty and discuss its mechanism and management.A 10-year-old boy.Cervical spine plain radiography followed by cervical traction.Range of motion and radiologic follow-up.The patient showed painful torticollis and rotation and fixation of the head to the right side (cock robin sign). Increased atlantodens interval and asymmetry between facet joints were found on cervical plain radiography. Full functional recovery and reduction of subluxation were achieved by conservative cervical traction.Forced surgical positioning of head rotation to the contralateral ear down and restriction during otologic surgery under general anesthesia may complicate AARS, especially in pediatric otologic surgery patients.

We often observe that uptake of tracer is not detected in the primary cancer focus in patients with histologically proven papillary thyroid carcinoma (PTC) on preoperative (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT). Therefore, we analyzed the clinical and pathologic variables affecting false-negative findings in primary tumors on preoperative (18)F-FDG PET/CT.We retrospectively reviewed the medical records of 115 consecutive patients who underwent (18)F-FDG PET/CT for initial evaluation and were diagnosed with PTC by postoperative permanent biopsy. The clinical and pathologic characteristics that influence the (18)F-FDG PET/CT findings in these patients were analyzed with respect to the following variables: age, gender, tumor size, multifocality of the primary tumor, perithyroidal invasion, lymphovascular or capsular invasion, and central lymph node metastasis-based final pathology.Twenty-six (22.6%) patients had false-negative (18)F-FDG PET/CT findings. In patients with negative (18)F-FDG PET/CT findings, tumor size, and perithyroidal and lymphovascular invasion were significantly less than in patients with positive (18)F-FDG PET/CT findings. Tumors1 cm in size were correlated with (18)F-FDG PET/CT positivity. On multivariate analysis, perithyroidal invasion (P = 0.026, odds ratio = 7.714) and lymphovascular invasion (P = 0.036, odds ratio = 3.500) were independent factors for (18)F-FDG PET/CT positivity. However, there were no significant differences between (18)F-FDG PET/CT positivity and age, gender, capsular invasion, and central lymph node metastasis based on final pathology.Tumor size and perithyroidal and lymphovascular invasion of papillary carcinoma can influence (18)F-FDG PET/CT findings. Absence of perithyroidal and lymphovascular invasion were independent variables for false-negative findings on initial (18)F-FDG PET/CT in patients with PTC.

Laryngotracheal separation (LTS) is the most immediately life-threatening airway injury. LTS is so rare that very few otolaryngologists have experience with it. LTS is one of the diagnostic and therapeutic challenges in airway diseases and its management remains to be established. We experienced a patient with complete LTS after attempted hanging. A high index of suspicion, adequate imaging, prompt airway establishment and early surgical repair are the most vital factors in managing a patient with LTS.

Objective/Hypothesis: The purpose of the study was to investigate the effect of intravenous adipose tissue-derived stem cell (ADSC) transplantation on olfactory epithelium regeneration following transection of the olfactory nerve in rats. Study Design: This was a experimental study using primary cultures of mesenchymal stem cells derived from animal adipose tissue with histological analysis of animal olfactory tissue. Methods: All rats underwent unilateral transection of the olfactory nerve to induce degeneration of olfactory epithelium, and then were observed for regeneration according to time sequences. ADSCs were cultivated from neck adipose tissue of rats, and systemically injected into the experimental group. The control group was injected with phosphate buffered solution, instead of ADSCs. After 30 days, regeneration of olfactory epithelium was observed with olfactory marker protein (OMP) and proliferating cell nuclear antigen. To observe the characteristics of the transplanted ADSCs, olfactory epithelium was stained with von Willebrant factor and OMP. Results: After olfactory nerve transection, mature olfactory cells disappeared in 5 days, but gradually regained their thickness with increased cell numbers at approximately 10 to 15 days. By 30 days post-transection, the thickness and cellular composition of epithelium was almost restored to baseline levels pretransection. However, OMP expressions remained decreased compared with day 0 or 3. Systemically injected ADSCs were transplanted into the olfactory epithelium and survived beyond 4 weeks. The ADSCs promoted regeneration of olfactory epithelium in the animal model and differentiated into olfactory receptor neurons and endothelial cells. Conclusions: Our findings suggest the feasibility of ADSC transplantation as a treatment for head trauma-related olfactory dysfunction. Laryngoscope, 2009

The use of compressive dressing is usually spread to enhance neovascularization of the dissected facial flap by elimination of dead space between the flap and the dermis in parotid surgery through facelift incision. The author reports a clinical case of compressive dressing after parotidectomy that was inappropriately performed to folding of the ear lobule, leading to ischemic injury. This iatrogenic complication resulted in the development of contracture of ear lobule and deformity of auricle. Consequently, careful compressive dressing after parotidectomy through facelift incision must be applied; and the wound must be inspected daily for early detection and prompt treatment of local complications.

Received March 5, 2013 Revised April 9, 2013 Accepted April 10, 2013 Address for correspondence Yong Ho Park, MD Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea Tel +82-42-280-7697 Fax +82-42-253-4059 E-mail parkyh@cnu.ac.kr Background and ObjectivesZZThere are several evidences of reduced cochlea blood flow after noise exposure in the cochlea. However, the pathophysiology of blood flow change is still obscure, and endothelins, proteins that constrict blood vessels and play a key role in vascular homeostasis using its receptors may have importance in this respect. In this study, we investigated the expression changes of endothelin-1 (ET-1), endothelin receptor A (ETAR) and B (ETBR) according to auditory threshold change after noise exposure. Materials and MethodZZMice were exposed to different noise to generate transient (group 2) and permanent threshold shift (group 3), respectively. Auditory threshold shifts were evaluated with auditory brainstem response and expression changes of ET-1, ETAR and ETBR after noise exposure were evaluated by immunohistochemistry and real time RT-PCR. ResultsZZAfter noise exposure, the increased ET-1, ETAR and ETBR immunoreactivities were observe in stria vascularis, spiral ligament and spiral ganglion neuron. ET-1 mRNA expressions increased after noise exposure in both group 2 and group 3 compared to those of the control group. At 2 weeks after noise exposure, however, the ET-1 mRNA expressions in group 3 increased compared to that of the control but decreased compared to that of group 2. On the other hand, ETAR mRNA expression increased at 2 weeks after noise exposure in both groups, just after noise exposure in group 2 and at 2 weeks after noise exposure in group 3. ConclusionZZThese results suggest that expression changes of ET-1, ETAR and ETBR might be associated with hearing threshold shift and recovery after noise exposure in the cochlea. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:278-85

Received November 1, 2010 Revised January 6, 2011 Accepted January 6, 2011 Address for correspondence Jin Woong Choi, MD Department of Otolaryngology-Head and Neck Surgery, Research Institute for Medical Sciences, Chungnam National UniversitySchool of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea Tel +82-42-280-7698 Fax +82-42-253-4059 E-mail conc-will@hanmail.net Seborrheic keratosis (SK) is a common benign lesion that develops from the proliferation of epidermal cells. Since SK usually occurs on the face, extremities, and upper trunk of the elderly, the finding of this lesion on the auricle is rare. Given the rarity of SK lesions of the auricle and the lack of familiarity with its presentation, otolaryngologists have difficulty diagnosing SK. Authors experienced a case of solitary SK that originated from the auricle in a 65-year-old man. We present this case with a review of the literature. Korean J Otorhinolaryngol-Head Neck Surg 2011;54:231-4 Key WordsZZSeborrheic keratosis ᆞAuricle.

Background and ObjectivesZZBacterial biofilm is thought to contribute to the progression and persistence of chronic rhinosinusitis. There are many studies which demonstrate these structures on chronic rhinosinusitis (CRS), but the majority of the studies just focus on the documentation of their presence and the method for identification. There are also a few researches that show the impact of biofilm on postoperative surgical outcomes. In this study, we demonstrated bacterial biofilm in CRS patients and determined whether they affect clinical courses and outcomes after surgery. Subjects and MethodZZThe mucosa of ethmoid bulla was obtained during endoscopic sinus surgery from 21 CRS patients. Fluorescent microscope and scanning electron microscopy (SEM) were used for the determination of biofilm. The outcomes of the surgery were evaluated by endoscope every two weeks for 6 months. Preoperative symptom scores, CT scores, and the post operative results were compared between patients with biofilm and patients without biofilm. ResultsZZBacterial biofilm were seen in 13 (62%) of the 21 CRS patients. A statistical association existed between the presence of biofilm and the worsened preoperative symptom scores, but the preoperative CT scores were not related to the presence of biofilm. Patients with biofilm had long-lasting postoperative mucosal inflammation and a prolonged healing time, and these differences have statistical significance. ConclusionZZThis study showed that the presence of bacterial biofilm were significantly correlated with worsening preoperative symptom scores and the prolonged postoperative recovery time. Therefore, bacterial biofilm may play an important role in the recalcitrant and resistant nature of CRS. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:349-53 Key WordsZZChronic rhinosinusitis·Biofilm.

Background and Objectives Staphylococcal exotoxins (SEs) have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyp (CRSwNP). In the current study, we determined the prevalence of specific immunoglobulin E (IgE) antibodies to SEs in serum and polyp tissues of patients with CRSwNP and tried to find out whether there is an association between the presence of SEs-IgE antibody and eosinophilic inflammation. Subjects and Method Blood, nasal polyp and mucosa samples were obtained from 43 patients undergoing endoscopic sinus surgery for CRSwNP and 11 controls undergoing septoplasty without CRS. Specimens were analyzed for the presence of specific IgE antibody to four SEs [staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B (SEB), staphylococcal enterotoxin C (SEC), toxic shock syndrome toxin 1 (TSST-1)] using ImmunoCAP assay. Eosinophil cationic protein (ECP) in serum and nasal polyp tissue were also analyzed using ImmunoCAP. Eosinophil counts were estimated in polyp tissue. Results SEs-specific IgE antibodies were detected in 13 (30.2%) patients of the CRSwNP group. In contrast, only one (9.1%) control patient had IgE to SEs. Serum ECP level was increased significantly in the CRSwNP group compared with controls. However, there were no significant differences in Lund-MacKay score, the ECP level in the serum and polyp tissue, and eosinophil count in the polyp tissue between the SEs-IgE antibody positive [SEs-IgE Ab (+)] group and the SEs-IgE antibody negative [SEs-IgE Ab (-)] group. Conclusion SEs may play a certain role in the pathogenesis of CRSwNP. However, there is no close correlation between the presence of SEs-IgE antibody and eosinophilic inflammation.