• 한방안이비인후피부과학회지
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• 제12권1호
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• pp.338-355
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• 1999

In the treatment of Nasal Polyps. which are produced with allergic rhinitis, chronic paranasal sinusitis at clinic. Herb-med., acupuncture and some medicine for external application have been used. The symptoms, however, has taken a turn for the better in temporary, the nasal polyps was not removed in completely. So the origin treatment was impossible by the use of herb-med.. acupuncture and medicine. Although a surgical operation (excision) of western-medicine is effective for a specified period of time (about 6 months), the nasal polyps tend to recur. Because of that the second and third operation might be needed, so we cannot consider the operation as the treatment of nasal polyps. The study was observed to investigate the nasal polyps treatment, and to search practical attempt for the clinic application through a literature study on Bisikyuk and Bithch which are similar with nasal polyps. As results, the practical application of external treatment for the nasal polyps treatment in clinic might be more necessary, and internal use of the Herb-med. with the external treatment might be treated as supplementary treatment.

• 한방안이비인후피부과학회지
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• 제19권2호
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• pp.180-191
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• 2006

Objectives : The purpose of this clinical report was to investigate the general characteristics of the patients with nasal polyps and estimate the efficacy of the oriental medical treatment on nasal polyps. Methods : We performed a clinical analysis of 50 patients who visited Kabsan oriental clinic due to nasal polyps. We inquired into distribution of age, sex, operation history related to nose, grade of nasal polyps, efficacy of treatment, etc. Results and Conclusions : 1. The sex ratio was 2.3 : 1. The average age was 40.02 years. 2. In the nasal operation history, inexperienced patients were 35 cases and experienced patients were 15 cases. 3. In the region of nasal polyps, there were 35 cases of bilateral types of nasal polyps, which is mon than in unilateral types. In the number of nasal polyps, multicentric types of 26 cases were similar in the number with solitary type of 24 cases. 4. In the predisposing or concomitant diseases, chronic sinusitis was the most frequent followed by allergic rhinitis, chronic rhinitis, septal deviation chronic otitis media, asthma, tonsilitis and allergic dermatitis. 5. In the main symptoms, nasal obstruction was the most important. In the concomitant symptoms, patients had frequent rhinorrhea, smell disturbance, postnasal drip, headache, etc. 6. The average treatment period was 3,58 months and the average number of treatment was 12.94 sessions. 1. In the amount of herbal medicine, 2 and 3 Ji(劑) were the most. The most frequently used herbal medicine to treat was Hyangbujamogeuntanggagam(香附子茅根湯加減) 8. In the change of grade after treatment, Grade I was the most. In the efficacy of treatment, 'good' was the most, followed by 'excellent' and 'uneffective'.

• 한방안이비인후피부과학회지
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• 제22권3호
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• pp.208-219
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• 2009

Object : Understanding the importance of the external treatment of nasal polyps and let know the necessity of development of the effect of herb medicine to use in these days. Method : I investigated about 12 oriental medical texts which recorded the external treatment of nasal polyps. I separated them to three part (prescription, herb medicine, the way of making the external application) and check the frequency. Also compared the external treatment of oriental medicine and western medicine. Result : 1. Prescription: There are 48 prescriptions -Nyosasan is used 4 cases, Gwajungsan is used 2 cases and others only 1 case each. 2. Herb-med: There are 67 herb medicines - Herba Asari(細辛) is used 15 cases, Pedicellus Melo (瓜蔕) is used 11 cases, Alunite(白礬) is used 10 cases, Realgar(雄黃)is used 9 cases. 3. The way of making the external application: obstructive method is used 19 cases, attaching method is used 9 cases, blowing method is used 8 cases, plaster method is used 7 cases, pouring method is used 3 cases. 4. The treatment takes about 1day to 15days and the soften nasal polyps like a water can be expect the positive prognosis. Conclusion: The external treatment is very important to treat nasal polyps. So we need to research more on eliminating the toxicity of the herb medicine and develop the convenient way of using the external treatment.

• 대한한방소아과학회지
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• 제13권1호
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• pp.191-204
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• 1999

Background: Nasal polyps are benign mass of nasal mucose, chronic sinusitis are swelling of nasal mucose, so nasal polyps and chronic sinusitis take a place at the same time. Nasal polyps are located lateral wall of nose, middle meatus, between middle nasal concha and inferior nasal concha. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis and nasal polyps before and after treatment using computed tomography (CT). To compared before and after treatment of otitis media using earscope. Materials and methods: Five patients (4 mail and 1 femail) treated in our hospital between August 1998 and July 1999 were studied. Ages ranged from 9 to 23 years (mean age:13 years). All patients had a underlying family history, and past history(allergy or sinusitis of parents or brothers). Illness period was from 1 to 36 months (mean period:10.5 month). To ascertain the efficacy of treatment, CT were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. We classified treatment period into the type of allergic disease. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms. Results: Treatment period was from 126 to 157 days (mean period:140.7 days). To 3 patients with chronic sinusitis and nasal polyp, treatment period was 140.7 days, to 2 patients with otitis media and chronic sinusitis and nasal polyp, treatment period was 141.5 days. So they had no significance. Not nasal polyp from middle meatus, but also polypoid mucosal change of maxillary sinus is polyps Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis and otitis media using earscope and CT. Herbal medicine therapy was effective in increasing immunity, inhibiting allergic reaction and inflammation of respiratory system. we practice ECP(eosinophil cataionic protein) and MAST examination, objectify herbal medicine therapy.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.16.3-17
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• 1982

E. N. T. Clinic에 내원하는 환자중 nasal symptoms을 호소하는 환자의 높은 비율에서 알레르기 질환이 있는 것을 느끼게 되며 특히 nasal cavity내에 오는 질환의 원인 중 알레르기가 놀라울 정도로 많은 것을 생각하면 이비인후과 영역에서의 알레르기에 대한 관심도 높다고 하겠읍니다. 일반적으로 비용증, 만성비염. 만성부비동염의 치료 방법으로는 약물요법과 수술요법을 병행하여 시행하는데 치료후 증상이 호전되다가 다시 계속적인 치료전의 증상이 재발되는 경우를 흔히 경험하게 된다. 특히 비용증 환자의 치료에서는 높은율의 재발을 경험하게 되는데 nasal symptoms을 일으키는 질환의 많은 원인이 allergy 라는데 착안하여 allegy symptoms은 호소하지 않았으나 비용증을 동반한 만성부비동염 환자에 수술 및 일반치료를 시행하였으나 얼마후 증상이 재현되어 Rinkels technique의 allergy test를 시행 하였다. 특정한 allergen에 양성을 보이지는 않았으나 일반적으로 nasal allergy의 많은 원인이 되는 House dust와 Mold groups의 allergen을 이용 (#2 ∼ #3 Solution)하여 계속적인 Desensitization을 시행함으로서 근치에 가까운 효과를 얻었기에 문헌고찰과 함께 보고하는 바이며 이러한 환자들에게 계속적인 allergy test상 양성반응을 보이지 않더라도 위의 방법을 적용하여 치료한 결과를 추후 발표드릴 것을 약속드립니다.

• Molecules and Cells
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• 제42권4호
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• pp.345-355
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• 2019

Eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the most challenging problems in clinical rhinology. FZD5 is a receptor for Wnt5A, and its complex with Wnt5A contributes to activating inflammation and tissue modification. Nasal polyps and eosinophil/non-eosinophil counts are reported to be directly correlated. This study investigated the expression and distribution of FZD5, and the role of eosinophil infiltration and FZD5 in eosinophilic CRSwNP pathogenesis. The prognostic role of eosinophil levels was evaluated in seven patients with CRSwNP. Fifteen patients with CRS were classified based on the percentage of eosinophils in nasal polyp tissue. Methylated genes were detected using methylCpG-binding domain sequencing, and qRT-PCR and immunohistochemistry were used to detect FZD5 expression in nasal polyp tissue samples. The results showed that mRNA expression of FZD5 was upregulated in nasal polyps. FZD5 expression was significantly higher in nasal polyp samples from patients with eosinophilic CRSwNP than in those from patients with non-eosinophilic CRSwNP, as indicated by immunohistochemistry. Furthermore, inflammatory cytokine levels were higher in eosinophilic CRSwNP-derived epithelial cells than in normal tissues. In conclusion, FZD5 expression in nasal mucosal epithelial cells is correlated with inflammatory cells and might play a role in the pathogenesis of eosinophilic CRSwNP.

• The Korean Journal of Physiology and Pharmacology
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• 제5권4호
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• pp.353-357
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• 2001

The pathogenesis of the nasal polyp is multifactorial and choanal polyps can be defined by its origin of genesis: antrochoanal (maxillochoanal), ethmochoanal and sphenochoanal polyp. Transforming growth $factor-{\beta}\;(TGF-{\beta})$ has various biologic activities, including the regulation of epithelial proliferation, the promotion of extracellular matrix formation and the induction of angiogenesis, hence closely related to pathogenesis of nasal polyp. Twenty cases of choanal polyps (13 antrochoanal, 4 ethmochoanal and 3 sphenochoanal polyps) were included in this study. Each polyp was subdivided into its origin, pedicle and choanal part. Hematoxylin and eosin stain for routine histopathology and immunohistochemistry were employed to detect expression of $TGF-{\beta}1.$ According to polyp type, edematous type is common at origin part and fibrous type at choanal part, and showed no difference at pedicle part in frequency. In ethmochoanal and sphenochoanal polyps, glandulocystic and edematous type is more common than fibrous type. $TGF-{\beta}1$ was expressed in epithelial cells, endothelial cells, eosinophils and lymphocytes. There was no different expression of $TGF-{\beta}1$ in each kind of choanal polyps and separate parts in each polyp. But histologic finding of choanal polyp is different between origin, pedicle and choanal part. Also infiltration of inflammatory cells including eosinophils has no difference between origin site. The expression of $TGF-{\beta}1$ was observed at all the choanal polyps and no difference between origin site and each portions was noted.

• Allergy, Asthma & Immunology Research
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• 제10권6호
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• pp.698-715
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• 2018

Purpose: Hrd1 has recently emerged as a critical regulator of B-cells in autoimmune diseases. However, its role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains largely unexplored. This study aimed to examine Hrd1 expression and B-cell accumulation and their possible roles in CRSwNP. Methods: Quantitative real-time polymerase chain reaction, immunohistochemistry, enzyme-linked immunosorbent assay and Western blotting were used to assess gene and protein expression in nasal tissue extracts. Cells isolated from nasal tissues and peripheral blood mononuclear cells were characterized by flow cytometry. Local antibody production was measured in tissue extracts with a Bio-Plex assay. Additionally, changes in Hrd1 expression in response to specific inflammatory stimuli were measured in cultured dispersed polyp cells. Results: Nasal polyps (NPs) from patients with eosinophilic CRSwNP (ECRS) had increased levels of Hrd1, B-cells and plasma cells compared with NPs from patients with non-eosinophilic CRSwNP (non-ECRS) or other control subjects (P < 0.05). The average Hrd1 levels in B-cells in NPs from ECRS patients were significantly higher than those from non-ECRS patients and control subjects (P < 0.05). NPs also contained significantly increased levels of several antibody isotypes compared with normal controls (P < 0.05). Interestingly, Hrd1 expression in cultured polyp cells from ECRS patients, but not non-ECRS patients, was significantly increased by interleukin-$1{\beta}$, lipopolysaccharide and Poly(I:C) stimulation, and inhibited by dexamethasone treatment (P < 0.05). Conclusions: Differential Hrd1 expression and B-cell accumulation between the ECRS and non-ECRS subsets suggests that they can exhibit distinct pathogenic mechanisms and play important roles in NP.

• Journal of Rhinology
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• 제59권1호
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• pp.49-58
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• 2021

Background: Nasal polyps in the nasal cavity and mucous discharge inside the maxillary sinus exhibit compressive stress on the nasal mucosal epithelium. However, there have been only a few studies on how compressive stress impacts the human nasal mucosal epithelium. Methodology: We investigated the effect of compressive stress on collective migration, junctional proteins, transepithelial electrical resistance, epithelial permeability, and gene expression in well-differentiated normal human nasal epithelial (NHNE) cells and human nasal polyp epithelial (HNPE) cells. Results: NHNE cells barely showed collective migration at compressive stress up to 150 mmH₂0. However, HNPE cells showed much greater degree of collective migration at a lower compressive stress of 100 mmH₂0. The cell migration of HNPE cells subjected to 100 mmH₂O compression was significantly decreased at day 3 and was recovered to the status prior to the compressive stress by day 7, indicating that HNPE cells are relatively more sensitive to mechanical pressure than NHNE cells. Compressive stress also increased transepithelial electrical resistance and decreased epithelial permeability, indicating that the compressive stress disturbed the structural organization rather than physical interactions between cells. In addition, we found that compressive stress induced gene expressions relevant to airway inflammation and tissue remodelling in HNPE cells. Conclusion: Taken together, these findings demonstrate that compressive stress on nasal polyp epithelium is capable of inducing collective migration and induce increased expression of genes related to airway inflammation, innate immunity, and polyp remodelling, even in the absence of inflammatory mediators.

• 수면정신생리
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• 제11권1호
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• pp.17-21
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• 2004

Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.