Faculty Bibliography

Endoscopy has altered our ability to diagnose pathology accurately during the preoperative assessment, and it has also offered surgeons the ability to perform surgeries in a minimally invasive manner. In this article, we review the senior author's experience with diagnostic and surgical endoscopy in functional septorhinoplasty. A thorough examination of the nasal cavity in the patient seeking cosmetic rhinoplasty along with correction of nasal obstruction is enhanced by the performance of office nasal endoscopy. Endoscopically guided septoplasty is useful as a minimally invasive approach for isolated septal deformities, and it is an indispensable approach in difficult revision nasal surgeries in which obstructing septal deviation persists. Endoscopy is a critical diagnostic and surgical tool in patients seeking cosmetic nasal surgery who also have functional nasal complaints.

Paradoxically, both hyaluronan (HA) and hyaluronidase are involved in malignant transformation and cancer progression. Their mechanisms of action, given the apparent disparities, are not understood. In many malignancies, levels of HA correlate with metastatic behavior while hyaluronidases suppress malignant progression. Hyal-1, product of one of six paralogous hyaluronidase-like sequences, is the predominant circulating hyaluronidase. HYAL1, the gene that codes for Hyal-1, is located on chromosome 3p21.3, a region containing a tumor suppressor gene. Loss of HYAL1 often correlates with tumor progression, particularly in tobacco-related cancers. In other malignancies, however, hyaluronidase functions as a tumor promoter. Testicular hyaluronidase (PH-20), used as an adjuvant in chemotherapy, is assumed to enhance drug permeability. By an unknown mechanism, hyaluronidases recruit tumor cells back into the cycling pool, making these malignancies more sensitive to chemotherapeutic drugs. Such contradictory observations might be resolved by assuming that HA and hyaluronidase are required at different times in the multiple steps that lead to malignant transformation. We have undertaken a systematic investigation of their roles in cancer progression. Here, we investigate the effect of Hyal-1 expression on cell cycle kinetics. A tumor cell line was constructed with an ecdysone-inducible promoter located upstream from the cDNA of HYAL1. Fluorescent-activated cell sorting was used to monitor cell cycle kinetics following Hyal-1 induction. Enhanced cell cycling was observed, with a 13.6% increase in S phase and 9.6% decrease in G(1)/G(0) phase cells.