Feasibility of Temporary Pancreatic Stenting after Early Endoscopic Retrograde Cholangiopancreatography in Patients with Acute Biliary Pancreatitis / 대한소화기학회지

BACKGROUND/AIMS: To assess the safety and effectiveness of temporary pancreatic stenting after early endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute biliary pancreatitis regardless of the severity or concomitant cholangitis. METHODS: Temporary pancreatic stenting was performed in 79 patients with visualized pancreatic duct during ERCP. The outcomes of 64 patients with adequate pancreatic stenting (PS) and 15 patients with inadequate pancreatic stenting (no PS) were compared in this prospective, observational trial. RESULTS: The baseline characteristics were similar. Development of systemic inflammatory response syndrome (7.8% for PS vs. 13.3% for no PS; p=0.50) and mortality (none for both groups; p=0.99) did not differ. However, fewer local complications occurred in PS than in no PS (4.7% for PS vs. 20.0% for no PS; p=0.04) and the difference was most outstanding in necrosis (1.6% for PS vs. 13.3% for no PS; p=0.03). CONCLUSIONS: Temporary pancreatic stenting after early ERCP should be considered safe, as complications did not increase even in cases of inadequate stenting. However, if successful, there appears to be a reduction in local complications.

Frontoethmoidal Cells on Computed Tomographic Analysis: The Prevalence and Relationship to Frontal Sinus/Recess Mucosal Thickening

OBJECTIVES: To determine the prevalence of frontoethmoidal cells (FECs) in patients with and without frontal sinus/recess mucosal thickening and to establish the relationship between the FECs and the frontal sinus/recess mucosal thickening. MATERIALS AND METHODS: We retrospectively reviewed 245 consecutive ostiomeatal CT scans (490 sides). The normal and frontal sinus/recess mucosal thickening groups were categorized based on these images. The latter group was sub-categorized into the frontal sinus mucosal thickening group (FS group) and the frontal recess mucosal thickening group (FR group). RESULTS: Types 1, 2, 3 and 4 frontal cells were found in 17.5, 6.7, 8.3 and 0% of 326 normal sides, respectively. The prevalence of agger nasi, suprabullar, frontal bullar, supraorbital ethmoid and interfrontal sinus septal cells was 85.6, 43.3, 4.9, 4.3 and 17.2% of the same 326 normal sides, respectively. Type 3 frontal cells, frontal bullar cells and suprabullar cells were more prevalent in the FS and FR groups than in the normal group. All types of cells were more prevalent in the FS group, but only the suprabullar cells were more prevalent in the FR group than in the normal group. CONCLUSION: These findings suggest that type 3 frontal cells, frontal bullar cells and suprabullar cells may have a significant association with frontal sinus/recess mucosal thickening.

Gender Differences in the Polysomnographic Findings among Obstructive Sleep Apnea Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the influence of gender on the polysomnographic differences between men and women with obstructive sleep apnea (OSA). SUBJECTS AND METHOD: A retrospective review was performed of 110 patients who snore (91 males, 19 females) and were suspected of OSA. Polysomnography was performed for each patient. Gender comparison of polysomnographic parameters were made by performing Mann-Whitney U-tests. RESULTS: OSA was observed about five times more often in men than in women. Women were significantly older but were not heavier than men. Sleep structure showed no significant differences between men and women except that stage 1 sleep was observed more in men and stage 2 sleep more in women, respectively. The apnea hypopnea index (AHI) and non-rapid eye movement sleep were higher in men, but rapid eye movement sleep AHI in women was not different to men. The total and respiratory arousal indices (AI) and oxygen desaturation index (ODI) were higher in men than in women. CONCLUSION: The fact that more stage 1 sleep and the greater AHI, AI and ODI were found in men suggest that sleep quality may be worse in men than in women patients.

Time Course of the Suppression Effect on Transient Evoked Otoacoustic Emissions by Prolonged Contralateral Acoustic Stimulation

BACKGROUND AND OBJECTIVES: Although the suppressive effect of the medial efferent acoustic reflex is well known, the time course of this effect over prolonged periods has yet to be fully evaluated. We assessed time-dependent change in the suppression of transient evoked otoacoustic emissions (TEOAEs) by the medial efferent acoustic reflex over a relatively long period. SUBJECTS AND METHODS: We measured TEOAEs in the right ear before contralateral acoustic stimulation (CAS), and then measured serial TEOAEs in the right ear at four intervals during a total of 16 minutes of continuous CAS, followed by three more recordings after termination of CAS. RESULTS: TEOAE amplitudes were reduced with CAS during a certain period (from the immediate period to 10 minutes depending on frequency) and subsequently recovered. TEOAE suppression values in the mean amplitudes for overall frequency were 0.76 dB at the initial recording, 0.35 dB at 5 minutes, 0.44 dB at 10 minutes, and 0.33 dB at 15 minutes during CAS. The initial suppression value was significantly larger than other suppression values of 5, 10, and 15 minutes (p<0.05). In recordings obtained after CAS, TEOAE amplitude exceeded pre-acoustic amplitudes at 1 kHz, 1.5 kHz, and 2 kHz. CONCLUSIONS: The present results show the existence of the medial efferent acoustic reflex and demonstrate the time course that TEOAE suppressions present initially after CAS, showing fatigue over time. Overshooting of TEOAE was observed in recordings at several frequencies after termination of CAS.

Time Course of the Suppression Effect on Transient Evoked Otoacoustic Emissions by Prolonged Contralateral Acoustic Stimulation

BACKGROUND AND OBJECTIVES: Although the suppressive effect of the medial efferent acoustic reflex is well known, the time course of this effect over prolonged periods has yet to be fully evaluated. We assessed time-dependent change in the suppression of transient evoked otoacoustic emissions (TEOAEs) by the medial efferent acoustic reflex over a relatively long period. SUBJECTS AND METHODS: We measured TEOAEs in the right ear before contralateral acoustic stimulation (CAS), and then measured serial TEOAEs in the right ear at four intervals during a total of 16 minutes of continuous CAS, followed by three more recordings after termination of CAS. RESULTS: TEOAE amplitudes were reduced with CAS during a certain period (from the immediate period to 10 minutes depending on frequency) and subsequently recovered. TEOAE suppression values in the mean amplitudes for overall frequency were 0.76 dB at the initial recording, 0.35 dB at 5 minutes, 0.44 dB at 10 minutes, and 0.33 dB at 15 minutes during CAS. The initial suppression value was significantly larger than other suppression values of 5, 10, and 15 minutes (p<0.05). In recordings obtained after CAS, TEOAE amplitude exceeded pre-acoustic amplitudes at 1 kHz, 1.5 kHz, and 2 kHz. CONCLUSIONS: The present results show the existence of the medial efferent acoustic reflex and demonstrate the time course that TEOAE suppressions present initially after CAS, showing fatigue over time. Overshooting of TEOAE was observed in recordings at several frequencies after termination of CAS.