Analysis of Chromosomal Aberrations in Thyroid Papillary Carcinomas Using Comparative Genomic Hybridization (CGH) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cancer of the thyroid is the sixth common cancer in Korea, and fourth common among the Korean women, in particular. Aming the prevalent carcinomas of thyroid, the papillary thyroid carcinoma is the most frequent type. Genomic instability is the characteristic of nearly all tumors as well as thyroid cancers. However, despite the high frequency of papillary thyroid carcinomas, their chromosomal alterations are poorly characterized in Korea. Comparative genomic hybridization (CGH) is a new fluorescence in situ hybridization (FISH) technique to identify genomic imbalances in cancers. In this study, CGH was carried out with the aim of analyzing non-random chromosomal aberrations involved in papillary thyroid carcinomas. MATERIALS AND METHOD: CGH was carried out. Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were co-hybridized to normal metaphase cells. Then, the ratio of fluorescence was analyzed by an image analyzer. In array-CGH, Cy3 labeled tumor DNA and Cy5 labeled normal DNA were hybridized to microarray template, and then image analysis was performed by microarray image analyzer. RESULTS: Gains of 22q13, 6p24, 7p13, 7q21, 7q31, 8q24, 17q24 and 19p13.3 were found frequently. CONCLUSION: Non-random aberrations which were disclosed in this study might be candidate regions for the abnormal genes involved in papillary thyroid cancer.

Prediction of HIV and AIDS Incidence Using a Back-calculation Model in Korea / 예방의학회지

OBJECTIVE: To estimate the status of HIV infection and AIDS incidence using a back-calculation model in Korea. METHODS: Back-calculation is a method for estimating the past infection rate using AIDS incidence data. The method has been useful for obtaining short-term projections of AIDS incidence and estimating previous HIV prevalence. If the density of the incubation periods is known, together with the AIDS incidence, we can estimate historical HIV infections and forecast AIDS incidence in any time period up to time t. In this paper, we estimated the number of HIV infections and AIDS incidence according to the distribution of various incubation periods RESULTS: The cumulative numbers of HIV infection from 1991 to 1996 were 708~1,426 in Weibull distribution and 918~1,980 in Gamma distribution. The projected AIDS incidence in 1997 was 16~25 in Weibull distribution and 13~26 in Gamma distribution. CONCLUSIONS: The estimated cumulative HIV infections from 1991 to 1996 were 1.4~4.0 times more than notified cumulative HIV infections. Additionally, the projected AIDS incidence in 1997 was less than the notified AIDS cases. The reason for this underestimation derives from the very low level of HIV prevalence in Korea. Further research is required for the distribution of the incubation period of HIV infection in Korea, particularly for the effects of combination treatments.

Laser-Assisted versus Coblation-Assisted Partial Turbinoplasty: Comparison by Their Postoperative Outcome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conventional turbinoplasty and laser-assisted partial turbinoplasty (LAPT) are commonly performed to control nasal obstruction secondary to inferior turbinate hypertrophy. Coblation, one of radiofrequency electrosurgeries, has recently been introduced as a new treatment modality for turbinate surgery. The aim of the current study is to compare the postoperative outcome of Coblation-assisted partial turbinoplasty (CAPT) with that of LAPT. MATERIALS AND METHOD: Forty-one patients with nasal obstruction due to inferior turbinate hypertrophy refractory to medical therapy were prospectively evaluated with a follow-up period of 6 months. Twenty-one patients (42 sides) were treated with LAPT, and 20 patients (39 sides) with CAPT. Postoperative changes in degree of nasal obstruction, minimal cross-sectional area (MCA) and nasal volume from the nostril to 5 cm posteriorly (V5), operation time, duration of crust formation, operation-associated pain, intraoperative bleeding and episodes of delayed bleeding were compared between the two surgical methods. RESULTS: Crust was formed for a shorter postoperative period and operation-associated pain was less in the LAPT group. Nasal patency (MCA and V5) was more improved and operation time was shorter in the CAPT group. However, there were no significant differences in improvement of nasal obstruction and operation-associated bleeding between the two groups. CONCLUSION: Thorough knowledge of advantages and limitations of LAPT and CAPT is required for clinicians to make appropriate use of surgical tools for the given patient characteristics and medical environment.

Efficiency of Short-term Admission Medical Records in Patients with Common Otolaryngologic Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A more simple medical record form has been needed for a more qualified and cost-effective health care. A short-term admission medical record (SAMR) is a standard fill-in-the-blank form on the patients' conditions for common otolaryngologic diseases. The aim of this study is to determine the efficiency of the SAMRs. MATERIALS AND METHOD: Nineteen doctors who had residency training in the Department of Otolaryngology of Ewha Womans University Mokdong Hospital from the year 1995 through 2000 were included in this study. Questionnaires consisted of 11 comparative questions: the subjects were instructed to express their degrees of satisfaction with conventional medical records (CMRs) and SAMRs on a 100mm visual analogue scale for each question. The degrees of satisfaction with SAMRs were compared to those with CMRs. RESULTS: There were no statistically significant differences in the degrees of satisfaction between the two types of records for accurate evaluation of patients' condition, efficient communication between medical and paramedical personnels, and the value of verified records in the medicolegal conflicts and insurance claims. However, the degrees of satisfaction with SAMRs were higher than those with CMRs for communication between doctors, the value in medical research, time-saving, simplicity, paper-saving and their convertibility into electronic medical records. CONCLUSION: SAMRs provides patients of common otolaryngologic diseases with not only the necessary conditions of medical records, but also the basis of computer-based patient records. In addition, SAMRs may be also be more cost-effective than CMRs.

Long Term Results after CO2 Laser Turbinate Surgery for Perennial Allergic Rhinitis

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.

Long Term Results after CO2 Laser Turbinate Surgery for Perennial Allergic Rhinitis

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.

Effects of External Nasal Dilators on Nasal Respiration and Patency in Patients with Deformity of the Nasal Septum by Mladina ClaSSIFICATION: An Acoustic Rhinometric Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The external nasal dilator (END) was designed to improve nasal respiration by expanding the nasal valve area and authors have proven in previous reports that the END improves nasal respiration and patency in patient with DSN. The present study attempts to assess the different effects of the END on nasal respiration and patency in DSN patients with dysfunction of the nasal valve area and in those with dysfunction of some other areas. MATERIALS AND METHODS: Fourty-six male patients (ages 18-49, average age 31.5) without any other nasal or sinus disease and who are not classified as Mladina types 1, 4 or 7 were used as subjects. The type of DSN was determined by Mladina classification. Those with dysfunction of the nasal valve area (Type 2) were classited as Group A and those with dysfunction of some other anatomical area as Group B (Type 3, 5, 6). The subjective sensation of nasal respiration, average minimum cross-sectional area (MCA) and nasal volume (V5: nasal volume from 0-5 cm) of all subjects were assessed and compared before and after the application of an END. RESULTS: Subjective sensation of nasal respiration, MCA and V, improved sign ificantly in both groups after the application of an END, but there were no significant differences between the two groups. CONCLUSION: Although an F,ND significantly improves nasal respiration and patency, this effect does not show any significant differences between patients with dysfunction of the nasal valve area and those with dysfunction of some other anatomical areas. This is because ENDs equally affect all Types of septal deformity.

Effects of External Nasal Dilators on Snoring and Obstructive Sleep Apnea in Korean Adults: A Polysomnographic Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It was reported that external nasal dilators (ENDs) can reduce snoring and obstructive sleep apnea (OSA) in white people by dilating the nasal valve area and then, improving nasal breathing. However, there are no available data on Asians, whose geometry of nasal cavities is different from that of white people. The aim of this study is to evaluate the effects of ENDs on snoring and OSA in Korean adults. MATERIALS AND METHODS: Twelve simple snorers (3 female and 9 males, aged 19 to 44 years) and 35 OSA patients (35 males, aged 22 to 65 years) without nasal diseases were included in this study. Polysomnography including measurement of snoring intensity was performed at two separate nights, one with and the other without an END. Averaged maximum snoring intensity, apnea index (AI), respiratory disturbance index (RDI), ratio of deep sleep (stage 3 and 4) to total sleep time, and minimum arterial oxygen saturation (SaO2) with and without an END were measured and compared. RESULTS: Snoring intensity was reduced in 6 (50.0%) of 12 simple snorers and 16 (45.7%) of 35 OSA patients. In overall, snoring improved significantly in both groups. In OSA patients, AI and RDI improved significantly, but ratio of deep sleep time and minimum SaO2 did not. There were no significant correlations between change of snoring intensity and change of AI or RDI in OSA patients. CONCLUSION: These results suggest that ENDs are helpful to improvement of snoring and respiration during sleep, but the sleep stages remain almost unchanged by ENDs in Korean adults with snoring and/or OSA.

Effects of Mechanical Trauma to the Sinus Mucosa on Polyp Formation in Induction of Maxillary Sinusitis in Rabbits by Streptococcus Pneumoniae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pathogenesis, definition, and treatment of sinonasal polyps remain uncertain. To elucidate them, many studies on polyps have been made. However, recently reported studies on polyps using animal models seldom provided comparative data on polyp formation in various conditions. The aim of this study is to develop an animal model of polyps which is more suitable for further polyp studies. We attempted a semiquantitative analysis on the effects of mechnical trauma to the sinus mucosa on formation of polyps and polypoid mucosa in duction of rabbit maxillary sinusitis by Streptococcus pneumoniae and compared the prevalences of polyps under the different conditions. MATERIALS AND METHODS: The natural ostia of both sinuses were occluded in 10 Pasturella-free New Zealand white rabbits. Both sinuses were inoculated with S. pneumoniae, without brushing the mucosa in the left maxillary sinuses (control group) and with brushing in the right sinuses (experimental group). After four weeks, all sinuses were re-opened. Macroscopic polyp and light microscopic polyps and/or polypoid mucosa were semiquantitatively analyzed and each prevalence was compared between the two groups. RESULTS: The number of macroscopic polyps per sinus was significantly larger in the experimental group (1.1 polyps) than that in the control group (0.1 polyps). Microscopic examination revealed significantly more polyps and/or polypoid mucosa in the experimental group than in the control group. CONCLUSIONS: Our results suggest that mechanically traumatizing the sinus mucosa, such as brushing, is more helpful to polyp formation when a rabbit model of polyps is to be induced by S. pneumoniae.