Antenatal Depressive Symptoms and Associated Risk Factors among Pregnant Women / 신경정신의학

OBJECTIVES@#Maternal depression has a detrimental effect on baby growth. Recent reports suggest that depressive symptoms are more likely to occur during pregnancy than in the postpartum period. In Korea, there are relatively few studies of depression during pregnancy compared to those related to postpartum depression. The purpose of this study is to identify factors associated with antenatal depression.@*METHODS@#The study included 143 pregnant women who had completed the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), the Korea-Marital Satisfaction Inventory's global distress scale, the Rosenberg Self-Esteem Scale, and the Connor-Davidson Resilience Scale-2. Based on the K-EPDS scores, we divided the participants into two groups. Logistic regression was performed to identify factors associated with antenatal depression.@*RESULTS@#Thirty (21%) of the subjects were evaluated as being depressed, pregnant women. Pregnant women with high self-esteem and marital satisfaction were less likely to have depression. Similarly, those who are younger and those with an abortion history were more likely to have depression. Past psychiatric history and family history were not significantly different between the two groups.@*CONCLUSION@#Dissatisfaction with marriage, low self-esteem, younger age, and abortion history were closely related to the presence of antenatal depression. The results of this study can be used as baseline data for the development of family-based education programs and early antenatal depression policies.

Laryngeal Trauma / 대한이비인후과학회지

The external laryngeal trauma is a rare but clinically important injury. The blunt trauma is more common than penetrating one. As other trauma, early suspicion and accurate diagnosis of acute laryngeal and tracheal injuries are crucial. If the airway obstruction is impending, secure airway should be made before diagnosis or treatment. The computed tomography scans play an important role in diagnosis and combined cervical esophageal injury should be evaluated. Proper restoration of the laryngeal framework with appropriately timed open reduction and internal fixation is critical for optimal recovery of the airway, voice, and swallowing.

A Novel Synthetic Compound 3-Amino-3-(4-Fluoro-Phenyl)-1H-Quinoline-2,4-Dione (KR22332) Exerts a Radioprotective Effect via the Inhibition of Mitochondrial Dysfunction and Generation of Reactive Oxygen Species

PURPOSE: Acute side effects of radiation such as oral mucositis are observed in most patients. Although several potential radioprotective agents have been proposed, no effective agent has yet been identified. In this study, we investigated the effectiveness of synthetic compound 3-amino-3-(4-fluoro-phenyl)-1H-quinoline-2,4-dione (KR22332) as a radioprotective agent. MATERIALS AND METHODS: Cell viability, apoptosis, the generation of reactive oxygen species (ROS), mitochondrial membrane potential changes, and changes in apoptosis-related signaling were examined in human keratinocyte (HaCaT). RESULTS: KR22332 inhibited irradiation-induced apoptosis and intracellular ROS generation, and it markedly attenuated the changes in mitochondrial membrane potential in primary human keratinocytes. Moreover, KR22332 significantly reduced the protein expression levels of ataxia telangiectasia mutated protein, p53, and tumor necrosis factor (TNF)-alpha compared to significant increases observed after radiation treatment. CONCLUSION: KR22332 significantly inhibited radiation-induced apoptosis in human keratinocytes in vitro, indicating that it might be a safe and effective treatment for the prevention of radiation-induced mucositis.

A Novel Synthetic Compound 3-Amino-3-(4-Fluoro-Phenyl)-1H-Quinoline-2,4-Dione (KR22332) Exerts a Radioprotective Effect via the Inhibition of Mitochondrial Dysfunction and Generation of Reactive Oxygen Species

PURPOSE: Acute side effects of radiation such as oral mucositis are observed in most patients. Although several potential radioprotective agents have been proposed, no effective agent has yet been identified. In this study, we investigated the effectiveness of synthetic compound 3-amino-3-(4-fluoro-phenyl)-1H-quinoline-2,4-dione (KR22332) as a radioprotective agent. MATERIALS AND METHODS: Cell viability, apoptosis, the generation of reactive oxygen species (ROS), mitochondrial membrane potential changes, and changes in apoptosis-related signaling were examined in human keratinocyte (HaCaT). RESULTS: KR22332 inhibited irradiation-induced apoptosis and intracellular ROS generation, and it markedly attenuated the changes in mitochondrial membrane potential in primary human keratinocytes. Moreover, KR22332 significantly reduced the protein expression levels of ataxia telangiectasia mutated protein, p53, and tumor necrosis factor (TNF)-alpha compared to significant increases observed after radiation treatment. CONCLUSION: KR22332 significantly inhibited radiation-induced apoptosis in human keratinocytes in vitro, indicating that it might be a safe and effective treatment for the prevention of radiation-induced mucositis.

The Effect of Osteotome Technique on Primary Implant Stability according to Bone Quality / 대한치주과학회지

The primary stability of implants is an important factor to predict the osseointegration. Recently, the resonance frequency analysis has been used to measure the primary stability. It is an objective method to monitor the stability of implants during healing phase. This study is to validate the differences in the effect of the osteotome method according to the bone quality as well the thickness of cortical bone. Two hundred seventy implants of 3.75mm in diameter(Neoplant, Neobiotech, Korea) were placed in 135 bovine ribs. The bone quality is classified into 3 classes according to the number of bone marrow spaces which implants would be placed, and then classified into 9 subclasses after the ribs were trimmed. Two implants were placed in 15 specimens of each class. The conclusion were as follows: 1. In case of less dense cancellous bone, the oseotome method is more effective in primary stability rather than the drilling method(p<0.05). 2. If there was cortical bone, it is more advantagous to get stronger primary stability. 3. If cancellous bone is more dense or if cortical bone exists, there is no statistical significance between drilling and osteotome method(p<0.05).

Treatment Outcome, Prognostic Factors and Patterns of Failure of Nasopharyngeal Carcinoma / 대한이비인후과학회지

PURPOSE: The first treatment of choice for nasopharyngeal carcinoma (NPC) is radiotherapy as NPC is more responsive to radiotherapy than any other head and neck cancer. We analyzed the clinical characteristics and prognostic factors of NPC patients treated at the Severance Hospital. SUBJECTS AND METHOD: Charts of 123 patients diagnosed with NPC at the Severance Hospital from 1995 to 2002 were reviewed and retrospectively analyzed. They were staged according to the 1997 AJCC criteria. According to the WHO classification, the type I included 14 cases, type II 44 cases, and type III 65 cases. Sixty-five cases were treated with radiotherapy only and 58 cases were treated with a combined modality of chemotherapy and radiotherapy. RESULTS: The factors for a poor prognosis were age over 47 years' old, histologic findings of WHO type I and advanced T, N stage. The overall 5 year survival rate was 66.22%. According to treatment modality, only the radiotherapy group was 68.6%, while the chemoradiotherapy group was 63.6%. There was no difference in survival (p>0.05). In chemoradiotherapy group, the survival of induction chemoradiotherapy group was 82.1% and the concurrent chemoradiotherapy group was 36.8%. There was significant difference in survival. CONCLUSIONS: There was no significant difference in the 5 year survival rate between the patients who were treated with radiotherapy only and those who were treated with both radiotherapy and chemotherapy.

Proteomic and Transcriptomic Analysis of Interleukin-1beta Treated Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mucin hypersecretion is one of the main symptoms of inflammatory diseases in the respiratory tract. The authors previously reported that pleiotypic pro-inflammatory cytokine, interleukin (IL)-1beta, plays significant roles in the respiratory tract inflammation by inducing mucins (MUC2, MUC5AC, MUC8). However, the molecular mechanism for mucin hypersecretion in the respiratory tract is still unclear. MATERIALS AND METHOD: In order to understand the mechanisms of mucin hypersecretion in the airway epithelium, the differentially expressed proteins and genes in the lung mucoepidermoid carcinoma cell line (NCI-H292 cells), which were treated for 6 and 24 hours with IL-1beta (10 ng/ml), were identified using 2-dimensional polyacrylamide gel electrophoresis (2-D PAGE) proteomics and cDNA microarray analysis (8.6 K). RESULTS: In the 2-D PAGE, 8 differentially expressed proteins and 14 post-translational modification proteins were identified 6 and 24 hrs after the IL-1beta treatment. Microarray analysis identified a total of 413 genes (6.6%) in the 6-hour treatment group and 115 genes (2.0%) in the 24-hour treatment group that were regulated after the IL-1beta treatment. The differentially expressed genes that were regulated by the IL-1beta treatment were mostly found in the metabolic pathway rather than in the regulatory pathway. A comparison of the proteomic and microarray data showed that there was a large discrepancy between the protein expression and the gene expression levels. Among the genes encoding the proteins secreted in the airway, MUC5B was down-regulated but sialomucin CD 164, lysozyme, and the secretory leukocyte protease inhibitor (SLPI) were up-regulated. CONCLUSION: These results clearly show that the transcript levels have little value in predicting the extent of protein expression. Genomics and proteomics have different evaluation fields. Therefore, they may not provide all the information on the gene and protein profiles.

Mucosal Melanoma Arising in the Eustachian Tube: A Case Report / 대한이비인후과학회지

Mucosal melanoma is a very rare disease. Most cases of mucosal melanoma have their origins in the head and neck region. To date, only three cases of melanoma originating from the eustachian tube have been reported. We present a case of mucosal melanoma of eustachian tube origin in which a complete excision was performed. The treatment of mucosal melanoma is not well established, but surgical excision is considered to be the treatment of choice. Radiotherapy is controversial but given consideration in the present case because of the anatomic complexity and difficulty in performing a complete excision. In this case, the patient underwent adjuvant radiotherapy and the mass size was greatly decreased which aided the subsequent surgical excision. Systemic chemotherapy was not utilized in this case. However, it is often used for palliative purposes. A literature review was conducted in the presentation of this case.

Effect of Patient-Controlled Analgesia after Tonsillectomy with Laser Resection of Palatopharynx (LRPP)

BACKGROUND AND OBJECTIVES: Pain control is one of the most important factors for the patients that underwent the snoring surgery. This study was performed to investigate the effectiveness of intravenous patient-controlled analgesia (PCA) for postoperative pain control after tonsillectomy with laser resection of palatopharynx. MATERIALS AND METHODS: In this double-blind randomized study, 44 patient were randomly allocated to 2 groups. In the PCA group comprising 32 patients, fentanyl citrate, ketorolac tromethamine and zofran in normal saline solution were administered by PCA equipment. In the control group comprising 12 patients, normal saline solution was given without analgesic drug by PCA equipment. Visual analogue pain score (VAS) was recorded right after surgery and 2, 4, 6, 12, 18, and 24 hours after surgery and satisfaction score was recorded just before discharge from the hospital. RESULTS: VAS was significantly higher in the control group of all time points. Overall satisfaction score was also higher in PCA group than control group. CONCLUSION: The results of this study suggest that intravenous PCA is an effective method for postoperative pain control after tonsillectomy with laser resection of palatopharynx.

The Effect of MAC (Monitored Anesthesia Care) on Perioperative Pain in Endoscopic Sinus Surgery

BACKGROUND AND OBJECTIVES: Pain and anxiety control is the most important factor for patients that have undergone endoscopic sinus surgery under local anesthesia. Monitored anesthesia care (MAC) technique has been applied to local anesthetic patients for anxiolysis and analgesia. This technique encompasses the use of sedatives, tranquilizers and analgesics in combination to local supplements. This study was performed to evaluate the effectiveness of MAC for intraoperative pain control in patients who have undergone endoscopic sinus surgery. MATERIALS AND METHODS: We studied 83 patients undergoing ambulatory endoscopic sinus surgery. Patients were randomly allocated into 2 groups of MAC (n=49) and placebo (n=34). We administrated alfentani1 and propofol intravenously at 2-3 minutes before local anesthesia for endoscopic sinus surgery. We evaluated the intraoperative pain with visual analogue pain score (VAS) and satisfactory score to pain control. RESULTS: Overall, MAC cases showed statistically significant better VAS than placebo cases. Satisfactory score to pain control was also higher in MAC cases than placebo cases. CONCLUSION: We conclude that MAC is an effective method using intravenous sedatives and analgesics for intraoperative sedation and pain control in patients undergoing endoscopic sinus surgery under local anesthesia.

Effect of Cervical Lymph Node Metastasis on Prognosis and it's Risk Factors in Parotid Carcinomas / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Management of the clinically negative neck remains a controvertial issue in patients with carcinoma of the parotid gland. In order to assist in selecting appropriate patients of elective neck dissection, we sought to determine how regional nodal metastasis affects survival in patients with parotid carcinomas and to identify clinical predictors for nodal disease. MATERIALS AND METHOD: We retrospectively evaluated 124 patients with parotid carcinoma who received their definitive treatment at the Severance hospital between 1988 and 2003. A total of 84 neck dissections (ND) were performed. 24 of 84 patients who underwent neck dissection had pN(+)-staged stage. Seventy patients had an elective ND (subdigastric ND in 50 and supraomohyoid ND in 20), usually because of ominous histology or high T stage. Kaplan-Meier survival analysis was conducted to compare patients with and without histopathologic evidence of nodal disease. Univariate and multivariate analyses were carried out using logistic regression evaluating the significance of demographic, clinical, and pathological data. RESULTS: Patients with no evidence of nodal disease had significantly improved survival over patients with pathologically positive nodes (p<0.00001). The following variables were significantly associated to the risk of lymph node metastasis by univariate analysis: sex (p=0.0093), facial palsy (p=0.0001), T stage (p=0.0003), tumor location (p=0.01) and histologic type (p=0.0009). By multivariate analysis, only facial palsy had the highest correlation with lymph node metastasis. CONCLUSION: Nodal disease significantly decrease survival in patients with parotid carcinoma. Tumor histopathologic type and facial nerve involvement are the most important predictors of nodal disease. Therefore, even in cN0, we should consider elective neck dissection in parotid carcinomas in case of high-grade malignancy and/or facial nerve paralysis.