Gene Expression Analysis in Nasal Polyp Using Microarray / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A nasal polyp is a chronic inflammatory disease that affects 1~4% of the general adult population. It is characterized by edematous inflamed mucosa prolapsing into the nose, leading to nasal obstruction, abnormal secretions, loss of smell, headache, and a reduced quality of life. We sought to screen for diseases related genes in nasal polyp by using DNA microarray and to validate the altered expression of selected genes. SUBJECTS AND METHOD: The samples were obtained from nine patients with nasal polyps and two patients with pituitary adenoma. DNA microarrays containing 22,063 genes were used to compare individual gene profiles of nasal polyp samples and normal mucosal samples. A study of mRNA expression of selected genes was performed using RT-PCR. RESULTS: 126 genes were up-regulated at least 2-fold, and 161 genes were down-regulated at least 50% in nasal polyps compared with the normal sinus mucosa. The three most up-regulated genes (STATH, TCN1, DMBT1) and one most down-regulated gene (SCGB1A1) were retested by means of RT-PCR. RT-PCR confirmed the differential expressions of all the genes in nasal polyp compared with normal sinus mucosa. CONCLUSION: This study could provide a clue for investigating possible pathophysiologic processes involved in nasal polyps.

Correlation Analysis between Self-reported Measures in Patients with OSA / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Our study evaluated the necessity of measuring the quality of life (QOL) with physiologic parameters by assessing inter-relationship between self reported measures, which are known as a tool for evaluation of generic and disease specific QOL. SUBJECTS AND METHOD: From Oct. 2004 to Apr. 2006, polysomnograpy (PSG) results of 127 patients were retrospectively reviewed. QOL was assessed using the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), Self-reported measures including Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Stanford Sleepiness Scale (SSS), Insomnia Severity Index (ISI), and Beck Depression Inventory (K-BDI). The association between each domain on the SF-36 and self-reported measures were examined by Spearman correlation measures. RESULTS: ESS, SSS, PSQI and ISI correlated well with SF-36, except for ESS, which didn't with Physical Functioning of SF-36. PSG indexes of patients with OSAS did not show correlation with self-reported measures. CONCLUSION: All self reported measures including generic and disease specific QOL have their own significance in reflecting psychosomatic status in patients with OSAS. Self-reported measures could be more informative in the reflecting severity and pre/post treatment results in the aspect of psychosomatic effects in OSAS patients.

Chondrosarcoma of the Skull Base ; Report of Three Cases / 대한이비인후과학회지

Chondrosarcomas are slow-growing tumors with low grade malignancy and unclear histopathogenesis. Surgical excision is the treatment of choice. Combined treatment is usually recommended for high-grade lesions and residual lesions. The oncologic outcome depends on complete resection as well as on the grade of tumor. We experienced 3 cases of the chondrosarcoma of skull base. They were treated by different approaches, which were temporal/infratemporal approach, cervical/mastoid approach and transnasal endoscopic approach. In the first two cases, tumor invaded cranial dura mater. After complete excision with postoperative radiotherapy, tumor had local recurrence. In the third case, tumor invaded sellar region but only palliative surgical excision was done considering the complications of radiotherapy.

Treatment of Nasopharyngeal Angiofibroma with Intraoperative Serial Intratumoral Embolization : 2 Cases / 대한이비인후과학회지

Angiofibroma is a rare disease that is diagnosed typically in adolescent male patients as a nonencapsulated, submucosal spreading tumor. Because these tumors are highly vascular, embolization and surgery remain as the two major therapeutic tools. For reducing the blood supply of the tumor and decreasing intraoperative bleeding, embolization has become an effective preoperative procedure. There are two embolization methods which are intravascular and intratumoral embolization. Recently, we experienced two cases of nasopharyngeal angiofibroma that were resected by endoscopic approach after intraoperative serial intratumoral embolization with good results. We report these with a review of literature.

Comparison of Nasal Packing and Septal Suturing Following Septoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal packing at the completion of septoplasty is considered routine by most surgeons. However, nasal packing can cause nasal injury, hypoxia, cardiovascular change and most importantly patients' discomfort. The purpose of this study was to compare nasal packing and septal suture (through-and-through suture) with respect to immediate postoperative patients' discomfort and final outcome. SUBJECTS AND METHOD: Fifty patients undergoing routine septoplasty were randomized on the basis of sex and age to receive either nasal packing or septal suture. Fourty-two patients completed their symptom and discomfort scores according to the visual analogue scale (VAS) for 4 days after septoplasty and completed another questionnaire before and 8 weeks after septoplasty. RESULTS: The nasal packing group gave significantly higher scores in headache compared with the septal suturing group. The final outcome of the procedure was the same between both groups. CONCLUSION: Septal suture is a good alternative for nasal packing. It does cause less pain for patients and no statistically significant differences in outcome were found between both groups.

Anchoring Suture for Correction of Septal Deviation

BACKGROUND AND OBJECTIVES: Septoplasty is often dismissed as a simple procedure and this can lead to unsatisfactory results. Although multiple techniques of septal surgery have been performed, approximately 20 to 30% of patients find their symptoms are not corrected adequately. Causes of failure may be found in the inherent memory of that cartilage possesses or in the requirement to end septal correction surgery when support of nose is at risk for compromise. The purpose of this study was to introduce and evaluate the efficacy of an anchoring suture-a new technique for correction of septal deviation. MATERIALS AND METHODS: We studied 40 patients who underwent septoplasty with anchoring suture between October 2003 and December 2004. All patients completed their symptom, discomfort score on visual analogue scale (VAS) and acoustic rhinometry was performed before and 2 months after septoplasty with anchoring suture. Data was analyzed by paired t-test. RESULTS: Patients symptom and discomfort score were decreased and acoustic rhinometry parameters were increased significantly. There was no complication reported. CONCLUSION: Anchoring suture is simple, safe and attractive method for correction of septal deviation and some aspects do require further investigation.

MMP-2, MMP-8 Expression in gingival tissue of Chronic Periodontitis associated to Type 2 Diabetes Mellitus / 대한치주과학회지

No abstract available.

MMP-2, MMP-8 Expression in gingival tissue of Chronic Periodontitis associated to Type 2 Diabetes Mellitus / 대한치주과학회지

No abstract available.

A Case of Pyostomatitis Vegetans which Comes with Ulcerative Colitis / 대한이비인후과학회지

Pyostomatitis vegetans is a rare oral condition characterized by miliary pustules that primarily affect the labial gingiva as well as the buccal and labial mucosa. It is consistently associated with inflammatory bowel disease (IBD) and is a highly specific marker for IBD. Authors are reporting a 45 year-old female patient who developed pyostomatitis vegetans after she was diagnosed as having ulcerative colitis. Our experience indicates that there is an intimate relationship between pyostomatitis vegetans and inflammatory bowel disease (IBD). In a pyostomatitis vegetans patient whose IBD is in dormant state, the diagnosis of IBD can be missed. It is imperative, therefore, to suspect IBD in a patient with pyostomatitis vegetans who has no gastrointestinal symptoms and recommend thorough investigational study of the gatrointestinal system.

The Effects of Saline Solution Irrigation on Nasal Mucus Secretion: in vivo and in vitro Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various saline solution formulae have been used frequently in patients with rhinosinusitis. However, there are not enough scientific evidences supporting the effect of irrigation of the nose with saline solution. We investigated the effects of saline solution on mucus secretion, vascular response, subjective symptoms and nasal cavity air-space volume changes using in vitro and in vivo test. MATERIALS AND METHOD: In vitro study, inferior turbinate mucosa were harvested from patients who had chronic hypertrophic rhinitis. These were incubated with 0.9%, 3%, 6% of saline solutions, and control solution. Concentrations of mucin and lysozyme were measured from them. In vivo study, the nasal cavity of normal control group and patients with septal deviation were irrigated with 0.9%, 3%, 6% of saline solutions. Lavage fluids were collected from the ipsilateral and contralateral sides to measure the concentrations of varies constituents such as mucin, lysozyme, total protein, and albumin. Patients recorded subjective symptoms and nasal cavity air-space volume was assessed by acoustic rhinometry after each irrigations. RESULTS: In vitro study, the concentrations of mucin and lysozyme were increased in the dose-dependent manner by increasing the osmolarity. In vivo study, the sensation of rhinorrhea, pain and nasal blockage were increased as the concentration of saline increased. Furthermore, the concentrations of mucus and total protein also increased by increasing concentration of saline solution at ipsilateral side. However, contralateral reflex-mediated effect were negligible. There was no change in air-space volume. CONCLUSION: The saline solution induced secretion of mucus mignt be through axon reflex mediated neuronal effect. The increased mucus may change the rheology of mucus which, in turn, could increase mucociliary action in the nasal cavity.

Isolated Sphenoid Sinus Lesion: A Clinical Analysis of 17 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An isolated sphenoid sinus lesion is a rare disorder and is difficult to diagnose for several reasons. This lesion can easily spread to the adjacent structures and lead to severe complications. Thus, early diagnosis and treatments are needed. We experienced 17 cases of isolated sphenoid sinus lesions, including inflammatory, neoplastic, and vascular lesions, and reviewed the clinical findings, radiologic features, treatments and complications of these cases. MATERIALS AND METHOD: Isolated sphenoid sinus lesions were reviewed retrospectively of patients from January 1995 to July 2001. Patients were identified with radiologic findings and intraoperative endoscopic findings excluding other paranasal sinus involvements. RESULTS: The most common symptom was headache, and 13 patients (76%) complained. Nasal symptoms appeared only 4 patients (23%). Pathologic reviews showed 9 cases of acute and chronic sinusitis were 9 cases, 4 fungal sinusitis, 2 neoplastic diseases, 1 polyp, and 1 vascular disease. We carried out medical treatment in 5 cases, and diagnostic biopsy in 3 cases, and therapeutic surgery in 10 cases. In 7 cases, complications including cranial nerve palsy were observed, and 1 patient was expired due to meningitis. CONCLUSION: We can diagnose isolated sphenoid sinus lesions exactly with the use of radiologic findings and endoscopic examinations. With endoscopy, we can operate relatively less invasively and more effectively. It is apparent that early recognition and rapid treatment are essential if complications are to be avoided.

Development of Korean Version of Structured Clinical Interview Schedule for DSM-IV Axis I Disorder: Interrater Reliability / 신경정신의학

OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

Direct and Indirect Cost of Treating Out-Patients with Schizophrenia in Korea / 신경정신의학

OBJECTIVES: We have aimed to estimate the direct and indirect costs of treating out-patients with schizophrenia in Korea, to use this fundamental data for the effective management and proper distribution of the medical resource. METHOD: To estimate the direct cost, we surveyed the medical cost and time of two hundred and eighty-nine out-patients with schizophrenia for six months. And the lost productivity as many months was converted into the indirect cost. Those of eighty-two coronary heart disease patients were also estimated as a comparison group. RESULTS: An unemployement rate of schizophrenic patients was 72.1 percent. Moreover the ratio of the laborer in the sample was, even if employed, 64.5 percent. The mean direct cost of schizo-phrenic patients was, about 815,000 won, higher than that of coronary heart disease, 715,000 won however it was not statistically significant. The former was also estimated 2.5 times more than the latter for the indirect cost, or 6,456, 000 won versus 2,589,000 won. CONCLUSION: Schizophrenia is a relatively costly illness compared to other chronic illness, so the systematic estimation of the cost is necessary to provide mental health service of high quality.

Intraoperative Blood Salvage and Transfusion During Spinal Surgery / 대한마취과학회지

25 Patients were received major spinal surgeries at main operating theater of Kangnam General Hospital from May 1990 to December 1990 by using the Haemonetics cell saver which was employed as an intraoperative blood salvage and autologous blood transfuser. The products of washed red blood cells were an average of 1490 cc packed RBC per case. Under the Light Microscopy, Washed RBC disclosed the morphologies of normal RBC size and shape. Fragmented RBCs or cell debris were not found and in one case agglutinated and denaturated RBCs were seen. While 20 patients were received spinal surgery prior to the utilization of cell saver, an average of 7.85 units of banked whole blood was transfused compared with 5.55 units in the cases of using the cell saver (p<0.05). Homologous banked blood utilization during spinal surgery declined more than 30% with the use of the cell saver. There was no evidence of infection, renal and/or hepatic failure related to the use of the cell saver. Haemonetics cell saver appeared to be safe, efficient and more over in some instanes life saving.

The Effect of Aging on the Pulmonary Function of the Healthy Adults / 대한마취과학회지

Pulmonary function tests were conducted in 60 male adults and 60 female adults at 20~79 years of age. They showed noevidenee of pulmonary disease on clinical symptoms, X-ray finidngs and past history. We wanted to evaluate the deterioration of pulmonary functional reserve in the aged. The results were as follows: 1) In males, FVC decreased significantly (p <0.01) from 4440+/-271.38 ml in 20~29 year-old subjects to 3090+/-445.75 ml 70~79 year-old subjects. The correlation coefficient with age was-0.6846. 2) In females, FVC decreased significantly (p<0.01) from 2097+/-479.42ml in 20~29 year-old subjects to 2142+/-233.13ml in 70~79 year-old subjects The correlation coefficient woth age was 0.6454. 3) In males, FEV, decreased significantly (p<0.01) from 4005+/-268.26 ml in 20~29 year-old subjects to 2373+/-326.36ml in 10~79 year-old subjects. The correlation coefficient with age was-0.8229. 4) In females, FEV1 decreased significantly (p<0.01) from 2586+/-519.00 ml in 20~29 yrar-old subjects to 1645+/-330.36ml in 70~79 year old subjects The correlation coefficient with age was 0.7013. 5) In males, FEV1/FVC decreased significantly (p<0.01) from 90.17+/-4.90% in 20~29 year-old subjects to 76.72+/-8.13% in 70~79 year-old subjects. The correlation coefficient with age was-0.5595. 6) In females, FEV1/FVC decreased significantly (p<0.01) from 88.66+/-6.58% in 20-29 year-old subjects to 76.80+/-9.32% in 70~79 year-old subjects. The correlation coefficient with age wae-0.4489.