The Impact of Nasal Polyposis on Olfactory Dysfunction in Chronic Rhinosinusitis

BACKGROUND AND OBJECTIVES: Olfactory disturbance is a major sinonasal symptom of chronic rhinosinusitis (CRS) with nasal polyps (NP). The aim of this study was to investigate the relationship between the severity of nasal polyposis and olfactory dysfunction in CRS. SUBJECTS AND METHOD: A total of 277 subjects with CRS were included in this study. All participants were divided into four groups according to the size and degree of the nasal polyposis: the control group (no polyp; n=79); NP (nasal polyp) group I (both or unilateral simple polyposis; n=85); NP group II (unilateral diffuse polyposis; n=66); and NP group III (bilateral diffuse polyposis; n=47). We analyzed the relationships between the severity of nasal polyposis and olfactory dysfunction using both the Korean Version of the “Sniffin'Sticks” test (KVSS Test) II and the Questionnaire of Olfactory Disorders (QOD). RESULTS: The KVSS Test II TDI score was significantly decreased in the bilateral diffuse polyposis group (NP group III=15.62±13.39) compared to the other polyp groups [control group=25.04±9.67 (p<0.001); NP group I=21.67±11.18 (p=0.005); NP group II=21.51±10.85 (p=0.008)]. However, there were no significant differences in the KVSS Test II TDI score between the control group and NP groups I and II. For the QOD_NS score, only NP group III (11.51±9.87) had significantly increased values compared to the control group [8.42±12.27 (p=0.015)]. CONCLUSION: These results suggest that bilateral diffuse nasal polyposis is related to significant olfactory dysfunction in CRS.

Clinical Correlation between Perverted Nystagmus and Brain MRI Abnormal Findings

BACKGROUND AND OBJECTIVES: To analyze the clinical correlation between perverted nystagmus and brain magnetic resonance imaging (MRI) abnormal findings and to evaluate whether perverted nystagmus is clinically significant results of brain abnormal lesions or not. SUBJECTS AND METHODS: We performed medical charts review from January 2008 to July 2014, retrospectively. Patients who were suspected central originated vertigo at Frenzel goggles test were included among patients who visited our hospital. To investigate the correlation with nystagmus suspected central originated vertigo and brain MRI abnormal findings, we confirmed whether performing brain MRI or not. Then we exclude that patients not performed brain MRI. RESULTS: The number of patients with perverted nystagmus was 15, upbeating was 1 and down-beating was 14. Among these patients, 5 patients have brain MRI abnormal findings. However, 2 patients with MRI abnormal findings were not associated correctly with perverted nystagmus and only 3 patients with perverted nystagmus were considered central originated vertigo and further evaluation and treatment was performed by the department of neurology. CONCLUSIONS: Perverted nystagmus was considered to the abnormalities at brain lesions, especially cerebellum, but neurologic symptoms and further evaluation were needed for exact diagnosis of central originated vertigo.

Long-term Subjective and Objective Outcomes of Adenotonsillectomy in Korean Children With Obstructive Sleep Apnea Syndrome

OBJECTIVES: Adenotonsillar hypertrophy is the most common etiology in pediatric obstructive sleep apnea syndrome (OSAS), and adenotonsillectomy is the mainstay of treatment modalities. This study evaluates the long-term effectiveness of adenotonsillectomy in children with OSAS. METHODS: Subjective symptoms evaluated with a 7-point Likert scale and objective respiratory disturbances evaluated by polysomnography were compared before and after adenotonsillectomy. RESULTS: A total of 17 children with OSAS aged 4-15 years (mean age, 6.65+/-3.02 years; male:female, 13:4) completed the study. The mean follow-up period was 57 months (range, 30 to 98 months). Significant changes were found in apnea-hypopnea index (from 12.49+/-12.96 to 1.96+/-2.01, P<0.001), apnea index (from 5.64+/-7.57 to 0.53+/-0.78, P=0.006), minimum SaO2 (from 81.88+/-14.36 to 92.76+/-4.31, P=0.003), snoring (from 43.28+/-70.63 to 10.70+/-13.72, P=0.042), and arousal index (from 19.58+/-7.57 to 11.36+/-3.99, P=0.006) after adenotonsillectomy. Significant changes were also found after surgery in most of symptoms including snoring, witnessed apnea, morning headache, mouth breathing, gasping during sleep, restless sleep, nasal obstruction, and difficulty with morning arousal. Long-term surgical cure rate and response rate were 47.1% (8/17) and 70.6% (12/17), respectively. CONCLUSION: Most of subjective OSAS symptoms and objective respiratory disturbances improved continuously about 5 years after adenotonsillectomy in children with OSAS. However, close follow-up and a sufficient observation period are necessary because of the risk for long-term incomplete resolution.

Assessment of Cardiac Function in Neonates by Using Tissue Doppler Imaging / 소아과

PURPOSE: Tissue Doppler imaging(TDI) is recently being used for assessement of regional ventricular function in adults. However, data in neonates have not been established yet. The aim of this study is to establish reference values of TDI velocities and to investigate the effect of other factors on TDI velocites in the neonatal population. METHODS: Forty eight healthy neonates with anatomically normal hearts from July 2003 to August 2003 were enrolled. Blood was collected after 12 hours of birth and Troponin T(TnT) was measured. TDI of mitral and tricuspid annulus was obtained from apical four chamber views within three days. TDI measurements included peak early diastolic annular velocity, peak diastolic annular velocity with atrial contraction, peak systolic annular velocity and duration of systole. RESULTS: In neonates, peak systolic velocity and peak diastolic velocity were lower than those of children and adults. The ratio of peak early diastolic velocity to peak diastolic velocity with atrial contraction(e'/a') was lower compared with known data in children and adults. With faster heart rates, peak early diastolic velocity and peak systolic velocity of mitral septal annulus and peak early diastolic velocity of tricuspid lateral annulus were significantly increased. PFO, PDA and TR did not affect TDI parameters. CONCLUSION: Annular TDI parameters of neonates were different from those of children and adults. TDI is a simple, rapid tool for assessing global ventricular function and the data of this study can be used as reference values for ventricular dysfunction in the neonatal period.

Allele Distribution and Frequency of Human Surfactant Protein-A2 in Korean Neonates

PURPOSE: We evaluated allele frequencies and distribution of surfactant protein A2(SP-A2) in Korean neonates in order to estimate the prevalence of RDS, to find out new SP-A alleles, and to establish new steroid therapy. METHODS: Genomic DNA was extracted from 71 neonates and served as a template in PCR for genotype analysis. SP-A gene-specific amplications and gene-specific allele determinations were performed using PCR-cRFLP methods. RESULTS: The distribution for the alleles of the SP-A2 gene in the study population was 1A, 1A0, 1A1, 1A2, 1A3, 1A5, 1A6, 1A7, 1A8, 1A9, 1A11, 1A12. The specific frequencies for the alleles of the SP- A2 gene in the study population were : 1A=11.3%, 1A0=38%, 1A1=12.7%, 1A2=9.2%, 1A5=15.5%, 1A7= 2.9%, 1A8=4.9%, 1A9=2.2%, others=3.3%. CONCLUSION: The frequency of 1A0 was higher than the other SP-A2 alleles in Korean neonates. This finding suggests that the prevalence of RDS in Korea may be low compared with other countries. However, this finding also suggests that Korean neonates have a high risk of infection.