Usefulness of the SAFARI score for predicting convulsive seizure in patients with aneurysmal subarachnoid hemorrhage

OBJECTIVE: The SAFARI score was introduced to assess the risk of convulsive seizure during admission for aneurysmal subarachnoid hemorrhage in 2017. This study was conducted to determine whether the SAFARI score derived from the afore-mentioned study could be applied to patients with aneurysmal subarachnoid hemorrhage in Korea. METHODS: We conducted a retrospective study of patients who were diagnosed with aneurysmal subarachnoid hemorrhage from March 2013 to October 2017. Patients' age, sex, blood pressure, pulse rate, body temperature, Glasgow-Coma Scale, Hunt-Hess scale, modified Fisher grade, size of ruptured aneurysm, surgery type, transfusion, and SAFARI score were compared between the seizure and non-seizure groups. The area under the receiver operator characteristic curves was calculated to evaluate the predictive ability for seizure during admission. Logistic regression analysis was used to analyze predictive factors for seizure during admission. RESULTS: A total of 220 patients were included. Ninety-seven (44.1%) were male and 123 (55.9%) were female. The mean age of the patients was 65.8 years old (range, 56–75). The area under the curve of the SAFARI score for predicting seizure was 0.813. The SAFARI score was the only significant predictor of seizure during admission, while other factors were not statistically significant upon logistic regression analysis. CONCLUSION: The SAFARI score could be used for predicting seizure during admission in patients with aneurysmal subarachnoid hemorrhage.

Clinical Study on Blowout Fractures of the Medial Orbital Wall Reconstructed by Bulla Ethmoidalis Osteomucosal Flap / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed to treat fractures of the medial orbital wall. Among them, the transnasal endoscopic approach provides the chance to avoid external scars and to observe the fracture site clearly. These approaches mostly require the use of grafts or splints. Authors carried out a retrospective study on the blowout fractures repaired by bulla ethmoidalis osteomucosal flap (BOMF) and compared them with the groups that were treated with silastic sheet only and with Med-pore(R) registered to investigate the merits of BOMF with respect to results and complications. SUBJECTS AND METHOD: We reviewed 62 cases (64 sides) of medial wall fractures that were treated surgically. They were diagnosed with 3 mm facial CT scans and treated according to the authors' indications from February 1998 to March 2004 at Namgwang Hospital, Seonam University. The surgical treatment consisted of the reconstruction of the fractures and the repair of the remaining bone defects by graft and splint, and the type of graft was selected according to the size of the defect. For minor defects, silastic sheet was used alone, whereas major defects were repaired with BOMF or Med-pore(R) registered. All patients were evaluated regularly for at least six months postoperatively. RESULTS: There were no differences in the aspects of the final treatment results of diplopia and enopthalmos. But in the aspects of postoperative crust formation and granulation, the cases that were repaired with BOMF showed better results as well as the economic merits. In the BOMF cases, the average duration of silastic sheet stenting was 12.5 days and it could reduce the follow up period. CONCLUSION: BOMF demonstrated better results in the respects of duration of silastic sheet stenting, postope-rative crust formation, granulation and economic cost.

The Prevalence of Otitis Media in the Young Adult Men Group in Gwangju . Chonnam, Korea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Otitis media is one of the most common inflammatory disorders in the field of otolaryngology. Fortunately, with development in antibiotics and advances in preventive therapy otitis media is on the decrease. Nevertheless, there are only few reports about the prevalence rate of otitis media in Korea. Therefore, we investigated the prevalence of each type of otitis media among young adults in Gwangju and the Province of Chonnam, Korea. SUBJECTS AND METHOD: 28, 200 men aged 19 years old who underwent physical examination for conscription at the Military Manpower Administration in Gwangju from February to september, 2002 were analyzed, retrospectively. RESULTS: The overall prevalence of otitis media was 0.219%. Prevalence of each subtype was as follows; acute otitis media, 0%; otitis media with effusion, 0.049%; chronic otitis media, 0.17%, respectively. In the group of chronic otitis media, chronic perforated otitis media was 95.8%. The prevalence of otitis media did not vary by urban-rural difference, nor by coastal-inland area. CONCLUSION: The prevalence rate of chronic otitis media was remarkably decreased, compared with 10 years ago (0.70%), and conspicuously with 20 years ago (2.81%). Therefore, we think this low prevalence rate is partially due to remarkable improvement in socioeconomic conditions with better nutrition, housing, hygienic condition, social environments and advances in public health and medical care.

Correlations among Tumor Microvessel Density, p53 Protein Expression, and Cervical Lymph Node Metastasis in Squamous Cell Carcinoma of the Head and Neck / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Angiogenesis is a crucial step in tumor growth and progression, and regulated by the net balance between positive and negative angiogenic factors. Recent studies suggested that angiogenesis is controlled by p53 regulation. immunohistochemical study was carried out using monoclonal antibodies against p53 protein and CD34. In this study, immunohistochemical study was carried out using monoclonal antibodies against p53 protein and CD34 in order to determine the relationship between p53 protein expression and angiogenesis in squamous cell carcinoma in the head and neck. MATERIALS AND METHODS: Tumor tissues from 35 cases of paraffin block specimens of head and neck cancers were used from the archives of Department of Pathology in Chonnam University hospital to study the relationship between p53 protein expression and angiogenesis. RESULTS: p53 protein expression was present in 20 (57.1%) of 35 cases and the median micro-vessel count (MVD) was 49.0 (9-126) in x200 microscopic field. MVD was 45.5 (20-126) in cases with p53 protein expression and 50.0 (9-108) in cases without p53 protein expression. There was no statistical significance between MVD and p53 protein expression. An inverse relationship was seen between MVD and primary tumor size. P53 protein expression was not associated with nodal metastasis and primary tumor size. CONCLUSION: There were no significant relations between MVD and p53 protein expression, nor among MVD, p53 and nodal metastasis in head and neck squamous cell carcinoma.

Expression of Matrix Metalloproteinase-2 in the Cervical Lymph NodeMetastasis of the Head and Neck Squamous Cell Carcinoma-A Clinicopathologic Study- / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Death as a result of cancer is primarily due to regional and/or systemic metastasis. The first essential step of metastasis is active migration of cancer cells from their tissue organ. It is associated with the degradation of extracellular matrix macromolecule, including the basement membrane component of vessels and interstitial stroma. Matrix metalloproteinase-2, one of many matrix degrading enzymes, has been identified as a basement membrane-degrading enzyme and is thought to play an important role in the malignant behavior of cancer. But only a little is known about clinicopathologic features of head and neck squamous cell carcinoma in the relation to the production of MMP-2. This study was designed to investigate the relationship between MMP-2 expression in the cancer cell membrane and ervical lymph node metastasis in the head and neck squamous cell carcinoma using immunohistochemistry. MATERIALS AND METHODS: Tissues were obtained from 55 patients with head and neck cancer who underwent the surgery of primary tumor resection and radical neck dissection. And paraffin embedded 5nm thin sections were immunohistochemically stained for MMP-2. RESULTS: 1) Immunoreactivity for MMP-2 was detected primarily in the cancer cell nests, whereas it was either not observed or observed infrequently and only faintly in the normal epithelium. 2) Metastasis to a lymph node was more frequently observed with the MMP-2 production in the head and neck cancer than that with no expression of MMP-2 (p<0.01). 3)There was no significant correlation between the expression of MMP-2 and the patient's age, tumor size, primary tumor site, clinical tumor stage (TNM classification), and histologic grading. CONCLUSION: These results suggest that intensity of MMP-2 expression in the cancer nests may be a biochemical parameter to predict a metastatic potential, prognosis, and aggressiveness of the head and neck squamous cell carcinoma.

Augmentation Rhinoplasty Using Calvarial Bone Graft / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Multiple autogenous and alloplastic implants have been used in nasal reconstruction. Autogenous implants include auricular and septal cartilage as well as rib and iliac crest bone grafts. Alloplastic materials include acrylic, supramid mesh, Gortex, and silicone rubber. Autogenous grafts have been shown to provide excellent long-term reliable results in nasal reconstruction. our study was designed to demonstrate the usablility of calvarial bone as primary choice of graft material in nasal dorsum reconstruction. MATERIAL AND METHODS: Eleven patients with saddle nose underwent augmentation rhinoplasty using a calvarial bone graft from Jan. 1993 to Dec. 1996. We observed for any complications in the donor and/or recipient sites, stability of grafted bone, and final results including volume loss through medical records and photographs taken during follow-up periods. RESULTS: Hematoma in the scalp was the only complication. CSF leakage, or infection have been observed. Grafts were well fixed without screws or K wires. Displacement of grafted bone were not seen. External nasal contour was well achieved in all cases. CONCLUSION: In augmentation rhinoplasty, split calvarial bone is recommended as a good material.