Age Differences in Pet Sensitization by Pet Ownership

Objectives@#. The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age. @*Methods@#. We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups. @*Results@#. Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001). @*Conclusion@#. Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.

Olfactory and Taste Dysfunction in Patients with Asymptomatic and Mildly Symptomatic COVID-19 in Korea

Background and Objectives@#The association between chemosensory dysfunction (CSD) and coronavirus disease 2019 (COVID-19) remains unclear. The aim of the present study was to determine the incidence of olfactory and taste dysfunction in asymptomatic and mildly symptomatic patients with COVID-19 and to evaluate the symptoms associated with CSD in patients with COVID-19.Materials and Method: On March 9, 2020, 309 patients with asymptomatic or mildly symptomatic COVID-19 confirmed by real-time polymerase chain reaction (RT-PCR) were admitted to the No. 7 Community Treatment Center in Korea. An internet-based survey about symptomatology was administered to these patients, with responses obtained from 244 (79.0%). Subjects who completed the survey were enrolled in this study and were categorized into either a CSD group or a normal chemosensory group based on the presence or absence of CSD, respectively. @*Results@#General symptoms, including fever, myalgia, and chills, were most common (29.1%), followed by upper respiratory tract infection (URI) symptoms (20.9%), CSD (20.5%), and nasal symptoms (13.5%). In patients with CSD (n=50), 10 (4.1%) reported no other symptoms. After adjustment for age, sex, past medical history, and other symptoms, general symptoms [odds ratio (OR), 3.63; confidence interval (CI), 1.70-7.76] and nasal symptoms (OR, 7.00; CI, 2.61-18.80) were significantly associated with CSD. @*Conclusion@#The incidence of CSD was relatively high (20.5%) in asymptomatic and mildly symptomatic patients with COVID-19. General symptoms were independent risk factors of CSD, suggesting a sensorineural mechanism for the observed olfactory and taste dysfunction.

Age Differences in Pet Sensitization by Pet Ownership

Objectives@#. The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age. @*Methods@#. We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups. @*Results@#. Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001). @*Conclusion@#. Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.

Two Cases of Bilateral Paranasal Sinus Fungus Balls with Sphenoid Sinus Involvement / 대한이비인후과학회지

A fungus ball is the most common manifestation of fungal sinusitis. Bilateral involvement of fungus balls is rare, and bilateral sphenoid involvement is even more uncommon. The authors report two cases of bilateral fungus balls with sphenoid sinus involvement successfully treated with endoscopic sinus surgery. Both patients complained of nonspecific headache; diagnoses were made with CT and histopathological examinations, and surgical removal was achieved via transostial approach. Bilateral fungus balls involving the sphenoid sinus are rare but do occur; their removal is possible through endoscopic sinus surgery with a high cure rate. We thus recommend using CT scanning to identify typical findings of a sphenoid fungus ball even in bilateral paranasal sinusitis and perform aggressive surgical treatment.

Two Cases of Bilateral Paranasal Sinus Fungus Balls with Sphenoid Sinus Involvement / 대한이비인후과학회지

A fungus ball is the most common manifestation of fungal sinusitis. Bilateral involvement of fungus balls is rare, and bilateral sphenoid involvement is even more uncommon. The authors report two cases of bilateral fungus balls with sphenoid sinus involvement successfully treated with endoscopic sinus surgery. Both patients complained of nonspecific headache; diagnoses were made with CT and histopathological examinations, and surgical removal was achieved via transostial approach. Bilateral fungus balls involving the sphenoid sinus are rare but do occur; their removal is possible through endoscopic sinus surgery with a high cure rate. We thus recommend using CT scanning to identify typical findings of a sphenoid fungus ball even in bilateral paranasal sinusitis and perform aggressive surgical treatment.

Ethmoidal Sinus Mucocele as a Cause of Acquired Brown Syndrome

No abstract available.

Steroid Effect for Persistent Cough Developed after 2009 Pandemic Influenza A (H1N1) Infection: 5 Cases / 대한이비인후과학회지

After the report of the first case of pandemic influenza A virus H1N1 on April 2009, this infection caused more than 16 thousands deaths world-widely. Postinfectious cough is known to be one of the important causes of chronic cough. We experienced five cases of persistent cough, which developed after influenza A virus H1N1 infection. All of the cases showed bronchial hyperreactivity by methacholine inhalation challenge. We prescribed steroids, which resulted in complete symptomatic recovery within 50 days, but the bronchial hyperreactivity was not normalized. We describe these five cases in regard to clinical characteristics, methacholine challenge test, and anti-inflammatory treatment.

Efficiency of Chlamydia Pneumoniae Culture in the Upper Airway Epithelial Cell Lines: AMC-HN-4, AMC-HN-7, and AMC-HN-8 / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chlamydia pneumoniae (C. pneumoniae) is a well-known pathogen of upper and lower respiratory tract infection. For a more efficient and practical cell culture system, we studied the growth of two clinical isolates of C. pneumoniae in selected cell lines derived from the human respiratory tract. MATERIALS AND METHOD: HeLa 229, HEp-2, which are well-known cell lines for the culture of C. pneumoniae, and AMC-HN-4, AMC-HN-7, AMC-HN-8, which are the newly developed cell lines in Korea were examined. Strains of C. pneumoniae used in this study were TW-183 and LKK-1 (the first Korean strain). Chlamydia was inoculated on each confluent cell line and incubated for 48 hrs. After staining with anti-Chlamydial lipopolysaccharide monoclonal antibody, we compared the efficiency of the C. pneumoniae infection on each cell line by counting the inclusion bodies. RESULTS: In culturing C. pneumoniae LKK-1, AMC-HN-4 cells consistently yielded higher inclusion body counts than HeLa 229 cells did, whereas inclusion body counts by AMC-HN-7 cells was low. AMC-HN-7, AMC HN-8 cells yielded lower inclusion body counts than HEp-2 cells. In culturing C. pneumoniae TW-183, AMC-HN-4, AMC-HN-7, and AMC-HN-8 cells did not yield lower inclusion body counts than HeLa 229 cells did. AMC-HN-7 cells yielded lower inclusion body counts than HEp-2 cells. CONCLUSION: The newly established upper airway epithelial cell lines, AMC HN-4 and AMC HN-8, had similar culture efficiency as HeLa 229 and HEp-2 cells for Chlamydial infection; therefore, these two cell lines could be used for the future studies of C. pneumoniae.

Regulation of Ca2+ Signaling in Pulmonary Hypertension

Understanding the cellular and molecular mechanisms involved in the development and progression of pulmonary hypertension (PH) remains imperative if we are to successfully improve the quality of life and life span of patients with the disease. A whole plethora of mechanisms are associated with the development and progression of PH. Such complexity makes it difficult to isolate one particular pathway to target clinically. Changes in intracellular free calcium concentration, the most common intracellular second messenger, can have significant impact in defining the pathogenic mechanisms leading to its development and persistence. Signaling pathways leading to the elevation of [Ca2+]cyt contribute to pulmonary vasoconstriction, excessive proliferation of smooth muscle cells and ultimately pulmonary vascular remodeling. This current review serves to summarize the some of the most recent advances in the regulation of calcium during pulmonary hypertension.

Plasma Osteopontin Is a Useful Diagnostic Biomarker for Advanced Non-Small Cell Lung Cancer / 결핵및호흡기질환

BACKGROUND: Osteopontin (OPN) and carbonic anhydrase IX (CAIX), which are expressed on the surface of tumor cells, are associated with hypoxia during tumor development and progression. However, the roles of these proteins in the plasma of patients with non-small cell lung cancer (NSCLC) are poorly understood. Herein, we hypothesized that plasma OPN and CAIX levels could be used as diagnostic and prognostic tumor markers in patients with NSCLC. METHODS: Fifty-three patients with NSCLC and 50 healthy control subjects were enrolled. We selected controls without malignancy and matched them with NSCLC patient cases according to age and gender. Blood samples were collected at the time of diagnosis; the plasma levels of OPN and CAIX were measured by enzyme-linked immunosorbent assays. RESULTS: The plasma levels of OPN in the patients with NSCLC were significantly elevated as compared to those in the controls (p=0.016). However, there was no difference in the plasma level of CAIX between the NSCLC patients and controls. NSCLC patients with a distant metastasis had a remarkable increase in plasma OPN compared with patients without metastasis (p=0.026), but no such correlation was found for CAIX. There was no difference in overall survival rates according to the plasma level of OPN between the two groups (by Kaplan-Meier survival analysis). CONCLUSION: Plasma OPN levels were elevated in patients with NSCLC as compared with the controls, with greater elevation of OPN levels in the advanced stages of disease. Therefore, plasma OPN may have utility as a diagnostic, but not prognostic, biomarker of advanced NSCLC.

Subjective and Objective Results of Radiofrequency Ablation in Drug-Resistant Allergic Rhinitis Based on a 12-Month Follow-up Study

BACKGROUND AND OBJECTIVES: Allergic rhinitis is a common condition that has been treated using various methods. Nevertheless, it remains an intractable condition in some cases. We evaluated the long-term efficacy of radiofrequency ablation (RFA) therapy for drug-resistant allergic rhinitis. MATERIALS AND METHODS: Eighteen patients with allergic rhinitis were enrolled in this prospective interventional study. Their subjective symptoms and objective findings were assessed using a visual analogue scale and acoustic rhinometry before and after RFA therapy. Postoperative follow-up was carried out at 1, 3, 6, and 12 months. RESULTS: Nasal obstruction and rhinorrhea were improved significantly (p<0.001 and p=0.015, respectively), and these effects continued for 12 months after RFA therapy. However, the effects on nasal itching and sneezing did not last throughout the year of the study. Patients' overall satisfaction scores declined at 12 months. On acoustic rhinometry, the minimal cross-sectional area and the total nasal volume did not show improvement, and there were no correlations with the subjective symptoms. Most of the complications associated with the RFA procedure were minimal and resolved within 4 weeks. CONCLUSION: RFA is a safe, simple, and effective procedure for relieving nasal obstruction and rhinorrhea for at least 12 months in drug-resistant allergic rhinitis.

Sphenoidal Sinusitis with Epidural Empyema Presenting as Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a common condition that produces pain in the orofacial area. However, the exact cause of TN is still unknown. Various etiologies such as tumor, multiple sclerosis and other compressive lesions have been implicated as possible causes. A 35-year-old woman was admitted due to right facial pain which was diagnosed as TN. A brain MRI revealed sphenoidal sinusitis with epidural empyema. We report a case of complicated sinusitis with epidural empyema presenting as TN.

Effect of Practice based Program for Procedural Skills / 한국의학교육

PURPOSE: To evaluate the educational effectiveness of practice-based program for procedural skills at Kangwon National University College of Medicine. METHODS: In 2005, we conducted the training program composed of 19 procedural skills for third-year medical students during their first semester clerkship. The 14-week training used simulation models and was held for 3 hours per week, one hour for didactic session and 2 hours for practical exercise. A lecture was given only for wound dressing. OSCE, consisting of four 5-minute stations, was administered to analyze the students' achievement. 53 third-year students were given a survey following skills training and OSCE. RESULTS: Most students reported that the practice-based program was interesting and helpful in learning procedural skills. Students preferred practice to didactic medium. Students were satisfied with the faculty's instruction, but suggested that the training should be providedprior to clerkship. OSCE had an overall reliability coefficient (Cronbach's alpha) of 0.78. The mean score in the dressing case was lower than those in other cases. CONCLUSION: The practice-based program for procedural skills was effective in motivating students' learning as well as improving theirtechnical skills. Self-directed exercises and appropriate feedback are more effective training tools than lectures.

Convulsion, Symptomatic Hyponatremia and Paralytic Ileus Following Tonsillectomy: A case report / 대한마취과학회지

Severe symptomatic hyponatremia shows high mortality in association with cerebral edema and central nervous system dysfunction. Postoperative hyponatremia is usually attributed to administration of hypotonic fluids while antidiuretic hormone is acting. However, we experienced a severe symptomatic hyponatremia in spite of infusion of lactated Ringer's solution perioperatively in a case of 4-year-old girl's tonsillectomy. Inappropriate secretion of ADH caused by pain, stress, anxiety, nausea, vomiting. Paralytic ileus developed several hours after surgery, severe hyponatremia (Na 119 mmol/L) with convulsion notified. After prompt infusion of sodium supplement and fluid restriction, the patient recovered uneventfully.

The First Isolation of Chlamydia pneumoniae from a Korean Patient / 결핵

BACKGROUND: Chlamydia pneumoniae is one of common causes in upper and lower respiratory infections. Isolating C. pneumoniae from clinical specimens is very difficult due to the characteristics of the organism. Recently, we succeeded in isolating C. pneumoniae from a Korean patient, who suffered from acute pharyngitis. This is the first isolate from a clinical specimen in Korea. METHOD: We attained a nasopharyngeal swab from a 22-year-old female patient, and inoculated it on a monolayer of the Hep-2 cell line. After 8 passages, we found the inclusion bodies of C. pneumoniae by an immunofluorescence(IF) test. The species-specific monoclonal antibody IF staining and species-specific PCR were done to confirm the species of the isolate, and electron microscopy was used to characterize the morphology. RESULT: The isolate was confirmed to be C. pneumoniae by species-specific IF and PCR, and the strain was named LKK-1. The shape of the elementary body was round and with a narrow periplasmic space, as shown by electron microscopy, which is similar to the Japanese strain, but not the Western strain. CONCLUSION: We succeeded in isolating C. pneumoniae from a 22-year-old patient with acute pharyngitis, which is the first isolate in Korea. In the future, this Korean strain will be useful to the study of C. pneumoniae.

The Exploratory Tympanotomy in the Conductive Hearing Loss with Normal appearing Tympanic Membrane / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Exploratory tympanotomy is used in patients with conductive hearing loss when the cause of hearing loss is in doubt. By exploratory tympanotomy, the cause of conductive hearing loss could be found and corrected surgically at the same time. This study was designed to understand the pathology and the clinical feature of the conductive hearing loss with normal appearing tympanic membrane. MATERIALS AND METHODS: Twenty-six patients with conductive hearing loss who had under gone exploratory tympanotomy, from January, 1990 to May, 1997, were retrospectively analyzed. RESULTS: Of 26 cases, the most common cause of the conductive hearing loss was congenital ossicular anomalies, with congenital fixations of the stapes being the most frequent among them. The other middle ear pathology included congenital cholesteatoma, sequelae of otitis media, idiopathic incus-stapes separation. In most cases, postoperative hearing has improved. CONCLUSION: Through exploratory tympanotomy, abnormal middle ear findings could be found and corrected satisfactorily in most cases of the conductive hearing loss with normal appearing tympanic membrane.

Can the Acoustic Rhinometry Reflect the Real Volume Change of the Nasal Cavity?

BACKGROUND AND OBJECTIVES: Acoustic rhinometry (AR) measures nasal cavity geometry by analyzing reflected acoustic impulses. The authors aimed to find out whether AR could reflect the volume change developed from conchotomy. MATERIALS AND METHODS: To establish the test-retest reliability of the AR, 20 normal nasal cavities were tested with AR before conducting main study. The volumes of the 31 conchotomy specimens were measured with water displacement method (WDM). The nasal volume changes in accordance with conchotomy operations were measured with AR, and the paired values were compared. RESULTS: AR revealed highly consistent results as there was statistically significant correlation between test and retest values (r=0.98, p<0.0001). The volume of the conchotomy specimens measured with WDM was 1.40+/-0.63 cm3 (mean+/-SD) and the volume change measured with AR was 1.49+/-1.48 cm3 (mean+/-SD). There was statistically significant correlation between the two values (r=0.55, p<0.01), though they were not so consistent with each other. CONCLUSION: The nasal volume change after conchotomy measured with AR correlates with the conchotomy specimen volume with statistical significance, though the correlation between them does not always show consistency.

Comparative Study of the Sinusoidadal Harmonic Acceleration Test andthe Caloric Test in Peripheral Vestibular Disorders / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The shinusoidal harmonic acceleration (SHA) test is known to be useful for differentiating peripheral and central disorders and monitoring the progress of vestibular diseases. However, it is not fully known how SHA test results correlate with the degree of caloric response, which have been widely used and accepted as a standard test in evaluating vestibular functions. This study was designed to investigate the relationship between SHA test and caloric test in an attempt to further elucidate the clinical significance of SHA test. MATERIALS AND METHODS: Fifty-four patients who were diagnosed with peripheral vestibular disorder at Asan Medical Center participated in this study. All patients underwent caloric tests and SHA tests. The results of both tests were compared. RESULTS: The present study reveals that the results of the SHA test in peripheral vestibular disorder are correlated with those of the caloric test, that is, patients with unilateral canal paresis in the caloric test also tend to show phase leads at lower frequency and low response gain in the SHA test. CONCLUSION: This study could be used as a basis for further studies and for the clinical use of the SHA test.

Relationship between Direct Measured and Calculated Ionized Calcium in Maintenance Hemodialysis Patients / 대한신장학회잡지

It is important to maintain normal calcium concentration especially ionized calcium concentration in chronic renal failure patients on hemodialysis. The direct measurement of ionized calcium is less commonly used due to a lack of automated equipment as well as the cost of laboratory equipment. Numerous formulas for adjusted total calcium and calculated ionized calcium are used in clinical practice. We examined the relationship between direct measured ionized calcium and total calcium, corrected total calcium, calculated ionized calcium (formula of Nordin et al) in 53 chronic renal failure patients on hemodialysis. The results were as follows; 1) In predialysis group, plasma total and ionized calcium levels were 2.36+/-0.26, 1.04+/-0.21mmol/L respectively, and higher than normal controls. The correlations between plasma ionized calcium and total calcium, calculated ionized calcium, corrected total calcium were r=0.72 (P=0.0001), r=0.81 (P=0.0001), r=0.65 (P=0.0001) respectively. The plasma ionized calcium level was not correlated with the level of albumin, pH, phosphate, parathyroid hormone. 2) The plasma total and ionized calcium levels were significantly increased with hemodialysis and values were 2.49+/-0.14mmol, 1.14+/-0.14mmol/L respectively. The correlation between ionized and total calcium was r=0.41 (P=0.0021). These results suggested that the calculated ionized calcium (formula of Nordin et al) and total calcium can be used to predict the plasma ionized calcium level in chronic renal patients on hemodialysis.

Distortion Product Otoacoustic Emissions in Normal and Sensorineural Hearing Loss Ears / 대한이비인후과학회지

BACKGROUND: Distortion product otoacoustic emissions(DPOAE) are otoacoustic emissions evoked by two pure tones. They are proposed as a frequency specific test of the mechanical properties of the cochlea. OBJECTIVE: The purpose of the this study were to investigate of basic properties of DPOAE in normal hearing subjects and correlations between DPOAE amplitudes and conventional pure tone auditory thresholds in patients with sensorineural hearing losses. MATERIAL AND METHODS: The amplitude and growth functions of distortion product otoacoustic emissions(DPOAE) at 2f1-f2, elicited by two primary tones f1 and f2 with a constant frequency ratio f2/f1=1.22 and varing geometric mean values 0.5, 1, 2, 4, and 8kHz, were measured for 20 normal subjects and 50 patients with sensorineural hearing losses. RESULTS: In normal hearing subjects 1) The average DP audiogram peaked at two frequency ranges, 1 kHz and 8 kHz. 2) In DPOAE amplitudes, inter-subject variability was relatively high, but inter-aural dispersion were remarkably small(correlation coefficent=0.72). In patients with sensorineural hearing loss 3) DPOAE amplitudes were correlated significantly with pure tone auditory thresholds in that higher auditoty thresholds showd lower amplitudes(correlation coefficenct=-0.65 at 1kHz 70dB SPL stimulus, -0.66 at 4kHz 70dB SPL stimulus). 4) Based on the presence or absence of DPOAE, the screening limit values of 50dB HL showed that sensitivity and specificity were 96%, 75% at 1kHz, 97%, 81% at 4kHz with 70 dB SPL stimulus.