The Association of Patient-Reported Local Allergic Symptoms with Postoperative Outcomes of Chronic Rhinosinusitis

Clinical Characteristics and Short-term Outcomes of Acute Low Frequency Sensorineural Hearing Loss With Vertigo

OBJECTIVES: This study analyzed short-term prognosis in patients with acute low frequency hearing loss (ALHL), and also investigate hearing recovery rates in patients with ALHL accompanied vertigo. METHODS: Retrospective medical record review of the patients who received treatment for ALHL between June 2005 and June 2015 were analyzed. Of the 84 patients, 53 were without vertigo, and 31 were with vertigo. Of the 31 patients, eight were treated with steroids, seven with diuretics alone, and 16 with both. Clinical and auditory characteristics before and after treatment were compared in these three groups. RESULTS: Pure tone audiometry after 8 weeks of treatment showed that patients with vertigo had significantly higher than patients without vertigo (P=0.020). Patients with vertigo who recovered from ALHL had a greater tendency to receive early treatment than patients who did not recover. Patients who received the two steroid therapy groups (steroids alone and steroids plus diuretics) had a higher recovery rate than patients who received diuretics alone (P=0.043 and P=0.037, respectively). CONCLUSION: The prognosis of patients with ALHL is worse in those with vertigo compared to without vertigo. The hearing recovery rate in patients with vertigo tends to be higher in those treated with steroids than with diuretics alone.

Comparison of Characteristics According to Reflux Type in Patients With Laryngopharyngeal Reflux

OBJECTIVES: To analyze laryngopharyngeal reflux (LPR) as an acidic, nonacidic, or mixed type according to 24-hour multi-channel intraluminal impedance (MII) pH monitoring and the clinical characteristics of each type. METHODS: Ninety patients were prospectively enrolled in this study. All patients underwent 24-hour MII pH monitoring as a diagnostic tool. Eighty-three patients were diagnosed with LPR. The patients were classified into three groups according to the pH of the hypopharyngeal probe: the acid reflux group, nonacid reflux group, and mixed reflux group. Subjective symptoms and objective findings were evaluated based on patients' responses to the Short Form 12 Survey (SF-12), LPR health-related quality of life (LPR-HRQOL), reflux symptom index, and reflux finding score. RESULTS: The results of each group were compared. As a result, 34 patients were classified into the nonacid reflux group and 49 into the mixed reflux group. There were no patients classified as having acid reflux alone. There was no significant difference between the two groups when comparing the reflux symptom index, reflux finding score, LPR-HRQOL, or the mental component score of the SF-12. However, the physical component score of the SF-12 was higher in the nonacid reflux group (P=0.018). The DeMeester composite score (P=0.015) and total number of LPR events (P=0.001) were lower in the nonacid reflux group than in the mixed reflux group. CONCLUSION: In conclusion, no LPR patient had only acid reflux. The nonacid reflux LPR patients showed similar clinical characteristics and findings compared to the mixed reflux group, but exhibited significantly fewer LPR episodes.

Dysphagia due to Upper Esophageal Sphincter Disorder after Suicide Attempts

No abstract available.

Web-based Y-STR Database for Haplotype Frequency Estimation and Kinship Index Calculation / 대한법의학회지

We developed a web-based Y chromosomal short tandem repeat (Y-STR) database (ySTRmanager, http://ystrmanager.yonsei.ac.kr) to facilitate calculation of Y-STR haplotype frequency estimates for random matches and kinship indices for various relationship levels. The ySTRmanager database provides 3 functions: (i) Y-STR haplotype search, (ii) kinship index calculation, and (iii) user database configuration. The Y-STR haplotype search function allows researchers to retrieve Y-STR haplotypes that meet queried Y-STR allele, Y-haplogroup affiliation, and/or sample information from a selected population in the open database, which consists of 12-17 Y-STR loci. The number of matches in a selected population, haplotype frequency estimator, and detailed results for matched and neighbor haplotypes are displayed as a set of search results. The kinship index calculation function provides kinship indices of 2 input Y-STR haplotypes for the relationship represented by the number of meioses, with consideration of target population and mutation rate of each Y-STR. In addition, ySTRmanager allows registered users to configure their own database to store and analyze Y-STR haplotype and/or mutation rate data. The stored Y-STR data can be used in the search function and in the analysis to obtain forensic statistical values. The ySTRmanager will be a useful system to analyze and manage Y-STR data in the practice of forensic genetics.

Development of ocular myasthenia during pegylated interferon and ribavirin treatment for chronic hepatitis C / 대한간학회지

A 63-year-old male experienced sudden diplopia after 9 weeks of administration of pegylated interferon (IFN) alpha-2b and ribavirin for chronic hepatitis C (CHC). Ophthalmologic examinations showed ptosis on the right upper lid and restricted right eye movement without any other neurological signs. A brain imaging study and repetitive nerve stimulation test indicated no abnormality. The acetylcholine receptor antibody titer and response to acetylcholinesterase inhibitors were negative, and the results of thyroid function tests were normal. The patient's ophthalmological symptoms improved rapidly 3 weeks after discontinuation of pegylated IFN alpha-2b and ribavirin. The ocular myasthenia associated with combination therapy of pegylated IFN alpha-2b and ribavirin for CHC is very rarely reported; therefore, we present this case with a review of the various eye complications of IFN therapy.

Scleral Fixation of Foldable Intraocular Lenses Using Injector

PURPOSE: To introduce the method of scleral fixation, using Mport(TM) (Bausch & Lomb) injector and silicone three-piece foldable IOL (Silens 6, Bausch & Lomb). METHODS: The study was conducted for five cases of aphakia requiring secondary implantation of IOL. The partial-thickness scleral flaps were made on 2 and 8 o' clock site. A double-armed 10-0 polypropylene suture and 26G needle were inserted through each sclera. Surgical and 26G needle were conjoined and passed out through 2 o' clock site sclera. The clear corneal incision was made on 10 o' clock site through which a suture was pulled out and cut. The end of suture which originated from 8 o' clock site was passed through the injector and tied to the leading haptic of IOL, then inserted. The other end of suture was tied to the following haptic and complete the insertion of IOL with forceps. RESULTS: Time taken for the above procedure was within 20 minutes and postoperatively induced astigmatism was less than 1.5 diopters. No specific complication was noticed. CONCLUSIONS: This technique may be an effective and substitute procedure for that have been used for reasons of less astigmatism, and stable chamber maintenance during procedure.

Genetic characteristics of 22 Y-STR loci in Koreans / 대한법의학회지

To construct a Korean Y-chromosomal STR database for 22 Y-STRs (DYS19, DYS385, DYS388, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS446, DYS447, DYS448, DYS449, DYS456, DYS458, DYS464, DYS635, and GATA H4.1), 708 DNA samples from unrelated Korean males were analyzed using three multiplex PCR systems. During analysis, thirty two microvariant alleles were observed at DYS449, DYS458, and DYS464, and duplicated alleles were occurred once each for DYS19, DYS390, and DYS447. In haplotype analysis for the 22 Y-STRs, a total of 693 different haplotypes were observed with overall haplotype diversity of 0.9999, and of these, 680 haplotypes were unique. By combining each marker for the extended SWGDAM haplotype, DYS458 was the most informative marker. In addition, the diversity of combined haplotypes of DYS447, DYS458, DYS635, GATA H4.1, and the SWGDAM Y-STR loci was comparable to haplotypes of 17 loci in the AmpFlSTR(R) Yfiler(TM) kit.

Evaluation of Nine Non-CODIS MiniSTR Loci to aid Analysis of Degraded DNA / 대한법의학회지

For highly degraded DNA samples of forensic casework, new miniSTR PCR systems have been developed to supplement the current CODIS STRs. In the present study, we established the three miniplexes for nine miniSTRs (NC01 : D10S1248, D14S1434 and D22S1045; NC02 : D1S1677, D2S441 and D4S2364; and NC03 : D3S3053, D6S474 and D20S482) which had been previously suggested by Butler group (NIST, Gaitherburg, MD, USA). To evaluate the usefulness of the nine miniSTRs in analysis of degraded DNA, the sensitivity and efficacy of the three miniplexes were determined and then compared with those of the BigMini STR system which consists of six CODIS miniSTRs (TH01, CSF1PO, FGA, TPOX, D7S820, and D21S11). The three miniplexes gave better results in both the sensitivity test and efficiency test in comparison with BigMini. In the sensitivity test using serially diluted standard DNA, most loci in the three miniplexes showed reliable results for samples containing 50 pg of DNA and some even showed good sensitivity for samples containing 30 pg of DNA. Additionally, the three miniplexes generated useful profiles for both enzymatically degraded DNA and 50-year old skeletal remain samples. Among the nine miniSTRs, D4S2364, D3S3053, D14S1434, and D1S1677 produced the most successful DNA profiles for old skeletal remains. These results suggest that new miniSTRs could be useful supplements to the 13 CODIS STRs for forensic analysis of degraded DNA.

The Effectiveness of Visual Evoked Potentials in Disability Evaluation

PURPOSE: This study aimed to find out whether the pattern and flash visual evoked potentials (VEP) is useful as methods to examine functional visual loss (FVL) among patients complaining of decreased visual acuity after trauma. METHODS: The medical records of trauma-related patients entrusted to the department of ophthalmology for evaluation from January 2001 to October 2004 were reviewed, Correlation were then analyzed by comparing visual acuity, visual field, and visual evoked potentials. RESULTS: There were 45 subjects, 23 of whom complained of symptoms including decreased visual acuity or visual field constriction in one eye. However no abnormalities were found in ophthalmologic tests, and pattern of flash visual evoked potentials were found to be normal for their eyes. Therefore, the cases were diagnosed with functional visual loss. Among the 23 cases, 4 showed abnormal results in the pattern visual evoked potentials, but findings for the eyes in terms of flash visual evoked potentials were normal, so these were also diagnosed with functional visual loss. CONCLUSIONS: With visual evoked potentials only, one cannot diagnosed functional visual loss, but, it could be employed usefully as complementary test in the examination of patients for whom functional visual loss is doubted clinically.

Combined Surgery of Retinal Reattachment Surgery and Cataract Extraction for Retinal Detachment

PURPOSE: To report the anatomical and functional outcomes of combined surgery-pars planar vitrectomy, scleral encircling and phacoemulsification and posterior chamber intraocular lens implantation. METHODS: We retrospectively studied the anatomical success, functional success and complications in 12 patients who had undergone combined surgery due to retinal detachment with cataract and vitreous opacity from March 2001 to August 2003. RESULTS: Twelve eyes were included in this study. Anatomical success was achieved after the initial operation in 10 (83.3%) eyes, and functional success in 6 (50%). Intraoperative complications included posterior capsule rupture in 1 eye, postoperative complications including hyphema in 3 eyes, and increased intraocular pressure in 3. CONCLUSIONS: The results of this study suggest that combined surgery is a safe and effective procedure for patients with rhegmatogenous retinal detachment, concomitant cataract, and vitreoretinal diseases.

Haplotypes and mutations of 17 Y-STR loci from Korean father-son pairs / 대한법의학회지

We have investigated 17 Y-STR loci (DYS19, DYS385a/b, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635 (Y GATA C4), Y GATA H4) in 365 Korean father-son pairs of 355 families. Of 338 different haplotypes obtained from 355 fathers, 326 haplotypes were observed once, 10 haplotypes two times and the other two haplotypes were observed 4 and 5 times, respectively. The overall haplotype diversity was 0.9996. In 365 father-son pairs, a total of 21 mutations were observed at 12 Y-STR loci. Sequence analysis for mutant alleles demonstrated 21 single step mutations: 8 gains and 13 losses. However, there was no significant surplus of gains or losses. The locus-specific mutation rate estimates were between 0.0 and 8.2 x 10(-3) and the average mutation rate estimates were 3.4 x 10(-3)(95% C.I. 2.1-5.2 x 10(-3)) across all 17 Y-STR loci.

A Population Study of X-chromosomal STRs, DXS9898, DXS6809, DXS7424 and DXS10011 in Koreans / 대한법의학회지

A population study of the X-chromosomal short tandem repeat (STR) loci DXS9898, DXS6809, DXS7424 and DXS10011 was carried out by single multiplex PCR in a sample of 300 unrelated Korean individuals (150 males and 150 females). For accurate and reproducible STR typing, sequenced allelic ladders were constructed and GenoTyper macro was programmed. In this study, four types of the repre-sentative repeat sequence structure of DXS10011 were observed and the allele loss at DXS9898 was observed in 13 of 450 chromosomes (2.9%). The inter-population comparison of the allele frequencies at the 4 X-STRs showed significantly different distributions (p<0.01) for Koreans and Germans except DXS10011. All statistical parameters for forensic efficiency showed that the 4 X-chromosomal STRs are highly informative. Especially, DXS10011 is expected to be the most useful marker for forensic practice.

Simple Quantification and DNA Profiling from Degraded Low Copy Number DNA Samples / 대한법의학회지

DNA quantification is important to ensure the consistency and the reliability in the interpretation of degraded low copy number DNA typing. We applied the simple PCR quantification method using fluo-rescently labeled primers for the amplification of mtDNA and amelogenin gene in 50 year old skeletal remains (e.g. bone and tooth). K562 DNA was serially diluted and used as a standard for concentration marker to gauge the amount of DNA from PCR versus the peak area. The quantities of DNA extracted from bones and teeth did not show significant difference in the analyses both using mtDNA and amelo-genin gene as an amplification target. To test the efficiency of DNA profiling of degraded low copy number DNA samples, mtDNA PCR quality evaluation and DNA typing for 16 autosomal STR and 9 Y chromosomal STR loci were per-formed and the correlation between DNA quantities and PCR amplification efficiencies of the samples was analyzed. The DNA quantities assayed by the simple method suggested in the present study could be good indicator for mtDNA and STR analysis. As the allele drop-out was observed in less than 0.050ng DNA samples, at least 0.100ng of DNA is required to produce informative STR profiles. Also, STRs with less than 200bp amplification sizes produce efficient DNA profiles in most cases. Therefore, the develop-ment of mini-STRs with less than 200bp amplification sizes is expected to improve DNA typing in degraded low copy number DNA. Y-STRs are easy to detect allele drop-out or drop-in, and accordingly the efficiency test of Y-STRs as well as autosomal STRs for profiling of degraded low copy number DNA samples is thought to be important.

ReVersible Change of Vision in Patients Receiving Deferoxamine

PURPOSE: To report 2 cases of acute visual neurotoxicity in patients with paraquat poisoning receiving deferoxamine. METHODS: A 48-year-old woman and a 37-year-old man received intravenous infusion of deferoxamine at 3g/day for 7 days for treatment of paraquat poisoning. They presented with severely impaired visual acuity, generalized constriction of visual field, and decreased amplitude of visual evoked potential. They improved clinically upon drug-withdrawal. CONCLUSIONS: Deferoxamine is an effective agent for treatment of paraquat poisoning, but can cause visual neurotoxicity. We recommend careful regulation of the deferoxamine dosage and serial visual monitoring in patients receiving the drug.

Intra-individual Difference of Length Heteroplasmy in Blood and Hair Shaft Mitochondrial DNA / 대한법의학회지

To observe mtDNA length heteroplasmy in a homoploymeric cytosine tract of the mitochondrial HV2 region, we carried out size-based separation of PCR products, which was produced by using primers designed to minimize the stutter production. Blood and hair shaft samples were collected from 25 individuals. The result showed significant qualitative/quantitative peak pattern variations among blood and hair shaft mtDNA profiles. Based on the results of this study, an exclusion depended solely on differences in length of the major C-tract variant could thus be an erroneous interpretation. Therefore, differences in the number of cytosine or qualitative/quantitative peak pattern variations in the C-tract of the mtDNA HV2 region cannot be used alone to support an interpretation of exclusion.

Matrix metalloproteinases in human gliomas: activation of matrix metalloproteinase-2 (MMP-2) may be correlated with membrane-type-1 matrix metalloproteinase (MT1-MMP) expression

To evaluate possible roles of matrix metalloproteinase (MMP)-1, -2, tissue inhibitor of metalloproteinase (TIMP)-1, -2 and membrane-type-1 matrix metalloproteinase (MT1-MMP) in invasion of human gliomas, expressions of these proteins were investigated in ten cases of human glioma and two meningioma tissues and eight human glioma cell lines. In gelatin zymography, MMP-2 activities of glioblastomas were higher than astrocytomas. The activated form of MMP-2 was seen in five of six cases of glioblastomas, but not in astrocytomas. MMP-9 activity was detected in all cases of malignant astrocytomas but the reactivity of MMP-9 was weaker than that of MMP-2. MT1-MMP mRNA expression in glioblastomas was higher than that in astrocytomas. Five cases of glioblastomas with activated form of MMP-2 had MT1-MMP expressions. In vitro, human glioma cell lines with high expression of MT1-MMP also showed high MMP-2 activity. TIMP-1 transcripts were constitutively present in almost all glioma tissues and cell lines, whereas TIMP-2 mRNA were weak especially in malignant gliomas. Imbalance of TIMP-2/MMP-2 was observed using immunoprecipitation analysis in a glioma cell line. High expression of MMP-2 and MT1-MMP is possibly involved in invasiveness of malignant glioma.

Matrix metalloproteinases in human gliomas: activation of matrix metalloproteinase-2 (MMP-2) may be correlated with membrane-type-1 matrix metalloproteinase (MT1-MMP) expression

To evaluate possible roles of matrix metalloproteinase (MMP)-1, -2, tissue inhibitor of metalloproteinase (TIMP)-1, -2 and membrane-type-1 matrix metalloproteinase (MT1-MMP) in invasion of human gliomas, expressions of these proteins were investigated in ten cases of human glioma and two meningioma tissues and eight human glioma cell lines. In gelatin zymography, MMP-2 activities of glioblastomas were higher than astrocytomas. The activated form of MMP-2 was seen in five of six cases of glioblastomas, but not in astrocytomas. MMP-9 activity was detected in all cases of malignant astrocytomas but the reactivity of MMP-9 was weaker than that of MMP-2. MT1-MMP mRNA expression in glioblastomas was higher than that in astrocytomas. Five cases of glioblastomas with activated form of MMP-2 had MT1-MMP expressions. In vitro, human glioma cell lines with high expression of MT1-MMP also showed high MMP-2 activity. TIMP-1 transcripts were constitutively present in almost all glioma tissues and cell lines, whereas TIMP-2 mRNA were weak especially in malignant gliomas. Imbalance of TIMP-2/MMP-2 was observed using immunoprecipitation analysis in a glioma cell line. High expression of MMP-2 and MT1-MMP is possibly involved in invasiveness of malignant glioma.

cDNA Cloning and Expression of Angiostatin, an Angiogenesis Inhibitor , from Human Liver Tissue mRNA / 대한암학회지

PURPOSE: Angiostatin, a 38 kDa internal fragment of plasminogen, is a potent inhibitor of angiogenesis. It blocks neovascularization and growth of primary and metastatic tumors in mice. To produce recombinant angiostatin protem comprising kringle 1-4 of plasminogen, we cloned the angiostatin cDNA from human liver tissue mRNA and expressed it in E. coli. MATERIALS AND METHODS: We cloned angiostatin cDNA from human liver tissue mRNA using reverse transcriptase polymerase chain reaction (RT-PCR) method. Cloned cDNA was ligated to pET22b (+) expression vector, transformed into E. coli stram BL21 (DE3) and expressed by IPTG induction. Recombinant human angiostatin protein was purified from the inclusion bodies of lysated bacterial pellet with 8 M urea solubilization, refolding, single step Lysine-Sepharose 4B affinity chromatography and 0.2 M E-aminocarproic acid elution. The anti-angiogenic activity of purified recombinant angiostatin was assayed with endothelial cell proliferation assay and chorioallantoic membrane assay (CAM). RESULTS: The identification of cloned angiostatin cDNA was confirmed by Southern hybridization and Pst I restriction enzyme digestion pattern. Angiostatin cDNA was expressed in E. coli, refolded in vitro and purified by Lysine Sepharose 4B affinity chromatography. The molecular weight of purified recombinant angiostatin was about 55 kDa on the SDS-PAGE. It inhibited the proliferation of bovine capillary endothelial (BCE) cells in vitro with a half-maximal inhibition concentration (ED50) of approximately 500 ng/mL. It also suppressed neovasculrization on the CAM assay. CONCLUSION: These results demonstrated that recombinant human angiostatin has similar function and biological activity compared with human angiostatin which is purified from porcine elastase digested human plasminogen fragment.