Palatal Muscle Resection(PMR) for the Treatment of Snoring Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We aimed to introduce a new surgical method (Palatal Muscle Resection, PMR) for the treatment of snoring patients. This study contained the surgical technique of PMR and the objective and subjective outcomes of PMR. SUBJECTS AND METHOD: Twenty-one patients with snoring were examined (19 male, 2 female) in a prospective manner. Questionnaires based on the Epworth Sleepiness Scale (ESS) were completed by patients and their respective bed partners before and after PMR. Five patients who underwent PMR have completed pre and post operative (after 4 weeks) polysomnographic (PSG) studies. Visual Analogue Scale (VAS) was analyzed 1, 2, 3, and 7 days after the surgery. Statistical analysis was performed using the Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements (ESS; from 10.7 to 6.7). The VAS was decreased from 4.3 in 1 dayto 2 in 7 days. CONCLUSION: The PMR is a simple and painless office-based method to treat snoring. Long term follow up studies with more patients would be required.

Modulation of the Host Antimicrobial Peptide (Human beta-defensin-1, -2) Expression of Vaginal Squamous Epithelial Cells with using 17beta-Estradiol and Progesterone / 대한비뇨기과학회지

PURPOSE: In mammals, alphaand beta-defensins are antimicrobial peptides that are expressed in various epithelial and phagocytic cells. Human beta-defensin-1 and -2 (hBD-1, hBD-2) have recently been shown to be expressed in various epithelial cells. Vaginal mucosa can be a target of vaginitis and the site of uropathogens' colonization that precedes urinary tract infections. Therefore, innate host defense mediators like antimicrobial peptides in the vaginal mucosa are important. Estrogen and progesterone receptors have been shown to be expressed in the vaginal squamous epithelium. Sex hormones like estrogen and progesterone may cause vaginal atrophy or susceptibility to uropathogens. So, we performed this study to investigate the expression patterns of hBD-1 and -2 mRNA in vaginal squamous epithelium (VSE) with using lipopolysaccharide (LPS), 17beta-estradiol and progesterone. MATERIALS AND METHODS: Normal VSE cells that were retrieved from vaginal tissue during vaginoplasty were primarily cultured in keratinocyte growth medium and they we allowed to undergo their 3rd passage. Modulation of the expressions of hBD-1 and -2 mRNA by various stimuli (LPS 0.5microgram/ml, E2 2nM, P 1micrometer) was measured by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: HBD-1 and -2 were constitutively expressed in the normal VSE cell lines, but the hBD-2 expression was not significant. A marked increase of the constitutive expression of hBD-2 mRNA was observed upon stimulation with LPS, but not upon stimulation with E2. A moderate decrease of the constitutive expression of hBD-2 mRNA upon stimulation with LPS was observed with administering progesterone. CONCLUSIONS: These expressions of hBD-2 mRNA may have important roles in the innate host defense of the urogenital area. Artificial intake of progesterone may lead to susceptibility via a decrease of defensins.

Effects of Phytoestrogen on Potassium Channel Activities of Smooth Muscle Cells of Rabbit Seminal Vesicle / 대한남성과학회지

PURPOSE: This study was performed to determine the effects of phytoestrogen on seminal vesicle excitability. MATERIALS AND METHODS: Single smooth muscle cells of seminal vesicle were obtained from rabbits using proteolytic enzymes(collagenase). Using single cell and channel recording methods of patch clamp, the various currents of potassium channels in smooth muscle cells were recorded. Potassium currents were divided into calcium dependent and independent. RESULTS: Most of the calcium dependent K currents were maxi-K currents and most of calcium independent ones were delayed rectifier K currents. Inside-out patch clamp technique was used to characterize the maxi-K channel. The channel showed outward rectification and calcium dependency. The single-channel conductance of this channel estimated from slope conductance was 119.4+/-11.7 pS under physiological conditions. These characteristics were typical properties of maxi-K channels. Application of genistein(10micronM) rarely affected the delayed rectifier K channel activities, but it evoked significant increase of maxi-K channel activities at both single cell and channel levels. CONCLUSIONS: From these results it is strongly suggested that the excitability and contractility of seminal vesicle might be modulated by genistein through a mechanism of maxi-K channel activation.

A Case of Psoriasis Strictly Localized on a Vitiligo Lesion / 대한피부과학회지

Both vitiligo and psoriasis are common skin disorders, which rarely coexist. We report a case of psoriasis which developed on a vitiligo lesion in a 58-year-old woman. We also discuss the possible mechanism of co-localization of vitiligo and psoriasis, including the role of autoimmunity, Koebner phenomenon, and common neuropeptides.

Unilateral Parotid Glandular Aplasia and Ductal Atresia / 대한이비인후과학회지

Congenital absence of the major salivary glands, especially of the parotid gland, is a rare disorder whose etiopathogenesis is poorly understood. Aplasia of the parotid glands may be unilateral or bilateral and may occur alone or in association with the absence of other salivary glands or with other developmental anomalies of the first branchial arch, such as hypoplasia or aplasia of the lacrimal glands, hemifacial microsomia, mandibulofacial dysostoses, and multiple congenital anomalies. Various degree of xerostomia and dental caries with early loss of teeth may occur due to decreased salivary production. The authors experienced a case of unilateral parotid aplasia in a 22-year old female who had painless swelling in the right parotid region. We present this case with review of literature.

Computed Tomographic Study of the Temporal Bone of Chronic Otitis Media Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Computed tomography plays a role in the evaluation of many temporal bone disorders and provides us a lot of information preoperatively. The objectives of this study is to get various measurements of the temporal bone, and to compare the normal ear groups with the diseased ear group. Materials and Method: The measurements on CT were the distance from the outer cortical plate of bone to the sigmoid sinus, the distance from the posterior semicircular canal to the sigmoid sinus, the distance from the fallopian canal to the sigmoid sinus, mastoid width, the depth of the sinus tympani, the distance from the external auditory canal to the sigmoid sinus, the distance from the outer cortical plate of bone to the lateral semicircular canal, and the level of jugular bulb. RESULTS: The distance from the posterior semicircular canal to the sigmoid sinus of adult group was longer than that of adolescent group (p<0.05). In diseased ear group, the distance from the posterior semicircular canal to the sigmoid sinus and the depth of sinus tympani of adult group were longer than those of adolescent age group (p<0.05). In adult group, the distance from the posterior semicircular canal to the sigmoid sinus and the distance from the posterior wall of the external auditory canal to the sigmoid sinus of diseased ear group were significantly shorter (p<0.05). CONCLUSION: We could get various measurements of the temporal bone on CT and we expect that they would be useful for middle ear surgery.

An Acoustic and Radiologic Study on Voice Change after Tonsillectomy and Adenotonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Some patients who have undergone tonsillectomy complain of voice change, but few studies for the mechanism of voice change were found. To solve this problem, study of voice change after tonsillectomy and adenotonsillectomy was done. MATERIALS AND METHODS: We analyzed voice change of 22 patients who underwent tonsillectomy and 15 patients who underwent adenotonsillectomy at CSL (computerized speech laboratory), St. Benedict Hospital. With the measured cross sectional area of vocal tract and its length from the glottis on MR images, we presented the change of cross sectional area schematically after tonsillectomy. RESULTS: Acoustically, the frequencies of the second formant of /e/ and /i/ increased and that of the first formant of /u/ decreased significantly after tonsillectomy and the frequency of the second formant of /o/ and those of the second and third formants of /i/ and /u/ increased significantly after adenotonsillectomy. It was also showed acoustically that the formant bandwidths of /a/ and /hana/ after tonsillectomy and those of /e/ and /hana/ after adenotonsillectomy increased due to nasalization. Anatomically, it was showed that the cross sectional area of oropharyngeal cavity increased and coupling effect of vocal tract happened after tonsillectomy. CONCLUSION: This study showed that acoustic characteristics and vocal tract shapes of the patients did change following tonsillectomy and adenotonsillectomy. It is imperative that we explain to patients about the postoperative voice change. Research should also be done to find ways to induce better voice changes following the operations.

A case of Simple Ureterocele Complicated by a Stone / 대한비뇨기과학회지

A ureterocele is a cystic dilatation of the terminal ureter. On the base of location of the orifice, ureteroceles are divided into simple and ectopic types. The simple ureteroceles arise from normally located ureteral orifice and are more common in adults than in children and relatively small. The ectopic ureteroceles arise from a ureteral opening in the bladder neck or urethra, some portion of the ballooning extending extravesically down into the urethra, and are related to the upper pole of a duplex system. Uncomplicated simple ureteroceles may be symptomless and need no treatment, but in cases complicated by stone, infection and stasis, excision of the ureterocele with ureteral reimplantation is recommended. Herein we report a case of simple ureterocele complicated by a stone in a 34 -year-old female, with a brief review of the literature.

The Effect of Antiepididymal Rabbit Serum on Rat Epididymis / 대한비뇨기과학회지

Evidence of antigenicity of testis and semen has been presented since Landsteiner (1899), Metchinikoff (1900) and Metalnikoff (1900) first demonstrated the induction of a spermatoxic antibody in animals sensitized with testicular homogenates or semen. Interest in the field of male accessory sex gland began longtime ago, when the first cross-reaction between extracts of prostate, seminal plasma were demonstrated. Saline extracts of prostatic secretion from bulls, tested by double agar diffusion technique showed four antigens common to serum proteins and spermatozoa. The seminal vesicle have been found to have three to five antigens, also with common reactivity to spermatozoa. Attempts have been made to induce cross-immunologic damage in the testes by repeated immunization of mice with epididymal extracts (free of sperm) plus adjuvant and it was claimed that spermatogenesis was adversely effected and fertility of females was markedify reduced following mating with immunized male (Shethye and Rao, 1968; Kim and Kim, 1982). Rabit antiserum produced against the tissue protein of rat epididymis and seminal vesicle was capable of immobilizing and agfflutinating the sperm of both animals and the rabbit antiserum against complex antigen of epididymal tissue protein and seminal vesicle tissue protein of rat was most potent on sperm immobilization and agglutination of both animals (Cha and Kim, 1975). The purpose of this study is to observe the effect of rabbit anti-rat epididymal serum on epididymis and spermatogenesis in rat. The results were as follow; 1. The intraluminalspermatozoa of epididymis were decreased in number but immature sperm cells were much more noted than normal control group. The interspaces of epididymal ducts were widened and infiltrated with mononuclear cells and congestion in some places. There was no definite degenerative changes on epididymal epithelium. 2. Spermatogenesis was mildly to moderately impaired in the experimental group whereasit was unaffected in the control group. Degeneration and exfoliation were found in the germinal cells of seminiferous tubules. Intraluminal Spermatozoa of seminiferous tubules were decreased in number.

A Clinical Observation on 8 cases with Primary Non-Transitional Cell Carcinoma of Bladder / 대한비뇨기과학회지

Eight patients with primary non-transitional cell carcinoma of the bladder during the period from January 1978 to December 1982 were reviewed, and following results ware obtained. 1. Primary non-transitional bladder carcinomas were 8 cases (11%) of 52 bladder carcinomas. 2. The age distribution was from 28 years to 72 years. Male to female ratio was 5 to 3. 3. Hematuria was presented in all cases, dysuria in 2 cases, frequency in 2 cases, lower abdominal pain in 2 cases. 4. Histopathological findings showed squamous cell carcinoma in 3 cases, adenocarcinoma in 3 cases, undifferentiated carcinoma in 1 cases, carcinosarcoma in 1 cases. According to 2Iewett classification, the degree of invasion was stage C in 5 cases, stage B2 in 1 case, stage B1 in 1 case and stage A in 1 case. 5. Five cases arised on lateral wall, 3 cases on dome, 1 case on posterior wall and 1 case on trigone. Four cases were nodular in type. 2 cases were papillary and 2 cases were smooth surface round pedunculated mass. Five cases were single and 3 cases were multiple. 6. 1) In stage C of adenocarcinoma, partial cystectomy was made in 1 case, radical cystectomy with ureteroileocutaneostomy in 1 case, partial cystectomy with postoperative irradiation in 1 case. In former two case, tumor metastasized to periaortic lymphnodes and lumber vertebrae after 6 months post-operatively. 2) Partial cystectomy was performed in 1 case of carcinosarcoma in stage A, tumor recurrence or metastasis did not occur after 1 year post-operatively. 3) In 2 cases of squamous cell carcinoma of stage C, preoperative irradiation with total cystectomy and ureterocutaneostomy was made in 1 case, total cystectomy with ureterocutaneostomy in 1 case and partial cystectomy with 5-FU instillation into the bladder was performed in 1 case of stage B2. In all cases, we couldn't follow up post-operatively. 4) In stage B1 of undifferentiated carcinoma, radical cystectomy with ureteroileocutaneostomy was performed. This case also couldn't be followed up.