Primary amelanotic melanoma of the mandibulargingiva

Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of whichdiffer from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva,which can invade the mandibular bone, is very rare worldwide. Here, we report a case in whichwe performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous freeflap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibulargingiva. The procedure was successful, and no recurrence was observed 10 months after surgery.Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate thancutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocyticlesions have been used effectively to treat the increasing number of patients developing thistype of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.

Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.

Value of the Post-Operative CT in Predicting Delayed Flap Failures Following Head and Neck Cancer Surgery

OBJECTIVE: To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. MATERIALS AND METHODS: We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3–14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42). Clinical data (age, sex, T-stage, type of flap, and time interval between reconstruction surgery and CT) and post-operative CT findings of flap status (maximum dimension of the flap, intra- or peri-flap fluid collection and intra- or peri-flap air collection, fat infiltration within the flap, fistula to adjacent aerodigestive tract or skin, and enhanced vascular pedicle) were assessed and compared between the two groups. RESULTS: CT findings showed that the following flap anomalies were observed more frequently in the delayed flap failure group than in the flap success group: intra- or peri-flap fluid collection > 4 cm (61.1% vs. 23.8%, p 2 cm (61.1% vs. 2.4%, p < 0.001), and fistula to adjacent aerodigestive tract or skin (44.4% vs. 0%, p < 0.001). The maximum dimension of the flap, fat infiltration within the flap, and enhanced vascular pedicle were not associated with delayed flap failures. CONCLUSION: A large amount of fluid or air collection and fistula are the CT findings that were associated with delayed flap failures in patients with suspected post-operative complications after head and neck cancer surgery.

Association Study of FOS-Like Antigen-2 Promoter Polymorphisms With Papillary Thyroid Cancer in Korean Population

OBJECTIVES: FOS-like antigen-2 (FOSL-2), a member of the FOS gene family, encode leucine zipper proteins that can heterodimerize with proteins of Jun family. Thus, activating protein (AP)-1 transcription factor is formed, has a crucial role in proliferation, differentiation and apoptosis of normal tissue as well as oncogenic transformation and progression. We performed an association study of single nucleotide polymorphisms (SNPs) in the FOSL-2 with papillary thyroid cancer (PTC). We also estimated the relationships between the SNPs and the clinicopathologic characteristics of PTC. METHODS: One promoter SNPs (rs925255) of FOSL-2 gene were genotyped with direct sequencing method in 94 PTC and 213 controls. PTC patients were dichotomized and compared with respect to clinical parameters of PTC. Genetic data were analyzed using Helixtree, SNPAnalyzer, SNPStats. Multivariate logistic regression analysis was fulfilled to evaluate the genetic effect with adjustment for age and sex. RESULTS: SNP (rs925255) in FOSL-2 showed a significant association (codominant 1 model [G/G vs. A/G]: odds ratio [OR], 0.531, 95% confidence interval [CI], 0.293 to 0.96, P=0.036; dominant model: OR, 0.50, 95% CI, 0.28 to 0.89, P=0.015) with PTC. The frequency of allele G in rs925255 was also significantly associated with PTC (OR, 0.59; 95% CI, 0.34 to 0.91; P=0.02). But we fail to prove significant association between this polymorphism (rs925255) and clinico-pathological parameters. CONCLUSION: Our findings suggest that the rs925255 SNP and its allele G show significant association with the PTC in Korean population.

Effectiveness of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in Patients with Swallowing Disorders -A Systematic Review-

OBJECTIVE: The objective of this systematic review is to evaluate the safety and effectiveness of fiberoptic endoscopic evaluation of swallowing (FEES) for dysphagia patients. METHOD: We performed a systematic review of the literature. We searched Ovid-Medline(R), EMBASE(R) and Cochrane library(R) and Eight domestic databases including KoreaMed up to 19 April 2010. In addition, we added hand search. Searches were conducted without language restriction. We identified ten studies that met our eligibility criteria. Two reviewers independently extracted prespecified data from each study. Also reviewers assessed quality of each study. The qualities of these studies were assessed according to Scottish Intercollegiate Guidelines Network (SIGN) tool. RESULTS: Ten studies (nine diagnostic evaluation studies and one case series) were identified. The complication rate of FEES was 6% which was reported only one study as nose bleeding that did not need further treatment. The effectiveness of FEES was evaluated based on diagnostic accuracy, agreement rate with videofluoroscopy as a reference test. The sensitivities of FEES were 0.87~1.0 (penetration), 0.22~0.96 (aspiration), 0.68~0.91 (pharyngeal residue), and 0.75 (premature spillage) respectively. Specificities of FEES were 0.75~1.0 (penetration), 0.88~1.0 (aspiration), 0.86~1.0 (pharyngeal residue), and 0.56 (premature spillage) respectively. Agreement rate with VFFS were 85~100% (penetration), 82.3~100% (aspiration), 80~89.3% (pharyngeal residues), and 60.7% (premature spillage) respectively. There was no evidence of statistical heterogeneity. The body of evidence as a whole suggests a grade C for FEES. CONCLUSION: FEES is considered as a safe and effective test in patients with dyspahgia and grade C evidence based on existing studies.

Surgery in patients with congenital factor VII deficiency: A single center experience

BACKGROUND: Congenital factor VII (FVII) deficiency is a rare hemorrhagic disorder that can cause excessive bleeding during and after surgery in affected patients. The recombinant form of activated factor VII (rFVIIa, NovoSeven(R) from Novo Nordisk, Bagsvaerd, Denmark), which was developed as a second-generation bypassing agent, has recently been used in the management of bleeding for patients with congenital FVII deficiency. METHODS: We reviewed the results of 8 surgical procedures in 5 patients with congenital FVII deficiency at the Kyung Hee University Hospital, Gangdong, Seoul, Korea, between January 2008 and June 2010. We administrated rFVIIa preoperatively in six patients and postoperatively in five patients. RESULTS: Between January 2008 and June 2010 at our center, 8 operations were performed successfully and no complications were observed in the 5 patients with congenital FVII deficiency. The median level of FVII activity was 2% (range, 0.6-7%). Four orthopedic procedures, 1 tonsillectomy, and 3 dental extractions were performed. The median duration of hospitalization was 8.5 days (range, 0-15 days). rFVIIa was administered at all procedures, except the dental extraction that was performed using only antifibrinolytic agents without any replacement. No bleeding or thrombogenic complications were observed in any case. CONCLUSION: Patients with congenital FVII deficiency who require surgery can be treated efficiently and safely with rFVIIa or antifibrinolytic agents. rFVIIa was well tolerated and maintained effective hemostasis and showed good clinical outcome after the major surgery.

Association of Toll-Like Receptor 2 Polymorphisms with Papillary Thyroid Cancer and Clinicopathologic Features in a Korean Population

Toll-like receptors (TLRs) single nucleotide polymorphisms (SNPs) were analyzed in patients with papillary thyroid cancer (PTC; n = 133) and their clinicopathologic features and age-matched controls (n = 321) using direct sequencing. PTC patients were divided into subgroups according to size, number, location, extrathyroidal invasion and lymph node metastasis. The two SNPs of TLR2 gene were not associated with the development of PTC. In clinical analysis, two SNPs were associated with location of cancer (rs3804099, P = 0.032, OR, 0.52; 95% CI, 0.28-0.96 in log-additive model; rs3804100, P = 0.039, OR, 0.46, 95% CI, 0.22-0.96 in codominant1 model; P = 0.018, OR, 0.42, 95% CI, 0.21-0.87 in dominant model; P = 0.011, OR, 0.46, 95% CI, 0.25-0.85 in log-additive model). The allele frequencies of two SNPs also showed significant associations with location of cancer (rs3804099, P = 0.046, OR, 0.57, 95% CI, 0.33-0.99 and rs3804100, P = 0.019, OR = 0.52, 95% CI = 0.30-0.90). However, two SNPs were not associated with the clinicopathologic features of PTC. It is suggested that TLR2 polymorphisms may contribute to the clinicopathologic features of PTC, especially the PTC in both lobes.

Association of Toll-Like Receptor 2 Polymorphisms with Papillary Thyroid Cancer and Clinicopathologic Features in a Korean Population

Toll-like receptors (TLRs) single nucleotide polymorphisms (SNPs) were analyzed in patients with papillary thyroid cancer (PTC; n = 133) and their clinicopathologic features and age-matched controls (n = 321) using direct sequencing. PTC patients were divided into subgroups according to size, number, location, extrathyroidal invasion and lymph node metastasis. The two SNPs of TLR2 gene were not associated with the development of PTC. In clinical analysis, two SNPs were associated with location of cancer (rs3804099, P = 0.032, OR, 0.52; 95% CI, 0.28-0.96 in log-additive model; rs3804100, P = 0.039, OR, 0.46, 95% CI, 0.22-0.96 in codominant1 model; P = 0.018, OR, 0.42, 95% CI, 0.21-0.87 in dominant model; P = 0.011, OR, 0.46, 95% CI, 0.25-0.85 in log-additive model). The allele frequencies of two SNPs also showed significant associations with location of cancer (rs3804099, P = 0.046, OR, 0.57, 95% CI, 0.33-0.99 and rs3804100, P = 0.019, OR = 0.52, 95% CI = 0.30-0.90). However, two SNPs were not associated with the clinicopathologic features of PTC. It is suggested that TLR2 polymorphisms may contribute to the clinicopathologic features of PTC, especially the PTC in both lobes.

A missense polymorphism (rs11895564, Ala380Thr) of integrin alpha 6 is associated with the development and progression of papillary thyroid carcinoma in Korean population / 대한외과학회지

PURPOSE: Integrins play crucial roles in the pathogenesis of papillary thyroid carcinoma (PTC). The aim of this study was to investigate whether two single nucleotide polymorphisms (SNPs) (rs2141698, -1687A/G; rs11895564, Ala380Thr) of the integrin alpha 6 (ITGA6) gene are associated with the development and clinicopathologic characteristics of PTC such as the size ( or =1 cm), number (unifocality and multifocality), location (one lobe and both lobes), extrathyroid invasion, and cervical lymph node metastasis. METHODS: We enrolled 104 PTC patients and 318 control subjects. Genotypes of each SNP were determined by direct sequencing. SNPStats, SNPAnalyzer, and Helixtree programs were used to evaluate odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Multiple logistic regression models were performed to analyze genetic data. RESULTS: A missense SNP rs11895564 was associated with the development of PTC. The A allele frequency of rs11895564 was higher in PTC patients than in controls (13.5% vs. 7.1%; P = 0.005; OR, 2.04; 95% CI, 1.24 to 3.37). In the clinicopathologic characteristics, the A allele frequency of rs11895564 showed difference in the size (19.6% in or =1 cm; P = 0.010; OR, 0.30; 95% CI, 0.12 to 0.75) and number (8.5% in unifocality vs. 20.8% in multifocality; P = 0.015; OR, 2.85; 95% CI, 1.23 to 6.59) of PTC. CONCLUSION: These results suggest that the A allele of rs11895564 (Ala380Thr) in ITGA6 may be a risk factor of PTC, and also contribute to the progression of PTC in the Korean population.

A missense polymorphism (rs11895564, Ala380Thr) of integrin alpha 6 is associated with the development and progression of papillary thyroid carcinoma in Korean population / 대한외과학회지

PURPOSE: Integrins play crucial roles in the pathogenesis of papillary thyroid carcinoma (PTC). The aim of this study was to investigate whether two single nucleotide polymorphisms (SNPs) (rs2141698, -1687A/G; rs11895564, Ala380Thr) of the integrin alpha 6 (ITGA6) gene are associated with the development and clinicopathologic characteristics of PTC such as the size ( or =1 cm), number (unifocality and multifocality), location (one lobe and both lobes), extrathyroid invasion, and cervical lymph node metastasis. METHODS: We enrolled 104 PTC patients and 318 control subjects. Genotypes of each SNP were determined by direct sequencing. SNPStats, SNPAnalyzer, and Helixtree programs were used to evaluate odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Multiple logistic regression models were performed to analyze genetic data. RESULTS: A missense SNP rs11895564 was associated with the development of PTC. The A allele frequency of rs11895564 was higher in PTC patients than in controls (13.5% vs. 7.1%; P = 0.005; OR, 2.04; 95% CI, 1.24 to 3.37). In the clinicopathologic characteristics, the A allele frequency of rs11895564 showed difference in the size (19.6% in or =1 cm; P = 0.010; OR, 0.30; 95% CI, 0.12 to 0.75) and number (8.5% in unifocality vs. 20.8% in multifocality; P = 0.015; OR, 2.85; 95% CI, 1.23 to 6.59) of PTC. CONCLUSION: These results suggest that the A allele of rs11895564 (Ala380Thr) in ITGA6 may be a risk factor of PTC, and also contribute to the progression of PTC in the Korean population.

Association of the Oncostatin M Receptor Gene Polymorphisms with Papillary Thyroid Cancer in the Korean Population

OBJECTIVES: To investigate the association between papillary thyroid cancer (PTC) and single nucleotide polymorphisms (SNPs) of oncostatin M receptor (OSMR) in the Korean population. METHODS: Retrospective case-control study was done. Eighty-five patients with PTC and 287 controls were studied. One missense SNP (rs2278329, Asp553Asn) and one promoter SNP (rs2292016, -100 G/T) of the OSMR gene were genotyped by direct sequencing. Genetic data were analyzed using the SNPStats, Helixtree, and SNPAnalyzer Pro. PTC patients were dichotomized and compared with respect to the clinicopathologic characteristics. RESULTS: There was no association between genotypes and allele frequencies of OSMR SNPs (rs2278329 and rs2292016) and PTC susceptibility. SNP rs2278329 was significantly associated with tumor size (dominant model; P=0.028; odds ratio [OR], 2.71; 95% confidence interval [CI], 1.12 to 6.57). The A allele was higher in sizes large than 1 cm (32.5% vs. 16.7%; P=0.018; OR, 2.41; 95% CI, 1.17 to 4.98). Regarding the number of tumors, we found no significant association with genotype, however, the A allele was higher in patients with multifocaltiy (33.3% vs. 19.1%; P=0.040; OR, 2.12; 95% CI, 1.03 to 4.34). CONCLUSION: The results suggest that OSMR polymorphism rs2278329 is associated with clinicopathologic characteristics of the tumor growth and multifocality development.

A Polymorphism (rs1801018, Thr7Thr) of BCL2 is Associated with Papillary Thyroid Cancer in Korean Population

OBJECTIVES: Among the apoptosis signals, B-cell CLL/lymphoma 2 (BCL2) is a well-known regulator of apoptosis with anti-apoptotic properties. We investigated here whether single nucleotide polymorphisms (SNPs) of the BCL2 were associated with host susceptibility of papillary thyroid cancer (PTC) occurrence and clinicopathologic parameters. METHODS: Ninety-two PTC patients and 222 control subjects were recruited. One promoter SNP (rs2279115, -938A/C) and one synonymous SNP (rs1801018, Thr7Thr) in the BCL2 gene were selected and genotyped using direct sequencing. Multiple logistic regression models were performed to evaluate odds ratios, 95% confidence intervals, and P-values. RESULTS: rs1801018 of the BCL2 gene was not associated with the development of PTC. In the clinicopathologic features, rs1801018 SNP was associated with the number and location. The G allele frequency of rs1801018 in PTC patients with multifocality (13.3%) was about four-fold higher than that in PTC patients with unifocality (3.4%). The G allele frequency of rs1801018 in PTC patients with both lobes (15.4%) was increased by about five-fold, compared to PTC patients with one lobe (3.2%). CONCLUSION: The results suggest that synonymous SNP rs1801018 and the G allele of the BCL2 gene may be associated with the multifocality and bilaterality of PTC in Korean population.

Fine Needle Aspiration for Thyroid Nodule: Clinical Application of Bethesda Classification / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To evaluate the usefulness of fine needle aspiration (FNA) for thyroid nodule using the new Bethesda classification. SUBJECTS AND METHOD: Patient cytology data were reviewed by retrospective search of thyroid FNA. Cytologic diagnoses were classified as unsatisfactory, benign/negative for malignancy, indeterminate (ID), follicular neoplasm (FN), suspicious for malignancy (SM), and positive for malignancy (PM) according to the proposing of The National Cancer Institute. We analyzed the follow-up FNA diagnoses and the cytologic-histologic correlations. RESULTS: Of 1983 patients, 16.8% was classified as unsatisfactory, 73.6% as benign, 1.1% as ID, 0.4% as FN, 1.4% as SM, and 6.8% as PM. After the cytologic follow-up, the groups designated as unsatisafactory (80.2%) and ID (50%) mainly showed significant change in diagnosis. Two hundred fifty patients had surgical follow-up. Sensitivity, specificity, and accuracy, positive predictive values and negative predictive values for malignancy of thyroid were 87.6%, 97.2%, 91%, 98.3% and 81.2%, respectively. The cytologic-histologic diagnostic discrepancy rate was 13.6%. CONCLUSION: FNA for thyroid nodule using the new Bethesda classification was an accurate and sensitive method for the diagnosis of thyroid nodule, and can provide useful information for the management of thyroid nodule.

The Value of Measuring Eustachian Tube Aeration on Temporal Bone CT in Patients with Chronic Otitis Media

OBJECTIVES: To evaluate that the cross-sectional area of the air space in the Eustachian tube (ET) on computed tomography (CT) images could be useful for predicting the postoperative aeration of the middle ear. METHODS: The patient group consisted of 80 patients (80 ears) with chronic otitis media and who underwent middle ear surgery from 2006-2007 and who were followed up for more than 1 yr. The control group consisted of 100 ears of 50 individuals with normal tympanic membranes and who underwent CT for other causes (such as tinnitus or hearing loss). The largest cross-sectional areas of the aerated ET were measured on the coronal images of the temporal bone CT by a single otologist using the computer-based "Region of Interest" picture archiving and communications system. The patient group was divided into two subgroups, 1) those with good postoperative aeration and 2) those with poor postoperative aeration. The largest cross-sectional areas of the aerated ETs were compared between the patients and the controls, and between the patients with good aeration and the patients with poor aeration. RESULTS: The mean cross-sectional areas significantly differed between the patient group and the control group, and between the good and poor aeration subgroups (P<0.05 each). The mean area of the poor aeration subgroup was smaller than that of the control group (P<0.05), but the mean area of the good aeration subgroup did not significantly differ from that of the controls. CONCLUSION: The cross-sectional area of the aerated ET, as measured on the preoperative coronal images of temporal bone CT scans, may be useful for predicting the postoperative condition of the tympanic cavity.

Follicular Dendritic Cell Sarcoma of the Tonsil

Follicular dendritic cell sarcoma (FDCS) is unusual, and those with an extranodal origin in the head and neck region are extremely rare. To date, no cases of tumors featuring the characteristics of follicular dendritic cells were reported in Korea. We report a new case of FDCS of the tonsils in a 65-year-old man. A diagnostic tonsillectomy was performed. Based on histopathologic and immunohistochemical findings, the patient was diagnosed with FDCS. Adjuvant radiotherapy was performed due to a high mitotic count. The patient survived with a 2-year disease free period. The differential diagnosis of a tonsillar mass must include FDCS. In cases in which FDCS is suspected on histopathologic examination, an immunohistochemical study is essential for the diagnosis

Tonsillar Squamous Cell Carcinoma Associated with Dermatomyositis: The First 2 Cases in Korea

Dermatomyositis (DM) is an autoimmune disorder with idiopathic myopathy and characteristic skin manifestations that one often accompanied by an internal malignancy. The association between dermatomyositis and malignancy has been reported several times, although tonsillar carcinoma is extremely rare not only in far eastern populations but also in caucasian populations. We report two cases of Korean patients with dermatomyositis associated with tonsillar carcinoma.

Clinical and Polysomnographic Characteristics in Rapid Eye Movement-Related Obstructive Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To evaluate the clinical and polysomnographic features of rapid eye movement (REM)-related obstructive sleep apnea (OSA). SUBJECTS AND METHOD: 185 consecutive OSA patients were classified as having REM and non- REM OSA. Subjective symptoms, anthropometric and polysomnographic characteristics between REM OSAS and non-REM OSAS patients were compared. RESULTS: Thirty-eight of the 185 patients (20.5%) were classified as REM OSA, and 147 patients (79.5%) were classified as non-REM OSA. Ninety five percent of the REM OSA patients belonged to the mild or moderate OSA group. The dominant occurrence of apnea and hypopnea in REM sleep did notseem to affect subjective symptoms and daytime sleepiness. Anthropometric and polysomnographic features did not help to differentiate REM OSA from non-REM OSA. CONCLUSION: REM OSA may not be a separate and specific disease entity of OSA.

Clinical analysis of Bell's palsy in pregnancy / 대한산부인과학회지

OBJECTIVE: Although Bell's palsy is not common in pregnancy, it is more prevalent among pregnant women than among non-pregnant women. Since the exact clinical characteristics of this condition are not fully understood, we evaluated the epidemiology, pathophysiology, onset time, as well as the recovery rate according to treatment modality of Bell's palsy in pregnancy, and compared them to those of the non-pregnant population in this study. METHODS: Between March 1996 and February 2006, we identified 43 patients who suffered from Bell's palsy during pregnancy and postpartum with a minimum 6 month follow up at Kyung Hee University Hospital. We conducted retrospective medical records analysis and compared them to similary chosen Bell's palsy case in non pregnant women who were matched for age. RESULTS: The median gestational age at the onset of Bell's palsy was 32 weeks. Among the 43 patients who had been diagnosed with Bell's palsy in pregnancy, 81.4% (35 of 43) showed a satisfactory outcome. Among the 36 patients with complete palsy, 77.8% (28 of 36) showed a satisfactory recovery. Recovery rate according to treatment modality in pregnant patients with Bell's palsy were 28/35 (80.0%) in the acupuncture group, 3/3 (100%) in the steroid therapy group, and 4/5 (80.0%) in the combined acupuncture and steroid therapy group, respectively. CONCLUSION: We did not detect any difference in clinical characteristics of Bell's palsy in the pregnant group compared with the non-pregnant group. Further study will be needed to select the method of treatment for Bell's palsy in pregnant women.

Comparison of Correlation of Subjective Symptoms Between Total Respiratory Disturbance Index and Supine Respiratory Disturbance Index

BACKGROUND AND OBJECTIVES: The aggravating effect of the supine body position on breathing abnormalities during sleep appears to be due to the effect of gravity on the upper airway. All patients have a higher supine RDI (respiratory disturbance index) than total RDI. The body position during sleep may be the cause of night-to-night variability in the results of the polysomnography (PSG). The aim of this study is to compare the correlation of subjective symptoms with supine RDI and total RDI. MATERIALS AND METHOD: One hundred and twenty nine patients who visited for snoring and/or apnea, excessive daytime sleepiness were included in the study. All patients underwent full night PSG and were administered 10 cm visual analogue scale (VAS) for 14 symtoms and Epworth sleepiness scale (ESS). Supine RDI, lateral RDI and total RDI were measured in PSG. Patients were divided to positional patients (PP) and non-positional patients (NPP). RESULTS: Fifty of 97 obstructive sleep apnea patients (51.5%) were divided into PP group and 47 patients (48.5%) were divided into NPP group. Several symptoms had correlation with supine RDI and total RDI. In correlated symptoms, total RDI had higher correlation coefficient than supine RDI in both PP group and NPP group. CONCLUSIONS: Our results suggest that total RDI may reflect patient's subjective symptoms.

Subjective Visual Vertical during Eccentric Rotation in Acute Vestibular Neuritis Patients

BACKGROUND AND OBJECTIVE: By assessing unilateral utricular function at the acute unilateral vestinuloneuritis (Acute UVN), we sought to determine the ability of the subjective visual vertical (SVV) during eccentric rotation (dynamic SVV) in localizing the site of the lesion in unilateral vestibular neuritis (UVN). METHODS: The static SVV and dynamic SVV of fifteen patients diagnosed with acute UVN were enrolled within 10 days of onset (average 7 days). First, the static SVV was measured in a dark booth without rotation. The dynamic SVV was measured during rotation with an eccentric displacement of the head to 3.5 cm from the vertical rotation axis during a constant velocity of 300 degrees/s. RESULTS: In the acute stage of UVN, the static SVV showed an increase in deviation to the side of the lesion compared to those of normal subjects. Also, we found 73% of abnormal findings in Acute UVN patients by assessing static conventional SVV. The dynamic SVV had a statistically significant increase in deviation to the side of the lesion compared to those of normal subjects and 93% patients showed beyond normal range. CONCLUSIONS: The dynamic SVV would be an effective method in the diagnosis and localization of acute unilateral vestibularneuritis.