Changes of Taste Function after Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The objective of the study was to investigate changes in taste sensation after tonsillectomy by using filter paper discs (FPD )method and visual analogue scale (VAS ). MATERIALS AND METHOD: Thirty healthy adult patients who had undergone tonsillectomy were included in this study. A taste test using the FPD method and a subjective rating of taste function based on VAS were performed preoperatively and postoperatively on the 14th day. Serum zinc level was checked at the operation day. Operative findings regarding adhesion, size, and inflammation were recorded. RESULTS: Four patients (13.3%)showed 2 points above the elevated taste identification threshold (TIT). Nine patients (30%)felt their taste sensitivity decreased more than 2 points in the VAS system after the operation. At the postoperative 2 week period, there were significant decrease in sensitivity to sweet and salty TIT, tendency to decrease in sour TIT, and tendency to increase in bitter TIT. The mean VAS decreased significantly. The changes in TIT (dTIT )to each taste stimuli and the changes of VAS (dVAS) had no significant correlation. The degree of adhesion, size and inflammation of the tonsil and serum zinc level showed no significant correlation with dTIT to each taste stimuli and dVAS. CONCLUSION: At 2 weeks after tonsillectomy, the taste sensitivity generally increased except for bitter stimuli. But this changes were not correlated with subjective taste assessment, which may be due to various postoperative discomforts. Tonsil adhesion, size, inflammation and serum zinc level did not influence acute postoperative changes in taste function.

Magnetic Resonance Imaging of the Mastoid Cavity and the Middle Ear: Prevalence and Clinical Significance of Incidental Abnormal Findings in a Non-ENT Adult and Pediatric Population / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of abnormalities in the mastoid cavity and middle ear in a non-ENT population, and to correlate with clinical data. SUBJECTIVES AND METHOD: Cross-sectional study. We prospectively evaluated a total of 100 adults and 30 children undergoing MRI scan for suspected intracranial pathology from May to July 2003. Patients who had previous history of mastoid/middle ear surgery and were suffering otitis media were excluded. The T2-weighted images were reviewed. The abnormalities found on MRI were divided into 1) mastoid cavity abnormality, and 2) middle ear abnormality. All patients were asked to complete a questionnaire pertaining to symptoms of mastoid/middle ear pathology and history of previous otitis media. Also, their ears were examined carefully by otoscope or otomicroscope. RESULTS: In both groups, most of abnormalities were found in the mastoid cavity. Analysis of the clinical data revealed that abnormal MRI findings of the mastoid cavity were significantly correlated to clinically significant mastoid/middle ear diseases in adults. CONCLUSION: Incidental MRI abnormalities in mastoid cavity and middle ear detected in a non-ENT population were relatively uncommon, compared to incidental paranasal sinus abnormalities. However, clinicians should remember the possibility of the pathologies that demand active treatment among these abnormalities, especially when high signal abnormality is found in the mastoid cavity of adults.

ICGA Findings and Clinical Features of Idiopathic Choroidal Neovascularization

PURPOSE: The purspose of this study was to investigate the ICGA findings and clinical features of idiopathic choroidal neovascularization (CNV) which is one of the important causes of CNV developed under 50 years of age. METHOD: We performed FAG and ICG angiography in 26 eyes (25 patients) which were diagnosed as idiopathic CNV and investigated the visual acuity, associated retinal findings, and treatment modality. RESULTS: The locations of CNV were subfoveal in 11 eyes, juxtafoveal in 11 eyes, extrafoveal in 4 eyes. All CNV were less than 1 disc diameter in size. On ICG angiography, hyperfluorescent neovascular network CNV was visible in early phase in 22 out of 26 eyes. Twelve eyes had dark rim surrouding the CNV, and 10 eyes had focal choroidal vascular dilation near the CNV. Twelve eyes showed obvious choroidal hyperpermeability in late phase, and 3 eyes showed the hypofluorescent dark spot near the CNV. Final visual acuity was improved in 9 eyes, decreased in 4 eyes, and unchanged in 13 eyes. CONCLUSION: Idiopathic CNV was small in size and located mostly in foveal area. ICG angiography showed CNV with various angiographic patterns, and the visual prognosis was relatively good.

Clinical features of Choroidal Neovascularization in Patient with High Myopia

PURPOSE: To investigate the clinical features and ICGA findings of choroidal neovascularization(CNV) in patients with high myopia which could be one of the important causes of CNV. METHODS: We performed FAG and ICG angiography in 21 high myopic patients(23 eyes) with CNV and investigated the visual acuity, associated retinal findings, and treatment modality. RESULTS: The locations of CNV were extrafoveal in 6 eyes(26.1%), juxtafoveal in 13 eyes(56.5%), and subfoveal in 4 eyes(17.4%). All cases of CNV were less than 1 disc diameter in size. On ICG angiography, CNV was better visible in late phase in 8 out of 23 eyes(34.8%) and 5 eyes(21.7%) had better fluorescence in early phase. In 7 eyes(30.4%), CNV was evident only in late phase. In 3 eyes(13.1%), CNV was very poorly visible with ICG angiography in both phases. Final visual acuity was improved in 4 eyes(17.4%), decreased in 6 eyes(26.1%), and unchanged in 13 eyes(56.5%). CONCLUSION: CNV in high myopia was small in size and located mostly in foveal area. ICG angiography showed CNV with different angiographic patterns, but most cases of CNV had better fluorescence in late phase. The visual prognosis was relatively good.

Anticancer Effect of Arsenic Trioxide in Acute Promyelocytic Leukemia

PURPOSE: Acute promyelocytic leukemia (APL or AML, M3) represents an unique model for cancer research in terms of biological and clinical features. Since 1988, it has been widely confirmed that all-trans retinoic acid (ATRA) can induce complete clinical remission in over 85% of APL patients by a differentiation process, with PML-RARalpha protein possibly being the direct target of ATRA. However, ATRA treatment has two clinical limitations, namely, retinoic acid syndrome and retinoic resistance. Recently, it has been shown that arsenic trioxide used in some traditional Chinese remedy is very effective in retinoic resistant APL treatment. We tried to observe arsenic effect on cell lines and APL patient cells. MEHTODS: We investigated arsenic trioxide-induced apoptosis on APL, HL60, K562, KPH1 cell lines through MTT assay, DNA fragmentation assay and morphologic features. RESULTS: In MTT assay, cell survival rate decreased as the concentration of arsenic trioxide increased. In DNA fragmentation assay with HL60 cell line, DNA fragmentation was more frequent in high concentrations of arsenic trioxide than in low concentrations. During arsenic trioxide treatment, the morphologic change in bone marrow cells of APL patient, included nuclear differentiation and dark cytoplasmic granule during arsenic trioxide treatment. Serum arsenic reached peak level at 4hr after injection. We experienced a case of a 9-year-old male with APL who had relapsed after cessation of retinoic acid treatment. The patient successfully achieved remission following arsenic trioxide treatment without bone marrow depression and exacerbating bleeding diathesis. CONCLUSION: Arsenic trioxide can be used effectively to treat APL patients by inducing apoptosis and partial differentiation in tumor cells. The precise cellular and molecular mechanisms of its therapeutic effects remain to be determined.

Anterior Cruciate Ligament Tear: Comparison of MR Features between Complete and Partial Tear

PURPOSE: To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament (ACL) and to thus improve MRI interpretation. MATERIALS AND METHODS: In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. RESULTS: Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine case (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i. e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. CONCLUSION: Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear.

The Significance of Alteration of Anterior Cruciate Ligament Axis as a Secondary Sign of Tear

PURPOSE: To assess the significance of alteration of the anterior cruciate ligament (ACL) axis as seen on magnetic resonance imaging of anterior cruciate ligament tear. MATERIALS AND METHODS: ACL angle (angle between lateral tibial plateau and ACL) and ACL-Blumensaat line angle (angle between ACL and Blumensaat line) were measured in 76 patients with ACL tear and 55 patients with normal ACL. The significance of the change in orientation of the ACL was evaluated. RESULTS: ACL angle was significantly smaller in the tear group (35.07 degrees +/- 10.34 degrees, mean+/-standard deviation) than in the normal group(54.11degrees+/-4.61degrees)(p<0.001); when cutoff value was less than 45 , sensitivity, specificity and accuracy were 85.5%, 98.2% and 90.8%, respectively. The ACL-Blumensaat line angle was significantly greater in the tear group (20.33degree+/-9.56degree) than in the normal group (2.55degree+/-4.86degree)(p<0.001). when cutoff value was more than 10degree, sensitivity, specificity and accuracy were 90.8%, 94.5%, and 92.4%, repectively. CONCLUSION: The change in orientation of the ACL was an important associated finding in cases of ACL tear. We suggest that cutoff values should be an ACL angle of less than 45 , and an ACL-Blumensaat line angle of more than10degree .

Photorefractive Keratectomy by Extimer Laser for the Correction of Myopia

Photorefractive keratectomy was performed, using the excimer laser, on 117 myopic eyes. The eyes were classified in three groups by preoperative refractive errors, Group I included eyes with myopla ranging from -2.00D to -5.75D; Group 2 included eyes with myopia ranging from -6.00D to -9.75D; Group 3 included eyes with myopia over -10.0D. The eyes were followed up over six months to one year. During the follow up period, slit lamp examination, visual acuity, refractive error, pachometer, corneal opaty, IOP and corneal topography were examined, The results were as follows; 1. Preoperative mean visual acuities were 0.07 and postoperative mean visual acuities were 0.72. 2. Postoperative refractive errors were smaller and visual acuities were better in eyes of Group I than Group 2 or 3. 3 Immediate postoperative refractive states were hyperopia and regress over 4 to 12 weeks. 4.Keratometer reading and central corneal thicknesses were decreased postoperatively, but 4 to 12 weeks later, they started to increase. 5 There were mirlimal comeal corneal peaking at 4 weeks and diminishing over the next 3 to 6 months, which were not felt to be visually signicant.

The Hemodynamics and Electrocardiogram in Isolated Ventricular Septal Defect

No abstract available.