Effects of a Bentonite Clay Product and a Preservative Blend on Ileal and Fecal Nutrient Digestibility in Pigs Fed Wheat Naturally Contaminated with Deoxynivalenol.

The objectives were to determine the effects of dietary deoxynivalenol (DON) on apparent ileal digestibility (AID) of nutrients and to evaluate the efficacy of a bentonite (BEN) and a preservative blend (PB) product for alleviating DON effects on the nutrient digestibility of pigs. Twelve crossbred barrows with an initial body weight of 69.4 kg (standard deviation = 3.5) equipped with a T-cannula in the distal ileum were allotted a triplicated 4 × 2 incomplete Latin square design with four dietary treatments and two periods. Dietary treatments were (1) an uncontaminated diet, (2) a contaminated diet (CD) mainly based on contaminated wheat with 1.6 mg/kg DON, (3) CD + 0.25% PB consisting of preservation components as major sources, antioxidants, microorganisms, and amino acids (AA), and (4) CD + 0.25% BEN. The AID and ATTD of dry matter, organic matter, crude protein, most minerals, and most AA were not affected by DON contamination. Dietary DON decreased the AID and ATTD of sodium (p < 0.05) but were restored by supplementing the PB product (p < 0.05). The AID of zinc was increased (p < 0.05) by dietary DON, but supplementing BEN decreased zinc digestibility (p < 0.05). The AID of Arg, Ile, Thr, and Asp was decreased (p < 0.05) by BEN addition. In conclusion, dietary DON affected the digestibility of some minerals but not AA in pigs. Supplemental BEN can negatively affect the nutrient digestibility of some minerals and AA in pigs. The addition of a PB product in pig diets can restore digestibility of sodium but not of other nutrients. Based on these observations, feed additives for alleviating DON effects on nutrient digestibility of pigs can be carefully selected by swine diet formulators.

Effects of Mycotoxin-Sequestering Agents on Growth Performance and Nutrient Utilization of Growing Pigs Fed Deoxynivalenol-Contaminated Diets.

The objective of this study was to investigate the effects of supplemental mycotoxin-sequestering agents on growth performance and nutrient utilization in growing pigs fed deoxynivalenol (DON)-contaminated diets. Twelve barrows with an initial body weight of 35.5 kg (standard deviation = 1.3) were assigned to six dietary treatments in a replicated 6 × 5 incomplete Latin square design. Five experimental diets consisted of an uncontaminated diet (PC), a DON-contaminated diet at 6.89 mg/kg (NC), NC + bentonite 0.5%, NC + yeast cell wall 0.5%, and NC + a mixture product 0.5% which consisted of enzymes, microorganisms, minerals, and plant extracts. Pigs had ad libitum access to the five diets. In the last group, the PC diet was restrictedly provided to pigs at the quantity of feed consumption of the NC group. Average daily gain, average daily feed intake, and gain:feed were not affected by supplemental mycotoxin-sequestering agents except for the mixed product that tended to improve (p = 0.064) gain:feed in pigs fed DON-contaminated diets. The apparent total tract digestibility (ATTD) of dry matter was not affected by DON contamination or by supplemental mycotoxin-sequestering agents, whereas the ATTD of Ca was decreased (p = 0.032) by supplemental yeast cell wall in pigs fed DON-contaminated diets. The ATTD of P was greater (p = 0.042) in pigs fed the NC diet compared with the pigs fed the restricted amount of the PC diet. In conclusion, bentonite and yeast cell wall did not affect growth performance of pigs fed DON-contaminated diets, but a supplemental mixed product consisting of enzymes, microorganisms, minerals, and plant extracts partially alleviated the negative effects of dietary DON on the gain:feed of pigs. Calcium digestibility was decreased by supplemental yeast cell wall in pigs fed DON-contaminated diets. Based on the present work, the use of a mixed product consisting of enzymes, microorganisms, minerals, and plant extracts is suggested, and the reduction of Ca digestibility by yeast cell wall needs to be considered in diet formulations.

Progress and Prospect: A Bibliometric Analysis of Research Papers by Korean Allergists Over Recent Five Years (2009-2013).

Since the establishment of the academic society in 1972, Korean allergists have made continuous efforts to elucidate pathogenic mechanisms and therapeutic advances for allergic diseases. The present study aimed to summarize recent progress and explore future prospects of research performance by Korean allergists. We performed a comprehensive bibliometric analysis for research papers published in the Science Citation Index (SCI) or SCI-expanded journals by Korean allergists between 2009 and 2013. Research performance was quantitatively analyzed for the numbers of papers by publication year, research type, and main topic. In addition, the performance was also examined for qualitative indices, such as impact factor and citation number. A total of 1,091 papers were identified. The number of publication increased continuously, with an annual increase rate of 12.3%. Clinical and basic studies were the most frequent types of research, and recently the number of epidemiological studies has increased. By research topic, asthma was the most commonly studied, accounting for 20.9% of the total number of publications. Notably, the amount of rhinitis/rhinosinusitis research has risen steeply in 2013. Qualitative analyses also indicated continuous progress; the median impact factor of published journals increased from 1.918 in 2009 to 2.746 in 2013, yielding an annual increase rate of 7.4%. In conclusion, the present analyses identified a continuous increase in the research performance of Korean allergists over a recent 5 year period (2009-2013), both quantitatively and qualitatively. A more significant contribution is expected in the forthcoming era.

Undetected metallic chopstick stabbed on neck resulting tinnitus and foreign body sensation.

Penetrating neck injuries constitute 5-10% of all trauma cases. These injuries may cause life-threatening suppurative or vascular complications, but the severity and extent of damage depends upon the inflicting object and the involved structures. If significant complications are not expected, then it is best to leave the foreign body embedded and avoid surgical risks. We present a rare case of a foreign body embedded in the neck causing tinnitus and foreign body sensation.

Long-term Effects of Specific Allergen Immunotherapy Against House Dust Mites in Polysensitized Patients With Allergic Rhinitis.

PURPOSE: Allergen-specific immunotherapy is the only currently available treatment to modify the natural history of allergic rhinitis (AR). If patients are polysensitized, it is difficult to identify the allergen causing the allergic symptoms. We evaluated the effectiveness of immunotherapy against house dust mites (HDMs) in AR patients polysensitized to both HDMs and seasonal allergens. METHODS: Thirty AR patients polysensitized to both HDMs and seasonal allergens (group A) and 30 patients sensitized to HDMs only (group B) were enrolled in this study. All subjects who received immunotherapy against HDMs for more than 2 years were evaluated by the multiple allergen simultaneous test (MAST) to determine the specific IgE level in luminescence units, total eosinophil counts in peripheral blood, serum total IgE, total nasal symptom scores, and the rhinoconjunctivitis quality of life questionnaire (RQLQ) before and after immunotherapy. RESULTS: There were no statistical differences in levels of total and specific IgE, or total eosinophil count between the two groups. The total nasal symptom scores, RQLQ and medication scores significantly decreased after immunotherapy in both groups, however no significant differences were noted between the two groups. CONCLUSIONS: We determined that the primary causative allergen of AR in Seoul, Korea is perennial allergens, such as HDMs, rather than seasonal allergens. This study provides a reference for the selection of allergens to use in immunotherapy for polysensitized AR patients living in an urban environment.

Analysis of mandibular structure using 3D facial computed tomography.

OBJECTIVE: This study measured and analyzed the position and dimension of genial tubercle (GT) and mental foramen (MF) STUDY DESIGN: Retrospective chart review study. SETTING: Tertiary care teaching hospital. SUBJECTS AND METHODS: Two hundred ten subjects were included who received 3-dimensional (3D) facial computed tomography (CT), and the GT and MF were evaluated. Subjects were divided into 4 groups by gender and skeletal type. Seven variables were measured: (1) height of GT (GTH), (2) width of GT (GTW), (3) distance from apices of lower incisors to superior border of GT (LI-SGT), (4) distance from inferior border of GT to inferior border of mandible (IGT-IBM), (5) thickness of anterior mandible (MT), (6) distance from symphysis of mandible to MF (S-MF), and (7) distance from superior border of GT to inferior border of mandible (SGT-IBM). RESULTS: All the parameters showed marked differences in individuals. Class I males showed longer GTH, MT, and SGT-IBM than class I females (P < .05). IGT-IBM and S-MF were longer in class II males than in class I females (P < .05). LI-SGT and IGT-IBM also showed personal variation. CONCLUSION: Anatomical features of mandibular structures showed individual variations. GTH, IGT-IBM, MT, S-MF, and SGT-IBM also showed differences between the groups.

Evaluation of mycotoxin sequestering agents for aflatoxin and deoxynivalenol: an in vitro approach.

An experiment was conducted to determine the efficacy of mycotoxin sequestering agents for binding or degrading aflatoxin B1 (AFB1) and deoxynivalenol (DON) by an in vitro method. Ten toxin binder products including 5 bentonite clays (bentonite A, B, C, D, and E), 2 cellulose products (cellulose A and B), a yeast cell wall, an activated charcoal, and a mixture product containing minerals, microorganisms, and phytogenic substances were used in this experiment. An in vitro procedure was used to mimic the digestive process in pigs. The binding ability for AFB1 of the cellulose products was less compared with the values of other sequestering products (p < 0.05). The percent adsorption of AFB1 by bentonite clays, cellulose products, yeast cell wall product, activated charcoal product, and the mixture product were 92.5 (average of 5 bentonite products), -13.5 (average of 2 cellulose products), 92.7, 100.2, and 96.6, respectively. The respective values for DON were 3.24, 11.6, 22.9, 14.4, and 4.3. In conclusion, most toxin sequestering agents used in the present study had potential to bind AFB1 rather than DON based on the in vitro study which simulated the pH condition of the gastrointestinal tract of pigs.

Change in position dependency in non-responders after multilevel surgery for obstructive sleep apnea: analysis of polysomnographic parameters.

This study was aimed to evaluate the change in positional dependency by analyzing polysomnographic data in non-responders who previously underwent multilevel surgery for obstructive sleep apnea. A total of 48 consecutive patients who had a <50% reduction of apnea/hypopnea index (AHI) and a postoperative AHI of ≤20 after multilevel surgery were enrolled in this study. Postoperative polysomnography (PSG) was carried out at least 6 months after surgical treatment, and both pre- and postoperative PSG data were analyzed. No significant differences were found in any of the measured polysomnographic parameters before and after multilevel surgery in non-responders. In position-dependent patients, supine AHI, non-supine AHI, supine oxygen desaturation index (ODI) and non -supine ODI did not significantly improve after surgery. However, non-supine AHI and non-supine ODI in non-position-dependent patients (NPPs) improved significantly. Ten of 15 initially NPPs had position dependency after surgery, increasing the proportion of PPs from 68.8% (33/48) to 83.3% (40/48). These results suggest that positional therapy may be a useful adjuvant therapy in non-responders with position dependency.

Prevalence of snoring and high risk of obstructive sleep apnea syndrome in young male soldiers in Korea.

There are little information on prevalence of obstructive sleep apnea syndrome (OSAS) and clinical features in the young military population. The purpose of this study was to estimate the prevalence of snoring and high risk of OSAS in young male soldiers in Korea and to identify the risk factors of OSAS. A total of 665 participants (aged 20-23 yr) who visited the Armed Forces Ildong Hospital for regular physical examination were enrolled. All participants completed the Berlin Questionnaire and underwent a physical examination. The participants with high risk for OSAS completed portable sleep monitoring. The prevalence of snoring and high risk of OSAS in young male soldiers in Korea was 13.5% and 8.1%, respectively. The prevalence of high arched palate, tongue indentation, long uvula, large tonsil and retrognathia was significantly higher in the high risk OSAS group. High arched palate, long uvula or low lying soft palate, tonsil size III or IV, Epworth Sleepiness Scale score > 10 and obesity (BMI > 27 kg/m(2)) were found to independently predict OSAS. For early identification and treatment of young soldiers with OSAS in a military environment, a precise screening by questionnaire and physical examination is needed.

Changes in histological features of nasal polyps in a Korean population over a 17-year period.

OBJECTIVE: Nasal polyps can be categorized as eosinophilic or non-eosinophilic, depending on inflammatory cell infiltration. There are geographical differences in the prevalence of types of pathologic polyps. The aim of this study was to evaluate the change in the prevalence of histological subtypes of polyps over time in a Korean population. STUDY DESIGN: A retrospective cross-sectional study with histologic analysis. SETTING: A single academic medical center. SUBJECTS AND METHODS: A total of 230 patients with nasal polyps were enrolled between 1993-1994 (group A) and 2010-2011 (group B). Specimens were fixed in formalin and embedded into paraffin blocks. Slides were stained with hematoxylin-eosin (H&E) and were subsequently reviewed by 2 of the authors. The numbers of eosinophils per high power field (HPF), as well as other cellular, epithelial, and stromal markers, were recorded. RESULTS: We compared nasal polyp eosinophil counts according to time period. The average eosinophil count/HPF increased from 6.8 in group A to 19.3 in group B (P = .006). The prevalence of eosinophilic polyps also increased from 24.0% in group A to 50.9% in group B (P < .001). Among other histologic markers, lymphocytes, basement membrane thickening, and gland hyperplasia showed significant differences between groups. CONCLUSION: After comparison of histopathologic findings of nasal polyps from 1993 and 2011 at 1 academic medical center in Korea, the prevalence of eosinophilic nasal polyps, which are known to be rare among Asians, has significantly increased.

Effects of uvulopalatopharyngoplasty with or without radiofrequency tongue base reduction on voice in patients with obstructive sleep apnea.

OBJECTIVES/HYPOTHESIS: To investigate voice change as a complication after uvulopalatopharyngoplasty (UPPP) with or without radiofrequency tongue base reduction (RTBR) in patients with obstructive sleep apnea. STUDY DESIGN: Before and after study. METHODS: Twenty-two patients with suspected velopharyngeal collapse only underwent uvulopalatopharyngoplasty (UPPP group). Twenty-five patients with velopharyngeal and retrolingual collapse underwent concurrent UPPP with RTBR (RTBR group). All patients were evaluated before surgery and at 8 weeks after surgery. Acoustic measures included mean fundamental frequency (mF0), maximal phonation time (MPT), jitter, shimmer, noise-to-harmonic ratio (NHR), hypernasality test, and the first three formant frequencies (F1, F2, F3) for sustained vowels. Voice handicap index (VHI) was used to determine subjective voice change. RESULTS: Postoperative values for mF0, MPT, jitter, shimmer, NHR, hypernasality test, and F1 did not significantly change in either group following surgery. There were the significant decreases at the F2 of /u/ and the F3 of /o/ in the UPPP group, and at the F2 of /o/ and the F3 of /a/, /i/, and /o/ in the RTBR group. Postoperative VHI score was increased only in the RTBR group. CONCLUSIONS: UPPP and UPPP with RTBR have an impact on formant frequencies of vowels. Despite a relatively small number of patients, it is apparent that UPPP with RTBR influences VHI. Patients, especially professional voice users, should be advised of this before considering the surgery.

Incidence and clinical characteristics of prelaryngeal lymph node metastasis in papillary thyroid cancer.

There is little data that determine the clinical characteristics of prelaryngeal lymph nodes (PLN) metastasis in patients with papillary thyroid cancer (PTC). The aims of this prospective study were to evaluate the incidence and the clinical characteristics of metastasis to the PLN for PTC patients who underwent total thyroidectomy and prophylactic central neck dissection. Sixty-seven patients who underwent total thyroidectomy and prophylactic bilateral central lymph node neck dissection for PTC were enrolled. Central neck compartment was further divided into prelaryngeal, ipsilateral/contralateral paratracheal, and pretracheal regions. Clinicopathologic factors including age, sex, tumor size and location, extrathyroidal extension, and central and lateral nodal metastasis were evaluated. Of the 67 patients who underwent PLN dissection, 13 (19.4 %) had evidence of PLN metastasis. Tumor size was significantly larger in patients with PLN involvement (2.28 versus 1.12 cm; p = 0.020). Additionally, primary tumors larger than 1 cm, extrathyroidal extension, and isthmus involvement were more prevalent in PLN-positive patients. Patients with positive PLNs were also more frequently found to have lateral lymph node metastasis (23.1 vs. 1.9 %; p = 0.021), pretracheal lymph node metastasis (76.9 vs. 27.8 %; p = 0.003), and bilateral central lymph node metastasis (38.5 vs. 11.1 %; p = 0.031) than PTC patients without PLN involvement. The incidence of PLN metastasis in PTC patients who underwent prophylactic central lymph node neck dissection was 19.4 %. PLN metastasis was associated with tumor size, extrathyroidal extension, isthmus involvement, and other compartment lymph node metastasis.

Changes of histamine receptors and CC chemokines in nasal epithelial cells and fibroblasts after respiratory syncytial virus infection.

BACKGROUND: Respiratory syncytial virus (RSV) is reported as the most influential factor that triggers hyperreactivity of the airway and causes asthma in infants and children. However, the mechanisms remain to be elucidated. The study evaluated the changes in the levels of four types of histamine receptor (HR) and CC chemokines, such as eotaxin and regulated on activation, normal T cell expressed and presumably secreted (RANTES), in nasal epithelial cells and fibroblasts after RSV infection. METHODS: Nasal cavity mucosa attained from 20 patients who had undergone inferior turbinoplasty were cleaned by normal saline mixed with gentamicin. Each sample was divided in half. One-half was used for incubation of epithelial cells, and the other half was used for culturing fibroblasts. The levels of HR 1 (H1R), 2 (H2R), 3 (H3R), 4 (H4R), eotaxin, and RANTES were measured by real-time polymerase chain reaction 0, 12, and 36 hours after infection with RSV. RESULTS: H1R was significantly increased at 12 and 36 hours compared with 0 hours in both cell types. The level of H2R was significantly increased in epithelial cells from 0 to 36 and 12 to 36 hours and in fibroblasts from 0 to 12 and 0 to 36 hours. There were significant increases of H3R level in fibroblasts from 0 to 12 and 0 to 36 hours, and of H4R in epithelial cells and fibroblasts from 0 to 12 and 0 to 36 hours. Eotaxin and RANTES were also significantly increased in both epithelial cells and fibroblasts from 0 to 12 and 0 to 36 hours. CONCLUSION: RSV infection increases the levels of all four HRs, especially H1R and H2R, as well as the levels of eotaxin and RANTES in nasal epithelial cells and fibroblasts. These findings suggest that RSV infection might cause respiratory tract hyperreactivity by increasing the content of HRs and CC chemokines.

Intralesional injection versus mouth rinse of triamcinolone acetonide in oral lichen planus: a randomized controlled study.

OBJECTIVE: To compare the efficacy, relapse, and adverse effects between intralesional injection and mouth rinse of triamcinolone acetonide (TA) in patients with oral lichen planus (OLP). STUDY DESIGN: A randomized controlled study. SETTING: College medical center. SUBJECTS AND METHODS: Forty consecutive patients, who had been diagnosed with OLP, were recruited. Participants were randomly divided into 2 groups using intralesional injection or mouth rinse of TA. The severity of pain and burning sensation on a 10-cm visual analog scale (VAS) and the Oral Health Impact Profile-14 (OHIP-14) were assessed at weeks 0, 1, 2, 3, 4, and 6. The signs of OLP were quantified using a special scoring system for OLP. The rate of relapse and the adverse effects were compared between both groups. RESULTS: The VAS scores for pain and burning mouth sensation and objective scoring for OLP were significantly improved at 1, 2, 3, 4, and 6 weeks in both groups. The changes in the VAS for burning mouth sensation, OHIP-14, and objective scoring for OLP were similar between both groups. The change in the VAS for pain from baseline to week 1 in the intralesional injection group was significantly higher than in the mouth rinse group. The rate of adverse effects was significantly higher in the mouth rinse group than in the intralesional injection group (44.4% vs 5.0%). CONCLUSION: The efficacies of both treatments were similar. The rate of adverse effects was significantly lower for intralesional injection of TA than mouth rinse of TA.

Change of prevalence and clinical aspects of fungal ball according to temporal difference.

Fungal ball in paranasal sinus was reported to be rare, but these days we have encountered numerous cases. We retrospectively analyzed the data of 4,485 patients with chronic rhinosinusitis (CRS) who underwent sinus surgery from 1999 to 2010. Patients were categorized into group A (patients from 1999 to 2004) and group B (patients from 2005 to 2010). We compared the prevalence and clinical aspects of fungal ball between the two groups by analyzing the medical records, PNS CT findings, surgical findings, and pathologic reports. One hundred and twelve patients were diagnosed with fungal ball during the study periods. The prevalence of fungal ball was 0.9 % (23/2,333) in group A and 4.1 % (89/2,152) in group B, showing that it increased 4.6 times over 6 years. The prevalence of underlying diseases was 21.7 % (5/23) for hypertension and 8.7 % (2/23) for diabetes in group A, and 23.6 % (21/89) for hypertension and 14.6 % (13/89) for diabetes in group B. On PNS CT examination, calcification was identified in 78.2 % (18/23) of cases in group A and 44.9 % (40/89) in group B. The most involved paranasal sinus in group A was the co-involved maxillary and ethmoid sinuses at 26.1 % (6/23), whereas, the most prevalent involved sinus in group B was the maxillary sinus at 33.7 % (30/89). We found that the prevalence of fungal ball has increased steadily each year since 2005, accompanied by changes in the clinical aspects. These facts should be kept in mind when diagnosing and treating patients with medically intractable CRS.

Interleukin-32-induced thymic stromal lymphopoietin plays a critical role in macrophage differentiation through the activation of caspase-1 in vitro.

INTRODUCTION: Interleukin (IL)-32 is an inflammatory cytokine induced by Mycobacterium tuberculosis and Mycobacterium bovis in a variety of cell types and discovered in the synovial of patients with rheumatoid arthritis (RA). Thymic stromal lymphopoietin (TSLP) play several roles in the pathogenesis of RA. However, the role of IL-32 and TSLP in RA has not been elucidated. METHODS: We evaluated the specific mechanism of between IL-32 and TSLP in RA using human monocyte cell line, THP-1 cells. RESULTS: Here we documented for the first time that IL-32 highly increased TSLP production in THP-1 cells and human blood monocytes. TSLP expression was induced by IL-32 via activation of caspase-1 and nuclear factor-κB. TSLP produced by IL-32 increased differentiation of monocytes but depletion of TSLP prevented differentiation of monocytes into macrophage-like cells. Chondroprotective drugs such as chondroitin sulfate (CS) and the traditional Korean medicine, BaekJeol-Tang (BT) decrease production of TSLP and activation of caspase-1 and nuclear factor-κB. In addition, CS and BT inhibited IL-32-induced monocytes differentiation. CONCLUSIONS: Taken together, IL-32 and TSLP are important cytokines involved in the development of RA. The effects of CS and BT were associated with the downregulation of TSLP and caspase-1 through negative regulation of IL-32 pathways in RA.

Local IgE-mediated hypersensitivity to Alternaria in pediatric adenoid tissue.

OBJECTIVE: Fungus may contribute to the development and exacerbation of allergic airway diseases. Several studies have demonstrated the presence of humoral immune responses to fungi, including Alternaria and Aspergillus, in patients with nasal polyposis, asthma, or rhinitis. The purpose of this study was to evaluate the role of Alternaria- and Aspergillus-specific IgE antibodies in allergic inflammation of adenoid tissue. METHODS: Thirty-nine atopic subjects who were sensitized to more than one common aeroallergen and 39 non-atopic subjects undergoing adenotonsillectomy were recruited. The Phadia ImmunoCAP was used to quantify total IgE, Alternaria- and Aspergillus-specific IgE, eosinophil cationic protein (ECP), and mast cell tryptase in adenoid tissue homogenates. Alternaria- and Aspergillus-specific IgE were detected in the adenoid tissues from some of the subjects (37.2% and 24.4%, respectively) without systemic sensitization to common airborne fungi. RESULTS: Both Alternaria- and Aspergillus-specific IgE were more prevalent in adenoid tissues from atopic children (48.7% and 38.5%, respectively) than in tissues from non-atopic children (25.6% and 10.3%, respectively). Subjects with high Alternaria-specific IgE level showed significantly higher serum and adenoid total IgE and adenoid ECP and tryptase than those without specific IgE. Alternaria-specific IgE levels were significantly correlated with serum and adenoid total IgE and with tryptase and ECP levels in adenoid tissue. CONCLUSIONS: Adenoid tissues from atopic and non-atopic children displayed local IgE-mediated hypersensitivity to fungi in the absence of systemic fungal hypersensitivity. Locally-produced Alternaria-specific IgE may contribute to mast cell and eosinophil activation, especially in the presence of tissue eosinophilia.

Comparison of pre- and post-operative stress levels in patients with allergic rhinitis and non-allergic rhinitis.

The effects of stressful events, such as surgery, on patients with allergic diseases are unclear. The aim of this study was to evaluate whether patients with allergic rhinitis (AR) are more susceptible to stress and oxidative stress than non-allergic individuals. 20 AR patients and 20 non-allergic rhinitis (NAR) patients were recruited to this study and underwent nasal septoplasty. To evaluate the degrees of stress and oxidative stress, we collected urine and blood samples 1 day before and 1 day after surgery. Stress was assessed by measuring urine cortisol levels. Oxidative stress was assessed by calculating the balance of reactive oxygen metabolites (ROM) measured by the diacron reactive oxygen metabolites test, and antioxidant capacity (AC) was measured by the biological antioxidant potential test. In both groups, the level of post-operative urine cortisol was significantly higher than the pre-operative level, with no significant difference between the two groups. ROM levels were significantly higher in both groups after surgery than before surgery. The antioxidant capacity of the AR group was lower after surgery than before surgery, while it was greater in the NAR group after surgery. There were no significant differences in pre- or post-operative ROM or AC levels between the two groups. The ROM/AC ratio was significantly higher after surgery in the AR group than it was in the NAR group. The post-operative ROM/AC imbalance of AR patients suggests that these patients might be vulnerable to stress, especially oxidative stress.

The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients.

Both allergic rhinitis (AR) and obstructive sleep apnea (OSA) are known to increase stress and fatigue, but the result of their coexistence has not been studied. The objective of this study was to evaluate the amount of stress and fatigue when AR is combined with OSA. One hundred and twelve patients diagnosed with OSA by polysomnography were enrolled. Among them, 37 patients were diagnosed with AR by a skin prick test and symptoms (OSA-AR group) and 75 patients were classified into the OSA group since they tested negative for allergies. We evaluated the Epworth sleepiness scale (ESS), stress score, fatigue score, ability to cope with stress, and rhinosinusitis quality of life questionnaire (RQLQ) with questionnaires and statistically compared the scores of both groups. There were no significant differences in BMI and sleep parameters such as LSAT, AHI, and RERA between the two groups. However, the OSA-AR group showed a significantly higher ESS score compared to the OSA group (13.7 ± 4.7 vs. 9.3 ± 4.8). Fatigue scores were also significantly higher in the OSA-AR group than in the OSA group (39.8 ± 11.0 vs. 30.6 ± 5.4). The OSA-AR group had a significantly higher stress score (60.4 ± 18.6 vs. 51.2 ± 10.4). The ability to cope with stress was higher in the OSA group, although this difference was not statistically significant. RQLQ scores were higher in the OSA-AR group (60.2 ± 16.7 compared to 25.1 ± 13.9). In conclusion, management of allergic rhinitis is very important in treating OSA patients in order to eliminate stress and fatigue and to minimize daytime sleepiness and quality of life.