Chan-Soon Park

Anti-IL-33 antibody has a therapeutic effect in a murine model of allergic rhinitis.

To cite this article: Kim YH, Yang TY, Park C‐S, Ahn S‐H, Son BK, Kim JH, Lim DH, Jang TY. Anti‐IL‐33 antibody has a therapeutic effect in a murine model of allergic rhinitis. Allergy 2012; 67: 183–190.

The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning:

OBJECTIVE: To evaluate change of the maxillary sinus volume according to patient age and gender by using a 3-dimensional (3-D) reconstruction of computed tomography images. STUDY DESIGN AND SETTING: One hundred seventy-three people (totaling 238 maxillary sinuses) who had undergone paranasal sinus CT scan between December 2000 and November 2003 and had no evidence of inflammation or hypoplasia in the CT finding and had no specific history of paranasal sinus surgery or maxillofacial trauma were retrospectively analyzed. The 3-D reconstruction images were obtained by using a surface-rendering technique (Vworks; CybeMed, Seoul, Korea) on a personal computer. The mean volume of maxillary sinus was evaluated according to patient chronologic age and gender. The ratio of the maximum horizontal and half-horizontal extension for the estimation of the morphological change of maxillary sinus and the degree of descent of the sinus below the nasal floor were evaluated in the 3-D image. RESULTS: The development of the maxillary sinus continued until the 3rd decade in males and until the 2nd decade in females. The mean maxillary sinus volume in early adults was 24,043 mm 3 (males) and 15,859.5 mm 3 (females). There was a significance difference in the sinus volume (P < 0.05) according to gender, and there was a significant difference in the maxillary sinus volume according to age before it reached maximum. After its maximum growth period, however, there was no significant difference in the volume change of maxillary sinus and the descent below the nasal floor between two adjacent groups. CONCLUSIONS: The growth of the maxillary sinus continues until the 3rd decade in males and the 2nd decade in females. Therefore, a maxillary sinus operation affecting the bony structures before these ages might affect the development of the sinus and needs to be performed carefully

Three-dimensional reconstruction based on images from spiral high-resolution computed tomography of the temporal bone : anatomy and clinical application

The aim of this study was to investigate the usefulness of a three-dimensional (3D) reconstruction of computed tomography (CT) images in determining the anatomy and topographic relationship between various important structures. Using 40 ears from 20 patients with various otological diseases, a 3D reconstruction based on the image data from spiral high-resolution CT was performed by segmentation, volume-rendering and surface-rendering algorithms on a personal computer. The 3D display of the middle and inner ear structures was demonstrated in detail. Computer-assisted measurements, many of which could not be easily measured in vivo, of the reconstructed structures provided accurate anatomic details that improved the surgeons understanding of spatial relationships. A 3D reconstruction of temporal bone CT might be useful for education and increasing understanding of the anatomical structures of the temporal bone. However, it will be necessary to confirm the correlation between the 3D reconstructed images and histological sections through a validation study.

Sleep-disordered breathing in premenopausal women: differences between younger (less than 30 years old) and older women.

OBJECTIVE To compare clinical manifestations and polysomnographic data of sleep-disordered breathing (SDB) in younger (less than 30 years old) versus older premenopausal women. METHODS A cohort of 420 premenopausal women diagnosed with SDB in a university sleep clinic during a 5-year period underwent systematic collection of clinical and polysomnographic variables. RESULTS One-hundred and fifteen (27.4%) women were younger than 30 (mean 24.5 ± 3.5 years), while 305 (72.6%) were older than 30 (mean 39.5 ± 5.7 years). The younger premenopausal women had less severe SDB with a trend towards upper-airway resistance syndrome. Despite similar daytime consequences, snoring was less common in the younger group. Both groups of premenopausal women frequently had insomnia and nasal abnormalities or craniofacial-deficiency. CONCLUSION Recognizing the different clinical features and understanding the different polysomnographic presentation of SDB in young premenopausal women are crucial to detecting and treating this syndrome.

Toll-Like Receptor 2 Gene Polymorphisms in a Korean Population Association With Chronic Rhinosinusitis

Objective. To investigate the role of single-nucleotide polymorphisms (SNPs) in the gene encoding Toll-like receptor (TLR) 2 in Korean patients with chronic rhinosinusitis (CRS) and controls. Study Design and Setting. A case-control study. Subjects and Methods. Subjects (N = 214) were all adults (>20 years old) and were divided into patients with CRS (n = 106) and controls (n = 108). Five SNPs (rs1898830, rs3804099, rs3804100, R677W, and rs5743708) were selected and genotyped in a case-control study with the single-base-pair primer extension (SNaPshot) assay. Results. The case-control study revealed that 2 SNPs in TLR2, rs3804099 (odds ratio [OR] = 2.88; 95% confidence interval [CI] = 1.17-7.09; P = .022) and rs3804100 (OR = 3.76; 95% CI = 1.42-9.96; P = .008), showed significant differences in minor allele frequency between CRS patients and controls. These 2 SNPs were correlated with CRS risk in Korean patients. Conclusions. Two SNPs in TLR2 may be associated with increased risk of CRS in Korean subjects.

The inhibitory effects of macrolide antibiotics on bone remodeling in chronic rhinosinusitis.

OBJECTIVE: To investigate the effect of nasal mucosal inflammation on bone remodeling and the inhibitory effect of macrolide antibiotics on bone remodeling through the inhibition of receptor activator of nuclear factor-kB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). STUDY DESIGN AND SETTING: Human nasal fibroblasts were primary-cultured from nasal polyp. After interleukin (IL)-1β stimulation of fibroblasts with or without macrolide pretreatment, real-time polymerase chain reaction for RANKL messenger RNA (mRNA) and enzyme-linked immunosorbent assay for M-CSF were performed at various intervals. Peripheral blood mononuclear cells (PBMCs) were cultured for 10 days with M-CSF only, M-CSF plus RANKL, or macrolide antibiotic plus M-CSF and RANKL. RESULTS: IL-1β stimulation of nasal polyp fibroblasts induced expression of RANKL mRNA and secretion of M-CSF. Macrolide antibiotics reduced RANKL mRNA and M-CSF expression by nasal polyp fibroblasts in a dose-dependent manner, and inhibited osteoclastogenesis from PBMCs. CONCLUSION: Nasal fibroblasts stimulated with IL-1β may take on the role of osteoblasts in osteoclastogenesis, which may be inhibited by macrolide antibiotics.

Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

OBJECTIVE Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. METHODS Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. RESULTS Subjects (N=80) were divided into control (n=32, apnea-hypopnea index [AHI]<1) and OSAS (n=48, AHI > or =1) groups; the OSAS group was subdivided into mild (1< or = AHI < 5) and moderate to severe (AHI > or =5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). CONCLUSIONS Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.

Usefulness of adenotonsillar size for prediction of severity of obstructive sleep apnea and flow limitation.

Objective Adenotonsillar hypertrophy is considered the most common cause of pediatric obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the relationships between tonsil/adenoid size, parameters of polysomnography, and subjective sleep symptoms. Study Design Case-control studies. Setting Tertiary care center. Subjects and Methods A 4-point tonsil grading method and adenoid-nasopharynx (AN) ratio were used to categorize tonsil and adenoid size, respectively. Sleep questionnaires (Korean version of the Obstructive Sleep Apnea–18 [KOSA-18]) and full-attended polysomnography were performed. Results The subjects (n = 70) were divided into a control group (n = 31, apnea-hypopnea index [AHI] <1) and an OSAS group (n = 39, AHI ≥1), which was subdivided into mild and moderate to severe groups. Tonsil/adenoid size showed a statistically significant difference between control and OSAS groups, but these differences had no clinical significance. In addition, tonsil/adenoid size did not differ significantly among 2 OSAS severity subgroups. Only adenoid size in the total and OSAS groups was related to quality of life (QOL) by the KOSA-18. The AN ratio was related to lowest oxygen saturation only in the OSAS group, especially in the moderate to severe OSAS group, but tonsil size was related to flow limitation in total and supine positions in the control group. In the control group, flow limitation was not associated with QOL. Conclusion Tonsil/adenoid size did not predict the severity of AHI. Nevertheless, adenoid size might be related to lowest oxygen saturation, which is thought to be related to subjective symptoms. Although flow limitation was related to tonsil size but not to QOL in the control group, further research will be needed to understand the importance of flow limitation and upper airway resistance syndrome in the pediatric population.

Changes in salivary cortisol levels in pediatric patients with obstructive sleep apnea syndrome after adenotonsillectomy

OBJECTIVE Obstructive sleep apnea syndrome (OSAS) activates the stress response system, including the hypothalamic-pituitary-adrenocortical (HPA) axis. The salivary cortisol, as an index of free circulating cortisol levels, may be used as a measure of HPA axis activity. We examined the change in the salivary cortisol level in pediatric OSAS patients before and after adenotonsillectomy (AT). METHODS Forty-eight subjects from 80 subjects suspicious of having OSAS were diagnosed with OSAS by overnight PSG, 34 of 48 OSAS patients undergoing AT, and 13 of 34 OSAS patients were finally enrolled prospectively for this study. Before and three months after the AT, the saliva was collected at night before PSG (n-sCor) and in the early morning after PSG (m-sCor) for the measurements of the salivary cortisol level. RESULTS Children in the study population (n=13) were divided into mild (1< or = AHI <5, n=5), moderate (5 < or = AHI <10, n=3), and severe (AHI > or =10, n=5) OSAS groups. The mean preoperative AHI in the children was 14.7, and the mean postoperative AHI was 0.33. The percentage of children with AHI <1 after AT was 92.3%. Postoperative m-sCor, the difference of cortisol level (sub-sCor: m-sCor minus n-sCor), and the ratio of cortisol level (r-sCor: m-sCor/n-sCor) showed significant difference postoperatively. CONCLUSIONS AT was associated with improvements in PSG and subjective symptoms in pediatric OSAS patients. In addition, these improvements were significantly related to normalization of salivary cortisol level after AT. Although further study on salivary cortisol levels needs to be done, the measurement of salivary cortisol level before and after AT may predict the outcome of AT as a treatment of OSAS.

Correlation of salivary alpha amylase level and adenotonsillar hypertrophy with sleep disordered breathing in pediatric subjects.

STUDY OBJECTIVES Obstructive sleep apnea syndrome (OSAS) and sleep disordered breathing (SDB) can affect the sympathetic adrenomedullary system (SAM). As a biomarker of SAM activity, salivary α-amylase (sAA) in pediatric subjects was evaluated whether it has any correlation with polysomnographic (PSG) parameters related to SDB. METHODS Sixty-seven children who attended our clinic during 1 year were enrolled prospectively and underwent clinical examinations and in-lab polysomnography. The sAA was measured at 2 points--at night before PSG and in the early morning after PSG. RESULTS Subjects were divided into control (n = 26, apneahypopnea index [AHI] < 1) and OSAS (n = 41, AHI ≥ 1) groups. The OSAS group was subdivided according to AHI (mild-moderate, 1 ≤ AHI < 10; severe, AHI ≥ 10). The sAA subtraction and ratio (p = 0.014 and p < 0.001, respectively) were significantly higher in severe OSAS than in the mild-moderate and control groups. Although oxygen desaturation index (ODI) and AHI were significantly associated with sAA, sAA in the OSAS group was not related to lowest oxygen saturation or adenotonsillar hypertrophy. CONCLUSION sAA was well related to polysomnographic (PSG) parameters related to SDB, such as AHI and ODI. Therefore, screening test for sAA in children suspected to have SBD may help to identify OSAS patients from control.