Kee Hwan Kwon

Advantages of Intraoral Removal Over Submandibular Gland Resection for Proximal Submandibular Stones: A Prospective Randomized Study

To compare surgical outcomes after intraoral removal of proximal submandibular stones versus traditional submandibular gland (SMG) resection.

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.

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

PDGFRA promoter polymorphisms are associated with the risk of papillary thyroid cancer.

Platelet-derived growth factor (PDGF) acts as a regulator in cancer development and progression. We investigated whether single nucleotide polymorphisms (SNPs) of platelet-derived growth factor receptor α polypeptide (PDGFRA) and platelet-derived growth factor receptor β polypeptide (PDGFRB) genes are associated with papillary thyroid cancer (PTC) in a Korean population. Two promoter SNPs (rs6554162, -1309A/G and rs1800812, -635G/T) of PDGFRA and one promoter SNP (rs3828610, -202A/C) of PDGFRB were genotyped using direct sequencing in 93 PTCs and 212 controls. Genetic data were analyzed using the SNPAnalyzer Pro, SNPStats and Haploview programs. Two promoter SNPs (rs6554162 and rs1800812) in PDGFRA revealed significant differences between PTC and controls (for rs6554162, p=0.0018 in the codominant model and p=0.0005 in the dominant model; for rs1800812, p=0.016 in the codominant model and p=0.007 in the dominant model). In the analysis of allele frequency, we also found that the A allele of rs6554162 (p=0.004) and the T allele of rs1800812 (p=0.029) were associated with PTC. Additionally, by haplotype analysis, the GG and AT haplotypes consisting of rs6554162 and rs1800812 were associated with PTC (GG, p=0.0033; AT, p=0.0270). However, rs3828610 in PDGFRB showed no significant difference between PTC and controls. The results suggest that PDGFRA promoter SNPs (rs6554162 and rs1800812) may be associated with the risk of PTC.

Associations between promoter polymorphism -106A/G of interleukin-11 receptor alpha and papillary thyroid cancer in Korean population.

BACKGROUND The interleukin11 (IL11) and IL11 receptor alpha (IL11RA) are involved in cellular growth, differentiation, invasiveness, and tumor progression in several tumors. We investigated whether coding single nucleotide polymorphisms (cSNPs) of IL11 and promoter SNP IL11RA would contribute to the development of papillary thyroid cancer (PTC). We also assessed the relationships between IL11 and IL11RA SNPs and the clinicopathologic characteristics of PTC. METHODS One coding SNP, designated as rs1126757, Ala82Ala, in IL11 and one promoter SNP, designated as rs1061758, -106A/G, in IL11RA were genotyped using direct sequencing in 94 patents with PTC and 213 patients without PTC (controls). Genetic data were analyzed using commercially available software. The patients with PTC were dichotomized and compared with respect to clinicopathologic characteristics of PTC. RESULTS We found an association between PTC and the coding SNP(rs1061758) in IL11RA (codominant model 1 [G/G vs. A/G], odds ratio [OR] = 2.91, 95% confidence interval [CI], 1.44-5.89; P = .003; codominant model 2 [G/G vs. A/A], OR = 2.95, 95% CI, 1.30-6.72; P = .01; and dominant model, OR = 2.92, 95% CI, 1.47-5.80; P = .002). Moreover, SNP rs1061758 in IL11RA was associated with the multifocality of PTC (codominant model 2 [A/A vs. G/G], OR = 9.56, 95% CI, 1.77-51.69; P = .009; and recessive model, OR = 7.22, 95% CI, 1.72-30.3; P = .007). Genotype and allele analyses of SNP variant rs1126757 in IL11 revealed no statistically significant differences between patients with PTC and controls. CONCLUSION Our results suggest that an IL11RA promoter polymorphism--rs1061758--may be associated with the risk of PTC in the Korean population. In addition, rs1061758 might be related to the multifocality of PTC.

Short-term effect of multilevel surgery on adipokines and pro-inflammatory cytokines in patients with obstructive sleep apnea.

Abstract Conclusion: This study shows the possibility that multilevel surgery for obstructive sleep apnea (OSA) is helpful to improve the levels of pro-inflammatory cytokines and adipokines, which are related to complications of OSA. Objectives: The effects of multilevel surgery on adipokines and pro-inflammatory cytokines in patients with OSA were assessed. Methods: Fifty-one patients with OSA underwent uvulopalatopharyngoplasty and radiofrequency tongue base reduction. Body mass index (BMI), Epworth sleepiness scale (ESS) and subjective symptoms using visual analog scales were assessed at baseline and 4 weeks after treatment. Adiponectin, leptin, interleukin (IL)-6, and tumor necrosis factor (TNF)-α were measured with a LINCOplex Human Immunoassay at baseline and 4 weeks after surgical treatment. Results: Significant improvements in subjective symptoms and ESS were found at 4 weeks after multilevel surgery. No significant change in BMI was observed. Adiponectin level was significantly increased after surgical treatment. Postoperative leptin, IL-6, and TNF-α levels were significantly decreased. The percent changes of adiponectin, leptin, IL-6, and TNF-α after multilevel surgery were not significantly different among patients with mild, moderate, and severe OSA.

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.

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.

Multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea.

Objective: To compare the anatomic features and the results of a multilevel surgery in patients with rapid eye movement–related obstructive sleep apnea (REM OSA) and non-REM OSA. Study Design: Cohort study of 90 consecutive mild or moderate OSA patients. Subjects and Methods: The apnea-hypopnea index (AHI) was also calculated during REM sleep (AHIREM) and during non-REM sleep (AHINREM), and patients were classified as having REM OSA if their AHIREM/AHINREM ratio was >2, otherwise they were classified as non-REM OSA patients. All patients underwent concurrent uvulopalatopharyngoplasty and a radiofrequency tongue base reduction procedure. Results: A total of 31.1 percent patients were classified as REM OSA and 68.9 percent patients as non-REM OSA. There were no differences in the anatomical features between two groups. However, the AHI, HI, and arousal index were significantly higher in the non-REM OSA group than in the REM OSA group. When a successful outcome was defined as a postoperative AHI <20 with at least a 50 percent reduction from the preoperative level, 50 percent of the patients with REM OSA and 35.5 percent of the patients with non-REM OSA met the criteria for a successful outcome. Conclusions: REM OSA patients had milder obstructive sleep apnea, and multilevel surgery might be more effective in REM OSA patients.

Association between a promoter polymorphism (rs2192752, –1028A/C) of interleukin 1 receptor, type I (IL1R1) and location of papillary thyroid carcinoma in a Korean population

The interleukin 1 receptor, type I (IL1R1) is important in the pathogenesis of cancer. We investigated whether single nucleotide polymorphisms (SNPs) of IL1R1 contribute to the development of papillary thyroid carcinoma (PTC), in addition to the clinicopathological features such as the size, number, location, extrathyroidal invasion and metastasis of PTC. Three promoter SNPs (rs949963 −615G/A, rs2192752 −1028A/C and rs3917225 −1099A/G) in IL1R1 were genotyped using direct sequencing in 118 patients with PTC and 347 controls. The odds ratio (OR), 95% confidence interval (CI) and P value were analysed using SNPStats and SNPAnalyzer Pro. For the exact results, Fisher’s exact test and Bonferroni correction (Pc) were performed. The three promoter SNPs of IL1R1 were not associated with PTC development. For the clinicopathological features of PTC, rs2192752 was associated with location (one lobe versus both lobes): dominant model, OR = 3.11, 95% CI = 1.39–6.96, Pc = 0.015; log‐additive model, OR = 2.79, 95% CI = 1.38–5.66, Pc = 0.0087. The C allele frequency of rs2192752 was higher in the both lobes group (28.0%) than the one lobe group (12.3%) (OR = 2.77, 95% CI = 1.40–5.48, Pc = 0.009). However, rs949963 and rs3917225 were not correlated with clinicopathological features including location of PTC. The IL1R1 promoter SNP rs2192752 may contribute to the location of PTC, and the C allele of rs2192752 may be a risk factor for the development of PTC in both lobes.