Kyung Su Kim

Surgical Anatomy of the Sphenopalatine Artery in Lateral Nasal Wall

Objective We investigated the surgical anatomy of the sphenopalatine artery. First, the location of the sphenopalatine foramen on the lateral nasal wall and the pattern of the main branches of the sphenopalatine artery from the sphenopalatine artery were studied. Second, the course of the posterior lateral nasal artery with respect to the posterior wall of the maxillary sinus, the perpendicular plate of the palatine bone, and the pattern of distribution of its branches on the fontanelle was determined. Third, the distribution pattern on the inferior turbinate was analyzed.

Surgical Anatomy of the Nasofrontal Duct: Anatomical and Computed Tomographic Analysis

Objectives Although complete anatomical knowledge of the nasofrontal duct has been of great importance, little is known about it. The aim of this study is to examine the drainage site of the nasofrontal duct and to investigate the anatomical boundaries of the nasofrontal duct according to the drainage site.

Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis

Purpose While curative resection is the only chance of cure in pancreatic cancer, controversies exist about the impact of surgical margin status on survival. Non-standardized pathologic report and different criteria on the R1 status made it difficult to implicate adjuvant therapy after resection based on the margin status. We evaluated the influence of resection margins on survival by meta-analysis. Materials and Methods We thoroughly searched electronic databases of PubMed, EMBASE, and Cochrane Library. We included studies reporting survival outcomes with different margin status: involved margin (R0 mm), margin clearance with ≤ 1 mm (R0-1 mm), and margin with > 1 mm (R>1 mm). Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. Results A total of eight retrospective studies involving 1,932 patients were included. Pooled HR for overall survival showed that patients with R>1 mm had reduced risk of death than those with R0-1 mm (HR, 0.74; 95% confidence interval [CI], 0.61 to 0.88; p=0.001). In addition, patients with R0-1 mm had reduced risk of death than those with R0 mm (HR, 0.81; 95% CI, 0.72 to 0.91; p < 0.001). There was no heterogeneity between the included studies (I2 index, 42% and 0%; p=0.10 and p=0.82, respectively). Conclusion Our results suggest that stratification of the patients based on margin status is warranted in the clinical trials assessing the role of adjuvant treatment for pancreatic cancer.

Cholesterol Depletion in Cell Membranes of Human Airway Epithelial Cells Suppresses MUC5AC Gene Expression

Purpose If cholesterol in the cell membrane is depleted by treating cells with methyl-β-cyclodextrin (MβCD), the activities of transmembrane receptors are altered in a cell-specific and/or receptor-specific manner. The proinflammatory cytokines, IL-1β is potent inducers of MUC5AC mRNA and protein synthesis in human airway epithelial cells. Cells activated by IL-1β showed increased phosphorylation of extracellular signal regulated kinase (ERK) and p38 mitogen-activated protein kinase (MAPK). Thus, we investigated the effects of cholesterol depletion on the expression of MUC5AC in human airway epithelial cells and whether these alterations to MUC5AC expression were related to MAPK activity. Materials and Methods After NCI-H292 cells were pretreated with 1% MβCD before adding IL-1β for 24 hours, MUC5AC mRNA expression was determined by reverse transcription-polymerase chain reaction (RT-PCR) and real time-PCR. Cholesterol depletion by MβCD was measured by modified microenzymatic fluorescence assay and filipin staining. The phosphorylation of IL-1 receptor, ERK and p38 MAPK, was analyzed by western blot. Results Cholesterol in the cell membrane was significantly depleted by treatment with MβCD on cells. IL-1β-induced MUC5AC mRNA expression was decreased by MβCD and this decrease occurred IL-1-receptor-specifically. Moreover, we have shown that MβCD suppressed the activation of ERK1/2 and p38 MAPK in cells activated with IL-1β. This result suggests that MβCD-mediated suppression of IL-1β-induced MUC5AC mRNA operated via the ERK- and p38 MAPK-dependent pathway. Conclusion Cholesterol depletion in NCI-H292 cell membrane may be considered an anti-hypersecretory method since it effectively inhibits mucus secretion of respiratory epithelial cells.

Anti-adhesive effect of a thermosensitive poloxamer applied after the removal of nasal packing in endoscopic sinus surgery: a randomised multicentre clinical trial.

To compare the efficacies of a thermosensitive poloxamer (TPX) and Merogel in preventing adhesion applied after the removal of nasal packing in endoscopic sinus surgery as a non‐inferiority trial.

Does Correction of Caudal Septal Deflection Affect Nasal Angle Parameters

Objectives: Verify whether one’s external appearance may change after correction of caudal septal deflection by estimating nasal angle parameters. Methods: Correction of caudal septal deflection was performed by first releasing the caudal septal cartilage along the maxillary crest and excising excessive portions. The incised cartilage was sutured, and the detached ventral cartilage of caudal septum was fixed at the midline. Preoperative and postoperative photographs (lateral view) were taken at postoperative 6 months. Nasolabial angle (NLA) and nasal tip angle (NTA), as well as the angle between the columella and a perpendicular line to the Frankfort line (CFL), were evaluated. The visual analogue score (VAS) for nasal obstruction was evaluated at pre- and post-operation. Results: A total of 35 patients per protocol were included in this study. The mean preoperative NLA was 98.67±9.17° and the mean NLA at postoperative 6 months was 98.64±9.27°; the NTA changed from 84.41±6.96° to 84.33±7.07°; the CFL changed from 80.06±7.91° to 80.08±8.02°. All parameters showed no significant change between pre- and post-operation. Subjective saddle nose or other external deformities were not reported. VAS score of subjective nasal obstruction decreased significantly from 7.89±1.37 to 1.80±1.05. Conclusions: After correction of caudal septal deflection, nasal angle parameters were not changed and VAS score was significantly improved. Therefore, caudal septal deflection can be safely and satisfactorily corrected through proper surgical methods.