OBJECTIVES: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. METHODS: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients' data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. RESULTS: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. CONCLUSION: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.
Adenine Nucleotides ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Advancement ; Mycophenolic Acid ; Sleep Apnea, Obstructive ; Temporomandibular Joint ; Tooth

No abstract available.
Neuroepithelial Cells* ; Regeneration*

BACKGROUND AND OBJECTIVES: The classic immunotherapy has the inconvenience and the risk of anaphylaxis. Recent reports revealed that immunostimulatory DNA sequences (CpG motif, ISS-ODN) have been shown to act as strong Th1 response-inducing adjuvants and DNA based vaccination might be an effective therapeutic option for the treatment of allergic disease. In our study, we investigated whether ISS-ODN have anti-allergic effect in the mouse rhinitis model of Dermatophagoides farinae (Der f), the most common allergen in Korea. MATERIALS AND METHOD: C57BL/6 mice were sensitized with crude extract of Der f extract. After injection of ISS-ODN, several parameters of allergic response were evaluated. RESULTS: Injection with ISS-ODN suppressed itching symptom, eosinophilic infiltration into nasal mucosa and the splenic T cell proliferation after Der f allergen challenge in the murine model of allergic rhinitis. However, injection with ISS-ODN did not show a detectable Der f-specific IgE suppression. CONCLUSION: Our findings suggested ISS-ODN have an anti-allergic effect in the allergic rhinitis model of Der f allergen. House dust mite allergy can be reduced by the injection with ISS-ODN.
Anaphylaxis ; Animals ; Base Sequence ; Cell Proliferation ; Dermatophagoides farinae ; DNA ; Eosinophils ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Korea ; Mice ; Nasal Mucosa ; Pruritus ; Pyroglyphidae ; Rhinitis* ; Vaccination

Background: The majority of patients with obstructive sleep apnea do not receive timely diagnosis and treatment because of the complexity of a diagnostic test. We aimed to predict obstructive sleep apnea based on heart rate variability, body mass index, and demographic characteristics in a large Korean population. Methods: Models of binary classification for predicting obstructive sleep apnea severity were constructed using 14 features including 11 heart rate variability variables, age, sex, and body mass index. Binary classification was conducted separately using apnea-hypopnea index thresholds of 5, 15, and 30. Sixty percent of the participants were randomly allocated to training and validation sets while the other forty percent were designated as the test set. Classifying models were developed and validated with 10-fold cross-validation using logistic regression, random forest, support vector machine, and multilayer perceptron algorithms. Results: A total of 792 (651 men and 141 women) subjects were included. The mean age, body mass index, and apnea-hypopnea index score were 55.1 years, 25.9 kg/m 2 , and 22.9, respectively. The sensitivity of the best performing algorithm was 73.6%, 70.7%, and 78.4% when the apnea-hypopnea index threshold criterion was 5, 10, and 15, respectively. The prediction performances of the best classifiers at apnea-hypopnea indices of 5, 15, and 30 were as follows: accuracy, 72.2%, 70.0%, and 70.3%; specificity, 64.6%, 69.2%, and 67.9%; area under the receiver operating characteristic curve, 77.2%, 73.5%, and 80.1%,respectively. Overall, the logistic regression model using the apnea-hypopnea index criterion of 30 showed the best classifying performance among all models. Conclusion Obstructive sleep apnea was fairly predicted by using heart rate variability, body mass index, and demographic characteristics in a large Korean population. Prescreening and continuous treatment monitoring of obstructive sleep apnea may be possible simply by measuring heart rate variability.

BACKGROUND: The aim of the current study was to investigate the changes of the olfactory function in the Korean elderly population related to cognitive decline by using the CDR (Clinical Dementia Rating scale) and KVSS Test (Korean Version of Sniffin' Sticks Test). METHODS: 41 subjects between the ages of 65-85 years, were included in this study. All subjects were screened to exclude conditions affecting olfactory functions. These subjects were divided into three groups according to CDR. 23 subjects belonged to the CDR 0 group, 9 to the CDR 0.5 group and 9 to the CDR 1 group. The KVSS Test consisted of the olfactory threshold test and olfactory identification test. RESULTS: Significant differences were found among the CDR 0 group, CDR 0.5 group and CDR 1 group (p<0.001) in the olfactory identification test. Scores in the olfactory identification test was lower in the CDR 1 group than in the CDR 0.5 group and CDR 0 group. There were no significant differences between the scores of subjects in the CDR 0 group and those in the CDR 0.5 group on the olfactory identification test. Scores in the olfactory threshold test were not different in the CDR 0 group, CDR 0.5 group and CDR 1 groups (p>0.05). CONCLUSIONS: These results suggest that the cognitive deficits were associated with the decrease of scores in the olfactory identification test and that the olfactory identification test may have clinical utility in the diagnosis of the dementia.
Aged ; Dementia ; Diagnosis ; Humans

BACKGROUND AND OBJECTIVES: Sinus surgery has been reported to improve pulmonary function and decrease the use of asthma medications in patients with chronic rhinosinusitis and asthma. Most studies, however, have used a small number of patients and were conducted over a short period. To demonstrate a causal relationship between sinus surgery and asthma, a sufficient amount of patient data observed over a long period is required. To address the limitations of the existing approaches, we conducted a preliminary methodological study for large-scale data analysis using data from the National Health Insurance Service (NHIS) to suggest a basis for the effect of sinus surgery on asthma. MATERIALS AND METHODS: The data from NHIS consisted of unidentified medical histories of a sample cohort representing the whole nation over a period of nine years. We selected the following types of study samples: 1) patients with surgical codes for sinus surgery; 2) patients with disease codes for sinusitis; 3) patients with disease codes for asthma; and 4) patients with medication codes for asthma treatment. RESULTS: In this study, we applied a methodology for selection of subjects from big data to investigate the effect of sinus surgery on improving asthma in the future. We could include 152 subjects after the four-stage selection method from 1,025,340 patients. CONCLUSION: We could establish a method to select patients with history of sinus surgery and asthma treatment from a big data. This methodology using big data may contribute to identify relationship between sinus surgery and asthma treatment in the future.
Asthma* ; Cohort Studies ; Humans ; Methods ; National Health Programs* ; Patient Selection ; Sinusitis ; Statistics as Topic*

The olfactory system is valuable in the study of some general properties of neural system and it provides as an excellent model for studying the effects of environmental toxicants on the sensory system. For example, the olfactory receptor neuron has become an important neurobiologic model system in the area of molecular and cell biology for the study of neuronal plasticity and neuronal development, including the developmental steps of cell birth and lineage, differentiation, synaptogenesis, migration, maturation, and death. The olfactory neuroepithelium is characteristic of neuron replacement and regeneration throughout life. Olfactory receptor neurons are rapidly replaced following traumatic lesions and they are the only known projection neurons with this property. Various toxicants put the olfactory system at risk for damage. Toxic agents comprise part of health hazard to human olfaction. However, the direct and indirect effects of these agents on the olfactory system are not completely understood.
Humans ; Neuronal Plasticity ; Neurons ; Olfactory Receptor Neurons ; Parturition ; Regeneration ; Smell

OBJECTIVES: Patients with smell loss after craniocerebral trauma are known to have some brain abnormalities, but there was no study to analyze the findings according to the time interval between injury and evaluation. We aimed to identify whether the time interval may influence on the findings in the brain. METHODS: Medical records of 19 patients with posttraumatic olfactory dysfunction were reviewed. All of them underwent a magnetic resonance imaging and olfactory function tests. The patients were divided into early (n=10) and delayed (n=9) groups according to the time interval. RESULTS: Magnetic resonance imaging was taken at a mean time of 2.2 and 59.6 months after trauma in the early and delayed groups, respectively. Abnormal findings in the brain were found in 6 and 8 patients in the early and delayed groups, respectively. The olfactory bulb and orbitofrontal cortex were commonly affected olfactory pathways in both groups. In the early group, the abnormalities were brain tissue defect, hemorrhage, and focal edema whereas tissue defect was the only finding in the delayed group. In the early group, 5 of 6 patients with severe olfactory dysfunction showed brain abnormality while 1 of 4 patients with mild dysfunction had abnormality. In the delayed group, all the patients had severe dysfunction and 8 of 9 patients showed brain abnormality. CONCLUSION: Most patients with traumatic olfactory dysfunction had abnormality in the brain, and brain abnormality might be different according to the timing of evaluation. Furthermore, there might be an association between the severity of olfactory dysfunction and radiological abnormalities.
Brain ; Craniocerebral Trauma ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Medical Records ; Olfactory Bulb ; Olfactory Pathways ; Smell

Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. The authors report an unusual case of a frontal sinus osteoma leading to subdural emyema formation. A 19-year-old man presented with headache and fever one month after minor facial trauma. Neuroradiological studies revealed subdural empyema in left frontal lobe with moderate cerebral edema and a osteoma in the left frontal sinus with sinusitis of maxillary sinus. The patient was surgically treated in one stage operation of decompressive craniectomy, removal of subdural empyema with frontal sinus osteoma, and endoscopic sinus surgery via cranial and nasal route. The patient recovered very well after surgery and postoperative antibiotic therapy. The etiology of intracranial infection and the treatment strategy are to be discussed.
Brain Edema ; Decompressive Craniectomy ; Empyema, Subdural* ; Fever ; Frontal Lobe ; Frontal Sinus* ; Headache ; Humans ; Maxillary Sinus ; Osteoma* ; Paranasal Sinuses ; Sinusitis ; Young Adult

BACKGROUND: Some authors recommend the surgical correction at early childhood in the selected cases of unilateral atresia as well as bilateral atresia. It has been enabled due to the improvement of imaging technique and it gives cosmetic satisfaction and biaural hearing. OBJECTIVES: The authors laid emphasis on the timing of canaloplasty in unilateral atresia, stage of canaloplasty, and postoperaitve hearing results. MATERIALS AND METHODS: A retrospective review of surgical results of congenital aural atresia from 1983 to 1995 in Seoul National University Hospital was performed. RESULTS: Forty four patients had unilateral atresia and 16 patients had bilateral atresia. Age range at the time of surgery was from 5.3 years to 14.6 years: average age was 8.1 years. Otoplasty was performed in 22 ears by plastic surgeons. It took precedence over canaloplasty in 17 ears. The endaural anterior approach through incision from temporal area to cavum cocha was performed in these cases. Meatal stenosis was the most common postoperative complication, but it has been decreased since the introduction of modification of anterior approach. The surgical attempts to improve hearing could not be performed in 14 ears due to various reasons. The audiologic follow-up period in the remaining 60 ears ranged from 1 year 9 months to 8 year 8 months(mean, 3 year 8 months). By analyzing final air conduction level, it was possible to attain 30 dB or better in 18(30%) of 60 cases and 40 dB or better in 36(60%) of 60 cases. CONCLUSION: The authors recommend the surgical correction at early childhood in unilateral atresia. and the otoplasty should be performed at first and it seems to be better in view of early audiologic rehabilitation that canaloplasty would be performed before the stage of elevation of rib cartilage graft. Meatal stenosis can be reduced by modification of anterior approach.
Cartilage ; Constriction, Pathologic ; Correction of Hearing Impairment ; Ear ; Follow-Up Studies ; Hearing ; Humans ; Postoperative Complications ; Retrospective Studies ; Ribs ; Seoul ; Transplants