Objective: : We performed an expanded multi-ethnic meta-analysis to identify associations between inflammation-related loci with intracranial aneurysm (IA) susceptibility. This meta-analysis possesses increased statistical power as it is based on the most data ever evaluated. Methods: : We searched and reviewed relevant literature through electronic search engines up to August 2022. Overall estimates were calculated under the fixed- or random-effect models using pooled odds ratio (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed according to ethnicity. Results: : Our meta-analysis enrolled 15 studies and involved 3070 patients and 5528 controls including European, Asian, Hispanic, and mixed ethnic populations. Of 17 inflammation-related variants, the rs1800796 locus (interleukin [IL]-6) showed the most significant genome-wide association with IA in East-Asian populations, including 1276 IA patients and 1322 controls (OR, 0.65; 95% CI, 0.56–0.75; p=3.24×10-9) under a fixed-effect model. However, this association was not observed in the European population (OR, 1.09; 95% CI, 0.80–1.47; p=0.5929). Three other variants, rs16944 (IL-1β), rs2195940 (IL-12B), and rs1800629 (tumor necrosis factor-α) showed a statistically nominal association with IA in both the overall, as well as East-Asian populations (0.01Conclusion : Our updated meta-analysis with increased statistical power highlights that rs1800796 which maps on the IL-6 gene is associated with IA, and in particular confers a protective effect against occurrence of IA in the East-Asian population.

BACKGROUND AND OBJECTIVES: Drug-induced sedation endoscopy (DISE) has recently gained popularity among otolaryngologists because it can provide direct information of upper airway obstruction in patients with obstructive sleep apnea (OSA). In that regard, we examined how DISE examination affected the decision of clinician's treatment plan and the consequent patient's compliance in OSA patients. SUBJECTS AND METHOD: All enrolled patients were classified into two groups according to the method of upper airway evaluation employed: a physical examination only group and a physical examination combined with DISE group. The clinician's treatment plan was categorized into the following four groups: sleep surgery, positive airway pressure, oral appliance, and sleep surgery combined with oral appliance. The change of patient's compliance was also evaluated. RESULTS: There were several differences in how DISE evaluation affected the decision of clinician's treatment plan and patient's compliance between the two groups. The rate for sleep surgery fell from 69.6% to 15.9%; on the other hand, the rate for positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 13.0% to 36.2%, 14.5% to 26.6%, and 2.9% to 21.3%, respectively. The patient's compliance also changed after DISE evaluation: sleep surgery, positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 78.1% to 87.9%, 16.7% to 76.0%, 25.0% to 87.3%, and 50.0% to 91.03%, respectively. CONCLUSION: We found that DISE examination influences the decision of clinician's treatment plan and patient's compliance. We suggest additional cohort studies to confirm these findings.
Airway Obstruction ; Cohort Studies ; Compliance ; Endoscopy* ; Hand ; Humans ; Methods ; Physical Examination ; Sleep Apnea, Obstructive*

BACKGROUND AND OBJECTIVES: Recently, mandibular advancement device (MAD) has been used widely used for the treatment of obstructive sleep apnea (OSA) because it can effectively reduce the collapsibility of upper airway during sleep. Although MAD is widely prescribed by otorhinolaryngologists, several studies described its complications arising from the anterior placement of the mandible with long-term use. However, there is still a lack of studies on long-term complications in Korean patients. SUBJECTS AND METHOD: Retrospectively, we included a total of 57 OSA patients in the study. In this study, all enrolled OSA patients had used MAD over two years with more than 4 hours/day. Dental consulting and cephalometric analysis were conducted to identify the change of dental and skeletal findings at two different times (baseline and after 2 year). RESULTS: The dental findings showed that the overbite and overjet were significantly decreased. Additionally, the proclination of the lower incisors were increased significantly, whereas there was no significant change on the retroclination of the upper incisors. Three patients showed a change of malocclusion type. On the analysis of skeletal findings, we found a significant increase in the sella turcica central point-nasion-supramental point angle and a decrease in the subspinal point-nasion-supramental point angle. Moreover, the anterior lower facial height and anterior facial height were significant increased. CONCLUSION: Consistent with Western studies, our findings suggest that the long-term use of MAD could induce changes in dental and skeletal morphologies in Korean OSA patients. Therefore, clinicians should thoroughly evaluate potential changes in dental and skeletal morphologies when they prescribe MAD to patients with OSA.
Humans ; Incisor ; Malocclusion ; Mandible ; Mandibular Advancement* ; Methods ; Overbite ; Retrospective Studies ; Sella Turcica ; Sleep Apnea, Obstructive*

We investigated the utility of the duck-feet collagen extraction patching procedure in the traumatic tympanic membrane (TM) perforation via a comparison with spontaneous healing or paper patch. Fifty-six ears of adult male Sprague-Dawley rats, each weighing in the range of 250 to 300 g, were used for the animal studies. Sixteen rats had one-side ear in the control group and the opposite-side ear in the treated groups. The remaining twelve rats had a one-side ear with the duck-feet collagen patch and the opposite-side ear with a paper patch. The proliferating cell nuclear antigen (PCNA) expression cells were calculated among the 200 basal cells, and the expression percentage was identified as the labeling index. The healing of the perforation in the duck-feet collagen patch group was confirmed to be more rapid compared to the healing of the other groups. PCNA staining was observed in the migrating portion of PCNA enhanced cell to collagen scaffold in Post operative day (POD) 7 of collagen patch group. Thus, the adhesive effect of the duck-feet collagen patch to perforated margin was better than that of the paper patch. After completing the healing process, the collagen patch shrank and detached from the tympanic membrane (POD 14). In this study, we confirmed that the use of a duck-feet collagen patch had the advantage of early healing, inducing natural TM contour, and disappearing ability after the patch effect is complete.
Adhesives ; Adult ; Animals ; Collagen* ; Ducks* ; Ear ; Ear, Middle ; Fibroins ; Foot* ; Humans ; Male ; Proliferating Cell Nuclear Antigen ; Rats ; Rats, Sprague-Dawley ; Tympanic Membrane Perforation* ; Tympanic Membrane*

No abstract available.
Tympanic Membrane Perforation* ; Tympanic Membrane*

Hydrocolloid dressings have been developed for many types of wound healing. In particular, dressing is a critical component in the successful recover of burn injuries, which causes a great number of people to not only suffer from physical but also psychological and economic anguish each year. Additionally, silk fibroin is the safest material for tissue engineering due to biocompatibility. In this study, we fabricated hydrocolloid dressings incorporating silk fibroin nanoparticles to enhance the efficacy of hydrocolloid dressing and then use this silk fibroin nanoparticle hydrocolloid dressing (SFNHD) in animal models to treat burn wounds. The structures and properties of SFNHD were characterized using tensile strength and Cell Counting Kit-8 assay. The results indicated the structural stability and the cellular biocompatibility of the hydrocolloid dressing suggesting that SFNHD can be applied to the treatment of wounds. To demonstrate the capacity of a silk fibroin hydrocolloid dressing to treat burn wounds, we compared SFNHD to gauze and Neoderm®, a commercially available dressing. This study clearly demonstrated accelerated wound healing with greater wound structural integrity and minimal wound size after treatment with SFNHD. These observations indicate that SFNHD may be an improvement upon current standard dressings such as Gauze and Neoderm® for burn wounds.
Bandages ; Bandages, Hydrocolloid* ; Burns ; Cell Count ; Colloids* ; Fibroins* ; Models, Animal ; Nanoparticles* ; Silk* ; Stress, Psychological ; Tensile Strength ; Tissue Engineering ; Wound Healing* ; Wounds and Injuries*

OBJECTIVES: The silk patch is a thin transparent patch that is produced from silk fibroin. In this study, we investigated the treatment effects of the silk patch in patients with traumatic tympanic membrane perforation (TTMP). METHODS: The closure rate, otorrhea rate, and closure time in all patients and the closure time in successful patients were compared between the paper patch and silk patch groups. RESULTS: Demographic data (gender, site, age, traumatic duration, preoperative air-bone gap, and perforation size and location) were not significantly different between the two groups. The closure rate and otorrhea rate were not significantly different between the two groups. However, the closure time was different between the two groups (closure time of all patients, P=0.031; closure time of successful patients, P=0.037). CONCLUSION: The silk patch which has transparent, elastic, adhesive, and hyper-keratinizing properties results in a more efficient closure time than the paper patch in the treatment of TTMP patients. We therefore believe that the silk patch should be recommended for the treatment of acute tympanic membrane perforation.
Adhesives ; Ear, Middle ; Fibroins ; Humans ; Silk* ; Tympanic Membrane Perforation*

BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate drug-induced sleep endoscopy (DISE) findings in patients with persistent obstructive sleep apnea (OSA) after uvulopalatopharyngoplasty (UPPP) surgery. SUBJECTS AND METHOD: Patients were included in this study if they had a postoperative DISE evaluation as well as pre- and postoperative polysomnography. DISE findings included the obstructive sites (velum, oropharyngeal lateral walls, tongue base, and epiglottis), and the obstructive patterns of velopharynx (anteroposterior, lateral, and concentric). RESULTS: A total of 77 patients were included in this study. Poor-responder patients to UPPP (n=50) and well-responder patients to UPPP (n=27) were similar with regard to age, gender, body mass index, preoperative AHI, and minimal O2 saturation. In our analysis of DISE findings on poor-responder, velopharynx was the most common obstruction site (100%), followed by oropharynx (88%), tongue base (70%), and epiglottis (44%). Results showed that most patients (n=49) had multiple obstructive sites. No significant differences according to position dependency and REM dependency were found in obstructive sites. However, severe OSA patients had tongue base obstruction more frequently than the moderate OSA patients did. The obstructive pattern of velopharynx usually showed concentric configuration (70%, 35 of 50). CONCLUSION: Our results suggest that the preoperative DISE may be a useful method for determination of the personalized surgery to OSA patients because of its more precise information to upper airway obstruction.
Airway Obstruction ; Body Mass Index ; Endoscopy* ; Epiglottis ; Humans ; Oropharynx ; Polysomnography ; Sleep Apnea, Obstructive* ; Tongue

BACKGROUND AND OBJECTIVES: Zygomatic arch fracture should be treated early, because failure of prompt treatment of these injuries November result in significant morbidity, including malar asymmetry, enopthalmos, and sensory deficits. The purpose of this study was to evaluate the radiologic and histological changes of healing process on zygomatic arch fracture with malunion in animal model. MATERIALS AND METHOD: Ten rats with malunion after zygomatic arch fracture were used in this study. Using micro computerized tomography, we evaluated the defect of fracture site with serial weeks (1, 2, 4, and 8). We also analyzed the histological findings at same period. RESULTS: The 2-D images were able to assess a difference in recovery process of a bone fracture, but it was too small to be recognized. However, we could find to the definite changes of healing process by using the 3-D reconstructed image according to time sequence. Additionally, fracture sites were healed by primary bone healing process in the zygomatic arch fracture malunion state. CONCLUSION: The 3-D image is more useful to evaluate for fracture healing state. Moreover, the proper evaluation and adequate management is necessary even after eight weeks, because healing of fracture was not completed.
Animals ; Fracture Healing ; Fractures, Bone ; Imaging, Three-Dimensional ; Models, Animal* ; Rats* ; Zygoma* ; Zygomatic Fractures

BACKGROUND AND OBJECTIVES: Zygomatic arch fracture should be treated early, because failure of prompt treatment of these injuries November result in significant morbidity, including malar asymmetry, enopthalmos, and sensory deficits. The purpose of this study was to evaluate the radiologic and histological changes of healing process on zygomatic arch fracture with malunion in animal model. MATERIALS AND METHOD: Ten rats with malunion after zygomatic arch fracture were used in this study. Using micro computerized tomography, we evaluated the defect of fracture site with serial weeks (1, 2, 4, and 8). We also analyzed the histological findings at same period. RESULTS: The 2-D images were able to assess a difference in recovery process of a bone fracture, but it was too small to be recognized. However, we could find to the definite changes of healing process by using the 3-D reconstructed image according to time sequence. Additionally, fracture sites were healed by primary bone healing process in the zygomatic arch fracture malunion state. CONCLUSION: The 3-D image is more useful to evaluate for fracture healing state. Moreover, the proper evaluation and adequate management is necessary even after eight weeks, because healing of fracture was not completed.
Animals ; Fracture Healing ; Fractures, Bone ; Imaging, Three-Dimensional ; Models, Animal* ; Rats* ; Zygoma* ; Zygomatic Fractures