Background and Objectives: The most common cause of snoring in children is enlarged tonsils and adenoids. However, there is insufficient evidence to determine whether the subjective measurement of tonsil hypertrophy, the most common prevailing method, reflects the actual tonsil size and volume. Therefore, we tried to determine whether the subjective grading of tonsil size and actual tonsil volume is related, and whether tonsil volume, weight, and adenoid index are correlated with the acoustic analysis of snoring.Subjects and Method The study was conducted on 21 children between the ages of 4 and 15 who came for tonsillectomy and adenoidectomy due to snoring symptoms. The degree of adenotonsillar hypertrophy was measured using the Brodsky grading scale and adenoid index. After tonsillectomy, the volume and weight of resected tonsil were measured. For acoustic analysis, the Praat software was used to determine formant frequency and sound intensity. A linear regression model and a dummy variable were used to determine the correlation between the quantitative values of tonsil, adenoid and the result of acoustic analysis. Results: The Brodsky tonsil grade tended to match the actual tonsil volume, but it was not statistically significant (p=0.073). There was no correlation between snoring intensity and actual tonsil volume, weight, and adenoid index. Formant frequency 1 and 2 were statistically negatively correlated with the actual tonsil volume (p=0.011, 0.002). Conclusion The study confirmed that the acoustic analysis of pediatric snoring could be a screening test to predict tonsil volume and changes in the vocal tract due to tonsil hypertrophy.

PURPOSE: To evaluate changes in the tear meniscus area and tear meniscus height over time in patients with dry eye syndrome, using anterior segment spectral-domain optical coherence tomography after the instillation of 3% diquafosol ophthalmic solution. METHODS: Sixty eyes from 30 patients with mild to moderate dry eye syndrome were included. Tear meniscus images acquired by anterior segment spectral-domain optical coherence tomography were analyzed using National Institutes of Health's image-analysis software (ImageJ 1.44p). Tear meniscus area and tear meniscus height were measured at baseline, 5 minutes, 10 minutes, and 30 minutes after instillation of a drop of diquafosol in one eye and normal saline in the other eye. Changes in ocular surface disease index score, tear film break-up time, corneal staining score by Oxford schema, and meibomian expressibility were also evaluated at baseline, and after 1 week and 1 month of a diquafosol daily regimen. RESULTS: Sixty eyes from 30 subjects (mean age, 29.3 years; 8 men and 22 women) were included. In eyes receiving diquafosol, tear volume was increased at 5 and 10 minutes compared with baseline. It was also higher than saline instilled eyes at 5, 10, and 30 minutes. Changes in tear volume with respect to baseline were not statistically different after the use of diquafosol for 1 month. Ocular surface disease index score, tear film break-up time, and Oxford cornea stain score were significantly improved after 1 week and 1 month of daily diquafosol instillation, but meibomian expressibility did not change. CONCLUSIONS: Topical diquafosol ophthalmic solution effectively increased tear volume for up to 30 minutes, compared to normal saline in patients with dry eye syndrome.
Academies and Institutes ; Cornea ; Dry Eye Syndromes* ; Humans ; Male ; Ophthalmic Solutions ; Purinergic P2Y Receptor Agonists ; Tears* ; Tomography, Optical Coherence*

No abstract available.

Adiponectin may affect bone through interactions with two known receptors, adiponectin receptors (ADIPOR) 1 and 2. We examined the association between polymorphisms of ADIPOR1 and ADIPOR2 and bone mineral density (BMD) in postmenopausal Korean women. Six polymorphisms in ADIPOR1 and four polymorphisms in ADIPOR2 were selected and genotyped in all study participants (n = 1,329). BMD at the lumbar spine and femur neck were measured using dual-energy X-ray absorptiometry. Lateral thoracolumbar (T4-L4) radiographs were obtained for vertebral fracture assessment and the occurrence of non-vertebral fractures examined using self-reported data. P values were adjusted for multiple testing using Bonferroni correction (Pcorr). ADIPOR1 rs16850799 and rs34010966 polymorphisms were significantly associated with femur neck BMD (Pcorr = 0.036 in the dominant model; Pcorr = 0.024 and Pcorr = 0.006 in the additive and dominant models, respectively). Subjects with the rare allele of each polymorphism had lower BMD, and association of rs34010966 with BMD showed a gene dosage effect. However, ADIPOR2 single nucleotide polymorphisms and haplotypes were not associated with BMD at any site. Our results suggest that ADIPOR1 polymorphisms present a useful genetic marker for BMD in postmenopausal Korean women.
Base Sequence ; Bone Density/*genetics ; Female ; Femur Neck/physiology ; Genetic Association Studies ; Genetic Markers ; Genetic Predisposition to Disease ; Genotype ; Humans ; Osteoporosis, Postmenopausal/*genetics ; Polymorphism, Single Nucleotide ; Postmenopause ; Receptors, Adiponectin/*genetics ; Republic of Korea ; Sequence Analysis, DNA

Osteoporotic fracture (OF), along with bone mineral density (BMD), is an important diagnostic parameter and a clinical predictive risk factor in the assessment of osteoporosis in the elderly population. However, a genomewide association study (GWAS) on OF has not yet been clarified sufficiently. To identify OF-associated genetic variants and candidate genes, we conducted a GWAS in a population-based cohort (Korean Association Resource [KARE], n=1,427 [case: 288 and control: 1139]) and performed a de novo replication study in hospital-based individuals (Asan and Catholic Medical Center [ACMC], n=1,082 [case: 272 and control: 810]). In a combined meta-analysis, a newly identified genetic locus in an intergenic region at 10p11.2 (near genes FZD8 and ANKRD30A ) showed the most significant association (odd ratio [OR] = 2.00, 95% confidence interval [CI] = 1.47~2.74, p=1.27x10(-5)) in the same direction. We provide the first evidence for a common genetic variant influencing OF and genetic information for further investigation in bone metabolism.
Aged ; Bone Density ; Cohort Studies ; DNA, Intergenic ; Genetic Loci ; Genome-Wide Association Study ; Humans ; Osteoporosis ; Osteoporotic Fractures ; Risk Factors

There is increasing evidence of a biochemical link between lipid oxidation and bone metabolism. Paraoxonase 1 (PON1) prevents the oxidation of low-density lipoprotein (LDL) and metabolizes biologically active phospholipids in oxidized LDLs. Here, we performed association analyses of genetic variation in PON1 to ascertain its contribution to osteoporotic fractures (OFs) and bone mineral density (BMD). We directly sequenced the PON1 gene in 24 Korean individuals and identified 26 sequence variants. A large population of Korean postmenopausal women (n = 1,329) was then genotyped for eight selected PON1 polymorphisms. BMD at the lumbar spine and femoral neck was measured using dual-energy X-ray absorptiometry. Lateral thoracolumbar (T4-L4) radiographs were obtained for vertebral fracture assessment, and the occurrence of non-vertebral fractures (i.e., wrist, hip, forearm, humerus, rib, and pelvis) was examined using self-reported data. Multivariate analyses showed that none of the polymorphisms was associated with BMD at either site. However, +5989A>G and +26080T>C polymorphisms were significantly associated with non-vertebral and vertebral fractures, respectively, after adjustment for covariates. Specifically, the minor allele of +5989A>G exerted a highly protective effect against non-vertebral fractures (OR = 0.59, P = 0.036), whereas the minor allele of +26080T>C was associated with increased susceptibility to vertebral fractures (OR = 1.73, P = 0.020). When the risk for any OFs (i.e., vertebral or non-vertebral) was considered, the statistical significance of both polymorphisms persisted (P = 0.002-0.010). These results suggest that PON1 polymorphisms could be one of useful genetic markers for OF risk in postmenopausal women.
Aged ; Alleles ; Aryldialkylphosphatase/*genetics ; Bone Density ; Female ; Gene Frequency ; Gene Order ; Genetic Markers ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Korea/epidemiology ; Linkage Disequilibrium ; Male ; Middle Aged ; Molecular Typing ; Osteoporotic Fractures/epidemiology/*genetics ; *Polymorphism, Genetic ; *Postmenopause ; Risk Factors

X-linked agammaglobulinemia is a common type of primary immunodeficiency disorder that's caused by mutation of the BTK gene. The absence of B lymphocytes and plasma cells causes recurrent infections. Patients with X-linked agammaglobulinemia also have a high risk for developing hematological malignancies and, to a lesser degree, carcinoma. We report here on a 26-years-old male patient who suffered with X-linked agammaglobulinemia that was caused by BTK gene mutation, and he developed a gastric cancer in the antrum. He was noted to have chronic atrophic gastritis and diffuse intestinal metaplasia on the endoscopic examination that was done 7 years previously. We recommend regular esophagogastroduodenoscopic evaluation for a patient with X-linked agammaglobulinemia in order to make an early diagnosis of stomach carcinoma.
Adenocarcinoma ; Agammaglobulinemia ; B-Lymphocytes ; Early Diagnosis ; Gastritis, Atrophic ; Genetic Diseases, X-Linked ; Hematologic Neoplasms ; Humans ; Male ; Metaplasia ; Plasma Cells ; Stomach ; Stomach Neoplasms

Vaginal agenesis is rare gynecologic condition, and the most common etiology is Mayer-Rokitansky-Kster-Hauser (MRKH) syndrome, characterized by the absence of uterus and vagina and presence of normal ovaries and tubes. In such patients, the evaluation for associated malformations as well as careful non-surgical and surgical approach are essential. The neovaginoplasty is an important issue for these patients in regard of functional and psychological standpoint. There are many options available for creation of neovagina. We report six cases of laparoscopic assisted neovaginoplasty using pelvic peritoneal flap.
Abnormalities, Multiple ; Female ; Humans ; Kidney ; Laparoscopy ; Mullerian Ducts ; Ovary ; Somites ; Spine ; Uterus ; Vagina

BACKGROUND: Strong immunosuppressive regimens have steadily improved both graft and patient survival, but posttransplant malignancy is still a clinical issue that needs to be resolved. METHODS: There were 1,500 transplant recipients between 1969 and 2005 at Kangnam St. Mary's hospital. The mean follow-up period was 108 77 months. We retrospectively analyzed the incidence, clinical course, treatment and prognosis of malignancy in the kidney transplant recipients. RESULTS: The incidence of malignancy after transplantation was 7.0% (10.5 cases out of 103 patients). The incidence of malignant lymphoma, thyroid cancer, renal cell carcinoma and Kaposi's sarcoma were higher in the renal transplanted patients than in the general population. The cancer incidence for women was higher than that for men, with stomach cancer being the most common in males and uterine cervix cancer the most common in females. The cumulative incidence of posttransplant malignancy at 1990, 1995, 2000 and 2005 were 0.72%, 2.91%, 4.62% and 7.0%, respectively. The cancer incidence with the use of initial immunosuppressive agents was 8.3% for azathioprine, 7.6% for cyclosporine, and 3.4% for tacrolimus. The mean times for making the diagnosis of malignancy after transplantation were 172+/-61 months for azathioprine, 91+/-49 months for cyclosporine, and 57+/-28 months for tacrolimus, respectively. During the observational period, 37 patients died (21 patients died of cancer) and 51 patients were still alive (7 grafts failed). CONCLUSIONS: The incidence of malignancy after renal transplantation increases according to the longer follow-up period. An active screening program is needed to lower the incidence of malignancy in renal transplant recipients.
Azathioprine ; Carcinoma, Renal Cell ; Cervix Uteri ; Cyclosporine ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Incidence* ; Kidney ; Kidney Transplantation ; Lymphoma ; Male ; Mass Screening ; Prognosis ; Retrospective Studies ; Sarcoma, Kaposi ; Stomach Neoplasms ; Tacrolimus ; Thyroid Neoplasms ; Transplantation* ; Transplants

Combined liver-kidney transplantation (LKT) has been increasingly performed procedure for end-stage liver and kidney disease. We experienced four cases of LKT. All patients were affected by viral hepatopathy. There were three patients of hepatocellular carcinoma, treated with trans-arterial chemoembolization or chemotherapy and one cirrhotic patient. The causes of chronic renal failure were polycystic kidney disease in one patient, glomerulonephropathies in two, and diabetes mellitus in one. Three of them were on dialysis treatment. All patients were selected based on blood group identity and negative cross-match before LKT. There was no post-operative surgical complication or acute rejection. At the mean follow-up of 37 months after LKT, all patients showed normal hepatic and renal function except for one case of biopsy-proven tacrolimus nephrotoxicity. Seroconversions of HBsAg, HBeAg, and HBV-DNA were achieved in hepatitis B positive patients. However, HCV-RNA was sustained in hepatitis C positive patient after LKT. Alpha-fetoprotein was normalized in every HCC patient. Combined liver-kidney transplantation can be a proper therapeutic procedure for the patient with liver failure and irreversible renal disease, and it can be done safely and effectively.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Diabetes Mellitus ; Dialysis ; Drug Therapy ; Follow-Up Studies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis C ; Humans ; Kidney ; Kidney Diseases ; Kidney Failure, Chronic ; Liver ; Liver Failure ; Polycystic Kidney Diseases ; Tacrolimus ; Transplantation