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ABSTRACT: STUDY OBJECTIVE: To compare the effects of aminophylline and doxapram on recovery, respiration, and bispectral index (BIS) values in patients after total intravenous anesthesia (TIVA) with propofol and remifentanil. DESIGN: Prospective, randomized, blinded clinical trial. SETTING: Operating room of a university hospital. PATIENTS: 90 adult, ASA physical status 1 and 2 patients scheduled for elective laparoscopic vaginal hysterectomy. INTERVENTIONS: TIVA was performed with the induction target of remifentanil 3 ng/mL and propofol 6 μg/mL, followed by the maintenance target of remifentanil 1-3 ng/mL and propofol 3-5 μg/mL at the effect site, and with BIS scores in 40-50 range. Patients were randomized to three groups to receive intravenous (IV) aminophylline 3 mg/kg (n = 30), IV doxapram 1 mg/kg (n = 30), or normal IV saline (control; n = 30). MEASUREMENTS AND MAIN RESULTS: After administration of the study drugs, return to spontaneous ventilation differed significantly among the three groups. The time to eye opening and hand squeezing on verbal command were similar. The time to extubation was shortened in both the doxapram aminophylline groups (P < 0.05). Tidal volumes were increased in the doxapram group at 5-14 minutes, and the aminophylline group, at 5-12 minutes (P < 0.05). Respiratory rates were increased at 2 to 8 minutes and then showed a decrease at the 12 to 14-minute mark in both the doxapram and aminophylline groups (P < 0.05). No difference was noted between the two groups. BIS values were increased in both the doxapram and aminophylline groups at 4-10 minutes (P < 0.05). Heart rates were increased in the doxapram group for the first 8 minutes, and at 1-2 minutes in the aminophylline group (P < 0.05). CONCLUSION: Aminophylline 3 mg/kg or doxapram 1 mg/kg shortened the time to spontaneous ventilation and improved early recovery from TIVA without appreciable side effects. The more rapid emergence correlates with higher BIS values when compared with the saline control group. The arousal and respiratory effects of aminophylline were comparable to those of doxapram.
Journal of clinical anesthesia 04/2013; · 1.32 Impact Factor
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ABSTRACT: OBJECTIVES/HYPOTHESIS: Several genes have been reported to be upregulated in human nasal polyps in previous genetic analyses. Among these genes, periostin is known to be overexpressed in nasal polyps obtained from aspirin-sensitive patients. Using periostin-null mice, we investigated the role of periostin in a murine model of eosinophilic rhinosinusitis with nasal polyps. STUDY DESIGN: Animal study. METHODS: Eosinophilic rhinosinusitis was induced in both periostin-null and wild-type mice according to previously established protocols. In brief, ovalbumin (OVA) was used for sensitization and prolonged intranasal stimulation. Staphylococcus aureus enterotoxin B was applied intranasally to develop polyplike lesions. To examine the inflammation and mucosal lesions, hematoxylin and eosin, Sirius red, and Giemsa staining were performed. RESULTS: There was no definite difference in the maximal mucosal thickness between periostin-null and wild-type mice. In contrast, some parameters of inflammation, including the number of polyplike lesions and mast cells, were aggravated in the periostin-null mice compared to wild type. Eosinophilic infiltration was aggravated in the OVA-stimulated periostin-null mice, compared to OVA-stimulated wild-type mice, whereas there was no apparent difference between wild-type and periostin-null mice challenged with additional S aureus enterotoxin B. CONCLUSIONS: The loss of periostin appears to enhance polyplike lesion formation and mast cell infiltration in a mouse model of eosinophilic rhinosinusitis with nasal polyps.
The Laryngoscope 11/2012; · 1.75 Impact Factor
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ABSTRACT: The patient-controlled sedation (PCS) allows for rapid individualized titration of sedative drugs. Propofol has been the most widely used IV adjuvant, during the monitored anesthesia care (MAC). This study was designed to compare the sedation quality, side effect and recovery of the propofol alone, and propofol-remifentanil combination, using PCS for breast biopsy.
Seventy five outpatients, undergoing breast biopsy procedures with local anesthesia, were randomly assigned to receive propofol alone (group P), propofol-25 ug/ml of remifentanil (group PR25), and propofol-50 ug/ml of remifentanil (group PR50), using PCS. Pain visual analogue scores (VAS) and digit symbol substitution test (DSST), Vital signs, bi-spectral index (BIS) and observer assessment of alertness and sedation (OAA/S) score were recorded.
Apply/Demand ratio in the group PR50 had a significant increase over the other groups (P < 0.05). The incidence of excessive sedation and dizziness were significantly more frequent in the group PR50 (P < 0.05). BIS and OAA/S score significantly decreased in the group PR25, PR50 at 15 min after the operation, the end of surgery (P < 0.05). At 5 min after the start of PCS, patients in the group PR25 and PR50 gave significantly less correct responses on the DSST than that of the group P (P < 0.05).
Compared with the propofol alone, intermittent bolus injection of propofol-remifentanil mixture could be used, appropriately, for the sedation and analgesia during MAC. The group PR25 in a low dose of remifentanil has more advantages in terms of sedation and satisfaction because of the group PR50's side effects.
Korean journal of anesthesiology 11/2012; 63(5):431-5.
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ABSTRACT: This study investigated the efficacy of glove finger-coated polyvinyl acetate (PA) pack on hemostasis, pain levels, and wound healing after endoscopic sinus surgery (ESS).
A prospective, randomized, double-blinded controlled study was performed in 30 patients who underwent bilateral ESS for chronic rhinosinusitis. Fifteen patients (control group) had both nasal cavities packed with PA pack (Merocel; Medtronic Xomed, Jacksonville, FL) and another 15 subjects (experimental group) had their nasal cavities packed with PA in a glove finger. Pain levels were assessed by patients on a visual analog scale 12 hours after surgery and at the time of packing removal. The amount of bleeding on removal were quantified by weighing it after removal. Lund-Kennedy score and synechiae formation were assessed at 4, 8, and 12 weeks after surgery. The use of analgesics and oral steroid was compared between the two groups.
The experimental group showed lower levels of pain and lessened bleeding during packing removal than the control group. There were no differences in pain levels at 12 hours after surgery, use of analgesics and oral steroid between the two groups. One (6%) of each group had postoperative bleeding and required additional packing for hemostasis. Lower Lund-Kennedy score at postoperative 4 weeks was documented in the experimental group. In addition, two (13%) control subjects developed a synechiae between the middle turbinate and the lateral wall.
PA packing in a glove finger is advantageous in terms of pain, bleeding on packing removal, and postoperative wound healing, compared with PA pack only.
American Journal of Rhinology and Allergy 09/2012; 26(5):147-9.
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ABSTRACT: With the advancement of transnasal endoscopic technique, endoscopic repair of basal skull fractures has considerably substituted former external approaches. The endoscopically feasible pedicled flap, named nasoseptal flap has been extending its range of application, since it was introduced for the reconstruction of the defect after resection of skull base tumors. We introduce two patients with complicated basal skull fractures at different sites who were successfully treated by the transnasal endoscopic approach using nasoseptal flap.
Auris, nasus, larynx 08/2012; · 0.58 Impact Factor
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Jung Ah Lee,
Jin Woo Choi,
Jang Hyeok In,
Hong Soo Jung,
Yong Shin Kim,
Yeon Soo Jeon,
Yoo Jin Kang, Dae Woo Kim,
Yong Gul Lim,
Jae Hee Park,
Jin Deok Joo
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ABSTRACT: We previously demonstrated that there are acute and delayed phases of renal protection against renal ischemia and reperfusion (IR) injury with renal ischemic preconditioning (IPC). This study assessed whether hepatic IPC could also reduce distant renal IR injury through the blood stream-mediated supply of reactive oxygen species (ROS). Male C57BL/6 mice were randomly divided into four groups: group I, sham operated including right nephrectomy; group II (IR), left renal ischemia for 30 min and reperfusion injury; group III (IPC-IR), hepatic ischemia for 10 min followed by 10 min of reperfusion before left renal IR injury; group IV (MPG - IPC + IR), pretreated with 100 mg/kg N-(2-mercaptopropionyl)-glycine (MPG) 15 min before hepatic IPC and left renal IR injury. Renal function, histopathologic findings, proinflammatory cytokines, and cytoprotective proteins were evaluated 15 min or 24 hr after reperfusion. Hepatic IPC attenuated the expression of proinflammatory cytokines, tumor necrosis factor α, intercellular adhesion molecule 1, and induced inducible nitric-oxide synthase, and the phosphorylation of Akt in the murine kidney. Renal function was better preserved in mice with hepatic IPC (group III) than groups II or IV. Hepatic IPC protects against distant renal IR injury through the blood stream-delivery of hepatic IPC-induced ROS, by inducing cytoprotective proteins, and by inhibiting inflammatory reactions.
Journal of Korean medical science 05/2012; 27(5):547-52. · 0.84 Impact Factor
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Hyun-Woo Shin,
Kumsun Cho, Dae Woo Kim,
Doo Hee Han,
Roza Khalmuratova,
Sang-Wook Kim,
Sea-Yuong Jeon,
Yang-Gi Min,
Chul Hee Lee,
Chae-Seo Rhee,
Jong-Wan Park
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ABSTRACT: Nasal polyposis implies a refractory clinical course in case of chronic rhinosinusitis (CRS). Although hypoxia is believed to be associated with nasal polyposis, little is known about the mechanism underlying polypogenesis.
To determine if hypoxia drives nasal polyposis by epithelial-to-mesenchymal transition (EMT).
Immunoblotting, immunofluorescence, flow cytometry, and real-time polymerase chain reaction were performed to evaluate EMT and hypoxic markers in human nasal epithelial cells (hNECs) and in sinonasal tissues from patients with CRS with or without polyps. In addition, the effects of hypoxia-inducible factor (HIF)-1α inhibitors on nasal polypogenesis were investigated in a murine model.
E-cadherin and α-smooth muscle actin (α-SMA) were down-regulated and up-regulated, respectively, in patients with polyps as compared with patients without polyps. Under hypoxia, hNECs transformed to a mesenchymal shape, and demonstrated representative changes in EMT markers; that is, mesenchymal markers (α-SMA, vimentin, and twist) increased but epithelial markers (E-cadherin and β-catenin) decreased. Mechanistically, E-cadherin level was recovered in hypoxia by silencing HIF-1α and decreased in normoxia by expressing HIF-1α. Furthermore, hypoxia was found to down-regulate PP2Ac phosphatase and up-regulate pSmad3, which led to α-SMA induction. In CRS sinonasal specimens, HIF-1α expression was found to correlate with E-cadherin loss and α-SMA expression. Finally, HIF-1α inhibitors suppressed nasal polypogenesis in a murine model.
hNECs undergo EMT during hypoxia and this process is critically mediated by HIF-1α and pSmad3. This study shows that hypoxia-induced EMT is likely to contribute to nasal polyposis in CRS, and suggests that HIF-1α be viewed as a therapeutic target for nasal polyposis.
American Journal of Respiratory and Critical Care Medicine 02/2012; 185(9):944-54. · 11.08 Impact Factor
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ABSTRACT: To investigate the clinical characteristics and the natural course of recurrent vestibulopathy (RV).
Retrospective study.
During the period April 2002 to February 2008, we reviewed the clinical records of 98 patients diagnosed with RV. All patients were approached by telephone and using a questionnaire. The analysis included age, sex distribution, natural history, pure-tone audiometry, caloric response, age at onset, and the characteristics of vertigo.
Median follow-up was 63.1 months (range, 24-103 months). Patients had a mean age at onset of 39 years and a mean duration of 4.2 years. An obvious female predilection was found, and unilateral caloric paresis (≥ 25%) was seen in 35%. Of the 98 patients, symptoms resolved in 82% but were unchanged in 12%. RV developed to Ménière's disease in four patients and to migraine in two. No patient with RV developed a central nervous system disease or benign paroxysmal positional vertigo during follow-up.
The study suggests that in the majority of cases, vertigo spontaneously resolves and that the risks of development to Ménière's disease or migraine are low.
The Laryngoscope 01/2012; 122(4):883-6. · 1.75 Impact Factor
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ABSTRACT: The aim of this prospective analysis was to objectify and quantify the sensory loss in the auricular area that occurs following surgery for chronic otitis media or cholesteatoma, and to assess the exact recovery time of the auricular sensation. Till now, no study has yet been conducted on the sensory loss that is developed after retroauricular incision is performed for chronic ear surgery. Forty-eight patients underwent surgery via retroauricular incision for chronic otitis media or for chronic otitis media or cholesteatoma between March 2009 and January 2010. The skin around the auricle was divided into six areas. The sensation of each area was assessed before the surgery and 3 days, 7 days, 1 month, 3 months, and 6 months after the surgery, using the Semmes-Weinstein monofilaments. The patients were also asked to record the sensation that they felt using the visual analog scale (VAS). In the objective sensory assessment, only area 5, which corresponds to the retroauricular area, showed significant sensory loss. Three months after the surgery, the sensation was recovered to a level comparable to that before the surgery in most of the patients. The mean subjective VAS score was 10 prior to the surgery, 8.56 (± 1.08) 3 months after the surgery, and 9.32 (± 0.74) 6 months after the surgery, respectively. In conclusion, following chronic ear surgery, the sensation of the auricle was recovered to the previous level within 3 months. Therefore, patients who are to undergo retroauricular incision should be informed that they will experience temporary sensory loss for approximately 3 months after the surgery.
Archives of Oto-Rhino-Laryngology 05/2011; 269(1):101-6. · 1.29 Impact Factor
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ABSTRACT: Postoperative treatment after functional endoscopic sinus surgery (FESS) aims to modulate the wound healing process. Systemic or topically applied corticosteroids have been reported to be beneficial for improving nasal wound healing after FESS. However, few studies have investigated the effects of postoperative systemic steroids on nasal wound healing with regard to histological changes. The aim of this study was to evaluate the effect of systemic dexamethasone on nasal wound healing after mechanical injury in the rat.
A unilateral wound in the nasal cavity was induced using the brushing technique in 4-week-old, Sprague-Dawley rats (n = 70). Dexamethasone (0.15 mg/kg daily for 7 days) and normal saline were administered i.p. to the experimental and control groups (n = 35 for each) after the injury. The rats (n = 7 for each) were killed on days 2, 5, 14, 28, and 42 after the injury. Histological changes in the nasal mucosa were examined and compared using hematoxylin and eosin and Masson's trichrome staining.
The experimental group showed less subepithelial edema formation and epithelial disarray at the early phase of the wound healing period. There were statistically significant differences in the subepithelial thickness and epithelial thickness indices between the experimental and control groups (p < 0.05). Ciliary and goblet cell indices were lower in the experimental group, which means that ciliary and goblet cell regeneration may be delayed by dexamethasone (p < 0.05). There were no differences in the subepithelial fibrosis index between the two groups. Adhesion formation between the nasal septum and turbinate were found only in the control group.
Systemic dexamethasone after mucosal injury may lessen subepithelial edema, goblet cell hyperplasia, and adhesion formation; however, it may cause delayed mucosal ciliary regeneration.
American Journal of Rhinology and Allergy 05/2011; 25(3):112-6.
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ABSTRACT: We present a 32-year-old, extremely obese, pregnant woman who developed severe hypotension and water intoxication after an accidental injection of large bolus of oxytocin during cesarean section under general anesthesia. The patient was initially thought to have an amniotic fluid embolism because of the abrupt hemodynamic changes developed immediately after fetal delivery and lack of recognition of medication error. It is highly recommended that careful attention should be paid not only to the possibility of hemodynamic deterioration and water intoxication if oxytocin is given rapidly in excessive doses, but to the confirmation of the proper use of the drug before it is injected.
Korean journal of anesthesiology 04/2011; 60(4):290-3.
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ABSTRACT: Preoperative inflammation of the olfactory cleft may cause not only the obstruction of this area, but also damage of the olfactory neuroepithelium, resulting in anosmia. Therefore, the evaluation of the affected olfactory cleft by computed tomography (CT) might help predict postoperative olfaction.
Fifty-two patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis (CRS) with nasal polyps were examined preoperatively and at 6 months after surgery. OMU CT was obtained preoperatively and olfactory function tests such as the butanol threshold test, the cross-cultural smell identification test, and questionnaires were performed at the initial preoperative visit and at 6 months after surgery. The correlation between the status of the olfactory cleft on CT and the postoperative olfactory results were investigated.
The findings of olfactory cleft opacification and the CT scores had a negative correlation with preoperative olfactory results (p < 0.05). The olfactory cleft opacification showed a stronger correlation with the preoperative olfactory results than the CT score. The total olfactory cleft opacification score and anterior olfactory cleft opacification score (AOCS) were more significantly correlated with the postoperative olfactory results than the other parameters (p < 0.05). Among the CT findings, the AOCS was a significant prognostic factor of olfactory results after surgery; these findings were significant on multiple regression analysis (p < 0.05). The postoperative olfactory scores and the improvement of olfactory scores after surgery were increased more in the mild AOCS group than in the moderate and severe AOCS groups (p < 0.05). Recovery and normosmia rates were much better in the mild AOCS group in this study (p < 0.05).
Preoperative CT findings, especially the anterior portion of the olfactory cleft, had a statistically significant association with the postoperative olfactory results in patients with CRS with nasal polyps.
American Journal of Rhinology and Allergy 03/2011; 25(2):e90-4.
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ABSTRACT: There have been few studies about the effect of histamine on ciliary beat frequency (CBF) in the acute phase of allergic rhinitis.
The present study was designed to investigate CBF in the acute phase of allergic rhinitis and the effect of histamine on CBF.
Nasal septal mucosae were obtained from 13 mice that had been systemically immunized and locally challenged with ovalbumin (OVA) (group A), 11 OVA immunized and phosphate-buffered saline-challenged mice (group B), and 12 nontreated negative control mice (group C). The CBFs were observed within 20 minutes of local challenge with OVA. Ciliary beat frequencies were measured before and after treatment with 10(-5), 10(-3), and 10(-1) mol/L histamine and after administering antihistamine or Dulbecco's modified Eagle's medium to histamine-exposed mucosa.
The baseline CBF in group A was higher than in groups B and C. After treatment with 10(-1) mol/L histamine, CBF in all groups decreased to 0 within 5 to 7 minutes, whereas treatment with 10(-5) or 10(-3) mol/L histamine had no effect. The application of 100 μmol/L fexofenadine or Dulbecco's modified Eagle's medium solution restored histamine-induced ciliostasis to near baseline CBF after 10 minutes.
Ciliary beat frequency increased in the acute phase of a mouse model of allergic rhinitis. Physiologic concentrations of histamine had no effect on CBF, and thus, it appears that other mechanisms control CBF in the acute phase of allergic rhinitis.
American journal of otolaryngology 02/2011; 32(6):517-21. · 0.77 Impact Factor
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ABSTRACT: Surgical removal of a dermoid cyst is usually accomplished through an external neck incision. However, this procedure inevitably results in a neck scar.
We report the case of a 17-year-old woman with a submental mass. We implemented a modified approach to dermoid cyst removal through the floor of the mouth using an endoscope system.
The patient received a modified approach to dermoid cyst removal and remains free of disease 6 months after excision.
Resection of the submental type dermoid cyst can be performed by an intraoral endoscope-assisted approach through the floor of the mouth. We describe the procedure of the endoscope-assisted intraoral resection.
Head & Neck 01/2011; 34(6):907-10. · 2.40 Impact Factor
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ABSTRACT: Traumatic brain injury (TBI) has been reported to be a common cause of benign paroxysmal positional vertigo (BPPV). However, only a few studies have investigated BPPV after TBI. The aim of this study was to identify the clinical characteristics of BPPV after TBI and to determine whether there are clinical differences between BPPV after TBI and idiopathic BPPV.
The authors reviewed the medical records of 192 consecutive patients with positional vertigo after head injury during the period 2003 to 2009 and investigated 112 patients with idiopathic BPPV treated over the same period. The clinical characteristics of BPPV after TBI and the clinical differences between the traumatic BPPV and idiopathic BPPV groups were investigated.
A total of 32 patients with BPPV after TBI fulfilled the inclusion criteria. Twenty-four patients in the traumatic BPPV group had posterior semicircular canal-BPPV and 11 patients lateral semicircular canal-BPPV. A total of 58 repositioning maneuver sessions were performed in these 32 patients. Members of the traumatic BPPV group required more treatment sessions than members of the idiopathic group (p<0.05), but no tendency to recur was observed in the traumatic group (p>0.05). Recurrence rates in the traumatic and idiopathic BPPV groups were 15.6% and 18.8%, respectively (p>0.05).
It is likely that BPPV after TBI is more difficult to treat than idiopathic BPPV, but no tendency to recur was observed in patients who developed BPPV after TBI compared with idiopathic BPPV. Further prospective clinical meta-analytic studies are needed to investigate the outcome of BPPV after TBI.
The Journal of trauma 05/2010; 70(2):442-6. · 2.48 Impact Factor
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ABSTRACT: The preferred treatment of pediatric intraoral ranulas remains controversial. We present our experience with ranulas at the Gyeongsang National University Hospital and review the literature.
The study involved 17 children under 15 years of age who visited our hospital from 2001 to 2008 and were diagnosed with a ranula exceeding 2 cm in diameter. The age and gender of the patients, the surgical procedures, presurgical observation period, postsurgical follow-up period, and complications of each case were determined. The unruptured specimens were all subjected to detailed pathological analysis.
The patients were on average 9.3 years and there were 10 girls and 7 boys. Spontaneous resolution was not detected in any of the cases during the presurgical observation period. Indeed, in two cases, the ranula had increased in size. The ranula and sublingual gland (SG) were resected in all cases. The average operation time was 1h. Recurrence and complications were not detected in any of the cases. Pathological analyses revealed that there was no communication of the ranula with the SG in any of the cases.
Our experiences suggest that the presurgical observation period need not be longer than 3 months and that the resection of ranulas along with the ipsilateral SG is a safe and effective primary treatment for symptomatic pediatric intraoral ranulas that exceed 2cm in diameter.
International journal of pediatric otorhinolaryngology 12/2009; 74(2):202-5. · 0.85 Impact Factor
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ABSTRACT: A 53-year-old healthy patient was admitted with unilateral nasal obstruction of one month duration which was suspected to be a malignancy because of mass-like finding on radiology and peripheral eosinophilia. The biopsy of the involved sinus showed tissue invasion by aseptate hyphae suggestive of a zygomycete and tissue infiltration of eosinophilia. He was diagnosed as invasive paranasal mucomycosis and treated with complete endoscopic sinus surgery and amphotericin B deoxycholate. Paranasal symptoms with peripheral eosinophilia might be a presentation of invasive fungal sinusitis.
Medical mycology: official publication of the International Society for Human and Animal Mycology 09/2009; 48(2):406-9. · 2.13 Impact Factor
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ABSTRACT: The workers in an animal laboratory are exposed to laboratory animal allergens (LAAs).
To evaluate the difference of sensitization to LAAs and the symptoms according to the exposure levels and to investigate the risk factors for sensitization to LAAs.
The subjects were divided into 3 groups according to the presence or absence of exposure: 74 subjects were in the direct exposure group, 33 subjects were in the indirect exposure group, and 30 subjects were in the control group. Each group answered the questionnaire and underwent skin prick tests that included 10 common allergens and 10 LAAs. The levels of total IgE and specific IgE to mouse and rat urine allergen were measured by enzyme-linked immunosorbent assay in 2 exposure groups. Allergic symptoms, skin sensitization, and serum IgE level were compared between the study groups.
Twenty-five (34%) of the 74 subjects in the direct exposure group experienced allergic symptoms since their exposure to laboratory animals. The subjects in the direct and indirect exposure groups had more sensitization to LAAs than did the control subjects. The direct exposure group had more positive results for total IgE than did the indirect exposure group. The subjects in the direct exposure group with atopy had more severe allergic symptoms than the subjects in the indirect exposure group with atopy. Atopy and total IgE level were risk factors for the sensitization to LAAs for the direct exposure group (odds ratios, 7.47 and 7.33, respectively).
Indirect exposure may be as risky for sensitization to LAAs as direct exposure. More careful protection is needed for laboratory animal workers with atopy.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 06/2009; 102(5):373-7. · 2.83 Impact Factor
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ABSTRACT: Interplay between migraine and balance disorder morbidities has been a topic of interest for many years. Serotonin (5-HT) receptor is closely related with migraine and is associated with vestibular symptoms. The mechanism underlying migrainous vertigo, however, has not been determined. 5-HT1F receptor has recently attracted attention in the treatment of migraine, and the release of glutamate from trigeminal neurons has been implicated in migraine. In this study, the authors observed the colocalization of 5-HT1F receptor and glutamate in the vestibular nuclei of rats using double immunofluorescence, which suggests that 5-HT1F receptor might modulate glutamate release from the vestibular nuclei. The results of this study suggest that 5-HT1F receptor agonists represent a potential therapeutic strategy for migraine and balance disorders by blocking the release of glutamate.
Neuroreport 01/2009; 20(2):111-5. · 1.66 Impact Factor
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ABSTRACT: Sinonasal mucosal melanoma is a rare and aggressive disease. The aim of this study was to analyze the clinical features of patients with sinonasal mucosal melanoma and to determine the role of Ki67 antigen as a predictor of prognosis in sinonasal mucosal melanoma.
This was a retrospective case-series study at a single institution, an academic tertiary referral center. From 1995 to 2007, 27 patients with sinonasal mucosal melanoma were reviewed retrospectively, and the expression of Ki67 antigen was assessed by immunohistochemistry.
The overall 5-yr survival rate was 33.9%. No significant differences were observed in 5-yr survival according to age, sex, stage, or the presence of melanin. The rates of local failure, regional failure, and distant failure were 37.0%, 14.8%, and 11.1%, respectively. Patients with spindle or mixed cell types had better prognoses than those with other cell types. At a cut-off value of 35%, patients with lower Ki67 scores showed better survival than those with higher Ki67 scores.
The presence of spindle or mixed cell types may indicate a better prognosis than other cell types. Ki67 immunostaining may be a useful predictor of prognosis in patients with mucosal malignant melanoma of the sinonasal tract.
Clinical and Experimental Otorhinolaryngology 01/2009; 1(4):206-10. · 0.92 Impact Factor
