Chan-Soon Park

Catholic University of Korea, Sŏul, Seoul, South Korea

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Publications (15)21.11 Total impact

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    ABSTRACT: Objective Obstructive sleep apnea syndrome (OSAS) activates the stress response system, including the hypothalamic–pituitary–adrenocortical (HPA) axis. The salivary cortisol, as an index of free circulating cortisol levels, may be used as a measure of HPA axis activity. We examined the change in the salivary cortisol level in pediatric OSAS patients before and after adenotonsillectomy (AT). Methods Forty-eight subjects from 80 subjects suspicious of having OSAS were diagnosed with OSAS by overnight PSG, 34 of 48 OSAS patients undergoing AT, and 13 of 34 OSAS patients were finally enrolled prospectively for this study. Before and three months after the AT, the saliva was collected at night before PSG (n-sCor) and in the early morning after PSG (m-sCor) for the measurements of the salivary cortisol level. Results Children in the study population (n = 13) were divided into mild (1⩽ AHI <5, n = 5), moderate (5⩽ AHI <10, n = 3), and severe (10⩽ AHI, n = 5) OSAS groups. The mean preoperative AHI in the children was 14.7, and the mean postoperative AHI was 0.33. The percentage of children with AHI <1 after AT was 92.3%. Postoperative m-sCor, the difference of cortisol level (sub-sCor: m-sCor minus n-sCor), and the ratio of cortisol level (r-sCor: m-sCor/n-sCor) showed significant difference postoperatively. Conclusions AT was associated with improvements in PSG and subjective symptoms in pediatric OSAS patients. In addition, these improvements were significantly related to normalization of salivary cortisol level after AT. Although further study on salivary cortisol levels needs to be done, the measurement of salivary cortisol level before and after AT may predict the outcome of AT as a treatment of OSAS.
    Sleep Medicine. 01/2014;
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    ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Subjects (N=80) were divided into control (n=32, apnea-hypopnea index [AHI]<1) and OSAS (n=48, AHI⩾1) groups; the OSAS group was subdivided into mild (1⩽AHI<5) and moderate to severe (AHI⩾5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.
    Sleep Medicine 07/2013; · 3.49 Impact Factor
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    ABSTRACT: Objective Adenotonsillar hypertrophy is considered the most common cause of pediatric obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the relationships between tonsil/adenoid size, parameters of polysomnography, and subjective sleep symptoms.Study DesignCase-control studies.SettingTertiary care center.Subjects and MethodsA 4-point tonsil grading method and adenoid-nasopharynx (AN) ratio were used to categorize tonsil and adenoid size, respectively. Sleep questionnaires (Korean version of the Obstructive Sleep Apnea-18 [KOSA-18]) and full-attended polysomnography were performed.ResultsThe subjects (n = 70) were divided into a control group (n = 31, apnea-hypopnea index [AHI] <1) and an OSAS group (n = 39, AHI ≥1), which was subdivided into mild and moderate to severe groups. Tonsil/adenoid size showed a statistically significant difference between control and OSAS groups, but these differences had no clinical significance. In addition, tonsil/adenoid size did not differ significantly among 2 OSAS severity subgroups. Only adenoid size in the total and OSAS groups was related to quality of life (QOL) by the KOSA-18. The AN ratio was related to lowest oxygen saturation only in the OSAS group, especially in the moderate to severe OSAS group, but tonsil size was related to flow limitation in total and supine positions in the control group. In the control group, flow limitation was not associated with QOL.Conclusion Tonsil/adenoid size did not predict the severity of AHI. Nevertheless, adenoid size might be related to lowest oxygen saturation, which is thought to be related to subjective symptoms. Although flow limitation was related to tonsil size but not to QOL in the control group, further research will be needed to understand the importance of flow limitation and upper airway resistance syndrome in the pediatric population.
    Otolaryngology Head and Neck Surgery 05/2013; · 1.73 Impact Factor
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    ABSTRACT: To compare clinical manifestations and polysomnographic data of sleep-disordered breathing (SDB) in younger (less than 30 years old) versus older premenopausal women. A cohort of 420 premenopausal women diagnosed with SDB in a university sleep clinic during a 5-year period underwent systematic collection of clinical and polysomnographic variables. One-hundred and fifteen (27.4%) women were younger than 30 (mean 24.5 ± 3.5 years), while 305 (72.6%) were older than 30 (mean 39.5 ± 5.7 years). The younger premenopausal women had less severe SDB with a trend towards upper-airway resistance syndrome. Despite similar daytime consequences, snoring was less common in the younger group. Both groups of premenopausal women frequently had insomnia and nasal abnormalities or craniofacial-deficiency. Recognizing the different clinical features and understanding the different polysomnographic presentation of SDB in young premenopausal women are crucial to detecting and treating this syndrome.
    Sleep Medicine 05/2012; 13(6):656-62. · 3.49 Impact Factor
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    ABSTRACT: The management of allergic rhinitis (AR) encompasses education, pharmacotherapy, immunotherapy, and surgery. FK506 (tacrolimus) is an immunosuppressant that inhibits allergic reactions. The purpose of this study was to reveal whether FK506 treatment reduces allergic inflammation in an AR mouse model and to elucidate the mechanisms. Forty mice were divided into four groups: control, AR, FK (FK506), and dexamethasone (DEX). All mice except for the control group were sensitized by an i.p. injection of ovalbumin (OVA). After sensitization, the FK and DEX groups were treated with FK506 and DEX intranasally. All sensitized mice were challenged intranasally with OVA. Allergic symptoms and tissue eosinophil counts were recorded. Interleukin (IL)-5, interferon gamma, and IL-10 levels in nasal lavage fluid (NALF) and serum OVA-specific IgE levels were measured. T-bet, GATA-3, and Foxp3 mRNA expression in splenic mononuclear cells were determined by real-time polymerase chain reaction. In the FK group and DEX group, allergic symptoms, serum OVA-specific IgE, tissue eosinophil counts, IL-5 in NALF, and GATA-3 mRNAs expression decreased (p < 0.05), and IL-10 in NALF and Foxp3 mRNAs expression increased compared with the AR group (p < 0.05). No significant difference was observed between the FK group and the DEX group. These results suggest that topical FK506 may reduce allergic inflammation and have potency equal to DEX in the AR model. This mechanism may involve not only Th2 cells but also regulatory T cells. Additional studies are needed on FK506, but in the future, we can consider FK506 as an alternative to topical steroids in the treatment of AR.
    American Journal of Rhinology and Allergy 03/2012; 26(2):e71-5.
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    ABSTRACT: To investigate the anti-inflammatory effect of levocetrizine (LCEZ) on the intracellular adhesion molecule-1 (ICAM-1) in human nasal epithelial cells stimulated by TLR3 and further analyze the anti-inflammatory mechanism of LCEZ in the MyD88-independent pathway before NF-κB is activated. A primary culture of human nasal epithelial cells (HNECs) was generated from nasal polyps. After stimulation of epithelial cells with LTA, double-stranded RNA (dsRNA), and LPS, reverse transcription-polymerase chain reaction (RT-PCR) was performed at 1, 6, and 24 h to clarify the optimal stimulation of ICAM-1 in HNECs. To investigate the anti-inflammatory effects of LCEZ, HNECs were pretreated with three different concentrations of LCEZ (500, 50, and 5 nM) for 2 h. HNECs were washed and then stimulated with dsRNA. At 1, 6, and 24 h after stimulation, the level of ICAM-1 was measured by RT-PCR and ELISA. Western blots for TRIF and RIP were performed. The level of ICAM-1 was significantly elevated by dsRNA. Pretreatment with LCEZ decreased the secretion of ICAM-1, which was observed in RT-PCR and Western blots but not in ELISA analyses. The expression of TRIF and RIP, measured by Western blot, was decreased by pretreatment with LCEZ. The activation of HNECs by TLRs (especially TLR3) could trigger an inflammatory process, which might be inhibited by LCEZ through the suppression of TRIF and RIP proteins.
    Auris, nasus, larynx 02/2011; 38(4):474-9. · 0.58 Impact Factor
  • Chan-Soon Park, Jin-Hee Cho, Yong-Jin Park
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    ABSTRACT: To investigate the role of single-nucleotide polymorphisms (SNPs) in the gene encoding Toll-like receptor (TLR) 2 in Korean patients with chronic rhinosinusitis (CRS) and controls. A case-control study. Subjects (N = 214) were all adults (>20 years old) and were divided into patients with CRS (n = 106) and controls (n = 108). Five SNPs (rs1898830, rs3804099, rs3804100, R677W, and rs5743708) were selected and genotyped in a case-control study with the single-base-pair primer extension (SNaPshot) assay. The case-control study revealed that 2 SNPs in TLR2, rs3804099 (odds ratio [OR] = 2.88; 95% confidence interval [CI] = 1.17-7.09; P = .022) and rs3804100 (OR = 3.76; 95% CI = 1.42-9.96; P = .008), showed significant differences in minor allele frequency between CRS patients and controls. These 2 SNPs were correlated with CRS risk in Korean patients. Two SNPs in TLR2 may be associated with increased risk of CRS in Korean subjects.
    Otolaryngology Head and Neck Surgery 01/2011; 144(1):96-100. · 1.73 Impact Factor
  • Chan-Soon Park, Dong-Hee Lee
    Otolaryngology Head and Neck Surgery 07/2010; 143(1):171; author reply 171-2. · 1.73 Impact Factor
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    ABSTRACT: Treatment of olfactory dysfunction is very difficult and has limited modality. Treatment with steroids has been used in patients with olfactory dysfunction but the side effects of steroid need to be weighed against its potential benefits. In the present study, the effect of systemic administration of dexamethasone and EGb 761 on damage to olfactory mucosa produced by zinc sulfate was examined. Expression of the immediate-early antigen (IEG), c-fos, in the olfactory bulb and piriform cortex was used to determine the effects of treatment. Young adult CD1 mice (6 to 8 weeks old, male) were used. After anosmic mice were made by bilateral intranasal irrigation with 0.2 ml of 5% (0.17 M) zinc sulfate, anosmia was confirmed by a food finding test. Four groups of anosmic mice were studied: a steroid group (steroid injection group, n=12), an EGb group (EGb injection group, n=12), a steroid-EGb group (steroid and EGb injection group, n=12), and a control group (anosmic mice and no Tx. n=12). The olfactory bulb and piriform cortex of four mice in each group were obtained at 1, 2, and 3 weeks after instillation of zinc sulfate by cardiac perfusion, and immunohistochemical staining for c-fos was also performed to evaluate brain activity. In approximately 10 well-defined glomeruli of the olfactory bulb and in one side of the piriform cortex, c-fos (+) cells were counted. Statistical analyses were performed by Kruskal-Wallis one-way analysis of variance (ANOVA) by rank. In all experimental groups, c-fos (+) cells increased in a time-dependent manner. The combination treatment of steroid and EGb was the most effective and the no-treatment group the least effective 1 week later after zinc sulfate irrigation. However, 3 weeks later after zinc sulfate irrigation, there was no statistically significant differences in the number of c-fos positive cells among all 4 groups (3 treatment groups and the control group). The combination treatment of EGb and steroid enhanced the regeneration of the olfactory pathway after olfactory mucosal injury by zinc sulfate. Our study suggests that EGb could be an effective treatment option for olfactory dysfunction.
    Auris, nasus, larynx 12/2008; 36(3):287-91. · 0.58 Impact Factor
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    ABSTRACT: To investigate the effect of rosiglitazone, a synthetic selective peroxisome proliferator-activated receptor (PPAR)-gamma agonist, for cytokine production and PPAR-gamma expression in nasal mucosa. Mice in allergic rhinitis group received ovalbumin sensitization followed by ovalbumin intranasal challenge. Mice in the rosiglitazone group received rosiglitazone treatment additionally. Various allergic responses were then assessed. The frequency of nasal rubs and ovalbumin-specific immunoglobulin E decreased significantly in the rosiglitazone group compared with the allergic rhinitis group. The rosiglitazone group also showed that inflammation was markedly reduced by rosiglitazone administration. Immunohistochemistry showed that PPAR-gamma protein expression in nasal mucosa was enhanced in the allergic rhinitis group and the rosiglitazone group compared with control mice. PPAR-gamma activation with rosiglitazone effectively inhibited allergic symptom development, nasal mucosal inflammation, and production of ovoalbumin-specific immunoglobulin E and Th2-type cytokine. Our results provide evidence of the therapeutic potential of PPAR-gamma agonist for the treatment of allergic rhinitis.
    Otolaryngology Head and Neck Surgery 08/2008; 139(1):124-30. · 1.73 Impact Factor
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    ABSTRACT: We present a rare case of an infratemporal fossa mucocele with facial paresthesia in a 36-year-old man. Both computerized tomography scans and magnetic resonance imaging confirmed a cystic lesion occupying the left infratemporal fossa. Marsupialization using transmaxillary and endoscopic intranasal approaches was performed to drain the mucocele into the nasal cavity and the application of mitomycin C to preserve the drainage of mucocele, which may be a good surgical option for the complete excision of infratemporal fossa cystic lesions without causing postoperative morbidity.
    Auris Nasus Larynx 12/2007; 35(3):455-8. · 0.95 Impact Factor
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    ABSTRACT: To investigate the effect of nasal mucosal inflammation on bone remodeling and the inhibitory effect of macrolide antibiotics on bone remodeling through the inhibition of receptor activator of nuclear factor-kappaB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). Human nasal fibroblasts were primary-cultured from nasal polyp. After interleukin (IL)-1beta stimulation of fibroblasts with or without macrolide pretreatment, real-time polymerase chain reaction for RANKL messenger RNA (mRNA) and enzyme-linked immunosorbent assay for M-CSF were performed at various intervals. Peripheral blood mononuclear cells (PBMCs) were cultured for 10 days with M-CSF only, M-CSF plus RANKL, or macrolide antibiotic plus M-CSF and RANKL. IL-1beta stimulation of nasal polyp fibroblasts induced expression of RANKL mRNA and secretion of M-CSF. Macrolide antibiotics reduced RANKL mRNA and M-CSF expression by nasal polyp fibroblasts in a dose-dependent manner, and inhibited osteoclastogenesis from PBMCs. Nasal fibroblasts stimulated with IL-1beta may take on the role of osteoblasts in osteoclastogenesis, which may be inhibited by macrolide antibiotics.
    Otolaryngology Head and Neck Surgery 09/2007; 137(2):274-9. · 1.73 Impact Factor
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    ABSTRACT: Osteoma in the external auditory canal (EAC) is an uncommon benign lesion, which presents as a solitary, unilateral, and slow-growing pedunculated mass in the outer half of the bony canal. It is usually asymptomatic; but symptoms can arise if a canal obstruction occurs. External canal cholesteatoma is also a rare lesion of the external auditory canal. Cholesteatoma of the external auditory canal may arise via several mechanisms. However, an occlusion or narrowing of the external auditory canal is the basic pathogenesis. The association of an osteoma with a cholesteatoma is extremely rare, and there have been very few reports published. We encountered a rare case of a 49-year-old man with an osteoid osteoma that was complicated by a cholesteatoma in the external auditory canal. The canal wall down mastoidectomy and tympanoplasty successfully removed the osteoma and the cholesteatoma, and no recurrence or complications had occurred in the first 6 months postoperatively.
    Auris Nasus Larynx 10/2005; 32(3):281-4. · 0.95 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the usefulness of a three-dimensional (3D) reconstruction of computed tomography (CT) images in determining the anatomy and topographic relationship between various important structures. Using 40 ears from 20 patients with various otological diseases, a 3D reconstruction based on the image data from spiral high-resolution CT was performed by segmentation, volume-rendering and surface-rendering algorithms on a personal computer. The 3D display of the middle and inner ear structures was demonstrated in detail. Computer-assisted measurements, many of which could not be easily measured in vivo, of the reconstructed structures provided accurate anatomic details that improved the surgeon's understanding of spatial relationships. A 3D reconstruction of temporal bone CT might be useful for education and increasing understanding of the anatomical structures of the temporal bone. However, it will be necessary to confirm the correlation between the 3D reconstructed images and histological sections through a validation study.
    The Journal of Laryngology & Otology 10/2005; 119(9):693-8. · 0.68 Impact Factor
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    ABSTRACT: To evaluate change of the maxillary sinus volume according to patient age and gender by using a 3-dimensional (3-D) reconstruction of computed tomography images. One hundred seventy-three people (totaling 238 maxillary sinuses) who had undergone paranasal sinus CT scan between December 2000 and November 2003 and had no evidence of inflammation or hypoplasia in the CT finding and had no specific history of paranasal sinus surgery or maxillofacial trauma were retrospectively analyzed. The 3-D reconstruction images were obtained by using a surface-rendering technique (Vworks; CybeMed, Seoul, Korea) on a personal computer. The mean volume of maxillary sinus was evaluated according to patient chronologic age and gender. The ratio of the maximum horizontal and half-horizontal extension for the estimation of the morphological change of maxillary sinus and the degree of descent of the sinus below the nasal floor were evaluated in the 3-D image. The development of the maxillary sinus continued until the 3rd decade in males and until the 2nd decade in females. The mean maxillary sinus volume in early adults was 24,043 mm 3 (males) and 15,859.5 mm 3 (females). There was a significance difference in the sinus volume ( P < 0.05) according to gender, and there was a significant difference in the maxillary sinus volume according to age before it reached maximum. After its maximum growth period, however, there was no significant difference in the volume change of maxillary sinus and the descent below the nasal floor between two adjacent groups. The growth of the maxillary sinus continues until the 3rd decade in males and the 2nd decade in females. Therefore, a maxillary sinus operation affecting the bony structures before these ages might affect the development of the sinus and needs to be performed carefully.
    Otolaryngology Head and Neck Surgery 04/2005; 132(3):429-34. · 1.73 Impact Factor

Publication Stats

43 Citations
21.11 Total Impact Points


  • 2007–2014
    • Catholic University of Korea
      • College of Medicine
      Sŏul, Seoul, South Korea
  • 2012
    • Stanford University
      Palo Alto, California, United States