Obstructive Sleep Apnea Is Associated With Late-Onset Preeclampsia in Overweight Pregnant Women in Korea

Ryu Gwanghui,김유민,Choi Suk-Joo,Hong Sang Duk,정용기,오수영,Kim Hyo Yeol,이경은 대한의학회 2023 Journal of Korean medical science Vol.38 No.2

Background: Obstructive sleep apnea (OSA) is closely related to maternal obesity in pregnant women, and the association increases with later pregnancy. Obesity and OSA are risk factors of pregnancy-related complications, including gestational hypertension, gestational diabetes mellitus (GDM), and fetal morbidities. We aimed to determine the prevalence of OSA and to assess the impact of OSA on pregnancy-related disorders in overweight pregnant women. Methods: Eligible participants who were overweight [body mass index (BMI) ≥ 23 kg/m2 ] in gestational age 30 weeks or more, assessed OSA using a portable polysomnography at home. Clinical data were collected from pregnant women and their babies. Results: The average age of 51 participants was 34.5 years (27–44 years). The number of primipara was 25 (49%) and that of multipara was 26 (51%). Eight cases of GDM (15.7%) and five cases of preeclampsia (9.8%) were reported, and six patients (11.8%) experienced preterm delivery. In results of polysomnography, 14 patients (27.5%) were diagnosed as OSA. Apnea-hypopnea index moderately correlated with BMI (r = 0.515, P < 0.001). The BMI (P < 0.005) and preeclampsia rate (P < 0.017) were higher in the OSA group compared to the control group. Odds ratios (ORs) adjusting age, BMI, parity, and abortion history were calculated. The presence of OSA increased OR of preeclampsia (OR, 13.1; 95% confidence interval, 1.1–171.3). The majority of preeclampsia patients (4/5, 80%) underwent preterm delivery. Conclusion: OSA is an important risk factor for preeclampsia, resulting in preterm delivery. For overweight pregnant women, an OSA evaluation should be mandatory.

Role of IL-17A in Chronic Rhinosinusitis With Nasal Polyp

Gwanghui Ryu,Jun-Sang Bae,Jihye Kim,Eun Hee Kim,Lele Lyu,Young-Jun Chung,모지훈 대한천식알레르기학회 2020 Allergy, Asthma & Immunology Research Vol.12 No.3

Purpose: Th17-associated inflammation is increased in chronic rhinosinusitis with nasal polyp (CRSwNP), and is associated with disease severity and steroid resistance. Overexpressed interleukin (IL)-17A affects CRSwNP by tissue remodeling, eosinophilic accumulation, and neutrophilic infiltration. We aimed to identify the role of IL-17A in CRSwNP and to evaluate the effects of anti-IL-17A blocking antibody on nasal polyp (NP) formation using a murine NP model. Moreover, we sought to investigate whether the inhibition of mechanistic target of the rapamycin (mTOR) signal pathway could suppress IL-17A expression and NP formation. Methods: Human sinonasal tissues from control subjects and patients with chronic rhinosinusitis (CRS) were analyzed using immunohistochemistry (IHC) and immunofluorescence staining. The effects of IL-17A neutralizing antibody and rapamycin were evaluated in a murine NP model. Mouse samples were analyzed using IHC, quantitative real-time polymerase chain reaction, and enzyme-linked immunosorbent assay. Results: IL-17A+ inflammatory cells were significantly increased in number in NP from patients with CRSwNP compared to that in uncinate process tissues from control subjects and patients with CRS without NP or CRSwNP. CD68+ M1 macrophages dominantly expressed IL-17A, followed by neutrophils and T helper cells, in NP tissues. Neutralization of IL-17A effectively reduced the number of NPs, inflammatory cytokines, and IL-17A-producing cells, including M1 macrophages. Inhibition of IL-17A via the mTOR pathway using rapamycin also attenuated NP formation and inflammation in the murine NP model. Conclusions: IL-17A possibly plays a role in the pathogenesis of CRSwNP, the major cellular source being M1 macrophage in NP tissues. Targeting IL-17A directly or indirectly may be an effective therapeutic strategy for CRSwNP.

편평세포상피암으로 오인한 비인두의 다형성 선종 2례

류광희(Gwanghui Ryu),홍상덕(Sang Duk Hong),정승규(Seung-Kyu Chung) 대한두개저학회 2018 대한두개저학회지 Vol.13 No.1

Pleomorphic adenoma (PA) of nasopharynx is very rare. Squamous metaplasia of PA is an unusual finding and has the possibility for misdiagnosis as squamous cell carcinoma (SCC). This study presents two cases of nasopharyngeal PA diagnosed as SCC from frozen sections, whereas permanent pathology was PA with squamous metaplasia. Preoperative endoscopy, radiographic images, and histopathological findings were reviewed. Two male patients underwent complete en-bloc resection of tumors with adequate margins because of the possibility of SCC from frozen section. The pathologic results were PA with squamous metaplasia and there was no recurrence during one year follow-up period. Nasopharyngeal PA can mimic SCC, surgeons should consider the clinical and radiological characteristics of tumors. We do not recommend deciding treatment modalities for nasopharyngeal tumors with only the frozen section.

A Survey on Biologics for the Treatment of Chronic Rhinosinusitis With Nasal Polyps Among Members of the Korean Rhinologic Society

Cha Hyunkyung,Ryu Gwanghui,Yoo Shin Hyuk,Mo Ji-Hun 대한비과학회 2023 Journal of rhinology Vol.30 No.3

Background and Objectives: In 2021, biologics were approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) in Korea. However, CRS is a heterogeneous disease, and its characteristics are thought to differ between Western and Korean populations. This study aimed to evaluate the experiences of members of the Korean Rhinologic Society during the first year of biologic usage for the treatment of nasal polyps.Methods: An anonymous survey consisting of 15 items was conducted from November to December 2021. The survey included questions about participant demographics, use of biologics for treating CRSwNP, and expectations regarding the effectiveness of biologics for treating CRSwNP.Results: In total, 44 members participated in the survey. Approximately half of the respondents were in their 40s (50.0%) and had 5–9 years of clinical experience as otorhinolaryngologists (47.7%). The majority of participants held academic positions (95.4%). About half of them worked in Gyeonggi Province. The utilization of biologics did not differ significantly based on clinical experience (p=0.192). When asked about the factors considered for prescribing biologics, the most common reason was recurrence of polyps after surgery (87.2%). The most frequent reason for discontinuing biologics was cost (48.6%). When asked about the extent to which they expected that the availability of biologics for CRSwNP treatment would reduce endoscopic sinus surgery (ESS), 45.5% of members expected a reduction of approximately 10%–29%. In addition, 20.5% expected a reduction of 50% or more. However, 61.4% expected a reduction of less than 10% in primary ESS. In addition, most respondents (93.2%) agreed with the need for Korea-specific guidelines for biologic treatment.Conclusion: There are discrepancies between the current guidelines for biologic treatment of CRSwNP and the reality of the situation, highlighting the need for the development of Korea-specific guidelines.

접형동의 함기화 정지 2예 및 문헌고찰

고성철(Sungchul Ko),류광희(Gwanghui Ryu) 대한두개저학회 2023 대한두개저학회지 Vol.18 No.1

Arrested pneumatization of the sphenoid sinus is normal developmental variant. Radiological find-ing on computed tomography (CT) or magnetic resonance image (MRI) may be confused with bony lesions of paranasal sinuses or invasive tumors of the skull base. A 43-year-old woman visited our hospital with headache, and an MRI scan performed at other hospital showed abnormal findings in the right sphenoid sinus. When the additional CT images were evaluated, it was diagnosed as an arrested pneumatization of the sphenoid sinus. A 46-year-old woman visited the neurologist with diplopia and had a brain MRI. Due to abnormal findings in the left sphenoid sinus, the patient was transferred to the otorhinolaryngology department. The left sphenoid sinus lesion was confirmed as an arrested pneumatization on CT and MRI. Both patients decided to follow-up without any special treatment. Differential diagnoses for this developmental variant would reduce treatment cost and exploratory surgery.

A Case of Bilateral Trigeminal Amyloidoma Diagnosed Through an Endoscopic Transsphenoidal Approach

Park Song I,Ryu Gwanghui 대한비과학회 2023 Journal of rhinology Vol.30 No.3

Amyloidosis is a systemic disease characterized by the accumulation of amyloid protein in multiple organs. Amyloidoma, in contrast, is an uncommon localized form of amyloidosis that presents as a single mass or tumor-like lesion. Primary amyloidoma in the central nervous system is rare, and only a few cases have been reported. Notably, the Gasserian ganglion is the most frequently affected site of amyloidoma in the central nervous system, and progressive trigeminal neuropathy is a characteristic finding. Among these cases, the bilateral occurrence of amyloidoma is exceedingly rare. In this report, we present the case of a 51-year-old woman diagnosed with bilateral trigeminal amyloidoma, confirmed by an endoscopic biopsy via the transsphenoidal approach.

Diagnostic accuracy of fine needle aspiration cytology for high-grade salivary gland tumors.

Kim, Bo Young,Hyeon, Jiyeon,Ryu, Gwanghui,Choi, Nayeon,Baek, Chung-Hwan,Ko, Young-Hyeh,Jeong, Han-Sin Raven Press 2013 Annals of surgical oncology Vol.20 No.7

<P>Preoperative differentiation between high-grade malignancy and others (benign or low-grade tumors) is more important than differentiation between malignant and benign tumors for surgical planning, treatment outcome, and prognosis in salivary gland tumors. Fine needle aspiration cytology (FNAC) has a relatively low sensitivity for differentiating malignant from benign salivary tumors. However, the diagnostic performance of FNAC has not been studied in predicting high-grade salivary malignancy, which can significantly affect patient care.</P>

KAAACI Allergic Rhinitis Guidelines: Part 1. Update in Pharmacotherapy

Yang Song-I,Lee Il Hwan,Kim Minji,Ryu Gwanghui,강성윤,Kim Mi-Ae,이상민,Kim Hyun-Jung,Park Do-Yang,Lee Yong Ju,Kim Dong-Kyu,Kim Soo Whan,Kim Do Hyun,Jun Young Joon,박상철,Kim Bong-Seong,Chung Soo Jie,Lee Hyun J 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.1

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life (QOL) of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence while considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines of AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine (INAH) combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.

Evaluation of the effects of photobiomodulation treatment on the neuronal development of olfactory stem cells

Reiza Dolendo Ventura,Jun-Sang Bae,Eun Hee Kim,Shin Hyuk Yoo,Gwanghui Ryu,Ji-Hun Mo 대한의학레이저학회 2022 MEDICAL LASERS Vol.11 No.4

Background and Objectives: The goal of this study was to assess the effects of photobiomodulation (PBM) on the neuronal differentiation of olfactory stem cells (OSCs).Materials and Methods: The OSCs were irradiated with different wavelengths (740 nm and 850 nm) and different energy densities (5 J/cm2 and 10 J/cm2). Immunofluorescence staining and polymerase chain reaction (PCR) analysis were utilized to evaluate the effects of PBM on the OSCs.Results: PCR analyses showed lower neuroepithelial stem cell protein (Nestin) expression in the 740 nm groups (energy densities 5 and 10 J/cm2), and increase in the 850 nm-10 J/cm2 compared to the control. SRY-box transcription factor 2 (Sox2) was downregulated in the 740 nm-10 J/cm2 and elevated in the 850 nm-10 J/cm2 group. Increased glial fibrillary acidic protein (GFAP) expression in the 740 nm groups. Microtubule-associated protein 2 (Map2) expression increased in all groups. Futhermore, Doublecortin (Dcx) expressions increased in 740 nm groups while decreased in 850 nm groups. The expressions of the leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr5) varied in 740 nm groups and increased in 850 nm groups. Increased expressions in 740 nm groups and decreased expressions in 850 nm groups in cluster of differentiation 36 (CD36). Early B-cell factor 1 (Ebf1) expressions were lower in 740 nm groups and higher in 850 nm groups. Immunofluorescence staining revealed increased tubulin beta 3 (Tubb3) and olfactory marker protein (OMP) intensities in 850 nm-5 J/cm2.Conclusion: The PBM treatment showed positive effects on the maturation and development of OSCs into mature olfactory neurons.

KAAACI Guidelines for Allergen Immunotherapy

Lee Hwa Young,이상민,강성윤,Kim Kyunghoon,Kim Ju Hee,Ryu Gwanghui,Min Jin-Young,Park Kyung Hee,Park So-Young,Sung Myongsoon,Lee Youngsoo,Yang Eun Ae,Jee Hye Mi,Ha Eun Kyo,Shin Yoo Seob,Chung Eun Hee,Choi Su 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.6

Allergen immunotherapy (AIT) is a causative treatment for various allergic diseases such as allergic rhinitis, allergic asthma, and bee venom allergy that induces tolerance to offending allergens. The need for uniform practice guidelines in AIT is continuously growing because of the increasing discovery of potential candidates for AIT and evolving interest in new therapeutic approaches. This guideline is an updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT published in 2010. This updated guideline proposes an expert opinion by allergy, pediatrics, and otorhinolaryngology specialists with an extensive literature review. The guideline deals with basic knowledge and methodological aspects of AIT, including mechanisms, clinical efficacy, patient selection, allergens extract selection, schedule and doses, management of adverse reactions, efficacy measurements, and special consideration in pediatrics. The guidelines for sublingual immunotherapy will be covered in detail in a separate article.