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Background and Objectives The purpose of this study is to provide a resource for clinicians and researchers regarding voice-related patient-reported outcome measures (PROMs) available in the Korean Language.Subjects and Method A systematic search for Korean voice-related PROMs was conducted in December 2021. The search used five electronic databases, including PubMed, Cumulative Index of Nursing and Allied Health Literature, Science Direct, Research Information Sharing Service, DataBase and Periodical Information Academic. Furthermore, reference lists from PROMs-related articles and voice-related journals were independently searched. Search terms emphasized “voice disorders,” “patient-reported,” and “instruments” both in English and Korean. Three independent investigators screened the electronic search results for relevance and selected articles based on the study’s inclusion and exclusion criteria.Results A total of 164 studies assessing Korean voice-related PROMs were identified, and this list was narrowed to 14 PROMs based on the predetermined inclusion and exclusion criteria. Fourteen voice-related PROMs validated in Korean were selected for a comprehensive review and were categorized as general voice handicap measures, symptom-oriented measures, socioemotional measures, and quality of life measures. Additionally, the characteristics of each of the fourteen Korean voice-related PROMs were summarized in evidence tables.Conclusion A total of fourteen Korean voice-related PROMs are available for clinical and research use; however, care must be taken when clinicians and researchers consider which instrument(s) to use. The current review provides a useful summary and could serve as a guide for future systematic reviews on Korean voice-related PROMs.

Background and Objectives The Voice Perceived Present Control scale (VPPC) has been developed to provide better insight into patients’ perceived control over their thoughts or behaviors related to voice disorders. The objective of the present study was to validate the Korean VPPC (K-VPPC) by evaluating its internal consistency and reliability.Materials and Method All items of the English VPPC were translated into Korean. Content validity was analyzed through three Delphi survey rounds by an expert panel (n=44) with active clinical and research experience in treating dysphonic patients. Twenty-three patients with a heterogeneous diagnosis of dysphonia and twenty-three gender-matched vocally normal controls (total n=46) were asked to complete the K-VPPC and the Korean Voice Handicap Index-10 (KVHI-10). Psychometric properties including internal consistency and reliability were evaluated to examine the appropriateness of cross-cultural use of K-VPPC.Results Cronbach’s alpha coefficient of K-VPPC was 0.89 for dysphonic patients, indicating good internal consistency in clinical samples. Furthermore, patients with dysphonia scored significantly lower on the total score of K-VPPC and higher on voice handicap than the vocally normal controls. Spearman’s correlation coefficients indicated an inverse and moderate association between the K-VPPC and all domains of KVHI-10 (Spearman’s r=-0.44– -0.68).Conclusion The findings of the current study indicated that the K-VPPC is a valid and reliable tool for the assessment of perceived control in Korean patients with dysphonia. Therefore, the K-VPPC could be a useful and complementary tool for the comprehensive evaluation of dysphonia, thereby improving care in Korean patients with voice disorders.

Sebaceous carcinoma is extremely rare in the parotid gland. Recently, we experienced a case of carcinoma with sebaceous differentiation arising from the parotid gland in patient who was diagnosed as parotid adenoma carcinoma and underwent total parotidectomy.A 73-year-old male visited our department for the evaluation of 3-month history of infra-auricular mass combined with pain. Radiologic finding showed lobulated enhancing and solid mass with calcification in the right parotid gland. Initially, total parotidectomy with supraomohyoid neck dissection was performed. Pathological findings showed capsulated whitish mass with hemorrhage and cystic degeneration. Immunohistochemically, CK7, CK5/6, p63 were positive and CEA was negative. The intra-operative frozen section diagnosis was mucoepidermoid carcinoma. The permanent diagnosis was changed to adenocarcinoma, NOS(not otherwise specified). Fourteen months later, the newly developed mass was noticed on the operation bed. The mass was clinically diagnosed as recurred adenocarcinoma. Revision parotidectomy was performed and pathological findings revealed that the tumor was newly developed sebaceous carcinoma. We report a case of carcinoma with sebaceous differentiation in parotid gland with a review of literature.

Background and Objectives There has been a long debate on whether intraoperative parathyroid hormone (IOPTH) monitoring is mandatory or not in the excision of a single abnormal parathyroid gland. The aim of this study is to suggest a new criteron of IOPTH monitoring. Subjects and Method We retrospectively analyzed 31 patients who underwent parathyroidectomy from 2005 to 2019. Patients had IOPTH not measured and those with secondary hyperparathyroidism were excluded. IOPTH was measured preoperatively (EX00), at 10 minutes (EX10) and 20 minutes (EX20) after the excision and analyzed. We determined the surgery as a ‘successful excision of lesion (SEOUL)’ when it met the following criteria: criterion 1) the level of EX10 or EX20 decreased under the upper normal or under upper limit of parathyroid hormone (65 pg/mL); criterion 2) EX20 decreased below 50% of EX00 and less than 195 pg/ mL (3 times the upper normal limit); criterion 3) multiglandular disease. Results Twenty-five patients among 31 patients were included this study (M:F=8:17). Twenty- two patients were suspected of single lesion and three patients of multiple lesions on preoperative images (99mTc-sestamibi scan, neck CT, and PET-CT). IOPTH of EX00, EX10, and EX20 were 488.92±658.74, 121.36±134.73, and 92.44±111.55 pg/mL, respectively. Sixty-four percent patients (16/25) met the criterion 1. Six patients (24%) successfully excised a lesion meeting the criterion 2. Three patients had multiglandular disease, meeting the criterion 3. Conclusion Our new criteria suggest when we could stop the procedure. If the level of IOPTH does not meet the SEOUL criteria, it means that there might be more lesions.

Nontuberculous mycobacteria (NTM) is commonly found in the surrounding environment and can cause opportunistic infection. Mainly, it causes lymph node infection in the cervical area, which is often known to occur in children. Recently, we have experienced a case of NTM infection on a branchial cleft cyst in a 36-year old male. NTM was diagnosed by fine needle aspiration and branchial cleft cyst was confirmed by postoperative pathologic findings. We report this case with a review of literature.

Background and Objectives Treatment using systemic antibiotic administration and surgical drainage has been the common treatment modality for deep neck infection. This study compared the changing pattern of isolated pathogens to recommend the best empirical antibiotics for deep neck infection.Subjects and Method Reviewed retrospectively were medical charts of 131 patients who, confirmed with deep neck infection, underwent surgical drainage for pus cultures at Ewha Womans University Medical Center between January, 2009 and July, 2019. We analyzed the changing pattern of isolated pathogens and antibiotic susceptibility tests using their pus cultures.Results Streptococcus viridans was the most commonly isolated organism (35.1%), followed by Klebsiella pneumonia (13.7%) and Staphylococcus aureus (4.6%). The isolation rate of Streptococcus viridans increased in the recent 10 years [p=0.016, odds ratio (OR)=3.417]. Antibiotic susceptibility tests showed that all pathogens were resistant to ampicillin, but susceptible to ampicillin/sulbactam and cephalosporin. The isolation rate of clindamycin resistant pathogens was increased with statistical significance (p=0.020, OR=8.076).Conclusion Antibiotics effective against both Streptococcus viridans and Klebsiella pneumonia should be used as the first-line of treatment for deep neck infection. Ampicillin/sulbactam or amoxicillin/clavulanic acid were sufficient to treat deep neck infection empirically regardless of age or underlying diseases.

BACKGROUND: Respiratory mucosa defects result in airway obstruction and infection, requiring subsequent functional recovery of the respiratory epithelium. Because site-specific extracellular matrix (ECM) facilitates restoration of organ function by promoting cellular migration and engraftment, previous studies considered decellularized trachea an ideal ECM; however, incomplete cell removal from cartilage and mucosal-architecture destruction are frequently reported. Here, we developed a decellularization protocol and applied it to the respiratory mucosa of separated porcine tracheas. METHODS: The trachea was divided into groups according to decellularization protocol: native mucosa, freezing–thawing (FT), FT followed by the use of Perasafe-based chemical agents before mucosal separation (wFTP), after mucosal separation (mFTP), and followed by DNase decellularization (mFTD). Decellularization efficacy was evaluated by DNA quantification and hematoxylin and eosin staining, and ECM content of the scaffold was evaluated by histologic analysis and glycosaminoglycan and collagen assays. Biocompatibility was assessed by cell-viability assay and in vivo transplantation. RESULTS: The mFTP mucosa showed low antigenicity and maintained the ECM to form a proper microstructure. Additionally, tonsil-derived stem cells remained viable when cultured with or seeded onto mFTP mucosa, and the in vivo host response showed a constructive pattern following implantation of the mFTP scaffolds. CONCLUSION: These results demonstrated that xenogenic acellular respiratory mucosa matrix displayed suitable biocompatibility as a scaffold material for respiratory mucosa engineering.

Mesenchymal stem cells (MSCs) can differentiate into endoderm lineages, especially parathyroid-hormone (PTH)-releasing cells. We have previously reported that tonsil-derived MSC (T-MSC) can differentiate into PTH-releasing cells (T-MSC-PTHCs), which restored the parathyroid functions in parathyroidectomy (PTX) rats. In this study, we demonstrate quality optimization by standardizing the differentiation rate for a better clinical application of T-MSC-PTHCs to overcome donor-dependent variation of T-MSCs. Quantitation results of PTH mRNA copy number in the differentiated cells and the PTH concentration in the conditioned medium confirmed that the differentiation efficiency largely varied depending on the cells from each donor. In addition, the differentiation rate of the cells from all the donors greatly improved when differentiation was started at a high cell density (100% confluence). The large-scale expression profiling of T-MSC-PTHCs by RNA sequencing indicated that those genes involved in exiting the differentiation and the cell cycle were the major pathways for the differentiation of T-MSC-PTHCs. Furthermore, the implantation of the T-MSC-PTHCs, which were differentiated at a high cell density embedded in hyaluronic acid, resulted in a higher serum PTH in the PTX model. This standardized efficiency of differentiation into PTHC was achieved by initiating differentiation at a high cell density. Our findings provide a potential solution to overcome the limitations due to donor-dependent variation by establishing a standardized differentiation protocol for the clinical application of T-MSC therapy in treating hypoparathyroidism.

Summary Objective The aim of this study was to determine the prevalence and demographics of benign vocal fold lesions (BVFL) and trends in its treatment in Korea based on data collected from the National Health Insurance Service database. Material and Methods Data for patients diagnosed with BVFL (ICM-10 codes J381, J382, J384) from 2006 to 2015 were selected for analysis. Patient characteristics, including sex, age, income, area of residence, and comorbidity, were analyzed. Treatment was divided into surgical management and conservative management using operation codes. Results The prevalence and incidence of BVFL increased from 7.07% and 5.29%, respectively, in 2006 to 12.47% and 7.98% in 2015. Compared with the non-BVFL population, patients with BVFL were more likely to be female, reside in an urban area, and have gastroesophageal reflux disease. There was no significant change in the incidence of surgical treatment during the study period (around 6000 per year); however, the surgical treatment rate decreased from 19.29% to 8.38%. The probability of undergoing surgical treatment for BVFL was higher in men, those aged 50–59 years, and those in the lowest quartile for income, except for the medical aid group. Conclusion In Korea, there was an increase in the number of patients diagnosed with BVFL and a decrease in the operation rate for this condition between 2006 and 2015. Diagnosis of BVFL varied significantly based on income and sex; however, the only variable affecting the operation rate was patient age.

Located near the oropharynx, the tonsils are the primary mucosal immune organ. Tonsil tissue is a promising alternative source for the high-yield isolation of adult stem cells, and recent studies have reported the identification and isolation of tonsil-derived stem cells (T-SCs) from waste surgical tissue following tonsillectomies in relatively young donors (i.e., under 10 years old). As such, T-SCs offer several advantages, including superior proliferation and a shorter doubling time compared to bone marrow-derived mesenchymal stem cells (MSCs). T-SCs also exhibit multi-lineage differentiation, including mesodermal, endodermal (e.g., hepatocytes and parathyroid-like cells), and even ectodermal cells (e.g., Schwann cells). To this end, numbers of researchers have evaluated the practical use of T-SCs as an alternative source of autologous or allogenic MSCs. In this review, we summarize the details of T-SC isolation and identification and provide an overview of their application in cell therapy and regenerative medicine.

Background Nasal septal perforation is caused by bilateral septal mucosal injuries resulting from nasal trauma and septal surgeries. Previous studies have reported that biocompatible materials may be effective for repairing nasal septal perforations. However, they were primarily used for treatment; no study has investigated their use for prevention of nasal septal perforation. Objective To determine whether porcine tracheal mucosa-derived decellularized patch can prevent the progression of nasal mucosa injuries to septal perforations. Methods Bilateral nasal septal mucosal defects were surgically induced in 36 rabbits. Silastic sheets were applied bilaterally in all rabbits, and decellularized mucosal patch was applied unilaterally (n = 12) or bilaterally (n = 12) at the defect site in the respective experimental groups. Between 1 and 8 weeks postoperatively, the animals were sacrificed, and their nasal septa were completely removed. The excised septa were examined macroscopically and microscopically (histopathological examinations). Moreover, glycosaminoglycan (GAG) estimations of the septa were performed to evaluate mucosal regeneration and mechanical properties. Results Septal perforations occurred in 5 animals in the control group (5/12; 42%), 1 in the unilateral group (1/12; 9%), and in none in the bilateral group. Compared with the control group, the experimental groups showed significantly different mucosal and cartilage regeneration. Conclusion Decellularized porcine tracheal mucosa can prevent mucosal defects from progressing to septal perforation, promote the repair of mucosal defects, and protect the nasal cartilage.

Objective Aesthetic reconstruction of the external ear is challenging due to the complex anatomical shape of the auricle. Recently, artificial scaffolds such as Medpor (Stryker, Kalamasoo, MI, USA) have become widely used in ear reconstruction. However, the Medpor scaffold is stiffer than the natural ear, which may lead to discomfort, and moreover has uniform design for every patient. In this study, we investigated whether three-dimensional (3D)-printed artificial polyurethane (PU) scaffolds are suitable for auricular reconstruction. Methods PU scaffolds were fabricated using 3D printing according to a design derived from a digital imaging and communications in medicine (DICOM) image of the human auricle. The microstructure of the scaffolds was observed using scanning electron microscopy, and the porosity was examined. Cell proliferation on the scaffolds was assessed in vitro using tonsil-derived mesenchymal stem cells to evaluate the biocompatibility of the scaffolds. The scaffolds were implanted in C57BL/6 mice, and histological analysis was performed. Results The structural study revealed that the 3D-printed porous PU scaffolds have rectangular microstructure with regular pitch and line, as well as high porosity (56.46% ± 10.22%) with a pore diameter of 200 µm. The mechanical properties of the 3D-printed PU scaffolds were similar to those of the human auricle cartilage. Cell proliferation on the PU scaffolds was greater than that on Medpor scaffolds. Histological evaluation demonstrated that the porous parts of the PU scaffolds became filled with collagen and vascular tissue. Conclusion Elastic, porous PU scaffolds can be obtained using 3D printing, have biomechanical properties similar to those of the natural ear, and are suitable for use in auricular reconstruction. Level of evidence NA Laryngoscope, 129:351-357, 2019.

Early detection of the zearalenone (ZEA) chemotype of Fusarium species could be a precautionary measure for preventing ZEA contamination in rice. In this study, a multiplex polymerase chain reaction (mPCR) assay for detecting ZEA-producing fungi in rice was established using a set of four primers targeting the ZEA biosynthesis genes PKS3, PKS13, ZEB1, and ZEB2. Two mPCR approaches were used: one that amplified the DNA obtained from Fusarium isolates (conventional method) and another that directly amplified the target DNA from rice samples without time-consuming DNA isolation (direct method). The two mPCR methods showed high sensitivity in detecting ZEA-producing species, with a detection limit of 1.25 pg/μL of genomic DNA and 102 and 103 spores/g of white and brown rice, respectively. Both methods were specific for ZEA-producing species and gave four band patterns. The application of the two mPCR methods to 51 Fusarium isolates and 41 rice samples revealed that 31% (16 of 51) and 24% (10 of 41) of the samples were contaminated with ZEA-producing species, respectively. The mPCR results were further evaluated using high-performance liquid chromatography; in general, the two methods yielded similar results. These findings indicate that both mPCR methods are suitable for the detection of ZEA-producing Fusarium species in white and brown rice; however, the direct method yielded more rapid results.

Laryngeal inflammation causes not only benign diseases of the larynx, such as laryngitis and granuloma, but also malignancy. Dietary factors are known to control or modulate the inflammatory reaction in the body. To date, the association between laryngeal inflammation and dietary factors has not been reported using nationwide population-based data. The aim of this study was to analyze the association between several dietary factors and inflammatory laryngeal disease in the Korean population. This study analyzed the data from Korean National Health and Nutrition Examination Surveys which is cross-sectional nationwide-population-based study. Association between the dietary nutrient intake and the prevalence of inflammatory laryngeal diseases was analyzed in 21,116 participants who underwent a laryngoscopy and filled in the dietary intake questionnaires. Of the 21,116 participants included in the analysis, 758 (3.59%) were diagnosed with inflammatory laryngeal disease. Prevalence of inflammatory laryngeal disease was higher in men (4.58%) than in women (2.84%). The mean age of patients was 53.77 years. When analyzing the risk using propensity score matching, ILD group tend to consume more coffee and to intake less fiber and iron than normal group. On Logistic regression analysis, an increased intake of carbohydrate, fiber, and iron was associated with lowered risk of having ILD in female. The association between inflammatory laryngeal disease and dietary factors was prominent in the group aged ≥50 years and female. Increased intake of fiber, iron, and vitamin A were associated with lower risk in the group aged ≥50 years. In female, increased intake of fiber, iron were associated with lower risk of having ILD. In the group aged ≤50 years, only an increased consumption of makgeolli, Korean traditional rice wine, was associated with a higher risk of ILD.

Objective In this study, we assessed the effectiveness of a tonsil-derived mesenchymal stem cell (TMSC)-transplanted polycaprolactone/beta-tricalcium phosphate prosthesis (specifically designed for easier fixing and grafting with a single scaffold) on rabbit mandible osteogenesis. Methods The mandibles of 18 rabbits were exposed, and 10 × 8-mm bone defects were made. Two rabbits did not receive implants; four were reconstructed with the scaffold control (SC) (SC group); four were reconstructed with scaffolds soaked in peripheral blood (PB) (PB group); four were reconstructed with TMSC-transplanted scaffolds (TMSC group); and four were reconstructed with differentiated osteocyte-transplanted scaffolds (DOC) (DOC group). Each rabbit was sacrificed 12 weeks after surgery, and the area of new bone formation was investigated by mechanical testing, histology, and micro-computed tomography. Results More extended and denser new bone masses were observed in the TMSC and DOC groups, although fibrosis and vascular formation levels were similar in all groups, suggesting that the dual-structured scaffold alone provides a good environment for bone attachment and regeneration. The bone volumes of representative scaffolds from the SC, PB, TMSC, and DOC groups were 43.12, 48.35, 53.10, and 57.44% of the total volumes, respectively. Conclusion The design of the scaffold resulted in effective osteogenesis, and TMSCs showed osteogenic potency, indicating that their combination could enable effective bone regeneration. Level of evidence NA Laryngoscope, 130:358-366, 2020.

Hypoparathyroidism is a deficiency of the parathyroid hormone (PTH) in the body. We previously reported the possibility of treating it using tonsil-derived mesenchymal stem cells (TMSCs) differentiated into PTH-releasing cells. The purpose of this study was to evaluate the feasibility of using autologous plasma gel as scaffold material in treatment of hypoparathyroidism with TMSC. We obtained plasma by venous sampling of autologous blood and centrifuged and fabricated the plasma gel using a sinusoidal pattern heating machine. After we created the hypoparathyroidism animal model, we administered undifferentiated TMSCs and TMSCs differentiated into parathyroid cells at each rat dorsum by intramuscular injection with and without the plasma gel. In the plasma gel groups, intact PTH was detected from on day 21 after TMSC injection; we did not detect intact PTH in the groups that were only transplanted with TMSCs during the entire experimental period. Serum calcium was higher and phosphorous was lower in the TMSC with plasma gel groups than in the groups with TMSCs alone. We detected PTH and chromogranin A in the TMSC-plasma gel-transplanted areas on immunohistochemistry and immunofluorescence stain. Plasma gel can be considered as a cell-delivery scaffold for treating hypoparathyroidism with tonsil-derived mesenchymal stem cells.

Aesthetic reconstruction of the external ear is challenging due to the complex anatomical shape of the auricle. Recently, artificial scaffolds such as Medpor (Stryker, Kalamasoo, MI, USA) have become widely used in ear reconstruction. However, the Medpor scaffold is stiffer than the natural ear, which may lead to discomfort, and moreover has uniform design for every patient. In this study, we investigated whether three-dimensional (3D)-printed artificial polyurethane (PU) scaffolds are suitable for auricular reconstruction.PU scaffolds were fabricated using 3D printing according to a design derived from a digital imaging and communications in medicine (DICOM) image of the human auricle. The microstructure of the scaffolds was observed using scanning electron microscopy, and the porosity was examined. Cell proliferation on the scaffolds was assessed in vitro using tonsil-derived mesenchymal stem cells to evaluate the biocompatibility of the scaffolds. The scaffolds were implanted in C57BL/6 mice, and histological analysis was performed.The structural study revealed that the 3D-printed porous PU scaffolds have rectangular microstructure with regular pitch and line, as well as high porosity (56.46% ± 10.22%) with a pore diameter of 200 µm. The mechanical properties of the 3D-printed PU scaffolds were similar to those of the human auricle cartilage. Cell proliferation on the PU scaffolds was greater than that on Medpor scaffolds. Histological evaluation demonstrated that the porous parts of the PU scaffolds became filled with collagen and vascular tissue.Elastic, porous PU scaffolds can be obtained using 3D printing, have biomechanical properties similar to those of the natural ear, and are suitable for use in auricular reconstruction.NA Laryngoscope, 129:351-357, 2019.

Summary Objectives/Hypothesis To investigate the proper approach and technical method of ultrasonography-guided laryngeal electromyography (US-guided LEMG). Study Design This is a prospective study. Methods Twenty patients who underwent US-guided LEMG were enrolled. US-guided LEMG was cooperatively performed by one otolaryngologist, one neurologist, and one radiologist. The location of the needle electrode was confirmed with US after electrode insertion into the laryngeal intrinsic muscle. The US transducer was applied on the neck by a transverse/midline and transverse/oblique approach to identify the cricothyroid (CT), thyroarytenoid (TA) muscles, and the location of the needle electrode. Results CT muscles were easily identified on US in all 20 patients. TA muscles were identified in 17 patients (85%). The transverse/oblique approach was helpful to detect TA muscle in case of calcified thyroid cartilage or anatomic variation. Conclusions US-guided LEMG, which enables the exact insertion of the needle electrode, improves the reliability of examination and is helpful in early detection and to prevent complications.

Patients with end-stage renal disease (ESRD) who are treated with hemodialysis (HD) frequently complain about hoarseness after completion of each HD session. The HD treatment affects laryngeal volume and muscle function. This study attempted to evaluate the vocal effect of HD by acoustic and aerodynamic analysis and to determine the difference between voice change group (VCG) and nonvoice change group (NVCG).A total of 55 patients (34 females and 21 males) diagnosed with ESRD and undergoing outpatient HD were enrolled. The subjects were divided into the VCG (n=13) and NVCG (n=42) by the change of the Korean Voice Handicap Index score. Patients underwent weighing and acoustic, aerodynamic analysis before and after the HD. Fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), pitch range, habitual pitch, voice energy, and maximal phonation time (MPT) were obtained. The pre- and post-HD data were compared using paired t test. The results were compared after dividing the total group into the VCG and NVCG categories. Correlation between the change of the weight and change of the voice analysis result was certified by Pearson correlation coefficient.The F0 and habitual pitch increased in all subjects. The NHR and MPT parameters significantly decreased (P0.05). In the NVCG group, all the results were same as the total group. In the VCG group, the NHR result differed from the total group. All acoustic parameters showed no statistically significant differences between the two groups. There was no correlation between the weight change (%) and the change of acoustic parameter results.The NVCG group of patient displayed improvement in NHR, whereas the VCG group showed no change. Weight change did not significantly correlate with the voice analysis results.

A ready-made, acellular patch-type prosthesis is desirable in repairing partial tracheal defects in the clinical setting. However, many of these prostheses may not show proper biological integration and biomechanical function when they are transplanted. In this study, we developed a novel 3D printed polyurethane (PU) tracheal scaffold with micro-scale architecture to allow host tissue infiltration and adequate biomechanical properties to withstand physiological tracheal condition. A half-pipe shaped PU scaffold (1.8 cm of height, 0.18 cm thickness, and 2 cm of diameter) was fabricated by 3D printing of PU 200 μm PU beam. The 3D printed tracheal scaffolds consisted of a porous inner microstructure with 200 × 200 × 200 μm3 sized pores and a non-porous outer layer. The mechanical properties of the scaffolds were 3.21 ± 1.02 MPa of ultimate tensile strength, 2.81 ± 0.58 MPa of Young's modulus, and 725% ± 41% of elongation at break. To examine the function of the 3D printed tracheal scaffolds in vivo, the scaffolds were implanted into 1.0 × 0.7 cm2 sized anterior tracheal defect of rabbits. After implantation, bronchoscopic examinations revealed that the implanted tracheal scaffolds were patent for a 16 week-period. Histologic findings showed that re-epithelialization after 4 weeks of implantation and ciliated respiratory epithelium with ciliary beating after 8 weeks of implantation were observed at the lumen of the implanted tracheal scaffolds. The ingrowth of the connective tissue into the scaffolds was observed at 4 weeks after implantation. The biomechanical properties of the implanted tracheal scaffolds were continually maintained for 16 week-period. The results demonstrated that 3D printed tracheal scaffold could provide an alternative solution as a therapeutic treatment for partial tracheal defects.

Echocardiography is the initial imaging modality to delineate the cardiac mass. Clinically echocardiographic information about morphology, location, motion and hemodynamic consequences of the tumor is very important for decision making in terms of additional imaging studies and treatment. We present a case of left atrial leiomyosarcoma masquerading as myxoma preoperatively and discuss the echocardiographic features for distinguishing leiomyosarcoma from a benign tumor, such as myxoma.

Situs ambiguous is rare congenital anomaly in adults. In 2 adult patients who admitted for different cardiac problems, situs ambiguous with polysplenia was detected. A 42-year-old male admitted for radio frequent catheter ablation of atrial fibrillation, and he had left-sided inferior vena cava (IVC), hepatic segment of IVC interruption with hemiazygos continuation, multiple spleens and intestinal malrotation. And in a 52-year-old female case who was hospitalized due to infective endocarditis after implanting pacemaker for sick sinus syndrome, multiple spleens, left-sided stomach, bilateral liver with midline gallbladder, and left-sided IVC were found. Those findings were consistent with situs ambiguous with polysplenia, but their features were distinctive.

Bronchial foreign bodies (FB) in children are difficult to diagnose when there is no witness to the aspiration event. The experience with three-dimensional CT and virtual bronchoscopic reconstruction (3D-CTVB) was reviewed for the diagnosis of bronchial FB in pediatric patients in this study. A retrospective review of ten pediatric patients (M:F = 5:5) who underwent rigid bronchoscopy by one otolaryngologist for the impression of a bronchial FB, at a tertiary training hospital, from February 2006 to September 2010 is reported. All patients had a plain chest X-ray and 3D-CTVB. The physical, radiological and bronchoscopic findings of the patients were analyzed. The mean duration from the aspiration event to hospital evaluation was 7 days (0-21 days). Four patients (44%) had witnesses to the aspiration event. Hyperaeration of the affected lung was noted in nine patients (90%) on the plain chest X-ray. In all of the patients, the foreign body location, suspected on the preoperative 3D-CTVB, was consistent with the intra-operative bronchoscopic findings. All FBs were successfully removed by rigid bronchoscopy without any complications. In conclusion, the 3D-CTVB was a very safe and useful diagnostic modality for bronchial FBs. The findings of this study suggest that the 3D-CTVB should be considered for the diagnosis of all patients with suspected bronchial FBs.

3,4-Dihydroquinazoline 1 as T-type calcium channel blocker was in vivo evaluated against A549 xenograft in BALB/c-nu Sic mice, which exhibited 54% tumor growth inhibition through oral administration of 8 mg/kg of body weight and was slightly less active than doxorubicin (68%). In addition, this compound was also profiled for its acute toxicity to ICR mice to afford oral LD 50 value of 1,038 mg/kg of body weight.

In the previous article we have reported that 3,4-dihydroquinazoline 1 is a potent and selective T-type calcium channel blocker that exhibited strong anti-cancer activity in vitro. Compound 1·2HCl was further in vivo evaluated against A549 xenograft in BALB/c nude mice, which exhibited 49% tumor-weight inhibition through intravenous administration of 2 mg/kg of body weight and was more potent than doxorubicin. Moreover, compound 1·2HCl has an oral bioavailability of 98% with LD(50) values of 693 mg/kg (p.o. route) and 40.0 mg/kg (i.v. route) of body weight. In addition, its efficient scale-up synthetic method was developed.

3,4-Dihydroquinazoline derivatives have been known to be the novel and potent T-type calcium channel blockers. From a systematic variation of 3,4-dihydroquinazoline derivative 5c (KYS05043), plausible SAR results were established. It was revealed that a 5-(dimethylamino)pentylamino group at R(1), a biphenyl group at R(2), and a benzyl amido group at R(3)in the 3,4-dihydroquinazoline backbone are closely related with the channel selectivity (T/N-type) as well as the potency based on the discovery of 6k (KYS05090).

Objective To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment. Methods A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed. Results Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation. Conclusion LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG.

Surgical transplantation of parathyroid tissue into the forearm muscle is one of the most commonly used surgical techniques. While simple, the procedure suffers from drawbacks. This study evaluated the feasibility of thermoreversible gel as an injectable carrier for parathyroid autotransplantation. Polyethyleneglycol-polyalanine-co-phenylalanine (PEG-PAF) thermoreversible gel (sol form at 4 °C, gel form at 37 °C) were manufactured. Thirty-eight Sprague-Dawley rats were divided into two groups (19 control, C group; 19 experimental, P group). The parathyroid glands of rats were excised. Parathyroid tissues were transplanted into the muscle pocket in sternocleidomastoid muscle in the C group. In the P group, the tissues were injected into the same muscle mixed with 0.3 ml thermoreversible gel. The serum levels of parathyroid hormone (PTH), ionized calcium, and phosphorous were measured before surgical procedure, on 7, 21, 56, and 70 days after surgery. Histology and immunohistochemistry were performed. Preoperative median PTH level of the C and the P group were 60.80 and 43.85 pg/ml, respectively (p = 0.641). Seventy days after surgery, median PTH level was 32.8 and 25.61 pg/ml, respectively. On day 70, the PTH level was restored by 54 % in the C group and 56 % in the P group compared to the preoperative value (p = 0.620). There were no significant intergroup differences in the ionized calcium/phosphorous level. Histology and immunohistochemistry revealed the successful transplantation of parathyroid tissues into the muscles in both groups. In conclusion, the PEG-PAF-based thermoreversible gel is a good candidate carrier material for intramuscular parathyroid autotransplantation.

Quadricuspid pulmonary valve is a rare congenital heart disease. It is infrequently associated with significant clinical complications and tends to be clinically silent. Because of its benign nature, it has been diagnosed mainly post mortem. Its diagnosis by transthoracic echocardiography is very difficult because of the anatomical features. We describe a case of quadricuspid pulmonary valve diagnosed by transthoracic echocardiography and electrocardiography-gated multi-detector row computed tomography.

The purpose of this study is to evaluate the feasibility of small intestinal submucosa (SIS) application on the parathyroid autotransplantation in a rat model of hypoparathyroidism. The rats were divided into four groups: NC (no procedure, n = 5), PTX (total parathyroidectomy, n = 6), PT (total parathyroidectomy and parathyroid autotransplantation, n = 10) and PT + SIS group (total parathyroidectomy and parathyroid autotransplantation with SIS, n = 10). The levels of parathyroid hormone (PTH), calcium, and phosphorous were measured on 0, 3, 7, 21, 56 and 84 days after surgery. PTH level was expressed as median (interquartile range) and histological and immunohistochemical examinations were performed. PTH levels were significantly decreased to "not detectable level" from day 3 in PTX group. PTH was not detected in both PT and PT + SIS groups on the 21st day. On the 56th day, PTH levels were increased in both groups: 3 out of 8 rats (37.5%) in the PT group, 6 out of 9 rats (66.7%) in the PT + SIS group. The PTH level was fully recovered to its preoperative range on the day 84 as 6 of 8 rats (75%) of the PT group and 7 of 9 rats (77.8%) of the PT + SIS group were recovered; the PTH levels were 117.84 and 178.36 pg/ml, respectively. The neo-vascularization was well observed around the parathyroid tissue, and the number of new vessels formed was higher in the PT + SIS group (15 vessels/high power field) as compared to the PT group (10 vessels/high power field). This study showed the feasibility and the treatment effect of SIS as the success rate of autotransplantation of parathyroid tissue was significantly increased without severe inflammatory response in hypothyroidism animal model.

Echocardiography is the initial imaging modality to delineate the cardiac mass. Clinically echocardiographic information about morphology, location, motion and hemodynamic consequences of the tumor is very important for decision making in terms of additional imaging studies and treatment. We present a case of left atrial leiomyosarcoma masquerading as myxoma preoperatively and discuss the echocardiographic features for distinguishing leiomyosarcoma from a benign tumor, such as myxoma.