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Chi YH, Woo JY, Koh TK, Koo SK, Son H. Solitary fibrofolliculoma on the nasal septum: a case report. Arch Craniofac Surg 2023; 24:139-142. [PMID: 37415472 PMCID: PMC10365899 DOI: 10.7181/acfs.2023.00185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6 × 6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.
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Affiliation(s)
- Young Hoon Chi
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Joo Young Woo
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Tae Kyung Koh
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Soo Kweon Koo
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Hyuni Son
- Department of Pathology, Busan St. Mary's Hospital, Busan, Korea
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Koo SK, Dignan R, Lo EYW, Williams C, Xuan W. Evidence-Based Determination of Cut-Off Points for Increased Cardiac-Surgery Mortality Risk With EuroSCORE II and STS: The Best-Performing Risk Scoring Models in a Single-Centre Australian Population. Heart Lung Circ 2021; 31:590-601. [PMID: 34756532 DOI: 10.1016/j.hlc.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/04/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Risk scoring models (RSMs) are commonly used for estimation of postoperative-mortality risk in patients undergoing cardiac surgery, but their prediction accuracy may vary in different populations and clinical situations. The prognostic accuracies of some RSMs have not yet been fully evaluated in the Australian population. In this retrospective observational study, our aims were to assess the performance of four contemporary RSMs, to identify the best RSMs for prediction of postoperative-mortality in the single-centre cohort, and to determine a statistical threshold for classification of patients with increased or "higher" mortality risk. METHODS The study population included patients who underwent cardiac surgery at Liverpool Hospital between January 2013 and December 2014. Demographic information was collected, and mortality risks were estimated with the ES2 (EuroSCORE II), STS (Society of Thoracic Surgeons Score), AS (AusSCORE total) and ASMR (AusSCORE multi-risk) RSMs. (Additive EuroSCORE) (AES) and LES (logistic EuroSCORE) were included for historical interest. Discrimination, the ability to stratify patients between mortality and no mortality outcomes, and calibration, the comparison of risk score estimated and observed outcome in the population, were evaluated for each RSM, to determine their predictive accuracy in the study population. Discrimination was assessed by the AUC (area under the receiver operating characteristic curve), and acceptable calibration by the p-value greater than 0.05 for the Hosmer-Lemeshow (H-L) test. The best AUCs in contempory models were compared using the DeLong test. For ES2 and STS risk scores, cut-off points, or thresholds, for patients at increased risk of mortality were derived using Youden's J-statistics, calculated from sensitivity and specificity of models in predicting mortality. RESULTS From a total study population of 898 patients, 738 had scores for all six RSMs. The three EuroSCORE risk models and Youden's J-statistics analysis included the total population. Of the models in contemporary use, ES2 had higher discrimination (AUC=0.850) in this population than ASMR (AUC=0.767, p=0.024) and AS (AUC=0.739) and non-significantly higher discrimination than STS (AUC=0.806, p=0.19). All contemporary models had acceptable calibration but the older LES (H-L p=0.024) did not. Estimated mortality was closest to observed mortality with the ES2 model. Both AES and LES over predicted mortality. The RSM with the highest discrimination in isolated coronary artery bypass graft surgery (CAGs) (AUC=0.847), isolated valves (AUC=0.830), and females (AUC=0.784) was the ES2 model. STS discrimination was highest in CAGs plus valve procedures (AUC 0.891), and males (STS AUC=0.891). Cut-off points for risk scores to define increased risk populations were 3.0% for ES2 and 1.7% for STS. Similar proportions of patients in each RSM (ES2-26% to STS-32%) were defined as higher risk by the model threshold score depending on type of procedure. CONCLUSION Among RSMs in contemporary use, ES2 and STS showed the best discrimination and acceptable calibration. Caution is recommended in specific subgroups. Increased mortality risk score cut-off points could be identified for these two RSMs in this single-centre cohort.
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Affiliation(s)
- S K Koo
- South West Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - R Dignan
- South West Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia; Department of Cardiothoracic Surgery, Liverpool Hospital, Sydney, NSW, Australia.
| | - E Y W Lo
- Department of Cardiothoracic Surgery, Liverpool Hospital, Sydney, NSW, Australia
| | - C Williams
- South West Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Wei Xuan
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia; South West Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
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Koo SK, Park GH, Koh TK, Jung SH, Lee HB, Ji CL. Effect of mouth closure on upper airway obstruction in patients with obstructive sleep apnoea exhibiting mouth breathing: a drug-induced sleep endoscopy study. Eur Arch Otorhinolaryngol 2020; 277:1823-1828. [PMID: 32162059 DOI: 10.1007/s00405-020-05904-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Snoring and obstructive sleep apnoea (OSA) exhibit multifactorial aetiologies; mouth breathing increases airway obstruction and upper respiratory tract resistance. Of the many published studies, few have evaluated sleeping subjects. We explored how mouth breathing affected the upper respiratory tract anatomy and OSA during sleep. METHODS Eighteen patients with OSA, confirmed via full-night polysomnography, were enrolled in this study. We performed drug-induced sleep endoscopy (DISE) and defined obstruction sites before and after mouth closure using commercial mouth strips. We evaluated obstruction sites in two ways, i.e. by grading obstructions using our DISE grading system and measuring the affected areas. Patients who improved by at least one DISE grade were defined as responders. Areas were measured based on DISE videos analysed using ImageJ software. The apnoea-hypopnoea index (AHI) and body mass index (BMI) were recorded. RESULTS Based on the DISE grade, 40% (7/18) of patients showed obstruction site improvement. When assessed areally, the mean number of pixels improved significantly at both the retropalatal (p = 0.045) and retrolingual (p = 0.019) levels. However, DISE non-responders exhibited no areal improvements. Responders and non-responders did not differ significantly in terms of AHI or BMI (both p < 0.05). CONCLUSIONS Mouth closure improves or at least does not lead to further deterioration of the upper airway. Improvements were evident at the retropalatal and especially retrolingual levels. Neither the BMI nor the AHI differed between the two groups. However, responders tended to have a higher AHI than non-responders (39.4 vs. 32.8 events/h).
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Affiliation(s)
- Soo Kweon Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea.
| | - Geun Hyung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea
| | - Tae Kyung Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea
| | - Sung Hoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea
| | - Ho Byung Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea
| | - Chang Lok Ji
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Yongho-dong, Nam-gu, Busan, 538-41, South Korea
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Koh TK, Kang EJ, Bae WY, Kim SW, Kim CH, Koo SK, Kim SJ, Kim MS, Lee JH. Quantitative analysis of carotid arterial calcification using airway CT in obstructive sleep apnea. Auris Nasus Larynx 2018; 46:559-564. [PMID: 30528535 DOI: 10.1016/j.anl.2018.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/06/2018] [Accepted: 11/25/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the relationship between obstructive sleep apnea (OSA) severity and carotid arterial calcification by quantitative analysis using airway computed tomography (CT). METHODS This study included a total of 180 consecutive OSA patients aged 45-80years underwent polysomnography and airway CT between March 2014 and October 2016. The subjects were divided into three groups based on the results of the respiratory disturbance index (RDI): mild (RDI 5-14, n=29), moderate (RDI 15-29, n=50), and severe (RDI≥30, n=101). The extent of carotid arterial calcification on each airway CT scan was quantified according to the modified Agatston scoring method. Differences among the three groups in clinical characteristics including age, gender, body mass index (BMI), comorbid disease, blood pressure, total cholesterol, and carotid arterial calcification score (CarACS) were analyzed. RESULTS The severe OSA group showed significantly stronger predominance for male and smoker, higher prevalence of diabetes, and larger BMI than those of mild and moderate OSA groups. The mean CarACS was significantly different among the three groups (mild RDI: 4.3±13.4, moderate RDI: 7.4±28.8, severe RDI: 48.6±121.6, P=0.011). Univariate linear regression showed that RDI, age, hypertension, male sex and diabetes significantly influenced on the CarACS. In a multivariate linear regression model, the CarACS was related to age, male sex, and diabetes. CONCLUSIONS The patients with severe OSA showed larger CarACS and a higher prevalence of atherosclerotic risk factors. The CarACS was correlated with severity of OSA, which might be more dependent on the conventional risk factors of atherosclerosis.
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Affiliation(s)
- Tae Kyung Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Eun-Ju Kang
- Department of Radiology, Dong-A University College of Medicine, Busan, Republic of Korea.
| | - Woo Yong Bae
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Sung Wan Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chul Hoon Kim
- Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Soo Kweon Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Mary's medical Center, Busan, Republic of Korea
| | - Sang Jun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Moon Sung Kim
- Department of Radiology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Jae Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea
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Park CS, Kim BY, Kim SW, Lee JH, Koo SK, Kim KS, Kim ST, Kim YD, Kim JH, Kim JK, Kim CH, Kim HJ, Kim HY, Rha KS, Roh HJ, Park DJ, Shin SH, Lim SC, Lee JH, Lee HM, Lee HG, Kim YH, Cho JH. The Relationship between the Causative Allergens of Allergic Diseases and Environments in Korea Over a 8-Year-Period: Based on Skin Prick Test from 2006 to 2015. J Rhinol 2018. [DOI: 10.18787/jr.2018.25.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Chan-Soon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, Seoul, Korea
| | - Boo-Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Soo Whan Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, Seoul, Korea
| | - Joo Hyung Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Daejeon, Korea
| | - Soo Kweon Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan St. Mary's Hospital, Pusan, Korea
| | - Kyung-Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seon Tae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University, Gil Medical Center, Incheon, Korea
| | - Yong-Dae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jeong Hong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeju Hospital, Jeju University, College of Medicine, Jeju, Korea
| | - Jin Kook Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kun Kook University, School of Medicine, Seoul, Korea
| | - Chang Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Shinchon Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Jun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyo Yeol Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki-Sang Rha
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University, School of Medicine, Daejeon, Korea
| | - Hwan-Jung Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Yangsan, Korea
| | - Dong-Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Heon Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University of Daegu, School of Medicine, Daegu, Korea
| | - Sang-Chul Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Heung Man Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University, School of Medicine, Seoul, Korea
| | - Heung Gu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, Seoul, Korea
| | - Young Ha Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, Seoul, Korea
| | - Jin Hee Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, Seoul, Korea
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Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: A retrospective radiologic study. Auris Nasus Larynx 2017; 44:561-570. [PMID: 28173975 DOI: 10.1016/j.anl.2017.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/22/2016] [Accepted: 01/05/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Identifying anatomical variations associated with pathological findings is very useful for diagnoses and therapeutics. We conducted a study to detect various anatomical variations (superior, middle, inferior turbinate concha bullosa, uncinate bulla and nasal swell body [NSB]) in connection with nasal septal deviation. METHODS This study used a retrospective radiological design to analyze 594 (1188 sides) osteomeatal computed tomography scans from 494 male patients and 100 female patients aged between 17 and 75 years. We randomly selected 100 male and 100 female patients as controls; we compared the groups and performed a statistical analysis. All patients in the control group had sinusitis only (i.e., they lacked nasal septal deviations). RESULTS Left-sided septal deviation was found to be slightly more prevalent than right-sided deviation (43.9% and 36.4%, respectively). The incidence of S-curved septal deviation was 18.5%, that of dorso-ventral deviation was 10.9%, and that of caudal-rostral deviation was 7.6%. The incidence of only septal spur was 1.2%. In the case of middle turbinate concha bullosa, the incidence of the unilateral type was 17.3% and that of the bilateral type was 36.4%. In superior turbinate concha bullosa, the incidence of the unilateral type was 11.3% and that of the bilateral type was 27.4%. The incidence of inferior turbinate concha bullosa was 1.0% and that of uncinate bulla was 1.7%. NSB was found in 25.1% of patients, 24.7% of males and 27.0% of females. The frequencies of middle and superior concha bullosa were about 10-12 fold higher on the concave side. The nasal septal deviation group exhibited a higher incidence of most anatomical variants than the non-deviated group; differences in the middle turbinate concha bullosa attained statistical significance. CONCLUSION The radiologist must focus on anatomical variants in the preoperative evaluation. It is important for surgeons to be aware of these variations.
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Affiliation(s)
- Soo Kweon Koo
- Department of Otorhinolaryngology, Busan Saint Mary's Hospital, Busan, South Korea.
| | - Jong Deok Kim
- Department of Radiology, Busan Saint Mary's Hospital, Busan, South Korea
| | - Ji Seung Moon
- Department of Otorhinolaryngology, Busan Saint Mary's Hospital, Busan, South Korea
| | - Sung Hoon Jung
- Department of Otorhinolaryngology, Busan Saint Mary's Hospital, Busan, South Korea
| | - Sang Hoon Lee
- Department of Otorhinolaryngology, Busan Saint Mary's Hospital, Busan, South Korea
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Koo SK, Moon JS, Jung SH, Mun MJ. A case of bilateral inferior concha bullosa connecting to maxillary sinus. Braz J Otorhinolaryngol 2016; 84:526-528. [PMID: 27133909 PMCID: PMC9449245 DOI: 10.1016/j.bjorl.2016.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/01/2016] [Accepted: 01/15/2016] [Indexed: 11/20/2022] Open
Affiliation(s)
- Soo Kweon Koo
- Busan Saint Mary's Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Busan, Republic of Korea.
| | - Ji Seung Moon
- Busan Saint Mary's Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Busan, Republic of Korea
| | - Sung Hoon Jung
- Busan Saint Mary's Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Busan, Republic of Korea
| | - Mi Jin Mun
- Busan Saint Mary's Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Busan, Republic of Korea
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Koo SK, Jung SH, Moon JS, Son H. A Case of Nasal Swell Body (Septal Turbinate) Combined with Pneumatization of Perpendicular Plate of the Ethmoid Bone. J Rhinol 2016. [DOI: 10.18787/jr.2016.23.1.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Soo Kweon Koo
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Sung Hoon Jung
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Ji Seung Moon
- Department of Otolaryngology-Head and Neck Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Hyuni Son
- Department of Pathology, Busan Saint Mary's Hospital, Busan, Korea
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Affiliation(s)
- Soo Kweon Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Medical Center, Busan, Korea
| | - Young Jun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Medical Center, Busan, Korea
| | - Sung Hoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Medical Center, Busan, Korea
| | - Hyuni Son
- Department of Pathology, Busan Saint Mary's Medical Center, Busan, Korea
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Koo SK, Kwon SB, Chon KM, Kim YJ, Kim YJ. The role of the maxillary sinus on the voice. Eur Arch Otorhinolaryngol 2014; 272:2347-50. [PMID: 25348340 DOI: 10.1007/s00405-014-3357-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 10/19/2014] [Indexed: 11/24/2022]
Abstract
The objective of the study was to determine the effect of the maxillary sinus on the voice. The prospective study was conducted at an academic secondary referral center. A prospective chart review of 43 patients (17 males, 26 females) who conducted a voice recording and survey before and 3 months after middle meatal antrostomy whose lesion was confined to the maxillary sinus. Subjective voice changes were surveyed using a questionnaire. After phonation [∧m ma: the Korean pronunciation of 'mother'], [Nu Na: the Korean pronunciation of 'sister'], we analyzed the nasal consonant [m] of [∧m ma] and nasalized vowel [a] of [∧m ma] and [a] of [Nu Na]. In the poll conducted, the change rates for males and females were 41.1 % (7/17) and 15.4 % (4/26), respectively; of the male patients, 85.7 % (6/7) felt that the sound quality was better and 14.3 % (1/6) that it was worse. However, all the female patients felt it was better. Among of the patients with an improved voice, reduced nasal sound was the most frequent observation. In an objective analysis, a tendency to lowered frequencies was observed for nasalized vowels after surgery. Significant differences were observed at second formant frequencies of [a] of [∧m ma] and first formant frequencies of [a] of [Nu Na] in female subjects (P < 0.005). Our findings indicated that the maxillary sinus plays a role in the modification of voice quality. Preoperative counseling is important for patients concerning expected changes in the voice after maxillary sinus surgery.
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Affiliation(s)
- Soo Kweon Koo
- Department of Otorhinolaryngology, Busan Saint Mary's Medical Center, Pusan, South Korea,
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Kim YJ, Myung NS, Lee HJ, Koo SK. A case of congenital aplasia of the epiglottis in an adult. Am J Otolaryngol 2014; 35:673-5. [PMID: 24888797 DOI: 10.1016/j.amjoto.2014.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
Abstract
Aplasia or hypoplasia of the epiglottis in an adult is rarely reported congenital anomaly of the larynx. Most patients with epiglottic aplasia have presented fatal symptom of respiratory distress and severe aspiration in infancy or childhood. We present a case of congenital absence of the epiglottis found in a 33-year-old woman complaining of recurrent lingual tonsillitis. Laryngoscopic finding and CT scan revealed an isolated epiglottic aplasia and normal appearance of other laryngeal structure. This is the first description of physiologic evaluation in an epiglottic anomaly to find the compensatory mechanism of aspiration prevention. We discussed this case with a review of literature.
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Koo SK, Choi JW, Myung NS, Lee HJ, Kim YJ, Kim YJ. Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy. Am J Otolaryngol 2013; 34:626-30. [PMID: 24011492 DOI: 10.1016/j.amjoto.2013.07.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 07/24/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE We analyzed site, pattern and degree of obstruction in Korean male obstructive sleep apnea syndrome (OSAS) patients by drug-induced sleep endoscopy (DISE). We also investigated possible links between BMI, AHI and DISE findings. MATERIALS AND METHODS Sixty-nine male patients underwent DISE. DISE findings were reported using our classification system in which modified 'VOTE classification' - obstruction type, site of obstruction, degree of obstruction and anatomical site contributing obstruction - was reported. Associations were analyzed among the results of the polysomnography, patients' characteristics and DISE finding. RESULTS Multilevel airway obstruction was found in 84.06% of patients and 15.94% had a unilevel obstruction. Among those with unilevel obstruction, 90.90% had retropalatal level obstruction and 9.10% had retrolingual level obstruction. Palate with lateral pharyngeal wall obstruction (49.28%) is the most common obstruction type of the retropalatal level and tongue with lateral pharyngeal wall (37.68%) is the most common obstruction type of the retrolingual level. Examining the relation between obstruction site according to body mass index (BMI) and severity of OSAS (apnea hypopnea index, AHI), the lateral pharyngeal wall had an increasing tendency associated with higher BMI and higher AHI. But the lateral pharyngeal wall of both levels was statistically significant associated with higher AHI. CONCLUSION The majority of the Korean male OSAS patients have multilevel obstruction and according to BMI and AHI, the DISE findings indicate that the lateral pharyngeal wall is the most important anatomical site contributing to obstruction regardless of the level at which the obstruction lies.
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Affiliation(s)
- Soo Kweon Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Busan, Korea.
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Myung NS, Kim YJ, Kim YJ, Koo SK. Complicated mumps viral infection: an unusual presentation affecting only submandibular gland. Am J Otolaryngol 2013; 34:600-2. [PMID: 23562490 DOI: 10.1016/j.amjoto.2013.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 02/13/2013] [Indexed: 11/25/2022]
Abstract
This case is a single submandibular gland mumps viral infection patient without parotid gland involvement who developed complications of meningitis and orchitis. Since spontaneous remission is common in mumps viral infection, missing opportunities for exact diagnosis is frequent. As in this case, single submandibular glands infection without parotid gland involvement not only delays diagnosis but also increases risk of developing complications. This case instructs us that despite the atypical manifestation, the clinician should suspect mumps and conduct serologic tests for diagnosis while observing for complications such as meningoencephalitis and orchitis.
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Choi BO, Park MH, Chung KW, Woo HM, Koo H, Chung HK, Choi KG, Park KD, Lee HJ, Hyun YS, Koo SK. Clinical and histopathological study of Charcot-Marie-Tooth neuropathy with a novel S90W mutation in BSCL2. Neurogenetics 2012; 14:35-42. [PMID: 23142943 DOI: 10.1007/s10048-012-0346-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 10/17/2012] [Indexed: 11/28/2022]
Abstract
The objective of the study was to investigate the disease-causing mutation in an autosomal dominant Charcot-Marie-Tooth disease type 2 family and examine the clinical and histopathological evaluation. We enrolled a family of Korean origin with axonal Charcot-Marie-Tooth disease neuropathy (FC305; 13 males, six females) and applied genome-wide linkage analysis. Whole exome sequencing was performed for two patients. In addition, sural nerve biopsies were obtained from two patients. Through whole exome sequencing, we identified an average of 20,336 coding variants from two patients. We also found evidence of linkage mapped to chromosome 11p11-11q13.3 (LOD score of 3.6). Among these variants in the linkage region, we detected a novel p.S90W mutation in the Berardinelli-Seip congenital lipodystrophy 2 (BSCL2) gene, after filtering 31 Korean control exomes. Our p.S90W patients had frequent sensory disturbances, pyramidal tract signs, and predominant right thenar muscle atrophy in comparison with reported p.S90L patients. The phenotypic spectra were wide and demonstrated intrafamilial variability. Two patients with different clinical features underwent sural nerve biopsies; the myelinated fiber densities were increased slightly in both patients, which differed from two previous case reports of BSCL2 mutations (p.S90L and p.N88S). This report expands the variability of the clinical spectrum associated with the BSCL2 gene and describes the first family with the p.S90W mutation.
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Affiliation(s)
- B-O Choi
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
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Wee YM, Kim SC, Koo SK, Kim YH, Jung EJ, Choi MY, Park YH, Park KT, Lim DG, Han DJ. Improved islet yields after purification following the novel endogenous trypsin inhibitor and histidine-tryptophan-ketoglutarate treatment in pigs. Transplant Proc 2008; 40:2585-7. [PMID: 18929808 DOI: 10.1016/j.transproceed.2008.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Adult porcine islet xenotransplantation into humans is greatly diminished by the difficulty to isolate islets because of their fragility. The goal of this study was to improve the efficacy of islet yields using endogenous trypsin inhibitor and histidine-tryptophan-ketoglutarate (HTK) perfusate. METHOD We compared two porcine islet isolation protocols: Eurocollins solution for in situ pancreas perfusion without use of an endogenous trypsin inhibitor versus HTK solution including endogenous trypsin inhibitor for pancreas perfusion. RESULTS Endogenous trypsin inhibitor and HTK strategies significantly improved total islet yield, recovery, and islet index after purification (P < .05), whereas unpurified islet yield did not increase. An average of 228,000 +/- 95,000 islet equivalents (IEQ) (n = 20) purified islets were obtained in the first group compared with 115,000 +/- 56,000 IEQ (n = 18) in the second group. The average islet index was significantly increased in the first group compared with the second group before and after purification: before: 0.28 versus 0.49 versus after: 0.25 versus 0.4 (P < .05). At this time, islet purity, viability, and stimulation index did not show a significant difference between groups. CONCLUSION Our study showed that endogenous trypsin inhibitor and HTK strategies significantly improved purified islet isolation efficacy because of reduction of islet fragility.
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Affiliation(s)
- Y M Wee
- Asan Institute for Life Science, Seoul, Korea
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16
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Koo SK, Kim SC, Wee YM, Kim YH, Jung EJ, Choi MY, Park YH, Park KT, Lim DG, Han DJ. Experimental microencapsulation of porcine and rat pancreatic islet cells with air-driven droplet generator and alginate. Transplant Proc 2008; 40:2578-80. [PMID: 18929806 DOI: 10.1016/j.transproceed.2008.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Transplantation of microencapsulated islets is proposed as an ideal therapy for the treatment of type 1 diabetes mellitus without immunosuppression. This strategy is based on the principle that foreign cells are protected from the host immune system by an artificial membrane. The aim of this study was to establish an ideal condition of microencapsulation using an air-driven droplet generator and alginate in vitro. The optimal conditions for islet encapsulation were an alginate inflow rate of 10 mL/h, CO2 flow rate of 2.0 L/min in a concentration of 2% alginate. For 2.5% alginate, the alginate inflow rate of 20 mL/h, CO2 flow rate 3.0 L/min was ideal; alginate inflow rate of 40 mL/h, CO2 flow rate of 4.0 L/min showed good microcapsules at 3% alginate. Viability of encapsulated islets was greater than 90%. In terms of insulin secretion, encapsulated islets secreted insulin in response to glucose in static culture medium. However, there was no normal response to low or high glucose challenge with a stimulation index less than 2.0. Microencapsulation of pig islets was successfully performed with air-driven droplet generator and alginate in vitro. Further studies about biocompatibility and glucose control in vivo may provide a useful tool for treatment of patients with diabetes mellitus.
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Affiliation(s)
- S K Koo
- Asan Institute for Life Science, Seoul, Korea
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17
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Yoon JS, Park HJ, Yoo SY, Namkung W, Jo MJ, Koo SK, Park HY, Lee WS, Kim KH, Lee MG. Heterogeneity in the processing defect of SLC26A4 mutants. J Med Genet 2008; 45:411-9. [PMID: 18310264 DOI: 10.1136/jmg.2007.054635] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mutations in the SLC26A4 gene are responsible for Pendred syndrome and non-syndromic hearing loss (DFNB4). This study analysed non-synonymous SLC26A4 mutations newly identified in East Asians, as well as three common mutations in Caucasians, to characterise their molecular pathogenic mechanisms and to explore the possibility of rescuing their processing defects. METHODS A total of 11 non-synonymous disease associated mutations were generated and their effects on protein processing and on ion transporting activities were examined. RESULTS Most of the mutations caused retention of the SLC26A4 gene product (pendrin) in the intracellular region, while wild-type pendrin reached the plasma membrane. Accordingly, these mutations abolished complex glycosylation and Cl(-)/HCO(3)(-) exchange activities of pendrin. However, significant heterogeneity in the processing of mutant pendrin molecules was observed. Each mutant protein exhibited a different cellular localisation, a different degree of N-glycosylation, and a different degree of sensitivity to the treatments that rescue processing defects. For example, H723R-pendrin, the most common mutation in East Asians, was mostly expressed in endoplasmic reticulum (ER), and its defects in protein processing and ion transporting activities were restored considerably by low temperature incubation. On the other hand, L236P-pendrin, the most common mutation in Caucasians, was mainly in the centrosomal region and was temperature insensitive. CONCLUSION These results indicate that the processing of pendrin mutant protein is determined by mutant specific mechanisms, and that a mutant specific method would be required to rescue the conformational defects of each folding mutant.
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Affiliation(s)
- J S Yoon
- Department of Pharmacology and Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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18
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Park HJ, Lee SJ, Jin HS, Lee JO, Go SH, Jang HS, Moon SK, Lee SC, Chun YM, Lee HK, Choi JY, Jung SC, Griffith AJ, Koo SK. Genetic basis of hearing loss associated with enlarged vestibular aqueducts in Koreans. Clin Genet 2004; 67:160-5. [PMID: 15679828 DOI: 10.1111/j.1399-0004.2004.00386.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sensorineural hearing loss associated with enlargement of the vestibular aqueduct (EVA) can be associated with mutations of the SLC26A4 gene. In western populations, less than one-half of the affected individuals with EVA have two mutant SLC26A4 alleles, and EVA is frequently caused by unknown genetic or environmental factors alone or in combination with a single SLC26A4 mutation as part of a complex trait. In this study, we ascertained 26 Korean probands with EVA and performed nucleotide sequence analysis to detect SLC26A4 mutations. All subjects had bilateral EVA, and 20 of 26 were sporadic (simplex) cases. Fourteen different mutations were identified, including nine novel mutations. Five mutations were recurrent and accounted for 80% of all mutant alleles, providing a basis for the design and interpretation of cost-efficient mutation detection algorithms. Two mutant alleles were identified in 21 (81%), one mutant allele was detected in three (11%), and zero mutant allele was detected in two (8%) of 26 probands. The high proportion of Korean probands with two SLC26A4 mutations may reflect a reduced frequency of other genetic or environmental factors causing EVA in comparison to western populations.
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Affiliation(s)
- H-J Park
- Soree Ear Clinic, National Institute of Health, 5 Nokbun-dong, Eunpyung-gu, Seoul 122-701, Korea
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Jung SC, Lee KS, Koo SK. Human gene mutations. Gene symbol: AR. Disease: Androgen insensitivity syndrome. Hum Genet 2004; 114:222. [PMID: 15046097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- S C Jung
- Division of Genetic Disease, Department of Biomedical Science, National Institute of Health, 5 Nokbun-dong, Eunpyung-Gu, Seoul 122-701, Korea.
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Kim DY, Kam Y, Koo SK, Joe CO. Gating connexin 43 channels reconstituted in lipid vesicles by mitogen-activated protein kinase phosphorylation. J Biol Chem 1999; 274:5581-7. [PMID: 10026174 DOI: 10.1074/jbc.274.9.5581] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The regulation of gap junctional permeability by phosphorylation was examined in a model system in which connexin 43 (Cx43) gap junction hemichannels were reconstituted in lipid vesicles. Cx43 was immunoaffinity-purified from rat brain, and Cx43 channels were reconstituted into unilamellar phospholipid liposomes. The activities of the reconstituted channels were measured by monitoring liposome permeability. Liposomes containing the Cx43 protein were fractionated on the basis of permeability to sucrose using sedimentation in an iso-osmolar density gradient. The gradient allowed separation of the sucrose-permeable and -impermeable liposomes. Liposomes that were permeable to sucrose were also permeable to the communicating dye molecule lucifer yellow. Permeability, and therefore activity of the reconstituted Cx43 channels, were directly dependent on the state of Cx43 phosphorylation. The permeability of liposomes containing Cx43 channels was increased by treatment of liposomes with calf intestinal phosphatase. Moreover, liposomes formed with Cx43 that had been dephosphorylated by calf intestinal phosphatase treatment showed increased permeability to sucrose. The role of phosphorylation in the gating mechanism of Cx43 channels was supported further by the observation that phosphorylation of Cx43 by mitogen-activated protein kinase reversibly reduced the permeability of liposomes containing dephosphorylated Cx43. Our results show a direct correlation between gap junctional permeability and the phosphorylation state of Cx43.
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Affiliation(s)
- D Y Kim
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Taejon 305-701, Republic of Korea
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Kam Y, Kim DY, Koo SK, Joe CO. Transfer of second messengers through gap junction connexin 43 channels reconstituted in liposomes. Biochim Biophys Acta 1998; 1372:384-8. [PMID: 9675339 DOI: 10.1016/s0005-2736(98)00075-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Gap junction channels reconstituted in liposomes provide a pathway for the transfer of second messengers. Gap junction channels were formed in the artificial unilamellar liposomes using immunoaffinity-purified connexin 43 gap junction protein from rat brain. Sucrose-permeable and -impermeable liposomes were separated on the basis of sucrose permeability in the iso-osmolar sucrose density gradient. The liposomes permeable to sucrose were also permeable to a communicating dye molecule, Lucifer yellow. In the present study, we examined the transfer of second messengers through the connexin 43 channels reconstituted in liposomes and first report the direct evidence that the gap junction channels are permeable to second messengers including adenosine 3',5'-cyclic phosphate and inositol 1,4,5-trisphosphate.
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Affiliation(s)
- Y Kam
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Taejon 305-701, South Korea
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Abstract
Gap junctional communication during the progression of cell cycle from quiescent G0 to S phase was examined in cultured clone 9 rat liver cells. The transfer of scrape-loaded fluorescent dye was suppressed immediately after the stimulation of cell cycle progression in a synchronized cell population. Northern blot analysis showed that the temporal disturbance of gap junctional communication in cells passing from G0 to S phase did not result from transcriptional down-regulation of connexin 43. It was also found that the PKC inhibitor, calphostin C, was able to restore intercellular communication in serum stimulated cells. Data suggest a control mechanism by PKC mediated phosphorylation in the regulation of gap junction function which is vulnerable to cell cycling. The loss of gap junctional communication correlated with the increased phosphorylation of connexin 43 on serine residues in clone 9 cells.
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Affiliation(s)
- S K Koo
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Taejon, South Korea
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Abstract
This study was conducted to assess the effects of chemical carcinogens on the gap junction-mediated intercellular communication in cultured mammalian cells. The method of scrape-loading dye transfer of lucifer yellow was adapted as a measure of gap junctional communication. Clone 9 cells derived from rat liver were treated with a model chemical carcinogen, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and the gap junctional communication was assessed by measuring the transfer of scrape-loaded lucifer yellow dye. When cells were treated with the carcinogen at 0.3 mg/ml, the fluorescent dye transfer was inhibited by 90% in 60 min. Other chemical agents, which include direct or indirect carcinogens and antitumor drugs, were also examined for their effects on the gap junctional communication. Direct carcinogens, such as MNNG, hydroxylamine and ethidium bromide, exhibited strong inhibition of intercellular communication, while indirect carcinogens, such as aflatoxin B1 and ethionine, exerted minor effects. Effects of test chemicals on the cell communication through gap junctions were readily quantitated by counting the number of cells stained with the fluorescent dye.
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Affiliation(s)
- M R Na
- Department of Life Science, Korea Advanced Institute of Science and Technology (KAIST), Taejon
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