Cross-sensitization between inhalant allergens and food allergens: the extent, intensity, and age-related shifts.

BACKGROUND: Encountering individuals sensitized to both inhalant and food allergens is challenging in clinical practice. Despite its rarity, studies have documented cross-sensitization between these allergens. However, the extent, diversity, and age-related variations of this phenomenon remain unclear. OBJECTIVE: Hence, our objective was to investigate a substantial quantity of allergy sensitivity test results in which both inhalant and food allergens were concurrently examined. The primary goal of our study is to calculate the cross-sensitization ratio, with a secondary objective of analyzing this phenomenon across four age groups. METHODS: A retrospective analysis was conducted on a multiple-antigen simultaneous test (MAST) obtained from a domestic laboratory medicine facility and comprising 55 food allergens and 49 inhalant allergens from 368,156 individuals aged 1 to 89. By calculating the cross-sensitization ratio, the degree of cross-sensitization between each food allergen and inhalant allergen was determined. Further subgroup analysis was conducted to ascertain the cross-sensitization ratio between the four subgroups categorized by age. RESULTS: The median cross-sensitization ratio between food and inhalant allergens was 5.14, indicating a significant level of cross-sensitization. The cross-sensitization ratio was greatest among pollen allergens and plant-derived food allergens, followed by between some animal aeroallergens and meat/fish/dairy/poultry food allergens. The degree of overall cross-sensitization was least prominent in adolescents, greater in adults and children, and most pronounced in the elderly. CONCLUSION: Our findings reveal that various inhalant and dietary allergens have considerable cross-sensitivity, with the elderly having the highest degree of cross-sensitivity and adolescents the lowest.

Comparison of body size perception of young women in Korea and the United States.

Body size perception among young women in Asian and Western countries is believed to be quite different, however, there are no confirming studies. We analyzed the data from young women aged between 20 and 40 who participated in the National Health and Nutrition Examination Survey (2001-2018) of the United States (US) and Korea. US young women had higher rates of being overweight and obesity than Korean young women, and there was no significant change over 20 years. In both countries, the percentage of properly estimating one's own weight exceeded 70 percent and remained relatively steady. The percentage of overestimating one's own weight was only about 10 percent in Korea in 2001, but increased to 20 percent. In the case of the US, the percentage was about 15 percent in 2001-2002, but has since continued to decline. The percentage of underestimating one's own body weight was about 18 percent in Korea in 2001, but decreased to about 8 percent. In the case of the US, the percentage was very low at about 10 percent in 2001-2002, but gradually increased to about 18 percent in 2017-2018. In conclusion, young women in the US tend to underestimate their body size, and those in Korea tend to overestimate it.

Limited Palatal Muscle Resection for the Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.

Background and Objectives: Limited palatal muscle resection (PMR) is a surgical technique employed to alleviate respiratory disturbances in obstructive sleep apnea (OSA) patients with retropalatal narrowing by reducing soft palate volume and tightening the muscles. Although some previous publications have demonstrated the effectiveness of limited PMR, the overall efficacy and therapeutic role of limited PMR for the treatment of OSA remain uncertain. This study utilized meta-analysis and a systematic literature review to estimate the overall effectiveness of limited PMR in treating OSA. Materials and Methods: Multiple databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, were searched using specific keywords related to OSA and limited PMR. Original articles assessing respiratory disturbances before and after limited PMR in patients with OSA were included. Data from selected articles were collected using standardized forms, including clinicodemographic characteristics, apnea-hypopnea index (AHI), and lowest pulse oximetry values (minimum SpO2). Random effect models were used for analyzing significant heterogeneity. Egger's test and funnel plot were used to identify publication bias. Results: Four studies were included in this meta-analysis for AHI, and three studies were included for minimum SpO2 during sleep. A significant reduction in the AHI and an increase in the minimum SpO2 were shown following limited PMR as the standardized mean difference (95% confidence interval) was 2.591 (1.092-4.090) and 1.217 (0.248-2.186), respectively. No publication bias was found in either analysis. Conclusions: The results of the meta-analysis and systemic review add to the literature that limited PMR can result in a reduction in the AHI and an increase in min SaO2. In OSA patients with suspected retropalatal obstruction, limited PMR may be efficiently performed.

Validation Study on Automated Sleep Stage Scoring Using a Deep Learning Algorithm.

Background and Objectives: Polysomnography is manually scored by sleep experts. However, manual scoring is a time-consuming and labor-intensive task. The goal of this study was to verify the accuracy of automated sleep-stage scoring based on a deep learning algorithm compared to manual sleep-stage scoring. Materials and Methods: A total of 602 polysomnography datasets from subjects (Male:Female = 397:205) aged 19 to 65 years (mean age, 43.8, standard deviation = 12.2) were included in the study. The performance of the proposed model was evaluated based on kappa value and bootstrapped point-estimate of median percent agreement with a 95% bootstrap confidence interval and R = 1000. The proposed model was trained using 482 datasets and validated using 48 datasets. For testing, 72 datasets were selected randomly. Results: The proposed model exhibited good concordance rates with manual scoring for stages W (94%), N1 (83.9%), N2 (89%), N3 (92%), and R (93%). The average kappa value was 0.84. For the bootstrap method, high overall agreement between the automated deep learning algorithm and manual scoring was observed in stages W (98%), N1 (94%), N2 (92%), N3 (99%), and R (98%) and total (96%). Conclusions: Automated sleep-stage scoring using the proposed model may be a reliable method for sleep-stage classification.

Association between obstructive sleep apnea and thyroid cancer incidence: a national health insurance data study.

PURPOSE: Little is known about the incidence of thyroid cancer in patients with obstructive sleep apnea (OSA). This study aimed to evaluate whether OSA is associated with the incidence of thyroid cancer based on the Korea National Health Insurance Service (KNHIS) database. METHODS: This study was designed as a retrospective cohort data analysis of the KNHIS dataset. A total of 198,574 patients who were over 20 years of age and had been newly diagnosed with OSA between 2007 and 2014 were enrolled. A control group of 992,870 individuals was selected based on propensity score matching by age and sex. The mean follow-up duration was 4.5 ± 2.3 years. The primary endpoint was the incidence of newly diagnosed thyroid cancer. RESULTS: The hazard ratio (HR) for thyroid cancer incidence among OSA patients compared to the control was 1.72 (95% confidence interval [CI] 1.60-1.84) based on Model 1 (not adjusted by any covariate) and 1.64 (95% CI 1.53-1.76) based on Model 2 (adjusted by income level, diabetes, hypertension, and dyslipidemia). Thyroid cancer incidence was significantly higher in male patients (HR = 1.93, 95% CI 1.74-2.12) than female ones (HR = 1.39, 95% CI 1.26-1.54). When compared by age, the HR of thyroid cancer was higher in middle-aged (40 ≤ age < 65 years) patients (HR = 1.68, 95% CI 1.55-1.83) than in young (20 ≤ age < 40 years, HR = 1.53, 95% CI 1.32-1.77) or old (65 ≤ age, HR = 1.28, 95% CI 0.94-1.74) patients. CONCLUSION: OSA may increase the risk of developing thyroid cancer, especially in middle-aged men.

Rare Case of Absent Common Carotid Artery Likely Associated with Intracranial Aneurysm Development.

Congenital absence of the common carotid artery without separate origin of internal carotid artery and external carotid artery from the aortic arch is a very rare anomaly. A persistent proatlantal intersegmental artery into adult life is also a rare condition. We report a patient with the coexistence of such rare conditions who presented with cerebral infarctions and intracranial aneurysms.

Inhibitor of DNA binding 2 is a novel therapeutic target for stemness of head and neck squamous cell carcinoma.

BACKGROUND: Head and neck squamous cell carcinomas (HNSCCs) are highly lethal epithelial tumours containing self-renewal cancer stem cells (CSCs). CSCs in HNSCCs are strongly associated with tumour initiation, invasion, and chemoradiation resistance. However, the important factors regulating stemness in HNSCCs remain unclear. Here, we investigated the molecular roles and clinical significance of inhibitor of DNA binding 2 (Id2) protein to determine if it constitutes a novel therapeutic target for ablating HNSCC cells with stemness. METHODS: We performed in vitro and in vivo studies of Id2 function and its effects on stemness using HNSCC cells. We also examined whether Id2 expression could be used as a prognostic indicator through immunohistochemical staining of 119 human HNSCC tumours. RESULTS: Expression of Id2 was higher in HNSCC cells with stemness compared with differentiated HNSCC cells. Overexpression of Id2 increased proliferation, self-renewal, and expression of the putative stemness marker CD44 in HNSCC cells in vitro and in vivo. In contrast, silencing of Id2 using short hairpin RNA attenuated the stemness phenotype of HNSCC cells by reducing self-renewal, CD44 expression, cisplatin chemoresistance, and xenograft tumourigenicity. Most importantly, increased expression of Id2 was closely associated with poorer post-treatment survival rates in HNSCC patients. CONCLUSIONS: Inhibitor of DNA binding2 represents a novel and promising therapeutic target for treating and improving the clinical outcomes for patients with HNSCC.

The effect of continuous positive airway pressure on cardiopulmonary coupling.

PURPOSE: The aim of the study was to investigate cardiopulmonary coupling (CPC) as a tool for evaluating the efficacy of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA). METHOD: The medical records of patients who had undergone either standard polysomnography (PSG-only group, n = 62) or split-night CPAP titration (CPAP titration group, n = 115) due to habitual snoring or sleep apnea were analyzed. RESULT: The apnea-hypopnea index, CPC variables, and sleep stage (%) during the first 2 h of the sleep study did not differ between the PSG-only and CPAP titration groups. A comparison of data collected over the first 2 h and that collected over the rest of the sleep study revealed that high-frequency coupling (HFC) increased, and low-frequency coupling (LFC) and elevated LFC (e-LFC) decreased only for the CPAP titration group, while they did not change for the PSG-only group. The proportions of N1 and N3 stages and arousal index decreased while the proportion of R stage increased for both groups. The proportion of N2 stage and mean O2 saturation increased only for the CPAP titration group, while they did not change significantly for the PSG-only group. HFC increased while LFC and e-LFC decreased linearly as apnea-hypopnea index decreased for the CPAP titration group. CONCLUSION: CPC effectively reflects the treatment effect of CPAP when compared with an electroencephalography-based sleep stage assessment.

Validation of ApneaLink™ Plus for the diagnosis of sleep apnea.

PURPOSE: The aim of this study is to evaluate the validation of ApneaLink™ Plus (ALP) based on a large number of subjects in a prospective design. METHOD: We recommended enrolling of 200 consecutive patients who had been referred because of habitual snoring or witnessed apnea during sleep. If consent was obtained, patients underwent standard polysomnography (PSG) and ALP evaluation simultaneously at the hospital (ALPlab), and repeated ALP at home (ALPhome) within 1 month. The parameters of ALP were scored based on three different systems, Manual, Auto AASM, and Auto scoring systems. RESULT: Among the 200 patients who were recommended for enrollment, 149 completed the study. Sensitivity was good for all three scoring systems, while specificity was poor for the Auto scoring system. The area under curve was highest for the manual scoring system and lowest for the auto scoring system, and increased as the apnea-hypopnea index (AHI) cutoff value increased from 5 to 30. Regarding agreement with PSG, the manual scoring system was most superior, followed by the Auto AASM, and Auto scoring systems. The degree of agreement between PSG and ALP was affected by sleep efficiency and the arousal index. Moderate agreement between PSG and ALP based on central apnea index was observed. CONCLUSION: ALP is an accurate and reliable device for the diagnosis of OSA. Manual scoring is recommended; however, Auto AASM is also acceptable. ALP detects central sleep apnea to a certain degree. Both sleep efficiency and the arousal index affect the results of ALP.

Association between sleep duration and the prevalence of atopic dermatitis and asthma in young adults.

BACKGROUND: Sleep duration affects allergic diseases; however, this association requires further investigation. OBJECTIVE: To evaluate the association between sleep duration and the prevalence of atopic dermatitis and asthma in young Korean adults. METHOD: We analyzed data of 10,148 subjects (4,239 men; 5,909 women) aged 19-39 years from the Korean National Health and Nutrition Examination Survey 2008-2010. Self-reported sleep duration was categorized into five groups: ≤5h, 6h, 7h, 8h, and ≥9h. The prevalence of atopic dermatitis and asthma was examined based on a questionnaire and compared between participants from five sleep duration groups after adjusting for potential confounding factors, including model 1 [age], model 2 [model 1 + BMI, current smoking, current alcohol use, regular physical activity, household income, and serum 25(OH)D level], and model 3 [model 2 + stress levels]. RESULTS: In female participants, a higher risk of atopic dermatitis was associated with sleep duration ≤5 hours [odds ratio (OR): 1.665, 95% confidence interval (CI): 1.004-2.762; model 1], and ≥9 hours (OR, 1.746, 95% CI, 1.145-2.661; model 3), compared to a 7-hour sleep duration. Similarly, a higher risk of asthma was associated with sleep duration ≤5 hours and ≥9 hours (OR, 1.553, 95% CI, 1.023-2.359 and OR, 1.569, 95% CI, 1.048-2.349, respectively; model 3). In male participants, there was no significant association between sleep duration and the prevalence of atopic dermatitis or asthma. CONCLUSIONS: Sleep duration ≤5 and ≥9 hours may be a risk factor for atopic dermatitis and asthma in young female adults.

Arterial supply of the human soft palate.

PURPOSE: Palatal surgery for snoring or obstructive sleep apnea is commonly performed; however, the vascular anatomy of the soft palate is not well described. The purpose of this study was to evaluate the vascular anatomy of the soft palate. METHODS: This study was performed on 22 adult cadaveric heads. All specimens were prepared with vascular injections using red liquid silicone through the common carotid artery. The palate was then harvested and decolorized, and the vascular anatomy was studied. RESULTS: Of 22 specimens, 20 had sufficient uptake of the silicone dye. The anterior and posterior branches of the ascending palatine artery were the main feeding vessels of the soft palate; however, they were not always present simultaneously. The anterior branch alone was identified 25% of the time (5/20), while the posterior branch alone was found in 35% (7/20) of specimens. Both anterior and posterior branches were simultaneously present in 40% (8/20) of cases. Mean diameter of the anterior branch (0.73 ± 0.09 mm) was significantly greater than that of the posterior branch (0.48 ± 0.08 mm, p < 0.001). Mean vertical distance from the palatal arch to the posterior branch was 9.3 ± 2.4 mm. CONCLUSIONS: The soft palate is supplied by the anterior and posterior branches of the ascending palatine artery; however, the arteries were not always present simultaneously. In cases where the anterior branch is absent and the posterior branches terminate close to the uvula, injury to the primary blood supply to the palate might occur more frequently during surgery.

Microembolic signal monitoring and the prediction of thromboembolic events following coil embolization of unruptured intracranial aneurysms: diffusion-weighted imaging correlation.

INTRODUCTION: Microembolic signal (MES) monitoring with transcranial Doppler ultrasonography (TCD) may allow for early prediction of thromboembolisms following endovascular coiling of unruptured intracranial aneurysms (UIAs). However, the method has not gained widespread use and may benefit from correlation with diffusion-weighted imaging (DWI) of acute ischemic lesions after coiling. This purposed to evaluate the relationship between MESs and DWI-positive lesions more precisely. METHODS: We conducted a prospective study on 45 consecutive patients. TCD was performed over the artery that is dependent on the site of aneurysm, but seven patients (15.6%) could not be examined due to the lack of an adequate cranial window. Consequently, 38 patients were available to detect MESs immediately (MES-1) and 24 h (MES-2) after coiling for UIAs. We also checked DWI 1 day after the coiling and analyzed correlations between the TCD and DWI findings. RESULTS: MES-1 and MES-2 were positive in 25 (65.7%) and 14 (36.8%) patients, respectively. DWI-positive lesions were seen in 20 (52.6%) patients, and only 1 (2.6%) patient was symptomatic. MES-1 and MES-2 were strongly correlated with the number of DWI-positive lesions (Spearman's correlation coefficient = 0.79 and 0.70, P < 0.01 and P < 0.01, respectively). Additionally, there was a significant correlation between MES-1 and MES-2 (Spearman's correlation coefficient = 0.70). CONCLUSION: Based upon the significant correlation between MES and DWI findings, MES may have a role for early detection of ischemic complications after coiling of UIAs. In addition, future study for further validation with clinical application seems requiring.

Analysis of the nasal vestibule mycobiome in patients with allergic rhinitis.

Advances in culture-independent sequencing methods have been utilised in recent studies to understand the phylogenetic composition of the human microbiome of healthy and diseased skin. Allergic rhinitis (AR) is an inflammatory condition of the nasal cavity caused by environmental allergens. Although nasal microbial communities have been considered important contributors in human health, no studies to date have comprehensively compared fungal communities (mycobiome) of the nasal vestibule using the culture-independent pyrosequencing method. This study aimed to investigate how fungal communities of the nasal vestibule skin surface are influenced by AR. The phylogenetic composition of the nasal vestibule mycobiome of patients with AR was analysed by culture-independent pyrosequencing methods and compared with healthy individuals. A total of 69 fungal genera were identified from both AR samples and healthy controls, and the genus Malassezia predominated in the nasal vestibule. Species-level analysis classified eight different Malassezia species including M. pachydermatis and M. cuniculi, which were normally isolated from animals, and revealed M. restricta to be the most abundant species in the nasal vestibule. Although high interpersonal variation was observed, some of the AR samples displayed significantly higher diversities than healthy controls at both the genus and species level.

Enhanced production of reactive oxygen species by gadolinium oxide nanoparticles under core-inner-shell excitation by proton or monochromatic X-ray irradiation: implication of the contribution from the interatomic de-excitation-mediated nanoradiator effect to dose enhancement.

Core-inner-valence ionization of high-Z nanoparticle atomic clusters can de-excite electrons through various interatomic de-excitation processes, thereby leading to the ionization of both directly exposed atoms and adjacent neutral atoms within the nanoparticles, and to an enhancement in photon-electron emission, which is termed the nanoradiator effect. To investigate the nanoradiator-mediated dose enhancement in the radio-sensitizing of high-Z nanoparticles, the production of reactive oxygen species (ROS) was measured in a gadolinium oxide nanoparticle (Gd-oxide NP) solution under core-inner-valence excitation of Gd with either 50 keV monochromatic synchrotron X-rays or 45 MeV protons. This measurement was compared with either a radiation-only control or a gadolinium-chelate magnetic resonance imaging contrast agent solution containing equal amounts of gadolinium as the separate atomic species in which Gd-Gd interatomic de-excitations are absent. Ionization excitations followed by ROS measurements were performed on nanoparticle-loaded cells or aqueous solutions. Both photoexcitation and proton impact produced a dose-dependent enhancement in the production of ROS by a range of factors from 1.6 to 1.94 compared with the radiation-only control. Enhanced production of ROS, by a factor of 1.83, was observed from Gd-oxide NP atomic clusters compared with the Gd-chelate molecule, with a Gd concentration of 48 µg/mL in the core-level photon excitation, or by a factor of 1.82 under a Gd concentration of 12 µg/mL for the proton impact at 10 Gy (p < 0.02). The enhanced production of ROS in the irradiated nanoparticles suggests the potential for additional therapeutic dose enhancements in radiation treatment via the potent Gd-Gd interatomic de-excitation-driven nanoradiator effect.

Peptoniphilus rhinitidis sp. nov., isolated from specimens of chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) is an inflammatory disorder of the nasal cavity and paranasal sinus related to bacterial infection. A previous study suggested that a specific bacterial group may have an important role in the course of CRS. In this study, bacteria isolated from CRS patients were characterized. A total of 15 strains were identified as Gram-positive anaerobic cocci (GPAC), which were able to utilize peptone as a sole carbon source. Sequencing of the 16S ribosomal RNA gene revealed that the isolates were closely related to members of the genus Peptoniphilus (>97% similarity) within the Clostridiales Family XI. Incertae Sedis. Genotypic and phenotypic characterization suggests that these isolates represent a novel species of the genus Peptoniphilus associated with CRS. The type strain of Peptoniphilus rhinitidis is 1-13T (=KCTC 5985T=JCM 17448T).

Changes in the upper airway after counterclockwise maxillomandibular advancement in young Korean women with class II malocclusion deformity.

PURPOSE: To evaluate the change in the upper airway in a Class II malocclusion deformity after counterclockwise maxillomandibular advancement. MATERIALS AND METHODS: Seventeen young Korean women with a Class II malocclusion deformity who had undergone Le Fort I and bilateral mandibular ramus sagittal split osteotomy in a counterclockwise rotation were enrolled in the present study. The upper airway was measured at 3 different levels (uvula tip, low C2, and mid C3) using lateral cephalograms at 3 points: preoperatively (T0) and 2 (T2) and 12 (T12) months postoperatively. The changes in the upper airway were then compared. RESULTS: The mandible advanced an average of 7.0 ± 3.8 mm. The upper airway had widened considerably at all 3 levels at T2 and had decreased slightly at T12, especially at the low C2 level compared with T0. However, the upper airway at T12 remained wider than at T0 at all 3 levels. The mandibular advancement and upper airway width correlated only at T12 at the mid C3 level. CONCLUSIONS: The upper airway became wider in patients with a Class II malocclusion deformity who had undergone mandibular advancement. However, this might become narrower with time.

Estimation of the Effectiveness of a Tighter, Reinforced Quarantine for the Coronavirus Disease 2019 (COVID-19) Outbreak: Analysis of the Third Wave in South Korea.

It has been claimed that a tighter, reinforced quarantine strategy was advocated to reduce the transmission of coronavirus disease 2019 (COVID-19) during major outbreaks; however, there have been no prior quantitative studies examining the effectiveness and duration of such a reinforced quarantine. Consequently, the purpose of this research was to determine the impact of a "tighter, reinforced" quarantine during the third COVID-19 breakout wave in South Korea, which occurred between late 2020 and early 2021. The efficacy of the quarantine was determined by comparing the number of newly diagnosed COVID-19 patients between the "prediction model" and "actual observed data." Two prediction models were developed using the autoregressive integrated moving average (ARIMA; 1, 0, 0) model. The effect of a "tighter, reinforced" quarantine, which would show as an immediate drop in the number of new cases, predicted its efficacy by lowering the number of new cases by 20,400. In addition, the efficacy of the quarantine lasted up to more than three months. The findings of our investigation confirmed the beneficial influence of "tighter, controlled" quarantine laws during a widespread COVID-19 epidemic. During an epidemic, when the population has not yet developed immunity to respiratory viral diseases, our study may be evidence for implementing stricter quarantine restrictions in order to reduce the number of new cases.

Incidence disparities of obstructive sleep apnea-associated lung cancer by gender; Korean National Health Insurance data analysis.

Introduction: Obstructive sleep apnea (OSA) is known to increase the risk of various cancers. By analyzing the Korea National Health Insurance Service (KNHIS) registry, the impact of OSA on the lung cancer incidence was analyzed in a retrospective cohort group. Methods: A retrospective cohort of adult patients newly registered with OSA in the KNHIS data from 2007 to 2017 was included and observed until December 2019 (12 years). The main outcome measure was newly diagnosed lung cancer. The control group was set with age and sex that matched those in the OSA group. Results: The hazard ratio (HR) of OSA for lung cancer incidence showed a significantly reduced HR of 0.87 (95% CI, 0.82-0.93). The observed significance of this finding was limited to male OSA patients [HR, 0.84 (95% CI, 0.78-0.90)], while no significant association was found in female OSA patients [HR, 1.05 (95% CI, 0.91-1.21)], irrespective of their age. Discussion: OSA patients have a lower risk of developing lung cancer, but this risk reduction is gender-specific, as female OSA patients do not show a reduction in hazard ratio.