Suk Won Chang

Background and Objectives: The serum galactomannan test (GM test) and the (1,3)-β-D-glucan test (G test) are utilized in diagnosing invasive fungal sinusitis. However, their effectiveness in detecting paranasal sinus fungus balls (FBs) has not been established. This study aimed to explore their diagnostic value in patients with FBs.Methods: We retrospectively reviewed the medical records of 105 patients (42 with FBs and 63 with chronic rhinosinusitis [CRS]) who underwent serum GM and G tests between June 2020 and May 2021. Olfactory test results and demographics were also analyzed.Results: There were 42 FB patients (10 men, 32 women) and 63 CRS patients (27 men, 36 women). The positivity rates for serum GM (7.1% in the FB group vs. 3.2% in the CRS group, p=0.640) and G test (9.5% in the FB group vs. 11.1% in the CRS group, p=0.482) did not differ significantly between groups. The sensitivities of the GM and G tests were 7.1% and 9.5%, respectively, and their specificities were 96.8% and 88.9%, respectively. The positive predictive values were 60.0% for the GM test and 36.3% for the G test, and the negative predictive values were 61.0% for the GM test and 59.6% for the G test.Conclusion: Serum GM and G tests demonstrated low sensitivity and high specificity, indicating limited effectiveness in differentiating between patients with FBs and those with CRS. Histological examination remains the gold standard for the definitive diagnosis of FBs.

Several studies have shown an association between albuminuria and obstructive sleep apnea (OSA). However, studies on the relationship between the STOP-BANG questionnaire that can screen for OSA and microalbuminuria are still insufficient. Therefore, this study attempted to clarify the relationship between microalbuminuria and OSA risk using the STOP-BANG questionnaire in Korean adults. A total of 7478 participants (3289 men and 4189 women) aged over 40 were enrolled in the Korean National Health and Nutrition Examination Survey from 2019 to 2020. STOP-BANG questionnaire to screen OSA was obtained from subjects. The urinary albumin/creatinine ratio (ACR) and proteinuria were measured via a single dipstick to evaluate renal function. The high OSA risk group had a higher mean ACR value than the low OSA risk group (36.8 ± 172.2 vs 17.7 ± 82.5; P < 0.001). The proportion of subjects with values of 30 ≤ ACR < 300 mg/g (11.9% vs 6.1%; P < 0.001) and ACR > 300 mg/g (2.1% vs 0.7%; P < 0.001) was significantly higher in high OSA risk group. Multivariate logistic regression results confirmed that microalbuminuria (OR 1.279, 95% confidence interval (CI) 1.068–1.532, P = 0.008) was significantly correlated with high OSA risk. In addition, significant correlation with high OSA risk was also found in macroalbuminuria (OR 1.684, 95% CI 1.073–2.530, P = 0.022) and proteinuria (OR 1.355, 95% CI 1.030–1.783, P = 0.030). We confirmed a significant correlation between high OSA risk and albuminuria/proteinuria in Korean adults. Therefore, renal function evaluation is required in high OSA risk patients, and OSA diagnosis through PSG test and treatment is necessary.

Objectives: To investigate the relationship between subjective voice changes and appendicular skeletal muscle in the elderly in Korea.Design: Retrospective cross‐sectional study.Setting: Population‐based survey data were collected by the Korean National Health and Nutrition Examination Survey between January 2009 and December 2011.Participants: A total of 2611 participants (1081 men and 1530 women) aged 65 to 80 years were enrolled in the Korean National Health and Nutrition Examination Survey from 2009 to 2011. A 70‐degree laryngeal endoscopy was performed to check for abnormalities in the larynx, while dual‐energy x‐ray absorptiometry was utilised to measure appendicular skeletal muscle mass. The correlation between subjective voice change and appendicular skeletal muscle index (ASMI) was analysed using a linear‐by‐linear association test and logistic regression analysis.Results: When comparing ASMI according to the presence or absence of subjective voice change, elderly men showed significantly lower ASMI values when subjective voice change was present (p = .021). However, in women, the ASMI was not significantly lower in the presence of subjective voice changes (p = .365). We confirmed that subjective voice change was significantly lower in the highest quintile of ASMI compared to lowest quintile of ASMI in the men using logistic regression analysis (B 0.281, 95% confident interval 0.082–0.964, p < .044).Conclusions: This study has shown that in Korean men aged >65 years, subjective voice abnormality significantly increased as skeletal muscle mass decreased. Further longitudinal studies are needed to determine whether a correlation exists between objective voice test results and ASMI.

There are very few reports of extranodal nasal-type NKTL with septal perforation, as seen in our patient. In addition, extranodal nasal-type NKTL is often diagnosed as chronic inflammation on histopathological examination. Therefore, if nasal septal perforation does not improve with appropriate conservative treatment, clinicians should consider a malignant disease such as extranodal nasal-type NKTL.