Objectives/Hypothesis: To determine whether there is a difference in the tongue size of patients with and without sleep-disordered breathing (SDB) and to evaluate whether tongue volume correlates with body mass index (BMI), neck circumference, age, Epworth Sleepiness Scale score, or apnea-hypopnea index (AHI). Study Design: Nineteen patients (9 with SDB; 10 without SDB) were enrolled in this prospective study. Methods: All patients completed a sleep questionnaire including the Epworth Sleepiness Scale and underwent a physical examination, portable sleep study, and magnetic resonance imaging (MRI) study. An examiner masked to the patients' disease status measured tongue volume from the MRI films. Results: There was a trend for patients with SDB to have a larger tongue volume than patients without SDB (P ‫؍‬ .065). Tongue volume only positively correlated with BMI (P ‫؍‬ .005) and neck circumference (P ‫؍‬ .013), but there was no correlation with age (P ‫؍‬ .23) or AHI (P ‫؍‬ .40). Conclusions: There is a statistical trend for patients with SDB to have larger tongue size compared with non-SDB patients, but tongue size is independent of AHI and correlates significantly with BMI and neck circumference. We interpret these findings to suggest that variations in tongue size alone cannot account for disease severity and may simply reflect the larger body habitus often seen in patients with SDB.

We conducte d a survey ofotolaryngo logi sts at all Veterans Administration and Department ofDefen se hospitals in the United Stat es to asee ttain the natu re and scope of their treatm eilt ofsleep-diso rdere d breathing. Questionnaire responses indic ate d that head and neck surgeons in military hospitals have a strong interes t in the management ofpatiellts with snoring and sleep apnea. Because of the difficulty in obtaining titnely sleep test results and the 10 1V number of referrals from pliysicia ns who pe iform such testing, many oto lary ngo logists express ed a desire to be able to perfortn their OIvn sleep testing.

Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, and highly specific home sleep study equipment is now available. The present study was undertaken to determine whether an otolaryngologist could easily and effectively dispense home sleep equipment from the office. We used a portable AutoSet home sleep machine. Our experience with the first 100 consecutively presenting patients was recorded and analyzed under institutional review board approval. Ninety-nine of the 100 tests were completed successfully on the first attempt; the one failure was successful on the second attempt. Our results were consistent with those reported from in-house polysomnogram sleep studies; 71 % of our patients had an apnea-hypopnea index (AH1) of 15 or higher, and 93% had an AHI of at least 5. We conclude that an otolaryngologist, using state-of-the-art home sleep testing equipment, can accurately and cost-effectively prescribe home sleep studies.

42 Background: Gastric cancer development is multifactorial with varying incidence rates. People of Korean heritage have the highest rate of gastric cancer in the world and among Americans. While this gastric cancer disparity is well known, an evaluation of the population-specific risk factors and the effectiveness of selective screening in the Korean American communities have not been studied. Methods: Korean Americans living in Northern New Jersey over 40 years of age without a known history of gastric cancer were eligible to participate in this prospective study. Each participant received a 30-minute one-to-one consultation with a gastric cancer surgeon, given a 44-item questionnaire, and underwent an upper endoscopy with biopsies. The consultation included assessment for the presence of relevant history, symptoms, and signs. The questionnaire addressed patient-specific demographic, epidemiologic, and cultural information. Two gastroenterologists blinded to the consultation and questionnaire results performed the upper endoscopies. Results: Between September 2013 and September 2014, one hundred participants enrolled in our study. All participants denied the presence of alarm symptoms, such as acute weight loss, melena or persistent vomiting. Risk factors, including prior H. pylori infection (25%), family history of gastric cancer (15%), cigarette smoking (16%), and daily intake of salty and pickled foods (87%) were present. On upper endoscopy, 18% of the participants were found to have “moderate to severe H. pylori associated chronic active gastritis." Other endoscopic findings were mild gastritis (61%), severe erosive gastritis (4%), polyps (4%), and metaplasia (21%). Only 4 patients had normal mucosal pathology. Gastric dysplasia or cancer has not yet been identified. Conclusions: Korean Americans have high rates of modifiable risk factors for developing gastric cancer. Novel population-specific gastric cancer prevention and early detection strategies should be designed to eliminate gastric cancer from the Korean American Community.