bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech Intelligibility Differences across Sound Classes with in-the-Ear and Free-Field Microphones in Quiet
Authors: Estis Julie M. , Parisi Julie A. , Moore Robert E. , Brungart Douglas S.
Published: July 2011

Speech intelligibility performance with an in-the-ear microphone embedded in a custom-molded deep-insertion earplug was compared with results obtained using a free-field microphone. Intelligibility differences between microphones were further analyzed to assess whether reduced intelligibility was specific to certain sound classes. 36 participants completed the Modified Rhyme Test using recordings made with each microphone. While speech intelligibility for both microphones was highly accurate, intelligibility with the free-field microphone was significantly better than with the in-the-ear microphone. There were significant effects of place and manner of sound production. Significant differences in recognition among specific phonemes were also revealed. Implications included modifying the in-the-ear microphone to transmit more high frequency energy. Use of the in-the-ear microphone was limited by significant loss of high-frequency energy of the speech signal which resulted in reduced intelligibility for some sounds; however, the in-the-ear microphone is a promising technology for effective communication in military environments.
What is the Role of Partial Middle Turbinectomy in Endocanalicular Laser-assisted Endonasal Dacryocystorhinostomy?
Authors: Basmak Hikmet , Cakli Hamdi , Sahin Afsun , Gursoy Huseyin , Ozer Ahmet , Colak Ertugrul
Published: July 2011

Background

This study was designed to compare outcomes of endocanalicular laser-assisted endonasal dacryocystorhinostomy (DCR) with and without partial anterior middle turbinectomy.

Methods

A prospective randomized comparative study was conducted on 91 subjects with primary acquired nasolacrimal duct obstruction, undergoing endocanalicular (ECL) procedures. Group 1 was composed of 44 (7 bilateral) patients undergoing ECL diode laser-assisted endonasal DCR without partial anterior middle turbinectomy and group 2 was composed of 47 (7 bilateral) patients undergoing partial anterior middle turbinectomy and ECL diode laser-assisted endonasal DCR. Follow-up period was 11.0 (6.0–14.5 months) months for group 1 and 9.2 (5.0–14.2 months) months for group 2. Functional success was defined as absence of epiphora and anatomic success was defined as ability to irrigate the lacrimal system. Anatomic and functional success at the 1st week, 3rd month, and final postoperative examinations of two groups were compared using chi-square tests.

Results

Final anatomic successes were 39/51 (76%) cases for group 1 and 51/54 (94%) cases for group 2. Final functional successes were 36/51 (%71) patients in group 1 and 48/54 (88%) patients in group 2. Group 2 had higher success at the final examination and the difference was statistically significant.

Conclusion

We recommend partial anterior middle turbinectomy in all laser ECL laser-assisted endonasal DCR, but further studies with larger sample sizes are needed to strengthen our hypothesis.
Epidemiology of Allergic Rhinitis Caused by Grass Pollen or House-dust Mites in Spain
Authors: Valero Antonio , Justicia José L. , Antón Encarna , Dordal Teresa , Fernández-Parra Beatriz , Lluch Magdalena , Montoro Javier , Navarro Ana M.
Published: July 2011

Background

Although the prevalence of allergic rhinitis (AR) is increasing, relatively little is known about patient characteristics in Spain. The aim of this study was to investigate the clinical profile and therapeutic strategies in patients attending Spanish specialists for AR caused by grass pollen or house-dust mites (HDMs.

Methods

This was a multicenter cross-sectional epidemiological study of consecutive patients aged ≥5 years with confirmed diagnosis of AR caused by grass pollen or HDMs attending allergy specialists throughout Spain. Demographic and clinical data and information on treatment were collected.

Results

Data from 1043 patients were analyzed (524 with grass pollen allergy and 519 with HDM allergy; mean age, 27.1 years). Three-quarters had persistent AR as per the Allergic Rhinitis and Its Impact on Asthma (ARIA) definition, with disease duration of >2 years in 94.3% of those with pollen allergy and 85.5% of those with HDM allergy. Approximately 38% had concurrent asthma. Over one-half of the patients were considered to have gotten worse since the first onset of symptoms. In total, 51.5% did not achieve good disease control with pharmacotherapy and 47.7% were treated with immunotherapy (52.2% of HDM allergic patients and 43.2% of grass pollen-allergic patients.

Conclusion

The duration of AR in patients attended for the first time by specialists is long and, in general, the disease does not improve over time and is often not well controlled with pharmacologic interventions. Less than one-half of patients receive allergen-specific immunotherapy that is more often prescribed in HDM allergy.
Comparison of the Effect of Corticosteroid Therapy and Decongestant on Reducing Rhinoplasty Edema
Authors: Saedi Babak , Sadeghi Mohammad , Fekri Khaveh
Published: July 2011

Background

Comparison of the two methods of decongestant and three doses of dexamethasone on reducing edema and ecchymosis after septorhinoplasty.

Methods

Seventy-four patients who were candidates for rhinoplasty were randomly divided into three groups. Group A received 8 mg of i.v. dexamethasone preoperatively and again after 24 and 48 hours after surgery, group B received three pseudoephedrine tablets (60 mg) per day for 1 week, and group C received three pseudoephedrine tablets (60 mg) per day for 2 weeks. Finally, their effects on the eye, tip and dorsal edema, and ecchymosis were evaluated.

Results

Our findings showed that both decongestant and corticosteroid had significant short-term effects on edema and ecchymosis, but only continuation of pseudoephedrine could reduce the evaluated variables after 1 week.

Conclusion

Pseudoephedrine can be effective for reducing eyelid edema and ecchymosis after rhinoplasty. Also, administration of three doses of dexamethasone in the postoperative care of nasal plastic surgery harmlessly diminished postsurgical edema.
Dog Allergen Levels in Homes with Hypoallergenic Compared with Nonhypoallergenic Dogs
Authors: Nicholas Charlotte E. , Wegienka Ganesa R. , Havstad Suzanne L. , Zoratti Edward M. , Ownby Dennis R. , Johnson Christine Cole
Published: July 2011

Background

Despite the public interest in hypoallergenic dogs, few scientific, including epidemiological studies have attempted to evaluate claims of hypoallergenicity. This study was designed to determine whether dog breeds reported as hypoallergenic correspond to lower dog allergen in the home versus nonhypoallergenic dogs.

Methods

A web search was conducted to identify breeds cited as hypoallergenic. Four separate classification schemes using combinations of purebred and mixed breed dogs were used to compare the levels of Canis familiaris 1 in dust samples collected from homes with hypoallergenic versus nonhypoallergenic dogs from an established birth cohort.

Results

No classification scheme showed that the level of dog allergen in homes with hypoallergenic dogs differed from other homes.

Conclusion

Dog-allergic individuals should have access to scientifically valid information on the level of allergen shedding of different breeds of dogs.
The Candy Smell Test in Clinical Routine
Authors: Haxel Boris R. , Bertz-Duffy Shannon , Faldum Andreas , Trellakis Sokrates , Stein Bernhard , Renner Bertold , Kobal Gerd , Letzel Stephan , Mann Wolf J. , Muttray Axel
Published: July 2011

Background

The “Candy Smell Test” (CST) has been introduced as a new testing method for the evaluation of the human sense of smell. In contrast to other established orthonasal smell tests, the CST addresses the retronasal application of odors, typical for food aroma effects during mastication and swallowing. The aim of this study was to evaluate the CST in a clinical setting in patients with olfactory dysfunction and normal controls against the Sniffin’ Sticks test. Furthermore, cutoff points for normal and pathological results in the CST should be determined.

Methods

The olfactory performance of 96 patients presenting with olfactory disorders and 71 healthy controls was evaluated with the CST—comprised of 23 different aromatized smell candies and the extended Sniffin’ Sticks test (threshold, discrimination, and identification). The control group was gender matched but included also younger persons.

Results

The tested subjects could easily understand the procedures and were motivated to participate. The CST correlated well with the Sniffin’ Sticks for all tested subjects and for patients (n = 96) and controls (n = 71). The proposed cutoff value to differentiate normosmia from hyposmia in the CST was a score of <16 (i.e., 16 correctly identified odors) of 23. A score below 13 in the CST was the cutoff value for anosmia.

Conclusion

The CST is an easy-to-handle reliable tool to investigate retronasal olfaction suited for clinical determination of normosmia, hyposmia, and ansomia. In addition, it can be used for investigation where self-application is necessary such as in large survey studies.
Association between Severity of Asthma and Degree of Chronic Rhinosinusitis
Authors: Lin David C. , Chandra Rakesh K. , Tan Bruce K. , Zirkle Whitney , Conley David B. , Grammer Leslie C. , Kern Robert C. , Schleimer Robert P. , Peters Anju T.
Published: July 2011

Background

There is a clinical association between asthma and chronic rhinosinusitis (CRS). This study was designed to determine whether severity of coexistent asthma affects the clinical presentation of CRS.

Methods

Cross-sectional analysis was performed of prospectively collected data in 187 patients with CRS who were evaluated in a large, tertiary academic nasal and sinus center. Patients were stratified into three groups based on asthma status using National Institutes of Health criteria: (1) nonasthmatic, (2) intermittent/mild asthma, (3) or moderate/severe asthma.

Results

Mean Lund-Mackay scores were 9.7, 11.6, and 15.6, respectively. ANOVA testing with post-hoc Tukey analysis revealed that Lund-MacKay scores were significantly greater in group 3 than either group 1 (p < 0.05) or group 2 (p < 0.01). The prevalence of allergic sensitization was 72.4, 82.8, and 100% in groups 1, 2, and 3, respectively (p = 0.03). The prevalence of nasal polyposis was 31.4% in group 1, 48.3% in group 2, and 94.4% in group 3 (p < 0.0001). No differences were observed regarding demographic factors or the incidence of the triad of aspirin sensitivity, asthma, and nasal polyposis among those with different severities of asthma.

Conclusion

Increasing severity of asthma is associated with advancing radiological severity of CRS and a greater prevalence of allergic sensitization and nasal polyposis. This large adult series shows that asthma severity may have a significant correlation with the presentation of CRS. This study adds to the growing support for the unified airway theory.
The Natural History of Epistaxis in Patients with Hereditary Hemorrhagic Telangiectasia in the Norwegian population: A Cross-sectional Study
Authors: Dheyauldeen Sinan , Abdelnoor Michael , Bachmann-Harildstad Gregor
Published: July 2011

Background

Epistaxis is usually the first and most common symptom in hereditary hemorrhagic telangiectasia (HHT), which is known also as Rendu-Osler-Weber syndrome. The severity of HHT-associated epistaxis is highly variable and can affect the patient's quality of life. In the literature, the natural history of epistaxis in HHT patients has been described in a few countries but not from the Norwegian population.

Objective

This work focused on the natural history of epistaxis in the Norwegian population in a cross-sectional study.

Material and Methods

Ninety-eight patients with three or four Curaçao criteria were included. The severity of epistaxis was graded depending on epistaxis intensity, frequency, and the amount of blood transfusion during a period of 4 weeks. The epistaxis grades were studied in association with age, gender, gene mutation, age of onset, and whether the patient had or had not been treated for epistaxis during the last 2 years.

Results

Most of the HHT patients (90%) complained of mild-to-moderate epistaxis. Seventy-seven percent of the patients started epistaxis by or before the age of 20 years. The progression of HHT-associated epistaxis with age could not be proved statistically in this study. There was no statistically significant difference in the grades of epistaxis between HHT1 and HHT2 type, neither between female and male patients. Most of the patients started epistaxis by or before the age of 20 years. There was a significant difference in the grade of epistaxis between non-ENG, non-ALK1 carrier patients, and ENG or ALK1 carrier patients.

Conclusion

Compared with other populations, the grading of epistaxis in Norwegian patients with HHT gave generally similar results. A multicenter epidemiological study is required to get a larger study population. A common internationally accepted grading or classification system for epistaxis in HHT is highly recommended.
Effects of Methotrexate on Vascular Endothelial Growth Factor, Angiopoietin 1, and Angiopoietin 2 in Nasal Polyps
Authors: Park Seong Kook , Kim Hyeong In , Yang Young Il , Hur Dae Young
Published: July 2011

Background

Methotrexate (MTX) is a very effective treatment for chronic inflammatory diseases, which are often associated with increased angiogenesis. Angiogenesis is dependent on a perfectly coordinated balance between endogenous-positive and -negative regulatory factors, including vascular endothelial growth factor (VEGF) and the angiopoietins (Ang). The aim of this study was to investigate the effects of MTX on levels of VEGF, Ang-1, and Ang-2 in organ-cultured nasal polyps (NPs.

Methods

To determine the effects of MTX, NP tissues were cultured using an air-liquid interface method. Cultures were maintained in the absence or presence of MTX (10 or 100 micromoles) for 24 hours. Hematoxylin and eosin, and TUNEL (terminal deoxynucleotidyl transferase [Tdt]-mediated dUTP-biotin nick-end labeling) staining were performed to observe apoptosis. Enzyme-linked immunosorbent assay was used to quantify tissue concentrations of VEGF, Ang-1, and Ang-2.

Results

MTX treatment resulted in marked alterations in inflammatory cells, especially eosinophils. In contrast, the mucosal epithelium, microvessels including arterioles, veins and capillaries, and fibroblasts maintained their structure. TUNEL+ cells (apoptotic cells) were seen in the MTX-treated specimens. The more induction of TUNEL+ cells was observed 100-micromolar MTX-treated specimens. VEGF and Ang-1 levels were significantly lower, and Ang-2 levels were significantly higher in NPs treated with 100-micromolar MTX than in nontreated NPs (p < 0.01.

Conclusion

MTX may inhibit the growth of NPs via local regulation of VEGF, Ang-1, and Ang-2 protein levels. We suggest that MTX can be used to treat NPs.
Microporous Polysaccharide Hemospheres do not Increase Synechiae after Sinus Surgery: Randomized Controlled Study
Authors: Antisdel Jastin L. , Matijasec Jackie L. , Ting Jonathan Y. , Sindwani Raj
Published: July 2011

Background

Many surgeons use absorbable packing materials after endoscopic sinus surgery (ESS). Despite their popularity, some of these agents have been shown to contribute to synechiae formation. Microporous polysaccharide hemospheres (MPH) is a plant-based hemostatic powder that does not interfere with regenerating sinus mucosa in the animal model. The goal of this study was to examine the impact of MPH on healing and synechiae formation after ESS in human subjects.

Methods

A prospective, randomized, controlled, double-blind study was performed. Forty consenting adult patients with chronic sinusitis requiring symmetric ESS were randomized to receive MPH unilaterally at the conclusion of surgery. The opposite side was untreated. Standard postoperative care was performed bilaterally. Outcomes measured included blinded observer ratings for synechiae formation, edema, and infection. Each side was examined endoscopically and scored at postoperative days 7, 14, and 30.

Results

Twenty men and 20 women with an average age of 48.2 years were included. There were no complications and all patients were discharged home the same day. There was no significant difference in synechiae formation at any point postoperatively. The rate of synechiae formation was determined to be 10% (4/40) on the MPH-treated side versus 7.5% (3/40) on the untreated side (p = 0.7639). In addition, there were no significant differences observed in edema (p = 0.7480) or infection (p = 0.5533).

Conclusion

The use of MPH after sinus surgery does not increase synechiae formation and does not appear to deleteriously affect the healing of postoperative sinus cavities.
Aspergillus Fumigatus Biofilm on Primary Human Sinonasal Epithelial Culture
Authors: Singhal Deepti , Baker Leonie , Wormald Peter-John , Tan LorWai
Published: July 2011

Background

Bacterial biofilms have been implicated in chronic rhinosinusitis (CRS). However, direct evidence in support of fungal biofilms in sinus disease is lacking in the literature. This study was designed to develop and characterize an in vitro Aspergillus fumigatus biofilm model on primary human sinonasal epithelial cell culture.

Methods

Sinonasal biopsy specimens harvested during endoscopic sinus surgery of six CRS patients and three pituitary tumor (control) patients were cultured in Dulbecco's modified Eagle media (DMEM; Invitrogen)/Hams F12 airway media to encourage epithelial cell proliferation. Epithelial cells separated by immunomagnetic beads were seeded in tissue culture-treated Y-shaped microslides. At confluence the primary cultures were inoculated with A. fumigatus spores. Fungus was allowed to germinate and form biofilms under two in vitro conditions: (1) static (no flow through of media) and (2) continuous flow coculture (continuous flow movement of media). At regular intervals cocultures were stained with FUN-1, concanavalin A–alexa fluor 488, and examined by confocal scanning laser microscopy. Comstat software was used to assess biomass and thickness.

Results

A. fumigatus formed three-dimensional biofilm structures with parallel-packed, cross-linked hyphae and channels/passages. Metabolically active hyphae showed orange–red fluorescing intravacuolar structures. Extracellular matrix (ECM) between/around the hyphae fluoresced intense green. A. fumigatus biofilms development occurred in five stages: (1) conidial attachment to epithelial cells, (2) hyphal proliferation, (3) ECM production, (4) hyphal parallel packing and cross-linking, and (5) channel/pores formation. Mature biofilms showed basal conidial, middle hyphal, and superficial ECM layers. Biofilms formed underflow conditions displayed more robust and faster growth kinetics when compared with that under static conditions, with a thick, stocky, wrinkly/undulating hyphal growth and extensive ECM production. The differences in biomass and average thickness of the cocultures under static and flow conditions were statistically significant after similar periods of incubation (p = 0.0002; p < 0.0001, respectively.

Conclusion

To our knowledge, this is the first article of an in vitro model characterizing A. fumigatus biofilm formation using primary human sinonasal epithelium under different growth conditions.
The Effect of Passive Smoking on the Levels of Matrix Metalloproteinase 9 in Nasal Secretions of Children
Authors: De Sujata , Leong Samuel C. , Fenton John E. , Carter Stuart D. , Clarke Raymond W. , Jones Andrew S.
Published: July 2011

Background

Matrix metalloproteinase (MMP) 9 is a gelatinase associated with tissue remodeling. It is thought to play a part in the pathogenesis of allergy. Increased levels of MMP-9 have been shown to increase in the acute allergic response in the nose, lungs, and skin. Exposure to passive tobacco smoke is associated with an increase in sneezing, nasal blockage, and a decreased sense of smell. The aim of this study was to study the effect of passive smoking on the levels of MMP-9 in nasal secretions of children.

Methods

A prospective descriptive study was performed. Thirty-nine children aged between 7 and 16 years were enrolled in the study. They were selected based on attendance at the Otorhinolaryngology Outpatients Clinic with a primary complaint unrelated to the nose or paranasal sinuses. Children with allergic rhinitis, sinusitis, or a recent cold were excluded. The study was performed at a tertiary pediatric referral center. Exposure to passive smoking was determined by measuring the urinary cotinine to creatinine ratio. Nasal fluid was obtained by using a Rhino-Probe curette (Arlington Scientific, Inc., Springville, UT). The concentration of MMP-9 was determined by ELISA. MMP-9 activity was determined by gelatin zymography. Data were tabulated on Microsoft Excel (Microsoft Corp., Redmond, WA) and analyzed using SPSS (SPSS Inc., Chicago, IL).

Results

Using a cutoff urinary cotinine/creatinine ratio of 0.025 ng/mg, 15 children were found to be exposed to passive smoking. Both the MMP-9 concentration and the activity were significantly higher in nasal secretions of children exposed to passive smoking. There was a distinct difference between the two cohorts with regard to the level of enzyme activity per weight of protein. The lowest level of enzyme activity recorded in the “exposed” cohort was over twice that of the level in the “not exposed” cohort.

Conclusion

MMP-9 activity and concentration is higher in nasal secretions of children exposed to passive smoking. This suggests that passive smoking might alter the inflammatory response within the nasal mucosa in a similar way to allergy.
The Effect of Montelukast Sodium on Serum Arginase Levels in Patients with Seasonal Allergic Rhinitis
Authors: Yasar Husamettin , Kiran Bayram , Cagatay Tulin , Ozkul Haluk , Icten Sacit
Published: July 2011

Background

Nitric oxide (NO) imbalance appears to be important in the pathogenesis of allergic rhinitis. NO is synthesized from L-arginine by NO synthase (NOS). Competing with NOS for L-arginine is arginase, which catalyzes the hydrolysis of arginine to urea and ornithine. Therefore, increased serum arginase activity could potentially limit NO production catalyzed by inducible NOS, thus contributing to allergic rhinitis. This study was designed to investigate the effect of the cysteinyl leukotriene type 1 receptor antagonist, montelukast sodium on serum arginase levels in patients with seasonal allergic rhinitis.

Methods

Twenty-five patients with seasonal allergic rhinitis (SAR; treatment group) and 16 nonasthmatic patients without allergic rhinitis (control group) were included in the study. Serum arginase levels and the mean total nasal symptoms scores were measured before and after oral montelukast sodium (10 mg) was administered daily for 4 weeks to the treatment group.

Results

Serum arginase levels and the mean total nasal symptoms scores were significantly lower in the treatment group after montelukast sodium administration compared with the baseline levels (p = 0.001). Serum arginase levels were significantly lower in the treatment group compared with the control group (p = 0.01). There was no statistically significant difference between the serum arginase levels of the treatment group before treatment and the control group (p = 0.05). There was a weak correlation between the mean total nasal symptoms scores and serum arginase levels in the treatment group before montelukast sodium administration (rs = 0.40; p = 0.05.

Conclusion

Montelukast sodium may reduce serum arginase levels and total nasal symptoms scores of patients with SAR. Additional studies that compare the effectiveness of nasal corticosteroid and montelukast sodium on serum arginase levels should be conducted.
Human Lysozyme has Fungicidal Activity against Nasal Fungi
Authors: Woods Charmaine M. , Hooper David N. , Ooi Eng H. , Tan Lor-Wai , Carney A. Simon
Published: July 2011

Background

The cationic antimicrobial peptide lysozyme is the most prevalent innate immune protein in nasal secretions but there is a paucity of research regarding its role in paranasal sinus disease. Lysozyme is generally regarded as an antibacterial agent; however, some data suggest activity toward yeast. This study was designed to determine if lysozyme displays fungicidal activity toward fungi commonly identified in patients with chronic rhinosinusitis (CRS) or fungal sinusitis.

Methods

Using a colony-forming unit assay the fungicidal activity of lysozyme (0, 0.5, 5, and 50 micromolar; 0- to 7-hour treatment) was tested against strains of Aspergillus fumigatus, the yeast Candida albicans, and other fungi commonly identified in mucin of patients with CRS. Fungi cultured directly from the mucin of two CRS patients were also tested to determine if they were resistant to the fungicidal activity of lysozyme.

Results

The fungicidal effect of lysozyme was both concentration and time dependent. After 7-hour treatment lysozyme (5 micromolar) had >80% fungicidal activity against A. fumigatus, Penicillium sp., Acremonium sp., C. albicans, and Candida parapsilosis. The fungicidal activity of lysozyme toward Alternaria alternata could not be determined. Lysozyme was also fungicidal toward the clinical isolates A. fumigatus and Aspergillus terreus cultured from the mucin of CRS patients.

Conclusion

Lysozyme displays fungicidal activity toward many fungi commonly identified in patients with CRS, as well as clinical fungi isolates cultured from the mucin of CRS patients. Additional studies are required to determine the regulation of lysozyme in CRS.
Outcomes and Cost Comparison of Three Therapeutic Approaches to Allergic Rhinitis
Authors: Fairchild Carol J. , Durden Emily , Cao Zhun , Smale Patrick
Published: July 2011

Background

Allergic rhinitis (AR) is a global health problem because of its increasing impact on economics, society, and the individual's quality of life. This study compares the outcomes and cost of three intranasal therapeutic approaches to the treatment of AR.

Methods

This was a retrospective cohort study using propensity scores to achieve balanced cohorts. The study population included patients ≥16 years of age with at least one intranasal prescription claim, without concurrent nasal polyps or sinusitis. Health care use and costs, airway infections, pharmacy costs, and indicators of unsatisfactory treatment (i.e., treatment augmentation or switching) were evaluated in the 1-year follow-up period using a claims database.

Results

Data from 141,190 patients in intranasal antihistamines (INA) therapy, intranasal steroids (INS) therapy, and intranasal combination therapy (ICT) cohorts were analyzed. The INA cohort showed the lowest rate of change in treatment (switching or augmentation). Switching rates were lowest in the INS therapy cohort, whereas augmentation was lowest in the INA cohort. AR- and asthma-related medication costs were significantly lower in the INA cohort. No differences were observed in airway infections and overall health care costs. Concurrent chronic obstructive pulmonary disorder and asthma were the strongest predictors of health care cost and respiratory infection in the follow-up period.

Conclusion

A change in treatment was noted in ∼⅓ of the entire study population. None of the treatments had a remarkable effect on health care costs or the occurrence of airway infections. The INA treatment cohort had lower AR- and asthma-related medication costs.
Sphenoid Sinus Fungus Ball: Our Experience
Authors: Pagella Fabio , Pusateri Alessandro , Matti Elina , Giourgos Georgios , Cavanna Caterina , De Bernardi Francesca , Bignami Maurizio , Castelnuovo Paolo
Published: July 2011

Background

Fungal rhinosinusitis is a common disease of the paranasal sinuses. The fungus ball (FB) is defined as an extramucosal mycotic proliferation that fills one or more paranasal sinuses. Sphenoid sinus is an uncommon localization of this disease, as reported in the literature. This study describes our experience in the diagnosis and treatment of sphenoid sinus FB (SSFB), with a particular focus on the surgical approach to the sphenoid sinus.

Methods

We retrospectively analyzed the clinical records of patients affected by FB of the sphenoid sinus, who underwent endoscopic sinus surgery (ESS) in our institutions between 1995 and 2009. We described the surgical technique, the methods of mycological and histopathological evaluation, as well as the perioperative and postoperative management.

Results

From 1995 to 2009, 226 patients affected by sinonasal FB underwent ESS in our institutions. A sphenoid localization was found in 56 patients (24.78%; mean age, 62 years). Cephalea was the most common symptom, and 14.3% of patients complained of ocular symptoms. We performed a direct paraseptal sphenoidotomy in 31 patients (55.4%) and a transethmoidal sphenoidotomy in 25 patients (44.6%). Histology unveiled fungal hyphae with absent mucosal invasion in all cases. Cultural results revealed positivity for mycotic colonization in 26 cases (46.4%, most commonly Aspergillus fumigatus). Follow-up ranged from 12 to 181 months with a mean of 70.7 months.

Conclusion

The description of our experience in the diagnosis and treatment of SSFB underlines the importance of a precise diagnostic pathway in case of sphenoidal disease. Nowadays, in our opinion, the paraseptal direct sphenoidotomy represents the less invasive, fastest and most anatomically conservative approach to the sphenoid sinus in case of SSFB.
Comparison Study between MAST CLA and OPTIGEN
Authors: Kim Jin Kook , Yoon Yeo-Min , Jang Won-Jong , Choi Yeon-Joo , Hong Seok-Chan , Cho Jae Hoon
Published: July 2011

Background

The MAST-CLA system (Hitachi Chemical Diagnostics, Inc., Mountain View, CA) is an in vitro diagnostic test for the simultaneous determination of specific IgE to different allergens. Recently, a new generation of MAST-CLA was developed (OPTIGEN; Hitachi Chemical Diagnostics). The purpose of this study was to determine the performance of these two tests for the diagnosis of allergic rhinitis.

Methods

Suspicious allergic rhinitis patients were divided into four groups and their medical records were reviewed: group 1 patients were tested with the MAST-CLA and skin-prick tests (251 patients), group 2 patients were tested with the OPTIGEN and skin-prick tests (319 patients), group 3 patients were tested with the MAST-CLA and CAP (104 patients) tests, and group 4 patients were tested with the OPTIGEN and CAP tests (270 patients). The correlation between MAST-CLA and OPTIGEN to skin-prick and CAP tests was determined.

Results

The positivity percentage of MAST-CLA results was higher than with skin-prick and CAP tests, and the results for the OPTIGEN test were comparable with skin-prick test and CAP. This suggests that the MAST-CLA test might have a slightly higher rate of giving false positive results. The OPTIGEN test correlated better with the skin-prick test and CAP.

Conclusion

The OPTIGEN test performed better than the MAST-CLA test for diagnosing allergic rhinitis.
The Drainage System of the Paranasal Sinuses: A Review with Possible Implications for Balloon Catheter Dilation
Authors: Mann Wolf J. , Tóth Miklós , Gouveris Haralampos , Amedee Ronald G.
Published: July 2011

Background

Intersinus connections and accessory ostia of the maxillary sinus are well known to rhinologic surgeons but are less known for the remaining paranasal sinuses. Probing and dilatation of the natural ostia of diseased sinuses is being popularized currently by the clinical value of balloon catheter dilation (BCD). Although short-term high success rates with treatment of the dilated ostia/duct have been reported with this technique, the potential impact of fractures of adjacent bony septae on accessory sinus ostia, on mucosally lined surfaces, and on intersinus drainage pathways still has not been considered. The aim of this study was to review the literature on accessory sinus ostia, intersinus connections, and mucociliary drainage pathways for the entire sinus system that are relevant to BCD.

Methods

A literature review was performed.

Results

Accessory sinus ostia exist for each paranasal sinus. Many sinuses drain not only directly into the nasal cavity but also indirectly through adjacent sinuses. Of note, one major drainage pathway of the frontal sinus is over the ethmoid sinuses and via the ethmoids into the maxillary sinus and subsequently into the nose. Drainage of the sphenoid sinus exists both through posterior ethmoidal cells and directly into the nasopharynx.

Conclusion

Accessory ostia are not only common for the maxillary sinus but also for the entire paranasal sinus system. BCD may potentially inadvertently impair mucociliary clearance of the sinuses through effects on secondary drainage pathways.
Outcomes after Endonasal Septoplasty Using Caudal Septal Batten Grafting
Authors: Kim Ji Heui , Kim Do-Youn , Jang Yong Ju
Published: July 2011

Background

This study evaluated surgical outcomes after endonasal septoplasty using caudal septal batten grafting for caudal septal deviation.

Methods

Fifty-six patients completed questionnaires to assess nasal obstruction by telephone interviews 8–63 months postoperatively (12.2 months on the average). In addition, patients assessed the severity of nasal symptoms (i.e., mouth breathing, mouth dryness, hyposmia, rhinorrhea, epistaxis, trouble sleeping, snoring, and being concerned about nasal problems) preoperatively and postoperatively using a visual analog scale (VAS). These VAS scores were compared with those of patients who underwent endonasal septoplasty using the cutting and suture technique. Complications were analyzed.

Results

Thirty-four (60.7%) patients reported their nasal obstruction was much improved, 17 (30.3%) reported their condition was improved, and 5 (8.9%) reported no change postoperatively. Patients reported a decrease in severity of all nasal symptoms (p < 0.05 for each). Their nasal obstruction improvement was not significantly different from that of patients managed by the cutting and suture technique. Complications after surgery included hyposmia in two cases, small septal perforation in one case, chondritis in one case, and septal abscess in one case, and all were managed successfully. No patient required revision septoplasty due to recurrence during the follow-up period.

Conclusion

Endonasal septoplasty using caudal septal batten grafting for caudal septal deviation resulted in improvement in nasal obstruction and nasal symptoms and was associated with an acceptable complication rate.
Outcomes Research in Rhinoplasty: Body Image and Quality of Life
Authors: Cingi Cemal , Songu Murat , Bal Cengiz
Published: July 2011

Background

Although hundreds of quality-of-life (QOL) studies are available in the literature, very few were designed that include both a global and a procedure-specific evaluation of QOL and an inventory for the assessment of body image. The purpose of this study was to use condition-specific and global measures as well as psychological evaluations in a case series of rhinoplasties for a more comprehensive assessment of patient-reported outcomes.

Methods

Records of 225 patients aged 18–57 years who underwent rhinoplasty were prospectively included in the study. Study participants completed both a baseline questionnaire before the rhinoplasty operation and a postsurgical patient questionnaire 12 months after the operation, including the European QOL Questionnaire (EQ), Rhinoplasty Outcomes Evaluation Questionnaire (ROE), and the Multidimensional Body–Self Relations Questionnaire (MBSRQ).

Results

Mean values corresponding to the EQ VAS results except for discomfort and anxiety domains increased after treatment compared with baseline. Both male and female patients experienced significant improvement in ROE scores, with larger differences between pre- and postoperative ROE scores in male patients compared with female patients. The analyses of variance in the MBSRQ results revealed significant postsurgical improvements on the appearance orientation subscale.

Conclusion

The development, standardization, and use of validated procedure-specific QOL tools are essential components for accurately measuring patient-reported outcomes of facial plastic surgery procedures. To measure patient satisfaction in a more objective and standardized manner, specific questionnaires or instruments should be used that can determine the QOL changes associated with each procedure of interest.
Advanced Methods for Natural Product Drug Discovery in the Field of Nutraceuticals
Authors: Wolfender Jean-Luc , Eugster Philippe J. , Bohni Nadine , Cuendet Muriel
Published: July 2011

Advances in analytical methods and bioassay development have helped to push forward the research in natural products. In plant extracts and nutraceuticals, bioactive compounds are part of a complex mixture. The development of high-resolution methods related to HPLC for both chemical
and biological profiling has significantly increased the efficiency of classical bioactivity-guided fractionation procedures. Furthermore, the level of sensitivity obtained by these methods give the possibility to work with few micrograms of compound. This represents a key advantage for rapid
localisation of the biological activity and subsequent identification of the compounds of interest. The same methods are also used to study the extracts from a metabolomic view point. The possibility to study them as a whole can highlight synergetic effects, which are likely to occur in plant
extracts and nutraceuticals. In this paper, the main trends are summarised and the developments made in our laboratory on profiling crude extracts with UHPLC-TOF-MS, natural product identification at the microgram level using microflow NMR and integration of these methods with biological evaluation
are highlighted.
Exploring Natural Products for New Taste Sensations
Authors: Starkenmann Christian , Cayeux Isabelle , Birkbeck Anthony A.
Published: July 2011

This paper discusses the discovery of uncommon taste or trigeminal active compounds and their associated sensory analysis using human tasting panels with the aim of enhancing the over all taste experience whilst reducing where possible the sugar and salt content of foods. The first
example outlines the discovery of the sensory quality attributes of (R)-2-(carboxymethylamino)propanoic acid, named (R)-strombine, as assessed by a panel of 47 subjects to confirm its contribution to the typical taste of scallop muscle. The second example discusses the pungency
and trigeminal effect of polygodial, which is compared with piperine and capsaicin, as well as the elucidation of a new structure eliciting a trigeminal effect, (±)-trans-2,3,3a,7a-tetrahydro-1H-indene-4-carbaldehyde, discoveredin Amomum tsao-ko. Finally, the time intensity
trigeminal effect of (–)-menthol is compared with (1R,2RS,4RS)-1-isopropyl-4-methylbicyclo[3.1.0]hexan-2-ol, named dihydroumbellulol, a new cooling compound obtained by hemi-synthesis from umbellulone extracted from Umbellularia californica Nutt.
Bioreduction-Mediated Food-Drug Interactions: Opportunities for Oncology Nutrition
Authors: Erzinger Melanie M. , Sturla Shana J.
Published: July 2011

Chemical and biochemical processes underlying food–drug interactions in cancer therapy have not been well addressed with a systematic focus, even though they offer significant potential for enhancing the efficacy of cancer chemotherapy. Bioreductive anticancer drugs are metabolically
activated by reductase enzymes. The levels and activities of relevant metabolic enzymes are regulated by transcription factors, which are under the control of chemical interactions with small molecules, including bioactive food components (BFCs) such as minerals, vitamins, and a variety of
phytochemicals. One important and well-established process is the upregulation of enzymes involved in xenobiotic metabolism and redox regulation. Thus, BFCs might help to over come resistances of some cancer cells towards anticancer agents or to increase efficacy by sensitizing cancer cells
towards synergistic drugs. By understanding chemical and biochemical processes involved in food–drug interactions, not only can the risk of harmful food–drug interactions be diminished, but appropriate nutritional recommendations for cancer patients can be made and new functional
foods with specific benefits in anticancer therapy may be developed.
Out in the Green: Biologically Active Metabolites Produced by Cyanobacteria
Authors: Gademann Karl
Published: July 2011

Dried cyanobacteria ('Spirulina') are sold as a nutraceutical for their high content of proteins, essential fatty acids and vitamins. Beyond spirulina, other genera of cyanobacteria produce interesting small molecules that could find use in nutraceutical or pharmaceutical applications.
This account presents recent research efforts on antimalarial nostocarboline and the aerucyclamides, as well as on potent toxins such as cyanopeptolin 1020 and microcystins. Combinations of spectroscopic, computational, chemical and biological studies investigated the mechanism of action of
these compounds. Their application potential with regard to nutraceuticals or pharmaceuticals is discussed.
Large-Scale Production of Bioactive Ingredients as Supplements for Healthy Human and Animal Nutrition
Authors: Wüstenberg Bettina , Stemmler René T. , Létinois Ulla , Bonrath Werner , Hugentobler Max , Netscher Thomas
Published: July 2011

In this review, synthetic strategies and the development of environmentally benign methods for the production of economically important vitamins, carotenoids, and nutraceuticals used as food and feed supplements are illustrated by selected examples. The application of efficient catalytic
transformations in multi-step chemical syntheses of such natural products enables technically feasible and cost-effective processes. For the preparation of fat-soluble (isoprenoid) vitamins A and E and the water-soluble vitamin (+)-biotin, homogeneous metal catalysis, including enantioselective
transformations, heterogeneous and enzymatic catalysis serve as key methodologies. In the area of carotenoids, general building concepts and coupling methods for the total synthesis of ?-carotene and astaxanthin are discussed. Biotechnological methods and isolation from natural sources
are also employed successfully, as exemplified for the xanthophyll lutein and the antioxidant (–)-epigallocatechin gallate. Lastly, key steps of the chemical synthesis of the polyphenol resveratrol are highlighted.
Vestium or Ruthenium – What Does a Study of the Literature Tell Us?
Authors: Sioda Roman Edmund
Published: July 2011

The process of the discovery of the sixth new element and metal present in raw platinum ore granules, and called vestium or ruthenium, took place between 1807 and 1844. The element was first discovered by the Polish chemist and medical doctor, J?drzej ?niadecki, professor
at Vilnius University, presently Lithuania. It took almost 40 years to confirm the discovery by two German chemists working in Russia, Gottfried Osann and Carl Ernst Claus, who had at their disposition platinum ore recently discovered in the Ural Mountains. The discovery work of J?drzej
?niadecki was supported by his older brother Jan ?niadecki, a noted mathematician and astronomer, who was also the Rector of Vilnius University at the time of the original discovery. ?niadecki brothers were educated in Poland (Pozna? and Cracow) and abroad: J?drzejin
Pavia (Italy), Edinburgh (Scotland) and Vienna, and Janin Göttingen, Leiden, Utrecht and prerevolutionary Paris.
La chimie et l'industrie papetière
Authors: Naef Olivier
Published: July 2011

This short paper presents the relationship between the pulp and paper industry and chemistry. The history of this industry is presented including current paper production and consumption statistics. The production of paper pulp is realized by chemically or mechanically separating cellulose
fibres from wood and removing the unwanted lignin. This article concludes with an ecological aspect.
Cutaneous Manifestations in Chronic Renal Failure Patients
Authors: Shakya NB , Rajbhandari SL , Sharma A , Deo RK , Jha SM
Published: July 2011

Introduction: Chronic renal failure is a pathophysiologic process with multiple etiologies, resulting in the inexorable attrition of nephron number and function, and frequently leading to end stage renal disease. There are various cutaneous changes in chronic renal failure. Objectives: To observe the cutaneous manifestations in chronic renal falure and find out any difference in occurrence of cutaneous manifestation with modality of treatment of CRF.  Methods: The study was conducted in 50 (fifty) adult patients with chronic renal failure and another 50 (fifty) patients with similar age admitted with other renal diseases but not suffering from chronic  renal failure as control to facilitate comparison were considered in the Department of Dermatology and Venereology and the Department of Medicine, Shree Birendra Hospital, Chhauni from September 2008 to June 2010. Results: A significant occurrence of pruritus, xerosis and pallor in CRF patients: the highest being pruritus followed by xerosis and pallor. Occurrence of pruritus was found to be more in HD patients (68%) than in IPD patients (38%). No correlation was found between ages, sex, and duration of dialysis with complaint of pruritus. Skin xerosis is considered an important factor contributing or initiating pruritus. Conclusion: Pruritus is the commonest cutaneous manifestation of chronic renal failure. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5020 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 13-16
Association between Neutrophilic Leucocytosis and Congestive Heart Failure after Acute Myocardial Infarction
Authors: Khatri D , Islam N , Ali A
Published: July 2011

Key words: leucocytosis; neutrophilia; myocardial infarction; congestive heart failure.DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5021 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 17-24
Pattern of Fine Needle Aspiration Cytology of Superficially Palpable Lesions: One year hospital based study
Authors: Piya E , Panth R , Singh S
Published: July 2011

Introduction: This is a retrospective study on fine need aspiration cytology (FNCA) of superficially palpable lesions done in Shree Birendra Hospital, Chhauni, over a period of one year from 14th April 2008 to 13th April 2009. Aim: The aim of this study was to review cytological diagnosis on superficially palpable lesions in various sites. Methods: A total of 323 cytological diagnoses of palpable lumps performed in one year by pathologists were retrieved. Sites of FNA and diagnoses were analyzed and correlated with age and sex of the patients. Results:This study has included 323 FNACs. Lymph node was the most common site for FNAC (32%), followed by breast (29%), thyroid (22%), and salivary gland (2%). Other site comprised 15% of cases. In lymph node, reactive lymphadenitis was the most common benign lesion (42.7%) and metastatic squamous cell carcinoma was the commonest malignant lesion(12.62%). In breast, benign proliferative breast disease was the most common(84.1%) and ductal carcinoma was commonest among malignant lesions(8.5%). Among thyroid lesions, benign proliferative thyroid disease was the commonest one (47.9%)followed by papillary carcinoma among malignant lesions(11.3%).Among salivary gland lesions, Chronic sialadenitis was common inflammatory lesion (37.5%) followed by pleomorphic adenoma among benign lesions(25%) and carcinoma comprised 25%. Lipoma was the commonest lesion ( 63%) from other sites. Conclusion: Wide range of lesions, both benign and malignant, can be diagnosed by FNAC thus restricting surgery to cases only requiring further histopathological evaluation. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5022 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 25-29