bluuebunny/crossref_metadata_2025 huggingface dataset:
Marshall McLuhan as Educationist: Institutional Learning in the Postliterate Era
Authors: Kuskis Alexander
Published: July 2012

Acknowledged as the father of media studies and prophet of the information age, Marshall McLuhan is scarcely recognized at all as an educational theorist. But that is changing. Harshly critical of the educational practices of his time, McLuhan offered a vision of learning that replaced
lectures with active student participation, interaction, and active involvement, engaging learners in discovery learning, rather than prepackaged teacher and textbook-delivered content to be regurgitated on tests. His vision of "classrooms without walls" included a transition from
hardware to software, redefinition of teacher roles, elimination of subjects, reform of assessment, and the use of instructional media, not just books. The curriculum would focus on media literacy and include the training of perception through figure/ground analysis and the inclusion of arts
education. Noting the trend toward "learning a living," the constant upgrading of knowledge and skills by professional workers, he anticipated today's emphasis on lifelong learning and workplace training. McLuhan's ideas on education align with the philosophy and theory of constructivism
espoused by educational reformers today and anticipate reform initiatives in pedagogy, curriculum, assessment, and the media literacy movement.Not all of McLu is nu or tru, but then again neither is all of anybody else. —John M. Culkin, S.J. (1967, p. 51)
On Disciplining Media Ecology
Authors: Cali Dennis D.
Published: July 2012

The author undertakes research into conceptions of media ecology held by some of its leading scholars and disciplinary identity formation. Identifying media ecology as a field of study that stresses either network, nodal features or coherence of content, conceptualizing media ecology
as a network seems to correspond more closely with pedagogical practice while an emphasis on primary theorists bears out in the classroom. Becher and Trowle's analysis of disciplines suggest that media ecology is an emerging discipline not yet a fully realized one. Viewing media ecology comparatively
against identity studies of other emerging disciplines leads to the same conclusion. That author concludes that what marks media ecology as an emerging discipline is not its conceptual closure but the inter-relatedness of its ideas.
Is the Internet the New Temple? McLuhan Looks at Religion Looks at McLuhan
Authors: Osicki Ryszard (Richard) J.
Published: July 2012

This article offers a glimpse of the religious dimensions of the life and work of Marshall McLuhan. It posits that, in addition to being seen as a literary and media scholar, McLuhan should be considered equally seriously as a theologian. With this proposition as a premise, the article
also is a brief exposition of the research being conducted and the technology and religion seminars being offered under the Marshall McLuhan Initiative at St. Paul's College, University of Manitoba.
REVIEWS
Authors: Anton Corey , Dress Abby
Published: July 2012

KORZYBSKI: A BIOGRAPHY, BY BRUCE I. KODISH, (2011) Pasadena CA: Extensional Publishing, (694 pp.) ISBN 978-0970066404 $29.95 (paperback)FAST MEDIA, MEDIA FAST: HOW TO CLEAR YOUR MIND AND INVIGORATE YOUR LIFE IN AN AGE OF MEDIA OVERLOAD, BY THOMAS W. COOPER, (2011) Boulder,
CO: Gaeta Press, (225 pp.) ISBN: 978-1-4520-8500-5, $19.95 (paperback)
Estimating Population-Level Coancestry Coefficients by an Admixture F Model
Authors: Karhunen Markku , Ovaskainen Otso
Published: July 2012

In this article, we develop an admixture F model (AFM) for the estimation of population-level coancestry coefficients from neutral molecular markers. In contrast to the previously published F model, the AFM enables disentangling small population size and lack of migration as causes of genetic differentiation behind a given level of FST. We develop a Bayesian estimation scheme for fitting the AFM to multiallelic data acquired from a number of local populations. We demonstrate the performance of the AFM, using simulated data sets and real data on ninespine sticklebacks (Pungitius pungitius) and common shrews (Sorex araneus). The results show that the parameterization of the AFM conveys more information about the evolutionary history than a simple summary parameter such as FST. The methods are implemented in the R package RAFM.
Integrity and Function of theSaccharomyces cerevisiaeSpindle Pole Body Depends on Connections Between the Membrane Proteins Ndc1, Rtn1, and Yop1
Authors: Casey Amanda K , Dawson T Renee , Chen Jingjing , Friederichs Jennifer M , Jaspersen Sue L , Wente Susan R
Published: July 2012

The nuclear envelope in Saccharomyces cerevisiae harbors two essential macromolecular protein assemblies: the nuclear pore complexes (NPCs) that enable nucleocytoplasmic transport, and the spindle pole bodies (SPBs) that mediate chromosome segregation. Previously, based on metazoan and budding yeast studies, we reported that reticulons and Yop1/DP1 play a role in the early steps of de novo NPC assembly. Here, we examined if Rtn1 and Yop1 are required for SPB function in S. cerevisiae. Electron microscopy of rtn1Δ yop1Δ cells revealed lobular abnormalities in SPB structure. Using an assay that monitors lateral expansion of the SPB central layer, we found that rtn1Δ yop1Δ SPBs had decreased connections to the NE compared to wild type, suggesting that SPBs are less stable in the NE. Furthermore, large budded rtn1Δ yop1Δ cells exhibited a high incidence of short mitotic spindles, which were frequently misoriented with respect to the mother–daughter axis. This correlated with cytoplasmic microtubule defects. We found that overexpression of the SPB insertion factors NDC1, MPS2, or BBP1 rescued the SPB defects observed in rtn1Δ yop1Δ cells. However, only overexpression of NDC1, which is also required for NPC biogenesis, rescued both the SPB and NPC associated defects. Rtn1 and Yop1 also physically interacted with Ndc1 and other NPC membrane proteins. We propose that NPC and SPB biogenesis are altered in cells lacking Rtn1 and Yop1 due to competition between these complexes for Ndc1, an essential common component of both NPCs and SPBs.
Rapid Divergence of Prolamin Gene Promoters of Maize After Gene Amplification and Dispersal
Authors: Wu Yongrui , Messing Joachim
Published: July 2012

Seeds have evolved to accommodate complicated processes like senescence, dormancy, and germination. Central to these is the storage of carbohydrates and proteins derived from sugars and amino acids synthesized during photosynthesis. In the grasses, the bulk of amino acids is stored in the prolamin superfamily that specifically accumulates in seed endosperm during senescence. Their promoters contain a conserved cis-element, called prolamin-box (P-box), recognized by the trans-activator P-box binding factor (PBF). Because of the lack of null mutants in all grass species, its physiological role in storage–protein gene expression has been elusive. In contrast, a null mutant of another endosperm-specific trans-activator Opaque2 (O2) has been shown to be required for the transcriptional activation of subsets of this superfamily by binding to the O2 box. Here, we used RNAi to knockdown Pbf expression and found that only 27-kDa γ- and 22-kDa α-zein gene expression were affected, whereas the level of other zeins remained unchanged. Still, transgenic seeds had an opaque seed phenotype. Combination of PbfRNAi and o2 resulted in further reduction of α-zein expression. We also tested the interaction of promoters and constitutively expressed PBF and O2. Whereas transgenic promoters could be activated, endogenous promoters appeared to be not accessible to transcriptional activation, presumably due to differential chromatin states. Although analysis of the methylation of binding sites of PBF and O2 correlated with the expression of endogenous 22-kDa α-zein promoters, a different mechanism seems to apply to the 27-kDa γ-zein promoter, which does not undergo methylation changes.
Tissue-Specific Activation of a Single Gustatory Receptor Produces Opposing Behavioral Responses in Drosophila
Authors: Joseph Ryan M , Heberlein Ulrike
Published: July 2012

Understanding sensory systems that perceive environmental inputs and neural circuits that select appropriate motor outputs is essential for studying how organisms modulate behavior and make decisions necessary for survival. Drosophila melanogaster oviposition is one such important behavior, in which females evaluate their environment and choose to lay eggs on substrates they may find aversive in other contexts. We employed neurogenetic techniques to characterize neurons that influence the choice between repulsive positional and attractive egg-laying responses toward the bitter-tasting compound lobeline. Surprisingly, we found that neurons expressing Gr66a, a gustatory receptor normally involved in avoidance behaviors, receive input for both attractive and aversive preferences. We hypothesized that these opposing responses may result from activation of distinct Gr66a-expressing neurons. Using tissue-specific rescue experiments, we found that Gr66a-expressing neurons on the legs mediate positional aversion. In contrast, pharyngeal taste cells mediate the egg-laying attraction to lobeline, as determined by analysis of mosaic flies in which subsets of Gr66a neurons were silenced. Finally, inactivating mushroom body neurons disrupted both aversive and attractive responses, suggesting that this brain structure is a candidate integration center for decision-making during Drosophila oviposition. We thus define sensory and central neurons critical to the process by which flies decide where to lay an egg. Furthermore, our findings provide insights into the complex nature of gustatory perception in Drosophila. We show that tissue-specific activation of bitter-sensing Gr66a neurons provides one mechanism by which the gustatory system differentially encodes aversive and attractive responses, allowing the female fly to modulate her behavior in a context-dependent manner.
Genetic Annotation of Gain-Of-Function Screens Using RNA Interference and in Situ Hybridization of Candidate Genes in the Drosophila Wing
Authors: Molnar Cristina , Casado Mar , López-Varea Ana , Cruz Cristina , de Celis Jose F
Published: July 2012

Gain-of-function screens in Drosophila are an effective method with which to identify genes that affect the development of particular structures or cell types. It has been found that a fraction of 2–10% of the genes tested, depending on the particularities of the screen, results in a discernible phenotype when overexpressed. However, it is not clear to what extent a gain-of-function phenotype generated by overexpression is informative about the normal function of the gene. Thus, very few reports attempt to correlate the loss- and overexpression phenotype for collections of genes identified in gain-of-function screens. In this work we use RNA interference and in situ hybridization to annotate a collection of 123 P-GS insertions that in combination with different Gal4 drivers affect the size and/or patterning of the wing. We identify the gene causing the overexpression phenotype by expressing, in a background of overexpression, RNA interference for the genes affected by each P-GS insertion. Then, we compare the loss and gain-of-function phenotypes obtained for each gene and relate them to its expression pattern in the wing disc. We find that 52% of genes identified by their overexpression phenotype are required during normal development. However, only in 9% of the cases analyzed was there some complementarity between the gain- and loss-of-function phenotype, suggesting that, in general, the overexpression phenotypes would not be indicative of the normal requirements of the gene.
Energy-Dependent Modulation of Glucagon-Like Signaling inDrosophilavia the AMP-Activated Protein Kinase
Authors: Braco Jason T , Gillespie Emily L , Alberto Gregory E , Brenman Jay E , Johnson Erik C
Published: July 2012

Adipokinetic hormone (AKH) is the equivalent of mammalian glucagon, as it is the primary insect hormone that causes energy mobilization. In Drosophila, current knowledge of the mechanisms regulating AKH signaling is limited. Here, we report that AMP-activated protein kinase (AMPK) is critical for normal AKH secretion during periods of metabolic challenges. Reduction of AMPK in AKH cells causes a suite of behavioral and physiological phenotypes resembling AKH cell ablations. Specifically, reduced AMPK function increases life span during starvation and delays starvation-induced hyperactivity. Neither AKH cell survival nor gene expression is significantly impacted by reduced AMPK function. AKH immunolabeling was significantly higher in animals with reduced AMPK function; this result is paralleled by genetic inhibition of synaptic release, suggesting that AMPK promotes AKH secretion. We observed reduced secretion in AKH cells bearing AMPK mutations employing a specific secretion reporter, confirming that AMPK functions in AKH secretion. Live-cell imaging of wild-type AKH neuroendocrine cells shows heightened excitability under reduced sugar levels, and this response was delayed and reduced in AMPK-deficient backgrounds. Furthermore, AMPK activation in AKH cells increases intracellular calcium levels in constant high sugar levels, suggesting that the underlying mechanism of AMPK action is modification of ionic currents. These results demonstrate that AMPK signaling is a critical feature that regulates AKH secretion, and, ultimately, metabolic homeostasis. The significance of these findings is that AMPK is important in the regulation of glucagon signaling, suggesting that the organization of metabolic networks is highly conserved and that AMPK plays a prominent role in these networks.
Unresectable Metastatic Colorectal Cancer Treatment and Survival – Pauls Stradins Clinical University Hospital Experience
Authors: Skuja Elīna , Purkalne Gunta , Miklasevics Edvins
Published: July 2012

Introduction.Despite recent advances in the medical treatment of metastatic colorectal cancer (mCRC), which include oxaliplatinand irinotecan-based first-line regimens and the increasing use of targeted monoclonal antibodies, survival rates for patients with mCRC remain unacceptably low.

Aim of the Study.Is to analyze survival in patients with unresectable metastatic colorectal cancer.

Materials and Methods.Retrospective study of unresectable metastatic colorectal cancer patients who underwent palliative chemotherapy in Clinic of Oncology of PaulsStradins Clinical University Hospital from 2004 to 2011was done.

Results.102 patients had a median PFS of 8 months and median OS of 16 months. Subgroup analysis revealed median PFS of 9 months in the synchronous metastatic disease group and 7 months in the metachronous metastatic disease group (p=0.0089) and median OS of 16 months and 12 months, respectively (p=0.0168).Median OS was 11 months in patients received only one line palliative chemotherapy compared to 19 months in patients received more than one line therapy (p<0.0001).

Conclusions.The parameter of synchronous and metachronous metastases is of prognostic value in mCRC patients.Second line palliative chemotherapy prolongs overall survival in patient with mCRC.
The Value of Magnetic Resonance in Differentiation between Brain Glioma and Treatment Induced Injury
Authors: Bieza Anvita , Krumina Gaida
Published: July 2012

Introduction.The further therapeutic management decisions in glioma patients after the radiation/chemotherapy may be difficult because the treatment induced brain injury can mimic tumor recurrence clinically and on neuroimaging.

Aim of the Studywas to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in differentiation between glial tumor recurrence and radiation/chemotherapy-induced changes in the brain.

Material and methods.73 patients with primary brain gliomas and 77 gliomas patients after combined therapy with possibly treatment induced changes underwent MRS and DTI. Fractional anisotropy (FA) and metabolite ratios were measured in the tumor and pathological signal intensity area adjacent to post-surgical cavity.

Results.Mean choline/creatine (Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine (LL/Cr) ratios of brain gliomas was statistically significant higher and FA values lower than those in the pathological signal intensity area adjacent to post-surgical cavity. No differences were found in mean N-acetyl aspartate/creatine (NAA/Cr) ratios among two groups.

Conclusions.Our study suggests that Cho/Cr, MI/Cr, LL/Cr and FA measures should be recommended as additional highly informative tool to conventional structural magnetic resonance imaging (MRI) when monitoring gliomas patients after combined therapy.
Pathology of Breast Cancer: from Classic Concepts to Molecular Pathology and Pathogenesis
Authors: Strumfa Ilze , Vanags Andrejs , Abolins Arnis , Gardovskis Janis
Published: July 2012

Breast cancer has high incidence and still significant mortality. Due to the widespread application and efficacy of surgery in breast cancer treatment, the surgeon has a crucial role in the treatment planning. Taking into account the tendency to personalized cancer care and the heterogeneity of breast cancer, the surgeon has to be aware about the prognostic and predictive characteristics of breast cancer. We discuss here the classaic pathology of breast cancer along with molecular subtypes, novel prognostic markers and molecular pathogenesis.
Primary Adenocarcinoma of the Appendix
Authors: Vanags Andrejs , Strumfa Ilze , Abolins Arnis , Brikuns Andrejs , Simtniece Zane , Gardovskis Janis
Published: July 2012

Primary Adenocarcinoma of the Appendix

Primary adenocarcinoma of the appendix is exceedingly rare type of malignancy with the incidence of 0.4 cases per 100,000. It composes less than 0.5% of gastrointestinal malignant neoplasms. Frequently, the diagnosis is reached only after histological examination of surgically excised appendix due to suspected inflammation. Despite the low survival rate in case of primary appendix tumours aggressive therapy is necessary to obtain long-term survival. We present a well-documented case of instant neoplasm evaluated at our institution. To the best of our knowledge, no such detailed studies have been carried out before in Latvia.
Human Dirofilariasis in Latvia - the First Case in Surgical Practice
Authors: Melbarde-Gorkusa Inga , Abolins Arnis , Strumfa Ilze , Martinsons Aigars , Gardovskis Janis
Published: July 2012

Human Dirofilariasis in Latvia - the First Case in Surgical Practice

Though dirofilariasis in humans occurs rarely, the number of cases due toDirofilaria repenshas been increasing worldwide over the last decade. Climatic changes and animal migration extend geographic area of human dirofilariasis, now including Latvia. The diagnosis is based on histopathological features. Surgical excision is the only curative treatment. Practitioners should bear in mind the possibility of human dirofilariasis in residents of Latvia.
Recurrent Pericarditis in a Pediatric Patient
Authors: Ligere Elina , Leznina Marija , Lacis Aris , Bergmane Inta , Ozolins Valts , Smits Lauris
Published: July 2012

Recurrent Pericarditis in a Pediatric Patient

Recurrent pericarditis is a chronic condition with the recurrence of pericardial effusion within 3 months after the documented acute pericarditis. The knowledge about this disease is based on observations in adults (6). The common identifiable causes of pericardial effusion in children are a prior cardiac surgery, bacterial pericarditis, malignancy or connective tissue disorders. In a significant number of children, however, despite extensive investigation, it is not possible to identify a clear aetiology. A viral cause is often suspected, though rarely confirmed. There are only few reports on the clinical course of idiopathic pericardial effusions in children. We demonstrate a case of recurrent idiopathic pericarditis with 3 episodes of recurrence within a period of 6 months with no autoimmune disease present, not related to prior surgery or malignancy.
Spinal Cord Stimulation for Chronic Pain Relief: First Experience in Baltics
Authors: Golubovska Iveta , Miscuks Aleksejs , Jurkevics Vitolds , Skaida Sarmite
Published: July 2012

Spinal Cord Stimulation for Chronic Pain Relief: First Experience in Baltics

We report the first case of spinal cord stimulator implantation in Baltics to patient with massive posttraumatic plexus lumbosacralis dxtr lesion, severe neuropathic pain syndrome and drug addiction problems. Follow-up time is 6 month since December 2011 and we have observed an obvious clinical and social improvement in patient status. Besides significant pain relief she has got employed and is tax payer instead of low-income person.
Monitoring of Oral and Nasal Exhaled Nitric Oxide in Eosinophilic Chronic Rhinosinusitis: A Prospective Study
Authors: Noda Noriaki , Takeno Sachio , Fukuiri Takashi , Hirakawa Katsuhiro
Published: July 2012

Background

We aimed to examine the effect of different therapeutic modalities on levels of fractional concentrations of exhaled nitric oxide (FeNO) in patients with eosinophilic chronic rhinosinusitis (ECRS).

Methods

Thirty-six ECRS patients with nasal polyps were treated either medically or surgically. Oral and nasal FeNO levels were measured using an electrochemical NO analyzer initially and at 1 and 6 months. The mRNA expression and localization of nitric oxide synthase (NOS) isoforms in sinus mucosa and nasal polyps were analyzed by real-time polymerase chain reaction (PCR) and immunohistochemistry.

Results

The mean oral FeNO levels in the surgical group had decreased significantly from 50.9 to 36.8 ppb 6 months after endoscopic sinus surgery. All patients in this group showed significantly higher nasal FeNO levels after treatment. The mean nasal FeNO levels were 62.3 ppb at 1 month and 93.6 ppb at 6 months. Mean oral and nasal FeNO levels in the medical group after treatment remained unchanged when compared with the baseline levels. Positive immunoreactivity of inducible NOS (iNOS) was observed in both epithelial cells and submucosal inflammatory cells. Real-time PCR analysis showed significant up-regulation of iNOS and IL-5 mRNA expression.

Conclusion

A combination of oral and nasal FeNO measurements is useful to monitor the extent of inflammation in CRS patients. The increase in nasal FeNO in the surgical group indicates prompt recovery of NO release from healed sinus mucosa through the opened sinus ostia. Reduction of oral FeNO levels may reflect a cessation of the underlying lower airway inflammation that is characteristic of ECRS.
A 26-week Tolerability Study of Ciclesonide Nasal Aerosol in Patients with Perennial Allergic Rhinitis
Authors: Berger William E. , Mohar Dale E. , LaForce Craig , Raphael Gordon , Desai Shailesh Y. , Huang Holly , Hinkle Joseph
Published: July 2012

Background

A new, hydrofluoroalkane nasal aerosol solution formulation of ciclesonide (CIC-HFA) delivered via a metered dose inhaler is currently in clinical development for treatment of allergic rhinitis.

Objective

To study tolerability and quality of life following administration of CIC-HFA 74- or 148-μg doses once-daily compared with placebo in patients with perennial allergic rhinitis (PAR) over 26 weeks.

Methods

Patients ≥12 years of age with a ≥2 year history of PAR were randomized in a placebo-controlled, double-blind, parallel group, multicenter study to CIC-HFA 74 μg, 148 μg, or placebo QD AM for 26 weeks. Safety was assessed by monitoring treatment-emergent adverse events (TEAEs). Quality of life was assessed by using a rhinoconjunctivitis quality of life questionnaire with standardized activities (RQLQ[S]) in patients with baseline RQLQ ≥3.00. Reflective total nasal symptom scores (rTNSS) and instantaneous total nasal symptom scores (iTNSS) over 26 weeks were also evaluated.

Results

In this study, 1111 patients were randomized. The overall incidence of TEAEs was comparable between the treatment groups. Treatment with CIC-HFA 74- or 148-μg doses showed improvements in RQLQ[S] [least squares (LS) mean change 0.40 and 0.37, respectively from baseline, p < 0.01 versus placebo for both], rTNSS (LS mean change 0.65 and 0.52, respectively from baseline; p ≤ 0.01 versus placebo for both), and iTNSS (LS mean change 0.51 and 0.42, respectively from baseline; p < 0.05 versus placebo for both) from baseline.

Conclusion

In this study, once-daily treatment with CIC-HFA 74- or 148-μg doses over 26 weeks was well tolerated with comparable incidence of TEAEs between the treatment groups.
Rhinosinusitis-Related Quality of Life during Pregnancy
Authors: Gilbey Peter , McGruthers Lauren , Morency Anne-Maude , Shrim Alon
Published: July 2012

Background

Pregnancy rhinitis manifests as nasal congestion, with resolution of symptoms after delivery. Eighteen to 30% of pregnant patients report symptoms of rhinitis. Pregnancy rhinitis may have an adverse effect on quality of life (QOL) and may cause obstructive sleep apnea (OSA), which in turn may adversely affect the outcome of pregnancy. Previous examinations of the prevalence of pregnancy rhinitis during different stages of pregnancy have been inconclusive. This study aimed to determine rhinosinusitis-specific QOL during different stages of pregnancy.

Methods

A cross-sectional observation study of patients in the second and third trimesters of pregnancy using the 22-item Sino-Nasal Outcome Test (SNOT-22) was conducted in the obstetric clinic at McGill University Health Center in Montreal, Canada. Seventy-six low- risk pregnant patients were included in the study. Thirty-two patients were in the second trimester of pregnancy and 44 patients were in the third trimester.

Results

Average item scores for the entire questionnaire were significantly higher (p = 0.041), indicating more severe impairment of QOL, in the third trimester in comparison with the second trimester. A comparison between women with and without preexisting allergic rhinitis, in both the second and the third trimesters, shows significantly higher SNOT-22 scores for the allergic group (p = 0.007). QOL was lower in the third trimester than in nonrhinosinusitis patients (p = 0.011).

Conclusion

Rhinosinusitis-specific QOL is lower in the third trimester of pregnancy in comparison with the second trimester and also in comparison with nonrhinosinusitis patients. Increased awareness may enhance the QOL of pregnant patients, prevent OSA, and thereby positively influence the outcome of pregnancy.
Subcutaneous Approximation Suture for Preventing Soft Tissue Pollybeak Deformity
Authors: Tosun Fuat , Arslan Hasan Huseyin , Hidir Yusuf , Karslioglu Yildirim , Durmaz Abdullah , Gerek Mustafa
Published: July 2012

Background

Pollybeak deformity due to abundant fibrosis formation in the supratip region after rhinoplasty is still a common problem. The aim of this study was to investigate the effects of a modified subcutaneous approximation suture on pollybeak deformity of soft tissue origin.

Methods

Three groups, each consisting of eight rabbits, were included in the study. Nasal skin was elevated with an open rhinoplasty approach in all groups. During closure of the skin, to minimize supratip dead space, a horizontal subcutaneous approximation suture was used in group I, external tape fixation was used in group II, and no further action was taken for supratip skin approximation in the control group. Full-thickness supratip skin biopsy specimens reaching down to the underlying cartilage tissue were taken from each subject on the 60th day after the operation. Thicknesses of subcutaneous scar tissues were measured histologically in all groups and compared.

Results

The mean thickness of the subcutaneous scar tissues was significantly lower (0.98 ± 0.32 mm) in group I than in group II (1.65 ± 0.61 mm; p = 0.036) and the control group (1.72 ± 0.49 mm; p = 0.019). However, there were no significant differences between group II and the control group in the mean thickness of subcutaneous scar tissues (p = 1.000).

Conclusion

The findings of this study indicate that the subcutaneous approximation suture is effective for preventing excessive scar tissue formation in the supratip area after rhinoplasty in rabbits. Further clinical studies are needed to determine its efficacy in humans.
A Retrospective Comparison of Acute Rhinosinusitis Outcomes in Patients Prescribed Antibiotics, Mometasone Furoate Nasal Spray, or Both
Authors: de Moor Carl , Reardon Gregory , McLaughlin John , Maiese Eric M. , Navaratnam Prakash
Published: July 2012

Background

Antibiotics are frequently used to treat acute rhinosinusitis (ARS; acute sinusitis), although many episodes are viral. Because of community resistance concerns, current evidence provides limited support for the use of antibiotics in ARS. We conducted a retrospective comparative effectiveness outcomes assessment of the nasal steroid mometasone furoate nasal spray (MFNS) versus antibiotics among ARS patients in clinical practice.

Methods

Using the General Practice Research Database (United Kingdom), the earliest ARS event between January 1, 2005 and December 31, 2008 (index event) for patients aged 12–75 years and an antibiotic or MFNS prescription ±2 days was identified. Treatment cohorts were MFNS monotherapy (MM), MFNS + antibiotic (MAT), and antibiotic monotherapy (AM). Logistic regression adjusted for potential confounders and compared odds of rhinosinusitisrelated medical encounters and related prescriptions in the 3- to 30-day postindex period.

Results

There were 12,679 eligible patients (651 MM; 2285 MAT; 9743 AM). Compared with the reference cohort AM, during the 3- to 30-day postindex period, lower adjusted odds (p < 0.001) of having one or more rhinosinusitis-related medical encounters was observed for MM (odds ratio [OR] = 0.39; 95% CI, 0.26–0.58) and MAT (OR = 0.51; 95% CI, 0.42–0.62); having one or more rhinosinusitis-related prescriptions for MM (OR = 0.51; 95% CI, 0.42–0.63) and MAT (OR = 0.58; 95% CI, 0.52–0.65); having one or more antibiotic, nasal steroid, or oral steroid prescriptions for MM (OR = 0.36; 95% CI, 0.28–0.46) and MAT (OR = 0.51; 95% CI, 0.46–0.58); and having one or more antibiotic prescriptions for MM (OR = 0.43; 95% CI, 0.33–0.58) and MAT (OR = 0.63; 95% CI, (0.55–0.72).

Conclusion

Compared with AM, using MFNS for initial ARS treatment, alone or with an antibiotic, is associated with a decreased likelihood of both subsequent rhinosinusitis-related medical encounters and use of related prescriptions.
Transnasal Endoscopic Approach to Symptomatic Sinonasal Osteomas
Authors: Pagella Fabio , Pusateri Alessandro , Matti Elina , Emanuelli Enzo
Published: July 2012

Background

One of the most challenging benign tumors for the ear, nose, and throat (ENT) surgeon is represented by sinonasal osteomas. Surgical treatment should regard just symptomatic osteomas, because these tumors can provoke rhinosinusitis and mucoceles. Recently, new instruments have been applied in endoscopic sinus surgery (ESS). This study was designed to present our experience in the endoscopic management of osteomas of the paranasal sinuses. Clinical findings, preoperative imaging strategy, and surgical techniques are discussed.

Methods

We retrospectively reviewed clinical records of patients who underwent ESS for sinonasal osteomas between 2003 and 2010 in our institutions.

Results

We have treated with a transnasal endoscopic approach 29 patients affected by paranasal osteomas (13 men and 16 women; age range, 20–78 years; mean, 49.5 years). We found frontoethmoidal junction localization in 14 patients, frontal sinus in 6 patients, ethmoid in 6 patients, sphenoid in 1 patient, maxillary in 1 patient, and multiple osteomas in 1 patient. Initially, patients were treated by the cavitation technique with standard ESS instruments, whereas in more recent cases surgery was assisted by the use of ENT navigation system, curved drills, and ultrasound bone emulsifier. No major complications occurred. No radiological or endoscopic signs of recurrence (mean follow-up, 52 months; range, 6–89 months) have been observed.

Conclusion

Endoscopic removal of osteomas of the sinonasal region is feasible, taking into account the location and size of the lesion. Particular importance should be given to new instruments that have been applied in the last years in ESS.
New Adenylate Kinase 7 (AK7) Mutation in Primary Ciliary Dyskinesia
Authors: Mata Manuel , Lluch-Estellés Javier , Armengot Miguel , Sarrión Irene , Carda Carmen , Cortijo Julio
Published: July 2012

Background

Primary ciliary dyskinesia (PCD) is a congenital hereditary disease affecting 1/20,000–60,000 people that causes chronic sinusitis, bronchiectasis, sinus hypoplasia, secretory otitis media, and low fertility. The complexity and heterogeneity of the disease make diagnosis difficult. Although the genetic origin of PCD is clear, mutations in only five genes have been associated with the disease, and, to date, no disease-causing gene has been identified. Recently, low levels of AK7 gene expression have been linked to PCD. This study was designed to determine the mutational status of the AK7 gene in 31 PCD (17 PCD and 14 Kartagener syndrome diagnosed) patients compared with 40 healthy volunteers. We also determined the AK7 sequence in two families with members with PCD and investigated ciliary activity and ciliogenesis in one patient with a mutation in AK7.

Methods

We analyzed nasal mucociliary transport and cilial ultrastructure by electron microscopy and studied nasal ciliary beat frequency and beat pattern using high-resolution digital high speed video (DHSV) imaging. Mutation analyses were performed by direct resequencing of the 18 exons of the AK7 gene. Air–liquid interface differentiated cultures were studied using DHSV imaging and histochemistry. AK7 gene expression was studied by real-time reverse-transcription polymerase chain reaction.

Results

We identified two mutations in the AK7 gene, the described single nucleotide polymorphism (rs2369679), and a new mutation (c.1214insT) that, to the best of our knowledge, has not been described previously. Family and functional studies indicated that c.1214insT could be related to PCD.

Conclusion

Our results indicate that AK7 may be involved in the development of PCD.
Augmenting the Nasal Airway: Beyond Septoplasty
Authors: Simon Patrick , Sidle Douglas
Published: July 2012

Background

Nasal airway obstruction is a common complaint of patients presenting to otolaryngology clinics and can be caused by a variety of anatomic factors. A number of advances in the surgical management of nasal airway obstruction have been made over the last century. The objective of this article is to provide descriptions of the surgical procedures used to augment specific anatomic deviations that lead to obstruction of the nasal airway.

Methods

The descriptions of surgical procedures were derived from a literature review as well as the empiric knowledge of the senior author. Preoperative considerations of nasal anatomy, the nasal airway, and the L-strut are detailed.

Results

Functional rhinoplasty techniques are reviewed including septoplasty, extracorporeal septoplasty, spreader grafts, batten grafts, alar rim grafts, and correction of caudal septal deviation.

Conclusion

The symptom, nasal obstruction, may arise from a number of different anatomic and physiological elements. The rhinoplasty surgeon must consider these contributing elements and manage accordingly, to achieve optimal results.
Radiofrequency Volume Turbinate Reduction versus Partial Turbinectomy: Clinical and Histological Features
Authors: Garzaro Massimiliano , Landolfo Vincenzo , Pezzoli Matteo , Defilippi Simona , Campisi Paola , Giordano Carlo , Pecorari Giancarlo
Published: July 2012

Background

Nasal obstruction is a common symptom related to turbinate hypertrophy in 20% of cases. When medical treatment failed different surgical options were available. Actually, nasal physiology impairment after surgical treatment is not fully clear. This study evaluates microscopic mucosal changes and physiological function, by means of mucociliary transport time (MCT), after radiofrequency volume turbinate reduction and partial inferior turbinectomy.

Methods

Forty-eight nonallergic patients were treated for chronic nasal obstruction. Twenty-six patients (group A) underwent radiofrequency turbinate reduction and 22 patients (group B) underwent partial turbinectomy associated with septoplasty. Mucosal specimen obtained before T0 and 6 months (T1) after surgery were compared by means of optical microscope and transmission electron microscope. All patients were evaluated using MCT at T0 and T1.

Results

Optical analysis showed circumscribed squamous metaplasia and fibrosis in specimens obtained from group A. Same changes were more evident in group B. Ultrastructural analysis evidenced loss of ciliated epithelium in group B, whereas in group A a normal number of cilia was found. In all patients at T1, MCT time was prolonged in comparison with the preoperative values. After surgery, group B showed significantly prolonged MCT in comparison with group A (p < 0.05).

Conclusion

In our study both surgical techniques achieved good clinical outcomes with improved nasal function, although the ciliated epithelium appeared partially impaired. These findings resulted in a prolonged MCT in all patients, especially those treated with partial turbinectomy. Compared to partial resection, intraturbinal turbinate reduction seems to be the method of choice to better preserve nasal physiology.
Fungicidal Activity of Lysozyme is Inhibited in vitro by Commercial Sinus Irrigation Solutions
Authors: Woods Charmaine M. , Hooper David N. , Ooi Eng H. , Tan Lor-Wai , Carney A. Simon
Published: July 2012

Background

Lysozyme is an innate immune peptide with bactericidal and fungicidal activity (FA). Despite increased expression of lysozyme protein in chronic rhinosinusitis (CRS) sinus mucosa, CRS patients experience repeated bacterial and/or fungal infections. Commercial sinus irrigation solutions are often used to provide symptomatic relief. However, one of the mechanisms of action of lysozyme involves ionic interactions with the microbial cell wall, which may be inhibited by ionic solutions such as commercial sinus irrigation solutions.

Objective

Determine if the FA of lysozyme is reduced in the presence of solutions with increasing ionic strength and inhibited in the presence of commercial sinus irrigation solutions.

Methods

Using an in vitro colony-forming unit (CFU) assay, the FA of lysozyme (5 μM) was tested against a fungi commonly isolated from CRS patients, Aspergillus fumigatus, in solutions of increasing ionic strength or commercial sinus irrigation solutions. FA was presented as percent of control.

Results

FA of lysozyme against A. fumigatus was 95% in a 21-mM ionic strength solution. However, with increasing ionic strength, FA decreased and was abolished in a 46-mM ionic strength solution. Commercial sinus irrigation solutions abolished the FA of lysozyme against A. fumigatus.

Conclusion

The in vitro FA of lysozyme is dependent on the ionic strength of the solution. The use of sinus irrigation solutions should be further evaluated with regard to maintaining functional activity of cationic antimicrobial peptides involved in sinonasal innate immunity.
Nasal Mucosa Temperature as a Marker of Disease in Children with Allergic Rhinitis
Authors: Peroni Diego G. , Cattazzo Elena , Chinellato Iolanda , Piazza Michele , Tezza Giovanna , Boner Attilio L. , Piacentini Giorgio L.
Published: July 2012

Background

Allergic rhinitis (AR) is a symptomatic disorder of the nose induced after allergen exposure by an IgE-mediated inflammation of the nasal mucosa. This study was designed to investigate the role of nasal mucosa temperature in AR.

Methods

We investigated the relationship between eosinophilic infiltration, nasal obstruction, and nasal mucosa temperature in 35 children with rhinitis aged 6–12 years.

Results

A significant relationship was shown between nasal temperature values and eosinophil infiltration at nasal cytology (p < 0 01). Nasal temperature was also significantly associated with nasal obstruction, assessed in terms of nasal volume (Vol [2–5 cm]; p < 0.05) and minimum cross-sectional area (p < 0.01). No significant correlation emerged between the degree of nasal obstruction and presence of eosinophils at nasal cytology (p > 0.05).

Conclusion

These results suggest a relationship between nasal temperature and nasal mucosa inflammation and obstruction. ( ClinicalTrials.gov number: NCT00952835)
The Accessory Posterolateral Nerve: An Immunohistological Analysis
Authors: Bleier Benjamin S. , Feldman Rachel , Sadow Peter M. , Wu Arthur , Ting Jonathan , Metson Ralph
Published: July 2012

Background

Recent endoscopic dissection studies have redefined the postganglionic pterygopalatine autonomic pathways suggesting that neurovascular rami, termed “accessory posterolateral nerves,” project directly through the palatine bone to innervate the posterolateral nasal mucosa rather than traveling with trigeminal arborizations. The goal of this study was to characterize these accessory posterolateral nerves by immunohistochemistry to determine their morphology and composition.

Methods

This is an Institutional Review Board approved study in seven patients in whom the presence of accessory posterolateral nerves were surgically identified exiting the perpendicular plate of the palatine bone and sampled. The presence of neural tissue was confirmed by hematoxylin and eosin and S-100 protein staining. Nerves were then stained with anti-human choline acetyl-transferase (ChAT; 1:100) and anti-human dopamine beta-hydroxylase (DBH; 1:100) followed by a fluorescein isothiocyanate–labeled secondary antibody to test for the presence of peripheral parasympathetic and sympathetic fibers, respectively. Human cadaveric sensory nerves were used as a negative control.

Results

All seven samples contained neural elements. Two specimens were also associated with arteries. All nerves were comprised of a single fascicle containing an approximately equal distribution of ChAT+ and DBH+ fibers.

Conclusion

This histological study supports prior descriptions defining a newly recognized neural pathway for innervation of the nasal mucosa. Our data confirm that these accessory posterolateral nerves project directly through the perpendicular plate of the palatine bone and are composed of autonomic fibers. Recognition of this pathway may be exploited in the treatment of sinonasal disease resulting from autonomic dysregulation.
Cell Shape Regulation Based on Hepatocyte Sheet Engineering Technologies
Authors: Takagi Soichi , Ohno Maki , Ohashi Kazuo , Utoh Rie , Tatsumi Kohei , Okano Teruo
Published: July 2012

The de novo engineering of a uniform hepatocyte sheet in vitro is considered as a novel approach for liver-directed therapeutics. Hepatocytes can be cultured on a temperature-responsive culture dishes coated with poly( N-isopropylacrylamide) (PIPAAm). Following multiple days of culturing, the hepatocytes can be easily harvested as a uniform sheet by decreasing temperature from 37°C to 20°C. By modifying the sheet harvesting protocol, we have noticed that two different forms of the hepatocyte sheets, “extended” and “shrinking,” were obtained. This study describes the methods for harvesting the two different forms of sheets, and their cellular structure and hepatocyte-specific functions. To obtain an “extended sheet” form, a cluster of hepatocytes covered with a support membrane was harvested by the temperature reduction. For the “shrinking sheet” form, the hepatocyte sheet was floated after reducing the culture temperature, and the floating process allowed the sheet to shrink spontaneously. Histological analysis revealed that the hepatocytes in the extended sheet form were predominantly flat, whereas the shrinking sheet contained cuboidal shaped hepatocytes. The preservation of hepatocyte-specific ultrastructures was confirmed in both types of sheets. To investigate hepatocyte-specific functionality, the harvested hepatocyte sheets were recultured on Matrigel-coated dishes. Assessment of protein production levels and chemical metabolizing activities showed the similar functionalities for each form. In contrast, the recalculation of these values per sheet versus per square centimeter of sheet surface demonstrated that the function of the shrinking sheet was significantly higher than that of the extended sheets. This study demonstrated that the hepatocyte sheets created on the PIPAAm dish could spontaneously shrink in size, but retain their hepatocyte functionality. This type of hepatocyte sheet could be utilized for the engineering of liver tissue in limited areas that are unable to give adequate transplant space.
Evaluation of a Hybrid Artificial Liver Module Based on a Spheroid Culture System of Embryonic Stem Cell-Derived Hepatic Cells
Authors: Mizumoto Hiroshi , Hayashi Shunsuke , Matsumoto Kinya , Ikeda Kaoru , Kusumi Tomoaki , Inamori Masakazu , Nakazawa Kohji , Ijima Hiroyuki , Funatsu Kazumori , Kajiwara Toshihisa
Published: July 2012

Hybrid artificial liver (HAL) is an extracorporeal circulation system comprised of a bioreactor containing immobilized functional liver cells. It is expected to not only serve as a temporary liver function support system, but also to accelerate liver regeneration in recovery from hepatic failure. One of the most difficult problems in developing a hybrid artificial liver is obtaining an adequate cell source. In this study, we attempt to differentiate embryonic stem (ES) cells by hepatic lineage using a polyurethane foam (PUF)/spheroid culture in which the cultured cells spontaneously form spherical multicellular aggregates (spheroids) in the pores of the PUF. We also demonstrate the feasibility of the PUF-HAL system by comparing ES cells to primary hepatocytes in in vitro and ex vivo experiments. Mouse ES cells formed multicellular spheroids in the pores of PUF. ES cells expressed liver-specific functions (ammonia removal and albumin secretion) after treatment with the differentiation-promoting agent, sodium butyrate (SB). We designed a PUF-HAL module comprised of a cylindrical PUF block with many medium-flow capillaries for hepatic differentiation of ES cells. The PUF-HAL module cells expressed ammonia removal and albumin secretion functions after 2 weeks of SB culture. Because of high proliferative activity of ES cells and high cell density, the maximum expression level of albumin secretion function per unit volume of module was comparable to that seen in primary mouse hepatocyte culture. In the animal experiments with rats, the PUF-HAL differentiating ES cells appeared to partially contribute to recovery from liver failure. This outcome indicates that the PUF module containing differentiating ES cells may be a useful biocomponent of a hybrid artificial liver support system.