bluuebunny/crossref_metadata_2025 huggingface dataset:
Dose-Response Relationships in Human Experimental Exposure to Solvents
Authors: Iavicoli Ivo , Carelli Giovanni , Marinaccio Alessandro
Published: August 2006

Previous studies carried out in the field of experimental toxicology have shown evidence of biphasic dose-response relationships for different experimental models, end-points and chemicals tested. As these studies excluded humans as the experimental model, we have examined the literature of the last three decades in order to verify data concerning human experimental exposure with the aim of highlighting possible biphasic dose-response relationships. The substances used for experimental exposures included hydrocarbons, esters, alcohols, ketones, ethers, glycoethers, halogenated hydrocarbons, and carbon sulphide; the absorption route was inhalation. We did not detect any biphasic dose-response relationship and, in the studies reviewed, our examination revealed major methodological limitations that prevented us making a more detailed examination of experimental data. We concluded that the experimental data available did not allow us to support evidence of biphasic dose-response relationships in human experimental exposure to the above-mentioned chemical substances.
Intracranial Complications of Pediatric Frontal Rhinosinusitis
Authors: Herrmann Brian W. , Chung James C. , Eisenbeis John F. , Forsen James W.
Published: August 2006

Background

The aim of this study was to review the presentation and management of children admitted for intracranial complications arising from frontal rhinosinusitis. We performed a retrospective case series review at two academic tertiary care children's hospitals.

Methods

This study consisted of children <18 years old who presented with intracranial complications from frontal rhinosinusitis between January 1, 1990 and December 31, 2002. Relevant literature was reviewed with the assistance of Medline. Presentation, type of intracranial complication, radiographic evaluations, response to treatment, and prognosis were evaluated.

Results

Sixteen patients were identified with intracranial complications due to frontal rhinosinusitis. Patients were usually older (mean age, 14 years and 3 months), of male gender (M/F, 4.3:1.0), and African American (AA/W, 3.0:1.0). Headache, nasal congestion, and visual changes were the most common early symptoms and neurological findings indicated advanced disease. Subdural (56%), epidural (44%), and cerebral abscesses (19%) were the most common complications. Meningitis alone was identified in 13% and was associated with another intracranial complication in 6%. Multiple intracranial complications were noted in 31%. Polymicrobial cultures were obtained in 50% of patients. Although CT was excellent in identifying orbital pathology, MRI was superior for characterization of intracranial disease.

Conclusion

Intracranial complications of frontal rhinosinusitis are rare in children. Early symptoms often are nonspecific, with neurological findings more commonly seen in advanced disease. Adolescent African American male patients were found to be at highest risk for intracranial complications from frontal rhinosinusitis. Headache and orbital complaints associated with rhinosinusitis in older children failing to respond to initial therapy should prompt an aggressive evaluation including MRI.
Association of Nasopharyngeal and Laryngopharyngeal Reflux with Postnasal Drip Symptomatology in Patients with and without Rhinosinusitis
Authors: Wise Sarah K. , Wise Justin C. , DelGaudio John M.
Published: August 2006

Background

Patients often report postnasal drip (PND), but objective rhinosinusitis and allergy findings are frequently absent. In this study, we evaluate the association between PND and pharyngeal reflux.

Methods

Sixty-eight participants underwent 24-hour pH testing, including chronic rhinosinusitis (CRS) patients persistently symptomatic after endoscopic sinus surgery, CRS patients successfully treated by endoscopic sinus surgery, and volunteers without a CRS history. The pH probes contained nasopharyngeal (NP), laryngopharyngeal (LP), and distal esophageal sensors. Participants completed the Sinonasal Outcome Test-20 (SNOT-20) and Modified Reflux Symptom Index (MRSI) questionnaires. Survey items addressing PND symptomatology were compared with NP reflux (NPR) below pH 4 and pH 5 (defined as ≥1 event), and LP reflux (LPR; defined as ≥7 events or reflux area index <6.3).

Results

Pearson analyses revealed a positive correlation of r = 0.87 between SNOT-20 and MRSI PND items. For NPR < pH 4, no significant difference existed between participants with and without reflux on the SNOT-20 or MRSI (p < 0.05). However, for NPR < pH 5, reflux-positive participants exhibited significantly more PND symptoms on the SNOT-20 (p = 0.030) and the MRSI (p = 0.018) compared with participants without reflux. Finally, participants with LPR had significantly more PND symptomatology on the SNOT-20 (p = 0.010) versus those without LPR. A borderline significant difference existed on the MRSI PND item between participants positive and negative for LPR (p = 0.055).

Conclusion

Objective evidence of NPR and LPR exists in patients reporting PND. Reflux treatment may reduce PND complaints.
Characteristics of Nasal Inverted Papilloma and Its Malignant Transformation: A Study of Cell Proliferation and Programmed Cell Death
Authors: Fan Guo-Kang , Imanaka Masashi , Yang Beibei , Takenaka Hiroshi
Published: August 2006

Background

In nasal inverted papilloma (IP) and its malignant transformation process, abnormal cell growth has been regarded as an altered proliferation of the epithelial cells, while the role of programmed cell death in this process remains to be determined.

Methods

An apoptotic index was calculated, and the proliferation ability by using Ki67 as a marker was evaluated in the study subjects, which consisted of 15 cases of nasal chronic sinusitis, 23 cases of nasal IP, 9 cases of nasal IP with dysplasia, 8 cases of nasal IP with squamous cell carcinoma (SCC), and 21 cases of primary SCC. In addition, expressions of apoptosis-related molecules p53, Bcl-2, Bax, and Fas were investigated also.

Results

The result showed that the Ki67 index increased in IP and IP with dysplasia. The Ki67 value was further enhanced in SCC within IP and primary SCC. The apoptotic index was low in IP with dysplasia, IP with SCC, and primary SCC. Concerning the expression of apoptosis-related proteins, p53 protein accumulated in IP with dysplasia, IP with SCC, and primary SCC. The p53 overexpression was directly correlated with the Ki67 index in IP and primary SCC diseases. No remarkable differences were found regarding expression of Bcl-2 and Fas productions among these diseases, and Bax protein was decreased only in primary SCC.

Conclusion

We concluded that inhibition of apoptosis could be an early sign of IP undergoing malignant transformation. A high proliferative rate was a characteristic of IP-associated malignant diseases.
Comparison of Norepinephrine Responsiveness of Mucosal Veins in Vivo with that of Isolated Mucosal Tissue in Vitro in Guinea Pig Nasal Mucosa
Authors: Chiba Yoshihiko , Oshita Michiko , Matsuo Kensuke , Sakai Hiroyasu , Misawa Miwa
Published: August 2006

Background

The vascular responsiveness of nasal mucosa has been determined frequently by using isolated mucosal tissues although it is not clear whether the response of the whole tissue truly reflects the response of the vasculature (especially veins) in mucosa. In this study, the in vivo responsiveness of mucosal veins was compared with in vitro responsiveness of isolated mucosal tissue in guinea pig nasal septa.

Methods

The in vivo venous responsiveness to norepinephrine (NE) of guinea pig nasal septal mucosa was measured by changes in the diameters of mucosal veins, stereomicroscopically. The in vitro responsiveness to NE of isolated nasal septal mucosae from guinea pigs also was determined by standard organ-bath technique.

Results

Application of NE induced concentration-dependent contractile responses both in vivo and in vitro with the pD2 (negative logarithm for 50% effective concentration [M] of NE) values of 5.23 ± 0.29 and 5.00 ± 0.17, respectively.

Conclusion

The equal potencies obtained by the in vivo and in vitro experiments suggest that an increase in tension of isolated nasal mucosal tissue might be caused by the contraction of mucosal veins. Both the in vivo and the in vitro methods used in this study might be useful for determining vasoreactivity of nasal mucosa in experimental animals.
The Effects of Zinc on the Olfactory Neuroepithelium and Olfactory Bulbs of the Sprague-Dawley Rat after oral Administration of Zinc-Gluconate Trihydrate
Authors: Carboni Anthony A. , Cullen Kay J. , Lavelle William G.
Published: August 2006

Background

The most frequent causes of upper respiratory infections are human rhinoviruses. The nasopharyngeal area, which includes the respiratory epithelium, mucosa, and the olfactory neuroepithelium (ONe), is a first-line of defense against airborne viruses and allergens, some of which manage to penetrate the nasal mucosa and invade the tissues of the nasal respiratory epithelium. Biochemical evidence from several studies suggests that zinc is an effective cold treatment and that over-the-counter (OTC) zinc-gluconate compounds may provide the high pharmacologic doses of zinc needed to act as an effective means of treating and reducing the duration and severity of symptoms of the common cold.

Methods

A series of male Sprague-Dawley rats were fed an oral preparation of zinc-gluconate trihydrate or received the equivalent through drinking water to investigate the potential cytotoxic and/or neurotoxic insult to the olfactory receptor cells and other tissue in the ONe and afferent neuronal pathways.

Results

Coronal sections of the rat ONe and corresponding olfactory bulbs showed consistent cellular and tissue damage of increasing severity that correlated with the duration of treatment with the zinc compound when compared with the control group animals.

Conclusion

The results of this analysis indicate that the repeated oral administration of such zinc-containing compounds have neurotoxic effects on the ONe and to the mitral cells in the olfactory bulbs of treated rats. These findings point toward the need for increased investigation into the potential deleterious effects of zinc-containing compounds to humans as well.
The Incidence of Concurrent Osteitis in Patients with Chronic Rhinosinusitis: A Clinicopathological Study
Authors: Lee Jivianne T. , Kennedy David W. , Palmer James N. , Feldman Michael , Chiu Alexander G.
Published: August 2006

Background

The pathogenesis of chronic rhinosinusitis (CRS) has been found to be multifactorial, with environmental, general host, and local anatomic factors all contributing to its development. Recent studies have indicated that local osteitis of the underlying bone also may play a critical role in the elaboration of CRS by inducing persistent inflammatory changes in the surrounding mucosa. The purpose of this study was to determine the clinical incidence rate of osteitis in patients with CRS undergoing functional endoscopic sinus surgery.

Methods

From January to July 2003, a prospective study was performed on 121 patients undergoing functional endoscopic sinus surgery for CRS. Age, number of previous surgeries, radiographic bony characteristics, and pathological findings were all documented. The presence of concurrent osteitis was assessed using both radiographic (neoosteogenesis) and pathological (bony remodeling) criteria.

Results

The mean age of the patients was 44.3 years. Fifty-eight percent of the cases were revision surgeries, with each patient having an average of 2.2 operative procedures in the past. Computed tomography (CT) showed neoosteogenesis in 36% of patients, and 53% showed pathological evidence of osteitis on histological analysis of surgical specimens.

Conclusion

Concurrent osteitis can be found in 36–53% of patients with CRS, using both radiographic and pathological criteria, respectively. Although a causal relationship between osteitis and CRS can not be inferred from this data, these clinical findings correlate well with previous evidence of bone involvement in CRS found in animal models, further reaffirming the association between underlying osteitis and the pathogenesis of CRS.
Nasal Patency Measured by Acoustic Rhinometry in East Asian Patients with Sleep-Disordered Breathing
Authors: Liu Shih-An , Su Mao-Chang , Jiang Rong-San
Published: August 2006

Background

Nasal obstruction is thought to be a risk factor in obstructive sleep apnea (OSA). However, the relationship between nasal patency and sleep-disordered breathing remains controversial. The aim of this study was to examine the association between acoustic rhinometry findings and results of overnight polysomnography.

Methods

From February to October 2003, patients who underwent overnight polysomnography assessment were enrolled in the study. We excluded patients who were under 20 years old, had severe deviated nasal septum, had previously received nasal or palatal surgery, or could not complete sleep test or acoustic rhinometry examination. Participants’ basic data including age, gender, neck circumference, and body mass index (BMI) were collected. All participants received acoustic rhinometry before overnight polysomnography. The results along with sleep-test outcomes were recorded and analyzed.

Results

A total of 87 patients were included in this study. Patients with respiratory disturbance index (RDI) less than 5/h (n = 26) or with RDI of 5–30/h (n = 28) tended to have larger minimal cross-sectional area (MCA) compared with those of patients whose RDI was more than 30/h (n = 33) (P = 0.001). A stepwise multiple regression analysis showed that BMI, male gender, and MCA were contributing factors in RDI. The R2 value of the multiple regression analysis was 0.406.

Conclusion

Patients with severe OSA tended to have smaller MCA when compared with patients with RDI less than 30/h. However, it was hard to predict whether patients had OSA from acoustic rhinometry examination.
Radiofrequency-Induced Thermotherapy on Nasal Polyps: Preliminary Results
Authors: Fischer Yvonne , Gronau Silke , Rozsasi Ajnacska , Rettinger Gerhard , Gruen Philipp M.
Published: August 2006

Background

The aim of this study was to determine the effects of radiofrequency-induced thermotherapy (RFITT) in patients with nasal polyps.

Methods

A retrospective analysis was performed of prospectively collected data from 17 consecutive patients (11 men and 6 women; mean age, 51.7 ± 16.9 years) treated with RFITT from 2002 to 2003. The postoperative outcome was assessed using active anterior rhinomanometry, “sniffin’ stick” test, and endoscopic nasal examination preoperatively and 4 weeks postoperatively. Subjective complaints were assessed with Likert scales.

Results

Transnasal airflow increased by 40.3% 4 weeks postoperatively (p = 0.029). Endoscopic appearance of nasal polyps indicated a nonsignificant reduction of 37.1%. Subjective complaints such as impaired nasal ventilation (p = 0.014), nasal discharge (p = 0.0007), postnasal drip (p = 0.0002), and hyposmia (p = 0.048) improved significantly 4 weeks after surgery.

Conclusion

RFITT is well tolerated as a day case procedure under local anesthesia and might be a procedure for treating recurrence of NP after sinus surgery. It remains unclear at this point whether RFITT for nasal polyps results in a permanent reduction.
Presence and Characterization of Prostaglandin D2–Related Molecules in Nasal Mucosa of Patients with Allergic Rhinitis
Authors: Okano Mitsuhiro , Fujiwara Tazuko , Sugata Yuji , Gotoh Daisuke , Masaoka Yoshihisa , Sogo Masahiro , Tanimoto Wakana , Yamamoto Miki , Matsumoto Rie , Eguchi Naomi , Kiniwa Mamoru , Isik Abdulcemal Umit , Urade Yoshihiro , Nishizaki Kazunori
Published: August 2006

Background

Prostaglandin D2 (PGD2) is the major prostanoid produced in the acute phase of allergic reactions. However, its pathophysiological role in addition to the pathway of production in allergic rhinitis remains unclear. We sought to determine the expression of synthases and receptors for PGD2 in human nasal mucosa. These expressions were compared between allergic and nonallergic patients.

Methods

The expression and localization of hematopoietic-type (h)-PGD2 synthase (PGDS) and lipocalin-type (l)-PGDS were detected by immunohistochemistry. The expression of D prostanoid (DP) receptor and chemoattractant receptor–homologous molecule expressed on Th2 cells (CRTH2) was determined by quantitative real-time PCR.

Results

The h-PGDS but not l-PGDS was clearly expressed in nasal mucosa. The expression of h-PGDS in allergic patients was significantly higher than in control patients without mucosal hypertrophy. A variety of infiltrating cells including mast cells, eosinophils, macrophages, and lymphocytes as well as constitutive cells such as epithelial cells and fibroblasts expressed h-PGDS. The expression of both DP and CRTH2 was confirmed also. Although either the amount of DP or the amount of CRTH2 was not correlated with serum levels of IgE, the amount of CRTH2 but not DP was highly and significantly correlated with the number of eosinophils infiltrating into nasal musosa.

Conclusion

These results suggest that PGD2 is released via the action of h-PGDS from various cells, and the expression of h-PGDS may be associated with the hypertrophic inflammation in the nose. In addition, ligation of PGD2 to CRTH2 appears to be selectively involved in eosinophil recruitment into the nose regardless of atopic status.
The Effect of Triamcinolone Acetonide Aqueous Nasal Spray on the Nasal Carriage of Staphylococcus Aureus
Authors: Yilmaz Fahrettin , Karabay Oguz , Talay Fahrettin , Koybasi Serap , Kocoglu Esra
Published: August 2006

Background

In this study we aimed to investigate the effect of triamcinolone acetonide aqueous (TAA) intranasal spray that was used for 2 months to treat allergic rhinitis (AR) on the nasal carriage of Staphylococcus aureus (NCSA).

Methods

A total of 125 adult AR patients (study group) and 133 healthy individuals (control group) were enrolled for the study. The subjects were diagnosed with AR after a detailed history, physical examination, and prick testing. The AR subjects were administered TAA in a daily dosage of a 220-μg intranasal route. Nasal cultures were obtained on the 1st (baseline), 55th, and 60th days, and the subjects in the last two cultures of whom S. aureus was detected were accepted as NCSA.

Results

After all exclusion criteria were used, 110 AR and 114 control group subjects were enrolled in the study. Based on the culture results that were obtained on the 55th and 60th days, 10 (%9.1) patients from the study group and 18 (%15.7) individuals from the control group were defined to be NCSA (p > 0.05).

Conclusion

We conclude that the use of TAA treatment for AR does not increase the prevalence of NCSA. However, additional studies with a larger series are required to explain the effects of steroids on nasal colonization of S. aureus.
Benzalkonium Chloride and Nasal Mucociliary Clearance: A Randomized, Placebo-Controlled, Crossover, Double-Blind Trial
Authors: Rizzo José Ângelo , Medeiros Décio , Silva Almerinda Rego , Sarinho Emanuel
Published: August 2006

Background

Benzalkonium chloride (BKC) has been considered an innocuous preservative for prescription drugs.

Methods

We performed a double-blind, placebo-controlled, randomized, crossover, single-center trial with a 3-week washout period in 43 healthy volunteers comparing the effect of 3-week use of saline nasal spray containing BKC 0.01% to preservative-free saline t.i.d. on nasal mucociliary clearance rate. Evaluations were done at the beginning and the end of each period by γ-scintigraphy with technetium99m-labeled strontium.

Results

Nasal mucociliary clearance rate was significantly impaired by BKC with a difference of 1.23 mm·min-1 (p < 0.01) between periods.

Conclusion

BKC in the concentration used in nasal preparations impaired mucociliary clearance in healthy individuals after 3 weeks of use. Presently, when preservative-free alternatives are available, BKC could be a risk without benefit.
Catheter-Based Dilation of the Sinus Ostia: Initial Safety and Feasibility Analysis in a Cadaver Model
Authors: Bolger William E. , Vaughan Winston C.
Published: August 2006

Background

Over the past 20 years, many patients have benefited from endoscopic sinus surgery and its ability to relieve sinus obstruction. However, problems still occur with surgery, thereby leaving room for innovation. Recently, catheter-based technology has provided new options for treating cardiac, vascular, and urologic diseases. We speculated that catheter technology also might offer new treatment options for sinusitis patients. The purpose of this investigation was to explore the feasibility and safety of catheter-based technology to relieve sinus ostial obstruction.

Methods

Anatomic models and human cadaver specimens were used initially to design and iterate catheters to open sinus ostial drainage pathways. Thereafter, the safety of balloon-catheter dilation was evaluated in six human cadaver heads. CT scan obtained before and after catheter ostial dilation was analyzed for evidence of catheter-induced trauma. Dilated ostia also were examined by endoscopy and gross anatomic dissection for unwanted catheter-induced trauma.

Results

Catheters successfully dilated 31 of 31 ostia, including 9 maxillary, 11 sphenoid, and 11 frontal ostia/recesses. CT scan, endoscopy, and gross anatomic dissection revealed that such dilation did not cause trauma to surrounding structures such as the orbit or skull base. Mucosal trauma imparted by catheter dilation appeared to be less than that normally seen with standard endoscopic instruments.

Conclusion

This initial study suggests that catheter technology can be used to dilate sinus ostia safely. Mucosal preservation and ease of use make catheters an attractive minimally invasive treatment strategy. Additional testing in patients is indicated to gain additional safety information and to explore the usefulness of catheter-based technology.
Gauze-Assisted Technique in Endoscopic Removal of Fungus Balls of the Maxillary Sinus
Authors: Chao Ting-Kuang , Liu Chia-Ming
Published: August 2006

Background

The aim of this study was to establish and evaluate a newly developed gauze-assisted technique in complete removal of fungus balls of the maxillary sinus with usual instruments of endoscopic sinus surgery.

Methods

Fifteen adults with fungus balls of the maxillary sinus were collected. A newly developed surgical technique that involves the replacement of the fungus balls with the gauze strip was applied. The number of course and duration of this procedure were recorded.

Results

The fungal material was removed with less than two courses of this procedure in these patients. The duration of this procedure ranged from 2 to 5 minutes with an average of 4 minutes. Postoperatively, these patients had been followed for 16–50 months with an average of 29 months. Neither recurrence nor complication was noted.

Conclusion

With the excellent results, we strongly suggest this easy and timesaving technique in the management of such patients.
Eicosanoid Metabolism and Eosinophilic Inflammation in Nasal Polyp Patients with Immune Response to Staphylococcus Aureus Enterotoxins
Authors: Pérez-Novo Claudina Angela , Claeys Cindy , Van Zele Thibaut , Holtapples Gabriele , Van Cauwenberge Paul , Bachert Claus
Published: August 2006

Background

Staphylococcus aureus–derived enterotoxins (SEs) have been implicated in the pathogenesis of airway inflammatory diseases, especially nasal polyposis. However, the exact role of these molecules in the regulation of eicosanoid synthesis in this pathology remains unexplored. We studied the possible impact of SE-induced immune responses on the eicosanoid production in nasal polyp (NP) patients.

Methods

Tissue sample homogenates from NP patients, with (NP-SEs[+]) and without detectable IgE-antibodies to SEs (NP-SEs[–-]; ImmunoCap system), were assayed for IL-5, myeloperoxidase, leukotriene C4/D4/E4 (LTC4/D4/E4), LTB4, lipoxin A4, total IgE, and eosinophil cationic protein.

Results

Inflammatory makers, eicosanoids, and total IgE were significantly increased in NP-SEs(+) compared with NP-SEs(–) tissues, with the exception of myeloperoxidase, which was similar in both groups. Eicosanoid concentrations correlated to IL-5 and eosinophil cationic protein; however, only cys-leukotriene levels correlated with IgE-antibodies to SEs, independently of allergy and asthma.

Conclusion

Eicosanoid synthesis is up-regulated in polyp tissue of patients with immune response to SEs and seems to be related to the inflammatory reaction induced by these enterotoxins.
Impaired Norepinephrine-Mediated Contraction of Isolated Nasal Mucosa in Guinea Pigs with Allergic Rhinitis
Authors: Chiba Yoshihiko , Matsuo Kensuke , Sakai Hiroyasu , Misawa Miwa
Published: August 2006

Background

One of the causes of nasal obstruction associated with allergic rhinitis probably is caused by the dilatation of plexus cavernosum in nasal mucosa. In this study, the change in vascular responsiveness of nasal mucosa was investigated in the septal mucosae isolated from guinea pigs with allergic rhinitis.

Methods

An allergic rhinitis model was prepared in guinea pigs by repeated challenge with aerosolized dinitrophenylated-ovalbumin antigen. Twenty-four hours after the last antigen challenge, the changes in the isometrical tension of isolated nasal septal mucosa were measured.

Results

In isolated nasal mucosal tissues, both norepinephrine (NE) and leukotriene D4 caused concentration-dependent contractile and relaxant responses, respectively. The NE-induced contractile response was significantly attenuated in nasal mucosae of the repeatedly antigen challenged guinea pigs. The mucosal relaxation induced by leukotriene D4 was slightly attenuated in this animal model of allergic rhinitis.

Conclusion

This study shows an attenuation of NE-induced contraction of isolated nasal mucosa in the antigen-exposed guinea pigs. The impaired contractile response mediated by sympathetic α-adrenoceptors of nasal blood vessels might be involved in the development of nasal obstruction in allergic rhinitis.
Severe Chemotherapy-Induced Parosmia
Authors: Müller Antje , Landis Basile N. , Platzbecker Uwe , Holthoff Vjera , Frasnelli Johannes , Hummel Thomas
Published: August 2006

Background

Smell and taste disorders are among the side effects of chemo- and radiotherapy. Although direct radionecrosis of the salivary glands and the taste buds might explain the chemosensory problems after radiotherapy, the olfactory and gustatory complaints seen after chemotherapy remain unexplained. The patients reporting olfactory symptoms rarely complain about qualitative olfactory disorders such as parosmia or phantosmia. Quantitative olfactory loss such as anosmia and hyposmia seem to be more frequent.

Methods

We present the case of a 63-year-old woman with chemotherapy-induced parosmia leading to severe nutrition and appetite problems resulting in a life-threatening weight loss.

Results

With the aid of a simple nose clip the parosmia could be abolished and oral food intake became possible again. Parosmia resolved gradually over an observation period of 9 months, in parallel to an increase of olfactory sensitivity. The patient progressively gained appetite and weight.

Conclusion

Parosmia can occur as a severe and potentially life-threatening complication of chemotherapy. This rare presentation of parosmia illustrates the importance of olfactory testing with an adequate recognition of the underlying problem and a consecutive treatment.
Endoscopic Transphenoidal Pituitary Surgery with Real-Time Intraoperative Magnetic Resonance Imaging
Authors: Anand Vijay K. , Schwartz Theodore H. , Hiltzik David H. , Kacker Ashutosh
Published: August 2006

Background

The aim of this study was to report and show the technique, results, and complications of combined endoscopic and intraoperative magnetic resonance imaging (IMRI) surgical treatment of pituitary disease from both a technical and a surgical perspective.

Methods

We performed a retrospective chart review of 10 endoscopic, endonasal resections of 10 pituitary macroadenomas using the Polestar N-10 IMRI system in a tertiary health care facility. The patient demographics, tumor measurements, and postoperative symptoms and complications were assessed. The effect of the magnetic field on the video screen, the image quality of the IMRI images, and IMRI detection of residual tumor were evaluated also.

Results

IMRI images were obtained in all cases and were of sufficiently high quality to indicate adequate decompression of the optic chiasm and the removal of all suprasellar tumor. However, there was significant distortion of the video monitor regardless of the viewing angle. This was overcome with a wall-mounted plasma screen. Residual tumor was found with IMRI and resected endoscopically in three cases. In two other cases, suspected residual tumor on IMRI was examined endoscopically and found to be a normal postoperative change. In two cases no tumor was seen on the IMRI. Five patients who had preoperative progressive visual loss preoperatively improved postresection and two patients who had increased insulin growth factor 1 preoperatively normalized postoperatively. No delayed cerebrospinal fluid leaks or any other complications occurred.

Conclusion

Combining intraoperative endoscopy and IMRI is an effective surgical modality for pituitary surgery. Each technology provides complimentary information, which can assist the surgeon in safely maximizing the extent of resection.
Lobular Capillary Hemangioma of the Nasal Cavity: A Retrospective Study on 40 Patients
Authors: Puxeddu Roberto , Berlucchi Marco , Ledda Gian Peppino , Parodo Giuseppina , Farina Davide , Nicolai Piero
Published: August 2006

Background

Nasal lobular capillary hemangioma (LCH) is a benign lesion of unknown etiology that must be included in the differential diagnosis of vascular lesions. Based on a large cohort of LCH patients, we retrospectively analyzed the clinical presentation, histological and radiological findings, and the treatment strategy.

Methods

Clinical records of 40 patients affected by LCH, treated in a 10-year period at two university hospitals, were reviewed. Data concerning symptoms, possible etiologic factors, endoscopic findings, imaging studies, and treatment were collected.

Results

Previous nasal trauma and pregnancy were identified as possible causes in six (15%) and two (5%) patients, respectively. The main symptoms were unilateral epistaxis (95%) and nasal obstruction (35%). Lesions ranged in size from 1 to 8 cm and mainly involved the nasal septum (45%) and the nasal vestibule (17.5%). In the four (10%) patients with a large lesion, radiological evaluation was helpful not only in assessing the extent, but also in suggesting the possible nature of the lesion. All patients underwent endoscopic resection under local (72.5%) or general (27.5%) anesthesia. At mean follow-up time of 53 months, no recurrence has been observed.

Conclusion

To the best of our knowledge, this is the largest series of patients with nasal LCH. When the mass is considerable in size, differentiation from other hypervascularized lesions may be intriguing. Under these circumstances, information obtained with imaging may sometimes suggest a correct diagnosis without resorting to biopsy. Endoscopic surgery is the treatment of choice even for large lesions, that do not require preoperative embolization.
Superantigens and Chronic Rhinosinusitis II: Analysis of T-Cell Receptor Vβ Domains in Nasal Polyps
Authors: Conley David B. , Tripathi Anju , Seiberling Kristin A. , Suh Lydia A. , Harris Kathleen E. , Paniagua Mary C. , Grammer Leslie C. , Kern Robert C.
Published: August 2006

Background

The superantigen (SAg) hypothesis of chronic rhinosinusitis (CRS) suggests that toxins within the nose stimulate massive oligoclonal expansion of T-cell populations with subsequent eosinophil recruitment and tissue inflammation. SAgs are capable of activating 1 × 104 more lymphocytes than conventional antigens by binding specific Vβ-domains of the T-cell receptor (TCR). The net effect is skewing from the normal Vβ-profile by oligoclonal expansion of specific domains. This study will assess polyp tissue for evidence of an SAg response in CRS with nasal polyps (CRSwNP).

Methods

This study consists of a prospective analysis of 18 CRSwNP subjects undergoing sinus surgery. Flow cytometry was used to analyze the distribution of 24 specific TCR Vβ-domains in lymphocytes from polyp tissue and blood. Evidence of oligoclonal expansion was tabulated for each specimen and defined as mean normative percentage + 2 SD.

Results

Eighteen of 18 CRSwNP subjects showed expansion of polyp lymphocytes expressing TCRs with specific Vβ-domains. The average number of Vβ-clones per CRSwNP subject was seven in polyp lymphocytes but only two in blood lymphocytes.

Conclusion

The current results indicate that polyp lymphocytes exhibit significant oligoclonal expansion of specific Vβ-domains. These data are considered diagnostic of a SAg effect. The corresponding blood profile is much less, suggesting that the nose is the primary source of stimulus. Although the trigger(s) for this expansion are unknown, these data are consistent with the hypothesis that staphylococcal toxins are central to the development of CRSwNP.
Nasal Airway Measurements in Children Treated by Rapid Maxillary Expansion
Authors: Compadretti Giacomo Ceroni , Tasca Ignazio , Bonetti Giulio Alessandri
Published: August 2006

Background

Rapid maxillary expansion is an orthodontic procedure that is commonly used to widen the maxilla. It is generally admitted that this technique is effective to correct palate narrowing, whereas there has not been agreement on the effect of this procedure in nasal parameters. The availability of a reliable and objective technique to assess the geometry of nasal cavities, such as acoustic rhinometry, stimulated the present investigation.

Methods

Twenty-seven children, undergoing rapid maxillary expansion, were evaluated by rhinomanometry and acoustic rhinometry. Postero-anterior radiographs were taken in 15 patients for cephalometric measurements. Examinations were performed before expansion treatment and after 12 month follow-up and compared to the measurements obtained from an untreated control group.

Results

With regard to rhinomanometry, we recorded a significant reduction in nasal airway resistance (NAR) after the orthodontic procedure only in decongestion. Using acoustic rhinometry, we found a significant increase in total minimum cross-sectional areas (TMCA) and total nasal volume (TNV) after the expansion both in basal and decongested conditions. Also, nasal cavity width and interzygomatic distance had a significant mean increase after the treatment. Comparison of measures between the control group and the treated group showed that the increase in TMCA and TNV, as well as the decrease in NAR, were significantly greater in the treated group in both basal and decongested conditions.

Conclusion

We demonstrated that rapid maxillary expansion is an effective procedure in widening nasal cavities with respect to an untreated control group and that the reported improvement in nasal breathing after palatal expansion, is a consequence of an increase in nasal size.
Studies on the Effects of Ice Collars on Nasal Blood Volume using Optical Rhinometry
Authors: Scheibe Mandy , Wüstenberg Eike G. , Hüttenbrink Karl-B. , Zahnert Thomas , Hummel Thomas
Published: August 2006

Background

The possible benefit of ice collars for treatment of nosebleed is controversial. The aim of this study was to investigate changes of nasal blood volume before and after application of ice collars to the neck. Nasal blood volume was investigated using optical rhinometry.

Methods

A total of 15 young, healthy volunteers participated. After ice collars were placed on the neck area of the subjects, changes in the blood volume of the nose were measured by means of optical rhinometry for the whole nose, but also regionally at the nasal septum (Kiesselbach's area). After baseline measurements over 1 minute, the ice collar was applied. Optical rhinometric measurements were performed continuously.

Results

Although the ice collar showed no effect on the blood volume of the whole nose, there was a significant decrease in blood volume (p < 0.01) at the septum.

Conclusion

Application of ice collars to the neck area of the subjects is followed by a decrease in blood volume of Kiesselbach's area, which may provide the basis for the clinical observation that ice collars are helpful in the treatment of nosebleeds.
A Prospective Randomized Blinded Cross-Over Trial Using Nasal Drops in Patients with Nasal Polyposis: An Evaluation of Effectiveness and Comfort Level of Two Head Positions
Authors: Raghavan Ullas , Jones Nicholas S.
Published: August 2006

Background

The aim of this study was to compare the efficacy and the degree of discomfort caused by the Mygind's (supine and head extended) position and the lying on the side head down (LSHD) position used for instilling nasal drops. We performed a prospective randomized blinded cross-over trial.

Methods

Twenty-three patients with nasal polyps were recruited and were given Betnesol nasal drops for 6 weeks after assessing their peak nasal inspiratory flow rate and grading the polyps. The assessor was blinded to the position used by the patient that was selected randomly. The patients were reviewed after 6 weeks when both their flow rates and their polyp grades were reassessed. They were given a visual analog chart to record the ease by which drops could be instilled and any discomfort caused by the position. After a 2-week washout period the patients were treated for another 6 weeks with the same drops using the other head position.

Results

Twenty-one patients completed the study. The LSHD and Mygind's positions were equally effective in controlling the nasal polypi. Mygind's position was easier to instill drops in the nose although LSHD position caused less discomfort for the patient. The nasal peak inspiratory flow increased linearly as the polyp size decreased. In 86 and 90% of the patients the nasal obstruction and nasal discharge, respectively, were well controlled.

Conclusion

The drops were efficacious in both head positions. The LSHD position caused the least discomfort, although patients found Mygind's position easier to instill drops. Steroid nasal drops are an effective way to manage patients with nasal polyposis.
Treatment of Epistaxis in Hereditary Hemorrhagic Telangiectasia Patients by Argon Plasma Coagulation with Local Anesthesia
Authors: Pagella Fabio , Semino Lucia , Olivieri Carla , Corno Sabrina , Dore Roberto , Draghi Ferdinando , Lanzarini Luca , Vespro Valentina , Buscarini Elisabetta , Danesino Cesare
Published: August 2006

Background

Recurrent epistaxis is the most common manifestation of hereditary hemorrhagic telangiectasia (HHT). The aim of this study was to determine the role and efficacy of argon plasma coagulation (APC) in the management of epistaxis caused by HHT.

Methods

From 1997 to 2004, 43 patients with diagnosed HHT were treated for recurrent epistaxis with APC in our department.

Results

Thirty-six patients reported substantial reduction of bleeding after treatment. Of the 18 patients who previously needed blood transfusions, 13 reported substantial reduction of bleeding after treatment and no blood transfusions were necessary.

Conclusion

APC allows a control of epistaxis in HHT patients and guarantees a long time free from blood transfusions. This treatment modality can be performed with local anesthesia, is not invasive, is well tolerated, is inexpensive, and can be used as a first step even in patients who need to undergo several blood transfusions for their epistaxis.
Periorbita: Computed Tomography and Magnetic Resonance Imaging Findings
Authors: Kim Hak Jin , Lee Tae Hong , Lee Hyun-Sun , Cho Kyu-Sup , Roh Hwan-Jung
Published: August 2006

Purpose

The periorbita has been regarded as the critical structure in decision of exenteration in the patients with paranasal (PNS) malignancies. The purpose of this study is to present the CT and MRI findings of the periorbita with PNS malignancies.

Materials and Methods

Ten patients with PNS cancers were chosen for this study. PNS CT and MRI scans were performed on all patients. The imaging findings were reviewed retrospectively by consensus of two neuroradiologists. Assessment of the defect of the orbital bone and invasion of the orbital fat was made by CT and MRI. The signal intensity (SI), thickness, enhancement, and correlation with the orbital bone of the periorbita were analyzed on MRI. The intraoperative and pathologic reports were used as the gold standard for orbital invasion.

Results

In patients with bone defects, it was impossible to differentiate the periorbita from the mass on CT. The periorbita showed hypointensity on T2-weighted images compared with the SI of mass. On Gd-enhanced T1-weighted images, the periorbita showed less enhancement than the mass in nine patients. Six patients showed two hypointense layers (the outer bony wall and the inner periorbita) between the mass and orbital fat on T2-weighted images. The thickness of the periorbita was 0.79–1.4 millimeter. Orbital invasion was more conspicuous on T2-weighted coronal images than on the CT images.

Conclusions

MRI was more conspicuous for detecting orbital invasion than CT. The mass beyond the thickened periorbita on T2-weighted images was considered to be a positive finding of orbital invasion.
Nasal Airflow during Respiratory Cycle
Authors: Chung Seung-Kyu , Son Young Rak , Shin Seok Jae , Kim Sung-Kyun
Published: August 2006

Background

Knowledge on the airflow patterns in the nasal cavity is essential to understanding the function of the nasal cavity. This study has attempted to observe the breath cycle of nasal airflow during respiration at rest.

Methods

We constructed a nasal cavity model by rapid prototyping using 1.25-mm-thick CT data and devised a piston pump driven by a cam, to simulate respiration at rest. The airflow was evaluated with particle image velocimetry and visualized in coronal reconstructed images.

Results

During the inspiration, a maximal velocity was observed at the valve area and the main stream occurred in the middle and superior airways. During the expiration, main stream was noted in the middle airway and was slow compared with the flow during inspiration. Vortexes were observed between inspiration and expiration.

Conclusion

This result widens our knowledge of nasal airflow and this technique will allow a more physiological understanding of nasal operations.
Immunolocalization of Surfactant Protein A and D in Sinonasal Mucosa
Authors: Woodworth Bradford A. , Lathers Deanne , Neal Jeffery G. , Skinner Margaret , Richardson Mary , Young M. Rita , Schlosser Rodney J.
Published: August 2006

Background

Surfactant-associated proteins (SP) A and D are in the family of collectin proteins that play an integral part in the innate defense system. SP-A and SP-D expression and function are altered in a variety of inflammatory and infectious diseases of the lungs, such as asthma, allergies, and cystic fibrosis. Our prior studies are the first to identify the presence of these proteins in the human sinonasal cavity. The objective of this study was to immunolocalize SP-A and SP-D in human sinonasal tissue.

Methods

Sinonasal mucosal biopsies were performed in patients with various forms of chronic hyperplastic rhinosinusitis with nasal polyposis and nondiseased mucosa from patients undergoing transsphenoidal hypophysectomy. (n = 10) Immunolocalization of surfactant proteins was performed with antibodies to SP-A and SP-D using immunoperoxidase staining technique. Isotype-negative controls were performed on all specimens.

Results

Analyses of mucosal biopsy specimens from human sinonasal tissue reveals staining within respiratory and intermediate (metaplastic)-type surface epithelium. In addition, staining was intense in the submucosal ductal epithelium of the seromucinous glands. These properties appear to be consistent regardless of disease state and location within the sinuses.

Conclusion

This is the first study to immunolocalize SP-A and SP-D in sinonasal human mucosa. These are secreted proteins that are intricately involved in innate immunity in the lungs. Their secretion in the upper airway indicates that future studies may allow manipulation of these proteins and development of novel treatments for sinonasal pathology.
Molecular Profile of the Antrochoanal Polyp: Up-Regulation of Basic Fibroblast Growth Factor and Transforming Growth Factor β in Maxillary Sinus Mucosa
Authors: Mahfouz Magdy Elsayed , Elsheikh Mohamed Nasser , Ghoname Nagla Fawzy
Published: August 2006

Background

Various pathogenetic mechanisms have been proposed to explain the development of antrochoanal polyps (ACPs); however, the cause is still largely unknown. The aim of this study was to characterize the expression and the potential role of a battery of molecular markers in the development of ACPs. A prospective controlled study of a case series was performed.

Methods

Tissue samples of maxillary sinus mucosa were obtained from 14 patients with ACPs, 17 patients with chronic nonpolypoid maxillary sinusitis, and 4 patients with normal maxillary sinus mucosa; RNAs were extracted from the sinus mucosa, and semiquantitative reverse transcription–polymerase chain reaction was performed for basic fibroblast growth factor, transforming growth factor β, and mucin genes (MUC), MUC5AC, MUC5B, and MUC8, to investigate their expression.

Results

The expression of basic fibroblast growth factor and transforming growth factor β was significantly higher in ACPs than in chronic rhinosinusitis and healthy mucosa. Meanwhile, the levels of expression of MUC genes were higher in ACPs and chronic rhinosinusitis compared with healthy mucosa.

Conclusion

These findings suggest that ACPs may represent an inflammatory reaction caused by overproduction of tissue-derived growth factors in an inductive environment.
Ba0.5Sr0.5Co0.8Fe0.2O3‐δ ceramic hollow‐fiber membranes for oxygen permeation
Authors: Liu S. , Tan X. , Shao Z. , Diniz da Costa J. C.
Published: August 2006

Self‐supported asymmetric hollow‐fiber membranes of mixed oxygen‐ionic and electronic conducting perovskite Ba0.5Sr0.5Co0.8Fe0.2O3‐δ (BSCF) were prepared by a combined phase‐inversion and sintering technique. The starting inorganic powder was synthesized by combined EDTA–citrate complexing process followed by thermal treatment at 600°C. The powder was dispersed in a polymer solution and then extruded into hollow‐fiber precursors through a spinneret. The fiber precursors were sintered at elevated temperatures to form gastight membranes, which were characterized by SEM and gas permeation tests. Performance of the hollow fibers in air separation was both experimentally and theoretically studied at various conditions. The results reveal that the oxygen permeation process was controlled by the slow oxygen surface exchange kinetics under the investigated conditions. The porous inner surface of the prepared perovskite hollow‐fiber membranes considerably favored the oxygen permeation. The maximum oxygen flux measured was 0.031 mol·m−2·s−1 at 950°C with the sweep gas flow rate of 0.522 mol·m−2·s−1. To improve the oxygen flux of BSCF perovskite membranes, future work should be focused on surface modification rather than reduction of the membrane thickness. © 2006 American Institute of Chemical Engineers AIChE J, 2006