bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Connexin 43 Expression Correlated with Eosinophil Infiltration in Nasal Polyps
Authors: Yeh Te-Huei , Hsu Wei-Chung , Chen Yuh-Shyan , Hsu Chuan-Jen , Lee Shiann-Yann 
Published: August 2018

Background A nasal polyp usually is characterized by eosinophil infiltration. Eosinophil-fibroblast interaction is an important event of persistent inflammation in airways. We have found abundant connexin 43 (Cx43) expression in subepithelial fibroblasts of nasal mucosa. Thus, we aim to analyze the relationship of Cx43 expression and eosinophil in nasal polyps. Methods In 25 nasal polyps and 19 inferior turbinates, indirect immunofluorescent and hematoxylin and eosin staining were performed in adjacent sections. We calculated the density of Cx43 staining and eosinophil individually by fluorescent and light microscope. Results Positive Cx43 staining under confocal microscope was shown as punctated spots on cell margin. The density of Cx43 and eosinophil staining was significantly different between groups of inferior turbinate and nasal polyp (p = 0.01 and 0.03, respectively). Decreased Cx43 expression in the subepithelial fibroblast was correlated with eosinophil infiltration in nasal polyps. Spearman rank order coefficient was equal to —0.43 (p < 0.05). Conclusion This is the first demonstration of decreased Cx43 expression related to eosinophil infiltration. To the best of our knowledge, interleukin-8 may be a link between Cx43 and eosinophil and orchestrating both in developing nasal polyps.
New Immunohistologic Findings on the Differential Role of Cyclooxygenase 1 and Cyclooxygenase 2 in Nasal Polyposis
Authors: Gosepath Jan , Brieger Juergen , Mann Wolf J. 
Published: August 2018

Background Cyclooxygenase 1 (Cox-1) plays a key role in arachidonic acid metabolism and in the pathophysiology and immunology of nasal polyposis in patients suffering from aspirin intolerance. We hypothesize that Cox-2 also might be relevant in the etiology of nasal polyps of aspirin-tolerant patients by their effects on inflammatory mediators as well as on microvascular permeability. Methods Fifty-two surgical specimens were immunohistochemically labeled for Cox-1 and Cox-2. Specimens were taken from chronically inflamed mucosa (n = 19) and from nasal polyps (n = 19) during endonasal sinus surgery. Controls were obtained from healthy nasal respiratory mucosa (n = 14), harvested during turbinate surgery in patients with nasal obstruction without inflammatory disease. Staining intensities were semiquantitatively assessed and statistically analyzed. Results In chronically inflamed tissue the expression of Cox-1 and Cox-2 was strongly labeled. However, in nasal polyps the staining pattern of Cox-1 was similar, but Cox-2 expression in epithelial cells was significantly less than in inflamed, nonpolypous specimens. Conclusion These data suggest that while Cox-1 is strongly up-regulated, Cox-2 expression is significantly lower in epithelial cells of nasal polyps than in those of chronic sinusitis without polyps. The relevance of this finding has to be discussed with respect to the regulatory function of Cox on the inflammatory reaction in nasal respiratory mucosa and its hypothetical role in alterations of capillary permeability via vascular permeability factor/vascular endothelial growth factor.
Fungi: A Normal Content of Human Nasal Mucus
Authors: Lackner Andreas , Stammberger Heinz , Buzina Walter , Freudenschuss Kurt , Panzitt Thomas , Schosteritsch Stefan , Braun Hannes 
Published: August 2018

Background In recent studies, we showed that 91.3% of both CRS patients and healthy controls grew positive fungal cultures out of their nasal mucus, which therefore appears to be a common finding within the adult population. However, it still was unknown as of when fungi could be cultured from nasal mucus in human beings. We attempted to ascertain this point of time in the nasal mucus of neonates. Methods We examined nasal mucus from 30 neonates immediately after birth, on the 1st and 4th day postpartum and after 2 and 4 months of life. The samples obtained with sterile cotton swabs were cultured on agar plates. Fungal cultures were identified either conventionally by microscopy or with molecular techniques. To prove possible contamination during birth, mucus of the maternal birth canal was examined as well. Results In 6 of 30 (20%) of our neonates we found positive fungal cultures immediately after birth in (3 of them Candida albicans) most likely because of contamination passing the maternal birth canal. In 2 of 29 (7%) of our neonates, positive fungal cultures were obtained on the 1st day postpartum, and in 4 of 26 (15%) positive fungal cultures were obtained on the 4th day, all limited to 1 day only and without clinical symptoms of colonization. After the 2nd month of life, examination of nasal mucus yielded positive fungal cultures in 8 of 11 (72%), and after 4 months examination of nasal mucus yielded positive fungal cultures in 17 of 18 (94%) of our babies, with a wide array of different species. Conclusions Fungi can be cultured from nasal mucus as soon as contact with the environmental air exists but they are not persistent in the 1st day of life. However, after 4 months, the situation is similar to the one in adults: fungal cultures can be obtained from almost everyone's nose. Therefore, fungi must be considered a normal content of nasal mucus.
A Comparison of Symptom Scores and Radiographic Staging Systems in Chronic Rhinosinusitis
Authors: Bhattacharyya Neil 
Published: August 2018

Background The aim of this study was to determine if one of the popular computed tomography (CT) scan staging systems exhibits better correlation with sinonasal symptom severity in chronic rhinosinusitis (CRS). Methods Adult patients meeting diagnostic criteria for CRS were prospectively studied with the Rhinosinusitis Symptom Inventory and their paranasal sinus CT scan was staged according to the Kennedy, Harvard, and Lund staging systems. From the Rhinosinusitis Symptom Inventory, Likert symptom severity scores were obtained and the nasal, facial, oropharyngeal, systemic, and total symptom scores were computed. Correlation analysis was conducted between symptom scores and CT scan stage for each of the three staging systems. Results Two hundred patients met inclusion criteria (mean age, 41.1 years; 42% men). The mean Lund score for the entire cohort was 10.0 (SD, 5.3). The Kennedy stage distributions were 40, 42, 84, and 34 patients for stages 1–4, respectively. The Harvard stage distributions were 17, 53, 85, and 45 patients for stages 1–4, respectively. All three staging systems exhibited statistically significant Pearson correlation (all p < 0.001) for the nasal symptom domain (nasal obstruction, rhinorrhea, and hyposmia), although the magnitude of the correlation coefficient generally was small (range of Pearson's r, 0.242–0.345). The Kennedy and Harvard systems exhibited significant but negative correlation with the oropharyngeal symptom domain. All three staging systems failed to significantly correlate CT stage with facial symptoms, systemic symptoms, and total symptom scores. Conclusion The Lund staging system exhibited the best correlation between nasal symptom scores and CT stage in CRS, but the degree of correlation remained small. All three systems were lacking in staging value for nonnasal sinonasal symptoms.
Development of Transgenic Mouse Models for the Study of Human Olfactory Dysfunction
Authors: Lane Andrew P. , Zhao Haiqing , Reed Randall R. 
Published: August 2018

Background Olfactory loss is a significant health problem that remains incompletely understood. The development of suitable animal models is essential to the progress of human olfactory loss research. Recent advancements in transgenic technology allow the creation of model systems to address causes of olfactory neuron dysfunction. Methods This review describes two transgenic mouse models with potential usefulness in the study of olfactory loss and highlights the molecular techniques that underlie the development of such systems. Results Genetic constructs generated using standard molecular biological techniques are introduced into mouse germ lines either by homologous recombination or by random integration. One construct (UbI7) places the olfactory receptor I7 under control of the olfactory marker protein promoter. The other two constructs (TI) act together to direct expression of cytokines in the olfactory epithelium, creating a novel approach to the study of inflammatory olfactory loss. Conclusions Powerful scientific tools now exist to develop animal models useful to the study of human olfactory disease. Transgenic olfactory neurons from the UbI7 mouse strain will respond to known odorants, facilitating experiments that examine in vitro modulation of olfactory neuron function. The ability to express specific genes in the olfactory mucosa of the TI mouse has great potential in elucidating the role of cytokines in the development of olfactory dysfunction in vivo.
Early Effect of Exogenous Na Hyaluronate on Mucociliary Clearance
Authors: Yildirim Altan , Turgut Bulent , Bebek Ali Ihsan , Gumus Cesur , Kocaturk Sinan , Kunt Tanfer 
Published: August 2018

Background An animal study is performed to determine the early effect of 1% Na hyaluronate on mucociliary clearance function. Methods One percent of Na hyaluronate was introduced into the maxillary sinuses of rabbits by anterior antrostomy. A physiological solution of 1% NaCl was introduced into the maxillary sinuses of a control group to equalize the influence of Na for both groups. The treatment material was sprayed with an atomizer for coating the maxillary sinus lining. Technetium-99m diethylenetriamine pentaacetate dynamic scintigraphic imaging was performed to evaluate mucociliary clearance function on all rabbits 72 hours after the surgical procedure. Results Although the mean rate of mucociliary clearance of the Na hyaluronate group was slightly worse than the control group; there was no statistically significant difference between them. Conclusion There is no early effect of exogenous 1% Na hyaluronate on mucociliary clearance function.
Frequency Spectra of Normal Expiratory Nasal Sound
Authors: Seren Erdal 
Published: August 2018

Background The computerized analysis of the nasal sound reflects the nasal airflow. We have developed a new software program that analyzes the nasal sound to use in the research area and clinical applications. We aimed to analyze automatically the spectral parameters of nasal sound in healthy people by our new versatile PC-based nasal sound analyzer software. Methods In this study, we analyzed and recorded the expiratory nasal sound in 30 healthy people. This analysis includes the time-expanded waveform, the spectral analysis with time-averaged fast Fourier transform, the automatic detection, and the waveform analysis of nasal sound. Results We calculated the mean frequency of low-intensity sound (LIS) and high-intensity sound (HIS). The mean frequency of LIS was found as 1254 ± 10.23 Hz at the right nose and 1375 ± 18.45 Hz at the left nose. The mean frequency of HIS was found as 2453 ± 22.23 Hz at the right nose and as 2234 ± 21.12 Hz at the left nose. These results showed that the values between LIS and HIS are statistically significant (p < 0.005) and different from each other. We found that the nasal sound of the similar nasal airflow was the same type and amplitude in the analysis of the nasal sound recordings. Conclusion The frequency of the nasal sound is an indicator of the intensity of the nasal airflow. The method that provides the analysis of the nasal sound may lead to a new diagnostic method. The method, which is noninvasive, rapid, of low cost, and even applicable for small children, requires little cooperation of the subjects. In addition, it will be possible to record and save the analysis of the nasal airflow as digital data.
Correlation of Complications during Endoscopic Sinus Surgery with Surgeon Skill Level and Extent of Surgery
Authors: Soyka Michael B. , Holzmann David 
Published: August 2018

Background Endoscopic sinus surgery (ESS) produces a great range of potential complications. Rough segregation into “minor” and “major” complications seems insufficient. This study uses a recently published new classification system that is based more on the patient's point of view, with a greater variety of options. Methods A retrospective review was undertaken of 421 ESS procedures. Both, the surgeon's experience and the extent of surgery were correlated with the complication rate. Results The overall complication rate was 39.7% (grades A–D) and did not correlate significantly with either the experience of the surgeon or with the extent of surgery. Conclusion The new classification is simple, precise, and takes complications into account that used to be neglected. ESS is even safe in the hands of less skilled surgeons as long as the degree of difficulty stays highly adapted to his/her ability. Some complications (grade A) seem to be inherent to the procedure.
Effects of the Nasal Muscles on the Nasal Airway
Authors: Kienstra Matthew A. , Gassner Holger G. , Sherris David A. , Kern Eugene B. 
Published: August 2018

Background The nasal muscles and their function are not clearly defined. The nasal muscles generally are thought to act synergistically to produce mimetic motion and affect the nasal airway. We proposed direct examination of the effects of the nasal muscles on the nasal airway. Methods Rhinomanometry was performed on volunteers. After paralysis of the nasal muscles with lidocaine, rhinomanometry was performed again to measure nasal airway function with the patient at rest and attempting to flare his/her nostrils. Each patient's rhinomanometric results (at rest and attempting to flare the nostrils) taken before injection of lidocaine served as the control for comparison of his/her results postinjection. The structural tension of the ala at rest and with active flaring of the nostril was measured also, and the results pre- and postparalysis with lidocaine were compared. Results The data from both the stiffness (structural tension) and the airflow portions, taken together, support the following conclusions. First, the paralysis was significant, although not complete. Clinical and stiffness data supported complete paralysis. Airflow data, which we think most sensitive, support a statistically significant affect of the injection, although incomplete paralysis. Conclusion All of the evidence supports an important role for the nasal muscles when actively used to increase nasal airflow. Second, the majority of the evidence supports an important resting nasal muscle tension that opens the nasal airway.
The Effect of Lateral Osteotomy of Septorhinoplasty on Nasolacrimal Duct Functions: A Radionuclide Imaging Study
Authors: Uzun Lokman , Ugur Mehmet Birol , Peksoy Irfan , Cabuk Mehmet , Cinar Fikret 
Published: August 2018

Background The aim of this study was to evaluate the effects of lateral osteotomy of septorhinoplasty on nasolacrimal duct functions by dacryoscintigraphy. Methods The study group comprised 60 nasolacrimal systems of 30 consecutive patients who underwent septorhinoplasty. Dacryoscintigraphy images were taken in the preoperative period and postoperative 1st week and 3rd month. After Tc-99m pertechnetate instillation, dynamic images were obtained every 15 seconds. For cases of normal drainage, the study was terminated after 10 minutes but when obstruction was suspected, external ocular massage and rapid nasal inspiration were applied and the test was extended for an additional 10 minutes. Systems were classified either as passage without massage (normal nasolacrimal test), passage with massage (physiological obstruction), or presac or postsac obstruction (partial or complete obstruction) according to test results. Transit time was determined for cases with normal test or physiological obstruction. Results In the preoperative period eight systems (two presac and six postsac) had obstruction. There were a total of 11 (18.3%) additional systems with obstruction (4 presac and 7 postsac) in the 1st postoperative week and patient symptoms were not in complete agreement with the test results in this period. By the 3rd month, nine systems (three presac and six post sac) had obstruction. Transit time was prolonged in both the postoperative 1st week and the postoperative 3rd month tests compared with the preoperative tests (p = 0.000 and p = 0.023, respectively). Conclusion We did not encounter any permanent obstructions after lateral osteotomy of rhinoplasty. Temporary obstructions in the 1st postoperative week improved to normal preoperative status by the postoperative 3rd month.
Surgical Revision of the Failed Obliterated Frontal Sinus
Authors: Hwang Peter H. , Han Joseph K. , Bilstrom Evan J. , Kingdom Todd T. , Fong Karen J. 
Published: August 2018

Background Surgical revision of failed frontal sinus obliteration, traditionally, has been limited to repeat obliteration. However, endoscopic techniques may be successful in selected cases. We review our experience in surgical revision of failed frontal obliteration and propose a management algorithm. Methods Retrospective chart review was performed over a 5-year period for patients who presented for surgical revision of a previously obliterated frontal sinus. Indications for surgery, radiological findings, and surgical approach were reviewed. Results Nineteen patients were identified, presenting an average of 9.7 years from the initial obliteration. Eighty-four percent (n = 16) were approached endoscopically and 16% (n = 3) were approached by revision obliteration. The mean follow-up was 25 months. In the endoscopic group, patients had either mucoceles in the inferomedial aspect of the frontal sinus or incomplete obliteration with persistent disease in the pneumatized frontal remnant. Eighty-one percent (13/16) were managed successfully with a single endoscopic procedure. Nineteen percent (3/16) had persistent disease requiring either a subsequent obliteration or Riedel ablation because of infected fat graft or frontal osteomyelitis. All patients who were managed successfully endoscopically remained free of disease with patent frontal sinusotomies throughout the follow-up period. The endoscopic failures required one to two additional external procedures to achieve disease resolution. In the revision obliteration group, all patients had mucoceles in either the lateral or the superior frontal sinus. All three patients had resolution of disease after a single procedure and remained free of disease throughout the follow-up period. Conclusion Selected patients undergoing revision of frontal obliteration may benefit from endoscopic approaches. If disease is localized in the frontal recess or inferomedial frontal sinus, endoscopic management may be successful in the majority of patients. Superior or lateral frontal disease appears to be best approached externally. Patients undergoing endoscopic salvage should be counseled about the possible need for revision obliteration if disease persists.
Evaluation of Postoperative Pain after Sinonasal Surgery
Authors: Wise Sarah K. , Wise Justin C. , DelGaudio John M. 
Published: August 2018

Background Pain after sinonasal surgery concerns both patients and surgeons. Factors affecting sinonasal postoperative pain have not been examined extensively. Methods Using a prospective survey design, sinonasal surgery patients evaluated postoperative pain (on a scale of 0–10), pain location, and medication use. Results One hundred twenty-seven patients consented to participate. One hundred fifteen patients returned surveys, with 100 patients appropriate for analysis over the 6-day postoperative period. Pain score and medication use were evaluated with respect to sex, primary/revision case, nasal packing, and other factors. Repeated measures analysis of variance and chi-square analysis were conducted (p < 0.05). Pain ratings and analgesic use declined significantly over the postoperative period (p < 0.05). Mean pain score on postoperative day (POD) 1 was 3.61 and on POD 6 was 1.72. Mean medication use was 1.37 tablets on POD 1 and 0.55 tablets on POD 6. Additionally, a significant interaction existed, such that narcotic medication use declined from 1.91 tablets on POD 1 to 0.52 tablets on POD 6, whereas nonnarcotic medication use remained steady (p < 0.05). Periorbital pain was most frequent (46.3%), with unilateral facial pain reported least (4.1%). A significant difference existed for distribution of pain location (p < 0.05). Finally, the difference in pain rating between primary and revision procedure for women (0.65) was less than for men (1.12); this interaction was significant (p < 0.05). Conclusion Multiple patient and operative factors affect pain rating and medication use after sinonasal surgery. Generally, pain level should be low with little analgesic use postoperatively.
Does Nitrogen Dioxide Affect Inflammatory Markers after Nasal Allergen Challenge?
Authors: Barck Charlotte , Lundahl Joachim , Holmström Mats , Bylin Gunnar 
Published: August 2018

Background Exposure to high ambient levels of nitrogen dioxide (NO2) enhances the bronchial inflammatory reaction to allergen in humans. We tested whether this NO2 effect occurs also in the upper airways. Methods Sixteen allergic subjects with rhinitis and mild asthma were exposed at rest to either purified air or 500 μg/m3 NO2 for 30 minutes, followed 4 hours later by a nasal allergen challenge. Nasal lavage was performed before air/NO2 exposure, before allergen challenge, and 1, 4 and 18 hours after allergen challenge. Symptoms were recorded. Results The percentage of eosinophils and neutrophils, eosinophil cationic protein, and myeloperoxidase were similar after exposure to air + allergen and to NO2 + allergen. We noticed a tendency to increased sneezing the day after exposure to NO2 + allergen. Conclusion The priming effect of an ambient brief NO2 exposure on subsequent allergic response was not noticeable in activation of inflammatory cells and mediators in the upper airways.
The Effect of a Hyaluronic Acid–Based Nasal Pack on Mucosal Healing in a Sheep Model of Sinusitis
Authors: Rajapaksa Suresh P. , Cowin Allison , Adams Damian , Wormald Peter-John 
Published: August 2018

Background A hyaluronic acid–based nasal pack has been shown previously to have a beneficial effect on mucosal healing in a healthy sheep model. However, endoscopic sinus surgery (ESS) usually is performed in the presence of infection and inflammation. The aim of this study was to examine the efficacy of hyaluronic acid–based nasal packing on mucosal healing in a sheep model of chronic sinusitis. Methods A standardized sheep model of chronic sinusitis was used. Full-thickness mucosal injuries were performed under endoscopic guidance with a microdebrider. Adjacent wounds were created between the lateral nasal wall and the ethmoid turbinate. Then, the injuries were either packed with a dissolvable hyaluronic acid–based pack or left unpacked to serve as a control. Serial biopsies of the healing mucosa were performed at days 28, 56, 84, and 112 postsurgery, and the presence or absence of adhesions between the ethmoid turbinate and lateral nasal wall was noted. The biopsy specimens were assessed for reepithelialization and epithelial height using light microscopy, and for reciliation using scanning electron microscopy. Results There was no significant difference in reepithelialization or relative epithelial height between the packed sides and the control sides at any time point. There was a statistically significant difference in reciliation between the two groups at day 112 but this was not deemed clinically significant. The packing had no significant effect on adhesion formation. Conclusion In the sheep model of chronic sinusitis, a dissolvable hyaluronic acid–based pack did not have any significant effect on mucosal healing or adhesions formation after ESS, as assessed by examining reepithelialization, epithelial height, reciliation, and the presence of adhesions.