bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eosinophilic Angiocentric Fibrosis of the Sinonasal Tract in a Male Patient with Chronic Bowel Inflammation
Authors: Slovik Youval , Putterman Marc , Nash Michael , Sion-Vardy Netta 
Published: August 2018

Background Eosinophilic angiocentric fibrosis (EAF) is an uncommon inflammatory fibrosing lesion involving the upper respiratory mucosa, occurring mainly in young to middle aged women (female/male ratio = 2:1). The etiology is unknown; however, several factors might play a role in the development of EAF. Among them are prior nasal trauma (in most of the reported cases nasal surgery had been performed a few years prior to diagnosis) and inflammatory or autoimmune etiology (suggested by the ratio and the fact that in many of the reported cases a history of nonspecific allergy was found). Methods We report the first case of EAF affecting a male patient who also suffered from chronic inflammatory bowel disease and rheumatic fever. Results The patient underwent a diagnostic biopsy of his nasal lesion via an open rhinoplasty approach, with the resulting diagnosis of EAF. Despite the fact that the literature does not show advantages to any specific therapy, the patient elected to remain under observation. During a two-year follow-up period, there is no evidence of progression of disease. Conclusion The presence of concomitant rheumatoid arthritis and chronic inflammatory bowel disease in our patient, as well as the fact that nine previously reported cases of EAF had allergic/immune symptoms, raise the possibility that inflammatory or autoimmune factors may have a role in the development of this unusual pathological entity.
Serum Amyloid A, Properdin, Complement 3, and Toll-Like Receptors are Expressed Locally in Human Sinonasal Tissue
Authors: Lane Andrew P. , Truong-Tran Quynh-Ai , Myers Allan , Bickel Carol , Schleimer Robert P. 
Published: August 2018

Background There is a growing appreciation of the role that nasal mucosa plays in innate immunity. In this study, the expression of pattern recognition receptors known as toll-like receptors (TLRs) and the effector molecules complement factor 3 (C3), properdin, and serum amyloid A (SAA) were examined in human sinonasal mucosa obtained from control subjects and patients with chronic rhinosinusitis (CRS). Methods Sinonasal mucosal specimens were obtained from 20 patients with CRS and 5 control subjects. Messenger RNA (mRNA) was isolated and tested using Taqman real-time polymerase chain reaction with primer and probe sets for C3, complement factor P, and SAA. Standard polymerase chain reaction was performed for the 10 known TLRs. Immunohistochemistry was performed on the microscopic sections using antibodies against C3 Results Analysis of the sinonasal sample mRNA revealed expression of all 10 TLRs in both CRS samples and in control specimens. Expression of the three effector proteins was detected also, with the levels of mRNA for C3 generally greater than SAA and properdin in CRS patients. No significant differences were found in TLR or innate immune protein expression in normal controls. Immunohistochemical analysis of sinonasal mucosal specimens established C3 staining ranging from 20 to 85% of the epithelium present. Conclusion These studies indicate that sinonasal mucosa expresses genes involved in innate immunity including the TLRs and proteins involved in complement activation. We hypothesize that local production of complement and acute phase proteins by airway epithelium on stimulation of innate immune receptors may play an important role in host defense in the airway and, potentially, in the pathogenesis of CRS.
Quantification of Ciliary Beat Frequency in Sinonasal Epithelial Cells Using Differential Interference Contrast Microscopy and High-Speed Digital Video Imaging
Authors: Schipor Ioana , Palmer James N. , Cohen Akiva S. , Cohen Noam A. 
Published: August 2018

Background Mucociliary clearance is a critical upper airway host defense mechanism. Ciliated epithelium in the mammalian airway continually beat at a baseline frequency. Importantly, during times of stress such as exercise or infection, the cilia beat faster to increase clearance. Nasal epithelial ciliary beat frequency (CBF) has been analyzed previously in ex vivo specimens using a variety of methods including photodiode detectors and conventional video recording. Recent studies performed using lower airway ciliated mucosa have shown poor correlation between CBF quantified by photodiode/conventional video and those using high-speed digital video capture at temperatures close to physiological temperatures. Thus, to more rigorously interrogate sinonasal CBF at physiological conditions, we have incorporated a high-speed digital video camera to our CBF analysis system. This is the first report of sinonasal epithelial CBF analysis performed using high-speed video digital analysis. Methods Ex vivo samples of sinonasal epithelium were placed in lactated Ringer's in a temperature-controlled microscope stage chamber. An edge of tissue containing beating cilia was observed at a magnification of 630 X using differential interference contrast microscopy. The images were captured using a high-speed digital camera with a sampling rate of 250 frames per second. CBF was determined using computerized data analysis. Results The mean nasal CBF was calculated from a minimum of five regions for each sample. Temperature curves were generated from tissue obtained from chronically infected subjects. Conclusion Analysis of high-speed digital video capture of sinonasal CBF observed under differential interference contrast microscopy is a powerful method to investigate environmental as well as host influences on mucociliary clearance within the upper airways.
Regional Analysis of Sinonasal Ciliary Beat Frequency
Authors: Shaari Jeffrey , Palmer James N. , Chiu Alexander G. , Judy Kevin D. , Cohen Akiva S. , Kennedy David W. , Cohen Noam A. 
Published: August 2018

Background Mucociliary clearance, a primary host defense mechanism, depends on mucus production and its clearance by the coordinated beating of cilia lining the airways. Numerous investigations have analyzed ciliary activity in brushings from the inferior turbinate. To date, only one study has investigated whether there exists variation in ciliary beat frequency (CBF) within the sinonasal cavity. We analyzed CBF from the inferior turbinate, uncinate process, and sphenoethmoid recess in nonsinusitis patients to determine regional variability of ciliary activity within the sinonasal cavity. Methods Explants of sinonasal epithelium were analyzed at 37°C. Beating cilia were visualized with differential interference contrast microscopy. Images were captured using a high-speed digital camera with a sampling rate of 250 frames per second. A one-dimensional tracking algorithm analyzed individual pixel grayscale values within each frame of the video. The differences in grayscale were plotted as a time-dependent waveform, and frequency was calculated as the inverse of the peak-to-peak distance. A minimum of three areas of beating cilia were analyzed per regional sample. Statistical analysis was performed with repeated-measures analysis of variance. Results Complete sampling of all three sites was accomplished in 10 patients. No difference in CBF within the sinonasal cavity was identified (p < 0.05). The mean CBF for all sites in all patients was 12.6 ± 2.9 Hz, in agreement with published values. Conclusion This study shows no regional differences in CBF within the sinonasal cavity, supporting previous work and validating analysis of inferior turbinate cilia.
Massive Apoptosis Erodes Nasal Mucosa of Cocaine Abusers
Authors: Trimarchi Matteo , Miluzio Annarita , Nicolai Piero , Morassi Maria Laura , Bussi Mario , Marchisio Pier Carlo 
Published: August 2018

Background A threatening occurrence in some cocaine abusers is the progressive destruction of nasal structures (cocaine-induced midline destructive lesions [CIMDL]) that may end in a highly severe disease. Methods Thirty patients with CIMDL, 10 healthy patients, 10 patients affected by nasal polyposis, and 10 patients affected by Wegener granulomatosis were observed. Biopsy specimens of nasal mucosa were analyzed by immunohistochemistry for caspases −3, −9 and −8 and by the terminal deoxynucleotidyl transferase-mediated dUTP-digoxygenin nick end labeling (TUNEL) method. The time and concentration-dependent effects of cocaine in vitro were studied in HaCat cells by TUNEL and Western blotting. Results All CIMDL biopsy specimens showed abundant caspase-3 and caspase-9 expression but no caspase-8 positive cells. No obvious expression of any caspases was detected in biopsy specimens from healthy subjects or in patients affected by nasal polyposis or Wegener granulomatosis. In HaCat cells cellular changes were observed, which confirmed induction of massive apoptotic events. The rate of apoptosis in HaCat cells was dependent on the concentration of cocaine. After 1 hour, 2.5,5, and 10 mM of cocaine induced 16, 45, and 84% of apoptotic figures, respectively, while 6 hours of exposure increased apoptosis to 25, 54, and 94% at the same concentrations. Caspase expression and activation in HaCat cells treated with 100 μM and 1 mM of cocaine for 1 hour were confirmed by Western blotting. Conclusion Cultured epithelial cells show both time- and dose-dependent increases in apoptosis and cellular damage on cocaine treatment. We suggest that some abusers trigger CIMDL by abnormally boosting apoptosis within nasal epithelial cells. Cocaine abusers with higher apoptotic rates may predict whether they will eventually develop CIMDL.
Use of an Electronic Nose to Diagnose Bacterial Sinusitis
Authors: Thaler Erica R. , Hanson C. William 
Published: August 2018

Background Having previously established that an electronic nose (enose) can distinguish among bacteria samples, between cerebrospinal fluid leak and serum, and can identify patients with ventilator-associated pneumonia, we hypothesized that bacterial sinusitis could be diagnosed by sampling exhaled gas with an enose. Methods Using a nasal continuous positive airway pressure mask, we sampled gas exhaled through the nose of patients with sinusitis and compared them with controls. Data were first projected onto the principal components and then classified by support vector machine (SVM), a machine learning algorithm for pattern recognition. Results SVM analysis showed good discrimination using three approaches. First, 11 samples were used to create a training set that was used to predict whether individual samples from each set were a member of the control or infected sets. The enose was correct 98.4% of the time. Second, one-half of the samples from each of the same 11 control and infected groups were used to construct a training set, which was used to predict infection in the remaining samples. The enose was correct 82% of the time. Finally, 68 samples (34 positive and 34 controls) were analyzed using a leave-one-out scheme for creating training sets and testing sets. This method, designed to reflect the generalization property of the SVM classifier, scored a classification rate of 72%. Conclusion Using the enose to sample nasal exhalation from patients with suspected sinusitis, we were able to predict correctly the diagnosis of sinusitis in at least 72% of the samples. The next step will be to do forward prediction using this model.
The Sphenoid Sinus Natural Ostium is Consistently Medial to the Superior Turbinate
Authors: Millar D Anderson , Orlandi Richard R. 
Published: August 2018

Background This study was performed to determine the location of the natural ostium of the sphenoid sinus relative to the intact superior turbinate. Methods Forty-seven cadaveric specimens were examined. Mucosa over the sphenoethmoidal recess, superior turbinate, and posterior ethmoid was left intact. The position of the sphenoid sinus natural ostium relative to the superior turbinate was identified. Results The sphenoid ostium was identified in all specimens. In all specimens, the sphenoid ostium was found to be medial to the intact superior turbinate, notwithstanding lateral deflection of the posterior few millimeters of the superior turbinate in some cases. Conclusion The superior turbinate is an excellent landmark for the sphenoid sinus natural ostium. Previous observations of the ostium positioned lateral to the superior turbinate may have been caused by stripping of the superior turbinate mucosa before measurements were taken. In the intact specimen, the sphenoid ostium is reliably found medial to the superior turbinate.
Effects of Saline Sprays on Symptoms after Endoscopic Sinus Surgery
Authors: Pinto Jayant M. , Elwany Samy , Baroody Fuad M. , Naclerio Robert M. 
Published: August 2018

Background Topical saline is commonly recommended after endoscopic sinus surgery. The efficacy in this situation has never been shown. Methods We performed a controlled clinical trial to determine the effect of saline sprays on symptoms after endoscopic sinus surgery. Patients were randomized to receive normal saline (NS; n = 20), buffered hypertonic saline (HS; n = 20), or no spray (n = 20). A questionnaire measured symptoms of nasal obstruction, discharge, pain, headache, and trouble sleeping. Daily pain medication usage was recorded. Results Symptom scores over the first 5 postoperative days showed higher nasal discharge scores in the HS group. Day-by-day comparisons showed that the HS group reported significantly higher pain scores during some postoperative days. The NS group showed similar scores to control. Conclusion NS and HS sprays do not have a beneficial effect on symptoms compared with no treatment. HS sprays enhanced nasal drainage and pain. Our results do not support prescribing saline sprays early after sinus surgery but do not exclude the use of topical saline in other forms or for other uses, although they may be used for other intentions.
Two-Year follow-up with Acoustic Rhinometry in Children
Authors: Millqvist Eva , Bende Mats 
Published: August 2018

Background This is an explorative study of growth-related nasal geometry in healthy children. Methods A total of 88 girls and boys between the ages of 4 and 16 years were followed over a period of 2 years by acoustic rhinometry. The registrations were correlated to height at each occasion. Results Although both the minimal cross-sectional area and the nasal volume increased in all age groups over 7 years, large individual variations in nasal geometry led to a weak relationship with growth. Conclusion In the undecongested nasal cavity in children, correlation of nasal geometry makes sense for height but not for age.
Composition of Hyaluronan Affects Wound Healing in the Rabbit Maxillary Sinus
Authors: Proctor Matthew , Proctor Kerry , Shu Xiao Zheng , McGill Lawrence D. , Prestwich Glenn D. , Orlandi Richard R. 
Published: August 2018

Background Hyaluronan (HA) is a ubiquitous component of the extracellular matrix. HA and its derivatives have been used in the sinuses to reduce scarring and possibly promote wound healing. However, in recent animal studies, HA esters exhibited inflammatory effects. Mitomycin C (MMC) is another potential antiscarring treatment. This study prospectively evaluated the effects of three different HA constructs on wound healing in the rabbit maxillary sinus: (i) a novel cross-linked HA hydrogel, (ii) the cross-linked HA gel containing covalently bound MMC, and (iii) a commercially available woven HA ester (Merogel). Methods Ostia were created with a 4-mm otologic drill in the maxillary sinuses of 15 New Zealand white rabbits with one side randomly chosen for treatment. After 14 or 21 days the size of the maxillary ostia were recorded and the tissue was examined under light microscopy. Results Sinuses treated with the novel HA and HA-MMC hydrogels showed an increased ostial diameter compared with untreated controls. Woven HA ester–treated sinuses showed no improvement, with a trend toward a smaller ostium than controls. Histological examination showed that woven HA ester tended to cause increased fibrosis and granulomatous inflammation, and heterophilia was slightly increased in the HA hydrogel-treated sinuses. Blinded observation noted foamy macrophages surrounding the residual woven HA ester in each specimen while no similar reaction was noted near the residual HA or HA-MMC hydrogels. Conclusion This study suggests that the degree of ostial narrowing, inflammation, and fibrosis depends on the formulation of the HA used. Minimal, if any, additional benefit is seen with addition of MMC to the HA hydrogel in this pilot study.
Suppression of Allergic Response by CpG Motif Oligodeoxynucleotide–House-Dust Mite Conjugate in Animal Model of Allergic Rhinitis
Authors: Mo Ji-Hun , Park Seok-Won , Rhee Chae-Seo , Takabayashi Kenji , Lee Seung Sin , Quan Song-Hua , Kim In-Sang , Min Yang-Gi , Raz Eyal , Lee Chul Hee 
Published: August 2018

Background Although there have been many therapeutic options for allergic disease, the true allergen desensitization remains a challenging goal. The classic immunotherapy has a limited efficacy, is inconvenient, and has a risk of anaphylaxis. Recent reports revealed that immunostimulatory DNA sequences (ISS-oligdeoxynucleotide [ODN], CpG motif) act as a strong Th1 response–inducing adjuvants and that DNA-based vaccination might be an effective therapeutic option. In this study, we investigate whether ISS-ODN/Dermatophagoides farinae (Der f) conjugate has antiallergic effects in the allergic rhinitis mouse model, sensitive to house-dust mites. Der f is the most common allergen-inducing allergic rhinitis in Korea. Methods C57BL/6 mice were sensitized with crude extract of Der f. After injection of ISS-ODN or ISS-ODN/Der f conjugate, several parameters of allergic response were evaluated. Results Scratching and sneezing symptoms and eosinophilic infiltration into nasal mucosa were suppressed by injection with ISS-ODN only and ISS-ODN/Der f conjugate. Interleukin-5 level was decreased and interferon γ level was increased in nasal lavage fluid by injection of ISS-ODN/Der f conjugate. Der f–specific immunoglobulin E was decreased by injection of ISS-ODN or Der f /ISS-ODN conjugate; however, these were not statistically significant. Transforming growth factor β1 secreted by cultured splenocyte was increased significantly in ISS-ODN/Der f conjugate group. Conclusion These results suggest ISS-ODN/Der f conjugate induces an antiallergic effect and induces an increase in transforming growth factor β1 level in the allergic rhinitis model using Der f allergen. Allergic response developed by Der f allergen could be more effectively reduced by injection with ISS-ODN/Der f conjugate than by injection with ISS-ODN only.
Hemostatic Effect of Tranexamic Acid in Elective Nasal Surgery
Authors: Yaniv Eitan , Shvero Jacob , Hadar Tuvia 
Published: August 2018

Background Bleeding is the most frequent complication of nasal surgery. The aim of this prospective study was to evaluate the effectiveness of tranexamic acid (TA), an antifibrinolytic agent, in reducing bleeding during and after nasal surgery. Methods The study sample included 400 patients aged 18–60 years who underwent combination functional endoscopic sinus surgery with septoplasty and conchotomy. Two hundred patients were not given a hemostatic agent (control group) and 200 patients were administered 1 g of oral TA three times daily starting 2 hours before surgery, for 5 days. Bleeding was monitored during surgery and for 2 weeks postoperatively. Results Patients given oral TA showed significantly less operative and postoperative bleeding compared with controls. No patients required additional packing, compared with five patients in the control group. Adverse reactions to TA were minimal, and they disappeared when the treatment stopped. Conclusion TA is a safe and effective drug for the reduction of bleeding in nasal surgery. It may be recommended for routine use.
Does the use of the Combined Oral Contraceptive Pill Cause Changes in the Nasal Physiology in Young Women?
Authors: Wolstenholme Charlotte R. , Philpott Carl M. , Oloto Emeka J. , Murty George E. 
Published: August 2018

Background Changes in nasal physiology have been observed during pregnancy and the menstrual cycle. The role of female hormones in these changes is unclear. The aim is to investigate the effect of the modern combined oral contraceptive pill (COCP). Methods Eleven women were recruited from a family planning clinic. Anterior rhinoscopy, peak inspiratory flow rate, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time, and rhinitis quality-of-life questionnaire (RQLQ) scores were recorded at days 1 and 14 pre- and post-COCP. Results Increased nasal obstruction midcycle pre-COCP, with significant differences for anterior rhinoscopy (p = 0.001) and peak inspiratory flow rate (p = 0.022), was found. No statistical difference was shown between pre- and post-COCP results apart from day 1 anterior rhinoscopy findings (p = 0.05). Conclusion The modern COCP has no significant effect on nasal physiology.
Preparing Individuals With Disabilities for Inclusive Employment Through the Postsecondary Access and Training in Human Services (PATHS) Program
Authors: Zhang Dalun , Grenwelge Cheryl , Petcu Stefania 
Published: August 2018

Abstract
In an era of globalization, receiving postsecondary education (PSE) becomes necessary for young adults to gain meaningful employment and earn a decent income that supports his or her independent living. The same is true for individuals with intellectual and developmental disabilities who desire for inclusive employment and community living. However, although an increasing number of individuals with intellectual and developmental disabilities have participated in various formats of PSE, this population is still severely underserved. Moreover, those who receive PSE are sometimes simply gaining a college experience or learning functional skills on college campuses. The purpose of this article is to present inclusive employment outcomes of individuals with intellectual and developmental disabilities who graduated from the Postsecondary Access and Training in Human Services (PATHS) program. These individuals' successful stories demonstrate that individuals with intellectual and developmental disabilities can complete a PSE program focusing on employment outcomes and start a professional career.