bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing the Need for Endoscopic Sinus Surgery in Adult Patients with Cystic Fibrosis
Authors: Brook Christopher D. , Maxfield Alice Z. , Ahmed Hena , Sedaghat Ahmad R. , Holbrook Eric H. , Gray Stacey T. 
Published: February 2017

Background Risk factors in adult patients with cystic fibrosis (CF) associated with surgical intervention have not been delineated. Objective To identify characteristics of adult patients with CF and with chronic rhinosinusitis that predict surgical intervention with endoscopic sinus surgery (ESS). Methods Patients were identified in a tertiary sinus center by the International Classification of Diseases, Ninth Revision codes 277.00-277.03, which represent CF. Charts were reviewed for the CF transmembrane conductance regulator (CFTR) gene mutation, Lund-Mackay score (LMS), the 22-item Sino-Nasal Outcome Test (SNOT-22) score, previous ESS, and occurrence of ESS after presentation. The Fisher exact test was used to test frequency of events between the groups, and the Mann Whitney U test and the t-test were used to compare means among LMS, SNOT-22, and age. The Cox proportional hazard analysis was used to calculate hazard ratios (HR) for the impact of LMS, SNOT-22 score, previous ESS, and CFTR gene mutation status on the occurrence of ESS after presentation. Results One hundred and fifteen patients met the inclusion criteria for the study. Patients with a history of surgery more often underwent ESS after presentation (p ≤ 0.01). The LMS and the SNOT-22 score were not significantly different between the groups of previous ESS and no previous ESS (p = 0.23 and p = 0.28, respectively). A severe mutation genotype was predictive of ESS after presentation (p = 0.03). SNOT-22 scores did not differ between the severe and mild groups (36.0 and 32.4, respectively; p = 0.57), but the mean LMS was significantly higher in the severe mutation group (12.5 and 9.7; p ≤ 0.01). Univariate Cox proportional hazard analysis revealed an increased occurrence of ESS for patients with severe mutations (HR, 3.6; p ≤ 0.01) or a history of ESS (HR, 2.3; p ≤ 0.01). Conclusion The occurrence of ESS in adult patients with CF was predicted by previous ESS intervention as well as the severity of CFTR mutation.
Allergic Sensitization does not Predispose to Sinus Inflammation in Externalized Paranasal Sinuses
Authors: Ahmadi Navid , Christensen Jenna M. , Barham Henry P. , Oakley Gretchen M. , Sacks Raymond , Harvey Richard J. 
Published: February 2017

Background Chronic rhinosinusitis (CRS) has a multifactorial etiology, with a debate about the role of inhalant allergy in the pathogenesis of CRS. Objective This study assessed the impact of allergy status on externalized paranasal sinuses after tumor resection to determine if a predisposition to inhalant allergy brought about additional inflammation after sinus surgery. Methodology A case-control study was performed on patients who had no history of CRS who underwent paranasal sinus tumor resection. Allergic sensitization was defined by a positive serum ImmunoCAP test result. Outcomes were measured at least 6 months after surgery by using the modified Lund-MacKay endoscopic score and the 22-item Sino-Nasal Outcome test, with rhinitis, sleep, psychological, ear and/or facial, and sinus subscores to assess the impact of allergy status on mucosal inflammation. Results A total of 103 patients (53.44 ± 17.46 years; 46% women) were assessed. Of these, 61.17% were allergically sensitized at the time of surgery. Postsurgery endoscopic assessment was similar [the modified Lund-Mackay endoscopic score allergic sensitized 0.5 (1.7) versus nonallergic sensitized 0.0 (0.9); p = 0.15]. Sinonasal symptoms were also similar between the groups' 22-item Sino-Nasal Outcome test scores, allergic sensitized versus allergic nonsensitized, (allergic 28.9 ± 20.8 versus nonallergic 33.5 ± 19.7; p = 0.31), rhinitis score (5.9 ± 5.5 versus 6.4 ± 4.7; p = 0.66), sleep score (6.9 ± 5.9 versus 7.7 ± 4.8; p = 0.50), ear and/or facial symptom score (3.4 ± 3.6 versus 4.3 ± 3.3; p = 0.22), psychological score (6.9 ± 6.0 versus 8.3 ± 6.7; p = 0.29), and of nasal symptom score (6.4 ± 5.2 versus 7.0 ± 5.3; p = 0.61). Conclusions Externalization of the sinuses in patients with inhalant allergy did not bring about significant additional inflammation in patients after tumor surgery.
Specific Nasal Provocation Test with Dermatophagoides Pteronyssinus, Monitored by Acoustic Rhinometry, in Children with Rhinitis
Authors: Matsumoto Fausto Yoshio , Gonçalves Tessa Rachel Tranquillini , Solé Dirceu , Wandalsen Gustavo Falbo 
Published: February 2017

Background Currently, the diagnosis of allergic rhinitis (AR) is arrived at predominantly by a clinical history and by systemic sensitization tests, but specific nasal provocation tests (NPT) may establish a better direct correlation between etiologic surveyed allergens and nasal symptoms. Objectives To standardize the specific NPT with one of the most important house-dust mites, Dermatophagoides pteronyssinus, monitored by acoustic rhinometry, in children and adolescents, and propose a simplified specific NPT to improve its clinical applicability as a diagnostic tool. Methods Sixteen controls (group 1) and 17 patients with an AR diagnosis sensitized to D. pteronyssinus (group 2) underwent a specific NPT with D. pteronyssinus. The acoustic rhinometry was performed after instillation of 0.15 mL of increasing concentrations of D. pteronyssinus (5000 BU/mL). The test was finalized after (1) instillation of the final concentration of D. pteronyssinus, or (2) after a 20% or more reduction in the volume of the first 5 cm of the nasal cavity (V5), or (3) a score of >3 in the symptoms questionnaire (a score from 0 to 7). A simplified specific NPT with two concentrations was proposed and implemented in a group of 10 patients with AR (group 3). Results At the end of the specific NPT, the median (range) variation in V5 was -5.7% (-9 to 4%) in the control group and -22.8% (-24 to -20%) in group 2. None of the patients in the control group and 88% of group 2 (15/17) showed positive specific NPT results. The simplified specific NPT triggered a positive response in 80% of patients in group 3, with median (range) V5 variation of -30.4% (-36 to -20%). Conclusion This protocol has been proven safe and useful to differentiate between children and adolescents with AR and controls. Concentrations of 1:1000 and 1:100 D. pteronyssinus were the best for use in simplified specific NPT, which made it simpler and faster, and expanded its clinical applicability.
Oral Corticosteroid Prescribing Habits for Rhinosinusitis: The American Rhinologic Society Membership
Authors: Scott John R. , Ernst Hannah M. J. , Rotenberg Brian W. , Rudmik Luke , Sowerby Leigh J. 
Published: February 2017

Background In the field of otolaryngology, oral corticosteroids (OCS) are widely prescribed for rhinosinusitis. Although there is evidence in the literature regarding specific OCS dosing protocols, it is not known to what extent these recommendations are being followed. Objective To examine the current state of OCS prescribing habits for rhinosinusitis by American Rhinologic Society members. Methods An anonymous online survey was sent to all American Rhinologic Society members. Dosing, frequency, tapering, and overall prescribing habits for OCS were assessed in chronic rhinosinusitis with polyposis (CRSwP) and in chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis. The CRSwP group was subdivided into aspirin-exacerbated respiratory disease, allergic fungal sinusitis, and not otherwise specified. Results were compared with current guidelines. Descriptive statistics were used to analyze data. Results Ninety-three surveys were completed (response rate, 12.9%). Prednisone was the most common OCS prescribed. In the CRSwP-aspirin-exacerbated respiratory disease group (n = 86), the median starting dose was 60 mg (range, 4-80 mg) and the average duration was 8 days (range, 2-28 days). In the CRSwP-allergic fungal sinusitis group (n = 81), the median starting dose was 50 mg (range, 20-60 mg), and the average duration was 6 days (range, 2-35 days). In the CRSwP-not otherwise specified group (n = 84), the median starting dose was 50 mg (range, 20-80 mg) and the average duration was 5 days (range, 1-21 days). OCS were prescribed for chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis by 66.0 and 62.4% of respondents, respectively. Conclusion Significant heterogeneity existed in OCS prescribing habits for rhinosinusitis. Discrepancies were observed between survey results and evidence-based recommendations. Developing standardized OCS treatment protocols for rhinosinusitis may improve the quality of care by optimizing clinical outcomes and reducing the risk of complications.
Thrombin and Activated Coagulation Factor X Stimulate the Release of Cytokines and Fibronectin from Nasal Polyp Fibroblasts via Protease-Activated Receptors
Authors: Shimizu Shino , Tojima Ichiro , Takezawa Kumiko , Matsumoto Koji , Kouzaki Hideaki , Shimizu Takeshi 
Published: February 2017

Background Nasal epithelial cells and infiltrating eosinophils express tissue factor, and high thrombin activity and excess fibrin deposition are found in nasal secretion and in nasal polyp from patients with chronic rhinosinusitis with nasal polyp (CRSwNP). Activated coagulation factors play important roles not only in thrombosis but also in inflammation through interaction with protease-activated receptors (PAR). However, little is known about the effects of activated coagulation factors on the release of cytokines and extracellular matrix from nasal polyp fibroblasts (NPF). Purpose The purpose of this study was to analyze the expression of PARs, which are receptors for activated coagulation factors, on NPFs and to determine the roles of thrombin and activated coagulation factor X (FXa) in the release of cytokines and fibronectin from NPFs. Methods NPFs were obtained from patients with CRSwNP, and the messenger RNA (mRNA) and protein expression of PARs in these NPFs were examined. We then investigated whether thrombin or FXa stimulates the release of transforming growth factor (TGF) beta 1, fibronectin, eotaxin-1, interleukin (IL) 6, or IL-8 from cultured NPFs. The effects of PAR agonists on the release of cytokines and fibronectin were also examined. Results NPFs expressed the mRNA and proteins of all four PARs: PAR-1, PAR-2, PAR-3, and PAR-4. Both thrombin and FXa significantly stimulated the release of TGF beta 1, fibronectin, eotaxin-1, IL-6, and IL-8 from cultured NPFs. PAR-1 and PAR-2 agonists stimulated the secretion of TGF beta 1, fibronectin, eotaxin-1, IL-6, and IL-8. PAR-3 agonist stimulated the release of TGF beta 1, fibronectin, and eotaxin-1. PAR-4 agonist did not induce the release of these molecules. Conclusion NPFs play important roles in the pathophysiology of CRSwNP such as in nasal polyp formation and inflammatory cell infiltration by releasing cytokines and extracellular matrix proteins. Activated coagulation factors, thrombin and FXa, stimulate the release of these cytokines and fibronectin from NPFs via PARs.
Removable Sinus Stent for Endoscopic Sinus Surgery: An Animal Trial
Authors: Yaniv Dan , Shlosberg Lena , Flomenblit Joseph , Frenklach Gregory , Rath-Wolfson Lea , Yaniv Eitan 
Published: February 2017

Background The goal of endoscopic sinus surgery in chronic sinusitis is to create good drainage of the paranasal sinuses. Metal stents used to prevent lateralization of the middle concha are associated with adverse effects. Objective The aim of this experimental study was to evaluate the feasibility and safety of a newly developed composite removable stent. Methods The composite removable stent was implanted in nine sheep (18 stents) in the ethmoid cavity after performing an ethmoidectomy and was examined for stability, ease of removal, and adverse effects. Histologic findings were compared between implantation and nonimplantation sites at several time points after stent deployment and removal. Results None of the stents migrated or fell out of the nose. After 4 weeks, there was no infection in the nose or around the stents, and there was no damage to the mucosa. An histologic study showed only mild-to-moderate inflammatory cell infiltration relative to control sites, with no damage to the mucosal epithelium and no necrosis at distant sites. At 2 weeks after stent removal, slight-to-moderate fibroplasia was noted in the deep nasal tissue, with slight-to-moderate osteocartilaginous metaplasia and bone remodeling but no necrotic or inflammatory changes in surrounding tissues. At 4 weeks after stent removal, the middle meatus remained open. Conclusion The promising results of the composite removable stent in a sheep model justify further studies in patients undergoing endoscopic sinus surgery for chromic sinusitis.
The Effect of Smoking on Perforation Development and Healing after Septoplasty
Authors: Cetiner Hasan , Cavusoglu Ilker , Duzer Sertac 
Published: February 2017

Background The relationship between septal perforation and smoking (of cigarettes) was not previously studied in patients who underwent septoplasty. Objective To evaluate the effect of smoking on nasal septal perforation development and the postoperative healing process in patients who underwent septoplasty. Methods Medical records of patients who underwent septoplasty procedures between January 2010 and December 2014 were retrospectively reviewed. Any candidates with chronic systemic disease, were >40 years of age, were prone to complications (i.e., excessive septal deviation), or had previous nasal surgery were excluded from study. The subjects were grouped by smoking habits, and septal effects of smoking were evaluated clinically. Results Of 281 patients, 88 qualified as smokers (group 1) and 193 were considered nonsmokers (group 2). Septal perforation was observed in eight patients in group 1 and in one patient in group 2 (p < 0.05). In groups 1 and 2, the average healing times were 8.8 ± 2.04 days and 7.51 ± 1.75 days, respectively (p < 0.05). Conclusions Both nasal recovery time and development of septal perforation proved significantly greater in patients who smoked after septoplasty.
Sinonasal Imaging Findings in Granulomatosis with Polyangiitis (Wegener Granulomatosis): A Systematic Review
Authors: D'Anza Brian , Langford Carol A. , Sindwani Raj 
Published: February 2017

Background Granulomatosis with polyangiitis (GPA) (Wegener granulomatosis) frequently presents in the head and neck, and the sinonasal cavity is among the most common areas affected. Although the clinical findings, histologic appearance, and laboratory workup have been described, characteristic findings and the distribution of disease on sinonasal imaging are not well established. The appropriate imaging modality to evaluate for sinonasal involvement is also unclear. Objective To describe the imaging characteristics, distribution, and location of sinonasal pathology in patients with GPA as noted on computed tomography and magnetic resonance imaging modalities. Methods A systematic review was conducted of English language articles, by using appropriate search terms, which reported the computed tomography and magnetic resonance imaging findings specific to sinonasal disease in adult subjects with GPA. Studies were included only when they focused primarily on specific imaging results in patients with GPA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Results A total of 50 articles were identified on an initial search of medical literature data bases. There were seven articles that comprised 224 patients who met inclusion criteria. All the articles were retrospective case series and descriptive in nature. A high incidence of patients with GPA who were imaged showed evidence of pathologic findings. The prevalence of key radiographic findings in patients with GPA were the following: mucosal thickening (87.7% of patients), bony destruction (59.9%), and septal erosion (59.4%). There were no randomized or prospective studies that compared imaging findings between patients with GPA and the controls, and no studies that correlated imaging findings with prognosis. Conclusion Sinus imaging in GPA revealed a spectrum of nonspecific findings. The constellation of septal erosion, mucosal thickening, and bony changes should raise suspicion for GPA. The current literature was insufficient to make any comments on the time course of sinonasal disease and imaging manifestations. Further comparative studies are needed to determine a role for sinonasal imaging in the diagnosis and prognosis of GPA.
Sub-Zero Treatment of Cold Work Tool Steels – Metallurgical Background and the Effect on Microstructure and Properties*
Authors: Jurči P. 
Published: February 2017

Abstract
Sub-zero treatment is a commonly accepted process that is intended to increase the hardness, wear resistance and dimensional stability of tool steels and components over several decades. However, the metallurgical background of the phenomena responsible for these improvements is not yet entirely clear. Several theories have attempted to clarify the phenomena taking place during sub-zero treatment and their effect on the microstructure and properties of steels, but all of them manifested significant drawbacks from the point of view of generally accepted metallurgical theories. In this study, these theories are discussed based upon the results obtained by comprehensive investigations of sub-zero treatment of powder metallurgy-made Cr-V Vanadis 6 ledeburitic tool steel. A new theory respecting the main physical-metallurgical principles is also established.
Prozesstechnische Ansätze zur Optimierung des Wärmebehandlungsergebnisses des Niederdruck-Aufkohlens und des Niederdruck-Carbonitrierens
Authors: Franke J. , Steinbacher M. , Velten M. , Hoffmann F. , Zoch H.-W. 
Published: February 2017

Kurzfassung
Das Niederdruck-Aufkohlen bietet dem Anwender ein Verfahren, mit dem unter geringem Einsatz von Kohlenwasserstoffen quasi randoxidationsfreie, metallisch blanke Oberflächen erzeugt werden [1]. Die bei diesem Verfahren entstandene randoxidationsfreie Randschicht lässt gegenüber einer durch Randoxidation geschädigten Oberfläche höhere Dauerfestigkeiten erwarten. Allerdings treten andere Effekte auf, die die Lebensdauer vermindern können [2]. An Einsatzstählen der Sorten 18CrNiMo7-6, 20MoCrS4 und 20CrMo4 wurden verschiedene Ansätze zur Verminderung und Unterbindung dieser Effekte untersucht. Es werden Prozessstrategien vorgestellt, die ein bisher ungenutztes Potenzial des Niederdruckaufkohlens ausschöpfen sollen. Zusätzlich wird auf für den Praktiker relevante Ergebnisse eingegangen, die die Prozessübertragbarkeit zwischen den Anlagentypen, Konditionierungseffekte und Wechselwirkungen bei einem Niederdruck-Carbonitrieren behandeln.
Some Aspects of Low Methylamine Partial Pressure Carbonitriding*
Authors: Koch D. , Reimert R. , Bajohr S. 
Published: February 2017

Abstract
Low pressure carbonitriding is a case hardening process under development. At temperatures between 800 °C and 1050 °C and at total pressures below 50 mbar the carbon and nitrogen concentrations in the outer layer of steel parts are increased and the parts are subsequently hardened by quenching. As state of the art, ammonia is used as the nitrogen donor, in combination with a carbon donor gas, mainly acetylene or propane [1–3]. Other possible carbonitriding gases are not mentioned in recent literature with the exception of a Soviet Union patent [4], but no information on the application of this invention was found. At the Engler-Bunte-Institut of the Karlsruhe Institute of Technology, methylamine and dimethylamine were identified as potential carbonitriding gases, and their carbonitriding behavior was experimentally studied using a thermobalance. The experiments proved an increased nitrogen uptake of the steel samples in comparison to the state of the art. The carbon uptakes were in the same order of magnitude to a comparable process with acetylene. In addition to earlier published results for methylamine as the carbonitriding gas [5], this paper focuses on some operational and kinetic effects.
Prozessintegration von induktiver Wärmebehandlung und Festwalzen – sichere und zuverlässige Komponenten mit hoher Schwingfestigkeit
Authors: Oevermann T. , Saalfeld S. , Niendorf T. , Scholtes B. 
Published: February 2017

Kurzfassung
Mechanische Oberflächenbehandlungen, beispielsweise das Festwalzen, spielen in der technischen Praxis eine bedeutende Rolle und tragen wesentlich zur Steigerung der Zuverlässigkeit hochbeanspruchter Komponenten bei. In einer Reihe von Fällen wurde gezeigt, dass eine Erhöhung der Prozesstemperatur die Wirksamkeit der Verfahren noch steigert, weil dies zu einer besseren Stabilisierung der eingebrachten Druckeigenspannungen führt. Eine wesentliche Voraussetzung zur Einführung dieser Verfahren in die Praxis ist allerdings, dass insgesamt effiziente und möglichst kurze Prozesse resultieren, bei denen die erzielbaren Eigenschaftsverbesserungen in einer ausgewogenen Relation zum Mehraufwand im Vergleich mit konventionellen Prozessen stehen. In der vorliegenden Arbeit wird gezeigt, dass die Prozessintegration von induktiver Wärmebehandlung und Festwalzen in diesem Zusammenhang vielversprechend ist und es werden erste Versuchsergebnisse vorgestellt.
Simulation of Coupled Carbonitriding and Internal Oxidation of Steel
Authors: Larsson H. , Ågren J. 
Published: February 2017

Abstract
Carbonitriding and internal oxidation have been simulated simultaneously using the DICTRA homogenization model. The predicted carbon and nitrogen profiles as well as the oxide and nitride phase fraction profiles agree favourably with experimental data obtained from the literature, though some discrepancies exist. The present approach should be a very useful tool in process control and optimization.
Bilateral sagittal split mandibular osteotomies for enhanced exposure of the anterior cervical spine in children: technical note
Authors: Karsy Michael , Moores Neal , Siddiqi Faizi , Brockmeyer Douglas L. , Bollo Robert J. 
Published: February 2017

The bilateral sagittal split mandibular osteotomy (BSSMO), a common maxillofacial technique for expanding the oropharynx during treatment of micrognathia, is a rarely employed but useful adjunct to improve surgical access to the ventral cervical spine in children. Specifically, it provides enhanced exposure of the craniocervical junction in the context of midface hypoplasia, and of the subaxial cervical spine in children with severe kyphosis. The authors describe their technique for BSSMO and evaluate long-term outcomes in patients.
The pediatric neurosurgical database at a single center was queried to identify children who underwent BSSMO as an adjunct to cervical spine surgery over a 22-year study period (1993–2015). The authors retrospectively reviewed clinical and radiographic data in all patients.
The authors identified 5 children (mean age 5.3 ± 3.1 years, range 2.1–10.0 years) who underwent BSSMO during cervical spine surgery. The mean clinical follow-up was 3.0 ± 1.9 years. In 4 children, BSSMO was used to increase the size of the oropharynx and facilitate transoral resection of the odontoid and anterior decompression of the craniocervical junction. In 1 patient with subaxial kyphosis and chin-on-chest deformity, BSSMO was used to elevate the chin, improve anterior exposure of the subaxial cervical spine, and facilitate cervical corpectomy. Careful attention to neurovascular structures, including the inferior alveolar nerve, lingual nerve, and mental branch of the inferior alveolar artery, as well as minimizing tongue manipulation and compression, are critical to complication avoidance.
The BSSMO is a rarely used but extremely versatile technique that significantly enhances anterior exposure of the craniocervical junction and subaxial cervical spine in children in whom adequate visualization of critical structures is not otherwise possible.