bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of α2-adrenoceptors in Electrical Field Stimulation–induced Contraction of Pig Nasal Mucosa and Pharmacologic Characterization of a Novel α2C-adrenoceptor Agonist
Authors: Corboz Michel R. , Rivelli Maria A. , Shah Himanshu , Boyce Christopher W. , McCormick Kevin D. , Chapman Richard W. , Hunter John C. 
Published: March 2013

Background Blood vessels of the nasal mucosa are richly innervated by sympathetic nerves and neural mechanism is of great interest in upper respiratory tract disorders. This study was designed to determine the role of α2-adrenoceptors and, more specifically, α2C-adrenoceptors, on neurogenic sympathetic vasoconstrictor responses in pig nasal mucosa, and to define the pharmacologic profile of a novel selective α2C-adrenoreceptor agonist. Methods Electrical field stimulation (EFS) was applied to nasal mucosa strips placed in an organ bath and attached to force displacement transducers for continuous recording of isometric tension. The affinity and functional activity of compound B for α2C-adrenoceptors were determined by binding analysis and the ability of compound B to stimulate [35S]GTPγS binding to the receptors. Compound B was also tested in a postjunctional α2C-adrenoreceptor bioassay. Results EFS-induced contractions were partly blocked by the α2-adrenoreceptor antagonist yohimbine (41.1%) and the α2C-adrenoreceptor antagonist JP-1302 had no effect. The α2-adrenoreceptor agonist clonidine, but not compound B, exerted a significant blockade (70.6%). Compound B had high affinity (Ki = 18 nM), produced potent agonist (EC50 = 279 nM) and good efficacy (Emax = 73%) responses at the α2C-adrenoceptors, and displayed good functional agonist potency in the human saphenous vein α2C-adrenoreceptor bioassay (pD2 = 6.2). Conclusion (1) Neurogenic vasomotor contractility is largely regulated through an α-adrenergic mechanism; (2) pig nasal mucosa possesses post- and prejunctional α2-adrenoceptors; (3) the α2C-adrenoreceptor subtype does not seem to be involved; and (4) compound B is a novel, highly selective, and potent α2C-adrenoreceptor agonist.
Platelet-activating Factor Nasal Challenge Induces Nasal Congestion and Reduces Nasal Volume in Both Healthy Volunteers and Allergic Rhinitis Patients
Authors: Muñoz-Cano Rosa , Valero Antonio , Roca-Ferrer Jordi , Bartra Joan , Sanchez-Lopez Jaime , Mullol Joaquim , Picado Cesar 
Published: March 2013

Background Platelet-activating factor (PAF) is a lipid mediator produced by most inflammatory cells. Clinical and experimental findings suggest that PAF participates in allergic rhinitis (AR) pathogenesis. The aim was to assess the PAF ability to induce clinical response in nasal airway after local stimulation. Method Ten nonatopic healthy volunteers (HVs) and 10 AR patients out of pollen season were enrolled. PAF increasing concentrations (100, 200, and 400 nM) were instilled into both nasal cavities (0, 30, and 60 minutes, respectively). Nasal symptoms (congestion, rhinorrhea, sneezing, itching, and total 4 symptom score and nasal volume between the 2nd and 5th cm (Vol2–5) using acoustic rhinometry (AcR), were assessed at −30, 0, 30, 60, 90, 120, and 240 minutes. Result PAF increased individual and total nasal symptom score in both HVs and seasonal AR (SAR) patients from 30 to 120 minutes (maximum score at 120’, p < 0.05). Nasal obstruction was the most relevant and lasting nasal symptom. PAF also induced a significant reduction of Vol2–5 at 90’ (27%), 120’ (38.7%), and 240’ (36.4%). No differences in the response to PAF nasal challenge were observed between HVs and SAR subjects in either clinical symptoms or AcR. Conclusion This is the first description of PAF effects on human nasal mucosa using a cumulative dose schedule and evaluated by both nasal symptoms and AcR. Nasal provocation with PAF showed long-lasting effects on nasal symptoms and nasal obstruction in HVs and in patients with SAR. Nasal challenge may be a useful tool to investigate the role of PAF in AR and the potential role of anti-PAF drugs.
Therapeutic Equivalence of Triamcinolone Acetonide Hydrofluoroalkane and Chlorofluorocarbon Nasal Inhalers in Patients with Seasonal Allergic Rhinitis
Authors: Schenkel Eric , Newman Kenneth B. 
Published: March 2013

Background Triamcinolone acetonide (TAA) has been reformulated as an hydrofluoroalkane (HFA) aerosol for intranasal use in patients with seasonal allergic rhinitis (SAR). This study compared the TAA HFA formulation with the previously available chlorofluorocarbon (CFC) nasal inhaler in a dose-ranging study. Methods This was a double-blind, parallel-group, multicenter study in 780 adults with SAR. Patients had a history of fall seasonal rhinitis and positive skin tests to ragweed. After meeting minimum symptom requirements during the run-in phase, patients were randomized to one of eight groups: TAA CFC or HFA at 14, 110, or 440 micrograms once daily or matching placebo. Treatment was continued for two weeks and patient completed a daily diary for reflective and instantaneous rating of nasal and ocular allergy symptoms. Results All active treatment groups were statistically superior to placebo with respect to the primary outcome variable, total nasal symptoms. Furthermore, the TAA HFA and TAA CFC formulations were statistically comparable over the dose range. Within each formulation, there was a significant mean reduction from baseline in the symptoms of rhinitis that increased with increasing dose. Ocular symptoms were also reduced with both formulations. Both preparations were well tolerated without any safety concerns. Conclusion In conclusion, a new formulation of TAA with a HFA propellant was found to be effective in the treatment of SAR and comparable with the previously available TAA CFC formulation. There was a dose response to TAA, with doses as low as 7 micrograms per nostril once daily producing statistically significant improvement in rhinitis symptoms.
Mini-nasoseptal Flap for Recalcitrant Sphenoid Sinusitis
Authors: Thompson Christopher F. , DeConde Adam S. , Chiu Alexander G. , Lee John M. , Suh Jeffrey D. 
Published: March 2013

Background Recalcitrant sphenoid sinusitis occurs in 27% of patients undergoing revision functional endoscopic sinus surgery. One of the main causes of disease recurrence in the sphenoid is cicatricial scarring of the ostium. Highly inflammatory lesions such as fungal balls or chronic mucoceles can predispose patients to restenosis. We present a novel use of a modified nasoseptal flap to cover exposed bone after sphenoid wide sinusotomy to prevent restenosis and expedite healing. Methods A case series was performed. Results The mini-nasoseptal flap was successful in preventing sphenoid ostium restenosis in nine patients undergoing endoscopic sinus surgery for highly inflammatory sphenoid sinus pathology with a mean postoperative follow-up of 8.4 months (range, 2–21 months). Patients had a mean of 2.3 prior sinus surgeries (range, 0–7 surgeries). Most common indications for the flap in this series included long-standing fungal sinusitis or fungal balls (n = 6) with or without significant sphenoid wall osteoneogenesis (n = 6). There were no significant side effects related to flap harvest or inset. Conclusion The mini-nasoseptal flap decreases the risk of restenosis after sphenoid sinusotomy by preventing circumferential cicatricial scarring and offers an effective surgical option on the spectrum of sphenoid surgical interventions in select patients.
Toward Photorealism in Endoscopic Sinus Surgery Simulation
Authors: Ruthenbeck Greg S. , Hobson Jonathan , Carney A. Simon , Sloan Steve , Sacks Raymond , Reynolds Karen J. 
Published: March 2013

Background Endoscopic sinus surgery (ESS) is the surgical standard treatment for chronic rhinitis/rhinosinusitis and nasal polyposis. There is a reported complication rate of 5–10% associated with this type of surgery. Simulation has been advocated as a means to improve surgical training and minimize the rates of complication and medical error. This study aimed to show how a virtual reality ESS simulator was developed, with particular emphasis on achieving satisfactory photorealism and surgical verisimilitude. Methods Sinus computed tomography scans were processed to create a triangle-based three-dimensional mesh model; this was incorporated into a spring-damper model of thousands of interconnected nodes, which is allowed to deform in response to user interactions. Dual haptic handpiece devices were programmed to simulate an endoscope and various surgical instruments. Textures and lighting effects were added to the mesh model to provide an accurate representation of the surgical field. Effects such as vasoconstriction in response to “virtual” decongestant were added. Results The final simulated endoscopic view of the sinuses accurately simulates the moist and glossy appearance of the sinuses. The interactive tissue simulation system enables the user to interactively cut and remove tissue while receiving accurate haptic feedback. A working prototype of the simulator has been developed that leverages recent advances in computer hardware to deliver a realistic user experience, both visually and haptically. Conclusion This new computer-based training tool for practicing ESS provides a risk-free environment for surgical trainees to practice and develop core skills. The novel use of customized precision force feedback (haptic) devices enables trainees to use movements during training that closely mimic those used during the actual procedure, which we anticipate will improve learning, retention, and recall.
Effects of Budesonide on the Expression of the Glucocorticoid Receptor-α in Nasal Polyp Epithelial Cells
Authors: Wang De-Sheng , Liu Qin-Song , Lai Hai-Chun 
Published: March 2013

Background This study explores effects of budesonide on the proliferation of nasal polyp epithelial cells and expression of the glucocorticoid receptor (GR) alpha in nasal polyp epithelial cells. Methods Primary cultured, purified, and identified the epithelial cells collected from nasal polyps. The proliferation of nasal polyp epithelial cells was examined by a cell counting kit, and expression of GR-alpha mRNA in nasal polyp epithelial cells was examined by reverse transcription polymerase chain reaction, after training nasal polyp epithelial cells in budesonide solution. Results The average survival rate of nasal polyp epithelial cells was the lowest in 1 × 10−6 M budesonide solution (29.284 ± 0.311%), compared with other concentrations. Budesonide at 1 × 10−8 M caused down-regulation of GR-alpha mRNA expression levels at 6 and 12 ours, compared with the 0-hour group (p < 0.001); compared with the 0-hour group, there were significantly lower expression levels of GR-alpha mRNA at both 24 and 48 hours (p < 0.001); Expression of GR-alpha mRNA at either 48 or 12 hours was not significantly different from that at 24 hours. Conclusion Budesonide can significantly inhibit the proliferation of nasal polyp epithelial cells, down-regulate the expression of GR-alpha mRNA in nasal polyp epithelial cells with time dependence.
Mometasone Furoate Nasal Spray plus Oxymetazoline Nasal Spray: Short-term Efficacy and Safety in Seasonal Allergic Rhinitis
Authors: Meltzer Eli O. , Bernstein David I. , Prenner Bruce M. , Berger William E. , Shekar Tulin , Teper Ariel A. 
Published: March 2013

Background Allergic rhinitis (AR) and associated congestion adversely affect patients’ lives. The intranasal corticosteroid mometasone furoate nasal spray (MFNS) is effective for AR symptoms including nasal congestion, and the intranasal decongestant oxymetazoline (OXY) is effective against nasal congestion, but the combination has not been fully studied. This study was designed to assess the efficacy of the combination of MFNS and OXY for the relief of seasonal allergic rhinitis (SAR) symptoms. Methods This phase 2 controlled clinical trial randomized adolescent and adult subjects (≥12 years; 2-year SAR) to MFNS q.d. (200 μg) + 3 sprays/nostril of OXY 0.05% (MFNS + OXY3); MFNS q.d. + 1 spray/nostril of OXY (MFNS + OXY1); MFNS q.d.; OXY b.i.d.; or placebo for 15 days, with 1-week follow-up. Coprimary end points were change from baseline in morning/evening (A.M./P.M.) instantaneous (NOW) total nasal symptom score (TNSS) over days 1–15 and AUC (AUC[0–4 hr]) change from baseline in day 1 congestion. Results In 705 subjects, both combinations reduced A.M./P.M. NOW TNSS over days 1–15 significantly more than OXY b.i.d. or placebo (p ≤ 0.002). Mean standardized AUC(0–4hr) day 1 congestion change from baseline was significantly greater in combination and OXY b.i.d. groups (MFNS + OXY3, −0.92; MFNS + OXY1, −0.80; OXY b.i.d., −1.06) versus placebo (–0.57) and MFNS q.d. (–0.63). Combinations and MFNS q.d. were significantly effective for A.M./P.M. NOW TNSS over each weekly period; OXY b.i.d. was superior to placebo in week 1. Adverse events (AEs) were few and similar across treatments; one MFNS q.d. and one placebo subject experienced a serious AE, with neither considered treatment related. Conclusion Combining MFNS with OXY relieves SAR symptoms, including congestion, with faster onset of action than MFNS q.d. and better sustained efficacy than OXY b.i.d.
Nasal Provocation Test Using Allergen Extract versus Cold Dry Air Provocation Test: Which and When?
Authors: Kim Young Hyo , Jang Tae Young 
Published: March 2013

Background Nasal provocation tests (NPTs) are useful for evaluation of patients with allergic rhinitis. The cold dry air (CDA) provocation test is useful for evaluation of patients with nonspecific nasal hyperreactivity (NHR). This study aimed to determine whether the NPT or CDA provocation would be more useful for patients with different clinical pictures. Methods We evaluated changes in nasal symptoms (visual analog scale [VAS]) and acoustic parameters after NPT or CDA provocation in healthy volunteers (group A, n = 27), patients with allergic rhinitis (group B, n = 20), and subjects with nonallergic rhinitis (group C, n = 26). According to their subjective cold hyperresponsiveness (SCH), we compared changes in VAS and acoustic parameters after each protocol. The correlation between results of the skin-prick test (SPT) and changes in VAS after each protocol was analyzed. Finally, we performed an analysis of correlation between NPT and CDA provocation. Results After NPT, group B showed a larger change in VAS for rhinorrhea, sneezing, and itching (p < 0.01). After CDA challenge, the change in VAS for nasal obstruction was larger in group C (p < 0.05). Changes in acoustic parameters were larger in groups B and C after NPT (p < 0.01). After CDA challenge, the SCH+ group (n = 49) showed a larger decrease of acoustic parameters than the SCH– group (n = 24; p < 0.01). Significant correlation was observed between the size of SPT and degree of change in VAS after NPT. No significant correlation was observed between NPT and CDA. Conclusion CDA could be an adjunct tool for evaluating NHR in patients with self-reported SCH.
Nasal Eosinophilia and Serum Soluble Intercellular Adhesion Molecule 1 in Patients with Allergic Rhinitis Treated with Montelukast Alone or in Combination with Desloratadine or Levocetirizine
Authors: Ciebiada Maciej , Barylski Marcin , Ciebiada Malgorzata Gorska 
Published: March 2013

Background Because intercellular adhesion molecule (ICAM) 1 and recruitment of eosinophils are crucial in supporting allergic inflammation, their down-regulation may bring additional benefits in patients’ recovery. We have assessed nasal eosinophilia and serum soluble ICAM-1 (sICAM-1) concentrations in relation to nasal symptoms in patients with persistent allergic rhinitis (AR) treated for 6 weeks with either desloratadine, levocetirizine, montelukast alone, or in combination. Methods In this single-center, randomized, double-blind, placebo-controlled, crossover, two-arm study, 40 patients with persistent AR were randomized to receive either montelukast and/or levocetirizine or placebo (n = 20) or to receive treatment with montelukast and/or desloratadine or placebo (n = 20). Nasal eosinophilia and concentration of sICAM-1 in peripheral blood were assessed before and on the last day of each treatment period. Results All active treatments in both arms of the study resulted in the decrease of sICAM-1 and nasal eosinophilia, which correlated with the severity of nasal symptoms. In the montelukast/levocetirizine arm, montelukast decreased nasal eosinophilia more significantly than levocetirizine, whereas in reduction of sICAM-1 all active treatment options were equally effective. However, in the desloratadine/montelukast arm, the resulting improvement of combination therapy of sICAM-1 and the influx of eosinophils was not statistically significant. Conclusion The improvement of nasal symptoms in patients with AR treated with antihistamines, with or without montelukast, may additionally result from the reduction of sICAM-1 and nasal eosinophilia. Because the combination therapy may bring inconclusive benefits in this area there is a strong need of further studies to find mechanisms that favor combination therapy.
The Auricle's Cavum conchae Composite Graft in Nasal Reconstruction
Authors: Scheithauer Marc O. , Rotter Nicole , Lindemann Joerg , Schulz Melanie , Rettinger Gerhard , Veit Johannes A. 
Published: March 2013

Background Autologous transplants consisting of skin and cartilage, so-called composite grafts (CGs), are useful in nasal reconstruction of multilayered defects. A CG from the auricle's cavum conchae serves both functional and esthetic demands. This article outlines the indications and the requirements of the CG, making special considerations to improve wound healing, and discusses our results in consideration with recent publications. Methods A retrospective case–control study assessing the functional and esthetic long-term results in the donor and recipient site is presented. Results Between 2005 and 2011, 91 patients received differently sized CGs of the auricle for nasal reconstruction. In 85/91 cases the donor site defect was closed using a retroauricular pedicled island flap. Six of 91 defects were closed primarily. Indications were multilayered defects of the nasal vestibule, the nasal floor, the inner nasal valve, and the lateral sidewall. The main indication for surgery was skin malignancies. One of 91 major and 14/91 minor complications were observed. Seventy-seven of 91 patients received a custom-made prosthesis to prevent stenotic scarring. The 2.5-year follow-up showed excellent results of stability and shape at the donor and recipient site. Conclusion The auricular inner lining CG is a versatile and reliable autologous transplant, which is ideal for multilayered nasal reconstruction because of easy harvesting, little donor site morbidity, and its convex shape. Septal splints and custom-made prosthesis secure healing and prevent stenotic scarring.
Evaluation of a Polysaccharide Gel for Laser-assisted Skull Base Repair
Authors: Bleier Benjamin S. , Palmer James N. , Cohen Noam A. 
Published: March 2013

Background Endoscopic reconstruction of skull base defects remains a challenge. Laser tissue welding (LTW) is a technique in which a laser-activated solder is used to create instantaneous repairs of skull base defects with burst strengths far exceeding intracranial pressure (ICP). This study was designed to define the thermal and inflammatory profile of a novel polysaccharide soldering gel, to assess the burst strength of the repair, and to determine the time required for solder resorption. Methods A prospective study was performed in rabbit and mouse models. Ten dorsal rabbit maxillary sinusotomies were laser welded and burst pressure thresholds were compared with control wounds on postoperative days (PODs) 0 and 5. All welds were examined histologically on PODs 0, 5, and 45 for thermal injury, inflammation, and degree of solder resorption. In mice, dura was exposed and laser welding was performed (n = 2). Results were compared histologically with dura exposed to laser energy alone (n = 2) on POD 7. Results The burst pressures of the rabbit LTW group were significantly higher than control on PODs 0 (135.0 mmHg and SD = 5.8 versus 8.0 mmHg and SD = 0.5; n = 4) and 5 (155.4 mmHg and SD = 2.9 versus 41.7 mmHg and SD = 7.3; n = 4; p < 0.05). No significant thermal or inflammatory effect was found in any of the rabbit or mouse welds. Complete solder resorption was noted by POD 45. Conclusion LTW using a polysaccharide gel is capable of creating mucosal repairs capable of withstanding over four times normal ICP without additional grafting materials. These repairs increase in strength over time, have no thermal or inflammatory sequelae, and establish complete solder resorption within 45 days.
Floods of the Upper Danube River and Its Tributaries and Their Impact on Urban Economies (c. 1350-1600): The Examples of the Towns of Krems/Stein and Wels (Austria)
Authors: Rohr Christian 
Published: March 2013

Abstract
This paper examines the impact of disastrous and 'ordinary' floods on human societies in what is now Austria. The focus is on urban areas and their neighbourhoods. Examining institutional sources such as accounts of the bridge masters, charters, statutes and official petitions, it can be shown that city communities were well acquainted with this permanent risk: in fact, an office was established for the restoration of bridges and the maintenance of water defences and large depots for timber and water pipes ensured that the reconstruction of bridges and the system of water supply could start immediately after the floods had subsided. Carpenters and similar groups gained 10 to 20 per cent of their income from the repair of bridges and other flood damage. The construction of houses in endangered zones was adapted in order to survive the worst case experiences. Thus, we may describe those communities living along the central European rivers as 'cultures of flood management'. This special knowledge vanished, however, from the mid-nineteenth century onwards, when river regulations gave the people a false feeling of security.
Coastal Flooding and Socioeconomic Change in Eastern England in the Later Middle Ages
Authors: Galloway James A. 
Published: March 2013

Abstract
The coasts and coastal wetlands of Eastern England, like other lands around the North Sea basin, were subjected to recurrent and sometimes devastating floods in the later middle ages. Some towns and many rural settlements were destroyed or relocated, while others sustained repeated loss of life and property. Agricultural lands reverted to inter-tidal conditions in some areas, while major changes in land use occurred elsewhere. Coastal industries such as milling and peat-digging suffered, while estuarine fisheries expanded onto flooded farm-land. The changes were complex and can only be fully understood in terms of the interaction of environmental and socioeconomic processes. Population decline and economic recession changed the parameters within which risk and opportunity were evaluated after the middle of the fourteenth century.
Flood Security in the Medieval and Early Modern North Sea Area: A Question of Entitlement?
Authors: Soens Tim 
Published: March 2013

Abstract
Starting in the later Middle Ages, the coastal wetlands along the southern North Sea area were increasingly hit by a series of catastrophic storm surges. Deeply rooted in the collective memory of coastal society, these flood disasters are mostly discussed as products of meteorological disturbances, environmental vulnerability or technological failure. In this article, an alternative reading is proposed, drawing attention to massive distortions in the social allocation of flood protection in the later Middle Ages, which help to explain the increased frequency of storm disasters. Building on Amartya Sen's original entitlement approach, it is argued that the right of coastal peasants to flood security often witnessed severe setbacks preceding many flood disasters, caused by adverse economic conditions, but also by an increasing violation of their entitlement to flood protection mainly by non-peasant groups, backed by an expanding state power.