bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Fungal Sensitization in Patients with Polypoid Chronic Rhinosinusitis: A Cross‐Sectional Study
Authors: De Vilhena Ditza , Lopes Gustavo , Martins Cidália , Duarte Delfim , Opes Cristina 
Published: September 2014

Objectives:Although allergic fungal rhinosinusitis (AFRS) is a well‐recognized entity, few data are published concerning the prevalence of mold sensitization in patients with polypoid chronic rhinosinusitis (PCRS). Our aim was to determine the prevalence of fungal and common aeroallergen sensitization in a sample of adult patients with PCRS at an ear, nose, and throat clinical setting.Methods:All adult patients with PCRS who underwent sinus surgery between September 2012 and December 2013 were invited to participate. Prick tests were done with Alternaria alternata (Aa), Cladosporium herbarum (Ch), Aspergillus fumigatus (Af), Curvularia lunata (Cl), Fusarium monilifo (Fm), Dermatophagoydes pteronyssinus (Dp), and grass‐pollen extract (extracts Merck). T Student and chi‐square tests were determined using SPSS v22, and applied when appropriate. A P value <.05 was considered significant.Results:Sixty‐three patients were included (60% men), mean age (SD) 45 (15.4) years old. Of the patients, 14.3% had at least 1 positive skin prick test for molds (9.5% for Aa, 4.8% for Ch, 6.3% for Af, 4.8% for Cl and 4.8% for Fm). Forty‐percent were allergic to dust mite and 27% to pollen. We failed to detect an association between fungal sensitization and age (P =. 838), sex (P =. 674), and Dp sensitization (P =. 074), but we found a positive association between fungal and grass‐pollen sensitization (41.2% vs 4.3%, P <. 001).Conclusions:Almost one‐sixth of our patients were mold sensitized. The routine determination of fungal allergic profile may improve the assessment of patients with PCRS, increasing awareness to AFRS diagnosis.
Safety and Efficacy of Frontal Sinus Stents: A Systematic Review
Authors: Hussein Ahmed , Turner Justin 
Published: September 2014

Objectives:Postsurgical stenosis of frontal sinus can be a challenging problem for the endoscopic sinus surgeon. Frontal sinus stents are often used in an attempt to maintain frontal outflow patency. The current study systematically reviews the literature to determine the safety and efficacy of frontal stents.Methods:The Pubmed, Google Scholar, and Cochrane databases were reviewed and studies evaluating the usage and reliability of frontal sinus stents were extracted based on defined inclusion criteria.Results:Eleven studies comprising a total of 192 patients met inclusion criteria and were evaluated for stent material, stenting duration, surgical techniques, patient outcomes, and complication. All studies were classified as level 4 evidence provided by the Oxford Center for Evidence Based Medicine. Multiple stent materials were used with varying duration. Complications were generally minor and included stent migration, pain, epistaxis, and infection. Frontal sinus patency following stent replacement varied from 71.4% to 100%, however, the efficacy of stent placement in maintaining frontal sinus patency could not be evaluated due to a lack of controlled studies.Conclusions:Current literature evaluating the use of frontal sinus stents is limited and comprised entirely of level 4 studies. The efficacy of frontal sinus stenting could not be accurately evaluated because of the small number of studies and variable outcome measures. Larger, high‐quality studies are needed to support the use of stents in endoscopic surgery of frontal sinus.
Simvastatin Inhibited the IL‐5–Induced Chemotaxis toward Eotaxin and CCR3 Expression of HL‐60–Derived Eosinophils
Authors: Fu Chia‐Hsiang , Pang Jong‐Hwei Su , Huang Chi‐Che , Lee Ta‐Jen 
Published: September 2014

Objectives:IL‐5‐induced chemotaxis of eosinophils is an important feature for atopic diseases. Lipid lowering agents, statins, have been shown with inhibitory ability for inflammatory process and leukocyte accumulation. We herein investigate their effects on chemotaxis of eosinophils and the possible regulating mechanisms.Methods:Eosinophils were derived by treating HL‐60 clone 15 (HC15) with butyric acid in an alkaline condition. The 2 most potent chemokine and cytokine receptors for eosinophils, CC‐chemokine receptor‐3 (CCR3) and IL‐5 receptor (IL5R), were verified on the cell line. Dose effect of IL‐5 stimulation for chemotactic ability toward eotaxin and CCR3 presentation was measured. Simvastatin effect for IL‐5 induced chemotaxis and these two receptors was analyzed in RNA and protein level. Mevalonate effect for the behaviors of simvastatin was also evaluated.Results:IL‐5 in the dosage of 10 ng/mL had the most impressive enhancement on chemotaxis and CCR3 presentation for eosinophils harvested from HC15. Simvastatin inhibited IL‐5‐induced chemotaxis and CCR3 presentation in both mRNA and protein level but had no effect on IL5R. Mevalonate could reverse those inhibitory effects of simvastatin.Conclusions:Simvastatin inhibited IL‐5‐induced chemotaxis of HC15‐derived eosinophils by repression of CCR3 presentation instead of IL5R. This inhibitory effect of simvastatin acted via mevalonate pathway which could be reversed by mevalonate replacement.
Sleep Quality after Endoscopic Sinus Surgery in Patients with Sinonasal Polyposis
Authors: Majidi Mohammad R. , Nourizadeh Navid , Rasoulian Bashir , Ardani Amir Rezaei , Asadpour Hadi , Rezaeitalab Fariborz , Hassanzadeh Nadia 
Published: September 2014

Objectives:Evaluate the effect of functional endoscopic sinus surgery (FESS) for nasal polyposis on sleep efficiency and polysomnographic parameters.Methods:This clinical trial was conducted on 15 patients with bilateral massive sinonasal polyposis who underwent FESS between August 2012 and September 2013. All participants were evaluated subjectively by employing the Pittsburgh Sleep Quality Index (PSQI) questionnaire and objectively (provided by polysomnographic parameters) before and 2 months after surgery.Results:The evaluation of subjective criteria of sleep quality assessed by PSQI showed significant improvement, particularly in nocturnal awakening (P =. 002). However, Apnea Hypopnea Index (AHI) was not reduced significantly after surgery (P =. 233). Among patients who had suffered from obstructive sleep apnea, AHI was improved in 7 patients, deteriorated in 3 patients, and did not change in 1 patient. Although the mean duration of REM sleep stage increased from 15.2 ± 10.7 to 18.9 ± 7.9, this change was not statistically significant. Furthermore, arousal index decreased dramatically from 31.6 to 17.1 (P =. 02) and sleep efficiency index was improved after the surgery (P =. 008).Conclusions:This study documented the effect of resuming nasal cavity patency on improvement of sleep efficiency after FESS. In spite of insignificant effect of FESS on apnea index, alteration of other sleep parameters like arousal index following surgery may have a positive effect on sleep quality.
Staphylococcus Enterotoxin A Induces MUC5B Expression via TLR2‐dependent MAPK in Airway Epithelial Cells
Authors: Kim Young‐Dae , Choi Yoon Seok , Bae Chang Hoon , Song Si‐Youn 
Published: September 2014

Objectives:Staphylococcus aureus enterotoxins are known to induce an inflammatory response of the airways, increase sensitization to inhaled allergens, and decrease T‐cell sensitivity to steroids. However, the effects of Staphylococcus enterotoxin A (SEA) on mucin secretion of airway epithelial cells have not yet been reported. Therefore, in this study, the effect and brief signaling pathway of SEA on MUC5B expression were investigated in human airway epithelial cells.Methods:In the mucin‐producing human NCI‐H292 airway epithelial cells and the primary cultures of normal nasal epithelial cells, the effect and signaling pathway of SEA on MUC5B expression were investigated using reverse transcriptase‐polymerase chain reaction (RT‐PCR), real‐time PCR, enzyme immunoassay, and immunoblot analysis with several specific inhibitors and small interfering RNA (siRNA).Results:SEA increased MUC5B mRNA and protein expression. Toll‐like receptor 2 (TLR2) mRNA expression was significantly increased after treatment with SEA. Knockdown of TLR2 by siRNA significantly blocked SEA‐induced MUC5B mRNA expression. SEA significantly activated phosphorylation of extracellular signal‐regulated kinase 1/2 (ERK1/2) and p38 mitogen‐activated protein kinase (MAPK). U0126 (ERK1/2 MAPK inhibitor) and SB203580 (p38 MAPK inhibitor) significantly inhibited SEA‐induced MUC5B mRNA expression. In addition, knockdown of ERK1/2 and p38 MAPK by siRNA significantly blocked SEA‐induced MUC5B mRNA expression. Furthermore, the phosphorylation of ERK1/2 and p38 MAPK was significantly blocked by knockdown of TLR2 by siRNA.Conclusions:These results show for the first time that SEA induces MUC5B expression via TLR2, ERK1/2, and p38 MAPK signaling pathway in human airway epithelial cells.
Image Evaluation of Nasopharyngeal Mucosa Physical Change of Laryngopharyngeal Reflux Disease
Authors: Niwa Hideo , Shan Chong H. , Zhang Zhong , Horihata Satoshi , Makiyama Yasuhide 
Published: September 2014

Objectives:Evaluate a picture of narrow band imaging (NBI) examination for a diagnosis of laryngopharyngeal reflux disease (LPRD) using the image processing analysis objectively.Methods:Ten patients who underwent NBI were studied. Eight patients were LPRD and 2 patients were non‐LPRD patients. We performed image processing for pictures after NBI examination by using the application software of a perfect translation invariance complex discrete wavelet transform (PTI‐CDWT) developed at Toyohashi University of Technology and MATLAB (The MathWorks, Inc.). We looked into the nasopharyngeal mucosa physical changes that were detected by PTI‐CDWT and analyzed by MATLAB.Results:Images with LPRD showed many round opaque dots mostly consistent with round wavelet transform. On the contrary, images without LPRD represented a small number of linear lines, and any other area showed no feature. Morphologic operation by MATLAB distinguished the difference of nasopharyngeal mucosa physical exchange between LPRD and non‐LPRD.Conclusions:Though LPRD is a common disease for otolaryngologists to see, it may not yet be a definite diagnosis like gastroesophageal reflux disease. We have presented a correlation between LPRD and nasopharyngeal mucosa examination as mackerel cloud pattern at American Academy of Otolaryngology—Head and Neck Foundation annual meetings. We showed the possibility of image processing to diagnose LPRD with PTI‐CDWT last year. Images which were implemented morphological operation by MATLAB may show representative for each nasopharyngeal mucosa physical change. MATLAB characterized images which were modified using PTI‐CDWT. To use PTI‐CDWT and MATLAB is not only useful in diagnosing LPRD but may possibly allow one to develop image diagnosis or an analysis instrument.
The Association between Sleep Duration and Metabolic Variables in Obese Children with Obstructive Sleep Apnea
Authors: Bhushan Bharat , Maddalozzo John P. , Hoff Stephen , Ida Jonathan B. , Billings Kathleen 
Published: September 2014

Objectives:Sleep loss is problematic in adults and children. Decline in sleep duration has paralleled an increase in the prevalence of obesity and diabetes. The aim of this study was to analyze the association between sleep duration, severity of obstructive sleep apnea (OSA), and metabolic variables in obese children.Methods:In this study, patients between the ages of 2 and 12 years who had overnight polysomnography (PSG) at a tertiary care medical center were included. Patients were identified from a xenobase search of medical records. All patients had lipid levels, blood glucose, and insulin evaluated within 3 months of PSG. The demographics, laboratory data, body mass index (BMI), and blood pressure were collected from the medical records.Results:A total of 31 patients were studied. Twenty‐one (67.7%) were male, and the mean age of patients was 8.5 ± 1.9 years. The mean BMI z score was 2.7 ± 0.81. All patients were obese. Patients were categorized into groups with total sleep duration >6 hours and <6 hours. Sixteen patients slept <6 hours and 15 patients slept >6 hours. There was no statistical difference in the lipid variables and blood pressure in these patients. A nonsignificant trend of decreased sleep duration with an increase in severity of OSA was observed. Blood sugar was significantly increased in patients with sleep <6 hours (100.2 ± 8.1 mg/dL) when compared with patients with sleep >6 hours (95 ± 4.4 mg/dL; P =. 05). The homeostasis model assessment (HOMA) values were significantly higher in children with sleep <6 hours (1.81 ± 0.51) when compared with patients with sleep >6 hours (1.33 ± 0.55; P =. 04).Conclusions:Short sleep duration is associated with insulin resistance in obese children with OSA.
A New Technique of Virtual Modeling of Individual Patient Airways in Obstructive Sleep Apnea
Authors: Mitchell Jennifer L. , Liu Yang , Wang Robert C. , Orr Katelyn , Yim Woosoon , Chen Yitung 
Published: September 2014

Objectives:Up to 14% of the US population is estimated to have obstructive sleep apnea (OSA) related to obesity. Other than continuous positive airway pressure, treatments have had variable results since the exact site(s) of obstruction and the optimal method of modifying those sites with devices or surgery can be difficult to establish. We introduce a technique for modeling the upper airway that shows the behavior of the airway and predicts the location of collapse in OSA.Methods:Accurate modeling of air to solid fluid‐structure interaction, challenging to model in the past, was accomplished using ANSYS software applied to a 3‐dimensional rendering of an OSA patient's airway (with an AHI of 87.6/h) using thin‐cut computed tomographic scan data. Viscoelastic properties of the pharyngeal walls, tongue and palate, not previously well characterized, were measured using 5 fresh porcine cadaver heads with a Bose ElectroForce test instrument with Dynamic Mechanical Analysis software. Various dynamic displacements were applied to tissue samples and associated forces measured simultaneously to obtain dynamic material properties.Results:Areas of lowest pressure during inspiration were identified as likely regions of collapse during apneic episodes, such as the base of the tongue with pressures as low as –4730 Pa (–48.23 cm H2O), similar to values reported in human esophageal pressure measurements in upper airway resistance syndrome.Conclusions:This novel investigation virtually and accurately models the upper airway in OSA, and allows virtual modification of the airway to predict effects of treatment.
Outcomes of Patients Presenting to Sleep Disorder Clinic in Otolaryngology Practice
Authors: Ng Christina Hui Lee , Tan Alvin Kah Leong , Hsu Pon Poh 
Published: September 2014

Objectives:Continuous positive airway pressure (CPAP) has become the standard of care for obstructive sleep apnea (OSA). However, CPAP compliance has been shown to be poor and surgical correction of upper airway may be an option for selected patients. The study aimed to assess the outcomes of patients presenting to sleep disorder clinic with OSA.Methods:Subjects were identified by reviewing sleep laboratory records of patients presented for full polysomnography from 2010 to 2014. Case notes were traced and data collected retrospectively. The treatment prescribed include weight reduction, CPAP, surgery and oral appliance. The outcomes of treatment options offered were analyzed and full polysomnography parameters before and after treatment were compared.Results:Less than 20% of patients underwent surgical correction of the upper airway. Less than 50% of the patients used an oral appliance. More than 60% of patients showed improvement in the respiratory disturbance index (RDI) after the surgery. About 80% of patients defaulted treatment subsequently. A small proportion of patients were discharged from the sleep disorder clinic after significant improvement of symptoms.Conclusions:Surgery is indicated in patients who have a specific underlying abnormality causing the OSA and if they refused or failed CPAP therapy. However, only a small proportion of patients have such correctible lesions.
Polysomnography Outcomes after Transoral Robotic Lingual Tonsillectomy for Obstructive Sleep Apnea
Authors: Smith Chelsey , Argo Jimmy L. , Jones Kellie , Anderson Michael , Vasan Nilesh R. 
Published: September 2014

Objectives:Compare polysomnography (PSG) results before and after transoral robotic lingual tonsillectomy (TORLT) in patients with obstructive sleep apnea (OSA).Methods:Lingual tonsillar or base of tongue hypertrophy can be a cause of OSA but has proven difficult to address because of difficulty in accessing this area of the oropharynx through traditional surgical techniques. TORLT provides a simple, minimally invasive surgical technique for lingual tonsillectomy. Patients with OSA symptoms were assessed with preoperative PSG and sleep endoscopy for base of tongue obstruction. Selected candidates underwent TORLT followed by repeat PSG and nasal endoscopy after full recovery from the procedure. The pre‐ and postoperative PSG data were compared for each patient. Nonparametric comparisons were made using the signed rank test becasue of small sample size.Results:Ten patients underwent preoperative PSG and subsequent TORLT. Postoperative polysomnography data as available for 8 patients. Pre‐ and postoperative PSG comparisons (pre, post, P value) showed improvements in the median apnea‐hypopnea index (49.8, 19.5, P =. 84), sleep onset latency (11.8 minutes, 17.5 minutes, P =. 84), sleep efficiency (80.5%, 92.3%, P =. 2), and Epworth Sleepiness Scale (14.5, 10, P =. 88), but none were statistically significant.Conclusions:Transoral robotic lingual tonsillectomy improved polysomnography measures but not to a level of significance. This study is limited by small sample size and associated limited statistical power. Further study with larger sample sizes should be undertaken to more definitively study outcomes for this surgical technique.
Relationship between Oral Flow Patterns, Nasal Airway, and Respiratory Events
Authors: Suzuki Masaaki 
Published: September 2014

Objectives:Few investigations have examined oral flow (OF) patterns during sleep. This study aimed to clarify the relationship between OF patterns, nasal airway obstruction, and obstructive respiratory events.Methods:Nasal flow and OF were measured separately by polysomography. OF was measured 2 cm in front of the lips using a pressure sensor. Subjects were categorized into 2 groups: those with nasal obstruction (n = 44) and those without nasal obstruction (n = 41).Results:OF could be divided into 3 patterns: postapneic OF, OF during flow reduction (OF during FR), and spontaneous arousal‐induced OF (SpA‐induced OF). Postapneic OF refers to OFs that begin at the end of obstructive respiratory events (eg, flow limitation, hypopnea, and apnea), are preceded by respiratory arousals, and are accompanied by postapneic hyperventilation. OF during FR refers to OFs that occur during respiratory event‐like nasal flow reduction. SpA‐induced OFs are OFs that begin during stable breathing, are preceded by spontaneous arousal but not accompanied by apnea or hypopnea. Multivariate regression analysis showed that nasal obstruction was predictive of SpA‐induced OF. Only 1.3% of SpA‐induced OF led to apnea or hypopnea. SpA‐induced OF showed a negative correlation with the apnea‐hypopnea index.Conclusions:Postapneic OF and OF during FR led to apnea or hypopnea and were typical patterns seen in patients with moderate and severe sleep‐disordered breathing (SDB). By contrast, SpA‐induced OF was not associated with apnea or hypopnea but functioned as a “nasal obstruction bypasser” seen mainly in normal subjects and patients with mild SDB.
Subjective Assessment of Voice, Nasality, and Swallowing Changes in Patients with OSAS after Anterior Uvulopalatoplasty
Authors: Lisauskaite Laura 
Published: September 2014

Objectives:None provided.Methods:In this prospective clinical study, 41 adult patients (32 males, 9 females) diagnosed for obstructive sleep apnea syndrome (OSAS) and operated at university hospital by anterior uvulopalatoplasty between December 2008 and December 2010 at least 6 months (median 10.0 months) before investigation, formed the study group. A total of 17 nonoperated OSAS patients matched by age, sex, smoking rate, and OSAS severity served as controls. Post service with questionnaires and telephone conversation was accomplished. Patient and control symptoms (hoarseness, nasality of voice, and dysphagia) were assessed using 10‐point Likert scale (1‐normal). Voice quality was assessed by voice handicap index (VHI), and hypernasality by auditory perceptual Gutzmann hypernasality test.Results:Hoarseness ratings for OSAS patients were similar before and after the surgery, with no significant impact on voice handicap. Moreover, total VHI score significantly dropped after the surgery from 9.2 points to 5.4 points out of maximum 120 (P <. 05). Mild nasality of voice with mean intensity score of 1.4 ± 1.0 points was self‐rated by 17.1% of patients, but postoperative rating was significantly lower than that before surgery (2.0 ± 1.9; P <. 05). No significant differences were found in dysphagia scores and Gutzmann test before and after the palatal surgery and between treated by surgery and control groups.Conclusions:Anterior uvulopalatoplasty does not result in significant changes in voice, nasality and swallowing when rated by OSAS patients and by clinical assessment.
Use of Modified Swallow Study to Measure Posterior Airway Space in Obstructive Sleep Apnea Patients
Authors: Phillips Jeffrey , Carbo Alberto , Babcock Kelley , Nathan Cherie Ann O. 
Published: September 2014

Objectives:Obstructive sleep apnea affects over 15% of the population, presenting a major health burden. Research has focused on exploring imaging modalities that supplement polysomnography, eliciting potential sites of airway obstruction. While computed tomography (CT) imaging and sleep endoscopy have been used to accurately assess the posterior airway space (PAS), sedated endoscopy is invasive, and repeated CT imaging risks higher radiation exposure and does not assess the dynamics of the tongue base and PAS. We propose the use of modified barium swallow study as a simple modality to measure PAS. Advantages include its simplicity, lower radiation, and dynamic tongue base visualization, which may help predict surgical outcomes. We hypothesize cephalometric measurements obtained using modified barium swallow (MBS) will correlate well with CT.Methods:Retrospective chart review, tertiary care hospital. Thirty‐six adult patients who underwent both CT imaging and MBS for head and neck cancer were included. Cephalometric measurements of the PAS were obtained using each imaging modality. Statistical analysis focused on correlating measurements taken using CT or MBS.Results:The average PAS measurements were 12.53 ± 1.81 mm and 12.80 ± 1.75 mm when using MBS and CT imaging, respectively. There were no statistical differences based on age, sex, or cancer site. In comparing the 2 modalities, Pearson correlation between CT and MBS measurements revealed an extremely significant positive correlation between r = 0.6382 and 0.8932 (P <. 0001).Conclusions:Cephalometric measurement of the PAS using MBS appears to correlate well with CT imaging. These data suggest MBS may be an effective way to assess the PAS in patients with OSA.