bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Aspects of Alternaria alternata Sensitization in Patients with Allergic Rhinitis
Authors: Choi Suna , Shin Seung‐Youp , Lee Kun‐Hee , Kim Sung‐Wan , Cho Joong‐Saeng 
Published: August 2013

Objectives:Atopic sensitization to the mold Alternaria alternata (AA) has been associated with rhinitis and asthma. Fungal allergen exposure is associated with the development and severity of asthma in sensitized individuals. The contribution of indoor fungal allergen exposure to allergic diseases is still not completely clear. We explore the association of AA sensitization to other allergic diseases and study the influence on rhinoconjunctivitis symptom severity.Methods:2207 patients who were diagnosed with allergic rhinitis were enrolled in our study. After a skin allergy test, those with sensitivity to AA were placed in group A, and those sensitive to other allergens were placed in Group B. We evaluated the prevalence of other allergic disease and symptom severity using TNSS score.Results:Group A had 73 patients (6.4%), and Group B had 1053 patients. Group A had 8 patients with asthma (10.9%), 9 with atophy (12.3%), 6 with allergic conjunctivitis (8.2%), and 11 with sinusitis (15%) Group B had children under 14 years of age (35 patients), 7 with asthma (20%), 3 with allergic conjunctivitis (8.5%), 5 with sinusitis (14.2%), and 4 with asthma, allergic rhinitis, and atopic dermatitis (11.4%). In group A, TNSS score was higher than Group B, and it was statistically significant.Conclusions:Patients with allergic rhinitis may have other atopic conditions such as asthma or atopic dermatitis. Group B and those over 14 had a higher prevalence of other allergic disease. In group A, allergic rhinitis symptoms were severe. Allergen‐specific immunotherapy with standardized A. alternata extract will reduce symptoms of asthma and rhinoconjunctivitis.
The Increase of Global Health‐Related Research in Otolaryngology
Authors: Chambers Kyle J. , Creighton Pete , Abdul‐Aziz Dunia , Randolph Gregory W. 
Published: August 2013

Objectives:Determine trends in global health‐related otolaryngology publications.Methods:A systematic search of publications available on PubMed was undertaken reviewing two time periods ten years apart for the timeframes 1998 to 2002 (early time period) and 2008 to 2012 (recent time period) using the search word “otolaryngology” in combination with “developing countries,” “global health,” or “low income countries”; specifying human studies with abstracts in the English language. Publications related only to specific populations within the United States or Europe were excluded. The region of origin and type of publication were assigned as well as the author origin. Chi‐squared and t‐test analysis was used to identify trends.Results:In the 1998‐2002 time period, a total of 11 publications met inclusion criteria for the study with a mean of 2.2+/‐1.3 publications per year. In the 2008‐2012 time period, a total of 39 publications met inclusion criteria with a mean of 7.6+/‐3.1 publications per year. The 354% increase in global health‐related publications identified between the two study periods was statistically significant (P = 0.01). Eighteen percent of primary authors were from high‐income countries in the early time period versus 38% in the recent time period (P = 0.028). Asia and Africa were the most common region of origin in the recent time period with 49% and 23% of publications, respectively.Conclusions:There is a significant increased volume of global health‐related publications in English language otolaryngology journals over the past decade, providing strong evidence of the increasing trend of global health as an academic pursuit within otolaryngology.
Experimental System for the Analysis of Nasal Procedures: Initial Experience with Inferior Turbinate Reduction
Authors: Willson Thomas J. , Dion Gregory R. , Weitzel Erik K. 
Published: August 2013

Objectives:1) Develop simple cadaveric flow/pressure analysis system for experimental use for nasal procedure simulation. 2) Assess changes in nasal airway resistance in simulated inferior turbinate (IT) hypertrophy, normal state, and reduced, out‐fractured conditions.Methods:An open thermodynamic nasal cavity experimental cadaveric model was created using an Omega HHP‐103 digital manometer and oxygen flow regulator. For pressure testing, one pressure measurement catheter was placed at the internal nasal valve, isolating the nasal cavity from external nasal valve resistance. The second pressure measurement catheter was placed at the choana of the tested side, and the position was confirmed endoscopically. Repeatability was tested among nasal cavities, specimens, and repeat setups. Pressure measurements were taken incrementally between 0 and 25 liters per minute (Lpm) at each of three conditions: 1) control state, without augmentation, 2) simulated IT hypertrophy with 20% benzocaine topical anesthetic gel filler placed within sub‐periosteal flap, and 3) out‐fractured, reduced inferior turbinates.Results:The experimental system was simple to set up and repeatable. Experimentally, nasal airway resistance measurements revealed decreased resistance under control and out‐fractured configuration versus hypertrophied turbinates. Initial studies trended, under all conditions, to have exponential growth of pressure as flow rate increased.Conclusions:The physiologically isolated test system allows anatomic manipulation and measurement of resulting pressure‐flow relationships. IT alterations resulted in expected pressure‐flow changes, indicating future analysis at other anatomic locations, such as olfactory epithelium, septum, or middle turbinate, is feasible.
Flagellin/Toll‐like Receptor 5 Induces Interleukin‐17C in Human Nasal Epithelia
Authors: Kim Chang‐Hoon , Kim Jin Kook 
Published: August 2013

Objectives:Recently, it has been reported that IL‐17C mediates innate immune responses against microbial infection and inflammation in mucosal epithelium. However, little is known about the expression and biological function of IL‐17C in human airway epithelium.Methods:The family of Interleukin‐17 (IL‐17) cytokine is involved in host defense responses and various inflammatory diseases. Many studies indicate that IL‐17A and IL‐17F play an important role in the pathogenesis of airway inflammatory diseases. In this study, we found that IL‐17C mRNA expression was strongly induced by inflammatory cytokines such as TNF‐Î± or IL‐1Î2 and bacterial flagellin, recognized by toll‐like receptor 5 (TLR5), in primary cultured normal human nasal epithelial (NHNE) cells. We also confirmed that IL‐17C protein production was enhanced by TNF‐Î±, IL‐1Î2 and flagellin.Results:We demonstrated that pretreatment of neutralizing antibody against TLR5 completely inhibited flagellin‐induced IL‐17C expression, indicating elevated IL‐17C expression is specifically mediated by flagellin/TLR5 engagement. Moreover, IL‐17C stimulation induced innate immune responses including the expression of antibacterial peptides and proinflammatory cytokines in NHNE cells. Taken together, these results show that IL‐17C expression is enhanced in response to inflammation and flagellin/TLR5 activation and involved in inflammatory process in human nasal epithelial cells.Conclusions:Our findings suggest that IL‐17C cytokine may play an important role in TLR5‐dependent innate immune responses of human airway epithelia.
Olfactory‐Related Cerebral Representation with Odorant‐Induced Stimulation: A Preliminary Study Using Functional MRI
Authors: Choi Jee‐Min , Cho Jae‐Hoon , Moon Cheil , Kim Jin‐Kook 
Published: August 2013

Objectives:Recent neuroimaging studies have shown that odorant‐induced responses to prolonged stimulation in primary olfactory cortex (POC) are characterized by a rapidly habituating time course. We hypothesized that the different part of brain area would be activated when stimulating pleasant or unpleasant odors.Methods:Functional magnetic resonance imaging (fMRI) was used in an experiment comparing brain activation related to a pleasant (Citraval) and an unpleasant odor (Î2‐mercaptometh‐anol). The stimulation period was 10 seconds with 50 second interval. The total stimulation time was 50 seconds.Results:In normal group, the pleasant odor activated the area including the prefrontal cortex, anterior cingulum, and anterior insular cortex. The unpleasant odor activated the area including the prefrontal cortex and posterior cingulum. In the abnormal group, the brain activated area was scattered among 10 patients, and it was hard to categorize the activated brain areas in Z=4.59 (p<0.05).Conclusions:Olfactory stimulation with pleasant and unpleasant odor produces the activation of specific brain areas. The brain areas activated differed according to the specimen of odor and trauma. Further studies are needed to elucidate brain activation response according to the different kinds and intensities of olfactory stimulation.
Sublingual Immunotherapy for Allergic Rhinitis: A Prospective Study Based on AAOA Consensus Dosing Protocol
Authors: Leong Jern‐Lin , Zhang Edward Z. 
Published: August 2013

Objectives:Study the efficacy and safety of sublingual immunotherapy (SLIT) based on the original American Academy of Otolaryngologic Allergy (AAOA) Consensus dosing protocol for treatment of allergic rhinitis (AR).Methods:Patients undergoing SLIT for more than 12 months between 2007‐2010 were prescribed escalation (over 3 months) and maintenance doses as recommended by AAOA. Sinonasal‐Outcome‐Test‐20 (SNOT‐20) questionnaire scores were used for calculations of repeated measures analysis of variance (ANOVA) with contrast testing to define trends.Results:Data from fifteen males and six females with a mean follow‐up duration of 17.57 months were analyzed. Fourteen patients had minor side effects, including AR exacerbation (5 cases), itching (8), rash (2), diarrhea (1), and palatal ulcer (1). None required admission or treatment discontinuation. ANOVA testing revealed a significant linear decreasing trend in rhinological (F1,13 = 11.2), ear/facial (F1,13 = 5.4), sleep (F1,13 = 6.9), psychological (F1,13 = 13.1), and overall SNOT‐20 (F1,13 = 14.5) scores. Our results show overall SNOT‐20 scores improving by 31% from baseline within 3 months initiation of therapy, and continued to improve progressively during the maintenance phase up to 69%. Domain scores analyzed showed greatest improvements in ear/facial symptoms (up to 86%) and psychological function (up to 77%). Rhinologic and sleep function scores also showed impactful improvements of up to 56% and 61% respectively.Conclusions:This is the first published paper to study and demonstrate the safety and efficacy of SLIT based on AAOA consensus dosing protocol. A standardized regime will allow more meaningful comparison between studies.
Xanthoma of the Sphenoid Sinus: A Rare Presentation
Authors: Mercado Gustavo J. A. , Torre Carlos A. , Hernandez Gabriel , Salcedo Federico , Marcos Maria , Busquets Jose M. 
Published: August 2013

Objectives:1) Present what is to the best of our knowledge the first reported case of a patient with a sphenoid sinus xanthoma. 2) Discuss the details of the clinical presentation, histopathological and radiological findings, and management of this patient.Methods:Medical charts and the scientific literature were reviewed.Results:A 36‐year‐old female patient with family history of hyperlipidemia presented with a 1‐year history of sporadic epistaxis and an episode of severe headache 2 months prior to evaluation. The rest of her medical history and physical examination were unremarkable. Computed tomography (CT) scan and magnetic resonance images revealed a soft tissue lesion occupying and infiltrating the posterolateral aspect of an expanded sphenoid sinus on the left side. Patient underwent endoscopic sinus surgery in December 2011 with intraoperative findings of a yellow‐tan, friable soft tissue filling the left sphenoid sinus. Biopsy was taken for which histologic and immunohistochemical analysis revealed proliferating foamy histiocytes consistent with xanthoma cells. As of her last follow‐up examination (9 months post‐op), the patient has remained asymptomatic without evidence of disease progression on nasal endoscopy or CT scan.Conclusions:Very few cases of xanthomas arising in the paranasal sinuses have been described in the literature. Those that have been described have only occurred in the maxillary sinus. We present the case of a 36‐year‐old woman with family history of herlipidemia with a left sphenoid sinus xanthoma. This is to our knowledge the first case of such a lesion reported in the English literature.
Biological Effects of OSAHS Surgery on Endothelial Dysfunction and Oxidative Stress
Authors: Lin Hsin‐Ching , Friedman Michael 
Published: August 2013

Objectives:Prospectively study the changes of biomarkers related to cardio‐ or cerebro‐vascular diseases in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) before and after OSAHS surgery.Methods:Patients who failed continuous positive airway pressure (CPAP) therapy and then underwent OSAHS surgery were enrolled in this study. We assessed serum biomarkers of metabolic status, oxidative/antioxidative balance and sICAM‐1, sVCAM‐1, sE‐selectin, sL‐selectin and sP‐selectin preoperatively and postoperatively at 6 month follow‐up.Results:Eighty OSAHS patients (mean, 45 years) completed data for analysis. When both mild/moderate and severe OSAHS patients were considered, the level of triglyceride, sICAM‐1, and sE‐selectin were significantly decreased 6 months following surgery, while body mass index did not show significant decrease. Most biomarkers on endothelium dysfunction (sICAM‐1 in mild/moderate and severe OSAHS patients, sL‐selectin in mild/moderate group, and sE‐selectin in severe group) showed a decrease 6 months following surgery. There is a trend of decrease changes on level of TBARS and increased level of superoxide dismutase 6 months after surgery.; However, the difference is not significant.Conclusions:This study shows that surgical treatment could improve some of the biomarkers of metabolic status, oxidative/antioxidative balance, and inflammatory cell adhesion molecules in OSAHS patients. The successful translation of these approaches may offer the promise of reducing the cardiovascular risks associated with OSAHS patients undergoing upper airway surgery.
Comparative Analysis of Diagnostic Methods in Obstructive Sleep Apnea Syndrome: Polysomnography and Use Watch PAT 200
Authors: Silva Evandro M. , Balieiro Fernando O. , Xavier Sandra D. , Stamm Aldo E. C. , Kitice Adriano T. , Coronel Natalia W. , Calegaro Bibiana F. 
Published: August 2013

Objectives:Obstructive sleep apnea syndrome (OSAS) is a public health problem in terms of its impact on quality of life and increased risk of cardiovascular disease. One of the few national epidemiological studies was published and showed a prevalence of 32.8% of OSA in the population of Sao Paulo. The gold standard for diagnosis of OSA is polysomnography (PSG). Despite this, tests often show the same individual variability and inter night to night. Because it is costly and time consuming, other diagnostic tools such as the Watch PAT 200 (WP) were developed. This is an ambulatory device that consists of a actgraphy, sensors capturing peripheral arterial tonometry (PAT) and body position, pulse oximetry, and microphone to capture snoring.Objectives:Evaluate the difference between two diagnostic methods for OSAS: PSG and WP.Methods:A study in the sleep laboratory of the Complexo Hospitalar Edmundo Vasconcelos from June to August 2012, including 20 volunteers who had no exclusion criteria and performed using the same night of PSG and WP 200,interpreted by two different examiners.Results:20 patients, 70% male and 30% female, mean age 37.1 years (standard deviation ‐ SD ± 12.1), mean BMI 29.1 (SD ± 5.2), and Epworth average score of 11.9 (SD ± 3.1). There was agreement among examiners quantitative bias of PSG with average DP of 9.7 and ‐2.9, between the WP and the mean AHI of examiners was average bias of 3.2 and SD of 8.8. There was qualitative agreement between examiners. PSG AHI was classified in the same category by the two examiners in 13 (65%) between the average of PSG and WP no agreement in 13 subjects (65%). Accuracy of WP as a screening test for OSA, using PSG as the gold standard, the WP showed 100% sensitivity for the diagnosis of OSA (AHI 5), specificity 33.3%, positive predictive value of 89.4% and negative predictive value 100% for OSA.Conclusions:AHI agreement between WP and PSG was good. Being sensitive and 100% negative predictive value for the diagnosis of OSA (AHI 5) are ideal characteristics for a screening test.
Failure of Quality‐of‐Life Measures to Discriminate between Primary Snorers and Patients with Obstructive Sleep Apnea
Authors: Liu Jiaying , Toh Song‐Tar 
Published: August 2013

Objectives:Investigate differences in quality of life (QoL) between primary snorers and obstructive sleep apnea (OSA) patients using 2 measures: Short‐Form 36 (SF‐36) and Functional Outcomes of Sleep Questionnaire (FOSQ).Methods:This cross‐sectional study involved 69 patients who were investigated for snoring between February ‐ December 2011. Each patient completed a SF‐36 and FOSQ prior to polysomnogram. Based on polysomnogram outcomes, 4 patient groups were derived: normal, mild, moderate, and severe OSA. Variables analyzed were body‐mass‐index (BMI), Epworth‐ sleepiness‐score (ESS), SF‐36, and FOSQ scores.Results:Fourteen patients were normal (mean AHI 2), 14 mild OSA (mean AHI 7.7), 9 moderate OSA (mean AHI 21.9), and 32 severe OSA (mean AHI 57.5). BMI and ESS indices increased progressively from normal to severe OSA. We found no difference in SF‐36's Physical Health component among normal, mild, and moderate OSA, and though it was lowered in severe OSA this was not statistically significant (p = 0.273). Mental health component scores were similar across all groups. OSA patients scored higher across all 5 FOSQ domains compared with simple snorers, but none were statistically significant. However, primary snorers had a significantly higher (p= 0.013) self‐reported health state (67.3% +/‐16.85) than OSA patients (54.08% +/‐17.45).Conclusions:The broad‐based SF‐36 fails to distinguish differences in QoL between normal and OSA patients. FOSQ's psychometric properties have been reported to better reflect functional impairment caused by OSA. However, in our series, FOSQ has not been statistically significant in differentiating between patients with and without OSA.
Is the Trend in Indications for Tonsillectomy and Adenotonsillectomy Really Changing?
Authors: Ahmed Abdulazeez , Aliyu Ibrahim , Kolo Emmanuel 
Published: August 2013

Objectives:Infection and obstruction are the most common indications for performing tonsillectomy and adenotonsillectomy. In the past, infection was the main indication for these procedures; however, in the last few decades, obstruction is said to be more prominent as an indication when compared to infection. This study evaluates the changing trend in indications for tonsillectomy and adenotonsillectomies.Methods:This is a 2 year retrospective analysis of case records of patients aged 0‐18 years who have had tonsillectomy or adenoidectomy and tonsillectomy performed in Aminu Kano Teaching Hospital. IBM SPSS (for Windows, version 19) software was used to analyze these data.Results:A total of 115 patient case records were reviewed. 33.9% were children under 3 years old, 60.0% were between 4‐10 years, and 6.1% were between 11‐18 years. Obstruction accounted for a total of 68.7% while infection accounted for only 31.3% of the indications for these procedures. There was a significant association between age groups and indications for adenotonsillectomies (P = 0001, Phi and Cramer's V = 0.363, respectively).Conclusions:Obstruction as an indication is proportionally higher in younger children, while infection is proportionally higher in older children.
Nasal Symptoms, Resistance, and AHI Contributions to Subjective Sleep Outcomes
Authors: Woodson B. Tucker , Helm Cole 
Published: August 2013

Objectives:The contribution of nasal obstruction to sleep related quality of life is poorly understood. This study assesses the contribution of: 1) nasal symptoms and effective nasal resistance;2) AHI to sleep‐related quality of life.Methods:70 unselected adult patients (age 52.2 (13.9) years) undergoing polysomnography at an academic sleep center were evaluated with four phase rhinomanometry (RhinoLab, Rendsburg, Germany) in the upright and supine body positions and completed validated quality of life measures.Results:AHI demonstrated no associations with nasal obstruction symptom questionnaire (NOSE), insomnia score (PSQI), hypersomnia (ESS), or functional quality of life (FOSQ‐10). However, both nasal symptoms (NOSE) and resistance (Rsupine/effective) were associated with sleep metrics. NOSE was associated with insomnia, hypersomnia, and QOL (r = 0.44,0.29, and 0.40 respectively, all p < 0.01) while Rsupine/effective was associated with hypersomnia (r=0.24,p<0.02) and a trend to insomnia (p< 0.09). No association with change in upright to supine resistance was observed. In the group with OSA (AHI > 5/hr., n= 49) and without OSA (AHI < 5/hr.,n=21) nasal symptoms and Rsupine/effective maintained associations (r=0.30 and 0.32 p<0.05) with hypersomnia (ESS) but not AHI (p=NS) in either group.Conclusions:In a sleep lab cohort referred for evaluation of possible sleep disordered breathing, both subjective and objective measures of nasal obstruction but not AHI contribute to sleep related subjective outcomes. Further research is needed on the nasal contribution to sleep disorders independent of AHI.
Neurogenic Model of Obstructive Sleep Apnea in Rabbits
Authors: Lee Woo‐Hyun , Kim Jeong‐Whun , Joe Sam 
Published: August 2013

Objectives:An animal model of obstructive sleep apnea (OSA) can be helpful for evaluating the pathophysiology of OSA and application of novel treatment modalities. This study aimed to establish new OSA animal model simulating real upper airway conditions during sleep.Methods:A total of 27 New Zealand white male rabbits were used. Sleep was induced by intramuscular injection of 0.3 ml/kg of Zoletil and 0.2 ml/kg of Rompun. Drug‐induced sleep was evaluated using Embletta X100 for electroencephalography, electrooculography, chin electromyography, nasal airflow, breathing efforts, and pulse oxymetry. Upper airway obstruction was induced by injecting botulinum toxin into the genioglossus. Respiratory events (apneas or hypopneas) during sleep were evaluated using ApneaLink.Results:All the rabbits showed no apneas or hypopneas before injection of botulinum toxin. In the control rabbits injected with normal saline, apneas or hypopneas were not found. The respiratory events were observed in 5 of 8 rabbits injected with 2.5 units of botulinum toxin whereas they were observed in 7 of 10 rabbits injected with 5.0 units of botulinum toxin. The median AHI was 9.6 (5.3 – 14.8)/h and 45.6 (21.5 – 70.5)/h in the rabbits injected with 2.5 units and 5.0 units of botulinum toxin, respectively (P =. 028).Conclusions:The animal model of OSA could be developed by paralyzing the genioglossus in rabbits.