bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Expression of Innate Immunity Genes in Chronic Rhinosinusitis
Authors: Detwiller Kara Y. , Smith Timothy L. , Alt Jeremiah A. , Trune Dennis R. , Mace Jess C. , Sautter Nathan B. 
Published: September 2014

Background Prior research has identified several components of the innate immune system that may play a significant role in chronic rhinosinusitis (CRS), but the role of innate immunity in patients with CRS is poorly understood. The objective of this study was to determine differential expression of innate immunity genes in the mucosa of patients with CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP) when compared with controls. Methods Control patients (n = 9) and patients with CRS (n = 36) who failed medical management were prospectively enrolled. Ethmoid mucosa samples were harvested during surgery and quantitative real-time polymerase chain reaction was used to determine levels of mRNA expression of Toll-like receptor (TLR) 2 and TLR9 and interleukin-22 receptor (IL-22R). The average change in crossover threshold and fold change were calculated and differences between controls, CRSwNP, and CRSsNP were compared. Statistical analysis was performed using the Kruskall–Wallis and adjusted Mann-Whitney U tests. Results Patients with CRSwNP (n = 16) and CRSsNP (n = 20) showed lower mean expression of TLR2 (p < 0.05) compared with controls. Patients with CRSsNP showed significantly higher mean expression of IL-22R (p < 0.05) than controls. Conclusion The sinonasal innate immune system may have a significant role in the development of CRS. We found differential expression of innate immune mediators between patients with and without nasal polyposis. These results provide further evidence of disruption of innate immunity at the mucosal level in CRS and highlight differences between polyp- and non-polyp-forming CRS phenotypes at the molecular level. In addition to our knowledge, this is the first report of altered IL-22R expression in CRSsNP patients. This study was a part of the clinical trial NCT01332136 registered in www.clinicaltrials.gov .
Relationship between Sputum Eosinophilia and Sinus Disease in Patients with Eosinophilic Bronchitis
Authors: Neighbour Helen , Goodwin Jodi , Strychowsky Julie , Rahman Sadaf , Abdelshaheed Rami , Nair Parameswaran , Sommer Doron D. 
Published: September 2014

Background Sinus disease is commonly seen in patients with asthma, and several studies have been published describing the relationship between sinus disease and the inflammation seen in the sputum of asthmatic subjects. In this article, we expand on this knowledge by studying patients with eosinophilic bronchitis with and without asthma. Methods We describe the relationship between the severity of sinus disease determined by the Lund-Mackay score and sputum eosinophilia. Comparisons with blood eosinophil and total immunoglobulin (IgE) measurements are made. Results We have shown that the severity of sinus disease is positively correlated with sputum eosinophil counts, and the site of sinus disease affected the level of eosinophilia. There was a positive correlation between sputum eosinophils and blood eosinophils, but there was no relationship with blood total IgE levels. Conclusions We have confirmed that there is a link between upper and lower airway inflammation and that this is not limited to patients with asthma. The process is associated with systemic inflammation as evidenced by increased blood eosinophils but appears to be independent of IgE.
Respiratory Epithelial Adenomatoid Hamartoma of the Nose: An Updated Review
Authors: Nguyen Duc Trung , Gauchotte Guillaume , Arous Fabien , Vignaud Jean-Michel , Jankowski Roger 
Published: September 2014

Background This study was designed to update clinical and imaging features as well as treatment outcomes of the nasal respiratory epithelial adenomatoid hamartoma (REAH). Data sources included case reports, original articles, and reviews published in English or French in PubMed from 1995 to date. Methods Only published articles that met Wenig's histological criteria for the diagnosis of REAH were included. Results REAH is not rare and is probably underdiagnosed. It is usually observed in the fifth decade of life with a 3:2 male/female predilection. REAH can be represented in two forms: as an isolated lesion (less frequent) or in association with an inflammatory process (especially nasal polyposis). It was observed in 35–48% of patients undergoing endoscopic endonasal surgery for nasal polyposis. Its origin is found, in most cases, in the olfactory cleft, which is exhibited on computed tomography (CT) scans by widened opacified olfactory clefts without bone erosion. Resection of REAH from the olfactory clefts does not worsen, but instead, can improve the sense of smell after surgery. Conclusion Looking for REAH on CT scans and during endoscopic examination can lead to its diagnosis and help avoid aggressive surgical procedures and their complications. Endoscopic resection is the treatment of choice. The removal of REAH constitutes a specific surgery on the olfactory clefts, which can improve nasal obstruction as well as sense of smell. Whether REAH can be defined as a hamartoma, an inflammatory reactive process, or a neoplastic lesion remains to be determined.
Nasal Septal Turbinate: Cadaveric Study
Authors: Şişman A. Sezim , Acıoğlu Engin , Yiğit Özgür , Akakın Dilek , Cilingir Özlem Tugçe 
Published: September 2014

Background Despite the importance of its location, the functional behavior of the nasal septal turbinate (NST) is still not completely understood. Basic histological knowledge is still lacking. The aim of this study was to describe the histological features of the NST and to compare its morphometric features to those of the adjacent nasal septum and the inferior and middle turbinates. Methods The study included 50 fresh cadavers. Excisional biopsy specimens of the NST with adjacent posterior septum were collected. In addition, mucosal and submucosal biopsy specimens were taken of the inferior and middle turbinates. Morphometric analysis was performed on five different tissue types: glandular elements, connective tissue stroma, arterial structures, and capillary or venous sinusoids. Results The mean proportion of venous sinusoids was statistically lower in the nasal septum and NST than in the inferior and middle turbinate. The mean proportion of glandular tissues was higher in the NST than in other regions of the nasal cavity. The mean proportion of arterial tissue was lower in the nasal septum and the NST. Significantly fewer capillary elements were found in the inferior and middle turbinates than in the nasal septum and NST. The mean proportion of connective tissues was lower in the NST than in other regions of the nasal cavity. Conclusion The similar histopathological cell distribution in the middle and inferior turbinate supported a function as an erectile organ, but the findings for the NST pointed to different functional properties of this region.
Nasal Mucociliary Clearance in Obstructive Sleep Apnea Syndrome Patients
Authors: Deniz Mahmut , Gultekin Erdogan , Ciftci Zafer , Alp Recep , Ozdemir Damla Nihan , Isik Aklime , Demirel Oral Burak 
Published: September 2014

Background The main objective of this study was to investigate the correlation between the level of mucociliary dysfunction and severity of obstructive sleep apnea syndrome (OSAS). The effect of smoking in OSAS patients on mucociliary dysfunction was also assessed. Methods It is a descriptive study that compares variables between groups (univariate analysis). In this clinical trial 122 patients with varying degrees of OSAS and 49 healthy volunteers were included (n = 171). Patients were divided into three groups as having mild, moderate, and severe OSAS, according to their apnea hypopnea index (AHI) values. (AHI values are typically categorized as 5–15/hr, mild OSAS; 15–30/hr, moderate OSAS; and > 30/hr, severe OSAS.) The control group was comprised of healthy subjects. Each group was divided into smoking and nonsmoking subgroups. The mucociliary rates of the subjects were measured using the saccharin test. Statistical analysis was performed with the GraphPad Prism Version 3 pocket program. Results Mild and moderate OSAS groups showed similar results with control group (p = 0.869), but severe OSAS patients showed a statistically significant difference with control group (Kruskal–Wallis [KW] = 32.28; p = 0.0032 and p < 0.05). Although in the moderate OSAS group the mucociliary clearance rates showed a tendency to decrease, this decrease was not significant (p = 0.453). A statistically significant difference was observed between smokers and nonsmokers in terms of mucociliary clearance times in all groups (KW = 18.24; p = 0.001). Conclusion The nasal mucociliary system is significantly deteriorated in severe OSAS patients and they should be meticulously observed to prevent sinonasal infections. Measures to enhance mucociliary activity in these patients should be taken. Smoking, a well-known inhibitor of mucociliary activity, also has a negative impact on the mucociliary function of OSAS patients and quitting smoking would be of benefit for these patients.
La dimension collaborative, un espace professionnel du maître E
Authors: Thomazet Serge , Merini Corinne 
Published: September 2014

Entre aide directe à l’élève et aide indirecte, notre étude a pu identifier la position actuelle du maître E, certes dans l’école mais au seuil de la classe et montrer combien cette position « décalée » par rapport au centre de gravité de la classe était nécessaire pour construire des ruptures avec des situations difficiles. Cette position particulière lui offre des possibilités élargies de médiation et facilite les relations aux familles dont l’implication semble déterminante dans l’évolution de l’élève. L’espace professionnel dans lequel évolue le maître E croise une grande diversité de situations professionnelles. Certaines sont centrées directement sur l’élève (regroupement d’adaptation) ; d’autres sont orientées par l’élève mais partagées avec des partenaires au travers d’un PPRE par exemple. Partant d’une aide à l’élève, l’action du maître E peut viser, en même temps, le maître de la classe, au travers d’échanges formels ou informels ou encore de co-intervention, et les parents.
Efficacy of Surgical Interventions for a Bipartite Patella
Authors: Matic George T. , Flanigan David C. 
Published: September 2014

Educational objectives

As a result of reading this article, physicians should be able to:

1.
Identify common presenting characteristics of a symptomatic bipartite patella.

2.
Evaluate the most common surgical interventions used in the management of a symptomatic bipartite patella.

3.
Assess relief of symptoms and return to preoperative activity levels after surgical management of a bipartite patella.

4.
Identify complications from surgical management of a bipartite patella.

Bipartite patella is a relatively rare phenomenon. This anomaly is typically asymptomatic but can become painful with overuse, strenuous activities, or trauma, which is why it is typically seen in a young, athletic population. Although nonsurgical management is the initial treatment, if symptoms persist, surgical intervention may be necessary. Multiple surgical options exist, such as excision or fixation of the fragment or release of lateral soft tissue structures. The authors report the efficacy of various surgical interventions on a symptomatic bipartite patella, with outcomes related to symptom relief and ability to return to preoperative levels of activity. A systematic review was performed using multiple databases. Studies reporting outcomes of symptom relief or ability to return to activity following surgical intervention for a bipartite patella were included. Surgical technique, type of bipartite, and complications were recorded. Twenty-four articles with a total of 122 patients and 127 knees were included and reviewed. Relief of pain was achieved in 84.1% of patients, with 98.3% able to return to their preoperative activity levels after surgery. For patients with a symptomatic bipartite patella, return to preoperative activity levels with zero to minimal pain can be achieved with excellent results using any of the reported surgical methods. [
Orthopedics.
2014; 37(9):623–628.]
STAT3 Activation in Th17 and Th22 Cells Controls IL-22–Mediated Epithelial Host Defense during Infectious Colitis
Authors: Backert Ingo , Koralov Sergei B. , Wirtz Stefan , Kitowski Vera , Billmeier Ulrike , Martini Eva , Hofmann Katharina , Hildner Kai , Wittkopf Nadine , Brecht Katrin , Waldner Maximilian , Rajewsky Klaus , Neurath Markus F. , Becker Christoph , Neufert Clemens 
Published: September 2014

Abstract
The Citrobacter rodentium model mimics the pathogenesis of infectious colitis and requires sequential contributions from different immune cell populations, including innate lymphoid cells (ILCs) and CD4+ lymphocytes. In this study, we addressed the role of STAT3 activation in CD4+ cells during host defense in mice against C. rodentium. In mice with defective STAT3 in CD4+ cells (Stat3ΔCD4), the course of infection was unchanged during the innate lymphoid cell–dependent early phase, but significantly altered during the lymphocyte-dependent later phase. Stat3ΔCD4 mice exhibited intestinal epithelial barrier defects, including downregulation of antimicrobial peptides, increased systemic distribution of bacteria, and prolonged reduction in the overall burden of C. rodentium infection. Immunomonitoring of lamina propria cells revealed loss of virtually all IL-22–producing CD4+ lymphocytes, suggesting that STAT3 activation was required for IL-22 production not only in Th17 cells, but also in Th22 cells. Notably, the defective host defense against C. rodentium in Stat3∆CD4 mice could be fully restored by specific overexpression of IL-22 through a minicircle vector–based technology. Moreover, expression of a constitutive active STAT3 in CD4+ cells shaped strong intestinal epithelial barrier function in vitro and in vivo through IL-22, and it promoted protection from enteropathogenic bacteria. Thus, our work indicates a critical role of STAT3 activation in Th17 and Th22 cells for control of the IL-22–mediated host defense, and strategies expanding STAT3-activated CD4+ lymphocytes may be considered as future therapeutic options for improving intestinal barrier function in infectious colitis.
Negative Self-Regulation of TLR9 Signaling by Its N-Terminal Proteolytic Cleavage Product
Authors: Lee Sungwook , Kang Dongju , Ra Eun A. , Lee Taeyun A. , Ploegh Hidde L. , Park Boyoun 
Published: September 2014

Abstract
TLR signaling is essential to innate immunity against microbial invaders and must be tightly controlled. We have previously shown that TLR9 undergoes proteolytic cleavage processing by lysosomal proteases to generate two distinct fragments. The C-terminal cleavage product plays a critical role in activating TLR9 signaling; however, the precise role of the N-terminal fragment, which remains in lysosomes, in the TLR9 response is still unclear. In this article, we report that the N-terminal cleavage product negatively regulates TLR9 signaling. Notably, the N-terminal fragment promotes the aspartic protease-mediated degradation of the C-terminal fragment in endolysosomes. Furthermore, the N-terminal TLR9 fragment physically interacts with the C-terminal product, thereby inhibiting the formation of homodimers of the C-terminal fragment; this suggests that the monomeric C-terminal product is more susceptible to attack by aspartic proteases. Together, these results suggest that the N-terminal TLR9 proteolytic cleavage product is a negative self-regulator that prevents excessive TLR9 signaling activity.
A Major Deletion in the Vκ–Jκ Intervening Region Results in Hyperelevated Transcription of Proximal Vκ Genes and a Severely Restricted Repertoire
Authors: Xiang Yougui , Park Sung-Kyun , Garrard William T. 
Published: September 2014

Abstract
Our previous studies have shown that DNase I hypersensitive sites 1 and 2 (HS1-2) and HS3-6 within the mouse Vκ–Jκ intervening region are essential for controlling locus contraction and creating a diverse Ab repertoire. In this article, we demonstrate that a 6.3-kb deletion encompassing HS1-6 altogether not only leads to the predictable sums of these phenotypes, but also results in a novel hyperelevation of transcription of proximal Vκ genes, in both pre-B and splenic B cells. These findings reveal previously unrecognized additional functions for cis-elements within the Vκ–Jκ intervening region, namely, prevention of the production of massive levels of noncoding RNA species by silencing transcription of germline proximal Vκ genes in both developing and mature B cells.
Defining Central venous Line Position in Children: Tips for the Tip
Authors: Perin Giordano , Scarpa Maria-Grazia 
Published: September 2014

Purpose The purpose of this study is to analyse literature related to the position of centrally inserted central venous catheters and to review topics related to assessment of tip position of those catheters in children. Applications of specific techniques to PICCs (Periferally Inserted Central Catheters) and umbilical venous catheter will also be reviewed. Methods Analysis of 68 original manuscripts, 42 specifically related to the paediatric population, 26 related to the adult population. The papers analysed were published between 1949 and 2014; all articles were in English except one in Italian and one in German. Results From the analysed literature, most of the guidelines recommend tip positioning at a level between the superior vena cava and the right atrium. Several methods have been described to evaluate tip position in the paediatric population, but none of those is considered completely reliable. The standard methods used to identify catheter tip position are radiography and fluoroscopy, but no specific landmark can be recommended in the paediatric population. The ultrasonographic approach has been investigated mainly for PICCs positioning in the neonatal population. The electrocardiographic method has been evaluated in the general paediatric population. Conclusions No specific recommendation can be given due to the low level of evidence. Ultrasound and ECG (electrocardiogram) techniques are a potential alternative to chest X-ray and further studies should be implemented to establish them. A wider application of these techniques may reduce neonatal and paediatric exposure to radiations and additionally reduce costs.
Characterization of the Cephalic Arch and Location of Stenosis
Authors: Bennett Shelby , Hammes Mary S. , Blicharski Tom , Watson Sydeaka , Funaki Brian 
Published: September 2014

Purpose The purpose of this study is to accurately characterize the cephalic arch segments into four domains and to enable more specific evaluation of cephalic arch stenosis (CAS) and determine the frequency of stenosis in each domain. Methods After Institutional Review Board (IRB) approval, a retrospective chart review was done to define a population of patients receiving hemodialysis who developed CAS as apparent on clinically indicated radiologic imaging. A standardized approach was devised to categorize four domains of the cephalic arch. Domain I was defined as the peripheral portion of the arch and Domain IV was the distal portion of the cephalic vein near termination with the axillary vein. The magnitude of stenosis as measured by percentage was determined and compared in the four domains. Results The most frequent location for stenosis was found in domain IV when compared with domains II or I (p<0.01). The magnitude of stenosis differed across all domains (p<0.001) with the least common place for CAS in domain I. Treatment of CAS included angioplasty in all, thrombectomy in eight, and stent placement in five. Conclusions CAS occurs most commonly in the terminal portion of the arch. Four standardized domains have been defined; future work will validate these findings and determine the best intervention for each domain.
Tunneled Dialysis Catheter Exchange with Fibrin Sheath Disruption is not Associated with Increased Rate of Bacteremia
Authors: Valliant Amanda M. , Chaudhry Muhammad K. , Yevzlin Alexanders , Astor Brad , Chan Micah R. 
Published: September 2014

Purpose Tunneled dialysis catheters are the most common form of vascular access among incident dialysis patients in the United States. Fibrin sheath formation is a frequent cause of late catheter dysfunction requiring an exchange procedure with balloon disruption of the fibrin sheath. It is unknown whether fibrin sheath disruption is associated with increased incidence of bacteremia or catheter failure. Methods We reviewed all tunneled dialysis catheter exchange procedures at the University of Wisconsin between January 2008 and December 2011. The primary outcome was incidence of bacteremia, defined as positive blood cultures within 2 weeks of the procedure. Catheter failure, requiring intervention or replacement, was examined as a secondary outcome. Baseline characteristics examined included diabetic status, gender, race and age. Results A total of 163 procedures were reviewed; 67 (41.1%) had fibrin sheath disruption and 96 did not. Bacteremia occurred in 4.5% (3/67) of those with and 3.1% (3/97) of those without fibrin sheath disruption (p=0.65). Fibrin sheath disruption was not significantly associated with the risk of catheter failure (adjusted hazard ratio [aHR]=1.34; 95% confidence interval [CI]: 0.87-2.10; p=0.18). Diabetes was associated with greater risk of catheter failure (aHR=1.88; 95% CI: 1.19-2.95; p=0.006), whereas higher age was associated with a lower risk of catheter failure (aHR per 10 years=0.83; 95% CI: 0.72-0.96; p=0.01). Conclusions This study demonstrates that there is no significant increase in bacteremia and subsequent catheter dysfunction rates after fibrin sheath disruption compared to simple over the wire exchange. These results are encouraging given the large numbers of patients utilizing tunneled catheters for initial hemodialysis access and the known rates of fibrin sheath formation leading to catheter failure.
Frank Bidart's Voice and the Erasure of Jewish Difference in “Ellen West”
Authors: Morris Daniel 
Published: September 2014

ABSTRACTIn “Ellen West” (1977) Frank Bidart engages with an intertextual poetics by including “found” prose from the English translation of Lionel Binswanger's case history to lend historical veracity to lyric passages spoken by West, a European Jew who died in 1921. In his representation of Binswanger's text, however, Bidart omits key points that connect West's disgust with her “Jewish” body type to her internalization of an anti-Semitic discourse. Instead of focusing on the anti-Semitic discourse that animates West's body hatred, Bidart reads West's devaluation of the body and her wish for its erasure as in line with German idealism and an aesthetic sublime.