bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspergillus Fumigatus Biofilm on Primary Human Sinonasal Epithelial Culture
Authors: Singhal Deepti , Baker Leonie , Wormald Peter-John , Tan LorWai 
Published: July 2011

Background Bacterial biofilms have been implicated in chronic rhinosinusitis (CRS). However, direct evidence in support of fungal biofilms in sinus disease is lacking in the literature. This study was designed to develop and characterize an in vitro Aspergillus fumigatus biofilm model on primary human sinonasal epithelial cell culture. Methods Sinonasal biopsy specimens harvested during endoscopic sinus surgery of six CRS patients and three pituitary tumor (control) patients were cultured in Dulbecco's modified Eagle media (DMEM; Invitrogen)/Hams F12 airway media to encourage epithelial cell proliferation. Epithelial cells separated by immunomagnetic beads were seeded in tissue culture-treated Y-shaped microslides. At confluence the primary cultures were inoculated with A. fumigatus spores. Fungus was allowed to germinate and form biofilms under two in vitro conditions: (1) static (no flow through of media) and (2) continuous flow coculture (continuous flow movement of media). At regular intervals cocultures were stained with FUN-1, concanavalin A–alexa fluor 488, and examined by confocal scanning laser microscopy. Comstat software was used to assess biomass and thickness. Results A. fumigatus formed three-dimensional biofilm structures with parallel-packed, cross-linked hyphae and channels/passages. Metabolically active hyphae showed orange–red fluorescing intravacuolar structures. Extracellular matrix (ECM) between/around the hyphae fluoresced intense green. A. fumigatus biofilms development occurred in five stages: (1) conidial attachment to epithelial cells, (2) hyphal proliferation, (3) ECM production, (4) hyphal parallel packing and cross-linking, and (5) channel/pores formation. Mature biofilms showed basal conidial, middle hyphal, and superficial ECM layers. Biofilms formed underflow conditions displayed more robust and faster growth kinetics when compared with that under static conditions, with a thick, stocky, wrinkly/undulating hyphal growth and extensive ECM production. The differences in biomass and average thickness of the cocultures under static and flow conditions were statistically significant after similar periods of incubation (p = 0.0002; p < 0.0001, respectively. Conclusion To our knowledge, this is the first article of an in vitro model characterizing A. fumigatus biofilm formation using primary human sinonasal epithelium under different growth conditions.
The Effect of Passive Smoking on the Levels of Matrix Metalloproteinase 9 in Nasal Secretions of Children
Authors: De Sujata , Leong Samuel C. , Fenton John E. , Carter Stuart D. , Clarke Raymond W. , Jones Andrew S. 
Published: July 2011

Background Matrix metalloproteinase (MMP) 9 is a gelatinase associated with tissue remodeling. It is thought to play a part in the pathogenesis of allergy. Increased levels of MMP-9 have been shown to increase in the acute allergic response in the nose, lungs, and skin. Exposure to passive tobacco smoke is associated with an increase in sneezing, nasal blockage, and a decreased sense of smell. The aim of this study was to study the effect of passive smoking on the levels of MMP-9 in nasal secretions of children. Methods A prospective descriptive study was performed. Thirty-nine children aged between 7 and 16 years were enrolled in the study. They were selected based on attendance at the Otorhinolaryngology Outpatients Clinic with a primary complaint unrelated to the nose or paranasal sinuses. Children with allergic rhinitis, sinusitis, or a recent cold were excluded. The study was performed at a tertiary pediatric referral center. Exposure to passive smoking was determined by measuring the urinary cotinine to creatinine ratio. Nasal fluid was obtained by using a Rhino-Probe curette (Arlington Scientific, Inc., Springville, UT). The concentration of MMP-9 was determined by ELISA. MMP-9 activity was determined by gelatin zymography. Data were tabulated on Microsoft Excel (Microsoft Corp., Redmond, WA) and analyzed using SPSS (SPSS Inc., Chicago, IL). Results Using a cutoff urinary cotinine/creatinine ratio of 0.025 ng/mg, 15 children were found to be exposed to passive smoking. Both the MMP-9 concentration and the activity were significantly higher in nasal secretions of children exposed to passive smoking. There was a distinct difference between the two cohorts with regard to the level of enzyme activity per weight of protein. The lowest level of enzyme activity recorded in the “exposed” cohort was over twice that of the level in the “not exposed” cohort. Conclusion MMP-9 activity and concentration is higher in nasal secretions of children exposed to passive smoking. This suggests that passive smoking might alter the inflammatory response within the nasal mucosa in a similar way to allergy.
The Effect of Montelukast Sodium on Serum Arginase Levels in Patients with Seasonal Allergic Rhinitis
Authors: Yasar Husamettin , Kiran Bayram , Cagatay Tulin , Ozkul Haluk , Icten Sacit 
Published: July 2011

Background Nitric oxide (NO) imbalance appears to be important in the pathogenesis of allergic rhinitis. NO is synthesized from L-arginine by NO synthase (NOS). Competing with NOS for L-arginine is arginase, which catalyzes the hydrolysis of arginine to urea and ornithine. Therefore, increased serum arginase activity could potentially limit NO production catalyzed by inducible NOS, thus contributing to allergic rhinitis. This study was designed to investigate the effect of the cysteinyl leukotriene type 1 receptor antagonist, montelukast sodium on serum arginase levels in patients with seasonal allergic rhinitis. Methods Twenty-five patients with seasonal allergic rhinitis (SAR; treatment group) and 16 nonasthmatic patients without allergic rhinitis (control group) were included in the study. Serum arginase levels and the mean total nasal symptoms scores were measured before and after oral montelukast sodium (10 mg) was administered daily for 4 weeks to the treatment group. Results Serum arginase levels and the mean total nasal symptoms scores were significantly lower in the treatment group after montelukast sodium administration compared with the baseline levels (p = 0.001). Serum arginase levels were significantly lower in the treatment group compared with the control group (p = 0.01). There was no statistically significant difference between the serum arginase levels of the treatment group before treatment and the control group (p = 0.05). There was a weak correlation between the mean total nasal symptoms scores and serum arginase levels in the treatment group before montelukast sodium administration (rs = 0.40; p = 0.05. Conclusion Montelukast sodium may reduce serum arginase levels and total nasal symptoms scores of patients with SAR. Additional studies that compare the effectiveness of nasal corticosteroid and montelukast sodium on serum arginase levels should be conducted.
Human Lysozyme has Fungicidal Activity against Nasal Fungi
Authors: Woods Charmaine M. , Hooper David N. , Ooi Eng H. , Tan Lor-Wai , Carney A. Simon 
Published: July 2011

Background The cationic antimicrobial peptide lysozyme is the most prevalent innate immune protein in nasal secretions but there is a paucity of research regarding its role in paranasal sinus disease. Lysozyme is generally regarded as an antibacterial agent; however, some data suggest activity toward yeast. This study was designed to determine if lysozyme displays fungicidal activity toward fungi commonly identified in patients with chronic rhinosinusitis (CRS) or fungal sinusitis. Methods Using a colony-forming unit assay the fungicidal activity of lysozyme (0, 0.5, 5, and 50 micromolar; 0- to 7-hour treatment) was tested against strains of Aspergillus fumigatus, the yeast Candida albicans, and other fungi commonly identified in mucin of patients with CRS. Fungi cultured directly from the mucin of two CRS patients were also tested to determine if they were resistant to the fungicidal activity of lysozyme. Results The fungicidal effect of lysozyme was both concentration and time dependent. After 7-hour treatment lysozyme (5 micromolar) had >80% fungicidal activity against A. fumigatus, Penicillium sp., Acremonium sp., C. albicans, and Candida parapsilosis. The fungicidal activity of lysozyme toward Alternaria alternata could not be determined. Lysozyme was also fungicidal toward the clinical isolates A. fumigatus and Aspergillus terreus cultured from the mucin of CRS patients. Conclusion Lysozyme displays fungicidal activity toward many fungi commonly identified in patients with CRS, as well as clinical fungi isolates cultured from the mucin of CRS patients. Additional studies are required to determine the regulation of lysozyme in CRS.
Outcomes and Cost Comparison of Three Therapeutic Approaches to Allergic Rhinitis
Authors: Fairchild Carol J. , Durden Emily , Cao Zhun , Smale Patrick 
Published: July 2011

Background Allergic rhinitis (AR) is a global health problem because of its increasing impact on economics, society, and the individual's quality of life. This study compares the outcomes and cost of three intranasal therapeutic approaches to the treatment of AR. Methods This was a retrospective cohort study using propensity scores to achieve balanced cohorts. The study population included patients ≥16 years of age with at least one intranasal prescription claim, without concurrent nasal polyps or sinusitis. Health care use and costs, airway infections, pharmacy costs, and indicators of unsatisfactory treatment (i.e., treatment augmentation or switching) were evaluated in the 1-year follow-up period using a claims database. Results Data from 141,190 patients in intranasal antihistamines (INA) therapy, intranasal steroids (INS) therapy, and intranasal combination therapy (ICT) cohorts were analyzed. The INA cohort showed the lowest rate of change in treatment (switching or augmentation). Switching rates were lowest in the INS therapy cohort, whereas augmentation was lowest in the INA cohort. AR- and asthma-related medication costs were significantly lower in the INA cohort. No differences were observed in airway infections and overall health care costs. Concurrent chronic obstructive pulmonary disorder and asthma were the strongest predictors of health care cost and respiratory infection in the follow-up period. Conclusion A change in treatment was noted in ∼⅓ of the entire study population. None of the treatments had a remarkable effect on health care costs or the occurrence of airway infections. The INA treatment cohort had lower AR- and asthma-related medication costs.
Sphenoid Sinus Fungus Ball: Our Experience
Authors: Pagella Fabio , Pusateri Alessandro , Matti Elina , Giourgos Georgios , Cavanna Caterina , De Bernardi Francesca , Bignami Maurizio , Castelnuovo Paolo 
Published: July 2011

Background Fungal rhinosinusitis is a common disease of the paranasal sinuses. The fungus ball (FB) is defined as an extramucosal mycotic proliferation that fills one or more paranasal sinuses. Sphenoid sinus is an uncommon localization of this disease, as reported in the literature. This study describes our experience in the diagnosis and treatment of sphenoid sinus FB (SSFB), with a particular focus on the surgical approach to the sphenoid sinus. Methods We retrospectively analyzed the clinical records of patients affected by FB of the sphenoid sinus, who underwent endoscopic sinus surgery (ESS) in our institutions between 1995 and 2009. We described the surgical technique, the methods of mycological and histopathological evaluation, as well as the perioperative and postoperative management. Results From 1995 to 2009, 226 patients affected by sinonasal FB underwent ESS in our institutions. A sphenoid localization was found in 56 patients (24.78%; mean age, 62 years). Cephalea was the most common symptom, and 14.3% of patients complained of ocular symptoms. We performed a direct paraseptal sphenoidotomy in 31 patients (55.4%) and a transethmoidal sphenoidotomy in 25 patients (44.6%). Histology unveiled fungal hyphae with absent mucosal invasion in all cases. Cultural results revealed positivity for mycotic colonization in 26 cases (46.4%, most commonly Aspergillus fumigatus). Follow-up ranged from 12 to 181 months with a mean of 70.7 months. Conclusion The description of our experience in the diagnosis and treatment of SSFB underlines the importance of a precise diagnostic pathway in case of sphenoidal disease. Nowadays, in our opinion, the paraseptal direct sphenoidotomy represents the less invasive, fastest and most anatomically conservative approach to the sphenoid sinus in case of SSFB.
Comparison Study between MAST CLA and OPTIGEN
Authors: Kim Jin Kook , Yoon Yeo-Min , Jang Won-Jong , Choi Yeon-Joo , Hong Seok-Chan , Cho Jae Hoon 
Published: July 2011

Background The MAST-CLA system (Hitachi Chemical Diagnostics, Inc., Mountain View, CA) is an in vitro diagnostic test for the simultaneous determination of specific IgE to different allergens. Recently, a new generation of MAST-CLA was developed (OPTIGEN; Hitachi Chemical Diagnostics). The purpose of this study was to determine the performance of these two tests for the diagnosis of allergic rhinitis. Methods Suspicious allergic rhinitis patients were divided into four groups and their medical records were reviewed: group 1 patients were tested with the MAST-CLA and skin-prick tests (251 patients), group 2 patients were tested with the OPTIGEN and skin-prick tests (319 patients), group 3 patients were tested with the MAST-CLA and CAP (104 patients) tests, and group 4 patients were tested with the OPTIGEN and CAP tests (270 patients). The correlation between MAST-CLA and OPTIGEN to skin-prick and CAP tests was determined. Results The positivity percentage of MAST-CLA results was higher than with skin-prick and CAP tests, and the results for the OPTIGEN test were comparable with skin-prick test and CAP. This suggests that the MAST-CLA test might have a slightly higher rate of giving false positive results. The OPTIGEN test correlated better with the skin-prick test and CAP. Conclusion The OPTIGEN test performed better than the MAST-CLA test for diagnosing allergic rhinitis.
The Drainage System of the Paranasal Sinuses: A Review with Possible Implications for Balloon Catheter Dilation
Authors: Mann Wolf J. , Tóth Miklós , Gouveris Haralampos , Amedee Ronald G. 
Published: July 2011

Background Intersinus connections and accessory ostia of the maxillary sinus are well known to rhinologic surgeons but are less known for the remaining paranasal sinuses. Probing and dilatation of the natural ostia of diseased sinuses is being popularized currently by the clinical value of balloon catheter dilation (BCD). Although short-term high success rates with treatment of the dilated ostia/duct have been reported with this technique, the potential impact of fractures of adjacent bony septae on accessory sinus ostia, on mucosally lined surfaces, and on intersinus drainage pathways still has not been considered. The aim of this study was to review the literature on accessory sinus ostia, intersinus connections, and mucociliary drainage pathways for the entire sinus system that are relevant to BCD. Methods A literature review was performed. Results Accessory sinus ostia exist for each paranasal sinus. Many sinuses drain not only directly into the nasal cavity but also indirectly through adjacent sinuses. Of note, one major drainage pathway of the frontal sinus is over the ethmoid sinuses and via the ethmoids into the maxillary sinus and subsequently into the nose. Drainage of the sphenoid sinus exists both through posterior ethmoidal cells and directly into the nasopharynx. Conclusion Accessory ostia are not only common for the maxillary sinus but also for the entire paranasal sinus system. BCD may potentially inadvertently impair mucociliary clearance of the sinuses through effects on secondary drainage pathways.
Outcomes after Endonasal Septoplasty Using Caudal Septal Batten Grafting
Authors: Kim Ji Heui , Kim Do-Youn , Jang Yong Ju 
Published: July 2011

Background This study evaluated surgical outcomes after endonasal septoplasty using caudal septal batten grafting for caudal septal deviation. Methods Fifty-six patients completed questionnaires to assess nasal obstruction by telephone interviews 8–63 months postoperatively (12.2 months on the average). In addition, patients assessed the severity of nasal symptoms (i.e., mouth breathing, mouth dryness, hyposmia, rhinorrhea, epistaxis, trouble sleeping, snoring, and being concerned about nasal problems) preoperatively and postoperatively using a visual analog scale (VAS). These VAS scores were compared with those of patients who underwent endonasal septoplasty using the cutting and suture technique. Complications were analyzed. Results Thirty-four (60.7%) patients reported their nasal obstruction was much improved, 17 (30.3%) reported their condition was improved, and 5 (8.9%) reported no change postoperatively. Patients reported a decrease in severity of all nasal symptoms (p < 0.05 for each). Their nasal obstruction improvement was not significantly different from that of patients managed by the cutting and suture technique. Complications after surgery included hyposmia in two cases, small septal perforation in one case, chondritis in one case, and septal abscess in one case, and all were managed successfully. No patient required revision septoplasty due to recurrence during the follow-up period. Conclusion Endonasal septoplasty using caudal septal batten grafting for caudal septal deviation resulted in improvement in nasal obstruction and nasal symptoms and was associated with an acceptable complication rate.
Outcomes Research in Rhinoplasty: Body Image and Quality of Life
Authors: Cingi Cemal , Songu Murat , Bal Cengiz 
Published: July 2011

Background Although hundreds of quality-of-life (QOL) studies are available in the literature, very few were designed that include both a global and a procedure-specific evaluation of QOL and an inventory for the assessment of body image. The purpose of this study was to use condition-specific and global measures as well as psychological evaluations in a case series of rhinoplasties for a more comprehensive assessment of patient-reported outcomes. Methods Records of 225 patients aged 18–57 years who underwent rhinoplasty were prospectively included in the study. Study participants completed both a baseline questionnaire before the rhinoplasty operation and a postsurgical patient questionnaire 12 months after the operation, including the European QOL Questionnaire (EQ), Rhinoplasty Outcomes Evaluation Questionnaire (ROE), and the Multidimensional Body–Self Relations Questionnaire (MBSRQ). Results Mean values corresponding to the EQ VAS results except for discomfort and anxiety domains increased after treatment compared with baseline. Both male and female patients experienced significant improvement in ROE scores, with larger differences between pre- and postoperative ROE scores in male patients compared with female patients. The analyses of variance in the MBSRQ results revealed significant postsurgical improvements on the appearance orientation subscale. Conclusion The development, standardization, and use of validated procedure-specific QOL tools are essential components for accurately measuring patient-reported outcomes of facial plastic surgery procedures. To measure patient satisfaction in a more objective and standardized manner, specific questionnaires or instruments should be used that can determine the QOL changes associated with each procedure of interest.
Cutaneous Manifestations in Chronic Renal Failure Patients
Authors: Shakya NB , Rajbhandari SL , Sharma A , Deo RK , Jha SM 
Published: July 2011

Introduction: Chronic renal failure is a pathophysiologic process with multiple etiologies, resulting in the inexorable attrition of nephron number and function, and frequently leading to end stage renal disease. There are various cutaneous changes in chronic renal failure. Objectives: To observe the cutaneous manifestations in chronic renal falure and find out any difference in occurrence of cutaneous manifestation with modality of treatment of CRF. Methods: The study was conducted in 50 (fifty) adult patients with chronic renal failure and another 50 (fifty) patients with similar age admitted with other renal diseases but not suffering from chronic renal failure as control to facilitate comparison were considered in the Department of Dermatology and Venereology and the Department of Medicine, Shree Birendra Hospital, Chhauni from September 2008 to June 2010. Results: A significant occurrence of pruritus, xerosis and pallor in CRF patients: the highest being pruritus followed by xerosis and pallor. Occurrence of pruritus was found to be more in HD patients (68%) than in IPD patients (38%). No correlation was found between ages, sex, and duration of dialysis with complaint of pruritus. Skin xerosis is considered an important factor contributing or initiating pruritus. Conclusion: Pruritus is the commonest cutaneous manifestation of chronic renal failure. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5020 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 13-16
Garrett Hardin, The Tragedy of the Commons and the Firth of Forth
Authors: Smout T.C. 
Published: July 2011

Abstract
Garrett Hardin's theory of the 'tragedy of the commons' is applied to the marine environment of the Firth of Forth, Scotland, where many biological resources were much more plentiful before 1800 than they are today. His ideas are tested against the history of herring fishing, oyster dredging and pollution in the area. In two cases, irreversible resource depletion is found and associated both with failure of self-regulation and external control, and notably with accelerated demand from outside; in the third case, river pollution, degradation occurs but is reversed. The reasons for this are discussed.
The Rise of Blame and Recreancy in the United Kingdom: A Cultural, Political and Scientific Autopsy of the North Sea Flood of 1953
Authors: Hall Alexander 
Published: July 2011

Abstract
The North Sea Flood of January 1953 was the largest natural disaster in UK twentieth-century history, accounting directly for 307 deaths on land alone. The event highlighted huge inadequacies in sea defences and disaster policy within the UK and the resultant Waverley Report formed the basis of modern UK disaster policy. Despite the lack of central government involvement in rescue efforts and the apparent non-existence of co-ordinated rescue plans, little blame or accountability was assigned. Due to the relative infancy of the mass media and the post-war time frame the disaster is often overlooked by modern commentators from both academia and wider society. Through analysis of personal accounts, regional and national press and parliamentary papers it is shown how the devastation on the East coast in January 1953 acted as a trigger event for subsequent large scale policy and social change. By comparing the events of 1953 with subsequent UK flood events it is shown how public expectations of disaster response in the UK have grown.
Modernising the Urban Environment: The Musi River Flood of 1908 in Hyderabad, India
Authors: Cohen Benjamin 
Published: July 2011

Abstract
This article explores the Musi River flood in the city of Hyderabad in 1908. I argue that the flood served as a watershed moment for the native rulers of Hyderabad State (a princely state embedded within the British Raj) to rebuild Hyderabad city, and the river, along modern, Western lines.