bluuebunny/crossref_metadata_2025_split huggingface dataset:
The plodding diagnosis of monogenic autoinflammatory diseases in childhood: from the clinical scenery to laboratory investigation
Authors: Rigante Donato , Capoluongo Ettore 
Published: January 2011

Abstract
Autoinflammatory diseases (AID) are inherited errors of innate immunity which, although individually uncommon, collectively set up an emerging chapter of medicine. Careful analysis and identification of AID is essential to prompt effective treatment and improve survival and quality of life in these patients. Research into pediatric AID is lagging behind studies in adults, though a better understanding of AID in infancy could lead to improved diagnostic protocols and reduce long-term disability. This review provides a detailed summary of monogenic AID in childhood to help pediatricians correctly recognize these conditions and also highlight recent developments in the laboratory diagnostic work-up.
The Expression of Fibrinolytic Components in Chronic Paranasal Sinus Disease
Authors: Sejima Takayuki , Holtappels Gabriele , Bachert Claus 
Published: January 2011

Background Fibrinolytic components, their receptors, and inhibitors are considered to play an important role in inflammation and tissue remodeling including chronic rhinosinusitis (CRS). To clarify the relationship between these components and the pathology of CRS, we analyzed fibrinolytic components in sinonasal mucosa of CRS. Methods Sinonasal mucosa samples from 12 patients with CRS without nasal polyp (CRSsNP), 14 patients with CRS with nasal polyp (CRSwNP), and 12 control patients were prepared. By immunohistochemistry and ELISA, samples were studied with respect to urokinase-type plasminogen activator (uPA), uPA receptor (uPAR), plasminogen activator inhibitor-1 (PAI-1) and key mediators in sinus disease, TGF-beta1 and eosinophil cationic protein (ECP). Results uPA- or uPAR-positive inflammatory cells were increased in CRSwNP compared to controls and CRSsNP, whereas PAI-1-positive cells were increased in CRSsNP compared to CRSwNP and controls. ELISA measurements revealed that uPAR concentrations were increased in both CRSsNP (16.1 ng/mL; 10.4–22.9; p < 0.05) and CRSwNP (20.8 ng/mL; 9.62–25.9; p < 0.01) compared to controls (8.7 ng/mL; 7.9–12.9), and PAI-1 concentrations were increased in CRSsNP (198.8 ng/mL; 147.4–234.1) compared to controls (107.3 ng/mL; 92.6–175.3; p < 0.01) and CRSwNP (113.5 ng/mL; 105.1–193.5; p < 0.05). Moreover, the concentrations of TGF-beta1 correlated with PAI-1 in CRSsNP, and ECP correlated with uPAR protein in CRSwNP. Conclusion Fibrinolytic components were highly expressed in CRSwNP compared to normal controls, whereas the inhibiting protein was up-regulated in CRSsNP. Furthermore, correlations between the expressions of fibrinolytic components and key mediators in CRS were found.
A Novel Use of a Landmark to Avoid Injury of the Anterior Ethmoidal Artery during Endoscopic Sinus Surgery
Authors: Pernas Francisco G. , Coughlin Andrew M. , Hughes Sharon E. , Riascos Roy , Maeso Patricia A. 
Published: January 2011

Background The aim of this study was to describe and correlate radiographically the anterior ethmoidal artery (AEA) to useful endoscopic surgical landmarks, such as the nasal beak (NB), nasal crest (NC), and axilla of the middle turbinate, because these are commonly encountered during endoscopic sinus surgery and skull base surgery. Methods A retrospective review and software analysis was performed by three independent observers. Measurements of distance and angulation from the AEA to the NC, NB, and axilla of the middle turbinate were performed. A total of 138 unique computed tomography (CT) scans performed at a university tertiary care center were evaluated. Results The average age of the patients whose scans were analyzed was 50.5 (range, 17–90 years) years of age. The gender distribution was 61 male and 89 female patients. After comparing the measurements to the three landmarks noted, it was determined that the NB had the most interpatient concordance and the least interobserver variability. The average distance between the NB and the AEA as it penetrates the lamina papyracea is 2.34 cm (variance, 0.07) at an angle of 45.21° from the Frankfurt horizontal line. Conclusion The real advantage of this novel use of the NB as a landmark to identify the AEA is that it is easy to use, unobtrusive, and is not time-consuming. This relationship between the NB and the AEA is consistent across genders and ethnicities and is more valuable than others presented previously, which may be more variable.
A Theoretical Cause of Nasal Obstruction in Patients with Repaired Cleft Palate
Authors: Scott Andrew R. , Moldan Matthew M. , Tibesar Robert J. , Lander Timothy A. , Sidman James D. 
Published: January 2011

Background During cleft palate repair, mucoperiosteal flaps are elevated from the palatal shelves and the nasal septum to accomplish tension-free closure of the nasal floor. This study was designed to geometrically describe how palate repair inherently limits airflow by decreasing nasal cavity cross-sectional area and increasing nasal airflow resistance. In addition, this study investigates whether the width of the repaired cleft palate directly affects the degree of postoperative airflow resistance. Methods A simplified geometric model of normal nasal cavity anatomy was compared with an equivalent schematic representing an individual with an unrepaired palatal cleft. Mathematical equations approximating the cross-sectional areas of normal and cleft nasal cavities were created. The theoretical postoperative loss of nasal cavity cross-sectional area was then considered for both unilateral and bilateral palatal clefts. Results According to this geometric model, the cross-sectional area of the nasal cavity is decreased in patients who undergo cleft repair. Repaired bilateral clefts experience a greater area loss than their unilateral counterparts. Conclusion Nasal cavity resistance is higher in patients who have undergone cleft repair than in individuals who have not undergone cleft repair. because tension-free closure of the nasal floor inherently reduces cross-sectional breathing area. The wider the cleft, the higher the resistance to nasal airflow postoperatively. This iatrogenic source of nasal resistance is likely additive to other anatomic contributors to airflow resistance observed in individuals with cleft nasal deformities.
The Effect of a Low Concentration of Hypochlorous Acid on Rhinovirus Infection of Nasal Epithelial Cells
Authors: Yu Myeong Sang , Park Hyung Wook , Kwon Hyun Ja , Jang Yong Ju 
Published: January 2011

Background Low concentrations of hypochlorous acid (HOCl) have been shown to exhibit both antibacterial and anti-influenza virus activity, but HOCl still has not been used to kill human rhinovirus (HRV). To model the antiviral effect of nasal irrigation with low-level HOCl in patients with the common cold, we tested the effects of a low concentration of HOCl on HRV infection of primary human nasal epithelial cells (HNEC). Methods Cells were infected with HRV for 24 hours and treated with HOCl three times, for 5 minutes each time, at 12 hour intervals. The effects of HOCl on rhinovirus-induced secretion of IL-6 and IL-8 were assessed by ELISA and HRV replication was determined by viral titration. Results HOCl treatment significantly inhibited HRV-induced secretion of IL-6 and IL-8 and significantly reduced viral titer. The effects of HOCl peaked at 1 minute after HOCl generation and decreased thereafter. Conclusion These in vitro findings indicate that nasal irrigation with low-level HOCl solution may improve clinical symptoms in patients with the common cold.
Recombinant Marker Allergens in Diagnosis of Patients with Allergic Rhinoconjunctivitis to Tree and Grass Pollens
Authors: Canis Martin , Gröger Moritz , Becker Sven , Klemens Christine , Kramer Matthias F. 
Published: January 2011

Background The aim of this study was to investigate recombinant marker allergens in patients with allergic rhinoconjunctivitis to tree and grass pollens. Methods Sera of 260 tree pollen– and 282 grass pollen–allergic patients were analyzed. Bet v 1 and Phl p 1/p 5 were used as marker allergens for allergies to pollen from birch and grasses. Profilin (Bet v 2 and Phl p 12) and calcium-binding protein (Bet v 4 and Phl p 7) were used as markers for polysensitization. Results Two hundred thirty-nine (92%) patients tested positive for IgE anti–Bet v 1. All of them were positive for IgE antibodies against natural birch extract (t3), hazel (t4), and alder (t2). Bet v 1 in combination with t3 identified allergies from related trees with a sensitivity of 99.2%. Two hundred fifty-six patients (91%) tested positive for IgE anti–Phl p 1 and/or anti–Phl p 5. All of them were positive for IgE antibodies against natural timothy (g6) and rye (g12) extract. Phl p 1/p 5 and natural timothy extract identified allergies from grasses and rye with a sensitivity of 99.3%. All Patients reacting to the cross-reactive allergens Bet v 2, Phl p 12, Bet v 4, and Phl p 7 were polysensitized. Conclusion Bet v 1 in combination with natural birch pollen extract identifies allergies from related trees with a sensitivity of 99.2%. Phl p 1, Phl p 5, and natural timothy extract identifies allergies from grasses and rye in 99.3%. Reactivity to the allergens Bet v 2, Phl p 12, Bet v 4, and Phl p 7 identifies polysensitization and cross-reactivity.
Chitinolytic Activity in Nasal Polyps
Authors: Park Seong Kook , Heo Kyung Wook , Hur Dae Young , Yang Young Il 
Published: January 2011

Background Chitin is a recognition element for tissue infiltration by innate cells implicated in allergy and immunity. This process can be negatively regulated by vertebrate chitinases. Both acidic mammalian chitinase (AMCase) and chitotriosidase (ChT) have chitinolytic activity. This study aimed to determine the activities of AMCase and ChT in nasal polyps (NPs), as well as their in situ localization in NP tissue. Methods AMCase and ChT activities in NPs were compared with those in inferior turbinate tissue samples. Tissue samples were measured for AMCase and ChT activities at a range of pHs using the fluorogenic substrate 4-methylumbelliferyl-beta-D-N,N′,N″-triacetyl-chitotriose. Double immunofluorescent staining for the localization of both AMCase and ChT was performed using NP cryosections. Results Both AMCase and ChT displayed markedly increased chitinolytic activity in all NPs, compared with inferior turbinate tissues. Double immunofluorescent staining revealed that CD68 highlighted monocytes in the submucosa of NP and these cells disclosed coexpression of AMCase and ChT. CD31 detected capillary endothelial cells, but did not express any AMCase and ChT. Conclusion The increased chitinolytic activities of AMCase and ChT in NPs may be important in NP pathogenesis, suggesting that inhibition of chitinolytic activity may be a novel therapeutic strategy for the treatment of NPs.
Nonallergic Rhinitis and its Association with Smoking and Lower Airway Disease: A General Population Study
Authors: Håkansson Kåre , von Buchwald Christian , Thomsen Simon F. , Thyssen Jacob P. , Backer Vibeke , Linneberg Allan 
Published: January 2011

Background The cause of nonallergic rhinitis (NAR) and its relation to lower airway disease remains unclear. The purpose of this study was to perform a descriptive analysis of the occurrence of rhinitis in a Danish general population with focus on NAR and its association with smoking and lower airway disease. Methods A population-based, cross-sectional study conducted in Copenhagen, Denmark was performed. A random sample from the general population (n = 7931; age, 18–69 years) was invited to a general health examination including measurements of serum-specific immunoglobulin E (IgE) to common aeroallergens; 3471 (44%) persons were accepted. For further analysis, we divided the population into the following groups: (I) negative specific IgE and no rhinitis (controls); (II) negative specific IgE and rhinitis (NAR); (III) positive specific IgE and rhinitis (allergic rhinitis [AR]); and (IV) positive specific IgE but no rhinitis (sensitized). Results We found that NAR was associated with asthma (odds ratio [OR] = 2.51 [1.87–3.37]); chronic bronchitis (OR = 2.27 [1.85–2.79]); current smoking (>15 g/day; OR = 1.57 [1.18–2.08]); lower forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratios and reduced FEV1 values. The association with chronic bronchitis was stronger in NAR than in AR, whereas the opposite was true for asthma. FEV1/FVC of <70% was not significantly associated to any group. Conclusion This epidemiological study indicates that both asthma and chronic bronchitis are important comorbidities in NAR confirming the “united airway” hypothesis, and that smoking might be a significant modulator of disease. Although NAR was significantly associated with poor lung function, no significant association with chronic obstructive pulmonary disease was shown.
Hypoxia Induces Cysteine-rich 61, Vascular Endothelial Growth Factor, and Interleukin-8 Expressions in Human Nasal Polyp Fibroblasts: An Implication of Neutrophils in the Pathogenesis of Nasal Polyposis
Authors: Shun Chia-Tung , Lin Sze-Kwan , Hong Chi-Yuan , Huang Hung-Meng , Liu Chia-Ming 
Published: January 2011

Background The purpose of this article was to elucidate the roles of neutrophils and angiogenesis factors in the pathogenesis of nasal polyposis. The effect of hypoxia on the expressions of angiogenesis factors as cysteine-rich 61 (Cyr61) and vascular endothelial growth factor (VEGF) and neutrophil chemoattractant as interleukin (IL)-8 in nasal polyp fibroblasts (NPFs), and the role of nuclear factor kappa B (NF-kappaB) in this reaction were investigated. The action of Cyr61 on the synthesis of VEGF and IL-8 in NPFs was also examined. Methods Primary cultures of NPFs were established from nasal polyps (NPs). Productions of Cyr61, VEGF, and IL-8 by NPFs under hypoxia were detected by Western blot (Cyr61 and VEGF) or enzyme-linked immunosorbent assay (ELISA; IL-8). Immunohistochemical staining was used to examine the relation between fibroblastic expression of Cyr61 and neovascularization/neutrophil infiltration in NPs. Results Western blot showed that the hypoxia inducer CoCl2 stimulated Cyr61 synthesis in NPFs in a time-dependent manner, reaching a peak at 24 hours. Bay-117082 (a specific NF-kappaB inhibitor) attenuated the levels of Cyr61 stimulated by hypoxia. Cyr61 induced IL-8 secretion and VEGF synthesis by NPFs, as evidenced by Western blot and ELISA analysis. Bay-117082 abolished hypoxia-stimulated IL-8 and VEGF synthesis, whereas Cyr61 restored the stimulative effect of hypoxia readily. Immunohistochemical staining revealed the presence of Cyr61 and IL-8 in NPFs. Neutrophils and capillaries aggregating around these NPFs were frequently found. Conclusion Under hypoxia, NPFs contribute to NP propagation by expressing Cyr61, which subsequently stimulates VEGF and IL-8 production, leading to angiogenesis and activating neutrophil infiltration in NPs.
Critical Appraisal and Meta-Analysis of Nasal Surgery for Obstructive Sleep Apnea
Authors: Li Hsueh-Yu , Wang Pa-Chun , Chen Yu-Pin , Lee Li-Ang , Fang Tuan-Jen , Lin Hsin-Ching 
Published: January 2011

Background Nasal surgery is commonly involved in surgical treatment for obstructive sleep apnea (OSA). The aim of this study was to investigate the outcomes of nasal surgery for OSA using evidence-based methodology. Methods The MedLine database (1999∼2009) was searched for original articles published in peer-reviewed journals concerning nasal surgery for snoring/sleep apnea. Data extracted from these articles were reviewed and analyzed using meta-analysis technology. Results Thirteen articles were critically appraised. Two studies provided control groups and 11 articles (84.6%) consisted of prospective noncontrolled clinical trials (level II in evidence strength). The weighted mean apnea/hypopnea index measured by polysomnography in nine studies decreased from 35.2 ± 22.6 to 33.5 ± 23.8 event/hour after nasal surgery (overall, p = 0.69). The pooled success rate of nasal surgery in treating OSA was 16.7%. Epworth Sleepiness Scale scores in eight studies decreased from 10.6 ± 3.9 to 7.1 ± 3.7 (overall, p <0.001). Nasal surgery for snoring assessed by individual questionnaires and visual analog scale reported significant improvement (p < 0.05). Conclusion The critical literature appraisal and meta-analyses show that nasal surgery can effectively reduce daytime sleepiness and snoring. However, the efficacy of nasal surgery in treating OSA is limited.
Assessments of Nasal Bone Fracture Effects on Nasal Airflow: A Computational Fluid Dynamics Study
Authors: Chen Xiao Bing , Lee Heow Pueh , Chong Vincent Fook Hin , Wang De Yun 
Published: January 2011

Background The aim of this study was to evaluate effects of nasal bone fractures on nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. Methods A three-dimensional model of nasal cavity with a nasal bone fracture was constructed from computerized tomography (CT) scans of a patient with use of software Mimics 13.0 (The Materilize Group, Leuven, Belgium). CFD simulations were performed using Fluent 6.3 (ANSYS, Inc., Canonsburg, PA) with a turbulent flow model. Numerical results were presented with velocity, streamline, and pressure contour distributions in left and right nasal cavities and were compared with those of a healthy one. Possible outcomes on functional performances or patencies of the nose were also examined and discussed. Results For the nose with a nasal bone fracture, distributions of velocity contours showed there was more airflow in the right nasal cavity than in the left one, especially for inspiration status. In the left cavity, the airflow was redirected irregularly and there were also more circulations with larger sizes, higher pressure jumps, and greater wall shear stresses. Flow partitioning in the right and left cavities was noticeable with a larger nasal resistance compared with the healthy one. When the inspirational flow rate was increased, pressure jump from the nostril to the nasopharynx increased faster. Conclusion The aerodynamic flow was redistributed greatly for the nose with a nasal bone fracture compared with the healthy one, which might affect local normal nasal functions. Such physical assessments of nasal airflow based on a model from the patients’ CT scans may help clinicians determine the best treatment in advance.
Alterations of Vasoactive Intestinal Polypeptide Receptors in Allergic Rhinitis
Authors: Kim Dae-Hyung , Park Il-Ho , Cho Jung-Sun , Lee You-Mi , Choi Hyuk , Lee Heung-Man 
Published: January 2011

Background Vasoactive intestinal peptide (VIP) is one of the parasympathetic neurotransmitters involved in the regulation of airway mucus secretion. The biological functions of VIP are mediated through two receptors (vasoactive intestinal peptide receptor type 1 [VPAC1R] and type 2 [VPAC2R]). The purpose of this study was to determine the distribution of VIP receptors and to compare the level of VIP receptor expression in the nasal mucosa of patients with allergic rhinitis and normal controls. Methods Inferior turbinate mucosal samples were obtained from 20 normal subjects and 20 patients with allergic rhinitis. VPAC1R and VPAC2R mRNA was extracted from the nasal mucosa, and then a reverse-transcription—polymerase chain reaction was performed. Sections were immunostained using specific antibodies for VIP receptors. Western blot analysis was used to analyze differences in the level of expression of VPAC1R and VPAC2R protein between patients with allergic rhinitis and normal controls. Results The level of expression of VIP receptor mRNA and protein in patients with allergic rhinitis was significantly increased compared with normal nasal mucosa. VIP receptor immunoreactivity was detected on the nasal epithelium and submucosal glands in nasal specimens from both normal controls and patients with allergic rhinitis. In the epithelium from patients with allergic rhinitis, VIP receptor immunoreactivity was strong, whereas in the nasal epithelium from normal subjects it was faint. Conclusion These results suggest that an increased expression level of VIP receptors is one possible explanation for nasal hyperresponsiveness in patients with allergic rhinitis.
Early Bronchial Involvement in Children with Allergic Rhinitis
Authors: Ciprandi Giorgio , Capasso Michele , Tosca Maria Angela 
Published: January 2011

Background Allergic rhinitis (AR) may be frequently associated with asthma or precede it. Bronchial involvement in AR is usually detected by spirometry. Forced expiratory volume in 1 second (FEV1) is considered a reliable parameter for asthma diagnosis. However, forced expiratory flow at 25–75% (FEF25–75) could be considered a possible marker of early bronchial involvement in AR; indeed, it has been proposed that FEF25–75 values <70% of predicted may predict this evolution. The aim of this study was to evaluate a large cohort of children with AR to define an FEV1 value corresponding to impaired FEF25–75 values. Methods Eight hundred fifty AR children (555 boys; median age, 10 years) were studied. Spirometry and skin-prick test were performed in all of them. Descriptive statistic and multivariate analysis were considered. Results Three-hundred (35.3%) patients had FEF25–75 values <70% of predicted. Still, normal FEV1 values were associated with overt impaired FEF25–75 values and the cutoff value was 83%. Conclusion Spirometry should be adequately interpreted in AR patients; indeed, an FEV1 cutoff value of 83% detects with good efficiency AR children with early bronchial impairment.
Dolichandrone Platycalyx: New Entomophilous Pollen—A Report on Pollen Sensitization in Allergic Individuals
Authors: Mridula P.A. , Mahesh P.A. , Abraham Jacob N. , Amrutha D.H. , Agashe S.N. , Sitesh Roy , Vedanthan P.K. 
Published: January 2011

Background Dolichandrone platycalyx, commonly known as Nile trumpet tree, is believed to have originated in East Africa. However, this and the variants of this tree are found in Europe, Asia, and America (California and Florida). The tree mostly grows in tropical climates, but temperate species are also found. This study was designed to evaluate the allergenicity of D. platycalyx, one of the most common entomophilous avenue trees in Karnataka state, and to determine the pollen production of D. platycalyx. Methods All of the patients with allergic rhinitis and asthma attending a tertiary care center in South India during August 2007 to March 2008 underwent a detailed clinical evaluation and skin-prick testing to common allergens along with D. platycalyx. Control subjects without any symptoms of respiratory allergy also underwent skin testing. The pollen counts were determined for a mature unopened flower of D. platycalyx. Results A total of 317 subjects with respiratory allergy and 30 controls were included in the study. A significant percentage (16.1%) of patients evaluated were observed to be sensitive to Dolichandrone pollen extract by skin-prick testing, whereas none of the control subjects were found to be sensitized. D. platycalyx was the fourth most common sensitizer after Parthenium hysterophorus, Prosopis juliflora, and Artemesia vulgaris. D. platycalyx was found to be a moderate pollen producer at 66,000 pollens/flower. Conclusion Sensitization to D. platycalyx is common in subjects with respiratory allergies. The clinical relevance of this sensitization and other entomophilous plants needs additional study.