bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of L-Ascorbate on Chloride Transport in Freshly Excised Sinonasal Epithelia
Authors: Cho Do-Yeon , Hwang Peter H. , Illek Beate 
Published: February 2010

Background Chronic rhinosinusitis (CRS) occurs at high frequency in patients with cystic fibrosis, suggesting that the cystic fibrosis transmembrane conductance regulator (CFTR) chloride (Cl) ion channel might be involved in the development of chronic sinusitis in the general population. CFTR Cl ion transport controls the hydration of mucosal surfaces and promotes effective mucociliary clearance. Altered ion transport and, hence, disrupted mucociliary function, could play a role in the pathogenesis of sinus disease. L-Ascorbate is a metabolically active component of the nasal and tracheobronchial airway lining fluids and appears to serve as an important biological effector of CFTR-mediated chloride secretion. The purpose of this study was to determine the effects of L-ascorbate on Cl ion transport in freshly excised sinonasal epithelia from normal controls and patients with CRS. Methods Four different types of sinonasal tissue (normal sinus mucosa, sinus mucosa from CRS, normal nasal mucosa, nasal mucosa from CRS) were obtained during endoscopic sinus surgery and mounted on sliders with open areas of 0.03–0.71 cm2 between Ussing hemichambers. Short-circuit current (Isc) was continuously recorded, and a serosa-to-mucosa-directed Cl gradient was applied to increase the electrochemical driving force. Results L-Ascorbate (500 μM) stimulated Cl currents (DeltaICl, μA/cm2) across sinonasal epithelia from normal and CRS patients. The Cl secretory response to L-ascorbate was effectively blocked by the Cl ion transport inhibitors glibenclamide and bumetanide. A maximal dose of L-ascorbate (at 1 mM) stimulated 53–70% of Cl currents elicited by the cAMP agonist forskolin. CRS sinonasal tissue was characterized by impaired Cl secretory responses to L-ascorbate that were reduced by 33% in sinus epithelial tissue and by 70% in nasal epithelial tissue when compared with normal subjects. In nasal epithelial tissue from normal subjects, Cl secretion was approximately twofold increased when compared with sinus epithelial tissue. In contrast, nasal versus sinus epithelial tissue from CRS patients showed no differences. Conclusion Topical administration of L-ascorbate to freshly excised sinus and nasal mucosa enhances chloride secretion. Given that decreased CFTR-mediated Cl secretion may contribute to the development of CRS, L-ascorbate may offer potential as a therapeutic agent for the improvement of mucociliary clearance.
Expression of Glutaredoxin-1 in Nasal Polyps and Airway Epithelial Cells
Authors: Woo Hyun-Jae , Bae Chang Hoon , Song Si-Youn , Kim Yong-Woon , Lee Heung-Man , Kim Yong-Dae 
Published: February 2010

Background Glutaredoxins (GRX)-1 is glutathione-dependent oxidoreductase. However, the role of these enzymes remains unknown in airway inflammatory diseases. Therefore, we aimed to establish the expression pattern of GRX-1 in the nasal polyps (NPs) and to assess the regulatory mechanisms associated with GRX-1 expression in interleukin (IL)-1beta-treated airway epithelial cells. Methods The expression of GRX-1 in NPs and normal nasal mucosa were analyzed by reverse-transcription polymerase chain reaction and immunohistochemical staining. IL-1beta–induced reactive oxygen species (ROS) formation and GRX-1 expression in the airway epithelial cells was determined by flow cytometry and immunoassay. Results The expression level of GRX-1 in NPs was significantly higher than in the normal nasal mucosa (p < 0.05). GRX-1 was highly expressed in the surface epithelial cells and the submucosal glandular cells in the NPs. IL-1beta increased the intracellular ROS formation and GRX-1 expression in airway epithelial cells. The inhibition of IL-1beta–induced ROS production by N-acetyl-cystein, an ROS scavenger, reduced GRX-1 expression. Diphenyleneiodonium and apocynin, NADPH oxidase inhibitors, did not abolish IL-1beta–induced ROS ormation and GRX-1 expression, whereas budesonide attenuated it. Conclusion High GRX-1 expression in NPs might be a primary de ense against chronic in lammatory oxidative stress in nasal mucosa. IL-1beta–induced up-regulation o GRX-1 in airway epithelial cells is probably mediated by ROS. Glucocorticoids can regulate IL-1beta–induced ROS ormation and GRX-1 expression.
Biofilms in Chronic Rhinosinusitis: A Review
Authors: Cohen Michael , Kofonow Jennifer , Nayak Jayakar V. , Palmer James N. , Chiu Alexander G. , Leid Jeff G. , Cohen Noam A. 
Published: February 2010

Background Bacterial biofilms consist of a complex, organized community of bacteria that anchor to both biotic and abiotic surfaces. They are composed of layers of embedded, live bacteria within extruded exopolymeric matrix. This configuration allows for evasion of host defenses and decreased susceptibility to antibiotic therapy while maintaining the ability to deliberately release planktonic bacteria, resulting in recurrent acute infections. Thus, bacterial biofilms were hypothesized to contribute to the progression and persistence of chronic rhinosinusitis. Methods This review summarizes several of the seminal papers supporting this hypothesis. Results Multiple reports using various imaging modalities have demonstrated the presence of biofilms in sinonasal mucosa of patients with chronic rhinosinusitis. More recently, several studies have correlated the presence of biofilms with poor clinical outcomes in the disease process. Early therapeutic interventions have generated mixed results. Conclusions Bacterial biofilms appear to contribute to the progression of chronic rhinosinusitis in a subset of patients, although substantial effort toward therapeutic intervention is still necessary.
When Allergic Rhinitis is not Only Allergic
Authors: Gelardi Matteo , Russo Cosimo , Fiorella Maria Luisa , Fiorella Raffaele , Canonica Giorgio Walter , Passalacqua Giovanni 
Published: February 2010

Background In clinical practice it can be observed that some patients with seasonal allergic rhinitis (AR) continue to have symptoms even when the exposure to allergens is expected to be low or absent. We studied the clinical and cytological characteristics of these atypical forms of (AR) in a large population of patients. Methods Consecutive patients with symptoms of rhinitis and with positive skin test to pollens only were interviewed for the duration of symptoms, correlation with sensitization pattern, and presence of reactivity to nonspecific stimuli. All underwent rhinoscopy and nasal scraping for cytology. Results Five hundred nineteen patients with AR were studied. Of these 519 patients 60 (11.5%) had an atypical or mixed form of rhinitis, with symptoms independent of the exposure and also elicited by nonspecific stimuli. These patients clearly differed from typical forms, especially for the nasal inflammation. They had a greater number of eosinophils and mast cells out of season (p < 0.05). Moreover, these atypical forms had, more frequently, asthma and eosinophilic polyps. Conclusion In ∼12% of patients with AR, other mechanisms of inflammation seem to intervene. Nasal cytology can be helpful in discriminating these atypical forms.
Allergic Rhinitis and Aspirin-Exacerbated Respiratory Disease as Predictors of the Olfactory Outcome after Endoscopic Sinus Surgery
Authors: Katotomichelakis Michael , Riga Maria , Davris Spyridon , Tripsianis Gregorios , Simopoulou Maria , Nikolettos Nikolaos , Simopoulos Konstantinos , Danielides Vasilios 
Published: February 2010

Background Unlike the functional outcomes of endoscopic sinus surgery, which have been thoroughly studied, the effect of the surgery on olfactory performance and the relative predictive factors have not been adequately assessed by literature. Allergic rhinitis and aspirin-exacerbated respiratory disease (AERD) are examined as potential confounding factors of the olfactory outcome in patients with extensive nasal polyposis and rhinosinusitis treated with functional endoscopic sinus surgery (FESS). Methods A population of 116 adults with severe nasal polyposis was subjected to FESS after failure of the appropriate medical treatment. The olfactory outcome was quantified by Sniffin’ Sticks at the 1st, 3rd, and 6th postoperative month in relation to the concomitant presence of allergic rhinitis (n = 62) or AERD (n = 18). Results Allergic patients seemed to perform worse than nonallergic patients at all time frames. However, when patients with similar olfactory acuity, age, and medical history are compared, allergic rhinitis does not seem to affect the postoperative improvement of the composite threshold-discrimination-identification scores. The same seems to apply for the likelihood of acquiring normosmia after surgery. On the contrary, AERD significantly limits the recovery of olfactory function at all follow-up examinations and patients with AERD are unlikely to become normosmic. Conclusion The olfactory recovery after FESS for nasal polyposis is significantly affected by the concomitant presence of AERD. Although allergy seems to have a general negative effect on olfactory acuity, it was not found to affect the extent of the olfactory improvement, when patients with comparable preoperative characteristics are addressed.
Wound Healing in the Rabbit Paranasal Sinuses after Coblation: Evaluation for use in Endoscopic Sinus Surgery
Authors: Rosenthal Laura H. Swibel , Benninger Michael S. , Stone Chad H. , Zacharek Mark A. 
Published: February 2010

Background Bipolar radiofrequency can be used surgically to excise and cauterize tissue simultaneously. It has potential for use in endoscopic sinus surgery (ESS). This study was performed to determine the extent and pattern of injury in the paranasal sinuses with bipolar radiofrequency and evaluate wound healing. Methods Eight rabbits underwent Coblation of maxillary sinus mucosa with biopsy immediately, on postoperative day (POD) 3, 7, 14, or 29. Maxillary mucosa was exposed through the nasal dorsum, and a Coblator PROciseXP wand used on a power setting of 7 for 2 seconds. Three of the rabbits also had Coblation of ethmoid mucosa over the lamina papyracea, after extending the maxillary ostomy, with biopsy immediately. Results Coblation resulted in immediate loss of surface respiratory epithelium and thermal-type injury to the underlying seromucinous glands. On POD 3, the site showed reepithelialization with squamous metaplastic epithelium. The seromucinous glands underwent coagulative necrosis. At POD 7, there was partial replacement of overlying epithelium by respiratory epithelium. The underlying seromucinous glands were lost and replaced by fibroblastic proliferation, with less fibrosis than the mechanically created ostomy site. The underlying bone had reactive, regenerative changes. On PODs 14 and 29, there was further regeneration of respiratory epithelium. Fibrosis was mild. Coblation resulted in gross violation of the bony wall in one maxillary sinus. There were no histological changes in the orbit. Conclusion Rabbit paranasal sinus mucosa heals appropriately after Coblation injury.
Effects of a Dexamethasone-Releasing Stent on Osteoneogenesis in a Rabbit Model
Authors: Beule Achim G. , Steinmeier Elke , Kaftan Holger , Biebler Karl-Ernst , Gopferich Achim , Wolf Eduard , Hosemann Werner 
Published: February 2010

Background This study is an evaluation of wound healing in an animal model for surgery of frontal sinusitis and treatment effect of topically released dexamethasone using a drug-releasing stent with special emphasis of osteoneogenesis. Methods A prospective, controlled, randomized, double-blinded animal study was performed. Nineteen New Zealand white rabbits were subjected to surgery via an external approach, a 4-mm circular wound was created on the medial side of the maxillary sinus and the underlying bone was denuded of periosteum. The wound was covered in a randomized fashion with either a silicone foil or a new dexamethasone-releasing stent system. Twelve to 30 days later, the animals were killed and a histological examination was performed. Results In comparison with the baseline bony thickness (40 micrometer) obtained in one animal, osteoneogenesis occurred on both paranasal sides but was significantly less if a dexamethasone-releasing stent was applied (117 [95% CI, 116–128]; 52 [95% CI, 43–64]; p < 0.001). Maximal bony thickness was observed in both treatment groups between days 20 and 25 with a tendency toward a higher percentage decrease in the dexamethasone-treated sides (p < 0.08). Using a visual analog scale (0–5) a significantly smoother bony surface was observed for dexamethasone (2 [95% CI, 1.1–1.9]; 2 [95% CI, 1.8–2.2]; p < 0.01). Conclusion Using a new drug-releasing stent system, dexamethasone efficiently decreases postoperative osteoneogenesis in a standardized animal wound model for endoscopic sinus surgery. Therefore, the use of this system may be of value to decrease restenosis rates using corticosteroids in selected patients after frontal sinus surgery, especially the endoscopic modified Lothrop procedure.
Effects of Intranasal Steroid Spray in Bacterial Culture of Chronic Rhinosinusitis
Authors: Ho Ching-Yin , Chan Kee-Tak 
Published: February 2010

Background We attempted to determine whether use of a topical intranasal corticosteroid (INCS) preoperatively had an effect on bacterial culture and antibiotic sensitivity in chronic rhinosinusitis with nasal polyposis. Methods In a prospective study, patients that were diagnosed with rhinosinusitis with nasal polyposis received INCS for one month before functional endoscopic sinus surgery. Bacterial culture testing, obtained under telescope from a source near the middle meatus, was performed before and after INCS. Antibiotic sensitivity was also performed. Results One hundred fifty-six patients were enrolled in the prospective study, and 115 patients completed the procedures. The male-to-female ratio was 83:32 and the age range was 14∼76 years (46.7 ± 2.1). The positive culture rates were 80.9% and 79.1% pre-INCS treatment and post-INCS treatment, respectively. There was no significant difference between pretreatment and posttreatment samples in bacterial culture rate. The single bacterial culture rates were 66.7% and 65.9% pre-INCS treatment and post-INCS treatment, respectively. The drug sensitivities to oxacillin and cephaxolin showed no significant difference in coagulase negative Staphylococcus and Staphylococcus aureus. Conclusion INCS did not influence the rate of bacterial culture or antibiotic sensitivity in patients with chronic rhinosinusitis with nasal polyps.
Transseptal Approach for Extended Endoscopic Resections of the Maxilla and Infratemporal Fossa
Authors: Harvey Richard J. , Sheehan Patrick O. , Debnath Nick I. , Schlosser Rodney J. 
Published: February 2010

Background Larger and more extensive lesions of the maxilla and infratemporal fossa are being successfully managed by entirely endoscopic approaches. There are still limitations in access, especially the anterolateral maxilla. The suitability of various surgical approaches was assessed in relation to surgical access achieved. Methods Surgical access was compared in 10 cadaver heads. Five zones were defined: zone 1, nasal cavity; zone 2, medial to infraorbital nerve (ION); zone 3, lateral to ION; zone 4, anterior maxilla; and zone 5, premaxillary tissue. Endoscopic maxillary surgery consisted of standard antrostomy, modified medial maxillectomy, or complete medial maxillectomy with lacrimal duct resection. Transseptal and ipsilateral approaches were compared in each surgical state. The degree of angulations and resection zone accessed were recorded from image-guided surgery. The limits of both straight and curved instrumentation were also compared. Results Transseptal access improved surgical access by 14.7 ± 2.5° when compared with ipsilateral approaches (p < 0.001) across all situations. The access to zone 3 across all specimens was significantly improved by 63.3–97.6% (χ2 = 20.83; p < 0.001) after all three surgical states. After complete medial maxillectomy, access to zone 4 increased from 25.0 to 85.0% (χ2 = 14.54; p < 0.001) with a transseptal approach. Conclusion Extended endoscopic maxillary surgery combined with a transseptal option enables additional access to previously considered challenging locations. Preoperative assessment of skull base tumor, papilloma and angiofibroma extent, and resection margin will dictate surgical approach.
Integration of Patient-Specific Paranasal Sinus Computed Tomographic Data into a Virtual Surgical Environment
Authors: Parikh Sachin S. , Chan Sonny , Agrawal Sumit K. , Hwang Peter H. , Salisbury Curt M. , Rafii Benjamin Y. , Varma Gaurav , Salisbury Kenneth J. , Blevins Nikolas H. 
Published: February 2010

Background The advent of both high-resolution computed tomographic (CT) imaging and minimally invasive endoscopic techniques has led to revolutionary advances in sinus surgery. However, the rhinologist is left to make the conceptual jump between static cross-sectional images and the anatomy encountered intraoperatively. A three-dimensional (3D) visuo-haptic representation of the patient's anatomy may allow for enhanced preoperative planning and rehearsal, with the goal of improving outcomes, decreasing complications, and enhancing technical skills. Methods We developed a novel method of automatically constructing 3D visuo-haptic models of patients’ anatomy from preoperative CT scans for placement in a virtual surgical environment (VSE). State-of-the-art techniques were used to create a high-fidelity representation of salient bone and soft tissue anatomy and to enable manipulation of the virtual patient in a surgically meaningful manner. A modified haptic interface device drives a virtual endoscope that mimics the surgical configuration. Results The creation and manipulation of sinus anatomy from CT data appeared to provide a relevant means of exploring patient-specific anatomy. Unlike more traditional methods of interacting with multiplanar imaging data, our VSE provides the potential for a more intuitive experience that can replicate the views and access expected at surgery. The inclusion of tactile (haptic) feedback provides an additional dimension of realism. Conclusion The incorporation of patient-specific clinical CT data into a virtual surgical environment holds the potential to offer the surgeon a novel means to prepare for rhinologic procedures and offer training to residents. An automated pathway for segmentation, reconstruction, and an intuitive interface for manipulation may enable rehearsal of planned procedures.
Central Nervous System Infection in Patients with Postirradiated Nasopharyngeal Carcinoma: A Case-Controlled Study
Authors: Liang Kai-Li , Jiang Rong-San , Lin Jin-Ching , Chiu Yu-Jung , Shiao Jiun-Yih , Su Mao-Chang , Hsin Chung-Han 
Published: February 2010

Background It has been assumed that postirradiated nasopharyngeal carcinoma (NPC) patients are prone to central nervous system (CNS) infection. Objective The purpose of this study was to better understand this clinical entity. Methods From September 1989 to May 2006, we conducted a retrospective study of 18 postirradiated NPC patients with CNS infection including brain abscess, cavernous sinus thrombosis, epidural abscess, and meningitis in our institute. During the same period, 18 NPC patients without CNS infection who were matched for tumor stage, age, and gender with the study group were randomly selected from the cancer registry at our hospital and enrolled as the control group. All medical records of these patients were evaluated. Results The local tumor relapse rate, nasopharyngeal radiotherapy dose, and skull base osteoradionecrosis were all significantly higher in patients with CNS infection (p = 0.003, 0.011, and 0.001, respectively). Although the incidences of otitis media and chronic rhinosinusitis were higher in patients with CNS infection, there were no significant differences between the two groups (p = 0.469 and 0.568, respectively). The in-hospital mortality was 61.1%, and the overall mortality of CNS infection was 83.3%. There was a significant difference in overall survival rate between the two groups (p = 0.001). Conclusions Postirradiated NPC patients with skull base osteoradionecrosis are prone to have CNS infection. CNS infection is an adverse prognostic factor in postirradiated NPC patients.
The Proportion of Self-Rated Olfactory Dysfunction does not Change across the Life Span
Authors: Shu Chih-Hung , Hummel Thomas , Lee Po-Lei , Chiu Cheng-Hung , Lin Shih-Hsiang , Yuan Ben-Chih 
Published: February 2010

Background Previous reports indicated that self-reports of olfactory function are unreliable. The occurrence of measured olfactory dysfunction is ∼20% in the general population and consistently higher than that of self-reported olfactory dysfunction. To further understand the frequencies of self-rated olfactory function in different age groups and its relation with measured olfactory function, a prospective investigation of self-rated and measured olfactory function was performed. Methods One thousand five subjects were enrolled from the health care center, where subjects underwent a physical checkup for possible preclinical diseases. The subjects completed a questionnaire about demographic data and medical and surgical histories and self-rated their olfactory function. Then, they received a modified “Sniffin’ Sticks” odor identification test. Results The self-rated olfaction function did not correlate significantly with measured olfactory function. The frequencies of self-rated olfactory dysfunction (9–14%) were similar among various age groups. However, the frequencies of measured olfactory dysfunction in the three age groups, i.e., 18 to 35, 36 to 55, and >55 years, were 3.7%, 17.4%, and 35.6%, respectively. Conclusions Self-ratings of olfactory function were unreliable at all ages. The frequencies of self-rated olfactory function in various age groups did not differ significantly, in contrast to the decrease of measured olfactory function with age.
A Comparative Study of Brain Perfusion Single-Photon Emission Computed Tomography and Magnetic Resonance Imaging in Patients with Post-traumatic Anosmia
Authors: Atighechi Saeid , Salari Hadi , Baradarantar Mohammad Hossein , Jafari Rozita , Karimi Ghasem , Mirjali Mehdi 
Published: February 2010

Background Loss of smell is a problem that can occur in up to 30% of patients with head trauma. The olfactory function investigation methods so far in use have mostly relied on subjective responses given by patients. Recently, some studies have used magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) to evaluate patients with post-traumatic anosmia. The present study seeks to detect post-traumatic anosmia and the areas in the brain that are related to olfactory impairment by using SPECT and MRI as imaging techniques. Methods The study was conducted on 21 patients suffering from head injury and consequently anosmia as defined by an olfactory identification test. Two control groups (traumatic normosmic and nontraumatic healthy individuals) were selected. Brain MRI, qualitative and semiquantitative SPECT with 99mtc-ethyl-cysteinate-dimer were taken from all the patients. Then the brain SPECT and MRI were compared with each other. Results Semi-quantitative assessment of the brain perfusion SPECT revealed frontal, left parietal, and left temporal hypoperfusion as compared with the two control groups. Eighty-five percent of the anosmic patients had abnormal brain MRI. Regarding the MRI, the main abnormality proved to be in the anterior inferior region of the frontal lobes and olfactory bulbs. Conclusions The findings of this study suggest that damage to the frontal lobes and olfactory bulbs as shown in the brain MRI and hypoperfusion in the frontal, left parietal, and left temporal lobes in the semiquantitative SPECT corresponds to post-traumatic anosmia. Further neurophysiological and imaging studies are definitely needed to set the idea completely.