bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of Bacterial and Fungal Biofilms in Chronic Rhinosinusitis
Authors: Foreman Andrew , Psaltis Alkis James , Tan Lor Wai , Wormald Peter-John 
Published: February 2010

Background Conclusive evidence exists that biofilms are present on the mucosa of chronic rhinosinusitis (CRS) patients. Less is known about the species constituting these biofilms. This study developed a fluorescence in situ hybridization (FISH) protocol for characterization of bacterial and fungal biofilms in CRS. Methods Fifty CRS patients and 10 controls were recruited. Bacteria FISH probes for Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa and a universal probe for fungi were applied to sinus mucosal specimens and then analyzed using confocal scanning laser microscopy. Results Thirty-six of 50 CRS patients had biofilms present in contrast to 0/10 controls, suggesting a role for biofilms in the pathogenesis of this disease. S. aureus was the most common biofilm-forming organism. Eleven of 50 CRS patients had characteristic fungal biofilms present. Conclusion This is the largest study of biofilms in CRS. It has validated mucosal tissue cryopreservation for delayed biofilm analysis. Fungal biofilms have been identified and the importance of S. aureus biofilms in the polymicrobial etiology of CRS is highlighted.
Involving Stakeholders to Optimize a Study Protocol on Secondhand Tobacco Smoke and Chronic Rhinosinusitis in Adults
Authors: Irani Laili , Lin Sandra Y. , Clipp Sandra L. , Alberg Anthony J. , Navas-Acien Ana 
Published: February 2010

Background Epidemiological evidence evaluating the association between secondhand smoke exposure and diseases of the upper airway in adults is limited by a small number of studies and a lack of established protocols. This study was designed to optimize a research protocol on secondhand tobacco smoke exposure and chronic rhinosinusitis for a future population-based case-control study in Washington County, Maryland, using a participatory research model. Methods We conducted three focus groups with health professionals, community members, and research practitioners for protocol development; 10 one-on-one cognitive testings with community members for protocol refinement; and a pilot testing of the full study protocol (10 cases and 10 controls) for full evaluation of the study protocol. Results Health professionals recommended, among other themes, enrolling patients with confirmed chronic rhinosinusitis (minimum 12-week symptom duration and objective inflammation). Community members and research practitioners discussed optimal strategies for participant recruitment and interviewing. The protocol, revised with the focus group's feedback, was further evaluated in one-on-one sessions with 10 Washington County residents (3 with chronic rhinosinusitis). In the pilot study, 10 nonsmoking chronic rhinosinusitis cases (5 clinic based and 5 community based) and their community-based age, sex, and former/never smoking-matched controls were recruited. Sinonasal symptoms scores were higher in cases than controls but similar for clinic versus community-based cases. Conclusions This protocol development framework involving stakeholders resulted in a comprehensive questionnaire that was successfully evaluated during a pilot study and is now ready to be used in population-based and clinical epidemiological studies of chronic rhinosinusitis in adults.
Zinc Increases Ciliary Beat Frequency in a Calcium-Dependent Manner
Authors: Woodworth Bradford A. , Zhang Shaoyan , Tamashiro Edwin , Bhargave Geeta , Palmer James N. , Cohen Noam A. 
Published: February 2010

Background Dynamic regulation of respiratory ciliary beat frequency (CBF) is regulated by fluxes in intracellular calcium (Ca2+). P2X receptors (P2XR) are extracellular ATP-gated, Ca2+-permeable, nonselective cation channels. Zinc increases intracellular Ca2+ in a sodium (Na+)-free environment through activation of P2XR channels. We hypothesize that topical zinc increases CBF in a Ca2+-dependent fashion as a result of this mechanism. Methods The apical surface of mouse sinonasal air–liquid interface cultures were bathed in zinc in a Na+-free solution with or without Ca2+. High-speed digital video imaging captured and analyzed CBF at a sampling rate of 100 frames/s. Results CBF significantly increased fourfold over baseline from 5.99 ± 3.16 Hz to 22.4 ± 4.33 Hz in the presence of zinc chloride (50 micromoles) and calcium chloride (3 mM). This effect is abolished in the presence of extracellular Na+ and was pH dependent. Conclusions Zinc stimulates CBF in the presence of Ca2+ likely through activation of P2X receptors. Thus, zinc represents a promising agent for stimulation of mucociliary clearance.
Expression of SPLUNC1 Protein in Nasal Polyp Epithelial Cells in Air–Liquid Interface Culture Treated with IL-13
Authors: Yeh Te-Huei , Lee Shiann-Yann , Hsu Wei-Chung 
Published: February 2010

Background Short palate, lung, and nasal epithelium clone 1 (SPLUNC1) protein is an airway epithelial cell–derived molecule exerting host defense against pathogen. However, the function and regulation of SPLUNC1 in nasal epithelial cells are still unclear. Chronic rhinosinusitis with nasal polyps (CRSwNPs) is a disorder characterized by eosinophilic Th2 inflammation and frequent microbial colonization. The pathogenesis has been postulated as a disturbed mucosal immune response. This study investigates the SPLUNC1 expression of nasal polyp epithelial cells in air–liquid interface (ALI) culture and after treating with Th2 inflammatory cytokines IL-13. Methods Human nasal polyp epithelial cells isolated from patients with CRSwNPs were put in different cell culture models at days 0 and 21 and were assessed for expression of SPLUNC1 by microarray. Cultured cells in ALI plus retinoic acid (ALI + RA) model were then incubated with 0, 1, 10, and 100 ng/mL human recombinant IL-13 for up to 5 days. The expression of SPLUNC1 was assessed by real-time quantitative polymerase chain reaction (RT-Q-PCR), reverse-transcriptase PCR (RT-PCR) and Western blot analysis. Results ALI + RA culture model harvesting ciliary differentiated nasal epithelial cells constitutively expressed high levels of SPLUNC1. In contrast, SPLUNC1 is reduced under classic submerged single layer culture. SPLUNC1 is also dose-responsively down-regulated after incubation with IL-13. Conclusions A microenvironmental milieu containing IL-13 may be detrimental to the host innate immunity response, at least in part, through the inhibition of SPLUNC1 production.
Pathogenetic Role of Increased Nasal Resistance in Obese Patients with Obstructive Sleep Apnea Syndrome
Authors: Tagaya Mitsuhiko , Nakata Seiichi , Yasuma Fumihiko , Noda Akiko , Morinaga Mami , Yagi Hidehito , Sugiura Makoto , Teranishi Masaaki , Nakashima Tsutomu 
Published: February 2010

Background The role of increased nasal resistance in obstructive sleep apnea syndrome (OSAS) remains controversial. The aim of this study was to examine the pathogenetic role of nasal obstruction in obese patients with OSAS. Methods Patients with OSAS (n = 125) at a university hospital were divided into three groups according to body mass index (BMI): nonobese (BMI < 25 kg/m2), mildly obese (25 kg/m2 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2). The subjects underwent nasopharyngoscopy, measurement of nasal resistance, and polysomnography. Results We studied 42 nonobese, 47 mildly obese, and 36 obese patients with OSAS. Among the obese, but not the nonobese and mildly obese patients, we found significant correlations between the oxygen desaturation index (ODI) and bilateral nasal resistance (BNR; r = 0.412; p = 0.013), between the ODI and unilateral higher nasal resistance (UHNR; r = 0.413; p = 0.012), and between the apnea index and UHNR (r = 0.334; p = 0.046). Multiple regression analysis incorporating all patients showed that BMI (p < 0.001) and BNR (p = 0.033) were independently related to the ODI. Conclusions In obese patients with OSAS, increased nasal resistance could play an important pathogenetic role in hypoxemic apnea.
Evaluation of the Presence of B-cell attractant Chemokines in Chronic Rhinosinusitis
Authors: Patadia Monica , Dixon Julian , Conley David , Chandra Rakesh , Peters Anju , Suh Lydia A. , Kato Atsushi , Carter Roderick , Harris Kathleen , Grammer Leslie , Kern Robert , Schleimer Robert 
Published: February 2010

Background B-cell responses may play a role in the pathogenesis of nasal polyposis via local IgA and IgE production and activation of eosinophils and mast cells. B-cell attracting chemokines may therefore have relevance in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNPs) Methods Polyp and inferior turbinate tissues were obtained from CRSwNPs, CRS without NPs (CRSsNPs), and control patients; ELISA and reverse-transcription polymerase chain reaction were used to detect levels of protein and mRNAfor selected B-cell chemokines (B-cell attracting chemokine 1 [CXCL13/BCA-1/BLC]), thymus expressed chemokine (CCL25/TECK), mucosae-associated epithelial chemokine (CCL28/MEC), stromal cell–derived factor-1alpha (CXCL12/SDF-1alpha), and selected chemokine receptor genes (CXCR4, CXCR5, and CXCR7). Results BCA-1 and SDF-1alpha protein levels were significantly increased in polyp tissue compared with turbinate tissue from CRSsNP patients and controls (p < 0.05 and p < 0.01, respectively). Differences in TECK and MEC were not significant. For mRNA, expression of BCA-1 was significantly up-regulated in polyp tissue and levels correlated with CD20 mRNA expression. Additionally, significant up-regulation of mRNA for the SDF-1alpha receptors CXCR7 and CXCR4 was detected in polyps, while there was a trend for up-regulation of the BCA-1 receptor CXCR5. Conclusions Elevated levels of the BCA-1 and SDF-1alpha and their receptors may account for an increased presence of B cells and their products, contributing to eosinophilic inflammation in patients with CRSwNP.
The Congestion Quantifier Five-Item Test for Nasal Congestion: Refinement of the Congestion Quantifier Seven-Item Test
Authors: Stull Donald E. , Meltzer Eli O. , Krouse John H. , Roberts Laurie , Kim Susan , Frank Lori , Naclerio Robert , Lund Valerie , Long Aidan 
Published: February 2010

Background Patients report that nasal congestion is the most bothersome symptom of allergic rhinitis (AR). Recently, a short, patient-reported congestion screener questionnaire, the Congestion Quantifier Seven-Item Test (CQ7), was developed to identify a level of congestion that may warrant patients seeking evaluation and possible treatment. We explored further item reduction of the CQ7 and examined the psychometric properties of this reduced set of items in a 15-day study of patients with confirmed AR or self-identified and clinician-confirmed congestion. Methods The CQ7 was subjected to item reduction methods and the psychometric properties of the reduced set of items were assessed. Results Two items were dropped—sinus pressure/pain and impact on work/school—because of lower item-rest correlations. The resulting Congestion Quantifier Five-Item screener (CQ5) performed comparably with the CQ7. Internal consistency reliability of both instruments were identical (alpha = 0.93); test–retest reliability from baseline to day 15 was similar (CQ7, alpha = 0.85; CQ5, alpha = 0.79). Both instruments were comparable in discriminating patients and controls (CQ7, area under the curve [AUC] = 0.97; CQ5, AUC = 0.96). A CQ5 score of 6 provided optimum balance of sensitivity (89.4%), specificity (88.6%), and correct classification (89%) for detecting congestion. Conclusions The CQ5, a patient-reported outcome screener, is slightly shorter but equally reliable, valid, and responsive as the CQ7 for evaluating differences in levels of severity of nasal congestion. It may have wider applicability than the CQ7 because of exclusion of the work/school impact item.
The Effects of Serum and Urinary Cortisol Levels of Topical Intranasal Irrigations with Budesonide Added to Saline in Patients with Recurrent Polyposis after Endoscopic Sinus Surgery
Authors: Welch Kevin C. , Thaler Erica R. , Doghramji Laurie L. , Palmer James N. , Chiu Alexander G. 
Published: February 2010

Background The delivery of topical intranasal corticosteroid sprays has traditionally been the primary method of treating recurrent nasal polyposis. An emerging treatment for polyposis is budesonide nasal irrigations. Delivered at concentrations nearly 100 times greater than found in prescription nasal sprays, there have been little studies on the effects of budesonide irrigation on the adrenal axis. Therefore, we investigated whether irrigation with budesonide solution was associated with any increase in serum cortisol and 24-hour urinary cortisol levels. Methods Patients who previously had undergone endoscopic sinus surgery and were not taking prednisone for 3 months were prospectively enrolled in this study. Patients irrigated twice daily with 0.5 mg/2 mL of budesonide mixed with 240 mL of saline solution. Serum cortisol and 24-hour urinary cortisol were collected before drug administration and 6 weeks after continuous use. Results Ten patients completed this study. The average serum cortisol and 24-hour urinary cortisol before drug administration were 9.8 ± 5.4 μg/dL and 28.1 ± 15.1 μg/24 hours, respectively. After 6-week follow-up, the average serum cortisol and 24-hour urinary cortisol were 12.8 ± 3.5 μg/dL and 16.5 ± 5.6 μg/24 hours, respectively. Normal ranges for serum cortisol and 24-hour urinary cortisol are 5–25 μg/dL and 4–50 μg/24 hours, respectively. Conclusions: Irrigation with budesonide, 0.5 mg/2 mL, in 250 mL of saline solution does not result in decreases of serum cortisol and 24-hour urinary cortisol levels. Based on this, we feel irrigation with budesonide solution is safe to perform in patients as an alternative to traditional aerosolized steroid sprays or systemic corticosteroids.
Management of Sinonasal Inverted Papillomas and Comparison of Classification Staging Systems
Authors: Gras-Cabrerizo Juan R. , Montserrat-Gili Joan R. , Massegur-Solench Humbert , León-Vintró Xavier , De Juan Julia , Fabra-Llopis Josep M. 
Published: February 2010

Background The aim of this study was to describe treatment results in patients with sinonasal inverted papilloma and to compare recent classification staging systems. Methods We performed a retrospective study of 79 patients with primary paranasal sinus inverted papilloma from 1978 to 2008. Results The median age at diagnosis was 59 years. There were 68 men (86%) and 11 women (14%). Sixty inverted papilloma (76%) were located in the ethmoidal sinus complex, 16 (20%) were in the maxillary sinus, 2 were in the sphenoid sinus (3%), and 1 was in the septum (1%). Malignancy was simultaneously associated in four cases (5%). Intracranial extension was found in five patients (6%) and we did not find orbital content involvement. The external approach was used in 22 cases (28%) and 57 patients were treated with endoscopic nasal resection (72%). The overall recurrence rate in the total population was 21%. Recurrences were observed in 7 cases (32%) in the group of patients who received external approach and in 10 (17%) patients in the endoscopic group. Recurrences according to the Krouse system were 0% in T1 stage, 16% in T2 stage, 25% in T3 stage, and 60% in T4 stage (p = 0.05). Recurrences for groups A, B, and C stages using the Cannady staging system were 12, 26, and 60%, respectively (p = 0.039). Recurrences according to Han's system were 19% in both T1 and T2, 20% in T3, and 60% in T4 (p > 0.05). Conclusions Our results support the endoscopic approach as the treatment of choice when feasible in patients with inverted papilloma, combined in selected cases with external approaches. The Krouse and Cannady systems provided a good distribution of patients according to local control.
The Efficacy of a Novel Chitosan Gel on Hemostasis and Wound Healing after Endoscopic Sinus Surgery
Authors: Valentine Rowan , Athanasiadis Theo , Moratti Stephen , Hanton Lyall , Robinson Simon , Wormald Peter-John 
Published: February 2010

Background Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). Continued bleeding risks airway compromise from the inhalation of blood clots and from the aspiration of blood-stained vomitus. Additionally, adhesion formation is the most common reason for patients requiring revision surgery. This study aimed to determine the efficacy of a novel chitosan/dextran (CD) gel on hemostasis and wound healing after ESS. Methods A randomized controlled trial was performed involving 40 patients undergoing ESS for chronic rhinosinusitis. Immediately after surgery a baseline Boezaart Surgical Field Grading Scale was taken. Computer randomization was performed with one side receiving CD gel and the other side receiving no treatment (control). Boezaart bleeding scores were then calculated for each side every 2 minutes. Patient's endoscopic features of wound healing were assessed at 2, 6, and 12 weeks after surgery. Results CD gel achieved rapid hemostasis with the mean time to hemostasis at 2 minutes (95% CI, 2–4 minutes) compared with 10 minutes (95% CI, ≥6 minutes) for the control (p < 0.001). There were significantly less adhesions at all time points with CD gel versus control: 2 versus 18 at 2 weeks (p < 0.001), 3 versus 16 at 6 weeks (p < 0.001), and 2 versus 12 at 3 months (p < 0.001). There was no significant difference between CD gel and control with respect to crusting, mucosal edema, infection, or granulation tissue formation. Conclusions CD gel is rapidly hemostatic immediately after ESS and prevents adhesion formation, addressing two of the most common complications of sinus surgery.
Objective Improvement in Nasal Congestion and Nasal Hyperreactivity with Use of Nasal Steroids in Persistent Allergic Rhinitis
Authors: Wandalsen Gustavo F. , Mendes Aline I. , Solé Dirceu 
Published: February 2010

Objective Our objective was to evaluate the action of topical nasal steroid in nasal congestion and nasal hyper-reactivity in children and adolescents with persistent allergic rhinitis. Methods Twenty atopic children and adolescents (6 to 18 years) with moderate-to-severe persistent allergic rhinitis (PAR) were treated with mometasone furoate (100 μg once a day) for 21 days. At the beginning and end of treatment, the following were recorded: a) nasal symptoms score; b) several parameters of nasal congestion measured by acoustic rhinometry (SRE 2000 Rhinometrics); c) degree of nasal hyper-reactivity to histamine (concentration of histamine necessary to induce at least 100% increase in total nasal resistance during nasal provocation test). Data were compared with those from 20 controls. Results Compared to controls, PAR patients had significantly higher score of symptoms, as well as higher degree of nasal hyper-reactivity and lower nasal volumes. After treatment, there was a significant decrease in the mean nasal symptoms score (8.0 versus 3.8; p < 0.001) and in the nasal hyper-reactivity (histamine concentration: 0.72 mg/ml versus 2.60 mg/ml; p < 0.001). Congestion improvement was observed by the increase in all acoustic rhinometry parameters. Among all studied volumes, the volume in the segment between 2 and 5 cm showed the highest mean increase (19.8%). Conclusions Treatment with topical nasal steroid objectively reduced nasal congestion and nasal histamine hyper-reactivity in children and adolescents with PAR.
Anatomical and safety considerations in establishing portals used for canine elbow arthroscopy
Authors: Crevier-Denoix N. , Moissonnier P. , Viateau V. , Jardel N. 
Published: February 2010

Summary
Objectives: To describe the relationship of the major muscular, ligamentous and neurovascular structures in relation to standard medial elbow arthroscopic portals used in dogs, and to evaluate their potential iatrogenic lesions.
Design: Anatomical study using 20 canine cadaveric elbows.
Methods: Arthroscopic explorations were performed using medial portals. Three 4 mm orthopaedic pins were introduced in place of the arthroscope, egress canula and instrumental portals. Limbs were dissected. Distances between pins and neurovascular structures were measured. Muscle, ligament and cartilage lesions were recorded.
Results: Minimal muscular lesions were observed. No ligament injury was evidenced. Superficial iatrogenic cartilage lesions were observed in three joints. The arthroscopic portal was 23.1 mm (range: 16 to 28.5 mm) caudal to the brachial artery, 21.0 mm (13–30.5 mm) caudal to the median nerve, and 4.0 mm (1–7 mm) cranial to the ulnar nerve. The instrumental portal was 16.3 (9–24 mm) caudal to the brachial artery, 13.5 mm (7–24.5 mm) caudal to the median nerve, and 11.8 (8–18 mm) cranial to the ulnar nerve. The egress portal was 21.4 mm (12–37 mm) caudal to the ulnar nerve.
Conclusions and clinical relevance: The study confirmed the safety of elbow medial arthroscopic portals. Care must be taken when placing the camera portal so as to avoid injury of the ulnar nerve. Should extensive intra-articular procedures be needed, manipulation of instruments should be done cautiously in the cranio-medial compartment of the joint due to the proximity of the median nerve to the capsule.
The use of transarticular external skeletal fixation in the management of failed tibial tuberosity transposition in five dogs
Authors: Coughlan A. , Pettitt R. , MacDonald N. , Innes J. , Owen M. , Comerford E. , Higgins B. 
Published: February 2010

SummaryThe management of tibial tuberosity fracture-avulsion after tibial tuberosity transposition can be challenging. Implants must be able to resist the strong distractive force of the quad-riceps mechanism, yet implant size is limited by the amount of tuberosity bone stock available. Revision fixation is compromised further by fragmentation of the tubercle. Five stifle joints had temporary transarticular external skeletal fixators applied to manage complications of tibial tuberosity transposition. Fracture reduction was confirmed in four out of five tibial tuberosity fractures. Frames were in place for a mean of 44 days. Frame associated complications occurred in four out of five limbs, the most common being pin tract discharge and associated osteolucency. All frame-associated complications resolved. Long-term follow-up information was available for three of the five animals at 13 to 18 months after frame removal. All three owners reported occasional lameness, but this was attributed to concurrent orthopaedic disease. Transarticular external skeleton fixation protects internal fixation techniques, and good limb function was achieved in most cases. Transarticular external skeleton fixation can be successfully used to augment repair of tibial tuberosity fracture after tibial tube-rosity transposition.