bluuebunny/crossref_metadata_2025_split huggingface dataset:
Septal Dislocation for Endoscopic Access of the Anterolateral Maxillary Sinus and Infratemporal Fossa
Authors: Ramakrishnan Vijay R. , Suh Jeffrey D. , Chiu Alexander G. , Palmer James N. 
Published: March 2011

Background Transnasal approaches to the anterolateral maxillary sinus and infratemporal fossa are challenging with traditional endoscopic techniques and instrumentation. Additional access in the anterior and lateral direction can be obtained with modified endoscopic medial maxillectomy (MEMM) or total endoscopic medial maxillectomy (TEMM) or via a transseptal approach. Alternatively, we have used a septal dislocation technique to help access these areas. Access to these areas may be necessary for treatment of inverted papilloma, schwannoma, and juvenile nasopharyngeal angiofibromas. The aim of this study is to examine the effectiveness of septal dislocation for anterolateral reach in extended endoscopic sinus surgery. Methods Cadaver dissection was performed on eight sides. MEMM, TEMM, and septal dislocation were sequentially performed according to standard techniques. Image-guided axial screenshots were used to identify the extent of anterolateral reach in each stage by measuring the angle of access from the midline. Results TEMM adds 12° of anterolateral reach when compared with MEMM. With septal dislocation, an average of 20 additional degrees is provided over TEMM. The anterior maxillary sinus is routinely accessed with straight instruments after septal dislocation. Conclusion The anterolateral maxillary sinus and infratemporal fossa are difficult areas to access with standard endoscopic techniques. Septal dislocation is a straightforward technique to achieve additional visualization and access when combined with TEMM.
Middle Turbinate Suture Conchopexy during Endoscopic Sinus Surgery Does Not Impair Olfaction
Authors: Dutton Jay M. , Hinton Mark J. 
Published: March 2011

Background One of the primary goals of endoscopic sinus surgery (ESS) is to create widely patent paranasal sinus ostia, and lateralization of a middle turbinate (MT) after ESS can obstruct otherwise patent ethmoid and maxillary sinuses. Numerous methods have been used to assist in the avoidance of this complication including the use of packing in the ethmoid sinus as a “spacer,” controlled creation of synechia between the MT and septum, and suture medialization of the MT to the septum. The latter is an effective technique, but because the olfactory groove lies superior in the groove between the MT and septum, concerns have been raised as to the effect of this maneuver on olfaction. The aim of this pilot study was to objectively evaluate olfaction before and after suture conchopexy, and, secondarily, to evaluate the effectiveness of this technique in preventing lateralization of the MT. This study was designed to assess the effect of suture medialization of the MT during ESS on olfactory sensation. Methods Objective assessment of olfactory function using the University of Pennsylvania Smell Identification Test (UPSIT) was performed before and 6 months after ESS in 153 patients between January 2006 and January 2008. Postoperative follow-up exams were also performed to determine the effectiveness of the medialization procedure and the patency of the ethmoid cavities. Results UPSIT testing showed a small but statistically significant improvement in olfactory function after MT suture medialization to the septum when compared with preoperative assessment. Postoperative endoscopic examination revealed that lateralization of the MT was a rare complication after suture medialization of the MT. Conclusion MT suture medialization during ESS is an effective method for preventing lateralization of the MT and does not impair olfactory function.
Heparin Inhibits Mucus Hypersecretion in Airway Epithelial Cells
Authors: Ogawa Takao , Shimizu Shino , Tojima Ichiro , Kouzaki Hideaki , Shimizu Takeshi 
Published: March 2011

Background Heparin is one of the most important anticoagulant drugs. It has been known that heparin also possesses anti-inflammatory activities. Mucus hypersecretion is an important characteristic of airway inflammation. However, little is known about the regulatory effects of heparin on mucus hypersecretion in airway epithelial cells. To elucidate the anti-inflammatory function of heparin in airway epithelial cells, we examined the in vivo effects of heparin on mucus hypersecretion and neutrophil infiltration in rat nasal epithelium. We also examined the in vitro effects of heparin on mucin production and IL-8 secretion from cultured human airway epithelial cells. Methods We induced hypertrophic and metaplastic changes of goblet cells in rat nasal epithelium by intranasal lipopolysaccharide (LPS) instillation. The effects of intranasal instillation with heparin on mucus production and neutrophil infiltration were examined. In vitro effects of heparin on airway epithelial cells were examined using cultured NCI-H292 cells. Mucus secretion was evaluated by enzyme-linked immunosorbent assay using an anti-MUC5AC monoclonal antibody. Results Intranasal instillation with unfractionated heparin (UFH; 100 IU/0.1 mL) or low molecular weight heparin (LMWH; 100 IU/0.1 mL) at 30 minutes before LPS instillation significantly inhibited LPS-induced mucus production and neutrophil infiltration in rat nasal epithelium. UFH or LMWH inhibited tumor necrosis factor alpha (10 ng/mL)–induced secretion of MUC5AC and IL-8 from NCI-H292 cells in a dose-dependent manner (0.01–10 IU/mL). MUC5AC mRNA expression was also significantly inhibited. Conclusion These results indicate that heparin inhibits airway mucus hypersecretion in airway epithelial cells directly and indirectly through the suppression of IL-8 secretion and neutrophil infiltration.
Radiographic Distribution of Drops and Sprays within the Sinonasal Cavities
Authors: Rudman Kelli L. , O'Brien Erin K. , Leopold Donald A. 
Published: March 2011

Background Topical nasal sprays are commonly prescribed for sinonasal disease. Nasal drops applied in a head-down position are described alternatively to sprays. Multiple research methods have investigated the deposition pattern of intranasal medications, each with limitations. This pilot study analyzed the use of a conebeam computed tomography (CBCT) scanner to study deposition patterns of intranasal sprays and drops using radiopaque contrast solution. Methods Nine volunteers participated in this two-trial study. In trial 1, participants instilled 3 sprays of contrast into each nostril. After 3 minutes a CBCT scan was performed. In trial 2, 3 drops of contrast were instilled into the participants’ nostrils in the “vertex-to-floor” position. Again, after 3 minutes a CBCT scan was performed. Two otolaryngologists and a neuroradiologist reviewed the images and scored 21 sites within the sinonasal cavity for the presence of contrast. Results Contrast was detected in the nasal vestibule and inferior nasal vault in nearly every trial with the spray and drops. Nasal spray was more diffusely distributed within the nasal cavity and was detected at a greater proportion on the floor of the nose, inferior meatus, anterior inferior nasal cavity, and nasopharynx. Neither spray nor drops were consistently detected in spaces superior to the middle turbinate. Conclusion Radiopaque contrast delivered by nasal spray and drops were detected by the CBCT scanner, with a significant difference at one subsite. Neither spray nor drops were detected in superior nasal spaces. The CBCT scan provides an alternative to conventional CT scans in future studies using this technique.
Correlation Analysis of two Serum-specific Immunoglobulin E Test Systems and Skin-Prick Test in Allergic Rhinitis Patients from Northeast China
Authors: Jiang Xiao-Dan , Li Guang-Yu , Dong Zhen , Zhu Dong-Dong 
Published: March 2011

Background Skin-prick testing (SPT) is the most common screening method for allergy evaluation. The detection of serum-specific immunoglobulin E (sIgE) is also commonly used. The sensitivity and specificity of these testing methods may vary due to type of causative allergen and type of allergic manifestation. The purpose of this study was to evaluate the correlation between two methods of measuring sIgE (AllergyScreen [Mediwiss Analytic GmbH, Moers, Germany] and ImmunoCAP [Pharmacia, Uppsala, Sweden]) and SPT for the diagnosis of allergic rhinitis (AR). Methods All 216 patients who were referred to the allergist for suspected AR from June to October 2009 had SPT and the two serological tests. One hundred fifty-eight patients had a positive clinical history and a related positive SPT. The SPT was used as reference standard, and we selected three allergens (Dermatophagoides pteronyssinus, mugwort, and ragweed), which were common in fall in northeast China, to analyze the correlation of the two serum tests and SPT. Results Compared with the SPT, the diagnostic indexes (accuracy, sensitivity and specificity) of the AllergyScreen system and the ImmunoCAP system were 0.819 versus 0.810, 0.780 versus 0.872, and 0.862 versus 0.741, respectively. The accuracy was similar between the two systems (p > 0.05). The ImmunoCAP system method had a higher sensitivity (p < 0.01). The AllergyScreen system had a higher specificity (p < 0.01). Conclusion These data support that the AllergyScreen system and ImmunoCAP system can identify potentially significant allergens in the diagnosis of AR in patients from northeastern China.
RNA-containing Exosomes in Human Nasal Secretions
Authors: Lässer Cecilia , O'Neil Serena E. , Ekerljung Linda , Ekström Karin , Sjöstrand Margareta , Lötvall Jan 
Published: March 2011

Background Exosomes are nanovesicles of endocytic origin released by cells and present in human body fluids such as plasma, breast milk, and bronchoalveolar lavage fluid. These vesicles take part in communication between cells. Recently, it was shown that exosomes contain both mRNA and microRNA. This RNA can be shuttled between cells (exosomal shuttle RNA), which is a new route of communication between cells. The aim of this study was to determine whether nasal secretions harbor exosomes and furthermore, whether these exosomes contain RNA. Methods Human nasal lavage fluid (NLF) underwent centrifugation and filtration to discard cells and debris, followed by a final ultracentrifugation at 120,000 × g to pellet the exosomes. Exosomes were detected using electron microscopy (EM), flow cytometry, and Western blot. RNA was extracted and analyzed using a Bioanalyzer. Results Exosomes were visualized as 40–80 nm, CD63+ vesicles using EM. Flow cytometry of exosomes using anti–major histocompatibility complex class II beads revealed exosomes positive for the tetraspanins CD9, CD63, and CD81. Western blot confirmed the presence of exosomal protein and absence of proteins from the endoplasmic reticulum (ER), because the exosomes were positive for Tsg101, but negative for the ER marker, calnexin. Bioanalyzer analysis revealed that, these exosomes contain RNA. Conclusion This study shows for the first time that NLF contains exosomes and that these exosomes contain RNA. Further characterization of the exosomal RNA and proteins may provide important information about communication in the nose and potentially provide a source of biomarkers for upper airway diseases.
Hyaluronic Acid Gel in the Treatment of Empty Nose Syndrome
Authors: Modrzyński Marek 
Published: March 2011

Background Empty nose syndrome (ENS) along with atrophic rhinitis are disease entities that are bothersome for patients and difficult for their doctors to treat. The purpose of this study was to evaluate the usefulness of intranasal injection of hyaluronic acid (HA) gel in patients with symptoms of ENS. Methods Three patients suffering from ENS and atrophic rhinitis underwent trial treatment consisting of submucosal injections of HA preparations into the inferior nasal concha and under the mucous membrane of the septum. Result As a result of treatment, the patients’ symptoms improved for several months and no complications were recorded. Conclusion Because of its simplicity, safety, and fairly good, but impermanent clinical effects, HA injections appear to be worth considering in less severe forms of ENS.
Impact of Nasal Polyposis on Erectile Dysfunction
Authors: Gunhan Kivanc , Zeren Fatih , Uz Uzdan , Gumus Bilal , Unlu Halis 
Published: March 2011

Background Our male patients with chronic rhinosinusitis with nasal polyposis (NP) declare a better sexual function after functional endoscopic sinus surgery (FESS) with polypectomy. This study was planned to conduct the first prospective, controlled trial evaluating the possible relation between erectile dysfunction (ED) and NP by subjective and objective parameters. Methods Thirty-three male patients with NP and thirty randomly selected male control subjects were evaluated. All subjects underwent assessments of nasal endoscopy, rhinomanometry, body mass index (BMI), Epworth Sleepiness Scale, full in-laboratory polysomnograpy and serum levels of glucose, thyroid hormones, lipid profile, and testosterone. ED was evaluated by the erectile function domain of the International Index of Erectile Function (IIEF-EF) subjectively and nocturnal penile tumescence (NPT) objectively. The NP group was reassessed 6 months after FESS. Results The mean age, BMI, and laboratory tests of the patients and the control subjects had no significant difference. The well-recognized risk factors for ED were eliminated. Preoperative evaluation of the patients revealed that ED was present in 34 and 24% of the patients by IIEF-EF and NPT, respectively, which was significantly higher than the control group (p = 0.009 and p = 0.018, respectively). There was a significant improvement of ED in the assessment of IIEF-EF and NPT postoperatively (p = 0.014 and p = 0.037, respectively). Conclusion ED was determined in a high percentage of patients with NP and significantly ameliorated after FESS. NP might present a risk factor in the development of ED.
The Liquid Panax ginseng Inhibits Epidermal Growth factor–induced metalloproteinase 9 and cyclooxygenase 2 expressions via inhibition of inhibitor factor kappa-B-alpha and extracellular signal-regulated kinase in NCI-H292 human airway epithelial cells
Authors: Kim Jung-Hee , Kang Jeong Woo , Kim ManSub , Lee Dong Hun , Kim Heejong , Choi Hee-Sook , Kim Eun Jin , Chung Ill-Min , Chung Il-Yup , Yoon Do-Young 
Published: March 2011

Background Ginseng (Panax ginseng C.A. Meyer) has been used in Asian countries for the treatment of various diseases. However, the mechanisms of liquid Panax ginseng (LG) on allergic inflammatory response in epidermal growth factor (EGF)–stimulated human airway epithelial cells remain largely unclear. Methods MUC5AC, cyclooxygenase (COX) 2, and matrix metalloproteinase (MMP) 9 expressions were measured using reverse transcription-polymerase chain reaction, Western blotting, and gelatin zymogram analyses in NCI-H292 cells. Extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (MAPK) protein levels were analyzed by Western blotting. Results To gain insight into the antiallergy effects of LG, we examined its influence on epidermal growth factor (EGF)–induced MMP-9 and COX-2 productions in NCI-H292 cells. LG was treated for 1 hour and then followed by EGF treatment for 24 hours into NCI-H292 cells. The decrease of COX-2 production was correlated with the reduced levels of proteins and mRNAs of inducible MMP-9 and MUC5AC. LG blocked upstream signaling of NF-kappa-B activation via inhibition of phosphorylations of inhibitor factor-kappa- B-alpha (I-kappa-B-alpha) and ERK. These results suggest that LG protects NCI-H292 cells from EGF-induced damage by down-regulation of COX-2, MMP-9, and MUC5AC gene expressions by blocking NF-kappa-B and ERK. Conclusion LG modulates allergic inflammatory response in EGF-stimulated NCI-H292 human airway epithelial cells via inhibition of I-kappa-B-alpha and ERK.
Simultaneous inferior and middle meatus antrostomies in the treatment of the severely diseased maxillary sinus
Authors: Albu Silviu , Gocea Anamaria , Necula Sorin 
Published: March 2011

Background Although the majority of the maxillary pathology can be eradicated through the enlarged middle meatus antrostomy (MMA), some patients have extensive disease that is difficult to cope with. The aim of this study was to estimate the usefulness of simultaneous middle and inferior meatal antrostomies (MIMAs) in cases with severely diseased maxillary sinus by comparing the subjective and objective outcomes between patients that underwent MIMA and those who experienced maxillary clearance through conventional MMA. Methods A prospective study was performed on patients with nasal polyps and severely diseased maxillary sinus (Lund-Mackay CT score = 2). All diseased sinuses were addressed with the same endoscopic sinus surgery technique; the only difference consisted of the management of the maxillary sinus: 34 patients underwent MIMAs and in 38 cases maxillary sinus was approached solely through the MMA. After 12 months of follow-up, outcomes consisted of the visual analog scale (VAS) for the main symptoms, the Lund-Mackay and maxillary sinus endoscopic scores, and the percent of airspace occluded by inflammatory mucosal thickening on CT. Results Subjective improvement in VAS scores for nasal obstruction, facial pain, and nasal discharge/retronasal drip was significantly better in the MIMA group. The mucosal thickening as expressed by the CT scan and maxillary endoscopic score was significantly reduced in the MIMA group. Conclusion The MIMA technique is useful for removing severe disease that can not be reached through the MMA and yields both better subjective and better objective outcomes. The additional inferior antrostomy most likely improves drainage and ventilation in the postoperative period.
A Prospective, Randomized, Single-blinded Controlled Trial on Biodegradable Synthetic Polyurethane foam as a Packing Material after Septoplasty
Authors: Kim Yoo Suk , Kim Young Hoon , Kim Na Hyun , Kim Si Hong , Kim Kyung Rok , Kim Kyung-Su 
Published: March 2011

Background We evaluated synthetic polyurethane foam (SPF; Polyganics BV, Groningen, The Netherlands) as a packing material used after septoplasty compared with Merocel (Medtronic Xomed Surgical Products, Jacksonville, FL) in the aspects of clinical efficacy and the subjective severity of symptoms. Methods A prospective, randomized, single-blinded controlled study was performed in 64 patients who had undergone septoplasty. The patients were randomized to receive Merocel or SPF after septoplasty. Assessments of clinical efficacy on bleeding and pain were done and subjective symptoms related to packing materials were evaluated using questionnaires quantified by the visual analog scale. Results There was no difference in repacking or additional packing due to postoperative bleeding, bleeding and/or septal hematoma on the removal of packing, and the mucosal condition after packing removal during postoperative period between the Merocel and SPF groups. Bleeding and pain during packing removal was significantly lower in patients with SPF packing. Also, in the SPF group, patient's general satisfaction and willingness to reuse the material were higher compared with the Merocel group. Conclusion SPF is as suitable as Merocel to be used after septoplasty with beneficial effects on bleeding and pain at packing removal.
M1 and M3 Muscarinic Receptors Mediate Relaxation and Contraction in Canine Nasal Veins
Authors: Lung Mary A. 
Published: March 2011

Background Acetylcholine (ACh) has been shown to induce nasal congestion via vasorelaxation of intranasal posterior collecting veins (PCV) coupled with vasocontraction of extranasal outflow veins (dorsal nasal vein [DNV] and sphenopalatine vein [SPV]). The aim of this study was to characterize the muscarinic receptor subtype(s) involved in ACh-induced relaxation and contraction in canine nasal veins. Methods PCV, DNV, and SPV were isolated from the canine nose. In vitro isometric tension of segments from these veins was monitored to reflect vascular reactivity. ACh concentration–response curve was studied in the presence of muscarinic receptor subtype inhibitors. Immunohistochemical localization of M1–M5 receptor subtypes in the veins was performed. Results ACh-induced relaxation in PVC was inhibited by pertussis toxin (PTX; inhibitor of G-protein that couples M2/M4 receptors), methoctramine (selective M2 muscarinic receptor inhibitor), muscarinic toxin 7 (MT-7; selective M1 muscarinic receptor inhibitor), and 4-diphenylacetoxy-methylpiperidine methiodide (4-DAMP; selective M3 muscarinic receptor inhibitor). ACh-induced contraction in SPV and DNV was potentiated by PTX and methoctramine but was inhibited by MT-7 and 4-DAMP. Immunohistochemistry confirmed the presence of five muscarinic receptor subtypes in the endothelium of nasal veins, with staining of M3 > M1 > M5 > M2 = M4 in PVC but M2 = M4 > M3 > M1 > M5 in outflow veins. M1 and M3 receptor subtypes were localized in the smooth muscles of both types of veins. Conclusion The results show that ACh relaxes intranasal veins and contracts extranasal veins primarily via M1 and M3 muscarinic receptor subtypes, implying the therapeutic value of M1/M3-specific or highly selective anticholinergics on nasal congestion.
Agriculture and the economies of cultivation in India
Authors: Gill Navyug 
Published: March 2011

Anand Pandian, Crooked stalks: Cultivating virtue in South India. Durham: Duke University Press,
2009, pp. 325, ISBN 978-0-8223-4531-2 (paperback).Vinay Gidwani, Capital, interrupted: Agrarian development and the politics of work in India. Minneapolis:
University of Minnesota Press, 2008, pp. 336, ISBN 978-0-8166-4959-4 (paperback).
Combining multiple signals of an electromagnetic induction sensor to prospect land for metal objects
Authors: Saey T. , Van Meirvenne M. , Dewilde M. , Wyffels F. , De Smedt P. , Meerschman E. , Islam M. M. , Meeuws F. , Cockx L. 
Published: March 2011

ABSTRACTBuried unexploded ammunition is a major problem on arable land in former battle areas. Many battlefields of the First World War (WWI) still contain a lot of unexploded shells just below the plough layer, posing serious threats to soil editors and trenchers. Electromagnetic induction (EMI) sensors have been used for a variety of agricultural and archaeological purposes to map the natural soil variability and to locate buried archaeological remains. Besides its sensitivity to variations in soil texture and anthropogenic disturbances, EMI proves to respond strongly to metal objects in the soil. Most EMI sensors rely on a single signal, with magnitude and sign of the metal anomalies differing according to the instruments coil distance and separation. The multi‐coil EMI sensor, the DUALEM‐21S, provides four simultaneous apparent electrical conductivity (ECa) signals enhancing significantly the possibilities for signal processing. To calibrate our instrument, we buried different masses of metal at different depths. The fourECameasurements showed a response to the metal objects down to 1.2 m. The measurements were subtracted by their gradual trend to obtain the local anomalies (ΔECa). A combination of these four ΔECa’s was used to amplify the signal response to metal, influenced by both depth and mass of the buried objects. At an intensively shelled former WWI battle field near Ypres (Belgium), a detailed prospection was conducted with the DUALEM‐21S. Based on our multi‐signal procedure, we located 40 positions, 20 where we predicted buried metal and 20 where we expected that no metal was present within 1.2 m depth. There were no false negative predictions and at the 20 locations where we expected metal, shells up to 90 kg were excavated. As a final outcome we produced a map with predictions of the mass of metal objects in the soil assuming a fixed depth and alternatively a map with predictions of the depth of metal objects assuming a given mass.Apart from their potential for agricultural and archaeological investigations, multi‐ECasignals were shown to be useful for locating metal objects, like unexploded WWI shells, in the top 1.2 m of soil.