bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteoprotegerin: A Novel Independent Marker for Silent Myocardial Ischemia in Asymptomatic Diabetic Patients
Authors: Avignon Antoine , Sultan Ariane , Piot Christophe , Mariano-Goulart Denis , Thuan dit Dieudonné Jean-François , Cristol Jean Paul , Dupuy Anne Marie 
Published: October 2007

OBJECTIVE—We sought to evaluate osteoprotegerin, an inhibitor of osteoclastogenesis involved in atherosclerosis, and other novel risk factors as predictive markers of silent myocardial ischemia (SMI).
RESEARCH DESIGN AND METHODS—A total of 465 consecutive diabetic patients with more than one additional risk factor were evaluated for SMI using stress myocardial perfusion imaging (MPI). We studied the association of SMI (positive stress electrocardiogram and/or abnormal MPI) with osteoprotegerin, other novel risk factors (lipoprotein[a], homocysteine, adiponectin, C-reactive protein, and fibrinogen), and conventional risk factors (total, LDL, and HDL cholesterol and triglycerides).
RESULTS—A total of 92 patients were diagnosed with SMI. Of the six novel markers, osteoprotegerin was the only one associated with SMI; the relative risk (RR) of SMI in patients with osteoprotegerin values above the 75th percentile was 3.19 (95% CI 1.99–5.18; P &lt; 0.001) in comparison with those with osteoprotegerin below the 75th percentile. In univariate analyses, the other plasma markers significantly associated with SMI were higher triglycerides (P = 0.04) and lower HDL cholesterol (P = 0.02). The association of osteoprotegerin with SMI remained significant after correcting for other variables associated with SMI at P &lt; 0.15 in univariate analysis (RR 3.95 [95% CI 2.21–7.06]; P &lt; 0.0001). The association of osteoprotegerin with SMI was observed in male (P &lt; 0.0001) and female (P = 0.03) patients, in type 1 (P = 0.002) and type 2 (P = 0.0004) diabetic patients, in patients with (P = 0.0004) or without (P = 0.03) nephropathy, and in patients without (P &lt; 0.0001) but not with (P = 0.2) peripheral arterial disease.
CONCLUSIONS—Osteoprotegerin measurement, together with other conventional factors, can help to better define the diabetic population with an increased likelihood for SMI.
Changes in Vigorous Physical Activity and Incident Diabetes in Male Runners
Authors: Williams Paul T. 
Published: October 2007

OBJECTIVE—We examined the relationship between changes in reported vigorous exercise and self-reported physician-diagnosed diabetes in 25,988 active men.
RESEARCH DESIGN AND METHODS—The dose-response relationship between changes in reported vigorous exercise (running distance, change in kilometers per week) and self-reported physician-diagnosed diabetes was followed prospectively for 7.8 ± 1.8 years (means ± SD).
RESULTS—Logistic regression analyses showed that the log odds for diabetes declined significantly in relation to men's change in running distance (coefficient ± SE: −0.012 ± 0.004, P &lt; 0.01), which remained significant when adjusted for BMI (−0.018 ± 0.003, P &lt; 0.0001). The decline in the log odds for diabetes was related to the distance run at the end of follow-up when adjusted for baseline distance, with (−0.024 ± 0.005, P &lt; 0.0001) or without (−0.027 ± 0.005, P &lt; 0.0001) adjustment for BMI. Baseline distance was unrelated to diabetes incidence when adjusted for the distance at the end of follow-up. Compared with men who ran &lt;8 km/week at the end of follow-up, incidence rates in those who ran ≥8 km/week were 95% lower between 35 and 44 years of age (P &lt; 0.0001), 92% lower between 45 and 54 (P &lt; 0.0001), 87% lower between 55 and 64 (P &lt; 0.0001), and 46% lower between 65 and 75 (P = 0.30). For the subset of 6,208 men who maintained the same running distance during follow-up (±5 km/week), the log odds for diabetes declined with weekly distance run (−0.024 ± 0.010, P = 0.02) but not when adjusted for BMI (−0.005 ± 0.010, P = 0.65).
CONCLUSIONS—Vigorous exercise significantly reduces diabetes incidence, due in part to the prevention of age-related weight gain and in part to other exercise effects.
Fungus Culture of the Nasal Secretion of Chronic Rhinosinusitis Patients: Seasonal Variations in Daegu, Korea
Authors: Shin Seung-Heon , Ye Mi-Kyung , Lee Young-Ho 
Published: October 2007

Background The role of fungi in the pathogenesis of chronic rhinosinusitis (CRS) is being increasingly recognized. The presences of fungal spores are a necessary condition for fungal sinusitis, and fungal spore counts vary widely, both geographically and seasonally. The aim of this study was to characterize fungal seasonal variation in the nasal cavity of CRS patients and to compare it with histologic types of nasal polyps. Methods One hundred eight patients with a clinical diagnosis of CRS with polyps were enrolled in this study for 1 year. Nasal secretions were obtained by aspiration and cultured to identify fungi. Nasal polyps were divided into four histologic types: eosinophilic, fibroinflammatory, seromucinous, and atypical. Results Positive cultures for fungi were obtained in 60 of 108 (63.0%) CRS patients, and 28 of 45 (62.2%) normal volunteers. Fungus culture rates were higher during summer and fall. Cladosporium, Aspergillus, Alternaria, and Penicilium were frequently isolated from CRS patients and normal volunteers. The most common histologic type was the fibroinflammatory type (60.2%), although in the summer and fall the proportion of the eosinophilic type increased. Conclusion Fungi were commonly cultured during a hot and humid environment, during summer and fall, and cultured organism types were found to be seasonal dependent. Histologic types of nasal polyps appear to be associated with fungal culture rate, organism type, and seasonal variations.
Exhaled Inflammatory Markers in Aspirin-Induced Asthma Syndrome
Authors: Carpagnano Giovanna E. , Resta Onofrio , Gelardi Matteo , Spanevello Antonio , Di Gioia Giuseppe , Giliberti Tiziana , Depalo Annarita , Barbaro Maria P. Foschino 
Published: October 2007

Background Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome. Methods Twelve patients with AIA, 17 patients with mild asthma (MA), 12 patients with nasal polyposis (NP), 11 patients with mild asthma + nasal polyposis (MA + NP), and 10 healthy subjects (HSs) were enrolled. Nasal and oral exhaled IL-4 and IL-6 were measured by enzyme immunoassay kit. Results Higher levels of nasal and oral exhaled IL-4 and IL-6 were observed in AIA compared with MA, NP, MA + NP, and HSs. Moreover, a positive correlation was identified between nasal exhaled IL-4 and IL-6 and, respectively, the number of neutrophils and eosinophils and in nasal scraping. Conclusion The concentration of eosinophilic and neutrophilic markers in upper and lower airways of subjects with AIA syndrome is higher compared with HS and subjects with MA, NP, and MA + NP.
Can we Smell without an Olfactory Bulb?
Authors: Rombaux Philippe , Mouraux André , Bertrand Bernard , Duprez Thierry , Hummel Thomas 
Published: October 2007

Background Lack of an olfactory bulb (OB) is typically associated with anosmia. Methods We present a patient with subnormal olfactory function in whom the OB could not be detected with magnetic resonance imaging (MRI). Results Olfactory function was evaluated on two occasions. Orthonasal olfactory function was assessed with the “Sniffin’ Sticks” test providing a score equivalent to hyposmia. Retronasal olfactory function was studied with “smell powders” indicating a decreased, but not absence of, olfactory function. Importantly, chemosensory event-related potentials were clearly present in response to olfactory and trigeminal stimuli. Conclusion This indicates that olfactory function may be present in some subjects even when an OB can not be detected with MRI.
Murine Tracheal and Nasal Septal Epithelium for Air–Liquid Interface Cultures: A Comparative Study
Authors: Woodworth Bradford A. , Antunes Marcelo B. , Bhargave Geeta , Palmer James N. , Cohen Noam A. 
Published: October 2007

Background Air–liquid interface cultures using murine tracheal respiratory epithelium have revolutionized the in vitro study of airway diseases. However, these cultures often are impractical because of the small number of respiratory epithelial cells that can be isolated from the mouse trachea. The ability to study ciliary physiology in vitro is of utmost importance in the research of chronic rhinosinusitis (CRS). Our hypothesis is that the murine nasal septum is a better source of ciliated respiratory epithelium to develop respiratory epithelial air–liquid interface models. Methods Nasal septa and tracheas were harvested from 10 BALB/c mice. The nasal septa were harvested by using a simple and straightforward novel technique. Scanning electron microscopy was performed on all specimens. Cell counts of ciliated respiratory epithelial cells were performed at one standard magnification (1535×). Comparative analysis of proximal and distal trachea, midanterior and midposterior nasal septal epithelium, was performed. Results Independent cell counts revealed highly significant differences in the proportion of cell populations (p < 0.00001). Ciliated cell counts for the trachea (106.9 ± 28) were an average of 38.7% of the total cell population. Nasal septal ciliated epithelial cells (277.5 ± 16) comprised 90.1% of the total cell population. Conclusion To increase the yield of respiratory epithelial cells harvested from mice, we have found that the nasal septum is a far superior source when compared with the trachea. The greater surface area and increased concentration of ciliated epithelial cells has the potential to provide an eightfold increase in epithelial cells for the development of air–liquid interface cultures.
Sinus Fluid Penetration of Oral Clarithromycin and Azithromycin in Patients with Acute Rhinosinusitis
Authors: Margaritis Vasilios K. , Ismailos George S. , Naxakis Stefanos S. , Mastronikolis Nicholas S. , Goumas Panos D. 
Published: October 2007

Background The aim of this study was to investigate the extracellular concentration and the degree of sinus fluid penetration of newer macrolides, within the first 24–48 hours of treatment in patients with acute bacterial rhinosinusitis (ABRS), choosing clarithromycin and azithromycin as model antibiotics. An open, noninterventional pharmacokinetic study was performed at a tertiary teaching hospital. Methods In 36 outpatients with ABRS, sinus fluid aspirates and serum samples were collected 2, 4, 6, 8, and 12 hours or 2, 6, 12, and 24 hours after the administration of three doses of oral clarithromycin, 500 mg, twice daily or two doses of oral azithromycin, 500 mg, once daily, respectively. Drug concentrations were determined in both matrices by high-performance liquid chromatography with fluorometric detection, and the pH was estimated for all sinus fluid samples. Results The average clarithromycin sinus fluid concentration was found to be significantly higher than the corresponding azithromycin concentration (2.47 mg/L versus 0.65 mg/L), while the extent of the average sinus fluid penetration, expressed by the ratio of drug concentration in tissue versus serum, was similar for both drugs (115 and 120%, respectively). Conclusion In patients with ABRS, clarithromycin and azithromycin present adequate penetration into sinus fluid to eradicate erythromycin-sensitive strains of Streptococcus pneumoniae. Considering their comparative in vitro activity, the sinus fluid pH effect, and their sinus fluid penetration profile, we may conclude that among the erythromycin-resistant S. pneumoniae strains, clarithromycin might be advantageous over azithromycin in eradicating some of the low-level resistant strains.
Radiological Correlation between Pneumatization of Frontal Sinus and Height of Fovea Ethmoidalis
Authors: Gumus Cesur , Yildirim Altan 
Published: October 2007

Background We need more data about the variations of skull base to minimize the complications of ethmoidectomy. The aim of this study was to analyze the relationship between the pneumatization of the frontal sinus and height of the fovea ethmoidalis. Methods Paranasal coronal computed tomography (CT) scans of 487 sides of 300 patients were evaluated. The presence of the frontal cell and pneumatization of the frontal sinus were studied with respect to the height of the fovea ethmoidalis. Results We found a statistically significant correlation between the frontal cell and frontal sinus hyperpneumatization (p = 0.000). We determined that there was a deeper fovea ethmoidalis in the sides that have a frontal cell (p ≤ 0.001) and in the sides that have hyperpneumatization of the frontal sinus (p = 0.000). We also observed flatter fovea ethmoidalis in the sides that have hypopneumatization of the frontal sinus (p ≤ 0.001). Conclusion The presence of a frontal cell or hyperpneumatization of the frontal sinus on CT scan should alert the clinician that there may be a deep fovea ethmoidalis.
Septal Cartilage Graft for Nasal Valve Incompetence Associated with Deviated Septum
Authors: Paccoi Paolo , Di Peco Valerio 
Published: October 2007

Background The nasal valve is one of the major factors contributing to nasal airflow obstruction. Physiologically, the nasal valve offers the greatest resistance to nasal airflow and generally functions as an inflow device controlling nasal airflow and resistance. Many patients who have complaints of breathing impairment are affected by alterations of the nasal septum, the turbinates, the columellar base, the vestibule floor, or the lateral wall of the nose but may have associated incompetence of the nasal valve, which is too often undervalued by nasal surgeons. The aim of this study was to propose a relatively easy surgical technique to correct most nasal valve impairments associated with nasal septum deviation whether or not there also is inferior turbinate hypertrophy. Methods Between May 2004 and September 2006, 68 patients (26 women and 42 men; mean age, 37 years; range, 16–71 years) underwent primary or secondary functional nasal surgery, because of a nasal respiratory obstruction caused by nasal septal deviation eventually associated with inferior turbinates hypertrophy, and also demonstrated nasal valvular incompetence. A septal cartilage graft was used to correct the valvular incompetence. Results On postoperative visits almost all of the patients (with one exception) showed a remarkable improvement in the stiffening of the valvular region and had only minimal depression of the nostril during deep inspiration. Conclusion This study indicated that septal grafts were useful in the surgical management of nasal respiratory impairment because of nasal valve incompetence, where there had been flaccid mobile collapse of the ala of the nose associated with septal alterations.
Inverted Papilloma with New Bone Formation: Report of Three Cases
Authors: Unlu H. Halis , Songu Murat , Ovali Gulgun Yılmaz , Nese Nalan 
Published: October 2007

Background An inverted papilloma (IP) is a benign sinonasal tumor of ectodermal origin, which is locally aggressive and destructive, tends to recur if incompletely removed, and has significant malignant potential. On CT scan, the appearance of an IP is variable and nonspecific but most commonly it appears to have soft tissue density. The association of IPs and new bone formation is extremely rare; to the best of our knowledge, only one case has been reported in the literature to date. Methods We report three cases with existence of bony mass surrounded by polypoid soft tissue diagnosed as IP histopathologically. Results The nature, shape, and location of the bony mass were not in concordance with trapped bone, with tumoral calcifications, or with osteoma. Conclusion We propose that with regard to the three cases presented here, new bone formation may be associated with IP pathologically. We also believe that additional investigations are required to characterize the pathophysiological mechanisms involved in neoplasm-induced osteogenesis.
Combined use of Fibrin Tissue Adhesive and Acellular Dermis in Dural Repair
Authors: Shah Anil R. , Pearlman Aaron N. , O'Grady Kevin M. , Bhattacharyya Tappan K. , Toriumi Dean M. 
Published: October 2007

Background The management of cerebrospinal fluid (CSF) leaks can be challenging. Acellular dermal grafts derived from human cadavers can be used as a replacement material when autogenous materials are unavailable. Fibrin tissue adhesive (FTA) is a wound support product that has been used for hemostatic and tissue fixation purposes. The combined use of acellular dermis in conjunction with FTA for dural repair remains a subject of study. The aim of this study was to evaluate wound healing and tissue compatibility characteristics of acellular dermal substitute material when used both with and without FTA, for repair of a dural tear in a chinchilla model. Methods Forty-nine chinchillas were included in this randomized case-control study. The squamous portion of the temporal bone was removed to expose the tegmen. A 2 X 2 mm dural defect was removed to create an iatrogenic CSF leak. Then, animals were randomly assigned to one of three treatment groups: group 1, acellular dermis alone; group 2, acellular dermis with FTA; group 3, fibrinogen, acellular dermis, and FTA. Surgical sites were examined grossly at 1- and 2-week intervals. Temporal bones were examined histologically. Results Grossly, groups 2 and 3 had significantly less visible CSF leak and brain herniation noted at both 1- and 2-week intervals when compared with group 1. Histological results confirmed the gross results showing the best seal in group 2 and 3. Conclusion Acellular dermis combined with FTA provided superior support compared with acellular dermis alone in repair of induced dural defects.
Standardization of Diagnostic Criteria for Eosinophilic Chronic Rhinosinusitis in the Oestrus Ovis Infected Sheep Model
Authors: Thomas Devika C. , Surg M. , Wormald Peter-John 
Published: October 2007

Background The sheep is an established model for endoscopic surgical procedures, as well as for postsurgical healing. Standardization of the presence and the degree of eosinophilia within this model still has not been done. This study was undertaken to show the eosinophilic response secondary to Oestrus ovis parasitic infestation within the nasal cavity to standardize the sheep model of chronic rhinosinusitis (CRS) and to set diagnostic criteria for CRS in sheep. Methods Nasal mucosal secretions were obtained from sheep naturally infested with O. ovis and showed signs of CRS and from sheep treated with ivermectin to prevent the infestation. Full thickness mucosal biopsy specimens from the lateral nasal wall were obtained also from these sheep. After histological fixing and staining, the degree of eosinophilia in the mucous secretion smears and in the epithelial layer of the lateral nasal wall was quantified using a light microscope. Results The average number of eosinophils in the mucous secretions and in the nasal wall epithelium was significantly higher in the sheep that showed signs of rhinosinusitis and had visible O. ovis larvae compared with control sheep (p = 0.003 and p = 0.05, respectively). Conclusion Based on the average numbers of eosinophils observed the diagnostic criterion for CRS in sheep is two eosinophils per high-power field averaged over three fields of secreted mucous smears or an average of at least one eosinophil per high-power field of nasal wall epithelial biopsy specimens.
Endoscopic Reconstruction of Large Anterior Skull Base Defects using Acellular Dermal Allograft
Authors: Germani Ross M. , Vivero Richard , Herzallah Islam R. , Casiano Roy R. 
Published: October 2007

Background Endoscopic repair of small- to medium-sized anterior skull base (ASB) defects using bone, cartilage, fascia, fibrin glue, lipolized dura, and, more recently, acellular dermal allograft have all been described with equal efficacy. The purpose of this study was to review our experience with the use of acellular dermis as the sole graft material in endoscopic reconstruction of large ASB defects. Methods A retrospective chart review of all patients who underwent endoscopic repair of ASB defects at the University of Miami between the years of 2001 and 2006 was conducted. Fifty-six patients were identified who met these criteria. All repairs were performed by a transnasal, endoscopic approach. Outcome measures included success of graft take and incidence of major and minor complications. Dural defect size was defined as small (<0.4 cm), intermediate (0.4–2.0 cm), and large (>2.0 cm). Results AlloDerm (AlloDerm. LifeCell Corp. Woodlands, TX) was used as the primary graft material in 30/55 (55%) cases; 16/55 (29%) of the repaired defects were classified as large. Graft success was 97% in the AlloDerm group and 92% in the non-AlloDerm group. The incidence of major and minor complications in the AlloDerm group was 0 and 3.3%, respectively. In the non-AlloDerm group, the incidence of major and minor complications was 4 and 12%, respectively. There were no statistical differences in the complication rates based on the type of repair or defect size. Conclusion Alloderm can be used successfully to repair ASB defects, including large defects that are >2 cm in size with little or no morbidity.
A Cadaveric Model for Balloon-Assisted Endoscopic Paranasal Sinus Dissection without Fluoroscopy
Authors: Citardi Martin J. , Kanowitz Seth J. 
Published: October 2007

Background Recently, balloon catheter (BC) dilatation of paranasal sinus ostia has been introduced. In this procedure, a balloon-tipped catheter is placed across a sinus ostium over a flexible wire under fluoroscopic guidance, and inflation of the balloon enlarges the ostium. Some rhinologists have criticized this procedure for its failure to remove tissue and bone, especially in the setting of sinonasal polyposis. This project seeks to develop strategies for incorporating BC technology into standard functional endoscopic sinus surgery procedures. Methods Endoscopic sinus dissection of three human cadaveric heads was performed with conventional instruments supplemented by lacrimal duct BCs (LacriCATH; Quest Medical, Allen, TX). No fluoroscopy was used. Each dissection was videotaped for later review. Results For frontal recess dissection, these steps were performed under endoscopic visualization: (1) passage of the BC between frontal recess partitions, (2) BC inflation, and (3) removal of fractured frontal recess partitions with conventional instruments. This approach was used successfully in each frontal recess. Under endoscopic visualization, a BC was passed into the sphenoid ostium and inflated; this maneuver successfully dilated each sphenoid ostium. It was not feasible to reliably pass the BC through the natural maxillary ostium. Each BC was inflated to 8 atm for 30 seconds. No evidence of orbital or skull base injury was noted. No fluoroscopy was used. Conclusion BCs may be used as adjunctive instrumentation for endoscopic sinus dissection without fluoroscopy. This strategy warrants additional technical and clinical development.