bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Endoscopic Sinus Surgery for Chronic Rhinosinusitis associated with Sinonasal Polyposis
Authors: Poetker David M. , Mendolia-Loffredo Sabrina , Smith Timothy L. 
Published: January 2007

Background The aim of this study was is to investigate the outcomes of endoscopic sinus surgery (ESS) when performed for chronic rhinosinusitis associated with sinonasal polyps. Methods Forty-three patients with polyps were compared with 76 patients without polyps before and after ESS. Mean follow-up was 1.5 years. Patients were analyzed prospectively based on computed tomography (CT), endoscopy, quality-of-life (QOL) assessment, and visual analog scales (VASs). Univariate analyses were performed to evaluate whether the presence of polyps was predictive of outcome. Results Patients with polyps had worse CT and endoscopy scores both pre- and postoperatively when compared with patients without polyps (p < 0.0001 for each). All patients, regardless of polyps, improved on endoscopic exam; however, patients with polyps showed a greater degree of improvement (p = 0.002). Despite this, postoperative endoscopic scores in patients with polyps were worse than those without polyps (p < 0.0001). Patients with polyps had better QOL as measured by the Chronic Sinusitis Survey (CSS) both pre- and postoperatively (p = 0.001 and 0.044, respectively). The preoperative VAS indicated that patients with polyps had increased nasal obstruction compared with patients without polyps (p = 0.002) while having less facial pain and headache (p = 0.002 and 0.005, respectively). Patients with polyps showed a greater postoperative improvement in nasal congestion (p = 0.003) but no difference in level of improvement in postoperative headache or pressure. Conclusion Despite significantly worse objective testing scores, patients with polyps report significantly better QOL as measured by the CSS and less facial pain/headache as measured by VAS scores pre- and postoperatively. Polyps were not found to be predictive of QOL or endoscopic outcome.
Chronic Rhinosinusitis Patients with Polyps or Polypoid Mucosa have a Greater Burden of Illness
Authors: Banerji Aleena , Piccirillo Jay F. , Thawley Stanley E. , Levitt Robert G. , Schechtman Kenneth B. , Kramper Maggie A. , Hamilos Daniel L. 
Published: January 2007

Background Recent studies suggest chronic rhinosinusitis without nasal polyposis (CRSsNP) and CRS with nasal polyposis (CRScNP) represent distinct pathological entities. The aim of this study was to determine whether patients with CRSsNP, CRScNP, and polypoid CRS could be distinguished by clinical features, radiologic extent of disease or use of medications. Methods New patients with CRS (n = 126) were enrolled in a prospective outcomes study. Rhinoscopic evaluation was used to classify patients. The relationship between disease phenotype and clinical parameters was examined. Results Facial pain/pressure/headache was more prevalent in CRSsNP than CRScNP (p = 0.01). Nasal obstruction and hyposmia/ anosmia were more prevalent in CRScNP than CRSsNP (p = 0.025 and 0.01, respectively). Intermediate symptom prevalence was found in polypoid CRS. Multivariate analysis confirmed that prior surgery, CT scan score, and male gender were independent predictors of polyp/polypoid phenotype. Allergic status was unrelated to CRS classification. Medication use was higher in CRScNP patients than in CRSsNP patients. Conclusion Compared with CRSsNP, patients with CRScNP have a greater burden of symptoms, more prior surgery, higher CT scan scores, and greater use of medications.
Cytological Characterization of Persistent Paranasal Sinus Secretions after Endoscopic Sinus Surgery
Authors: Bhattacharyya Neil 
Published: January 2007

Background The aim of this study was to characterize the cellular composition of persisting sinus secretions after endoscopic sinus surgery (ESS). Methods Consecutive adult patients with persisting abnormal sinus secretions post-ESS were prospectively evaluated. Sinus secretions were aspirated and submitted for cytological analysis. Semiquantitative cell counts were obtained for epithelial cells (graded as present or absent), eosinophils (graded on a 4-point Likert severity scale), and neutrophils (3-point Likert scale). Prior operative histopathology from ESS and Lund CT scores were reviewed. Statistical analyses were conducted to determine the relationships between preoperative Lund score, operative histopathology, and subsequent cellular infiltrate in sinus secretions. Results Forty-three patients (mean age, 49 years) were enrolled. Epithelial cells were present in 13 (30.2%) of these individuals. Cytological eosinophilia was rated as absent in 14 (32.6%) cases, mild in 5 (11.6%) cases, moderate in 18 (41.9%) cases, and severe in 6 (14.0%) cases. Neutrophil presence was absent in 24 (55.8%) cases, present/mild in 15 (34.9%) cases, and severe in 4 (9.3%) cases. No significant correlation could be found between the presence of each of these three cell types, the presence or absence of polyps, or preoperative Lund score (all p > 0.05). Sloughed epithelial cell presence was inversely but significantly correlated with original sinus histopathological inflammation (Spearman's ρ, -0.348; p = 0.04); eosinophilic cytology tended to increase with prior operative histopathology inflammatory grade but neutrophils did not. Conclusion The cytological profile of persisting secretions after ESS is dominated by eosinophils and to a lesser degree neutrophils. The presence of sloughed epithelial cells may signify ongoing mucosal damage from persisting sinonasal inflammation.
Nasal Mucosal Temperature in Relation to Nasal Airflow as Measured by Rhinomanometry
Authors: Lindemann Joerg , Keck Tilman , Scheithauer Marc Oliver , Leiacker Richard , Wiesmiller Kerstin 
Published: January 2007

Background The aim of this study was to measure in vivo nasal mucosal temperature and assess its relationship to nasal patency. Methods Nasal mucosal temperature of 30 nasal cavities was measured by means of a miniaturized thermocouple within the anterior turbinate area during respiration. Temperature values were compared with corresponding rhinomanometrical data. Results The median mucosal temperature ranged from 30.2°C (range, 28.9–31.7°C) after inspiration to 32.2°C (range, 31.0–33.9°C) after expiration. The end-inspiratory (r = -0.85) and end-expiratory mucosal temperature values (r = -0.88) negatively correlated with the rhinomanometrical data. Conclusion This study supports the fact that there is a negative correlation between nasal mucosal temperature and nasal resistance. Changes in nasal patency seem to influence nasal mucosal temperature. Within this context, nasal thermoreceptors might play an important role concerning the perception of nasal patency.
Site of Attachment of Inverted Papilloma Predicted by CT Findings of Osteitis
Authors: Yousuf Kashif , Wright Erin D. 
Published: January 2007

Background The treatment of choice for sinonasal inverted papilloma (IP) is surgical resection, which typically includes identification of the site of origin with appropriate inclusion or management of this site in the surgical resection. Appropriate preoperative planning is thus of significant importance and will routinely include CT imaging and nasal endoscopy. The aim of this study was to determine whether findings of osteitis in the patients’ preoperative CT images could predict the site of attachment. Methods This bipartite study contained both retrospective and prospective arms. For the retrospective arm, preoperative CT images of all cases were reviewed electronically in a blinded fashion by the senior author and a prediction was made for the site of attachment. The actual site of attachment as documented in the operative note was then compared with the predicted site. A similar process was followed for the prospectively acquired patients except that the site of attachment was predicted preoperatively. Results Twenty-eight retrospective and six prospective patients were identified as eligible for the study. Six retrospective patients were excluded because of incomplete data. In patients that were reviewed retrospectively, osteitis was seen in 20/22 patients and was used to correctly predict the site of attachment in 18/20 times. Of the prospectively acquired patients osteitis was seen in 5/6 patients with the site of attachment predicted in 4/5 patients. Conclusion In patients in whom osteitis is detectable on the preoperative CT scan, the site of origin of the IP can be predicted with a high degree of accuracy.
Transblepharoplasty Approach to Sequestered Disease of the Lateral Frontal Sinus with Ophthalmologic Manifestations
Authors: Knipe Thomas A. , Gandhi Parag D. , Fleming James C. , Chandra Rakesh K. 
Published: January 2007

Background Sequestered disease within the lateral extent of the frontal sinus that has eroded into the orbit through the frontal sinus floor may be difficult to address with standard ESS techniques. We describe an approach to this problem using a transblepharoplasty incision concealed in the upper eyelid crease. Methods Five consecutive patients with lateral frontal sinus disease involving the orbit were treated with combined ESS/transblepharoplasty approach. This used an upper lid incision and elevation of a myocutaneous flap. The preexisting dehiscence in the sinus floor was exposed, permitting extraction of fungal debris and marsupialization of the mucocele. Frontal sinusotomy was performed via combined above/below technique Results The study group included 5 patients with mean age of 50 years. Two patients had post-traumatic mucopyocele, two had allergic fungal sinusitis, and one exhibited both entities. All patients had signs of ophthalmopathy: proptosis with increased IOP (5/5), gaze restriction (5/5), and decrease in visual acuity (2/5). Ophthalmologic symptoms improved postoperatively in 5/5, but 2 patients eventually required revision endoscopic surgery. No complications occurred, and incision healing was excellent in all patients. Conclusion In patients with sequestered disease of the lateral frontal sinus and ophthalmologic manifestations, the transblepharoplasty approach in combination with ESS affords excellent access while preserving cosmesis.
Impact of Depression on Disease-Specific Symptoms and Quality of Life in Patients with Chronic Rhinosinusitis
Authors: Brandsted Rebecca , Sindwani Raj 
Published: January 2007

Background Depression is associated with increased symptom burden in the setting of chronic medical conditions. Studies investigating the influence of depression on the symptoms of chronic rhinosinusitis (CRS) are lacking. The purpose of this project was to establish the prevalence of depression in patients with CRS and to explore the impact of this disorder on disease-specific symptoms and general quality of life (QOL) in the preoperative and postoperative setting. Methods We reviewed the records of 320 consecutive patients presenting with sinonasal symptoms to our specialty sinus clinic. Patients with CRS were evaluated by nasal endoscopy, CT imaging, and validated questionnaires including the Chronic Sinusitis Survey and SF-8 Health Survey, a QOL measurement. Findings in CRS patients with depression were compared with a matched-control group of CRS patients without depression before and after endoscopic sinus surgery. Results Overall, 26% of patients presenting with sinonasal symptoms had a diagnosis of depression. After evaluation including CT imaging, 33% of the initial population was diagnosed with CRS. The prevalence of depression in these CRS patients was 25%. Disease-specific symptoms were similar between groups; however, depressed CRS patients reported significantly worse pain and energy level and difficulty with daily activities (p < 0.050) when compared with a control group of CRS patients without depression. Postoperatively, nondepressed patients showed a marked improvement in disease-specific as well as general QOL scores (p < 0.050), whereas depressed patients did not. Conclusion CRS patients with and without depression have similarly poor disease-specific symptoms. However, depressed CRS patients have poorer disease-specific and overall QOL outcomes after sinus surgery.
Rhinologic Manifestations of Ectodermal Dysplasia
Authors: Mehta Umang , Brunworth Joseph , Lewis Richard Alan , Sindwani Raj 
Published: January 2007

Background The Ectodermal Dysplasias (ED) are a group of uncommon genetic disorders characterized by deficient development of tissues derived from ectoderm and mesoderm. Abnormalities of the respiratory epithelium prevent normal mucociliary function. We explored the prevalence and severity of sinonasal features in affected individuals. Methods Thirty-four subjects with ED were evaluated. A focused history and thorough nasal examination including flexible nasopharyngoscopy were performed. Patients and caregivers rated the severity of rhinologic symptoms with a standard scale. Standardized smell tests were also performed. Results The study included 21 males and 13 females whose mean age was 18.8 years (range, 4 months to 85 years). The majority (79%) had Hypohydrotic ED. Nearly half of the individuals evaluated reported moderate to severe nasal obstruction. Allergic symptoms were present in 44% of individuals whereas 41% had a history of sinusitis. Nasal concretions were significantly more troublesome in those aged 15 and under (p = 0.028). Eighteen percent had undergone sinonasal surgery. On examination, normal intranasal structures were identifiable in all patients. However, dry mucosae, prominent crusts, and concretions were found in most (79%). A deviated nasal septum was present in 23% of individuals and a saddle nose deformity in 18. Smell tests were normal for age in all subjects. Conclusion Rhinologic issues are prevalent and problematic in individuals with ED. Management should focus on humidification, nasal debridement, and tailored therapy for allergic rhinitis and sinusitis. Increased awareness of the sinonasal concerns in ED will facilitate diagnosis and improve the care of these patients.
New Bone Formation in Unilateral Rhinosinusitis
Authors: Cho Seok Hyun , Kim Su Young , Lee Keun Young , Lee Hyun Chang 
Published: January 2007

Background Computed tomography (CT) frequently shows abnormal bone thickening in patients with chronic rhinosinusitis. The sinus bone may be not in a static state, and remodeling occurs in response to chronic inflammation. Methods Ostiomeatal unit CT scans were reviewed in 29 patients with unilateral rhinosinusitis (URS) undergoing endoscopic sinus surgery. We defined new bone formation (NBF) as a remarkable bone thickening or hyperostosis of the intrinsic sinus walls in comparison with the normal side. Bony CT scores of sinus walls were expressed by the Hounsfield unit (HU) and soft tissue CT scores were measured by the Lund-Mackay system. Results Almost all of the NBF was located at the maxillary and anterior ethmoid sinuses (83.7%), and it was significantly increased in patients with higher Lund-Mackay scores (p = 0.043). The HU values were significantly different between NBF and non-NBF contralateral sides (p < 0.05). Conclusion The HU may be helpful to diagnose and quantify the bone remodeling in URS.
Endoscopic Anatomy of the Parasellar Region
Authors: Bassim Marc K. , Senior Brent A. 
Published: January 2007

Background The aim of this study was to describe the endoscopic anatomy of the cavernous sinus and adjoining parasellar regions and their relationships to the sphenoid sinus. Methods An endoscopic transnasal transsphenoidal approach to the pituitary gland and posterior skull base was performed on three fresh frozen cadaver heads (six sides). Neural and vascular anatomic landmarks of the cavernous sinus and parasellar regions were identified and correlated with sphenoid surface anatomy. Results The posterior wall of the sphenoid sinus presents several surface landmarks allowing the identification of the sella, carotid artery, and optic nerve. Identification of the optic-carotid recess allows reflection of the internal carotid artery medially and access to the cavernous sinus. Further lateral dissection allows for easy identification of the oculomotor, trochlear, trigeminal, and abducens nerves. The ophthalmic artery then can be followed from its origin on the internal carotid artery coursing anteriorly into the orbit. The optic chiasm also can be easily identified superiorly. Posteriorly, careful dissection allows access to the basilar artery along the clivus. Conclusion As endoscopic surgeons continue to expand their procedures to involve areas of the skull base outside the paranasal sinuses, knowledge of the endoscopic anatomy of the sella, parasellar, and adjacent areas is paramount. Critical landmarks are readily evident in the sphenoid sinus providing good access to neural and vascular structures of this region of the skull base.
Sinonasal Epithelial Cell Expression of Toll-Like Receptor 9 is Decreased in Chronic Rhinosinusitis with Polyps
Authors: Ramanathan Murray , Lee Won-Kyung , Dubin Marc G. , Lin Sandra , Spannhake Ernst W. , Lane Andrew P. 
Published: January 2007

Background Innate immune recognition of pathogens by sinonasal epithelial cells may play an important role in the pathogenesis of chronic rhinosinusitis (CRS). Previous studies have indicated that toll-like receptor (TLR) mRNA is present in sinonasal mucosa, and levels of TLR9 expression are decreased in recalcitrant CRS with nasal polyps (CRSwNP). However, the cellular source and function of TLR9 in the sinonasal epithelium is not known. In this study, primary epithelial cell cultures were analyzed from control subjects and CRSwNP patients to determine the presence and function of TLR9 protein. Methods Primary epithelial cell cultures were established from 5 controls and 10 CRSwNP patients undergoing sinus surgery. Flow cytometry was used to confirm purity of epithelial cells and to assess expression of TLR9 protein. Epithelial cells were stimulated with TLR9 agonist, and mRNA was analyzed by real-time PCR for expression of human β-defensin (HBD) 2 and interleukin (IL)-8. Results Flow cytometry showed TLR9 protein in 100% of epithelial cells from controls and CRSwNP patients. The level of expression was 50% lower in CRS patients than in controls. Stimulation of epithelial cells with TLR9 agonist produced a 1.5- to 9-fold increase in HBD-2 and IL-8 mRNA expression. Conclusion Functional TLR9 protein is expressed by normal and diseased sinonasal epithelial cells. The level of TLR9 expression is decreased in CRSwNP patients, consistent with the previous finding of decreased TLR9 mRNA in whole sinonasal tissue. These findings suggest that impaired innate immune responses to pathogens via TLR9 on sinonasal epithelial cells may represent a critical mechanism in chronic inflammatory sinus disease.
Immunolocalization of Dendritic Cells and Pattern Recognition Receptors in Chronic Rhinosinusitis
Authors: Rampey Andrew M. , Lathers Deanne M.R. , Woodworth Bradford A. , Schlosser Rodney J. 
Published: January 2007

Background Dendritic cell (DC) activation and antigen presentation to T cells are critical to innate and adaptive immunity. Toll-like receptors (TLRs) are known to bind pathogen-associated molecular patterns in addition to sinonasally secreted surfactant proteins (SP) such as SP-A and SP-D. TLR binding is known to activate DCs. Based on these observations, we sought to establish the presence, in sinonasal mucosa, of DC and the pattern recognition receptors (PRRs), CD14, TLR2, and TLR4. Methods Sinonasal biopsy specimens were taken from patients with eosinophilic nonatopic nasal polyposis (n = 4), allergic fungal sinusitis (n = 1), and nondiseased patients undergoing cerebrospinal fluid leak repair or pituitary tumor resection (n = 2). Tissue samples were stained immunohistochemically for PRR (CD14, TLR2, and TLR4), mature DC marker (CD208), iDC marker (CD209), or isotype controls. Results Immature and mature DC were immunolocalized to the subepithelial stroma and ciliated epithelial surface, respectively. Diffuse staining of CD14 was observed throughout the stroma with additional staining in the ciliated epithelium. The TLR markers showed no staining in the ciliated epithelium. TLR2 primarily localized in stroma immediately deep to the ciliated epithelial surface. TLR4 immunolocalized to submucosal seromucinous gland ductal epithelium. Data from nondiseased patients were mixed, with one patient showing minimal staining of any of the tested cellular markers. Conclusion This study indicates progressive DC activation and emigration of mature antigen-presenting cells from the epithelial surfaces of sinonasal mucosa. The presence of TLR known to bind SP-A and SP-D suggests a link between SP expression and immune response in sinonasal mucosa.
Electrophysiological Recordings from Neonatal Neocortical Brain Slices
Authors: Daw Michael , Isaac John 
Published: January 2007

AbstractMany brain processes and the expression of many neuronal proteins are developmentally regulated; therefore, studying cellular and molecular processes in tissue from very young animals is vital to understanding the development of the brain. Working on tissue from very young animals (first postnatal week) presents a number of specific problems. This unit describes techniques to overcome these problems to produce in vitro slices from neonatal rodents and to reliably achieve high‐quality patch‐clamp recordings from neurons in neonatal brain slices.
Assays for Cyclic Nucleotide‐Specific Phosphodiesterases (PDEs) in the Central Nervous System (PDE1, PDE2, PDE4, and PDE10)
Authors: Deng Chengjun , Wang Daguang , Bugaj‐Gaweda Bozena , De Vivo Michael 
Published: January 2007

AbstractSince the identification of phosphodiesterase activity in brain tissue more than 40 years ago, 11 distinct gene families have been identified, differing with respect to localization, regulation, affinity for cAMP and cGMP, and distinct functions within cells. PDEs 1, 2, 4, and 10 are currently of special interest to CNS pharmacology because of their high expression in specific areas of the brain and the behavioral effects of inhibitors of these enzymes in rodents. Efficient high‐throughput PDE enzyme assays are essential for PDE‐targeted drug discovery, and this unit details two types of assays. The first method is relatively inexpensive and is based on separating radiolabeled cNMPs from degradation products on alumina columns. The second method is fluorescence‐based; it is fast and better accommodates high‐throughput screening, but is more expensive. Although these methods have successfully been used for PDEs 1, 2, 4 and 10, they could be readily adapted to other PDEs.
Synthesis of Ribonucleosides by Condensation Using Trimethylsilyl Triflate
Authors: Vorbrüggen Helmut , Lagoja Irene M. , Herdewijn Piet 
Published: January 2007

AbstractThis unit describes, in detail, the optimized condition for the synthesis of nucleosides making use of the trimethysilyl triflate–mediated silyl‐Hilbert‐Johnson synthesis. This unit focuses on the mechanistic understanding of this universal and conveniently applicable method.
Synthesis of 2′‐O‐β‐d‐Ribofuranosylnucleosides
Authors: Mikhailov Sergey N. , Efimtseva Ekaterina V. , Rodionov Andrei A. , Bobkov Georgii V. , Kulikova Irina V. , Herdewijn Piet 
Published: January 2007

AbstractA simple and efficient method for the preparation of 2‐O‐β‐D‐ribofuranosylnucleosides, minor tRNA components, is described in this unit. The method consists of condensation of a small excess of 1‐O‐acetyl‐2,3,5‐tri‐O‐benzoyl‐β‐D‐ribofuranose activated with tin tetrachloride with N‐protected 3,5‐O‐tetra‐isopropyldisiloxane‐1,3‐diyl‐ribonucleosides in 1,2‐dichloroethane. Subsequent deprotection produces 2‐O‐β‐D‐ribofuranosylnucleosides in an overall yield of 46% to 72%.