[Analysis of prognostic factors in endoscopic surgery for juvenile nasopharyngeal angiofibroma]

OBJECTIVE

Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA).

METHOD

Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used.

RESULT

Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process.

CONCLUSION

Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.

Endoscopic endonasal surgery for recurrent cerebrospinal fluid rhinorrhea

CONCLUSIONS

CT and MRI are helpful to detect the precise site of the fistula, which is crucial for carrying out the repair, and transnasal endoscopic surgery is an effective treatment for recurrent cerebrospinal fluid (CSF) rhinorrhea.

OBJECTIVE

To discuss the cause and treatment of recurrent CSF rhinorrhea.

METHODS

A retrospective study was undertaken to analyze the clinical characteristics of 32 patients with recurrent CSF rhinorrhea. After detailed examination and radiological evaluation by CT and MRI, all of them underwent transnasal endoscopic surgery.

RESULTS

Six patients presented a leakage at the posterior wall of the frontal sinus, 12 at the ethmoid roof, and 14 at the sphenoid roof. Four cases with a defect in the frontal sinus and frontal recess were repaired with the DRAF III procedure, four cases with a defect in the sphenoid lateral recess were repaired through transpterygoid intervention and under an image-guided navigation system, while the others were operated by routine endoscopic sinus surgery. No recurrence was found during the follow-up for 14-60 months (mean 36.8) in 31 cases, and 1 case with recurrence recovered well after further surgery.

[The role of intracellular Ca2+ release in olfactory signal transduction]

OBJECTIVE

To setup the real time monitor system of the concentration of free intracellular calcium ([Ca2+]i) of olfactory receptor neurons (ORNs) cultured from olfactory epithelium explant, and to analyze the role of several important components in olfactory signal transduction.

METHOD

The [Ca2+]i of the cultured ORNs was determined by fluorescence microscopy using the fluorescent calcium indicator, Fura-2 AM, and calculated by means of dual-wavelength ratiometric method. Forskolin and IBMX were used to stimulate the cultured ORNs respectively. The source of corresponding [Ca2+]i elevation was studied by the depletion of extracellular or intracellular calcium.

RESULT

The [Ca2+]i of silent ORNs was (58.5 +/- 12.8) nmol/L. Forskolin or IBMX stimulation led to reversible accumulation of [Ca2+]i in the ORNs. The [Ca2+]i change was abolished with the removal of extracellular Ca2+ and un-affected by treatment with thapsigargin.

CONCLUSION

A system to visualize and quantify [Ca2+]i of the ORNs was established. [Ca2+]i of the ORNs was regulated by second messenger gated calcium channels.

Protocol optimization for long-term liquid storage of goat semen in a chemically defined extender

A specific problem in the preservation of goat semen has been the detrimental effect of seminal plasma on the viability of spermatozoa in extenders containing egg yolk or milk. The use of chemically defined extenders will have obvious advantages in liquid storage of buck semen. Our previous study showed that the self-made mZAP extender performed better than commercial extenders, and maintained a sperm motility of 34% for 9 days and a fertilizing potential for successful pregnancies for 7 days. The aim of this study was to extend the viability and fertilizing potential of liquid-stored goat spermatozoa by optimizing procedures for semen processing and storage in the mZAP extender. Semen samples collected from five goat bucks of the Lubei White and Boer breeds were diluted with the extender, cooled and stored at 5 degrees C. Stored semen was evaluated for sperm viability parameters, every 48 h of storage. Data from three ejaculates of different bucks were analysed for each treatment. The percentage data were arcsine-transformed before being analysed with anova and Duncan's multiple comparison test. While cooling at the rate of 0.1-0.25 degrees C/min did not affect sperm viability parameters, doing so at the rate of 0.6 degrees C/min from 30 to 15 degrees C reduced goat sperm motility and membrane integrity. Sperm motility and membrane integrity were significantly higher in semen coated with the extender containing 20% egg yolk than in non-coated semen. Sperm motility, membrane integrity and acrosomal intactness were significantly higher when coated semen was 21-fold diluted than when it was 11- or 51-fold diluted and when extender was renewed at 48-h intervals than when it was not renewed during storage. When goat semen coated with the egg yolk-containing extender was 21-fold diluted, cooled at the rate of 0.07-0.25 degrees C/min, stored at 5 degrees C and the extender renewed every 48 h, a sperm motility of 48% was maintained for 13 days, and an in vitro-fertilizing potential similar to that of fresh semen was maintained for 11 days.

Histological differences between the mucosa on the medial and lateral sides of the normal uncinate process

OBJECTIVES/HYPOTHESIS

To determine whether histological differences exist between the medial and lateral sides of the normal mucosa of the uncinate process (UP).

STUDY DESIGN

Retrospective histological analysis.

METHODS

Twenty UPs from the nasal cavities of 17 patients with no evidence of sinus disease were harvested during endoscopic sinus surgery. The dissected mucosa was stained with hematoxylin and eosin, chromotrope 2R, alcian blue-periodic acid-Schiff, and toluidine blue.

RESULTS

: The thickness of the nasal mucosa was significantly greater on the medial side of the UPs than on the lateral side (173 +/- 72 microm vs. 157 +/- 14 microm). The thickness of the basement membrane of the lamina propria of the mucosa was significantly greater on the medial side of the UPs than on the lateral side (2.8 +/- 2.5 microm vs. 0.8 +/- 1.0 microm). The thickness of the epithelium was greater on the lateral side than on the medial side (14 +/- 3 microm vs. 12 +/- 3 microm). The area of mucous glands was larger on the medial side than on the lateral side (43 +/- 13 x 10(-2) mm(2) vs. 33 +/- 12 x 10(-2) mm(2)). Meanwhile, the number of mast cells (4.0 +/- 1.2 vs. 1.8 +/- 0.2) and goblet cells (23.1 +/- 12.3 vs. 10.5 +/- 10.2) were both found to be higher on the lateral side than on the medial side.

CONCLUSIONS

There are histological differences between the mucosa on the medial and lateral sides of the normal UP.

Psychological aspects of female patients with moderate-to-severe persistent allergic rhinitis

BACKGROUND

Allergic rhinitis (AR) has been shown to impair social life and psychological functioning. The objective of our study was to explore the relationships between moderate-to-severe persistent AR and personality traits in non-psychiatric female outpatients.

METHODS

Female subjects were assigned to the allergic (n = 52, 24 singletons and 28 non-singletons) or non-allergic group (n = 28, 11 singletons and 17 non-singletons) on the basis of skin prick tests (SPT) and allergic symptoms. Individuals in this study were only allergic to Dermatophagoides pteronyssinus and/or D. farinae. The psychological aspects of the female subjects were assessed by using the Minnesota Multiphasic Personality Inventory (MMPI).

RESULTS

The allergic group scored significantly higher than the non-allergic group on 6 clinical scales [hypochondriasis (Hs), depression (D), hysteria (Hy), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si)] and 1 validity scale [infrequency (F)]. Analysis of female singleton outpatient MMPI profiles showed that allergic subjects scored significantly higher on D, Hy, masculinity/femininity (Mf), Pt, and F. In addition, the grade of skin index (resulting from an SPT) was positively correlated with T-scores on the Hs, Hy, Pt, and Sc scales.

CONCLUSION

Women with moderate-to-severe persistent AR, especially singleton patients, show poorer psychological functioning, indicating the close relationship between moderate-to-severe persistent AR and psychological functioning.

Efficient transduction of spiral ganglion cells using adenovirus type 5 vector in the rat

CONCLUSIONS

The adenovirus-5 vector specifically transduced spiral ganglion cells with high efficiency, suggesting that it is a potential gene therapeutic tool for the survival of spiral ganglion cells with secondary injury.

OBJECTIVES

This study aimed to find a suitable viral vector allowing efficient transduction to spiral ganglion cells.

METHODS

Lentivirus, adeno-associated virus-2 and adenovirus-5 constructs habouring green fluorescence protein (GFP) gene were injected into scala tympani via the round window membrane of rat. Distribution and fluorescence intensity of GFP within the cochlea were estimated using a fluorescence microscope.

RESULTS

The GFP expressions mediated by all three viral vectors were observed in multiple cell types of the cochlea. Compared with the other two viral vectors, the adenovirus-5 vector efficiently transduced cochlear spiral ganglion cells in vivo and was still present 2 weeks after viral vector injection.

Development and applications of alternative methods of segmentation for Mandarin Hearing in Noise Test in normal-hearing listeners and cochlear implant users

CONCLUSION

The study demonstrates that two methods of segmentation, i.e. word and character segmentations, produce equivalent results in the Mandarin Hearing in Noise Test (MHINT). Potentially, both methods of segmentation can be used clinically. A majority of the Mandarin-speaking cochlear implant subjects could complete MHINT - with the more relaxed adaptive rules. The results make it possible to compare the performance of cochlear implant users across languages.

OBJECTIVES

The primary purpose of the present study was to evaluate the modified adaptive scoring rules and to develop alternative methods of segmentations in MHINT that are suitable for the Chinese language.

METHODS

Thirty Mandarin-speaking normal-hearing adults were tested with MHINT using three adaptive rules based on character and/or word segmentation of the sentences. Twenty-three Mandarin-speaking post-lingually deafened cochlear implant patients were also recruited to participate in the testing.

RESULTS

There were no significant differences in the reception threshold for sentences and speech recognition scores obtained with either method of segmentation (p > 0.05). Fifteen of the 23 cochlear implant subjects (65%) could be tested with the modified adaptive scoring rules. The performance-intensity functions of the cochlear implant subjects were shifted at least 8-10 dB to higher signal-to-noise ratios as compared with those of the normal-hearing subjects.

PS-341 and histone deacetylase inhibitor synergistically induce apoptosis in head and neck squamous cell carcinoma cells

Proteasome inhibitor PS-341 (also known as bortezomib) and histone deacetylase (HDAC) inhibitors have emerged as novel therapeutic agents for a variety of malignancies. In this study, we examined whether PS-341 and the HDAC inhibitor trichostatin A (TSA) induced apoptosis in head and neck squamous cell carcinoma (HNSCC), a common and lethal malignancy. We found that, although TSA treatment alone did not induce apoptosis in HNSCC cells, it significantly enhanced PS-341-induced apoptosis in HNSCC cells in vitro. Consistently, TSA significantly improved PS-341-mediated inhibition of HNSCC tumor growth in nude mice. Mechanistically, we found that TSA increased PS-341-induced Noxa expression and caspase activation in HNSCC cells. The knockdown of Noxa significantly reduced apoptosis induced by cotreatment of PS-341 and TSA. Taken together, our results provide new insight into the mechanisms of synergistic antitumor activity of the PS-341 and HDAC inhibitor regimen, offering a new therapeutic strategy for HNSCC patients.

Mpz gene suppression by shRNA increases Schwann cell apoptosis in vitro

We investigated the effects of short hairpin RNA (shRNA) on myelin protein zero (MPZ) gene expression in Schwann cells (SCs) in vitro and determined the effects of the MPZ gene suppression on the survival of SCs. The MPZ-specific shRNA was introduced into a lentiviral vector for expression under the U6 promoter, and the viral vector-based shRNAs were used to infect cultured SCs. The efficiency of MPZ knockdown was analyzed by real time-PCR (RT-PCR) and western blotting. Flow cytometric analysis and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) were used to determine the cell cycle and the amount of apoptosis of SCs. We found that MPZ shRNAs significantly inhibited the expression of the MPZ gene and induced SC apoptosis in vitro. These results provided interesting experimental evidence for understanding the mechanism of demyelinating neuropathies caused by MPZ gene malfunction.

A modified septoplasty with three high tension lines resection

The modified septoplasty with three tension lines resection is an effective and well-tolerated procedure, which can improve the objective and subjective outcomes, and provide a good approach that is applicable for various septal deviations, especially caudal deviation.

OBJECTIVES

According to the biomechanics of the septal deviation, a modified septoplasty with three high tension lines resection was redefined. The purpose of this study was to review the surgical technique and objective and subjective outcomes.

METHODS

A retrospective review was conducted to identify patients undergoing septoplasty between 2005 and 2006 at Beijing Tongren Hospital. The records were reviewed for demographic data, intraoperative technique, surgical indications, objective and subjective outcomes, and postoperative complications.

RESULTS

A total of 54 patients were identified. The follow-up period ranged from 6 to 12 months. Indications for septoplasty included nasal obstruction (40.7%) and access (59.3%). The data showed that both the objective and subjective outcomes improved after septoplasty. Complications included transient dental pain/hypesthesia (5.6%), synechiae formation (7.4%), epistaxis (1.9%), septal hematoma (3.7%), asymptomatic septal perforation (0%), and nasal deformity (0%).

Audiological results in a group of children with auditory neuropathy spectrum disorder

OBJECTIVE

To enrich clinical information of auditory neuropathy spectrum disorder.

METHODS

Forty-eight infants and young children with severely abnormal auditory brainstem responses (ABRs) along with preserved distortion product otoacoustic emissions (DPOAEs) and/or cochlear microphonics (CMs) were included in this retrospective study. Click ABRs, CMs, DPOAEs, behavioral thresholds and tympanograms were established.

RESULTS

Audiological information of 88 ears (40 cases were bilateral and 8 unilateral) that met the inclusion criteria were analyzed. Most of the ears (68.2%) had absent click ABRs at the maximum presentation level of 100 dB nHL, while other ears had repeatable wave V with lowest thresholds of 80 dB nHL. Behavioral hearing of 23 cases ranged from mild (n = 1), moderate (n = 2) to severe and profound loss (n = 20). CMs were present in all ears in spite of those with middle ear pathology, while DPOAEs were present only in 40% of the affected ears.

CONCLUSION

Diverse results of audiological assessments are shown in this group of children. Concurrent pathologies may make auditory neuropathy spectrum disorder undetected. Absent or severely abnormal ABR along with present CMs are the most reliable measures for detecting this disorder at this stage.

Evaluation of the psychological status in seasonal allergic rhinitis patients

OBJECTIVE

To investigate the psychological status of Chinese adults with seasonal allergic rhinitis (SAR) in the allergic season, and evaluate the effects of nasal symptoms on their psychological status.

METHODS

The Symptom Checklist 90 (SCL-90) or Self-Reporting Inventory was employed to analyze the psychological status of 337 SAR patients.

RESULTS

The SCL-90 scores of the SAR patients were statistically higher than those of nonallergic adults in terms of somatization, depression, anxiety, hostility and psychosis. No statistical discrepancies existed in gender or age, the impact of disease course was limited to somatization, compulsion and phobic disorders and the impact of the educational level was that the lower the level of education, the more obvious the hostility. The behavior of somatization, compulsion, depression and anxiety in patients with a history of eczema or asthma was much more obvious than in patients without such a history. Nasal obstruction had a conspicuous impact on somatization, compulsion, interpersonal sensitivity, depression, anxiety and psychosis, while nasal itching contributed to somatization, depression and anxiety.

CONCLUSION

The psychological status of SAR patients is evidently worse than that of nonallergic adults. Symptoms such as nasal obstruction and nasal itching had an obvious impact on the psychological status of the patients.

Allergen-specific IL-10-secreting type I T regulatory cells, but not CD4(+)CD25(+)Foxp3(+) T cells, are decreased in peripheral blood of patients with persistent allergic rhinitis

We investigate the frequencies of CD4(+)CD25(+)Foxp3(+) T cells and allergen-specific IL-10(+)IL-4(-), IFN-gamma(+)IL-4(-), IL-4(+)IFN-gamma(-)CD4(+) T cells (which display characteristics of nTreg, Tr1-, Th1- and Th2- cells, respectively) in peripheral blood mononuclear cells (PBMCs) of patients with AR and of healthy individuals. In addition, we estimated the suppressive effect of CD4(+)CD25(+) Treg cells and allergen-specific, IL-10-secreting cells from both two groups. The frequency of CD4(+)CD25(+)Foxp3(+) T cells is similar in 43 AR patients compared with 38 healthy subjects. CD4(+)CD25(high) cells retain suppressive activity on allergen-stimulated cell proliferation and cytokine production of Th1 but not Th2 cells in both groups. However, the frequency of allergen-specific IL-10(+)IL-4(-)CD4(+) T cells is reduced in AR patients, and correlates inversely to clinical symptom scores. Allergen-specific, IL-10-secreting cells potently suppressed D. pteronyssinus major allergen 1-stimulated cell proliferation and cytokine production (IFN-gamma and IL-4) in healthy individuals. Altogether our data indicate that the number and function of CD4(+)CD25(+) Treg cells from allergic patients are not impaired. However, the deficiency of allergen-specific Tr1 cells may play a role in the development of AR.

The effects of age at cochlear implantation and hearing aid trial on auditory performance of Chinese infants

CONCLUSION

Most of the infants demonstrated rapid improvement in the three different auditory skills within the first year after switch-on. Infants undergoing hearing aid trial and habilitation demonstrated a significant positive effect on the development of auditory skills in comparison with infants without trial and habilitation.

OBJECTIVE

This paper aims to evaluate the auditory performance of infants of different age at cochlear implantation, emphasize the importance of the hearing aid trial and habilitation before implant, and provide baseline data of auditory development.

METHODS

In all, 259 infants with prelingually profound hearing loss participated in this study. The Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to assess auditory skills in infants at different intervals.

RESULTS

The mean scores for the auditory skills improved significantly over time. The mean scores of three skills for each group at each interval were significantly different. The mean scores of the auditory skills were significantly superior for infants undergoing hearing aid trial and habilitation in comparison with those of infants without hearing aid trial and habilitation.

The value of scutum erosion in the diagnosis of temporal bone cholesteatoma

CONCLUSIONS

Scutum erosion has an important role in the diagnosis of attic cholesteatoma, but it does not appear in other types of cholesteatoma in temporal bone. Without scutum erosion, the existence of cholesteatoma cannot be excluded.

OBJECTIVE

To evaluate the value of scutum erosion in the diagnosis of cholesteatoma in temporal bone and its limitations.

SUBJECTS AND METHODS

CT scanning and otoscopy were used in all patients who were suspected of developing, or were probably diagnosed with, cholesteatoma in temporal bone. The condition of the scutum was recorded by otoscopy, CT scanning and surgical findings in all patients with cholesteatomas.

RESULTS

Scutum erosion can be shown in attic retraction with cholesteatoma at an early stage, but not in marginal perforation or with posterior retraction with cholesteatoma, or in central perforation or intact tympanic membrane with cholesteatoma, even in relatively late stages.

4-Phase-Rhinomanometry (4PR)--basics and practice 2010

The last comprehensive publications about the theory and practice of rhinomanometry appeared more than 20 years ago. Since the 1980's, the general progress of sensor techniques, fluid physics and data processing was accompanied by the permanent work of the authors to analyze the errors of rhinomanometry and to create a fundament for a contemporary and practical method that can be used in functional diagnostics of the nasal air stream. In this special document, the objectives and measurement principles, as well as the history of rhinomanometry are described in the first three chapters. It is pointed out, that the key parameters are not only intranasal pressure and flow, but also the factor time. The technical requirements as following from the dynamics of breathing are described. The process of averaging of rhinomanometric data lead to a separate and time-dependent analysis of the changes of pressure and flow and implicated the introduction of the 4 breathing phases (ascending and descending curve part in inspiration and expiration) into rhinomanometry and is therefore called 4-Phase-Rhinomanometry (4PR). Chapter 4 is containing a comprehensive analysis of the practical errors, which may follow neglecting the 4 breathing phases. The in chapter 5 described mathematical-physical concept of 4PR is based on the introduction of the terms "steady" and "unsteady" flow, in addition to the up to now used terms of laminarity and turbulence. After the derivation of the HOFFRICHTER-equation as explaining the loops around the intersection point of the x-axis and y-axis, a clinical classification of the rhinomanometric findings is given and confirmed by physical experiments with "artificial noses". Finally, testing the rhinomanometric method by CFD (Computational Fluid Dynamics), lead to the same conclusions as to the importance of 4 phases of the breathing cycle. The precondition for the worldwide introduction of new parameters into the 4PR is a comprehensive statistical analysis. The disadvantages of the present recommended standard values are described in chapter 6. Following previous studies in 5800 cases, the parameters Vertex Resistance (VR), Effective Resistance (Reff) and their logarithmic transformations have been investigated in 1580 rhinograms of different degrees of obstructions, also including the correlations to a VAS. It could be confirmed, that the parameters VR and Reff after logarithmic transformation, have a significant and high correlation to the sensation of obstruction. The new clinical classification of obstruction and conductance of the nose is proposed in Table 1 for Caucasian noses. Table 1. Clinical classification of obstruction and conductance for Causcasian noses. [see text for table]. Chapter 7 is dedicated to the advantages of 4PR in the functional diagnosis of nasal valve problems. Graphical as well as numerical solutions are available by the fact, that the motions of the nasal entrance as caused by the breathing process are now visible from the shape of the 4PR-curve. Discussing practical aspects in chapter 8, the start point of proposals and discussions are the standard recommendations of the ISOANA and the results of its consensus conference in 2003. In particular the calibration processes, hygiene, the correct attachment of the pressure tube at the nostril ("tape method") and the different measurement procedures (AAR, APR), decongestion and provocation tests are extensively described. Both the final chapters are clinical contributions from mainland China, which are of high importance because of the racial differences in nasal respiratory function. In chapter 9, tests of the assessment of normal nasal airway in adult Chinese by 4PR, rhinomanometry and acoustic rhinometry are presented. This investigation lead to the conclusion that 4PR is an important supplement to classic rhinomanometry and acoustic rhinometry, if the classification of obstruction is adapted to the higher basic resistance of the Chinese population. Chapter 10 is dealing with 4PR and acoustic rhinometry in the functional evaluation of septal deviations and concludes, that both methods are valuable objective instruments for the evaluation of nasal obstruction.