Thesis (doctoral)--Ludwig-Maximilians-Universität zu München, 1979.

Thesis (doctoral)--University of Helsinki, 1989.

Thesis (doctoral)--University of Helsinki, 1989.

Objectives: To study the expression of cathelicidin antimicrobial peptides (CAMP) and surfactant protein D (SP-D) in patients with chronic rhinosinusitis (CRS) and eosinophilic mucus chronic rhinosinusitis (EMCRS) and by a nasal explant in vitro model cultured with fungal allergens. Methods: Nasal biopsies from 59 CRS and EMCRS patients, stratified into Allergic fungal sinusitis (AFS), Nonallergic fungal eosinophilic sinusitis (NAFES), and Nonallergic nonfungal eosinophilic sinusitis (NANFES) were studied by quantitative real-time (q)RTPCR, Western blot, immunostaining and ELISA. Nasal tissue from CRS and EMCRS patients were cultured with increasing concentrations of fungal allergens in a nasal explant in vitro model for 24 hours and CAMP and SP-D mRNA and protein levels in response to the fungi were determined by qRT-PCR and ELISA. Results: The expression of CAMP mRNA was significantly increased in EMCRS patients compared to CRS patients (p=0.0004). By immunohistochemistry, expression of CAMP was localised to nasal epithelial, submucosal glands and inflammatory subepithelial cells. Western blotting demonstrated the presence of CAMP in the study patients. Culturing nasal explants with fungal allergens demonstrated significant upregulation of CAMP mRNA expression in CRS, but not EMCRS patients, by Aspergillus (mean 4-fold increase) and Alternaria (mean 6-fold increase) extracts with a significant dose-response effect (p<0.001). CAMP protein levels in the nasal tissue from CRS patients increased in response to Alternaria (p<0.05). In contrast, with EMCRS patients the expression of CAMP peptide in nasal tissue increased with Aspergillus (p<0.001) but decreased with Alternaria. Staining for SP-D was detected in the submucosal glands from the nasal biopsies in all patient groups except for AFS. By ELISA, SP-D was undetectable in AFS and decreased in NAFES, NANFES, and CRS compared to controls. CRS patients cultured with Aspergillus and Alternaria allergens in the in vitro nasal explant model induced significant upregulation of SP-D mRNA (p<0.0001). In contrast, NANFES nasal tissue explants cultured with Aspergillus allergens induced downregulation of SP-D and only a modest upregulation of SP-D mRNA to Alternaria allergens. Conclusion: This study demonstrates expression of cathelicidin antimicrobial peptides and surfactant proteins in nasal mucosa supporting its potential role in innate defences against inhaled pathogens. There is significant upregulation of CAMP mRNA in the EMCRS group implying an increased inflammatory state. In vitro, CAMP is significantly upregulated at the mRNA and protein level in CRS tissue explants to Aspergillus and Alternaria allergens. However, EMCRS tissue cultured with Alternaria in vitro does not demonstrate increased CAMP at the mRNA or protein level. The expression of SP-D in nasal tissue is reported for the first time. SP-D expression in the CRS, but not the EMCRS group, is upregulated in vitro by Aspergillus and Alternaria. The EMCRS group compared to CRS group demonstrate abnormal CAMP and SP-D expression to common fungal allergens. These important findings in understanding the pathogenesis of chronic rhinosinusitis are discussed in this thesis and may provide potential novel therapies for chronic rhinosinusitis in the future. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1287042 / Thesis(PhD)-- School of Medicine, 2007

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Technikon Natal, 2005. / The purpose of this study was to evaluate the reaction of homoeopathic Luffa Operculata and a combination of Kalium Bichromicum and Cinnabaris on chronic sinusitis patients, with reference to the patients' perception of the treatment and the physical appearance of the nasal mucosa during treatment in order to determine the effectiveness of the two modes of treatment. Fourty patients were randomly selected and divided into two experimental groups . The study was double blind. The one group received Luffa Operculata and the other group received a combination of Kalium Bichromicum and Cinnabaris. Questionnaires were answered before and during the four month treatment period in order to assess the patients perception of the treatment. The physical appearance of the nasal mucosa was inspected on a monthly basis using a nasal speculum. Eight patients dropped out over the four month period. All data obtained from the questionnaires was depicted on spreadsheets and subsequently analysed using frequency tables, cross tabulation ,. Mann-Whitney-U-Test and the Wilcoxon Signed Rank Test. The results showed that both modes of treatment were equally effective in reducing the sinusitis headaches, with Luffa Operculata having a 44.1% decrease and Kalium 8ichromicum and Cinnabaris having a 37.3% decrease. The Mann-Whitney-U-Test was done within each group and showed values of P=O.033 and P=O.31 respectively, thereby indicating a statistically significant difference. There was no significant difference between the groups. However Luffa Operculata's results were more positive with respect to post-nasal drip, facial swelling, nasal mucosal swelling and nasal mucosal colour. The most dramatic difference in results occurred in the analysis of the fatigue data, where Luffa Operculata had a 44% decrease and Kalium 8ichromicum and Cinnabar is only had a 6% decrease. / M

Thesis (M.Dip.Tech.)--Technikon Witwatersrand, 2002. / Supervisor: Dr. B. W. Digby. Also available via World Wide Web.

M.Tech.

MTech

La tomografía computarizada ha llegado a ser examen radiológico de elección para el diagnóstico de Rinosinusitis crónica (RSC), en los pacientes con historia clínica y hallazgos en el examen físico sugestivo. Aunque el diagnóstico de RSC es primariamente basado en criterios clínicos, el examen tomográfico proporciona evidencias objetivas para el diagnóstico y la severidad de la enfermedad, además de referencias anatómicas que deben considerarse en la planificación quirúrgica. Desde los años noventa, la tomografía computada ha reemplazado a las placas radiográficas clásicas en el diagnóstico de RSC, porque incrementa la sensibilidad para demostrar los engrosamientos de la mucosa y la habilidad para delinear otras características patológicas como la obstrucción del complejo osteomeatal (1). La RSC es una patología que afecta a más de 30 millones de habitantes cada año, y se estima que 200,000 casos individuales requieren tratamiento quirúrgico anualmente (2,4). En el Perú no contamos con estadísticas publicadas, pero en el último decenio se ha apreciado su incremento progresivo llegando a representar en algunos meses alrededor de un 20 – 25% de las consultas de la especialidad en el Servicio de Otorrinolaringología del Hospital Arzobispo Loayza, convirtiéndose en un importante problema de salud, campo por investigar. El objetivo principal de este estudio fue determinar la frecuencia de las principales variantes anatómicas de nariz y senos paranasales, determinadas por Tomografía Helicoidal en los pacientes con Rinosinusitis crónica, en los pacientes que acuden al Servicio de Otorrinolaringología en el Hospital Nacional Arzobispo Loayza. El estudio fue realizado durante un periodo de 10 meses (Agosto 2003 – Mayo 2004), teniendo como instrumento de estudio láminas de tomografía helicoidal, de la cual se desprendió la información y se compilo a una ficha de registro a cargo del investigador y un equipo de un equipo de especialistas Otorrinolaringólogo – Radiólogo. Previamente al procesamiento se realizó un control de calidad de la información con lo que se verificó la consistencia interna; los resultados finales están presentados en tablas de doble entrada y para el análisis se emplearon las frecuencias y medidas de tendencia central.

Die Einbeziehung der Orbita in eine akute oder chronisch exazerbierte Sinusitis ist deren häufigste Komplikation. Sie kann wiederum Ausgangspunkt für lebensbedrohliche intrakranielle Folgeerkrankungen sein. In der hier vorliegenden Studie wurden die Symptome, die Ätiologie, die mikrobiologischen, augenärztlichen und neuroradiologischen Befunde von 132 betroffenen Patienten in einem Zeitraum von 1988-2005 analysiert. Weiterhin wurden die Indikationen, Art, Umfang und Langzeitergebnisse der konservativen und chirurgischen Therapie retrospektiv untersucht. Das Alter der Patienten lag zwischen 2 und 71 Jahren (Durchschnittsalter: 24 Jahre). Insgesamt traten 161 orbitale Komplikationen auf. Der Großteil der Patienten hatte eine akute Sinusitis (77%). Die Häufigkeiten der orbitalen Komplikationen, in Stadien eingeteilt, stellen sich wie folgt dar: entzündliches Ödem (44%), orbitale Periostitis (11%), subperiostaler Abszess (12%), Orbitaphlegmone (21%), sowie in 20 Fällen eine Zele. In 78% der Fälle wurde endonasal, mikroskopisch-endoskopisch und in 22% der Fälle wurde zusätzlich oder ausschließlich extranasal operiert. 26 Patienten waren von einem Rezidiv betroffen und mussten nachoperiert werden. Gründe hierfür waren u. a. eine zusätzliche Abkapselung des Abszesses in der Orbita. Die Resultate zeigen, dass die orbitale Komplikation einer akuten oder chronisch exazerbierten Sinusitis einer schnellen interdisziplinären Diagnostik bedarf. Abhängig von den erhobenen Befunden entsprechend der Stadieneinteilung sollte entweder ein konservativer Therapieversuch oder eine unverzügliche chirurgische Intervention erfolgen. Jeder einzelne Fall bedarf jedoch einer genauen Analyse, auf die in dieser Studie eingegangen wird. / The orbital involvement in acute or chronic sinusitis is its most common complication. It can also be the starting-point for a life-threatening intracranial complication. In this investigation were the symptoms and the etiology, considering the microbiological and neuroradiological results of 132 patients with orbital complications in the years 1988-2005, analyzed. Further were retrospectively investigated the indications, the quality, the extent and the long-term results of either conservative or surgical treatment. The age of the patients was between 2 and 71 years (average age: 24 years). Altogether occured 161 cases of orbital complications. Most cases were accompanied by acute sinusitis (77%). The frequency of the different stages of orbital complications consists of: inflammatory edema (44%), orbital periostitis (11%), subperiosteal abscess (12%), orbital cellulitis (21%) and in 20 cases occured a cele. In 78% of the cases was the endonasal, microscopic-endoscopic surgical method used and in 22% of the cases was operated extranasally or combined extranasally and endonasally. 26 patients had relapsing cases of orbital complications and needed surgical revision. Reasons therefore were e.g. another capsuled abscess formation in the orbit. The results show that any orbital complication caused by acute or chronic sinusitis needs an immediate interdisciplinary diagnosis. Depending on the symptoms of the different stages of orbital complications is either a conservative treatment or a quick surgical intervention indicated. Each case requires an exact analysis, which is focused on in this investigation.