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Among the materials used for dorsal augmentation rhinoplasty (DAR), cross-linked human acellular dermal matrix (ADM) has been claimed for its low risk of infection and extrusion. The aim of this study was to compare the effectiveness of ADM in subjects undergoing primary versus revision dorsal augmentation rhinoplasties. Using a retrospective cohort study design, the investigators enrolled a cohort set of DAR patients operated by a single surgeon during a 65-month interval. The predictor variable was the treatment group (primary or revision DAR). The main outcome variables were postoperative changes with regard to the degree of augmentation (ratio of the dorsal height [DH] and radix height [RH] to the nasal length) and patients' and surgeons' satisfaction with the aesthetic and functional results. Other study variables were grouped into the following categories: demographic, surgical, and pathological. Descriptive, uni-, and bivariate statistics were computed using P ≤ 0.05 as a cutoff value. The study cohort comprised 145 subjects (75.2% with primary DAR; 39.3% females) with a mean age of 30.7 ± 9.4 years (range, 19–58). DAR was linked to the significant changes in DH and RH in both the treatment groups. Comparison of the two groups revealed that there was no significant difference in DH and RH between both the groups. Surgeons' and patients' satisfaction rates were comparable between the two surgery groups, neither of which experienced serious complications. Microscopic findings of the removed ADM showed abundant collagen tissue with newly formed vessels without signs of foreign body reaction. Despite significant differences in patient characteristics (age; number of osteotomy, tip plasty, and hump reduction surgeries), the results of this study suggest that ADM can be used in both primary and revision DAR, with minimal complications. [ABSTRACT FROM AUTHOR]

By affecting the tongue position and oropharyngeal airway volume, torus mandibularis is an anatomical factor associated with obstructive sleep apnea (OSA). This study aimed to investigate the influence of torus mandibularis on the surgical outcomes of multilevel upper airway surgery with tongue base resection (TBR) in patients with OSA. Patients with OSA who underwent palatal surgery and TBR were retrospectively analyzed. The patients were divided into two groups according to the presence or absence of torus mandibularis upon physical examination or on computed tomography images. The anatomical characteristics of the upper airway and pre/postoperative polysomnography were analyzed. The control and torus mandibularis groups comprised 69 and 35 patients, respectively, with all of them showing improved sleep quality after surgery. Apnea–hypopnea index (AHI) scores decreased from 42.1 ± 22.2 preoperatively to 23.9 ± 21.4 postoperatively in the control group (p < 0.001), and from 45.2 ± 19.9 to 22.5 ± 13.5 in the torus mandibularis group (p < 0.001). Comparing the postoperative changes in AHI, the AHI of the torus mandibularis group improved by 22.7 ± 23.4, whereas that of the control group improved by 18.1 ± 19.6 (p = 0.296). Sleep efficiency improved from 90.0 ± 7.5 to 92.8 ± 6.8 in the control group, and from 90.3 ± 8.7 to 93.6 ± 6.5 in the torus mandibularis group; however, there was no statistical difference between the two groups (p = 0.816). The presence of torus mandibularis did not appear to significantly affect the surgical results in OSA patients, but it did elicit significant changes in polysomnographic parameters compared with the control group. Therefore, following the identification of torus mandibularis in OSA patients, TBR should be considered as part of planning, as it may help to predict surgical outcomes. [ABSTRACT FROM AUTHOR]

Arginine methylation is a posttranslational modification mediated by protein arginine methyltransferases (PRMTs). Although previous studies have shown that PRMT1 contributes to the severity of allergic airway inflammation or asthma, the underlying mechanism is poorly understood. This study aimed to explore the role of PRMT1 and its relevant mechanism in the development of allergic rhinitis (AR). The expression levels of PRMTs and cytokines were determined by RT-PCR, and the localization of PRMT1 was determined by immunohistochemistry and confocal microscopy. The levels of house dust mite (HDM)-specific immunoglobulins in serum and of cytokines in nasal lavage fluids were determined by ELISA. PRMT1 inhibition was achieved by siRNA and treatment with the pan PRMT inhibitor arginine N -methyltransferase inhibitor-1. PRMT1 expression was significantly increased in the nasal mucosa of patients and mice with AR. The degree of eosinophilic infiltration in the nasal mucosa was reduced in PRMT1 +/− AR mice compared with wild-type mice. PRMT1 haploinsufficiency reduced the levels of HDM-specific immunoglobulins in serum and those of T H 2 (IL-4, IL-5, and IL-13) and epithelial (thymic stromal lymphopoietin [TSLP], IL-25, and IL-33) cytokines in the nasal lavage fluids of AR mice. In nasal epithelial cells, HDM and IL-4 cooperate to enhance PRMT1 expression through a mitogen-activated protein kinase–dependent pathway. In addition, PRMT1 was essential for the production of TSLP, IL-25, and IL-33 in response to HDM and IL-4. Arginine N -methyltransferase inhibitor-1 treatment alleviated AR in the mouse model. PRMT1 plays an important role in AR development by regulating epithelial-derived cytokine production and might be a new therapeutic target for AR. [Display omitted] [ABSTRACT FROM AUTHOR]

The relationship between allergic and eosinophilic inflammation, either systemic or local, in allergic diseases remains unclear. We performed combined genome-wide association study (GWAS) and epigenome-wide (EWAS) for atopy and tissue eosinophilia to identify both genetic and epigenetic signatures between systemic and local allergic inflammation, and to capture global patterns of gene regulation. We included 126 subjects for atopy analysis and 147 for tissue eosinophilia analysis, as well as 18 normal nasal tissue samples. We identified differentially methylated positions (DMPs) and genes associated with atopy and tissue eosinophilia. Furthermore, we performed mendelian randomization analysis and penalized regression along with replication in an independent cohort. EWAS identified genes, including Musashi RNA binding protein 2 (MSI2) , associated with atopy, which contained enriched DMPs that genetically affect atopy. A direct association was observed between MSI2 single-nucleotide polymorphisms and atopy, as was a causal effect of changes in MSI2 expression and methylation on atopy, which was replicated in a Costa Rican population. Regarding tissue eosinophilia, EWAS identified genes with enriched DMPs directly contributing to tissue eosinophilia at the gene level, including CAMK1D. The gene ontology terms of the identified genes for both phenotypes encompassed immune-related terms. EWAS combined with GWAS identified novel candidate genes, especially the methylation of MSI2 , contributing to systemic allergic inflammation. Certain genes displayed a greater association with either systemic or local allergic inflammation; however, it is expected that a harmonized effect of these genes influences immune responses. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to validate and compare treatment outcomes for endoscopic resection of sinonasal inverted papilloma (IP) with or without the use of a navigation system. Materials and methods A total of 58 patients who underwent endoscopic resection of sinonasal inverted papilloma by a single surgeon from 2007 to 2016 at our institution were retrospectively reviewed. Depending on the use of the navigation system, subjects were divided into two groups: a conventional endoscopic resection group without navigation system (CER group) and a navigation-assisted endoscopic resection group (NER group). Results There were 24 patients (41.4%) in the CER group and 34 patients (58.6%) in the NER group. Treatment outcomes showed that navigation-assisted endoscopic resection was a more beneficial surgical technique than conventional endoscopic resection for sinonasal IP. Post-surgical recurrence was noted in seven cases (29.2%) in the CER group and two cases (5.9%) in the NER group. Accordingly, the recurrence rate was significantly less in the NER group compared to the CER group (p = 0.026). There were two cases of complications (8.3%) in the CER group comprising cerebrospinal fluid leak and periorbital fat exposure, while no complications were noted for the NER group (p = 0.167). Conclusion This study demonstrated that navigation-assisted endoscopic removal of sinonasal IP is helpful for reducing recurrence and avoiding surgical complications. Therefore, navigation systems should be always considered when performing endoscopic removal of sinonasal IP. [ABSTRACT FROM AUTHOR]

Objective This study aimed to re-assess the outcomes of different surgical methods for esthesioneuroblastoma (ENB) in a single institution, with emphasis on changes in surgical treatment with regard to endoscopic approaches in patients with ENB. Subjects and methods We retrospectively reviewed the data of 35 patients with ENB treated over the last 31 years. Results The 5-year overall and disease-free survival rates were 66.8% and 50.8%, respectively. Disease-free survival in the endoscopic surgery group was significantly higher compared to that of craniofacial surgery group (P = 0.035). In the endoscopic surgery group, nine of 10 patients did not exhibit local failure or regional recurrence over a mean followup period of 64.3 months, which was longer than the mean time to recurrence (22.0 months) observed in this study. Conclusion Given its significant survival outcomes and high rate of local control, endoscopic surgery could be preferred as a minimally invasive treatment with potentially low morbidity and possible oncological validity for the treatment of ENB. [ABSTRACT FROM AUTHOR]

This work addresses the problem of collision avoidance for vehicles in black zones where the risk of accidents increases. Vehicles have an inherent uncertainty of location because the exact position of a moving object is known, with certainty, only at the time of an update on position information. This paper proposes a collision prediction model and a monitoring algorithm for collision avoidance within black zones by considering the location uncertainty of moving vehicles. It formalizes the impact of trajectories of moving vehicles on probabilistic collision prediction. The proposed approach provides approximate answers to the user at the user's required level of accuracy while achieving near-optimal communication and computational costs. Finally, extensive experiments were conducted to show the efficiency and efficacy of the proposed approach. [ABSTRACT FROM AUTHOR]

In this paper, we investigate a new approach to moving k -nearest neighbor (M k NN) queries in directed and dynamic road networks, where each road segment has a particular orientation and its travel time changes depending on traffic conditions. An M k NN query continuously finds the k nearest neighbors (NNs) of a moving query object. Most existing studies have focused on M k NN queries in undirected and static road networks, where each road segment is bidirectional and its travel time does not change over time. However, little attention has been paid to M k NN queries in directed and dynamic road networks. In this research, we propose COMET, a collaborative approach to Moving k n E ares T neighbor queries in directed and dynamic road networks, where query processing is performed through collaboration between the server and query objects. In addition, we conduct extensive experiments to show that COMET substantially outperforms a conventional method in terms of query response time, bandwidth usage, and energy consumption. [ABSTRACT FROM AUTHOR]

Summary: A sinonasal inverted papilloma is a benign tumor which has been reported up to 4%. However, an inverted papilloma originating in the sphenoid sinus is even rarer, and a pediatric case has never before been reported. We report a case of pediatric inverted papilloma originating in the sphenoid sinus that presented with symptoms of sinusitis. Endoscopic sinus surgery was performed using a computer-aided image-guided system. The tumor was removed without any surgical complications or recurrence for 2 years. [Copyright &y& Elsevier]

Summary: Introduction: Olfactory neuroblastoma is a very aggressive tumour with high rates of locoregional recurrence and distant metastasis. Therefore, salvage therapy plays an important role in control of these neoplasms. In this study, we present our experience and treatment outcomes for salvage therapy in patients with recurrent olfactory neuroblastoma. Material and methods: We retrospectively analysed 17 patients treated for advanced olfactory neuroblastoma during the last 15 years. Results: The disease-free 5-year survival rate was 48% in all patients and 42% in the 17 patients with recurrence or distant metastasis. Salvage therapy was performed in 6 of 8 patients with recurrence or metastasis and proved successful in 50% of them. In the patients with locoregional recurrence, the success rate of salvage radiotherapy plus neck dissection was superior to salvage chemotherapy alone. In addition, 17% of the patients with distant metastasis after initial treatment died after salvage therapy. In 15% of patients with a clinical stage N0 at initial diagnosis, nodal recurrence developed and was successfully treated with salvage therapy. Conclusion: Complete surgical resection, including craniofacial resection and postoperative radiotherapy without elective neck dissection, is the preferred approach in the treatment of advanced olfactory neuroblastoma. In locoregional recurrence, successful salvage therapy may include selective neck dissection and radiotherapy, but in cases of distant metastasis, the prognosis was poor. [Copyright &y& Elsevier]

Abstract: Objective: To establish the clinical features and prognostic factors of sinonasal adenoid cystic carcinoma (ACC). Material and methods: Thirty patients with histopathological diagnosis of sinonasal ACC who were treated at Severance Hospital between 1990 and 2010 were included in this retrospective chart review study. Results: The 5-year disease-specific survival and disease-free survival rates were 75.3% and 37.2%, respectively. The maxillary sinus (63.3%) and nasal cavity (23.3%) were the most common sites of primary tumour. Most patients were diagnosed with advanced-stage (III/IV) disease (80.0%) and had undergone surgery and postoperative radiotherapy (70.0%). The most common histopathological subtype was cribriform type (40.9%). Local recurrence rate and distant metastasis rates were 26.7% and 23.3%, respectively. The mean time from primary treatment to recurrence was 44.5 months. Sinonasal ACC patients with stage IV and T4 disease had significantly worse survival than those with low stage and T disease. Patients with local recurrence had worse disease-specific survival than those with distant recurrence. Distant metastasis was associated with disease-free survival but not disease-specific survival. Conclusion: Despite the frequent occurrence of distant metastasis, early diagnosis and effective local control seemed to be the most important factors influencing the survival of sinonasal ACC. [Copyright &y& Elsevier]

Background: The submucosal gland (SMG) is important in the control of airway surface fluid. Protease-activated receptor (PAR) 2 contributes to the pathophysiology of allergies in response to nonspecific allergens bearing proteases and anion secretion. House dust mites (HDMs) have abundant proteases that can activate PAR2, but little is known about the direct effect of HDM on SMG secretion. Objective: The aim of this study was to investigate the effect of HDMs on glandular secretion and its mechanism in allergic patients, patients with chronic rhinosinusitis (CRS), or both. Methods: Inferior nasal turbinates were harvested from 55 patients and classified into 4 groups (the control, allergic rhinitis [AR], CRS, and AR+CRS groups). A microscope attached to a digital camera was used to quantify mucus bubbles from individual SMGs while stimulated with HDM extract, PAR2-activating peptide, and carbachol. PAR2 expression in the SMG was determined by means of immunostaining with anti-PAR2 mAb. Results: HDM induced a significantly higher secretion rate and number of responding glands in the AR and AR+CRS groups than in the control group. Interestingly, patients in the CRS group, who had no HDM-specific IgE antibody, showed a higher response than the control group, and its response was suppressed by a PAR2-selective antagonist. The responses to PAR2-activating peptide were similar to those to HDM, and their secretion rates positively correlated with HDM responses. PAR2 was highly expressed in all 3 disease groups with immunostaining. Conclusions: HDM allergens can induce glandular secretion in patients with AR, CRS, or both, and PAR2 represents a possible mechanism for nonspecific hyperreactivity in inflammatory airway diseases. [ABSTRACT FROM AUTHOR]