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Atypical teratoid/rhabdoid tumors (AT/RT) are deadly infantile brain tumors. Their aggressive phenotype results from a single recurring biallelic loss-of-function mutation in genes encoding components of the SWI/SNF chromatin-remodeling complex - SMARCB1 in the majority of tumors and SMARCA4 in remaining tumors. Residual SWI/SNF activity continues to inhibit EZH2 methyltransferase except at gene promoter regions where EZH2 co-localizes with the REST complex. At these sites, EZH2 increases repressive H3K27me3 marks. EZH2 co-localizes with REST on neuronal differentiation and tumor suppressor genes. As a result, this epigenetic abnormality helps maintain AT/RT in a stem cell-like state, driving its aggressive growth and therapy resistance. We study the consequences of disrupting SWI/SNF inhibition at sites of EZH2/REST co-localization to target AT/RT precisely. While there are no known interactions between the REST complex and SWI/SNF, there are interactions between REST’s primary co-factor CoREST and SWI/SNF. The CoREST complex consists of LSD1, HDAC1, and the scaffolding protein RCOR. We disrupted the CoREST complex with lentiviral knockdown of RCOR2 (kdRCOR2). KdRCOR2 reversed AT/RT’s stem cell-like state, driving neuronal differentiation and slowing AT/RT growth. Interestingly, kdRCOR1 had no impact on cell differentiation (microscopy and qRT-PCR) and had a modest impact on cell growth (MUSE cell viability assay). We next used Corin to pharmacologically target the CoREST complex in 3 AT/RT cell lines (CHLA05, CHLA06, and BT37). Corin is a bi-functional inhibitor of LSD1 and HDAC1/2, the component enzymes of the CoREST complex. Similar to kdRCOR2, Corin induced neuronal differentiation in AT/RT with increased adherence to plastic and new axonal development (microscopy). Cells also increased expression of neuronal differentiation markers identified by immunofluorescence (MAP2) and qRT-PCR (CEND1, and NEUROD2, t-test p Citation Format: Anupa Geethadevi, Marianne Collard, Nikhil Vaidya, Tyler Findlay, Kristen Malebranche, Charles Eberhart, Eric Raabe, Philip Cole, Rhoda Alani, Jeffrey Rubens. The CoREST complex as a novel target to disrupt AT/RT’s abnormal epigenetic landscape [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1141.

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremsstrahlung photon beam to investigate the excitation structure of the nucleon via meson photoproduction. The setup with a BGO calorimeter surrounding the target and an open dipole spectrometer covering the for ward region is ideally suited for investigating low momentum transfer processes, in particular in strangeness photoproduction. The associated photoproduction of K0S and hyperons is essential to understand the role of K* exchange mech anisms. A cusp-like structure observed in the yp → K0SΣ+ reaction at the K* threshold is described by models including dynamically generated resonances from vector meson-baryon interactions. Such interactions are pre dicted to give a peak like structure in K0SΣ0 photoproduction off the neutron. A very preliminary cross section is determined and compared to the prediction, the results appear to support the model

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremsstrahlung photon beam to investigate the excitation structure of the nucleon. The setup consists of a highly segmented BGO calorimeter surrounding the target, with a particle tracking magnetic spectrometer at forward angles. BGO-OD is ideal for investigating low momentum transfer processes due to the acceptance and high momentum resolution at forward angles. In particular, this enables the investigation of strangeness photoproduction where t-channel exchange mechanisms play an important role. This also allows access to low momentum exchange kinematics where extended, molecular structure may manifest in reaction mechanisms. First key results at low $t$ indicate a cusp-like structure in $K^+\Sigma^0$ photoproduction at $W = 1900$\,MeV, line shapes and differential cross sections for $K^+\Lambda$(1405)$\rightarrow K^+\Sigma^0\pi^0$, and a peak structure in $K^0_S\Sigma^0$ photoproduction. The peak in the $K^0_S\Sigma^0$ channel appears consistent with meson-baryon generated states, where equivalent models have been used to describe the $P_C$ pentaquark candidates in the heavy charmed quark sector., Comment: Proceedings of The 12th International Workshop on the Physics of Excited Nucleons (NSTAR 2019)

The unexpected nodal structure of the beam asymmetry recently reported by the GRAAL collaboration in η′ photoproduction very close to threshold could be explained by a previously unobserved narrow resonance. The BGO-OD experiment is ideally suited to verify this measurement via the detection of forward going charged particles which in the threshold region of interest allows the identification of the reaction γp → η′ p solely based on the proton going in the forward direction. This yields unprecedented statistics if, in the missing mass analysis of the η′ meson, the background can be sufficiently well controlled. Preliminary results using a linearly polarised photon beam are shown. The reaction γp → η′ p was identified in the BGO forward spectrometer, with simulated data used to seperate signal and background.

The BGOOD photoproduction experiment accesses forward meson angles and low momentum exchange kinematics in the uds sector, which may be sensitive to molecular-like hadronic structure. Recent highlights are summarised in these proceedings.

Talk from the Strong QCD from Hadron Structure Experiments Workshop 2019

Since the discovery of the Λ(1405), it remains poorly described by conventional constituent quark models, and it is a candidate for having an “exotic” meson-baryon or “penta-quark” structure, similar to states recently reported in the hidden charm sector.The Λ(1405) can be produced in the reactionγpK+Λ(1405). The pure I=0 decay mode into Σ0π0is prohibited for the mass-overlapping Σ(1385). Combining a large aperture forward magnetic spectrometer and a central BGO crystal calorimeter, the BGO-OD experiment is ideally suited to measure this decay with theK+in the forward direction. Preliminary results are presented.*Supported by DFG (PN 388979758, 405882627)

The study of electromagnetic transitions opens a window into the very nature of the strong interaction. And, indeed, such a study of how a ground-state nucleon transitions to an excited state, over a broad range of $$q^2$$ , will provide keen insight into the evolution of how dynamically-generated masses emerge from the asymptotically-free, nearly massless quarks of perturbative QCD as well as provide information on the ancillary effects from the meson–baryon cloud. The space-like ( $$q^20$$ ) region at GSI. We are living in exciting times whereby near-future prospects exist in extracting high-quality data in both the space-like and time-like regimes (JLab12 and FAIR, for example). The recent ECT* workshop, entitled space-like and time-like electromagnetic baryonic transitions, brought together several disparate communities of experimentalists and theorists. The goal and purpose of this workshop was to make the very first steps towards a much needed consistent description spanning the two kinematical regimes in $$q^2$$ . The discussions included photoproduction measurements (ELSA, JLab, LEPS, and MAMI), wherein the $$q^2=0$$ point anchors the connection between space-like and time-like regions and meson-beam data (GSI and J-PARC) and amply complements the requisite information for baryon spectroscopy. This paper presents the outcomes from this ECT* workshop, space-like and time-like baryon electromagnetic transitions, held at the European Centre for Theoretical Studies in Nuclear Physics and Related Areas in Trento, Italy, May 8–12, 2017.

We describe here the first example of the synthesis of 4-arm star poly(acrylic acid) for use as a water-soluble drag reducing agent, by applying Cu(0)-mediated polymerization technique. High molecular weight 4-arm star poly(tert-butyl acrylate) (Mn = 3.0–9.0 × 105 g mol−1) was first synthesized using 4,4′-oxybis(3,3-bis(2-bromopropionate)butane as an initiator and a simple Cu(0)/TREN catalyst system. Then, 4-arm star poly(tert-butyl acrylate) were subjected to hydrolysis using trifluoroacetic acid resulting in water-soluble 4-arm star poly(acrylic acid). Drag reduction test rig analysis showed 4-arm star poly(acrylic acid) to be effective as a drag reducing agent with drag reduction of 24.3%. Moreover, 4-arm star poly(acrylic acid) exhibited superior mechanical stability when compared with a linear poly(acrylic acid) and commercially available drag reducing polymers; Praestol and poly(ethylene oxide). The linear poly(acrylic acid), Praestol, and poly(ethylene oxide) all showed a large decrease in drag reduction of 8–12% when cycled 30 times through the drag reduction test rig while, in contrast, 4-arm star poly(acrylic acid) demonstrated much higher mechanical stability.

Background In modern rhinological practice and research, rhinomanometry and acoustic rhinometry are widely used. The goal of this study was to determine whether there is correlation between rhinomanometrically derived nasal airflow resistances and acoustic rhinometrically derived nasal airway volumes. Methods To achieve the goal, a prospective cross-sectional study of a total of 316 patients complaining of nasal obstruction was performed. Resulting data were compared by means of Spearman rank correlations of the total number of patients and of subgroups. Results The total number of patients, and most subgroups, in both their untreated and decongested states showed significant negative correlation unilaterally between nasal airflow resistances and nasal volumes. Conclusion Rhinomanometric nasal airflow resistances and concurrent acoustic rhinometric nasal airway volumes are closely correlated. The combination of the two objective methods provides insight into nasal airflow physiology and nasal airway anatomy.

Brian MacMahon was born in Sheffield, UK in 1923. He served as chair of the Department of Epidemiology at Harvard School of Public Health for more than 30 years. He was admired as a noble and generous man and respected for his shining intellect, scientific integrity, and broad culture. He set the pace for modern epidemiology and led the way for a whole school of epidemiologists who are now spread around the nation and the world. He made major scientific contributions, received several distinguished prizes and awards, and continued to publish insightful papers until the very end. Brian MacMahon was the first editor-in-chief of Cancer Causes and Control.

The proportion of Americans who smoke cigarettes has declined 50% since 1965. The effect on mortality of this considerable reduction has received little attention and is described in this study. U.S. national data were used to enumerate current, former, and never-smokers aged 35 years or older in 1987 and 2002. Mortality rate ratios were used to estimate smoking-attributable deaths among these groups, and corresponding age-adjusted smoking-attributable mortality rates (SAMRs) were calculated. There were 402,000 deaths attributable to smoking in 1987 and 322,000 in 2002. The SAMR for men aged 35 years or more was 556 deaths per 100,000 person-years in 1987, accounting for 24% of all male deaths. By 2002 the SAMR declined 41% to 329 and accounted for only 17% of deaths. The SAMR for women in 1987 was 175, accounting for 12% of deaths. By 2002 the SAMR among women had declined 30% to 122, representing 9% of deaths. The U.S. mortality rate attributable to smoking declined about 35% between 1987 and 2002. The impact of smoking on American society will diminish even further in the foreseeable future as smoking prevalence continues its decline among men and women.

The beam-spin asymmetry, Σ, for the reaction γd→pn has been measured using the CEBAF Large Acceptance Spectrometer (CLAS) at the Thomas Jefferson National Accelerator Facility (JLab) for six photon-energy bins, between 1.1 and 2.3 GeV, and proton angles in the center-of-mass frame, θc.m., between 25∘ and 160∘. These are the first measurements of beam-spin asymmetries at θc.m.=90∘ for photon-beam energies above 1.6 GeV, and the first measurements for angles other than θc.m.=90∘. The angular and energy dependence of Σ is expected to aid in the development of QCD-based models to understand the mechanisms of deuteron photodisintegration in the transition region between hadronic and partonic degrees of freedom, where both effective field theories and perturbative QCD cannot make reliable predictions.

The objective of this study is to compare the properties of two of the most frequently used acoustic rhinometers: the EcoVision (Hood Laboratories, USA) using the transient technique, and the Rhin2100 (RhinoMetrics, Denmark) using the continuous wide-band technique. In the wide-band rhinometer (Rhin2100), the transient analog signals of traditional rhinometers (EcoVision), are replaced by a digitally produced continuous wide-band noise signal. Tubular models and a plastic model produced by stereolithography (SLA), representing the true replicate of the nasal anatomy, were used to compare the accuracy of the two rhinometers. The effect of increasing angling (0–50°) between the sound wave tube and the cavity was evaluated in a tubular model. The curves obtained with the two rhinometers showed close similarity, and the acoustically derived volumes correlated well with the volumes of tubular (% error < 4%) as well as the complex nasal model (% error < 10.5%). Both rhinometers underestimated the minimum cross-sectional area (MCA) of the complex nasal model (mean % error complex model: Rhin2100 = –7.6%, EcoVision = –13%). The effect of increasing the angle between the nose adapter and the tubular models was small for both rhinometers (CV < 3% for MCA and CV < 1% for volumes). The similar, and in general, high accuracy of the two rhinometers evaluated, particularly in the complicated geometry of the SLA model, is an indication of the reliability of both. The small effect of changing the angle between the nose adapter and the models was unexpected and very encouraging. Nevertheless, some minor differences in performance and capabilities of the two rhinometers might influence interpretation and comparison of results. Further comparisons in a clinical setting are under current investigation.

It is well known that hearing acuity decreases with age. The precise mechanism responsible for this phenomenon, called presbycusis, is unknown. One hypothesis advanced to explain this loss of acuity implicates chronic exposure to snoring noise. Consequently, the purpose of this study was to investigate whether snoring is associated with hearing loss. We examined 219 patients (63 women and 156 men) referred to our sleep disorders center. All of the patients underwent nocturnal polysomnography with measurements of snoring, as well as standard audiometry (i.e., measurement of hearing thresholds at 250 Hz, 500 Hz, 1 kHz, 2 kHz, 3 kHz, 4 kHz, 6 kHz, and 8 kHz). Snoring was quantified by measuring three parameters: snoring index (SI = number of snores/h of sleep), average nocturnal sound intensity (dBav), and maximum nocturnal sound intensity (dBmax). We used simple correlation analysis to investigate the relationship between snoring and hearing thresholds; multiple linear regression analysis to determine individual contributions of age, sex, and snoring to the variability in hearing thresholds; and comparison tests to determine whether mild snorers had less hearing impairment than severe snorers. None of these statistical tests demonstrated that snoring was a significant determinant of hearing. We conclude that snoring is not associated with hearing loss and is therefore unlikely to account for presbycusis.

The purpose of the present investigation was to examine the relationship among upper airway resistance, snoring, and arousals, all measured simultaneously, in nonapneic snorers complaining of excessive daytime sleepiness (EDS). To accomplish this task, we selected a group of nine nonapneic snorers who presented because of snoring, EDS, tiredness, or fatigue. Ten healthy, alert, nonapneic, nonsnoring subjects recruited from among the hospital personnel acted as a comparison group. All subjects had nocturnal polysomnography, which included measurements of snoring, nasal and pharyngeal airway pressure, esophageal pressure, and total respiratory flow. Each polysomnogram was analyzed to identify all arousals and all respiratory events, i.e. apneas, hypopneas, and periods of increased upper airway resistance. Each arousal was examined to determine whether it was associated with a respiratory event, and each respiratory event was examined to determine whether it was associated with an arousal. The results were compared between snorers and nonsnorers. There was no significant difference between the two groups in the total sleep time (182+/-61 minutes in controls vs. 188+/-50 minutes in patients) or the total number of arousals per hour of sleep (24+/-12 in controls vs. 28+/-10 in snorers). However, the distribution of arousals, i.e. electroencephalogram (EEG) vs. respiratory, was different in snorers and nonsnorers. In snorers 55% of arousals were respiratory, whereas in nonsnorers only 17% of arousals were associated with respiratory events. Not unexpectedly, the snorers had significantly more respiratory events during the night (512) than controls (112). However, the relative proportion of these events that was accompanied by arousals was similar in both groups. We conclude that the difference in daytime function between symptomatic snorers and asymptomatic nonsnorers is unlikely to be due strictly to the number of arousals during the night; however, it is possible that respiratory and EEG arousals have different impacts on daytime performance, which may explain the difference in daytime function between our two groups.

The aims of this study are to assess nasal valve cross-sectional areas in healthy noses and in patients with nasal obstruction after rhinoplasty and to evaluate the effect of an external nasal dilator on both healthy and obstructive nasal valves. Subjects consisted of (i) volunteers with no nasal symptoms, nasal cavities unremarkable to rhinoscopy and normal nasal resistance and (ii) patients referred to our clinic complaining of postrhinoplasty nasal obstruction. All subjects were tested before and after topical decongestion of the nasal mucosa and with an external nasal dilator. In 79 untreated healthy nasal cavities the nasal valve area showed two constrictions: the proximal constriction averaged 0.78 cm2 cross-section and was situated 1.18 cm from the nostril, the distal constriction averaged 0.70 cm2 cross-section at 2.86 cm from the nostril. Mucosal decongestion increased cross-sectional area of the distal constriction significantly (p < 0.0001) but not the proximal. External dilation increased cross-sectional area of both constrictions significantly (p < 0.0001). In 26 post-rhinoplasty obstructed nasal cavities, only a single constriction was detected, averaging 0.34 cm2 cross-section at 2.55 cm from the nostril and 0.4 cm2 at 2.46 cm from the nostril, before and after mucosal decongestion respectively. External dilation increased the minimum cross-sectional area to 0.64 cm2 in these nasal cavities (p < 0.0001). We conclude that the nasal valve area in patients with postrhinoplasty nasal obstruction is significantly smaller than in healthy nasal cavities as shown by acoustic rhinometry. Acoustic rhinometry objectively determines the structural and mucovascular components of the nasal valve area and external dilation is an effective therapeutical approach in the management of nasal valve obstruction.

We investigated the effect of posture on nasal and pharyngeal resistance in 12 healthy subjects studied during wakefulness. Airway pressure and airflow were measured with subjects seated and in dorsal and left lateral recumbency, during inspiration and expiration. We found that pharyngeal resistance was approximately four to six times lower than the nasal resistance. Only pharyngeal resistance was significantly increased upon assumption of a supine posture, from 0.02 ± 0.01 Pa/mL per second when seated to 0.06 ± 0.05 Pa/mL per second in dorsal recumbency and to 0.05 ± 0.04 Pa/mL per second in left lateral recumbency. Mean nasal and pharyngeal resistances doubled upon assumption of a supine posture, but this difference was not statistically significant. There was no significant difference in pharyngeal resistance beween inspiration and expiration. Finally, there was a strong linear relationship between pharyngeal pressure and pharyngeal resistance (r = .98, p < .0001). We concluded that in normal awake subjects 1) pharyngeal resistance increases with assumption of a supine posture, 2) the walls of the pharynx are not compliant enough to alter their resistance in response to inspiratory and expiratory pressure changes, and 3) it may be possible to infer pharyngeal resistance from measurements of pressure alone, without measurement of airflow.

The principal features and the respiratory role of the nasal valve are surveyed briefly and contributions of current computer-aided techniques of imaging, rhinomanometry, and acoustic rhinometry to an understanding of its structure and function are presented. The nasal valve is a dynamic segment of the anterior nasal airway, where the major portion of nasal resistance is localized and nasal resistance to respiratory airflow approximates half the airflow resistance of the entire respiratory system. This functioning valvular segment of the airway extends several mm beyond its triangular entrance in the compliant vestibule to the hemi-piriform entrance of the rigid cavum. Alar muscles assist in stabilizing the compliant lateral wall of the valve by resisting transmural pressures generated by inspiratory airflow and, by adjustment of alar positioning, these muscles can also direct the inspiratory air stream (e.g., olfactory sniffs). Abundant erectile tissues of both medial and lateral nasal walls are prominent in the valve region, and they play the governing role in regulation of valve lumen and consequent nasal airflow resistance. Pathological mucosal swelling is the commonest cause of obstructive nasal disease, and the narrowed site of the valve is so vulnerable to obstruction that recurring physiological mucovascular swellings frequently impede airflow in the presence of small anterior structural deviations. Assessment of obstructive nasal disease by symptomatology is unreliable, and rhinoscopy has substantial limitations; however, current technology provides minimally invasive, objective, and reliable methods for the study of nasal patency and for the acquisition of useful and dependable clinical information.

The purpose of this study is to evaluate the reproducibility of acoustic rhinometric measurements obtained by means of a technique that avoids distortion of the compliant nasal vestibule. Subjects with noses untreated by decongestant were tested every minute for 6 consecutive minutes (576 area-distance curves–A-D curves), every 30 minutes for 6 consecutive hours (672 A-D curves), every day at 9 AM for 5 consecutive days (1200 A-D curves) and every Monday morning for 5 consecutive weeks (1200 A-D curves). The coefficient of variation found for the total minimum cross-sectional area (MCA) and total nasal volume (NV) increased with duration of the time interval between test and retest from 5% to 17% and from 4% to 9%, respectively. Variation of total MCA (combined right and left) and total NV (combined right and left) was smaller than variation of unilateral MCA or NV. Despite the dynamic nature of the nose, a standardized acoustic rhinometric technique can obtain acceptable results from subjects acting as their own controls in nasal physiological research and in clinical assessments.

This study was conducted to investigate the effects of sleep and nasal resistance on pharyngeal airflow in a group of healthy male adults without complaint of habitual snoring. Twelve subjects aged 21 to 60 years were studied in a sleep laboratory during exclusive nasal breathing. Nasal and pharyngeal airflow variables were measured concomitantly at different stages of sleep. Awake pharyngeal resistance averaged 0.02-0.03 Pa/cm3/s in recumbency. In stage 2 sleep and quiet breathing resistance increased by a factor of 3-4 and by a factor of 7-8 during snoring. Increased nasal loading did not increase pharyngeal resistance further or induce snoring. Mostly, increased pharyngeal resistances were of similar magnitude in both phases of respiration, but in a few instances inspiratory resistance exceeded that in expiration, and in a similar number the reverse was found. Overall, compliance of the pharyngeal airway was not a prominent feature in this group of subjects. The relationship between transpharyngeal pressure and resistance should be studied further in order to simplify future studies of airflow during sleep.

A comparison was made between polysomnographic recordings and recordings of airflow pressures in the pharynx and respiratory pressures in the esophagus of 10 adult sleeping subjects with differing degrees of apnea. Pressure measurements were obtained by microsensors mounted on a 7F gauge flexible catheter which sited them in the epi-, meso- and hypopharynx and the esophagus. Digitized overnight pressure data were stored on a PC memory card and subsequently displayed for analysis by means of a notebook computer. In 2 patients examination of 200 obstructive, mixed and central apneic events showed no significant differences in recordings of their incidence, duration of classification between polysomnographic and either pharyngeal or esophageal pressure techniques. Onset of apnea was demonstrated with particular clarity by computer integration of the pressure tracings. The multiple pressure sensor method offered a further important advantage in detecting the caudal limits of pharyngeal obstructions by steep elevation of the pressure gradient in the pharyngeal segment between adjacent sensors in which the caudal limit of the obstruction was sited. The multiple pressure sensor technique provided reliable and comprehensive diagnostic information of breathing disorders in sleeping subjects and together with its miniaturized recording equipment the method commends itself as suitable for home monitoring.

There is an extensive search for baryon resonances using the CLAS detector in Hall B of JLab. Extracting the transition helicity amplitudes (or the {gamma}{sub v}NN* photo- and electrocouplings) sheds light on nature of the non-perturbative strong interaction. We have extended the data on differential cross sections to Q{sup 2} = 6.0 GeV{sup 2} for the {pi}N electroproduction channel. Electroproduction data were also collected on the two-charged-pion channel off protons, which provides nine independent differential {pi}{sup +}{pi}{sup -}p cross sections at Q{sup 2} up to 1.5 GeV{sup 2}. The two-pion results, moreover, are consistent with those from independent {pi}N electroproduction analyses, where the background contributions in the two-pion channel are completely different from that of the single-pion one. A phenomenological approach developed at Jefferson Lab - Moscow State University is employed for separating the resonant and non-resonant contributions to the final state. The Q{sup 2}-dependent electrocouplings were then obtained for the P{sub 11}(1440) and D{sub 13}(1520) excited baryon states. The new data will be discussed in light of these new developments in systematically exploring the affects of meson-baryon dressing on the transition helicity amplitudes as a function of Q{sup 2}.

This study was designed to assess the subjective and objective effects of uvulopalatopharyngoplasty (UPPP) for treatment of snoring. We mailed a questionnaire dealing with snoring, quality of sleep, and interference with bed-partner's sleep to 100 unselected patients who were referred because of snoring. Replies were received from 69 patients. The answers were analyzed, and the subjective impressions were compared with preoperative and postoperative objective measurements of snoring and apnea. The average (+/- SD) length of follow-up was 45 +/- 20 mo. We found no significant differences in the apnea/hypopnea index, snoring index, and mean and maximal nocturnal sound intensity before and after surgery in this group. However, despite this lack of objective improvement. 78% of patients reported reduction in snoring, and 79% reported improvement in the quality of sleep; 18 of 69 bed partners no longer complained of interference with their sleep compared with only one preoperatively. We conclude that if the purpose of UPPP is to reduce the reported health hazards associated with snoring, then comparison between objective preoperative and postoperative measurements of snoring does not indicate success; if, on the other hand, the purpose of surgery is to alleviate the social hazard, then UPPP partially achieves this goal.

Resistances to respiratory airflow of nasal, pharyngeal, laryngeal, and tracheobronchial airway segments were determined by computer processing of digitized differential pressure and flow signals in four healthy, awake, male adults seated and breathing spontaneously at rest, exclusively through decongested noses. Resistances of the nasal and pharyngeal segments in Pa/cm3 per second averaged 0.139 (SD +/- 0.044) and 0.081 (SD +/- 0.051), respectively, with no resistive evidence of compliance with airflow pressures. The laryngeal segment exhibited the reciprocal of compliance, expiratory resistances exceeded those of inspiration, averaging 0.125 (SD +/- 0.037) and 0.035 (SD +/- 0.013), respectively (.005 < P < .01). Tracheobronchial resistances during spontaneous resting breathing were too small to record reliably at the calibration used, and values augmented by voluntary hyperventilation averaged only 0.012 (SD +/- 0.004). Laryngeal expiratory resistance approximated one fifth of the sum total of respiratory airflow resistances (including the pulmonary airways) and the authors suggest that, in addition to contributing to expiratory airflow braking, partial laryngeal closure induces orifice flow. This nonlaminar flow regime promotes the mucosal contact and mixing that enables greater than 30% of heat and water to be recovered from expiratory air by the human pharynx and nose.

We made measurements of nasal airway resistance in a patient with Japanese cedar pollinosis and also measured the environmental pollen counts under different exposure conditions. In the season of high Japanese cedar pollen counts in Japan values of mean nasal airway resistance were significantly increased, remained elevated for 2 months after the season, and eventually decreased. In the season of low pollen counts, the mean values of nasal airway resistance measurements were increased during the season but decreased more rapidly after the season. In a year with no exposure to the environmental allergen because the subject lived out of Japan, the mean nasal airway resistances were relatively increased closely in phase with the Japanese cedar pollen season.

• Major respiratory resistors situated at the nasal and oral portals are described, and the part they play in disrupting laminar flow of inspiratory air and facilitating the mucosal contact and mixing essential for effective cleansing, warming, and humidification is discussed. The resistors also determine the distribution of oronasal airflow. The contribution of structural and mucovascular elements to nasal airflow resistance is examined and the place of history, rhinoscopy, and rhinomanometry in clinical assessment of nasal patency and its variation in health and with age, race, and disease, is discussed. ( Arch Otolaryngol Head Neck Surg . 1992;118:790-793)

Epstein-Barr virus, a ubiquitous human herpesvirus, is associated with the development of carcinomas and lymphomas. We previously showed that transforming growth factor beta1 (TGF-beta1) mediated the virus to enter the lytic cycle, which is triggered by expression of Z Epstein-Barr virus replication activator (ZEBRA), through the ERK 1/2 MAPK signaling pathway. We report here that Akt, activated downstream from ERK 1/2, was required for TGF-beta1-induced ZEBRA expression and enabled Smad3, a mediator of TGF-beta1 signaling, to be acetylated by direct interaction with the co-activator CREB-binding protein and then to regulate TGF-beta1-induced ZEBRA expression.

Clinical assessments and rhinomanometric evaluations were performed in 143 consecutive cystic fibrosis (CF) patients ranging in age from 4 to 40 years (mean, 18.8). Nasal stuffiness, the most common symptom, correlated strongly with polyposis; however, nasal airflow resistance (NR) was not correlated with the incidence of polyps. Diminished NR was found in many CF patients, in 57 of them NR was < 1.0 cm H2O/L/sec (Pa/cm3/sec × 10), and was associated with impaired pulmonary function (p = 0.001).

Effects of nasal resistance on distribution of respiratory airflow between nose and mouth were investigated by a minimally invasive computer-assisted method using a modified CPAP nasal mask/pneumotach and a head-out body plethysmograph. In 18 subjects nasal resistance (p = 0.091), breathing frequency (p = 0.084), tidal volume (p = 0.352), and minute (p = 0.433) volumes were undisturbed by the masking procedure. Partial nasal breathing persisted in 16 of 33 healthy adults instructed to breathe through the mouth. Artificial additions to nasal airflow resistance that were made in 10 volunteers from the 16 persistent partial nose breathers whose nasal fraction > 25% increased the oral fraction of respiratory airflow. It is concluded that while the palate provides a switching mechanism for oronasal routing of respiratory airflow, the oral and nasal vestibules provide variable resistors that regulate its distribution.

To investigate the correlation between subjective assessment from clinician and patients and the objective measurement from active posterior rhinomanometry and acoustic rhinometry.Clinician and patients' assessment of nasal patency was achieved by visual analogue scale (VAS). Objective measurement included active posterior rhinomanometry and acoustic rhinometry. The mean of clinician's assessment and patients' VAS was compared by using paired-samples t-test. The correlation between unilateral nasal airflow resistance and unilateral nasal airway volume, unilateral minimal cross section area, and also subjective assessment and objective measurement of nasal patency were analysed by using Spearman correlation analysis in total patients.In total of 316 patients, pre-decongestion and post-decongestion, unilateral nasal airflow resistance and unilateral nasal airway volume, unilateral minimal cross section area had significant negative correlation respectively (P = 0.000). The mean of clinician's assessment and patients' VAS had significant difference (P0.001) before and after decongestion. Clinician's assessment had significant positive correlation with patients' VAS, nasal airflow resistance, and significant negative correlation with nasal airway volume, minimal cross section area of nasal cavity before and after decongestion (P = 0.000). Patients' VAS had significant positive correlation with nasal airflow resistance, and significant negative correlation with nasal airway volume, minimal cross section area of nasal cavity before and after decongestion (P = 0.000). The correlation coefficients from clinician's assessment and objective measurements were greater than those from patients VAS and objective measurements.The parameter of active posterior rhinomanometry had significant negative correlation with the parameters of acoustic rhinometry. Clinician assessment of nasal patency had significant positive correlation with patients' VAS; both of them had significant correlation with the parameters of rhinomanometry and acoustic rhinometry. Clinician's assessment was more objective and reliable to the parameters of objective measurement than patients' VAS.

The written obstetric records of maternal exposure to diethylstilbestrol (DES) were used as a criterion standard and compared with the DES exposure history recalled by mothers of women with vaginal, cervical, or indeterminable vaginal/exocervical clear cell adenocarcinoma. Among cervical cases, the sensitivity of maternal recall was 50% (N = 2), and its specificity was 100%. Among vaginal and vaginal/exocervical cases, this sensitivity was 72%; specificity was 60%; and the majority of these mothers who said they did not take DES were DES positive by written records. Thus investigators should avoid using maternal recall alone to measure DES exposure. Among subjects for whom written maternal obstetric records were available, 88% of vaginal cases and 46% of cervical cases were DES positive. the authors conclude that few cases of vaginal clear cell adenocarcinoma should occur in young women as the cohort of women exposed in utero to DES continues to age, whereas cases of cervical origin may continue to occur.

Oro-nasal distribution of respiratory airflow was determined in 120 'mouth breathing' children by a minimally invasive computer-assisted method that employed a modified CPAP nasal mask/pneumotach and a head-out body plethysmograph. Resulting measurements were reproducible but clinical assessments correlated poorly with these values. Airflow distribution was almost identical in inspiration and expiration. 100% nasal breathing was found over a wide range of nasal resistances, many subjects with lips apart. Overall, the nasal fraction was negatively correlated with resistance and it was increased by topical decongestant. Decreasing nasal resistance with increasing age was confirmed, but corresponding changes in airflow distribution were not demonstrated. Quantitative assessment is advocated in clinical management of 'mouth breathers'.

By contrast with the smoked drum and other mechanical systems, modern electronic rhinomanometers provide superior sensitivity and frequency response. They enable accurate measurement of nasal airflow resistance to be made and are commercially available. In addition to a rhinomanometer, nasal airflow measurements require a face mask fitted with a flow measuring device (a pneumotach connected to an electronic differential pressure transducer) or, as an alternative to a face mask, a head-out body plethysmograph. Concurrently with nasal respiratory airflow, transnasal pressures between the nostril and pharynx are measured via nasal or oral tubing by a second differential pressure transducer. The transduced electronic analogue signals are digitized, and nasal airflow resistances are computed from the ratio between transnasal pressure and airflow. At a single sitting, a series of measurements with modern rhinomanometry can determine (1) the response to topical decongestant of the mucovascular contribution to nasal airflow resistance at the time of examination and (2) in the decongested nose, the presence, side, site, and severity of structural obstruction. Rhinomanometry is not "medically necessary" in assessment of all cases of nasal obstructive symptoms, but, in many situations, it can provide valuable objective information in compliance with the requirements of evidence-based medicine. This article includes a table listing situations in which rhinomanometry is particularly useful.

There has been concern that the use of alcohol-containing mouthwash may increase the risk of developing oropharyngeal cancer, or OPC. The authors examine the epidemiologic literature relating to this issue.The authors identified all nine English-language epidemiologic studies of OPC that made reference to mouthwash. The findings and major strengths and limitations of each study are described. In addition, the authors reanalyzed data from one of the studies.The results of six of the studies reviewed are negative and provide no support for the hypothesis that use of alcohol-containing mouthwash increases the risk of OPC. One of the three studies with positive results was a case series and included a follow-up case-control study, the results of which were negative. The authors reanalyzed the study with the most positive results. This analysis found that the study results were just as positive for nonmucosal cancers developing in the mouth as they were for the usual type of OPC. The authors concluded that this study's positive finding resulted from recall bias.It is unlikely that the use of mouthwashes that contain alcohol increases the risk of developing OPC.

The nasal valve consists of four distinct airflow-resistive components. (i) The vestibule terminates in an airflow-resistive aperture between the septum and the caudal end of the upper lateral cartilage. Its cross-sectional area is stabilized by the cartilaginous structures and by inspiratory isometric contractions of alar dilator muscles. Its walls are devoid of erectile tissues that might otherwise affect its cross-sectional area and airflow resistance. By contrast, (ii) the bony entrance to the cavum is occupied by erectile tissues of both (iii) lateral (turbinate) and (iv) septal nasal walls that modulate the cross-sectional area of the airway and airflow resistance. The body of the cavum offers little resistance to airflow. Valve constrictions induce “orifice flow” of inspiratory air as it enters the body of the cavum, disrupting laminar characteristics and thereby enhancing exchanges with the nasal mucosa of heat, water, and contaminants. Acoustic rhinometric and rhinomanometric measurements show the sites, dimensions, and resistances of the valve constrictions and indicate that it is seldom necessary to extend septal and/or turbinate surgery far beyond the piriform aperture in the treatment of nasal obstruction.

Objectif: Comparer la pression des voies respiratoires superieures (VRS) des ronfleurs et des non-ronfleurs durant l'eveil et le sommeil. Localisation: Clinique du sommeil d'un hopital universitaire. Methode: Nous avons utilise des catheteres pour mesurer les pressions differentielles entre le nasopharynx et l'hypopharynx de 8 ronfleurs non-apneiques avec fatigue diurne exageree et 10 controles non-ronfleurs. Durant le sommeil, les pressions ont ete mesurees avec la bouche fermee par du sparadrap pour assurer une respiration exclusivement nasale. Durant l'eveil, les mesures ont ete prises soit en position assise (avec la tete en position neutre, flechie, etendues, ou en rotation) soit en decubitus (dorsal ou lateral). Mesures: Comparaison des pressions a l'interieur des groupes en fonction de la position et entre les groupes en fonction du ronflement. Resultats: Les pressions differentielles sont les memes en position assise autant pour les ronfleurs que les non-ronfleurs quelle que soit la position de la tete. Le passage au decubitus augmente les pressions pharyngees autant pour les non-ronfleurs (26 ± 18 Pa assis vs 52 ± 46 Pa couche, p