Influence of Chronic Sinusitis and Nasal Polyp on the Lower Airway of Subjects Without Lower Airway Diseases

Purpose

Upper and lower respiratory tract pathologies are believed to be interrelated; however, the impact of upper airway inflammation on lung function in subjects without lung disease has not been evaluated. This study investigated the association of CT finding suggesting chronic sinusitis and lung function in healthy subjects without lung disease.

Methods

This was a retrospective study of prospectively collected data from 284 subjects who underwent a pulmonary function test, bronchial provocation test, rhinoscopy, and osteomeatal unit computed tomography offered as a private health check-up option.

Results

CT findings showed that the sinusitis group had a significantly lower FEV1/FVC ratio than subjects without sinusitis finding (78.62% vs 84.19%, P=0.019). Among the sinusitis group, subjects classified by CT findings as the extensive disease group had a slightly lower FEV1/FVC than those of the limited disease group (76.6% vs 79.5%, P=0.014) and the associations were independent of the presence of airway hyperresponsiveness. The subjects with nasal polyp had also lower FEV1 and FEV1/FVC than subjects without nasal polyp (FEV1: 100.0% vs 103.6%, P=0.045, FEV1/FVC: 77.4% vs 80.0%, P=0.005).

Conclusions

CT findings suggesting chronic sinusitis and nasal polyp were associated with subclinical lower airway flow limitation even in the absence of underlying lung disease.     

Human papillomavirus genotype as a predictor of persistence and development of high-grade lesions in women with minor cervical abnormalities

Women referred for colposcopy with mild and moderate dyskaryosis and found to have only minor cervical abnormalities were screened for oncogenic human papilloma virus (HPV) types. The natural development of these abnormalities in 42 HPV-positive women was assessed by cytology and colposcopy at 6-month intervals for up to 2 years. As is the case with cancers and high-grade cervical intra-epithelial neoplasia (CIN), minor cervical abnormalities were frequently found to be associated with HPV16, -18, -31 and -33. Viral persistence and the development of high-grade lesions were found to be closely associated with HPV16; 56% of HPV16 isolates were persistent compared to 7% of other HPV types, and all 4 subsequent CIN 3 lesions were in women with persistent infection. A striking association of persistence with a variant of HPV16 having a base change at nucleotide 350 was observed. Ten of 12 women with this variant had persistent infection compared to only 1 of 16 women infected with the HPV16 prototype. © 1996 Wiley-Liss, Inc.     

Rat intercostal nerves as experimental nerve grafts

In this study, we dissected and measured both sets of intercostal nerves including lengths, diameters, and axon counts in 12 adult rats to provide data applicable to experimental nerve graft research. Dissections showed that total lengths of intercostal nerves from the spinal bifurcation to their last arborizations near the midline ranged from 10 to 89 mm, and diameters ranged from less than 0.1 to 0.5 mm from the thinnest to the thickest part. The segment of easiest dissection was the part between the spinal bifurcation and the lateral cutaneous branch. This part was 4–27 mm (mean, 13.3 mm) long and had an almost constant diameter of 0.18–0.5 mm (mean, 0.32 mm). Counts ranged from 201 to 566 axons/nerve. The segment proximal to the lateral cutaneous branch was the most convenient part to be harvested as a nerve graft, especially in the 8th to 12th intercostal nerves. These nerves could serve as sources for experimental grafts. © 1996 Wiley-Liss, Inc.     

Free posterior tibial perforator flap: Anatomy and a report of 6 cases

Anatomy of cutaneous perforators of the posterior tibial artery were studied in 20 limbs of 10 cadavers. The majority of the perforators (n = 74, 61%) were located in the middle two quarters of the leg, at an average of 18.6 cm (s.d. 4.5 cm; range 10.5–26 cm) from the medial malleolus, or around 54% (s.d 16%) of the length of the leg. There were usually 3 or 4 perforators in this region, with an average caliber of 1.5 mm (s.d. 0.2 mm; range 1–2 m.m.) and an average length from the posterior tibial artery to the skin of 4.0 cm (s.d. 1.3 cm; range 2.5–6 c.m.). A free fasciocutaneous skin flap based on one of these perforators (the posterior tibial perforator flap, PTP flap) was successfully transplanted in 6 cases. This modified technique of the posterior tibial flap enables the surgeon to retain the posterior tibial artery when the skin of the medial aspect of the leg is chosen to be used as skin flap donor © 1997 Wiley-Liss, Inc MICROSURGERY 17:503–511 1996     

Involuntary subordination or dependency as key dimensions of depressive vulnerability?

Dependency associated with depression involves at least two forms of social behavior: (a) needs for nurturance/protection and close attachment, and an inability to function independently and (b) being (de)valued, fear of disapproval, and social status. In many studies, measures of dependency combine these two dimensions. This paper argues that this has led to confusion on the salient dimensions related to depression. It is suggested that behaviors currently regarded as dependent, and linked to depression, are better understood as forms of involuntary subordination that involve judgments of personal inferiority, and submissive-appeasement behavior. This paper presents preliminary evidence that social status, and its associated features of negative self-other comparisons and submissive behavior, may be particularly relevant to depression.     

Binge eating disorder,retention, and dropout in an adult obesity program

Objective: The purpose of this study was to identify factors associated with dropout in a weight reduction program among obese, nonpurging binge and nonbinge eaters. Method: We categorized 156 obese, nonpurging women previously randomized to a behavior modification-based (BM) or a food addiction theory-based (FD) weight reduction intervention by binge status using the DSM-IV criteria for binge eating disorder (BED). Subjects were monitored prospectively for dropout during the 6-month intervention period. Results: Results of a Cox proportional hazards survival analysis indicated binge status had a statistically significant (p = .04) protective effect against dropout. Binge eaters were half as likely to dropout versus nonbinge eaters. Discussion: We conclude that (1) the DSM-IV criteria for BED is a useful method of classifying obese individuals in weight loss interventions and (2) the identification of subgroups among obese subjects is an important step in understanding retention in weight loss programs. Future research can confirm this finding. © 1995 by John Wiley & Sons, Inc.