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Biomedical subjects

R Jankowski

Publications and source records attributed to R Jankowski.

At least 37 records · Page 2Linked to original sources
PubMed2001

Efficacy and tolerability of budesonide aqueous nasal spray treatment in patients with nasal polyps.

OBJECTIVE: To assess the efficacy and tolerability of once-daily treatment with budesonide aqueous nasal spray in patients with nasal polyps. DESIGN: Randomized, double-blind, placebo-controlled, parallel-group study. SETTING: Sixteen hospital clinics. PATIENTS: One hundred eighty-three patients with moderate-sized nasal polyps causing clinically significant symptoms during a 1-week run-in period. INTERVENTIONS: Patients were randomized to receive 1 of the following 4 budesonide aqueous nasal spray treatments: 128 microg once daily in the morning and placebo in the evening, 128 microg twice daily, 256 microg once daily in the morning and placebo in the evening, or placebo for 8 weeks. Nasal polyp size was scored and peak nasal inspiratory flow was measured at clinic visits at the beginning and end of the run-in period and after 4 and 8 weeks' treatment. Patients recorded daily peak nasal inspiratory flow, symptom scores (ie, blocked nose, runny nose, and sneezing) and sense of smell on diary cards. MAIN OUTCOME MEASURES: Mean change in nasal polyp size at the end of treatment; mean changes in combined and individual symptom scores. RESULTS: All doses of budesonide aqueous nasal spray significantly (P<.01) reduced polyp size; no significant differences were noted between the 4 treatment groups. The mean improvement in clinic peak nasal inspiratory flow at 8 weeks was 65.9 L/min with budesonide aqueous nasal spray, 128 microg twice daily; 71.6 L/min with budesonide aqueous nasal spray, 256 microg once daily; and 54.6 L/min with budesonide aqueous nasal spray, 128 microg once daily (all P<.001 vs placebo). Combined and individual symptom scores and sense of smell improved significantly in all budesonide-treated groups; the effect on symptoms became apparent within 1 to 2 days of the first dose. Budesonide aqueous nasal spray was well tolerated. CONCLUSIONS: Doses of budesonide aqueous nasal spray, 128 microg once daily, were found to be effective in the treatment of nasal polyps, and doses of budesonide aqueous nasal spray, 256 microg once daily, did not show any significant additional efficacy.

Administration, Intranasal↗
PubMed2001

[Sinobronchial syndrome].

The sinobronchial syndrome consists of chronic sinusitis and chronic nonspecific inflammation of the lower airways, typically chronic bronchitis, bronchiectasis and diffuse panbronchiolitis. This airway disease of unknown etiology is not related to smoking. It is common in Japan and is poorly described in western countries. We report a case in a non-Asian patient. The known efficacy of long-term low-dose erythromycin therapy justifies careful diagnosis of sinobronchial syndrome in patients of non-Asian ethnic origin.

Anti-Bacterial Agents↗
PubMed2001

[Smell dysfunction in nasal and paranasal sinus disease: a review of the literature (I)].

Substantial advances have been achieved during the last decade in our understanding of the biological bases of the sense of smell, as well as in the clinical identification, diagnosis, and management of dysosmia. Nasal obstruction can result from inflammatory, neoplastic, traumatic, and developmental alterations within the nasal cavity. All these processes, if they result in bilateral restriction of airflow to the olfactory neuroepithelium, presumably alter the ability to smell. Rhinitis, nasal polyposis, and rhinosinusitis are accompanied by decreased ability to smell. Benign and malignant neoplasms can obstruct the nasal chamber and thereby alter airflow to the olfactory receptors without damaging the olfactory neuroepithelium. The purpose of this synthesis is to provide an advanced review of the literature in order to describe the basis of smell alterations in nasal polyposis and chronic rhinosinusitis.

Anti-Inflammatory Agents↗
PubMed2001

[Smell dysfunction in nasal and paranasal sinus disease: a review of the literature (II)].

Substantial advances have been achieved during the last decade in our understanding of the biological bases of the sense of smell, as well as in the clinical identification, diagnosis, and management of dysosmia. Nasal obstruction can result from inflammatory, neoplastic, traumatic, and developmental alterations within the nasal cavity. All these processes, if they result in bilateral restriction of airflow to the olfactory neuroepithelium, presumably alter the ability to smell. Rhinitis, nasal polyposis, and rhinosinusitis are accompanied by decreased ability to smell. Benign and malignant neoplasms can obstruct the nasal chamber and thereby alter airflow to the olfactory receptors without damaging the olfactory neuroepithelium. The purpose of this synthesis is to provide an advanced review of the literature in order to describe the basis of smell alterations in chronic rhinitis, nasal malformations and tumors.

Chronic Disease↗
PubMed2000

Clonal isolation of muscle-derived cells capable of enhancing muscle regeneration and bone healing.

Several recent studies suggest the isolation of stem cells in skeletal muscle, but the functional properties of these muscle-derived stem cells is still unclear. In the present study, we report the purification of muscle-derived stem cells from the mdx mouse, an animal model for Duchenne muscular dystrophy. We show that enrichment of desmin(+) cells using the preplate technique from mouse primary muscle cell culture also enriches a cell population expressing CD34 and Bcl-2. The CD34(+) cells and Bcl-2(+) cells were found to reside within the basal lamina, where satellite cells are normally found. Clonal isolation and characterization from this CD34(+)Bcl-2(+) enriched population yielded a putative muscle-derived stem cell, mc13, that is capable of differentiating into both myogenic and osteogenic lineage in vitro and in vivo. The mc13 cells are c-kit and CD45 negative and express: desmin, c-met and MNF, three markers expressed in early myogenic progenitors; Flk-1, a mouse homologue of KDR recently identified in humans as a key marker in hematopoietic cells with stem cell-like characteristics; and Sca-1, a marker for both skeletal muscle and hematopoietic stem cells. Intramuscular, and more importantly, intravenous injection of mc13 cells result in muscle regeneration and partial restoration of dystrophin in mdx mice. Transplantation of mc13 cells engineered to secrete osteogenic protein differentiate in osteogenic lineage and accelerate healing of a skull defect in SCID mice. Taken together, these results suggest the isolation of a population of muscle-derived stem cells capable of improving both muscle regeneration and bone healing.

Alkaline Phosphatase↗
PubMed2000

Eosinophil count in nasal secretions of subjects with and without nasal symptoms.

The aim of this paper, based on a cross-sectional study of 129 patients with nonallergic chronic nasal symptoms and 40 healthy controls, was to examine the leucocyte differential count in nasal secretions as a diagnostic test. Nasal secretions were collected using preweighed suction glass canulas under controlled conditions (-100Pa, 30 sec). Leucocyte and differential counts were performed using a Thoma hemocytometer and on cytospin slides after May-Grünwald-Giemsa staining. The percentage of eosinophils (Eo) was significantly higher in patients (mean +/- SEM: 15.1 +/- 2.3%) than in controls (5 +/- 2.6%) (p < 0.04). Comparison of the frequency distribution of the percentage of Eo in patients and controls clearly showed a subgroup of patients presenting with nasal secretion hypereosinophilia, and allowed us to set the positivity criterion at Eo = 20%. Diurnal variations in Eo count in 11 controls and 8 patients confirmed the value of the cutoff point. In 28 patients with nasal polyposis who underwent surgery, a correlation was found between secretion and tissue eosinophelia (r = 0.58, p = 0.001). Patients with nasal secretion hypereosinophilia had no more leucocytes in their secretions than healthy controls, the increase in eosinophils being balanced by a decrease in neutrophils. In patients without hypereosinophilia, the number of leucocytes per milligram of secretion was four times higher (8672 +/- 2521) than in the controls (2020 +/- 823) (p = 0.06) (cut-off point = 2500 leu/mg). These data show that the nasal cytogram can be modified either in qualitative or quantitative way, probably depending on the underlying inflammatory process.

Adult↗
PubMed1999

[Does idiopathic naso-sinusal polyposis exist in children?].

UNLABELLED: Nasal polyposis, a rare disease in childhood, can present itself as an idiopathic disease. The aim of this study was to describe some of the clinical features of idiopathic nasal polyposis in children and to emphasize this condition as a specific clinical entity. POPULATION AND METHODS: The study was based on a retrospective analysis of 26 cases of idiopathic nasal polyposis that were studied to our department between 1979 and 1996. In addition, a questionnaire was sent to parents of which 20 were returned completed. RESULTS: The clinical characteristics of idiopathic nasal polyposis in children (11 males and nine females; median: 12 years; range: 8-15 years) were very similar to those observed in adults (median: 50 years), in particular the relation to asthma (ten of 20 cases) and aspirin intolerance (two Fernand-Widal syndromes of 20 cases). Recurrent ENT infections during the maturing period of the immunological system (0-7 years) did not seem to play a role. There appeared, however, to be a strong genetic component as half of our cases had a family history of nasal polyposis and/or asthma. DISCUSSION: Idiopathic nasal polyposis should be recognized as an entity among nasal polyps in childhood. Management of idiopathic and secondary nasal polyposis is however different. Although the pathogenesis of nasal polyposis is not well understood, the study of this disease in children leads one to suspect a genetic transmission.

Adolescent↗
PubMed1998

Histologic changes in the sinus membrane after maxillary sinus augmentation in goats.

PURPOSE: Previous studies have reported on the morphologic aspects of bone regeneration after maxillary sinus grafting. However, no previous studies have examinated the morphology of the maxillary sinus mucosa after grafting. The purpose of this study was to evaluate the histologic changes in the lining membrane after sinus augmentation. MATERIALS AND METHODS: A unilateral osteotomy of the lateral maxillary wall, medial displacement of the bony segments, and elevation of the sinus mucosa were performed in 12 goats. An autogenous bone graft combined with coralline particles was placed on the floor of the sinus in three animals, and coralline particles alone were placed in three other goats. Six goats were not grafted and were used as controls. Samples were harvested at 2.5, 4.5, and 6.5 months. The maxillary sinus mucosa was examined using light microscopy and scanning and transmission electronic microscopy. RESULTS: The coralline particles were surrounded by fibrous connective tissue when used alone. The addition of iliac crest bone to the coralline particles stimulated bone formation. After the sinus augmentation, the mucosal lining showed a lack of glands in the lamina propria, and the epithelium showed an increase in goblet cells. CONCLUSION: It was concluded that the sinus mucosa undergoes physiologic adaptations and remains healthy and free of chronic sinusitis after maxillary sinus grafting.

Animals↗
PubMed1998

[Bone anchored hearing aid (BAHA): clinical evaluation].

UNLABELLED: The bone-anchored hearing aid (BAHA) allows direct bone-conduction through a titanium implant. This avoids skin irritation and seems to improve the sound quality when compared with a conventional bone hearing aid. Aim of this work was to evaluate this new hearing-aid. PATIENTS AND METHODS: 9 patients have been operated on between May 1994 and April 1997. Two aural atresia and 7 radical mastoidectomy; 6 had prior conventional bone hearing aid and one a bilateral air-conduction hearing aid. Their mean bone conduction threshold was 28 dB (17-38 dB). Their maximum speech discrimination score was 100%. Audiological tests and questionnaires were used for the evaluation. RESULTS: The mean follow-up was 9-months (3-35). Osseointegration succeeded in the 9 cases. Skin tolerance was excellent in 6 cases. 3 patients had transient adverse skin reactions, with one having needed a revision surgery under local anesthesia. All patients use their BAHA everyday. The mean prosthesis gain was 36 dB (20-50 dB). Eight patients completed the questionnaire. Patients reported an overall satisfaction score between 9 and 10 (range 6-10). BAHA advantageously replaced the prior hearing aid (mean satisfaction score: 9.1 for BAHA versus 5.9). The only complaints were sensitivity to wind noise and lack of a phone connexion.

Adult↗
PubMed1997

Comparison of functional results after ethmoidectomy and nasalization for diffuse and severe nasal polyposis.

Taking advantage of a natural experimental situation, we compared, retrospectively, functional results after nasalization and ethmoidectomy for diffuse nasal polyposis. Nasalization was a radical ethmoidectomy systematically removing all the bony lamellae and mucosa within the labyrinth, with large antrostomy, sphenoidotomy, frontotomy, and middle turbinectomy (Surgeon 1, 39 consecutive patients operated on between March and September 1991). Ethmoidectomy was a less systematic procedure, that was adapted to the extent of the pathology (Surgeon 2, 37 consecutive patients, operated on between October 1991 and November 1994). In May 1994, a third physician mailed a questionnaire simultaneously to all patients including 10-point visual analog scales 34/39 patients in the nasalization group (age: 28-71 years: 20 asthmatics; follow-up: 32-36 months), and 29/37 patients in the ethmoidectomy group (age: 26-65 years: 9 asthmatics: follow-up: 18-31 months) participated in the study. The overall nasal improvement was 8.8 +/- 0.2 (mean +/- SEM) after nasalization and 5.9 +/- 0.6 after ethmoidectomy (p = 0.0001). Olfaction improvement was similar in both groups 6 months after surgery, remained at the same level 36 months after nasalization (6.9 +/- 0.7), but decreased to 4.2 +/- 1 points 24 months after ethmoidectomy (p = 0.02). Asthma improvement remained significantly better after nasalization (p = 0.05), and the need for systemic steroids was also lower (p = 0.03). Results of this study suggest that when dealing with nasal polyposis, the more radical the surgery, the better the functional results.

Adult↗
PubMed1997

HLA class II antigens and T lymphocytes in human nasal epithelial cells. Modulation of the HLA class II gene transcripts by gamma interferon.

BACKGROUND: Nasal polyps are characterized by a proliferation of the epithelial layer of the mucosa, cellular infiltrates and other pathological changes; however the mechanisms involved in polyp pathogenesis remain largely unclear. OBJECTIVES: We have taken two different approaches to study the cellular events involved in nasal polyposis. METHODS: First, through use of immunohistochemical methods, we have studied the expression of HLA class II antigens in epithelial cells of nasal polyps and the distribution of lymphocytes in the epithelium and in the subepithelial layer in patients with clinical conditions, such as asthma, atopy, aspirin intolerance or cystic fibrosis, and in subjects with an absence of concomitant diseases. Second, in order to investigate whether HLA class II expression is controlled at the pre- or post-transcriptional level, we studied the effect of interferon gamma (INF gamma) on epithelial cells in primary culture, which were derived from HLA class II negative and HLA class II positive nasal polyps. Total RNA was extracted from the cells and reverse-transcribed, and the c-DNA corresponding to DR, DP, DQ loci was amplified by PCR. RESULTS: Expression of HLA class II antigens by the epithelia of nasal polyps was more common in the presence rather than in the absence of concomitant asthma, atopy or cystic fibrosis (59% versus 40%). HLA-DR was the only HLA class II antigen expressed in the seven polyps taken from cystic fibrosis patients. The number of CD8+ cells was significantly higher in polyps associated with known clinical conditions and HLA class II antigen expression than it was in 'isolated' polyps and in HLA class II negative polyps. RNA transcripts for at least one or all three HLA-DR, DP and DQ antigens were detected in 10 cultures of the II HLA class II positive polyps. Conversely, 8 of 10 cultures derived from HLA class II negative polyps did not express HLA class II transcripts in the absence of INF gamma. Adding INF gamma (100 U/ml) to the latter cell cultures caused expression of transcripts of one or more HLA class II genes. CONCLUSIONS: We have shown that HLA class II antigens were more frequently detected in polyps of patients with an identified clinical syndrome than in those of asymptomatic subjects. Our results also suggest that IFN gamma regulates expression of HLA class II antigens in airway epithelial cells of the nasal polyps at the transcriptional level, and that cultured cells from nasal polyps represent a suitable model to investigate immune mechanisms involved in diseases such as atopy, asthma and cystic fibrosis.

CD4-CD8 Ratio↗
PubMed1996

Eosinophils in the pathophysiology of nasal polyposis.

Nasal polyposis can be defined as a chronic inflammatory disease of the paranasal sinus mucosa, leading to a protrusion of benign edematous polyps from the meatus into the nasal cavities. Nasal polyps are histologically characterized by massive edema and accumulation of eosinophils. IgE-mediated allergy seems to play only a minor role in eosinophil accumulation, leaving the place for a new concept of non-allergic rhinitis with eosinophilia. The central question still remains, however, why eosinophils accumulate into nasal polyposis tissue. Some initial data show that tissue structural cells, i.e. epithelial cells or fibroblasts, could produce cytokines (GM-CSF) and play a role in eosinophil accumulation (micro-environmental theory). However, further studies showed, that GM-CSF was mainly produced by eosinophils themselves (autocrine theory), leading to the hypothesis of an intrinsic eosinophilic inflammatory process. Eosinophils may contribute to nasal polyp formation and growth not only through inflammation but also by exerting their effects on extracellular matrix including stimulation of collagen synthesis. Another feature associated with nasal polyposis is aspirin sensitivity. Some preliminary data indicate that eosinophils could also be involved in aspirin-sensitivity mechanisms.

Antigens, CD↗
PubMed1996

[vertebral and spinal cord tumors associated with scoliosis and kyphosis].

Eighteen cases of vertebral and spinal cord tumors associated with spine deformity are included in this study. Thoracic spine was involved most frequently. Neurological deficits were found in 14 patients. Surgical management was carried out in 14 cases. In 4 patients with complete transversal spine lesion percutaneous needle biopsy was done to establish the diagnosis. Surgery was supplemented by radiotherapy or radiotherapy and chemotherapy in 10 cases. Neurological improvement was found in 15 cases.

Adolescent↗
PubMed1996

Management of post-ethmoidectomy crust formation: randomized single-blind clinical trial comparing pressurized seawater versus antiseptic/mucolytic saline.

This study compared the efficacy of mechanical nasal lavages with pressurized seawater versus nasal irrigations with saline plus benzododecinium (antiseptic) plus oleosorbate (mucolytic). Twenty patients agreed to participate in a randomized, single-blind clinical trial. All patients underwent endoscopic endonasal ethmoidectomy for nasal polyps. The packing was removed after 48 h and patients were asked to start the same day nasal lavages three times a day. Clinical evaluations were performed: (1) by weighing residual nasal crusts and secretions after 21 +/- 2 days; and (2) by using visual analogue scales to daily record symptom scores. Data are presented as mean +/- SEM. T-test statistics for two independent groups were applied. The mean residual crust and secretion weights were 1,756 +/- 688 mg and 1,033 +/- 422 mg in the pressurized seawater group, 932 +/- 414 mg and 1,222 +/- 435 mg in the antiseptic-mucolytic saline group. No statistical differences were found. Sample size calculations showed that 100 subjects in each group would be necessary to confirm a 700-mg reduction in residual crusts in the antiseptic/mucolytic saline group (power = 0.80; two-sided type-I error = 0.05). Daily symptom score curves were similar in both groups and allowed us to give a description of post-operative complaints. The role of antiseptic, mucolytic and mechanical lavages in preventing post-ethmoidectomy crust formation is discussed.

Administration, Intranasal↗