Biomedical subjects

Rong-San Jiang

Publications and source records attributed to Rong-San Jiang.

18 recordsLinked to original sources

PubMed2007

Visual screening of oral cavity cancer: The role of otolaryngologists.

OBJECTIVES: Because most screening was done by dentists, the purpose of this prospective cohort study was to evaluate the effectiveness of oral visual screening by otolaryngologists. In addition, we wanted to determine which group of enrolled patients was at potential risk of contracting oral cancer. METHODS: All male patients age > or =18 years who visited our clinic received oral mucosal screening. Basic data, including personal habits, were also obtained. A multivariate logistic regression model was devised to determine relevant risk factors for developing oral cancer. RESULTS: A total of 5,825 patients were enrolled in this study. Positive findings were found in 226 patients (3.9%). One hundred seventy-two patients received biopsy and 131 patients were proven to have oral cancer (sensitivity rate: 76.2%). The results showed that those who smoked, consumed alcohol, and chewed betel quid on a regular basis were most likely to contract oral cancer (odds ratio = 49.81, 95% confidence interval = 29.38-84.42). CONCLUSIONS: The otolaryngologists involved in this study successfully performed the oral screening. The sensitivity and specificity rates were both satisfactory. We suggest that those who are habitual cigarette smokers, alcohol consumers, and betel quid chewers should receive oral mucosal screening regularly so that potential oral cancer can be detected as early as possible.

Adolescent↗

PubMed2006

Comparison of the prognostic impact of serum anti-EBV antibody and plasma EBV DNA assays in nasopharyngeal carcinoma.

PURPOSE: Nasopharyngeal carcinoma (NPC) has been proven as an Epstein-Barr virus (EBV)-associated cancer. Serum anti-EBV antibodies and plasma EBV DNA have been investigated as surrogate markers for NPC. A comparison of the prognostic impacts of both assays has never been reported. METHODS AND MATERIALS: Paired serum and plasma samples from 114 previously untreated NPC patients were collected and subjected to an immunofluorescence assay for immunoglobulin (Ig)A and IgG antibodies against the viral capsid antigen (VCA) and a real-time quantitative polymerase chain reaction assay for EBV DNA measurement. The effects of both assays on patient prognosis were thoroughly investigated. RESULTS: Relapsed patients had significantly higher pretreatment EBV DNA concentration than patients without relapse (p = 0.0006). No associations of VCA-IgA (p = 0.9669) or VCA-IgG (p = 0.6125) were observed between patients with and without relapse. The 4-year overall survival (60.3% vs. 93.1%, p < 0.0001) and relapse-free survival rates (54.4% vs. 77.9%, p = 0.0009) were significantly lower in patients with higher pretreatment EBV DNA load than in those with lower EBV DNA load. Patients with persistently detectable EBV DNA after treatment had significantly worse 4-year overall (30.8% vs. 84.6%, p < 0.0001) and relapse-free survival rates (15.4% vs. 74.0%, p < 0.0001) than those with undetectable EBV DNA. The VCA-IgA and VCA-IgG titer could not predict survivals (all p > 0.1). Cox multivariate analyses also showed the same results. CONCLUSION: Plasma EBV DNA is superior to serum EBV VCA antibodies in prognostic predictions for NPC.

Adult↗

PubMed2006

Association of p53 codon 72 polymorphism with risk of hypopharyngeal squamous cell carcinoma in Taiwan.

BACKGROUND: p53 polymorphism at codon 72 is a known risk marker for various malignancies, but it has not been studied in hypopharyngeal cancer. This study investigated the genotype distribution of p53 codon 72 polymorphism in hypopharyngeal cancer patients and non-cancer controls matched for age, gender, alcohol consumption and smoking habit. METHODS: Genomic DNA was extracted from peripheral blood cells of 53 patients with hypopharyngeal cancer and 53 non-cancer controls. Codon 72 polymorphism of p53 was identified by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: Patients with hypopharyngeal cancer had higher frequencies of Pro/Pro (26.4% vs. 13.2%) and Pro/Arg (51.0% vs. 45.3%) but lower frequencies of Arg/Arg (22.6% vs. 45.1%) compared to controls. Compared to Arg/Arg genotypes, Pro/Pro genotypes had a relative risk of hypopharyngeal cancer of 3.667 (95% confidence interval, 1.16-11.56; p = 0.03). As a group, patients with Pro/Pro or Arg/Pro who were carriers of the Pro allele had a higher relative risk of hypopharyngeal cancer compared to Arg homozygous carriers (odds ratio, 2.415; 95% confidence interval, 1.04-5.64; p = 0.04). CONCLUSION: This study demonstrated that p53 codon 72 Pro homozygosity is associated with a higher risk of developing hypopharyngeal cancer.

Adult↗

PubMed2006

Comparison of the skin test and ImmunoCAP system in the evaluation of mold allergy.

BACKGROUND: Mold is ubiquitous in our environment and is a common allergen in allergic diseases. The skin test and the Pharmacia ImmunoCAP system (CAP) for assay-specific immunoglobulin E (IgE) antibodies are both widely used. The goal of this study was to compare the performance of the skin test and CAP in the evaluation of mold allergy. METHODS: Patients with allergic rhinitis were enrolled at our outpatient department. The diagnosis of allergic rhinitis was based on typical symptoms for more than 2 years. All patients were tested by both intradermal skin test and serum assay for specific IgE antibodies. The skin test included house dust, cotton, ragweed, and 5 fungal antigens (Candida, Alternaria, Aspergillus, Cladosporium, and Penicillium). The serum-specific IgE antibodies were quantified using the radioimmunoassay version of CAP. RESULTS: Seventy-five patients (44 males and 31 females) with allergic rhinitis were enrolled in this study. Their ages ranged from 12 to 76 years old, with a mean of 31.9 years. The positive rates of skin test and CAP were 56.0% versus 9.3% for Candida, 22.7% versus 1.3% for Alternaria, 16% versus 9.3% for Aspergillus, 14.7% versus 1.3% for Cladosporium, and 32% versus 8% for Penicillium. There were statistically significant differences between the positive rates for Candida, Alternaria, Cladosporium, and Penicillium when analyzed by the McNemar test. CONCLUSION: The positive rate of the skin test is higher than CAP when evaluating mold allergy. Clinicians should note that a discrepancy may exist between the results of in vitro and in vivo tests when evaluating mold allergy.

Adolescent↗

PubMed2006

Efficacy of a leukotriene receptor antagonist in the treatment of perennial allergic rhinitis.

The objectives of this study were to investigate the efficacy of leukotriene receptor antagonists in the treatment of perennial allergic rhinitis. The study was designed as a randomized, 14-day treatment to compare the efficacy of zafirlukast, loratadine, and the combination of loratadine and pseudoephedrine in the treatment of perennial allergic rhinitis. Rhinitis symptom scores, acoustic rhinometry, and rhinomanometry were used to evaluate the efficacy. The results showed that after a 14-day treatment period, patients in all treatment groups had a lower mean score for the symptoms of rhinorrhea, nasal itching, and nasal obstruction (p < .05). Patients who took zafirlukast did not report a significant decrease in sneezing score (p = .1456), but the decrease in nasal obstruction score was more pronounced than in those who took loratadine or loratadine- pseudoephedrine (p = .014). However, the results of acoustic rhinometry and rhinomanometry did not have a significant difference among the three groups (p > .05). The study concluded that zafirlukast seemed to have a better effect on relieving the symptom of nasal obstruction in patients with perennial allergic rhinitis, but the actual mechanism needs further investigation.

Adolescent↗

PubMed2005

Correlation between bacteriology and computed tomography staging for chronic sinusitis.

In this study we report on the correlation between bacteriology and disease severity staging by computed tomography (CT) for chronic sinusitis. When patients with chronic sinusitis underwent functional endoscopic sinus surgery (FESS), swab specimens were taken from the ipsilateral middle meati and ethmoid sinuses under endoscope guidance. The severity of chronic sinusitis was evaluated by pre-operative CT scans. The CT scans were staged by the Lund and Mackay system. The scores for the frontal, anterior ethmoid and maxillary sinuses and for the ostiomeatal complex were added. The culture rates were correlated with the added scores. Between November 1998 and January 2003, 79 pairs of specimens were collected from 79 patients whose CT scans were done within a day before FESS. The culture rates of middle-meatus specimens were moderately correlated with the scores, but those of ethmoid sinus specimens were negatively correlated with the scores. If Staphylococcus epidermidis and corynebacteria were considered normal flora, the bacteriology of the middle meatus was highly correlated with the CT scores. This study shows that culture rates of middle-meatal specimens tended to increase with the severity of chronic sinusitis.

Adolescent↗

PubMed2004

Another way to estimate outcome of advanced nasopharyngeal carcinoma--is concurrent chemoradiotherapy adequate?

PURPOSE: To evaluate a simple risk grouping system and determine whether concurrent chemoradiotherapy (CCRT) is adequate for patients with advanced nasopharyngeal carcinoma (NPC). METHODS AND MATERIALS: A total of 284 patients with 1992 American Joint Committee on Cancer (AJCC) Stage III to IV (M0) NPC were analyzed retrospectively. They were treated by either radiotherapy (RT) alone or CCRT. We divided patients into high-risk and low-risk subgroups according to our experience. High-risk patients met at least one of the following criteria: (1) nodal size >6 cm, (2) supraclavicular node metastases, (3) 1992 AJCC stage T4N2, (4) multiple neck node metastases with 1 node >4 cm. The disease extent of each patient was stratified by our risk grouping system, AJCC 1992 and 1997 staging systems. Survival analyses-including nasopharynx disease free (TS), neck disease free (NS), distant metastasis disease free (MS), overall survival (OS), and progression-free (PFS) survival curves-were compared between these three different classifications. RESULTS: According to the 1992 AJCC staging system, 80.3% (228/284) of NPC patients are Stage IV, whereas only 19.7% are Stage III. Most patients are downstaged by the 1997 AJCC staging system with 28.5% (81/284) Stage IV and 71.5% (203/284) Stage III/II. Our risk criteria stratify more even patient distribution, because 119 patients (41.9%) are assigned to the high-risk group and 165 patients (58.1%) to the low-risk group. Log-rank test of Kaplan-Meier survival curves, multivariate comparison of the Cox proportional hazards model, and 3 goodness-of-fit indices validated that our risk grouping system seemed to be at least as efficacious as, or slightly superior to, the 1992 and 1997 AJCC systems. The 5-year TS (95.1% vs. 76.8%, p = 0.0012), NS (100% vs. 95.7%, p = 0.0974), MS (90.5% vs. 78.1%, p = 0.0282), OS (83.2% vs. 59.7%, p = 0.0041), and PFS (87.3% vs. 61.5%, p = 0.0003) were significantly better in patients receiving CCRT than RT alone for the low-risk group. However, the corresponding survival rates between CCRT and RT for high-risk patients were 74.9% vs. 67.6% (p = 0.2545) for TS, 92.1% vs. 86.8% (p = 0.4744) for NS, 59.7% vs. 60.0% (p = 0.5537) for MS, 55.8% vs. 46.3% (p = 0.1761) for OS, and 44.5% vs. 43.1% (p = 0.3911) for PFS, respectively. CONCLUSIONS: Concurrent chemoradiotherapy is superior to RT alone for low-risk patients but inadequate for high-risk patients. Adding neoadjuvant and/or adjuvant chemotherapy would be a reasonable approach for high-risk patients. Our risk grouping criteria are a simple and useful guide that will have important implications in the design of future therapeutic trials.

Adolescent↗

PubMed2004

Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma.

BACKGROUND: We investigated the clinical significance of plasma concentrations of Epstein-Barr virus (EBV) DNA in patients with advanced nasopharyngeal carcinoma. METHODS: Ninety-nine patients with biopsy-proven stage III or IV nasopharyngeal carcinoma and no evidence of metastasis (M0) received 10 weekly chemotherapy treatments followed by radiotherapy. Plasma samples from the patients were subjected to a real-time quantitative polymerase-chain-reaction assay. EBV genotypes of paired samples from plasma and primary tumor were compared. RESULTS: Plasma EBV DNA was detectable before treatment in 94 of the 99 patients, but not in 40 healthy controls or 20 cured patients. The median concentrations of plasma EBV DNA were 681 copies per milliliter among 25 patients with stage III disease, 1703 copies per milliliter among 74 patients with stage IV disease, and 291,940 copies per milliliter among 19 control patients with distant metastasis (P<0.001). Patients with relapse had a significantly higher plasma EBV DNA concentration before treatment than those who did not have a relapse (median, 3035 vs. 1202 copies per milliliter; P=0.02). The consistent genotyping of EBV DNA between paired samples of plasma and primary tumor suggested that the circulating cell-free EBV DNA may originate from the primary tumor. Unlike the rebound of plasma EBV DNA concentrations in the patients who had a relapse, the plasma EBV DNA concentration was persistently low or undetectable in patients with a complete clinical remission. Overall survival (P<0.001) and relapse-free survival (P=0.02) were significantly lower among patients with pretreatment plasma EBV DNA concentrations of at least 1500 copies per milliliter than among those with concentrations of less than 1500 copies per milliliter. Patients with persistently detectable plasma EBV DNA had significantly worse overall survival (P<0.001) and relapse-free survival (P<0.001) than patients with undetectable EBV DNA one week after the completion of radiotherapy. CONCLUSIONS: Quantification of plasma EBV DNA is useful for monitoring patients with nasopharyngeal carcinoma and predicting the outcome of treatment.

Adult↗

PubMed2004

Serum immunoglobulins and IgG subclass levels in sinus mycetoma.

OBJECTIVE: To study the immunity of patients with sinus mycetoma by measuring serum immunoglobulins and IgG subclass levels. STUDY DESIGN AND SETTING: Thirty patients with sinus mycetoma, 71 ordinary chronic rhinosinusitis patients without nasal polyps, and 77 ordinary chronic rhinosinusitis patients with nasal polyps were collected. In all subjects, the levels of total serum immunoglobulins and IgG subclasses were measured during surgical treatment. RESULTS: Among 30 patients with sinus mycetoma, decreased IgA level was found in 1 patient, and decreased IgM level was found in another 2 patients. There were no significant differences in the levels of total serum immunoglobulins or IgG subclasses between patients with sinus mycetoma and ordinary chronic rhinosinusitis patients with or without nasal polyps. CONCLUSION: Immunologic defects cannot be detected in patients with sinus mycetoma by measuring levels of total serum immunoglobulins or IgG subclasses. SIGNIFICANCE: Immunoglobulin deficiency may not play an important role in the pathogenesis of sinus mycetoma.

Adolescent↗

PubMed2003

Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival.

PURPOSE: Nasopharyngeal carcinoma (NPC) is a radiosensitive and chemosensitive tumor. This randomized phase III trial compared concurrent chemoradiotherapy (CCRT) versus radiotherapy (RT) alone in patients with advanced NPC. PATIENTS AND METHODS: From December 1993 to April 1999, 284 patients with 1992 American Joint Committee on Cancer stage III to IV (M0) NPC were randomly allocated into two arms. Similar dosage and fractionation of RT was administered in both arms. The investigational arm received two cycles of concurrent chemotherapy with cisplatin 20 mg/m(2)/d plus fluorouracil 400 mg/m(2)/d by 96-hour continuous infusion during the weeks 1 and 5 of RT. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: Baseline patient characteristics were comparable in both arms. After a median follow-up of 65 months, 26.2% (37 of 141) and 46.2% (66 of 143) of patients developed tumor relapse in the CCRT and RT-alone groups, respectively. The 5-year overall survival rates were 72.3% for the CCRT arm and 54.2% for the RT-only arm (P =.0022). The 5-year progression-free survival rates were 71.6% for the CCRT group compared with 53.0% for the RT-only group (P =.0012). Although significantly more toxicity was noted in the CCRT arm, including leukopenia and emesis, compliance with the combined treatment was good. The second cycle of concurrent chemotherapy was refused by nine patients and was delayed for > or = 1 week for another nine patients. There were no treatment-related deaths in either arm. CONCLUSION: We conclude that CCRT is superior to RT alone for patients with advanced NPC in endemic areas.

Adult↗

PubMed2002

Revision functional endoscopic sinus surgery.

Functional endoscopic sinus surgery (FESS) has recently become a popular procedure for treating chronic sinusitis. However, there is a 2% to 24% rate of primary FESS failure. Revision functional endoscopic sinus surgery (RESS) is indicated for patients who remain symptomatic after primary FESS and optimal medical therapy have failed. A retrospective study was conducted on all patients who underwent RESS in our department between April 1988 and March 1998. During this period, FESS was performed 1,227 times to treat chronic sinusitis; among those procedures, 142 were RESS. Complications occurred in 14 RESS procedures (9.9%). After RESS, 65% patients had improved. In this study, we concluded that although RESS is more difficult than primary FESS because of distorted or missing anatomic landmarks, complications did not increase with RESS if meticulous surgical procedures were performed. However, the 65% improvement rate with RESS was lower than that of primary FESS.

Adolescent↗

PubMed2002

Correlation between bacteriology of the middle meatus and ethmoid sinus in chronic sinusitis.

In this study we report on the correlation between the bacteriology of the middle meatus and ethmoid sinus in chronic sinusitis. When patients with chronic sinusitis underwent functional endoscopic sinus surgery (FESS), swab specimens were taken from the middle meati before surgery. After removing the ethmoid bullae, swab specimens were taken from the ethmoid sinuses. Between November 1998 and February 2001, 186 pairs of middle meatal and ethmoid sinus specimens were collected from 186 patients. No bacteria were cultured from either specimen in 32 patients. The same bacteria were cultured from both specimens in another 60 patients. The culture results differed between the middle meatal and ethmoid sinus specimens in the remaining 94 patients. There was a significant difference between culture rates of 63.4 per cent for middle meatal specimens and 76.3 per cent for the ethmoid sinus specimens. In analysing bacterial species, significantly more aerobic gram negative bacteria were cultured from the ethmoid sinus specimens than from the middle meatal specimens. This study shows that the bacteriology of the middle meatus was different from that of the ethmoid sinus. Therefore, the bacteriological findings in the middle meati may not reflect the real bacteriology in chronic sinusitis.

Adolescent↗

PubMedDate not supplied

Endoscopic sinus surgery for the treatment of chronic rhinosinusitis in patients with postirradiated nasopharyngeal carcinoma.

PURPOSE: Our purpose was to evaluate the efficacy and safety of endoscopic sinus surgery (ESS) in patients with nasopharyngeal carcinoma (NPC) after irradiation. MATERIALS AND METHODS: A retrospective study of postirradiated NPC patients who received ESS for the treatment of chronic rhinosinusitis in Taichung Veterans General Hospital. Symptoms, endoscopic findings, and computed tomography were used to evaluate the efficacy of ESS in these patients, and the safety was evaluated by intraoperative findings and complications. RESULTS: Since 1996, 10 postirradiated NPC patients with chronic rhinosinusitis have been treated by ESS and followed up for at least 2 years. The interval between radiotherapy and ESS was from 4 months to 16 years. After surgery, 7 patients felt improved except for one patient who died of tumor recurrence and computed tomography scores changed from 6.6 to 3.7, although prolonged nasal crusting was observed in most patients by endoscopy. One patient was complicated with cerebrospinal fluid leakage and the dura defect was immediately repaired without any sequelae. CONCLUSIONS: This study shows that ESS is effective for the treatment of chronic rhinosinusitis in postirradiated NPC patients if they failed medical treatment.

Adolescent↗

PubMedDate not supplied

Nasal patency measured by acoustic rhinometry in East Asian patients with sleep-disordered breathing.

BACKGROUND: Nasal obstruction is thought to be a risk factor in obstructive sleep apnea (OSA). However, the relationship between nasal patency and sleep-disordered breathing remains controversial. The aim of this study was to examine the association between acoustic rhinometry findings and results of overnight polysomnography. METHODS: From February to October 2003, patients who underwent overnight polysomnography assessment were enrolled in the study. We excluded patients who were under 20 years old, had severe deviated nasal septum, had previously received nasal or palatal surgery, or could not complete sleep test or acoustic rhinometry examination. Participants' basic data including age, gender, neck circumference, and body mass index (BMI) were collected. All participants received acoustic rhinometry before overnight polysomnography. The results along with sleep-test outcomes were recorded and analyzed. RESULTS: A total of 87 patients were included in this study. Patients with respiratory disturbance index (RDI) less than 5/h (n = 26) or with RDI of 5-30/h (n = 28) tended to have larger minimal cross-sectional area (MCA) compared with those of patients whose RDI was more than 30/h (n = 33) (P = 0.001). A stepwise multiple regression analysis showed that BMI, male gender, and MCA were contributing factors in RDI. The R2 value of the multiple regression analysis was 0.406. CONCLUSION: Patients with severe OSA tended to have smaller MCA when compared with patients with RDI less than 30/h. However, it was hard to predict whether patients had OSA from acoustic rhinometry examination.

Adult↗

PubMedDate not supplied

Changes in nasal resonance after functional endoscopic sinus surgery.

BACKGROUND: Hyponasality may be present in patients with chronic rhinosinusitis because of decreased resonance of nasal cavities. Nasalance is a parameter of nasality measured by a nasometer. This study investigated the influence of functional endoscopic sinus surgery (FESS) on nasalance and determined the correlation of the nasalance change with nasal volume change. METHODS: When patients with chronic rhinosinusitis underwent FESS, nasalance was measured by nasometry and nasal volume was measured by acoustic rhinometry before and at least 6 months after surgery. RESULTS: There were 81 eligible patients enrolled in the study. Nasalance scores and nasal volumes were significantly increased after FESS. The increased nasalance value was moderately correlated with the increased midnasal and postnasal volumes. The correlation between postoperative changes in nasalance scores and nasal volumes was more remarkable in patients without nasal polyps than in those with nasal polyps and it was also higher in patients with allergic rhinitis than in those without allergic rhinitis. CONCLUSION: This study showed that the FESS effectively increased nasalance scores and nasal volumes in patients with chronic rhinosinusitis, but the increase in nasalance scores did not appear to be achieved largely through the increased nasal volumes.

Adolescent↗

PubMedDate not supplied

Bacteriology of chronic maxillary sinusitis in relation to sinoscopic appearance.

BACKGROUND: The bacteriology of chronic maxillary sinusitis in relation to different sinoscopic appearances is reported in this study. METHODS: When transantral sinoscopy via an anterior wall puncture was used to examine the maxillary antra in patients with chronic maxillary sinusitis, the sinoscopic appearances were divided into five types. Maxillary antra in which ostia were recognized under the endoscope and no secretion existed were classified as type 1. Maxillary antra in which ostia were not recognized and no secretion existed belonged to type 2. Maxillary antra in which seromucoid secretion existed belonged to type 3. Maxillary antra in which mucopurulent discharge existed belonged to type 4. Maxillary antra in which fungal balls existed belonged to type 5. Swab specimens of these antra were sent for aerobic and anaerobic cultures. RESULTS: Between 1988 and 1998, 493 sinoscopic appearances of maxillary antra were classified. Among them, 72 were classified as type 1, 59 were type 2, 75 as type3, 227 were type 4, and 60 were type 5. The culture rate of swab specimens from those antra with type 1 sinoscopic appearance was 56.9%. The culture rates were 59.3% for type 2, 48% for type 3, 64.8% for type 4, and 88.3% for type 5. Common cultured bacteria were similar among antra with different types of sinoscopic appearances, except type 5 antra, but less gram-negative aerobes grew from type 1 antra. CONCLUSIONS: This study shows that the bacteriology of noninvasive fungal sinusitis was different from that of ordinary chronic maxillary sinusitis. However, among ordinary chronic maxillary sinusitis, the bacteriology was similar between maxillary antra with different sinoscopic appearances except with mild disease.

Adolescent↗

PubMedDate not supplied

Nasal mycology of chronic rhinosinusitis.

BACKGROUND: Ponikau used a novel collection and culturing method to recover fungi from nasal secretion in patients with chronic rhinosinusitis. The same method had been used previously in Europe with a similar result. However, the use of Ponikau's method has not been reported in Asia. METHODS: Fifty-one patients with chronic rhinosinusitis who were scheduled for functional endoscopic sinus surgery were enrolled in this study. One day before functional endoscopic sinus surgery, swab specimens were obtained from middle meatuses and were sent to the microbiology laboratory for routine bacterial and fungal cultures. Then, the same nasal cavity was lavaged with 20 mL of sterile water. The exhaled fluid was collected and processed using the Ponikau method. Skin testing with Candida extract was done also in all patients. The results obtained by different culture methods were compared. RESULTS: Bacteria grew from 45 of 51 swab specimens. The culture rate was 88.2%. Fungi were cultured from 6 of 51 swab specimens (11.8%) and from 25 of 51 lavage specimens (49%). The fungal culture rates were significantly different between swab and lavage specimens (p < 0.001). Candida was the most common cultured fungi in the lavaged specimens. CONCLUSION: The study showed that Ponikau's method resulted in a higher fungal culture rate than that obtained with the swab method, but the culture rate was lower than the bacterial culture rate. Additional study is needed to investigate the role of fungi in the pathogenesis of chronic rhinosinusitis.

Adult↗

PubMedDate not supplied

Bacteriology of chronic sinusitis in relation to middle meatal secretion.

BACKGROUND: The bacteriology of chronic sinusitis has been studied widely, but some factors may affect the results, such as sample sources and sampling techniques. However, whether the presence of secretion in the middle meatus affects the culture result has been studied rarely. METHODS: When patients with chronic sinusitis underwent functional endoscopic sinus surgery, swab specimens were taken from the ipsilateral middle meatuses and ethmoid sinuses under endoscopic guidance. While taking specimens from the middle meatuses, we observed the presence of secretions in the middle meatuses. The severity of chronic sinusitis was evaluated by preoperative computed tomography, which was scored by the Lund-Mackay system. The scores of the frontal, anterior ethmoid, maxillary sinus, and ostiomeatal complex were cumulated. RESULTS: Between March 2001 and February 2004, 210 pairs of specimens were collected. The secretion was present in 82 middle meatuses and was absent in the other 128 middle meatuses. The culture rates of middle meatus and ethmoid sinus specimens were 70.7 and 51.2%, respectively, for patients with secretions in the middle meatuses and 53.1 and 44.5%, respectively, for patients without secretions in the middle meatuses. The culture rate was significantly different for middle meatus specimens (p = 0.011) and the mean cumulated computed tomography score also was significantly higher in patients with secretions in the middle meatuses than in patients without secretions in the middle meatuses (p < 0.001). CONCLUSION: The results of this study suggest that the presence of secretion in the middle meatus indicates more severe disease in the anterior group of paranasal sinuses.

Adolescent↗