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Aeroallergens, air pollutants, and chronic rhinitis and rhinosinusitis

World Journal of Otorhinolaryngology-Head and Neck Surgery 2018年第3期4卷 209-215页

作者： Nyall R.London Jr lina ioan Murugappan Ramanathan Jr Johns Hopkins Department of Otolaryngology-Head and Neck Surgery BaltimoreMD 21287USA

Chronic rhinitis and rhinosinusitis are among the most common conditions world-wide with significant morbidity and decreased quality of life. Although the pathogenesis of these conditions is multifactorial, there has been increasing evidence for the role of environmental factors such as aeroallergens and air pollutants as initiating or exacerbating factors. This review will outline the current literature focusing on the role of aeroallergens and air pollution in the pathogenesis of chronic sinonasal inflammatory conditions.

关键词： Aeroallergens Air pollutants Inflammatory cytokines Innate immunity Particulate matter Rhinitis

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Techniques and accuracy of thoracolumbar pedicle screw placement

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World Journal of Orthopedics 2014年第2期5卷 112-123页

作者： Varun Puvanesarajah Jason A Liauw Sheng-fu Lo ioan a lina Timothy F Witham Department of Neurosurgery Johns Hopkins University School of Medicine Baltimore MD 21287 United States

Pedicle screw instrumentation has been used to stabilize the thoracolumbar spine for several decades. Although pedicle screws were originally placed via a freehand technique, there has been a movement in favor of pedicle screw placement with the aid of imaging. Such assistive techniques include fluoroscopy guidance and stereotactic navigation. Imaging has the benefit of increased visualization of a pedicle's trajectory, but can result in increased morbidity associated with radiation exposure, increased time expenditure, and possible workflow interruption. Many institutions have reported high accuracies with each of these three core techniques. However, due to differing definitions of accuracy and varying radiographic analyses, it is extremely difficult to compare studies side-by-side to determine which techniques are superior. From the literature, it can be concluded that pedicles of vertebrae within the mid-thoracic spine and vertebrae that have altered morphology due to scoliosis or other deformities are the most difficult to cannulate. Thus, spine surgeons would benefit the most from using assistive technologies in these circumstances. All other pedicles in thethoracolumbar spine should theoretically be cannulated with ease via a free-hand technique, given appropriate training and experience. Despite these global recommendations, appropriate techniques must be chosen at the surgeon's discretion. Such determinations should be based on the surgeon's experience and the specific pathology that will be treated.

关键词： Thoracic vertebrae Lumbar vertebrae Pedicle screw Fluoroscopy Computed tomography

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Value of acoustic radiation force impulse elastography for the assessment of ascites syndrome

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World Journal of Radiology 2011年第8期3卷 205-209页

作者： Simona Bota ioan Sporea Roxana Sirli Alina Popescu Mirela Dǎnilǎ Mǎdǎlina Sendroiu Department of Gastroen-terology and Hepatology University of Medicine and Pharmacy

AIM:To assess the feasibility of performing acoustic radiation force impulse(ARFI) elastography in patients with ascites and its predictive value for the cirrhotic or non-cirrhotic etiology of ***:Our study included 153 patients with ascites,mean age 58.8 ± 13.1 *** hundred and fifteen(75.2%) patients had ascites in the context of cirrhosis,29(18.9%) had non-cirrhotic ascites(diagnosed by clinical,ultrasound,endoscopic and/or laparoscopic criteria) and in 9(5.9%) cases we could not establish the etiology of *** performed 10 ARFI measurements and the median value was calculated and expressed in meters/second(m/s).Among the 29 patients with non-cirrhotic ascites were included:20 laparoscopically demonstrated peritoneal carcinomatosis with histological confirmation,7 acute pancreatitis with ascites which later resolved,and one case each of lymphatic ascites and ascites in the context of a liver *** 11 of the 20 patients with peritoneal carcinomatosis,the liver structure was homogenous in the ultrasound examination and in 9 patients the ultrasound exam revealed liver ***:We could not obtain valid ARFI measurements in 5 patients(3.2%).The mean liver stiffness measurements by means of ARFI were statistically significantly higher in patients with cirrhotic ascites than in those with non-cirrhotic ascites:3.04 ± 0.70 vs 1.45 ± 0.59 m/s(P < 0.001).For a cut-off value of 1.8 m/s for predicting cirrhosis(and ascites in the context of cirrhosis),as obtained in a previous study,ARFI had 98.1% sensitivity,86.2% specificity,96.4% positive predictive value,92.5% negative predictive value and 95.6% accuracy for predicting cirrhotic *** a cut-off value of 1.9 m/s the accuracy was 94.9% and for a 2 m/s cut-off value it was 92.8%.CONCLUSION:ARFI elastography is feasible in most patients with ascites and has a very good predictive value for the cirrhotic or non-cirrhotic etiology of ascites.

关键词： Ascites Liver stiffness Liver cirrhosis Acoustic radiation force impulse Elastography

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