Pre and post functional endoscopic sinus surgery nasal cavity volume assessment by acoustic rhinometry

Acoustic rhinometry is an objective method to determine nasal cavity geometry. The technique is based on sound wave reflexion analysis in the nasal cavity, and determines crossectional areas as a function of distance as well as volume. AIM: The purpose of this study is to analyse nasal cavity volume changes caused by functional endoscopic sinus surgery (FESS) in adults with chronic rhinosinusitis by acoustic rhinometry, and to correlate these changes with improvements in the sensation of nasal obstruction. MATERIAL AND METHOD: Forty patients aged from 18 to 73 years were prospectively evaluated between August and October 1999 at the Graz University Hospital, Austria. All patients were diagnosed with chronic rhinosinusitis, and undertook acoustic rhinometry before and after FESS. SCIENTIFIC DESIGN: A clinical prospective study. RESULTS: The nasal cavity total volume increased significantly after surgery. Nasal obstruction was improved in 88% of the patients, 20% with partial improvement and 68% with total improvement. There was no correlation between volume increase and improvement of the sensation of nasal obstruction. CONCLUSION: Total nasal cavity volume significantly increased after surgery; however, there was no correlation between volume increase and improvements of nasal obstruction. No significant pre or postoperative increase in total nasal cavity volume after decongestion were observed.A rinometria acústica é um método objetivo de determinar a geometria da cavidade nasal, pela análise da reflexão de ondas sonoras. Determina a área de secção transversal da cavidade em função da distância da narina e seu volume. OBJETIVO: Analisar a alteração do volume da cavidade nasal causada pela cirurgia endoscópica funcional dos seios paranasais, em adultos com rinossinusite crônica, e correlacionar esta alteração com a melhora da obstrução nasal. MATERIAL E MÉTODO: Foram avaliados 40 pacientes de 18 a 73 anos, entre agosto e outubro de 1999, na Universidade de Graz - Áustria, com rinossinusite crônica, antes e depois de serem submetidos à CEFSP. FORMA DE ESTUDO: Clínico prospectivo. RESULTADOS: O volume total da cavidade nasal aumentou significativamente no pós-operatório. 88% dos pacientes referiram melhora da obstrução nasal, 20% de forma parcial e 68% total. Nenhum paciente piorou deste sintoma. Não houve relação linear entre o aumento do volume da cavidade nasal e melhora subjetiva da obstrução nasal. CONCLUSÃO: O volume total da cavidade nasal aumentou no pós-operatório, mas não houve relação entre aumento do volume e melhora da obstrução nasal. Não houve aumento do volume da cavidade nasal após o uso do vasoconstritor, seja no pré ou no pós-operatório.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina setor de RinologiaUniversidade de Graz Depto. de OtorrinolaringologiaUNIFESP, EPM, setor de RinologiaSciEL

Maternal eNOS deficiency determines a fatty liver phenotype of the offspring in a sex dependent manner

ABSTRACT Maternal environmental factors can impact on the phenotype of the offspring via the induction of epigenetic adaptive mechanisms. The advanced fetal programming hypothesis proposes that maternal genetic variants may influence the offspring's phenotype indirectly via epigenetic modification, despite the absence of a primary genetic defect. To test this hypothesis, heterozygous female eNOS knockout mice and wild type mice were bred with male wild type mice. We then assessed the impact of maternal eNOS deficiency on the liver phenotype of wild type offspring. Birth weight of male wild type offspring born to female heterozygous eNOS knockout mice was reduced compared to offspring of wild type mice. Moreover, the offspring displayed a sex specific liver phenotype, with an increased liver weight, due to steatosis. This was accompanied by sex specific differences in expression and DNA methylation of distinct genes. Liver global DNA methylation was significantly enhanced in both male and female offspring. Also, hepatic parameters of carbohydrate metabolism were reduced in male and female offspring. In addition, male mice displayed reductions in various amino acids in the liver. Maternal genetic alterations, such as partial deletion of the eNOS gene, can affect liver metabolism of wild type offspring without transmission of the intrinsic defect. This occurs in a sex specific way, with more detrimental effects in females. This finding demonstrates that a maternal genetic defect can epigenetically alter the phenotype of the offspring, without inheritance of the defect itself. Importantly, these acquired epigenetic phenotypic changes can persist into adulthood