Osteocutaneous radial forearm flaps provide comparable functional outcomes with less morbidity compared to fibula free flaps for selected segmental mandibulectomy defects. The overall dental implantation rate was low and more commonly performed in osteocutaneous radial forearm flaps compared to fibula flaps.
Frontal sinus CSF leaks were successfully closed in 97.3% of individuals. Our data supports the routine use of endoscopic repair in the treatment algorithm for frontal sinus skull-base defects.
Sinupret strongly activates transepithelial Cl(-) secretion through a mechanism known to hydrate the ASL of respiratory epithelium. This is one means by which the medication is likely to exert therapeutic benefit.
Background
The cystic fibrosis transmembrane conductance regulator (CFTR) serves as a predominant Cl− transport conduit in airway epithelium and is inhibited by cigarette smoke in vitro and in vivo. Activation of secondary Cl− transport pathways through calcium-activated Cl− channels (CaCC) has been postulated as a mechanism to bypass defects in CFTR-mediated transport. Because it is not known whether CaCC’s are also inhibited by tobacco exposure, the current study was designed to investigate the effect of cigarette smoke condensate (CSC) on CaCC transport.
Study Design
In vitro study
Methods
Well-characterized primary murine nasal septal epithelial (MNSE) and human sinonasal epithelial (HSNE) cultures were exposed to CSC in Ussing chambers. We monitored CaCC short-circuit current through stimulation of P2Y purinergic receptors with UTP or ATP and selective inhibition of the CFTR dependent secretory pathway. Characterization of CaCC current was also accomplished in primary airway cells derived from transgenic CFTR−/− (knockout) murine models.
Results
Change in CaCC-mediated current (ΔISC - representing transepithelial Ca-mediated Cl− secretion in µA/cm2) was significantly decreased in CSC-exposed wild type MNSE when compared to controls{(32.8 +/− 4.6 vs. 47.5 +/− 2.3; respectively) p < 0.02}. A similar effect was demonstrated in CFTR−/− MNSE cultures(33.4 +/− 2.8 vs. 38.6 +/− 2.0; p<0.05}. HSNE cultures also had a significant reduction in ISC (16.1 +/− 0.6 vs. 22.7 +/− 0; p=0.008).
Conclusions
CSC affects multiple pathways fundamental to airway ion transport, including both cAMP and calcium activated Cl− transport. Inhibition of Cl− transport may contribute to common diseases of the airways, such as chronic rhinosinusitis and chronic obstructive pulmonary disease.
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