Resveratrol enhances airway surface liquid depth in sinonasal epithelium by increasing cystic fibrosis transmembrane conductance regulator open probability.

Background: Chronic rhinosinusitis engenders enormous morbidity in the general population, and is often refractory to medical intervention. Compounds that augment mucociliary clearance in airway epithelia represent a novel treatment strategy for diseases of mucus stasis. A dominant fluid and electrolyte secretory pathway in the nasal airways is governed by the cystic fibrosis transmembrane conductance regulator (CFTR).

Cystic fibrosis transmembrane conductance regulator modulation by the tobacco smoke toxin acrolein.

Objectives/hypothesis: Evidence indicates that decreased mucociliary clearance (MCC) is a major contributing feature to chronic rhinosinusitis. Tobacco-smoke exposure is thought to inhibit transepithelial Cl(-) secretion, a major determinant of airway surface liquid hydration and MCC. The objective of the current study was to evaluate the effects of acrolein exposure (a prominent tobacco smoke toxin) on vectorial Cl(-) transport through the major apical anion channel cystic fibrosis transmembrane conductance regulator (CFTR) in sinonasal epithelium.

Unusual presentation of extracardiac fetal rhabdomyoma of the larynx in a pediatric patient with tuberous sclerosis.

Tuberous sclerosis (TSC) is an autosomal-dominant genetic disease characterized by a spectrum of pathologic manifestations involving skin, brain, kidney, and heart. These manifestations include neuroectodermal, mesodermal, and skin lesions as well as a variety of associated tumors and hamartomas. We report an 11-year-old male with previously diagnosed TSC who presented with a laryngeal mass shown on histology to be fetal cellular rhabdomyoma.

Cerebrospinal fluid volume replacement following large endoscopic anterior cranial base resection.

Background: Large endoscopic skull-base resections often result in extensive postoperative pneumocephalus secondary to copious evacuation of cerebrospinal fluid (CSF) during the procedures. Replacing CSF lost during craniotomy with saline is a common technique in neurosurgery, but is difficult after extensive transnasal resection of the anterior cranial base because direct transnasal CSF augmentation will escape until the skull base reconstruction is sealed. The present study evaluated the effectiveness of intraoperative CSF volume replacement via lumbar drains on improving postoperative outcomes.

Transepithelial ion transport is suppressed in hypoxic sinonasal epithelium.

Objectives/hypothesis: Sinonasal respiratory epithelial mucociliary clearance is dependent on the transepithelial transport of ions such as Cl(-) . The objectives of the present study were to investigate the role of oxygen restriction in 1) Cl(-) transport across primary sinonasal epithelial monolayers, 2) expression of the apical Cl(-) channels cystic fibrosis transmembrane conductance regulator (CFTR) and transmembrane protein 16A (TMEM16A), and 3) the pathogenesis of chronic rhinosinusitis.

Study Design: In vitro investigation.

Juvenile nasopharyngeal angiofibroma.

Juvenile nasopharyngeal angiofibromas (JNAs) are rare, benign, highly vascular, locally aggressive tumors that primarily affect male adolescents. Historical treatment of these neoplasms has been primarily surgical. In the past decade, endoscopic resection of JNAs has become a viable and promising surgical treatment option.

Validation of a laryngeal dissection module for phonomicrosurgical training.

Objectives: To validate the use of a new phonomicrosurgical trainer called the laryngeal dissection module.

Study Design: The module used synthetic, multilayered vocal folds inside a model larynx mounted on a platform, a microscope, and microsurgical instruments. The study was designed to test the module's ability to differentiate novices from expert surgeons and to test the module's ability to improve novice performance with training.

Resource use associated with topiramate in migraine prophylaxis.

Purpose: The effect of topiramate prophylaxis on medication use and medical resource use for migraine patients was studied.

Methods: Medical and pharmacy claims from a commercially insured population were analyzed from July 1, 1999, to March 31, 2004. The study sample included patients with at least one physician encounter or facility claim with a diagnosis of migraine at any point during the study's time frame.

Topiramate in migraine prophylaxis: long-term impact on resource utilization and cost.

Objective: To evaluate the medical resource utilization and overall cost of care among patients treated with topiramate (TPM) for migraine prevention in a commercially insured population. Background.-Preventive migraine therapy with TPM significantly reduces the frequency of migraine attacks.

Modifying a breast cancer risk factor survey for African American women.

Purpose/objectives: To evaluate a breast cancer risk factor survey for use with African American women.

Design: Two focus groups consisting of women randomly selected from the patient population of Henry Ford Health System in Detroit, MI.

Setting: A large, vertically integrated, private, nonprofit health system.

Improving quality of care for acute myocardial infarction: The Guidelines Applied in Practice (GAP) Initiative.

Context: Quality of care of patients with acute myocardial infarction (AMI) has received intense attention. However, it is unknown if a structured initiative for improving care of patients with AMI can be effectively implemented at a wide variety of hospitals.

Objective: To measure the effects of a quality improvement project on adherence to evidence-based therapies for patients with AMI.

Taking the national guideline for care of acute myocardial infarction to the bedside: developing the guideline applied in practice (GAP) initiative in Southeast Michigan.

Background: The Guideline Applied in Practice (GAP) program was developed in 2000 to improve the quality of care by improving adherence to clinical practice guidelines. For the first GAP project, the American College of Cardiology (ACC) partnered with the Southeast Michigan Quality Forum Cardiovascular Subgroup and the Michigan Peer Review Organization (MPRO) to develop interventions that might facilitate the use of the ACC/AHA Acute Myocardial Infarction (AMI) guideline in the practice setting. Ten Michigan hospitals participated in implementing the project, which began in March 2000.