How to manage plant biomass originated from phytotechnologies? Gathering perceptions from end-users.

A questionnaire survey was carried out in four European countries to gather end-user's perceptions of using plants from phytotechnologies in combustion and anaerobic digestion (AD). Nine actors of the wood energy sector from France, Germany, and Sweden, and eleven AD platform operators from France, Germany, and Austria were interviewed. Questions related to installation, input materials, performed analyses, phytostabilization, and phytoextraction were asked. Although the majority of respondents did not know phytotechnologies, results suggested that plant biomass from phytomanaged areas could be used in AD and combustion, under certain conditions. As a potential benefit, phytomanaged plants would not compete with plants grown on agricultural lands, contaminated lands being not suitable for agriculture production. Main limitations would be related to additional controls in process' inputs and end-products and installations that might generate additional costs. In most cases, the price of phytotechnologies biomass was mentioned as a driver to potentially use plants from metal-contaminated soils. Plants used in phytostabilization or phytoexclusion were thought to be less risky and, consequently, benefited from a better theoretical acceptance than those issued from phytoextraction. Results were discussed according to national regulations. One issue was related to the regulatory gap concerning the status of the plant biomass produced on contaminated land.

Post-injury smell disorders.

Post-injury smell disorders. PROBLEMS/OBJECTIVES: Head trauma is the third most common aetioiogy of post-traumatic olfactory loss (PTOL). This literature review aims to report the existing knowledge surrounding this issue, exploring the current understanding of the inducing pathogenesis and the assessment and management standards from the early phases to longer-term considerations. METHODOLOGY: Literature search and appraisal in PubMed on the following themes directly associated with PTOL: olfactory disorders, trauma, pathogenesis, examination, recovery and treatment. RESULTS: Scientific evidence was mainly available for epidemiology and exploration tools in cases suffering from PTOL. The current research into obj6ctive batteries of olfactory tests is promising. CONCLUSIONS: This paper highlights the importance of an adequate assessment of PTOL for an early start in olfactory training.

French adaptation and validation of the sino-nasal outcome test-22: a prospective cohort study on quality of life among 422 subjects.

OBJECTIVES: ENT surgeons are facing an ever-increasing demand to demonstrate their efficacy. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a fully validated and easy-to-use outcome measure in rhinology. Our goal was to translate and validate the SNOT-22 in a cohort of 422 French-speaking subjects. DESIGN, SETTING AND PARTICIPANTS: The French version of the SNOT-22 was obtained by forward and backward translations by six independent interpreters. Five experienced rhinologists compared the translations to each other, and a group of 12 naive patients selected the most appropriate translation of each item. To evaluate this questionnaire, we conducted a prospective cohort study on 376 rhinological patients and 46 healthy volunteers in three University-affiliated teaching Hospitals. MAIN OUTCOME MEASURES: Reproducibility (test-retest reliability), internal consistency, known-group differences, responsiveness to treatment, validity and correlation to other clinical instruments (visual analogue scale, Nasal Obstruction Symptoms Evaluation score and Lund-Mackay score). RESULTS: The test-retest reliability coefficient was 0.78, indicating a good reliability when administering the instrument on two different occasions. The internal consistency was high with a Cronbach's α value of 0.93. Our questionnaire was able to detect differences between rhinological patients and control subjects (P < 0.0001) and improved significantly after nose and sinus surgery (P < 0.0001), indicating a good responsiveness. There was a relative correlation with visual analogue scale and Nasal Obstruction Symptoms Evaluation (NOSE) score, but no correlation with Lund-Mackay score. CONCLUSION: The SNOT-22 is a reliable and valid tool to assess quality of life in French-speaking patients and correlates well with known indices of disease severity.

Faecal nitrogen excretion as an approach to estimate forage intake of wethers.

Data from twenty-two digestibility trials were compiled to examine the relationship between faecal N concentration and organic matter (OM) digestibility (OMD), and between faecal N excretion and OM intake (OMI) by wethers fed tropical or temperate forages alone or with supplements. Data set was grouped by diet type as follows: only tropical grass (n = 204), only temperate grass (n = 160), tropical grass plus supplement (n = 216), temperate grass plus supplement (n = 48), tropical grass plus tropical legume (n = 60) and temperate grass with ruminal infusion of tannins (n = 16). Positive correlation between OMD and either total faecal N concentration (Nfc, % of OM) or metabolic faecal N concentration (Nmetfc, % of OM) was significant for most diet types. Exceptions were the diet that included a tropical legume, where both relationships were negative, and the diet that included tannin extract, where the correlation between OMD and Nfc was not significant. Pearson correlation and linear regressions between OM intake (OMI, g/day) and faecal N excretion (Nf, g/day) were significant for all diet types. When OMI was estimated from the OM faecal excretion and Nfc-based OMD values, the linear comparison between observed and estimated OMI values showed intercept different from 0 and slope different from 1. When OMI was estimated using the Nf-based linear regressions, the linear comparison between observed and estimated OMI values showed neither intercept different from 0 nor slope different from 1. Both linear comparisons showed similar R(2) values (i.e. 0.78 vs. 0.79). In conclusion, linear equations are suitable for directly estimating OM intake by wethers, fed only forage or forage plus supplements, from the amount of N excreted in faeces. The use of this approach in experiments with grazing wethers has the advantage of accounting for individual variations in diet selection and digestion processes and precludes the use of techniques to estimate forage digestibility.

Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis.

Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin' Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP [corrected].

Different aspects of respiration: relationships between the upper and lower respiratory tracts, and the middle ear cleft, nasal versus oral breathing.

This paper outlines the normal functioning of the child's upper airway: defending the lower airway by means of air conditioning, filtration, initiation of inflammatory reactions or immune responses. We investigate the hypothetical mechanisms that explain the influence of, and interrelations between, mouth breathing and obstructive sleep apnoea on craniofacial development. We advise orthodontic diagnosis and/or intervention at a young age.

Chronic inflammation of upper airways in children: basic principles.

PROBLEMS/OBJECTIVES: A child's immune system has to initiate the immune response from scratch and cannot depend on a memory-type of immune response. Moreover, the immune system in newborns is also less efficient in inducing cytokine responses. In consequence, newborns and children are more susceptible to upper-airway infections and inflammation than adults. This manuscript summarises basic considerations relating to immune and inflammatory response in the upper airways and presents data about the processes involved in immunity development and maturation in children. METHOD: Literature review. RESULTS: Inflammation is a complex set of interactions between soluble factors and cells that can arise in any tissue in response to both exogenous (infectious, toxic...) and endogenous (auto-immune, ischaemia...) insults. It interacts actively with the adaptive immune response by launching the antigen processing and presenting phases. Reduced cytotoxic response during foetal life, poor T-lymphocyte response to mitogens, immaturity of T and B lymphocytes, inadequate cytokine synthesis, a marked deficiency of antibody production and reduced neutrophil, complement and natural killer activity are important contributors to the complex physiological deficiency of immunological function in neonates and young children. CONCLUSIONS: The importance of the control and self-limitation of the inflammatory reaction is demonstrated by observations that, in certain chronic infectious or inflammatory conditions, the inflammatory response causes more damage to the host than the microbe.

Esterase polymorphisms for analysis of genetic diversity and structure of soybean (Glycine max) cultivars.

We used native polyacrylamide gel electrophoresis to identify polymorphism levels in α- and ß-esterase loci from leaf tissues of Brazilian soybean cultivars for the analysis of population genetic diversity and structure, and to investigate relationships between conventional and genetically modified cultivars. The cultivars included lines developed by a soybean-grower cooperative (CD), by EMBRAPA (BR), and "Roundup Ready" (RR) cultivars. Esterase isozymes recorded with α-naphthyl acetate and ß-naphthyl acetate were produced from 14 loci. Two to three allelic variants were detected in leaves from 420 plants of 21 CD, BR, and RR cultivars at Est-1, Est-2, Est-3, Est-5, and Est-14 loci. The estimated proportion of polymorphic loci in CD cultivars was 21.4%, and in BR and RR cultivars it was 28.6%. High and low H(O) and H(E) values were observed within CD and BR cultivars and a very high cultivar differentiation level was evident in the plants of the 21 CD, BR, and RR cultivars (F(ST) = 0.3865). A low level of differentiation (F(ST) = 0.0289) was detected between conventional and RR cultivars. Plants from cultivar BR37 had the highest level of genetic differentiation compared to the other cultivars. The genetic basis of BR cultivars (0.5538-0.9748) was found to be broader than the genetic basis of CD cultivars (0.7058 for CD205 and CD209 and 0.9995 for CD205 and CD208). Higher genetic identity was detected between plants of CD and CDRR cultivars (I = 0.9816). Understanding the genetic structure of these populations can help provide specific culture strategies for each cultivar, depending on its level of heterozygosity.

Genetic evidence for a role of IL33 in nasal polyposis.

BACKGROUND: Little is known about the genetic factors that contribute to nasal polyposis (NP). A genome-wide association study identified 10 single nucleotide polymorphisms (SNPs) associated with eosinophilia. As eosinophils play a key role in the pathogenesis of NP, we assessed if any of these SNPs contribute to genetic susceptibility of NP. METHODS: We recruited 284 patients with NP in four participating hospitals in Belgium and 427 healthy controls, and genotyped 10 SNPs affecting eosinophilia (rs1420101 in IL1RL1, rs12619285 in IKZF2, rs4431128 in GATA2, rs4143832 in IL5, rs3184504 in SH2B3, rs2416257 in WDR36, rs2269426 in MHC, rs9494145 in MYB, rs748065 in GFRA2, and rs3939286 in IL33) using MALDI-TOF. A two-stage design was used while correcting for multiple testing. RESULTS: First stage analysis, involving 150 NP patients and 250 controls, identified rs3939286 nearby IL33 as a susceptibility factor for NP. Per at-risk A-allele, rs3939286 increased the risk for NP with an odds ratio (OR) of 1.60 (95% CI = 1.16-2.22; P = 0.0041). Second stage replication analysis in another 123 NP patients and 165 controls confirmed this association (OR = 1.43; CI = 1.00-2.06; P = 0.046). The combined analysis of both stages revealed an OR of 1.53 (CI = 1.21-1.96; P = 0.00041). Given the association of IL33 with NP, we also investigated rs1420101 in IL1RL1, which is the receptor for IL33. Although rs1420101 itself failed to associate with NP, a combined risk assessment of rs3939286 and rs1420101 further increased the risk for NP. CONCLUSION: We provide unprecedented genetic evidence suggesting a role for the IL33 pathway in the pathogenesis of NP.

My surgery of the nasal valve.

We discuss the physiopathology and relevant anatomy of the nasal valves--internal and external--paying particular attention to the dynamics of the airflows in this area. We describe and comment on methods for medical examination, anterior rhinoscopy, endoscopy and fibrescopy of the valve, as well as the causes and sites of nasal valve dysfunction. We propose a review of the various treatments, medical and surgical, with a special emphasis on nasal valve surgery. Surgical techniques commonly used by the authors in daily practice for nasal valvuloplasty (such as spreader grafts and Z-plasty of the nostrils) are discussed and illustrated in depth. Some one-year postoperative results are presented and discussed.

The use of grafting material in rhinoseptoplasty.

Grafting is one of the current range of instruments that rhinoplasticians deploy to achieve durable and desired aesthetic and functional outcomes. Grafts can be classified according to anatomical site and, in the vast majority of cases, they involve augmentation rhinoseptoplasty. Visible grafting material is used for aesthetic purposes and functional grafting may involve invisible grafts. This article reviews the more widely described and more common indications for grafts in rhinoseptoplasty. The authors' rhinoseptoplasty philosophy involves a preference for autogenous grafts rather than alloplastic implants to achieve both aesthetically and functionally favourable results, particularly in long-term follow-up. They also prefer grafts in an open approach, reserving graft insertion with an endonasal approach for selected cases. The rate of complications associated with grafting is very low. The aim of this paper is to discuss the relevant anatomy, functional purpose and terminology, and to describe the authors' philosophy for grafting in rhinoseptoplasty.

Genetic diversity in somatic mutants of grape (Vitis vinifera) cultivar Italia based on random amplified polymorphic DNA.

Random amplified polymorphic DNA (RAPD) markers were used to detect polymorphism and to examine relationships among four table grape clones from northwestern Paraná, in southern Brazil. The 10 primers used for RAPD fingerprints generated 126 reproducible fragments, of which 63, 68, 76, and 72 were polymorphic in cultivars Italia, Rubi, Benitaka, and Brasil, respectively. Among the primers, OPP-08 generated the highest number of fragments, whereas OPE-15 was the most efficient for discriminating polymorphic fragments. The distribution of the clones by cluster analysis indicated that there were no differences in RAPD markers between the colored mutant and the original clone (cultivar Italia), supporting the hypothesis that the non-colored and the colored mutant are the same cultivar. However, we found high levels of polymorphism within and between the cultivars Italia, Rubi, Benitaka, and Brasil (65.1%), contrary to a previous hypothesis that the four clones are genetically uniform. This confirmed our expectation of genetic variation among the clones and within each clone. We conclude that the primers are useful for analyzing the development of the genetic diversity within each of these clones.

Usefulness and feasibility of psychophysical and electrophysiological olfactory testing in the rhinology clinic.

TOPIC: Olfactory dysfunction may be assessed in the clinic with psychophysical testing and electrophysiological recording. Chemosensory event-related potentials (CSERPs) constitute an objective method to assess chemosensory function. Olfactory and trigeminal stimuli activate chemoreceptors from the olfactory neuroepithelium and from the nasal mucosa to evoke an electrophysiological response respectively called olfactory (OERPs) and trigeminal ERPs (TERPs). The purpose of this study is to assess the usefulness and feasibility of these diagnostic tools in the rhinology clinic and to correlate these results to the olfactory disorder aetiology. MATERIALS AND METHODS: This study encompasses a cohort of 229 patients with a complaint of olfactory dysfunction from different origins. Orthonasal (Sniffing stick test with the treshold-discrimination-identification score: maximal score 48) and retronasal olfactory (maximal score 20) testing as well as CSERPs both after olfactory and trigeminal stimuli have been routinely performed. Olfactory dysfunction aetiologies were as follows: congenital (Cong.), chronic rhinosinusitis (CRS), idiopathic (Idiop.), post-medication (PM), neurologic (Neuro.), post-traumatic (PT) and post-infection (PI). RESULTS: Mean orthonasal and retronasal scores were respectively: 11.8 and 10.1 for Cong., 18.5 and 13.1 for CRS, 15.6 and 10.4 for Idiop., 15.3 and 10.2 for PM, 17 and 10.6 for Neuro., 15 and 9.9 for PT and 18.3 and 12 for PI. Correlations between orthonasal and retronasal scores were present for all subgroups except congenital and chronic rhinosinusitis subgroups. Orthonasal and retronasal scores were different (p < 0.05) when comparing CRS vs Cong., CRS vs PT and PT vs PI. Technical problems (olfactometer or olfactory stimulation, EEG amplifier,...) and patients discomfort (anxiety, stress,...) did not allow to draw any conclusion in 2 patients. Three patients after olfactory stimulus and 6 patients after trigeminal stimulus demonstrated too much eye blinking or muscular artifacts that did not allow us to perform electrophysiological analysis and averaging as 60% of artifact-free recording was not achieved. Olfactory ERPs were recorded in 28% of the patients and trigeminal ERPs were obtained in almost every patient (95%). There was no statistical difference between each subgroup regarding the presence or absence of OERPs. CONCLUSIONS: Psychophysical olfactory testing is a useful method to assess olfactory function in patients with olfactory loss and may help us to obtain a semi-objective and a basal evaluation of the olfactory performances. Feasibility and usefulness of CSERPs are also underlined in this study with only a limited number of patients who did not complete the examination. Psychophysical testing gives different results according to the aetiology of the olfactory disorder, which was not the case for electrophysiological recording. Olfactory acuity assessment should be based on psychophysical and CSERPs evaluation in a clinical setting.

A Pott's puffy tumour as a late complication of a frontal sinus reconstruction: case report and literature review.

A Pott's Puffy Tumour (PPT) is a rare clinical entity, which, traditionally has been described as an acute abscess with periosteitis secondary to osteomyelitis of the external table of the frontal bone of the skull, complicating an acute frontal sinusitis. The aim of this article is to present a case of progressively evolving PPT, which emerged during the course of a common rhinitis, in a patient who, thirty years previously, had undergone a reconstruction of the frontal sinus involving osteosynthesis. The patient was treated with antibiotic therapy coupled with external access surgery using the Cairn Unterberger approach. This allowed the drainage of pus, the removal of infected osteosynthetic material and a complete debridement of osteomyelitic bone from the affected area. Frontal sinus obliteration was undertaken using methyl methacrylate, preferable in this case to hydroxyapatite, due to the direct communication with the neighbouring sinus cavities and the presence of defective bone in the superior orbit. A review of literature available on Medline up to January 2008 reveals that this is the third published case of PPT complicating a frontal reconstruction.

Chemosensory pathways: from periphery to cortex.

The aim of this article is to summarise the anatomy of the chemosensory pathways. The vomeronasal organ, the olfactory system, the trigeminal system and the gustatory system will be reviewed in succession. For each of these systems, we will provide a description of the anatomy of the pathways sending the sensory message from the peripheral receptor to the cortical areas, passing through different relays in the nervous system. Particular emphasis will be paid to the anatomical features of the structures involved in chemosensory perception. This will help us to understand better how these systems interact and influence our social lives, our memories and our behaviour, and to evaluate patients with chemosensory dysfunction better.

Post-infectious olfactory loss: a cohort study and update.

Post-infectious olfactory loss is defined as an olfactory dysfunction in the course of an upper respiratory tract infection. Quantitative olfactory dysfunction is usually moderate to severe, with many patients experiencing a qualitative disorder such as parosmia. Diagnosis is made on the basis of patient history, normal clinical examination (no inflammatory disease in the olfactory cleft) and decreased olfactory function. This paper provides an update of pathophysiology, clinical management and prognosis, and also looks at the clinical characteristic of a cohort of 122 patients from our department. Results from orthonasal and retronasal testing, chemosensory event-related potentials and olfactory bulb volume confirmed previous findings: our post-infectious olfactory patients were middle-aged women (sex ratio 2.4; mean age 53.9), with 47.5% and 18% of them complaining of parosmia and phantosmia respectively. More of them were hyposmic than anosmic (64.7% and 35.3% respectively) and 18 suffered repeat episodes. Olfactory bulb volume was correlated to psychophysical olfactory testing and orthonasal to retronasal scores. Olfactory-event-related potentials were found in about one-third of the patients and the vast majority of them had reproducible intranasal trigeminal event-related potentials. As there is no proven medical therapy for this disease, complete clinical evaluation of the patients may help to counsel patients about the recovery prognosis that applies to one-third of them.

Post-traumatic olfactory dysfunction: a cohort study and update.

OBJECTIVES: Post-traumatic olfactory loss (PTOL) is the third most common aetiology for olfactory disorders. Mechanisms that lead to post-traumatic olfactory disorders include sinonasal affections, damage to the olfactory nerve and lesions of the cerebral olfactory centres. The purpose of this review is to present an update of this condition and to present a cohort study of 90 patients. METHODOLOGY: A review of the literature was made on Medline Pubmed up to May 2009 and a review was also conducted of patients with post-traumatic olfactory loss. RESULTS: The degree of olfactory impairment was related to the severity of head trauma and was particularly frequent in cases of occipital impact. Typically, patients experienced a sudden onset of olfactory symptoms and were more severely affected than in other aetiologies. Results from orthonasal and retronasal testing, chemosensory event-related potentials and olfactory bulb (OB) volume confirmed previous findings: patients are usually anosmic, OB volume correlates with the degree of olfactory loss (better correlation with retronasal scores than with orthonasal scores) and olfactory event-related potentials were recorded in only 18 patients. CONCLUSIONS: Accuracy in the evaluation of PTOL patients is based on the expertise and the time spent by the clinician on defining the complaint. Failing treatment, complete evaluation of the PTOL patients may help in counselling for the recovery prognosis, and appropriate counselling must be given to secure the environment and alimentation.

Olfactory testing in clinical practice.

Numerous techniques are available in the clinic for the investigation of chemosensory function. Psychophysical testing using orthonasal and retronasal stimulation routes may help to distinguish anosmic from hyposmic patients. These psychophysical tests are most frequently used for odour identification and odour threshold. Chemosensory event-related potentials using olfactory and trigeminal stimulation have become part of the routine investigation of patients with olfactory loss in specialised smell and taste centres. The interpretation of results from psychophysical testing is frequently supported by the assessment of chemosensory event-related potentials. This review will discuss these methods, including how to perform them, focusing on normative data and describing some clinical examples from our centre (olfactory and trigeminal event-related potentials).

The role of nasal cavity disinfection in the bacteriology of chronic sinusitis.

OBJECTIVES: Several factors may influence the results of bacteriological studies in chronic rhinosinusitis. We investigated the potential role of nasal cavity disinfection in the bacteriology of the bulla ethmoidalis in patients suffering from chronic sinusitis. MATERIAL AND METHODS: Bacteriology of the bulla ethmoidalis was studied in 176 consecutive adult patients presenting a chronic sinusitis refractory to standard medical treatment who underwent functional endoscopic sinus surgery. Two different techniques were used: (A) a technique with nasal vestibule and facial disinfection with chlorhexedin (N = 89 patients and 165 samples) vs. (B) a technique with facial, nasal vestibule and nasal cavity disinfection with a povidone-iodine solution followed by a cleansing of the nasal cavity (N = 87 patients and 166 samples). RESULTS: Culture rate was 89.6% (183 bacterial isolates) for technique (A) vs 76.5% (164 bacterial isolates) for technique (B) (p < 0.001). Major bacteria encountered in the (A) group and in the (B) group were respectively: Coagulase Negative Staphylococcus: 77 vs 40 isolates (p < 0.001); Coagulase positive Staphylococcus: 44 vs 30 isolates (p = 0.061); Streptococcus pneumoniae: 4 vs 5 isolates; Others: Streptococcus sp.: 12 vs 16 isolates; Haemophilus influenzae: 8 vs 6 isolates; Enterobacteriacea: 33 vs 53 isolates (p = 0.013) and others Gram Negative Bacilli: 3 vs 7 isolates. CONCLUSIONS: The standard (A) technique to study the bacteriology of the bulla ethmoidalis in patients with chronic sinusitis yielded a higher percentage of positive culture and of bacterial isolates than a more advanced (B) technique. This is mainly due to the higher percentage of contaminant bacteria such as Coagulase Negative Staphylococcus recovered with the standard technique. Enterobacteriacea and others Gram Negative Bacilli were more often encountered into the bulla ethmoidalis with the technique where disinfection of the nasal cavity was performed.

Smell disorders in ENT clinic.

Olfactory disorders may have several causes. Nasal polyposis or chronic sinusitis can result in nasal obstructions that block the access of odorants to the olfactory epithelium, and this can explain the development of olfactory disorders. On the other hand, when nasal endoscopy has revealed that the nasal cleft is free of inflammatory or tumoural disease, olfactory disorders may be explained by neuroepithelial or central nervous system disturbances. This paper will provide information about current approaches to smell disorders in otorhinolaryngology. Major causes will be reviewed as outcomes after medical or surgical treatment. An algorithm will also be given to standardise clinical investigations, including psychophysical olfactory testing, imaging and electrophysiological examinations.