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Neil Bhattacharyya - One of the best experts on this subject based on the ideXlab platform.
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Radiographic Density profiles link frontal and anterior ethmoid sinuses behavior in chronic rhinosinusitis
International forum of allergy & rhinology, 2012Co-Authors: Ahmad R. Sedaghat, Neil BhattacharyyaAbstract:Background: Chronic rhinosinusitis (CRS) may occur through heterogeneous disease processes. It is possible that more than 1 inflammatory process underlies CRS in any given patient. If so, heterogeneity in processes may be a function of the spatial organization of the paranasal sinuses. Density characteristics of sinus opacities on computed tomography (CT) scans offer insight into the nature of sinus opacities and disease, in general, and may thus be used to detect spatial heterogeneity of sinus disease within a given patient. Methods: The study was a retrospective chart review of CRS patients with available sinus CT scans. Radiographic Density profiles of sinus opacities were assessed by raw measures of densities (in Hounsfield units [HU]). Radiographic Density profiles of the different affected sinuses were compared to each other, checked for correlation, and finally, checked for evidence of clustering using a principal component analysis. Results: Frontal sinus opacities appear to be more heterogeneous, with both higher and lower Density components than other sinuses. There was strong correlation between the Radiographic Density profiles of opacities in the frontal, anterior ethmoid, and sphenoid sinuses (p < 0.001). However, on principal component analysis the Radiographic Density characteristics of the opacities of the frontal and anterior ethmoid sinuses appeared to cluster together more than the other sinuses. Conclusion: Radiographic properties of sinus opacities suggest the nature of sinus opacities are related not only to some common underlying pathology but also to factors related to the specific sinus as well as other spatially close affected sinuses. This suggests an anatomic orientation for sinus pathophysiology in CRS.
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Chronic rhinosinusitis symptoms and computed tomography staging: improved correlation by incorporating Radiographic Density.
International forum of allergy & rhinology, 2012Co-Authors: Ahmad R. Sedaghat, Neil BhattacharyyaAbstract:Background: Traditional methods for staging of chronic rhinosinusitis (CRS) by computed tomography (CT) have not proven to be predictive of subjective reports of patients' symptoms. An objective measure of CRS severity that correlates well with patients' symptoms, particularly if available from CT data, would be a valuable tool in assessment of disease status and outcomes after surgery. Methods: Retrospective chart review of CRS patients with symptom data from the Rhinosinusitis Symptom Inventory (RSI) and objective data from a sinus CT scan. CRS disease severity on CT imaging was measured according to the traditional Lund-Mackay scoring, as well as by raw measures of the densities of sinus opacities (in Hounsfield units [HU]) and Density-weighted Lund-Mackay scoring. These data were related to symptom severity scores using a multivariate regression model. Results: There was no significant correlation between either raw Density values of sinus opacities or weighted Lund-Mackay scores with facial or total symptom scores. Oropharyngeal symptoms scores were negatively correlated with the sum of “average HU” values (p = 0.036, β = −1.120) but were positively correlated with the sum of “maximum HU” values (p = 0.047, β = 1.221). There was a significant negative correlation between the systemic symptoms score and mean of “average HU” values (p = 0.010, β = −0.272). Finally, there was a positive correlation between “maximum HU” value-weighted Lund-Mackay score with nasal symptom scores (p = 0.016, β = 0.241), systemic symptom scores (p = 0.008, β = 0.605), and total symptom scores (p = 0.078, β = 0.179). Conclusion: Incorporation of Radiographic characteristics of sinus opacification with Lund-Mackay scores offers greater predictive power of patients' subjective symptom severity. © 2012 ARS-AAOA, LLC.
Ahmad R. Sedaghat - One of the best experts on this subject based on the ideXlab platform.
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objective Radiographic Density measurements of sinus opacities are not strong predictors of noninvasive fungal disease
American Journal of Rhinology & Allergy, 2014Co-Authors: Daniel E Killeen, Ahmad R. Sedaghat, Mary E. Cunnane, Stacey T. GrayAbstract:Background High-Density paranasal sinus opacities are often deemed consistent with fungal elements. No studies of objective quantitative Radiographic Density measures have been performed to support this assertion. Methods A consecutive series of 120 patients with chronic rhinosinusitis who underwent maxillary antrostomy with microbiological evaluation of contents within 60 days of sinus computed tomography scanning was investigated. Radiographic Density characteristics of opacities in cultured maxillary sinuses (minimum, maximum, average, and standard deviation of Hounsfield units [HUstd]) were recorded. Receiver operator characteristic (ROC) curves were used to analyze the accuracy of Radiographic characteristics in predicting fungal opacities. Results Of 133 maxillary sinus opacities, 22 were ultimately consistent with noninvasive fungal disease: 11 allergic fungal rhinosinusitis and 11 fungal balls. Fungal balls had higher-Density components and were more heterogeneous and allergic fungal mucin was generally more radiodense. These findings were reflected by statistically significant ROC curves for maximum HU (p = 0.019) and HUstd (p = 0.023) for fungal balls and for average HU (p = 0.002) for allergic fungal mucin. A maximum HU cutoff of 334.0 detected fungal balls with 90.9% sensitivity and 72.7% specificity. An average HU cutoff of 42.9 HU detected allergic fungal mucin with 100% sensitivity and 46.3% specificity, although specificity improved to 73.2% with inclusion of nasal polyposis as a second requirement. Conclusion Higher average HU more accurately predicts allergic fungal mucin whereas heterogeneity/high-Density components more accurately predict fungal balls. No objective Radiographic Density measure, in isolation, is both sensitive and specific in predicting noninvasive fungal sinusitis.
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Objective Radiographic Density measurements of sinus opacities are not strong predictors of noninvasive fungal disease.
American journal of rhinology & allergy, 2014Co-Authors: Daniel E Killeen, Ahmad R. Sedaghat, Mary E. Cunnane, Stacey T. GrayAbstract:High-Density paranasal sinus opacities are often deemed consistent with fungal elements. No studies of objective quantitative Radiographic Density measures have been performed to support this assertion. A consecutive series of 120 patients with chronic rhinosinusitis who underwent maxillary antrostomy with microbiological evaluation of contents within 60 days of sinus computed tomography scanning was investigated. Radiographic Density characteristics of opacities in cultured maxillary sinuses (minimum, maximum, average, and standard deviation of Hounsfield units [HUstd]) were recorded. Receiver operator characteristic (ROC) curves were used to analyze the accuracy of Radiographic characteristics in predicting fungal opacities. Of 133 maxillary sinus opacities, 22 were ultimately consistent with noninvasive fungal disease: 11 allergic fungal rhinosinusitis and 11 fungal balls. Fungal balls had higher-Density components and were more heterogeneous and allergic fungal mucin was generally more radiodense. These findings were reflected by statistically significant ROC curves for maximum HU (p = 0.019) and HUstd (p = 0.023) for fungal balls and for average HU (p = 0.002) for allergic fungal mucin. A maximum HU cutoff of 334.0 detected fungal balls with 90.9% sensitivity and 72.7% specificity. An average HU cutoff of 42.9 HU detected allergic fungal mucin with 100% sensitivity and 46.3% specificity, although specificity improved to 73.2% with inclusion of nasal polyposis as a second requirement. Higher average HU more accurately predicts allergic fungal mucin whereas heterogeneity/high-Density components more accurately predict fungal balls. No objective Radiographic Density measure, in isolation, is both sensitive and specific in predicting noninvasive fungal sinusitis.
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Radiographic Density profiles link frontal and anterior ethmoid sinuses behavior in chronic rhinosinusitis
International forum of allergy & rhinology, 2012Co-Authors: Ahmad R. Sedaghat, Neil BhattacharyyaAbstract:Background: Chronic rhinosinusitis (CRS) may occur through heterogeneous disease processes. It is possible that more than 1 inflammatory process underlies CRS in any given patient. If so, heterogeneity in processes may be a function of the spatial organization of the paranasal sinuses. Density characteristics of sinus opacities on computed tomography (CT) scans offer insight into the nature of sinus opacities and disease, in general, and may thus be used to detect spatial heterogeneity of sinus disease within a given patient. Methods: The study was a retrospective chart review of CRS patients with available sinus CT scans. Radiographic Density profiles of sinus opacities were assessed by raw measures of densities (in Hounsfield units [HU]). Radiographic Density profiles of the different affected sinuses were compared to each other, checked for correlation, and finally, checked for evidence of clustering using a principal component analysis. Results: Frontal sinus opacities appear to be more heterogeneous, with both higher and lower Density components than other sinuses. There was strong correlation between the Radiographic Density profiles of opacities in the frontal, anterior ethmoid, and sphenoid sinuses (p < 0.001). However, on principal component analysis the Radiographic Density characteristics of the opacities of the frontal and anterior ethmoid sinuses appeared to cluster together more than the other sinuses. Conclusion: Radiographic properties of sinus opacities suggest the nature of sinus opacities are related not only to some common underlying pathology but also to factors related to the specific sinus as well as other spatially close affected sinuses. This suggests an anatomic orientation for sinus pathophysiology in CRS.
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Chronic rhinosinusitis symptoms and computed tomography staging: improved correlation by incorporating Radiographic Density.
International forum of allergy & rhinology, 2012Co-Authors: Ahmad R. Sedaghat, Neil BhattacharyyaAbstract:Background: Traditional methods for staging of chronic rhinosinusitis (CRS) by computed tomography (CT) have not proven to be predictive of subjective reports of patients' symptoms. An objective measure of CRS severity that correlates well with patients' symptoms, particularly if available from CT data, would be a valuable tool in assessment of disease status and outcomes after surgery. Methods: Retrospective chart review of CRS patients with symptom data from the Rhinosinusitis Symptom Inventory (RSI) and objective data from a sinus CT scan. CRS disease severity on CT imaging was measured according to the traditional Lund-Mackay scoring, as well as by raw measures of the densities of sinus opacities (in Hounsfield units [HU]) and Density-weighted Lund-Mackay scoring. These data were related to symptom severity scores using a multivariate regression model. Results: There was no significant correlation between either raw Density values of sinus opacities or weighted Lund-Mackay scores with facial or total symptom scores. Oropharyngeal symptoms scores were negatively correlated with the sum of “average HU” values (p = 0.036, β = −1.120) but were positively correlated with the sum of “maximum HU” values (p = 0.047, β = 1.221). There was a significant negative correlation between the systemic symptoms score and mean of “average HU” values (p = 0.010, β = −0.272). Finally, there was a positive correlation between “maximum HU” value-weighted Lund-Mackay score with nasal symptom scores (p = 0.016, β = 0.241), systemic symptom scores (p = 0.008, β = 0.605), and total symptom scores (p = 0.078, β = 0.179). Conclusion: Incorporation of Radiographic characteristics of sinus opacification with Lund-Mackay scores offers greater predictive power of patients' subjective symptom severity. © 2012 ARS-AAOA, LLC.
G. L. Chew - One of the best experts on this subject based on the ideXlab platform.
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Effects of Tamoxifen and oestrogen on histology and Radiographic Density in high and low mammographic Density human breast tissues maintained in murine tissue engineering chambers
Breast Cancer Research and Treatment, 2014Co-Authors: G. L. Chew, C. W. Huo, D. Huang, T. Blick, P. Hill, J. Cawson, H. Frazer, M. C. Southey, J. L. Hopper, K. BrittAbstract:Mammographic Density (MD) is a strong risk factor for breast cancer. It is altered by exogenous endocrine treatments, including hormone replacement therapy and Tamoxifen. Such agents also modify breast cancer (BC) risk. However, the biomolecular basis of how systemic endocrine therapy modifies MD and MD-associated BC risk is poorly understood. This study aims to determine whether our xenograft biochamber model can be used to study the effectiveness of therapies aimed at modulating MD, by examine the effects of Tamoxifen and oestrogen on histologic and Radiographic changes in high and low MD tissues maintained within the biochamber model. High and low MD human tissues were precisely sampled under Radiographic guidance from prophylactic mastectomy fresh specimens of high-risk women, then inserted into separate vascularized murine biochambers. The murine hosts were concurrently implanted with Tamoxifen, oestrogen or placebo pellets, and the high and low MD biochamber tissues maintained in the murine host environment for 3 months, before the high and low MD biochamber tissues were harvested for histologic and Radiographic analyses. The Radiographic Density of high MD tissue maintained in murine biochambers was decreased in Tamoxifen-treated mice compared to oestrogen-treated mice ( p = 0.02). Tamoxifen treatment of high MD tissue in SCID mice led to a decrease in stromal ( p = 0.009), and an increase in adipose ( p = 0.023) percent areas, compared to placebo-treated mice. No histologic or Radiographic differences were observed in low MD biochamber tissue with any treatment. High MD biochamber tissues maintained in mice implanted with Tamoxifen, oestrogen or placebo pellets had dynamic and measurable histologic compositional and Radiographic changes. This further validates the dynamic nature of the MD xenograft model, and suggests the biochamber model may be useful for assessing the underlying molecular pathways of Tamoxifen-reduced MD, and in testing of other pharmacologic interventions in a preclinical model of high MD.
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Dynamic changes in high and low mammographic Density human breast tissues maintained in murine tissue engineering chambers during various murine peripartum states and over time.
Breast cancer research and treatment, 2013Co-Authors: G. L. Chew, C. W. Huo, T. Blick, P. Hill, J. Cawson, H. Frazer, M. C. Southey, J. L. Hopper, David C. S. Huang, Michael A. HendersonAbstract:Mammographic Density (MD) is a strong heritable risk factor for breast cancer, and may decrease with increasing parity. However, the biomolecular basis for MD-associated breast cancer remains unclear, and systemic hormonal effects on MD-associated risk is poorly understood. This study assessed the effect of murine peripartum states on high and low MD tissue maintained in a xenograft model of human MD. Method High and low MD human breast tissues were precisely sampled under Radiographic guidance from prophylactic mastectomy specimens of women. The high and low MD tissues were maintained in separate vascularised biochambers in nulliparous or pregnant SCID mice for 4 weeks, or mice undergoing postpartum involution or lactation for three additional weeks. High and low MD biochamber material was harvested for histologic and Radiographic comparisons during various murine peripartum states. High and low MD biochamber tissues in nulliparous mice were harvested at different timepoints for histologic and Radiographic comparisons. Results High MD biochamber tissues had decreased stromal (p = 0.0027), increased adipose (p = 0.0003) and a trend to increased glandular tissue areas (p = 0.076) after murine postpartum involution. Stromal areas decreased (p = 0.042), while glandular (p = 0.001) and adipose areas (p = 0.009) increased in high MD biochamber tissues during lactation. A difference in Radiographic Density was observed in high (p = 0.0021) or low MD biochamber tissues (p = 0.004) between nulliparous, pregnant and involution groups. No differences in tissue composition were observed in high or low MD biochamber tissues maintained for different durations, although Radiographic Density increased over time. Conclusion High MD biochamber tissues had measurable histologic changes after postpartum involution or lactation. Alterations in Radiographic Density occurred in biochamber tissues between different peripartum states and over time. These findings demonstrate the dynamic nature of the human MD xenograft model, providing a platform for studying the biomolecular basis of MD-associated cancer risk.
K. Britt - One of the best experts on this subject based on the ideXlab platform.
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Effects of Tamoxifen and oestrogen on histology and Radiographic Density in high and low mammographic Density human breast tissues maintained in murine tissue engineering chambers
Breast Cancer Research and Treatment, 2014Co-Authors: G. L. Chew, C. W. Huo, D. Huang, T. Blick, P. Hill, J. Cawson, H. Frazer, M. C. Southey, J. L. Hopper, K. BrittAbstract:Mammographic Density (MD) is a strong risk factor for breast cancer. It is altered by exogenous endocrine treatments, including hormone replacement therapy and Tamoxifen. Such agents also modify breast cancer (BC) risk. However, the biomolecular basis of how systemic endocrine therapy modifies MD and MD-associated BC risk is poorly understood. This study aims to determine whether our xenograft biochamber model can be used to study the effectiveness of therapies aimed at modulating MD, by examine the effects of Tamoxifen and oestrogen on histologic and Radiographic changes in high and low MD tissues maintained within the biochamber model. High and low MD human tissues were precisely sampled under Radiographic guidance from prophylactic mastectomy fresh specimens of high-risk women, then inserted into separate vascularized murine biochambers. The murine hosts were concurrently implanted with Tamoxifen, oestrogen or placebo pellets, and the high and low MD biochamber tissues maintained in the murine host environment for 3 months, before the high and low MD biochamber tissues were harvested for histologic and Radiographic analyses. The Radiographic Density of high MD tissue maintained in murine biochambers was decreased in Tamoxifen-treated mice compared to oestrogen-treated mice ( p = 0.02). Tamoxifen treatment of high MD tissue in SCID mice led to a decrease in stromal ( p = 0.009), and an increase in adipose ( p = 0.023) percent areas, compared to placebo-treated mice. No histologic or Radiographic differences were observed in low MD biochamber tissue with any treatment. High MD biochamber tissues maintained in mice implanted with Tamoxifen, oestrogen or placebo pellets had dynamic and measurable histologic compositional and Radiographic changes. This further validates the dynamic nature of the MD xenograft model, and suggests the biochamber model may be useful for assessing the underlying molecular pathways of Tamoxifen-reduced MD, and in testing of other pharmacologic interventions in a preclinical model of high MD.
T. Blick - One of the best experts on this subject based on the ideXlab platform.
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Effects of Tamoxifen and oestrogen on histology and Radiographic Density in high and low mammographic Density human breast tissues maintained in murine tissue engineering chambers
Breast Cancer Research and Treatment, 2014Co-Authors: G. L. Chew, C. W. Huo, D. Huang, T. Blick, P. Hill, J. Cawson, H. Frazer, M. C. Southey, J. L. Hopper, K. BrittAbstract:Mammographic Density (MD) is a strong risk factor for breast cancer. It is altered by exogenous endocrine treatments, including hormone replacement therapy and Tamoxifen. Such agents also modify breast cancer (BC) risk. However, the biomolecular basis of how systemic endocrine therapy modifies MD and MD-associated BC risk is poorly understood. This study aims to determine whether our xenograft biochamber model can be used to study the effectiveness of therapies aimed at modulating MD, by examine the effects of Tamoxifen and oestrogen on histologic and Radiographic changes in high and low MD tissues maintained within the biochamber model. High and low MD human tissues were precisely sampled under Radiographic guidance from prophylactic mastectomy fresh specimens of high-risk women, then inserted into separate vascularized murine biochambers. The murine hosts were concurrently implanted with Tamoxifen, oestrogen or placebo pellets, and the high and low MD biochamber tissues maintained in the murine host environment for 3 months, before the high and low MD biochamber tissues were harvested for histologic and Radiographic analyses. The Radiographic Density of high MD tissue maintained in murine biochambers was decreased in Tamoxifen-treated mice compared to oestrogen-treated mice ( p = 0.02). Tamoxifen treatment of high MD tissue in SCID mice led to a decrease in stromal ( p = 0.009), and an increase in adipose ( p = 0.023) percent areas, compared to placebo-treated mice. No histologic or Radiographic differences were observed in low MD biochamber tissue with any treatment. High MD biochamber tissues maintained in mice implanted with Tamoxifen, oestrogen or placebo pellets had dynamic and measurable histologic compositional and Radiographic changes. This further validates the dynamic nature of the MD xenograft model, and suggests the biochamber model may be useful for assessing the underlying molecular pathways of Tamoxifen-reduced MD, and in testing of other pharmacologic interventions in a preclinical model of high MD.
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Dynamic changes in high and low mammographic Density human breast tissues maintained in murine tissue engineering chambers during various murine peripartum states and over time.
Breast cancer research and treatment, 2013Co-Authors: G. L. Chew, C. W. Huo, T. Blick, P. Hill, J. Cawson, H. Frazer, M. C. Southey, J. L. Hopper, David C. S. Huang, Michael A. HendersonAbstract:Mammographic Density (MD) is a strong heritable risk factor for breast cancer, and may decrease with increasing parity. However, the biomolecular basis for MD-associated breast cancer remains unclear, and systemic hormonal effects on MD-associated risk is poorly understood. This study assessed the effect of murine peripartum states on high and low MD tissue maintained in a xenograft model of human MD. Method High and low MD human breast tissues were precisely sampled under Radiographic guidance from prophylactic mastectomy specimens of women. The high and low MD tissues were maintained in separate vascularised biochambers in nulliparous or pregnant SCID mice for 4 weeks, or mice undergoing postpartum involution or lactation for three additional weeks. High and low MD biochamber material was harvested for histologic and Radiographic comparisons during various murine peripartum states. High and low MD biochamber tissues in nulliparous mice were harvested at different timepoints for histologic and Radiographic comparisons. Results High MD biochamber tissues had decreased stromal (p = 0.0027), increased adipose (p = 0.0003) and a trend to increased glandular tissue areas (p = 0.076) after murine postpartum involution. Stromal areas decreased (p = 0.042), while glandular (p = 0.001) and adipose areas (p = 0.009) increased in high MD biochamber tissues during lactation. A difference in Radiographic Density was observed in high (p = 0.0021) or low MD biochamber tissues (p = 0.004) between nulliparous, pregnant and involution groups. No differences in tissue composition were observed in high or low MD biochamber tissues maintained for different durations, although Radiographic Density increased over time. Conclusion High MD biochamber tissues had measurable histologic changes after postpartum involution or lactation. Alterations in Radiographic Density occurred in biochamber tissues between different peripartum states and over time. These findings demonstrate the dynamic nature of the human MD xenograft model, providing a platform for studying the biomolecular basis of MD-associated cancer risk.