April 19, 2005—Leaving Gifts

In this dialogue, Nell lets go of possessions and gifts them to friends and relatives. She was especially pleased with transferring 120,000 frequent-flyer miles to her niece’s family so they could make their annual pilgrimage to Michigan from Seattle. This is the second time she has downsized in two years. When she and Al moved from their home to this apartment, they had to place furniture in storage or sell it. A major loss with the move was her highly valued garden with its associated activities, especially digging in the good earth. Nell once again spoke of her intense fear of suffocation and likened it to “skating in the dark.” She feels the same type of fear and panic when she cannot swallow due to dry mouth. Her shortness of breath has been a continual challenge; the addition of an oxygen apparatus has helped. Unfortunately, she had difficulty getting the machine to work properly because it was delivered without an essential component, the humidifier. Consequently, her nasal passages were drying out and bleeding. She subsequently needed to increase her self-advocacy efforts with the hospice healthcare providers. We practiced a breathing exercise to help her settle herself when she feels short of breath.

Normative Nasalance Values in Vietnamese With Southern Dialect: Vowel and Tone Effects

Purpose The purpose of the current study was to examine normative nasalance values in Vietnamese adult speakers with Southern dialect and to investigate the effects of vowels and tones on nasalance. Previous studies examining nasalance have been mainly conducted with Indo-European languages. Limited information on nasalance is available in tone languages other than Chinese. Furthermore, tone and vowel effects on nasalance scores in tone languages have not been fully examined. Method Nasalance scores of various speech stimuli including passages, syllables, and prolonged vowels were obtained from Vietnamese-speaking adults with Southern dialect ( M age = 23 years) using a nasometer (KayPENTAX 6450). Results The average nasalance scores of Southern Vietnamese adult speakers were 24.16%, 38.17%, and 70.03% for the oral, oral–nasal, and nasal passages, respectively. Southern Vietnamese speakers produced the highest nasalance scores on the vowel /a/, followed by /i/ and /u/. Nasalance scores of stimuli produced with the falling and restricted tone were significantly lower than those produced with the other tones. Conclusions The normative nasalance values of the current study will contribute as a reference index for the Vietnamese language. The effects of vowels and tones can also provide insight into the development of nasalance testing stimuli and for characterizing nasalance values across languages.

Macroscopic anatomy of the fetal nasal cavity

Objectives to describe the macromicroscopic anatomy of the nasal cavity in the intermediate fetal period of human ontogenesis. Material and methods. The object of the study was horizontal histotopograms of the nose of 15 fetuses of both genders at the age of 1922 weeks of the intermediate fetal period of ontogenesis. The study used the method of macromicroscopic preparation, the modified method of saw cuts according to N.I. Pirogov, and the histotopographic method. Results. On the horizontal histotopographic sections the external nose was shaped like a triangle. The structures of the external nose were covered with skin soldered to the underlying tissues. In soft tissues, there was a large accumulation of arterial and venous vessels, nerves, and glands. In the intermediate fetal period, the nasal passages had the shape of a triangle, with the base turned to the nasal part of the pharynx. It was found that the anterior-posterior size of the nasal septum in fetuses of the intermediate fetal period was 14.054.34 mm, with a range of fluctuations from 5.75 to 19.85 mm. The anterior-posterior size of the nasal septum in female fetuses was greater than the anterior-posterior size of the septum of male fetuses. The value of the width of the nasal septum was the maximum in the lower third, and reached up to 2.540.67 mm. The narrowest part of the nasal septum was its middle third, the value was 1.630.47 mm. The areas of the nasal passages had no bilateral differences. Conclusion. In the intermediate fetal period there is the establishment of qualitative and quantitative macromicroscopic anatomy of the nasal cavity. All the main structures are determined: the nasal septum, nasal conchs, mucosa, and blood vessels. Sexual differences begin to form, and there are no bilateral differences. Quantitative characteristics of the structures of the nasal cavity in fetuses can serve as a justification for early surgical intervention in choanal atresia.

AGE-RELATED VARIABILITY OF THE WIDTH OF THE NASAL MEATUSES ACCORDING TO DATA OF THE CRANIOMETRY

The use of video-endoscopic equipment in pediatric rhino-surgery necessitates a thorough study of the structure of the nasal cavity structures at different age periods. The aim of the study was to study the width of the nasal meatuses in childhood based on craniometrics data. Craniometry of 65 children's skulls was performed, divided into six groups (infancy, early childhood, first and second childhood, adolescence and youth). It was found that the width of the nasal meatuses increases unevenly with the age of the child; periods of the permanency are replaced by periods of growth. The maximum values of the width of the lower and middle nasal meatuses of the skull reach in adolescence, and the general meatuses - in adolescence. Also, an increase in the width of the middle and common nasal meatuses was revealed along their length from the anterior to posterior edges of the nasal conches by an average of 30%, while the width of the lower nasal meatuses remains constant. The ratios of the width of the lower and middle nasal meatuses to the width of the common nasal passages were determined depending on age. The width of the inferior nasal meatus to the width of the common nasal meatus at 1-1.5 years is 1: 2 at the level of the anterior end of the inferior nasal conchae and 1: 3 at the level of its posterior end, in other age groups it is 1: 1.5 and 1: 2 respectively. The width of the middle nasal meatus to the width of the common nasal meatus at the level of both ends of the middle meatus in each age group is 1: 1. The obtained data are of clinical importance for the choice of trans-nasal surgical access, for the choice of the size of endoscopic instruments, the diameter and angle of view of endoscopes, the preservation of age-related physiological relationships of the structures of the nasal cavity, and the reduction of the risk of intraoperative complications. Up to 4 years old, it is recommended to use endoscopes and endoscopic instruments of the smallest diameter; over 4 years old, the size of the nasal passages makes it possible to increase the diameter of the endoscopic set to improve access.

Mathematical modeling explains differential SARS CoV-2 kinetics in lung and nasal passages in remdesivir treated rhesus macaques

Remdesivir was recently demonstrated to decrease recovery time in hospitalized patients with SARS-CoV-2 infection. In rhesus macaques, early initiation of remdesivir therapy prevented pneumonia and lowered viral loads in the lung, but viral loads increased in the nasal passages five days after therapy. We developed mathematical models to explain these results. We identified that 1) drug potency is slightly higher in nasal passages than in lungs, 2) viral load decrease in lungs relative to nasal passages during therapy because of infection-dependent generation of refractory cells in the lung, 3) incomplete drug potency in the lung that decreases viral loads even slightly may allow substantially less lung damage, and 4) increases in nasal viral load may occur due to a slight blunting of peak viral load and subsequent decrease of the intensity of the innate immune response, as well as a lack of refractory cells. We also hypothesize that direct inoculation of the trachea in rhesus macaques may not recapitulate natural infection as lung damage occurs more abruptly in this model than in human infection. We demonstrate with sensitivity analysis that a drug with higher potency could completely suppress viral replication and lower viral loads abruptly in the nasal passages as well as the lung.One Sentence SummaryWe developed a mathematical model to explain why remdesivir has a greater antiviral effect on SARS CoV-2 in lung versus nasal passages in rhesus macaques.

GENETIC (RAPD-PCR) VARIABILITY OF STAPHYLOCOCCUS AUREUS STRAINS EXTRACTED FROM LOCUS MORBI AND INTAKT SKIN OF PATIENTS WITH ALLERGODERMATOSIS

The article presents data on the study of genetic relatedness of S. aureus strains growing on the skin and nasal passages of patients with allergodermatoses. A study of the possible correlation between the genotype of the pathogen and the burden of allergodermatoses using the RAPD-PCR method was done. The aim of the research: determination by RAPD-PCR analysis (Random Amplified Polymorphic DNA) of genetic variability and affinity of S. aureus strains extracted from locus morbi, intact areas of skin and nasal mucosa of patients with allergodermatoses (AD and IE). Materials and methods. RAPD-PCR was used to genotype 111 strains of Staphylococcus aureus extracted from the skin and nasal passages of patients with allergodermatoses (AD and IE), as well as 11 strains isolated from the skin of almost healthy individuals to identify genetic links between these strains. These strains were removed from patients with AD and IE who sought medical help in the dermatological department of the State Institution "Institute of Dermatology and Venereology of the National Academy of Medical Sciences of Ukraine" during 2016-2019. Results. When comparing the RAPD spectra of strains extracted from the affected and intact areas of the skin of patients with mild and severe AD, the degree of genetic relatedness of the strains was 75.1±4.4 % and 98.8±0.8 %, (P˂0,001), respectively, indicating a high level of affinity of the strains. Strains of S. aureus removed from the nasal passages of patients with AD had a high level of genetic affinity with strains removed from the affected areas of the skin – 79.5±1.6 %, which indicates the auto-origin of strains growing on the skin of patients. The affinity of strains isolated from patients with IE with the reference culture of S. aureus ATCC 25923 was 27.4±1.8 % and 52.0±5.2 % for strains isolated from patients with AD, indicating their low genetic relatedness. Conclusions. In the study of RAPD spectra of S. aureus strains isolated from patients with both AD and IE, no genotype was identified that would be associated with the disease or its severity. A high level of genetic affinity of strains extracted from locus morbi with strains extracted from the nasal passages of patients with AD, indicating the auto-origin of strains that grow on the skin of patients. It is shown that with increasing severity of AD, the genetic monotype of isolated pathogens increased: in patients with mild AD, 3 genetic clusters of the microorganism were identified, with moderate – 2, and with severe only one.

Sheep Bot Fly Oestrus ovis Linnaeus (1761) (Insecta: Diptera: Oestridae)

The sheep bot fly, Oestrus ovis, is an obligate parasite found all over the world. It cannot complete its life cycle without parasitizing the nasal passages, frontal and maxillary cavities, and sinuses of sheep. Unlike other flies, females do not lay eggs, instead depositing droplets containing live larvae into the nostrils of sheep. This 4-page fact sheet written by Hannah A. Sholar and Jennifer L. Gillett-Kaufman and published by the UF/IFAS Entomology and Nematology Department describes the life cycle of the pest and its veterinary significance and management. https://edis.ifas.ufl.edu/in1267

Enzootic nasal adenocarcinoma in small ruminants in Jordan

Enzootic nasal adenocarcinoma (ENA) is a viral-associated tumor of the secretory epithelium of the nasal passages of small ruminants. The tumor is locally invasive but not metastatic. Although disease prevalence (up to 15%) and geographic distribution have been reported in the literature throughout most of the world (except Australia and New Zealand), the disease has until now remained unreported in Jordan. In this report, we describe the occurrence, clinical signs, radiographic signs and pathological features of the disease in a series of cases in Awassi sheep (3 cases) and Damascus breed goats (2 cases) for the first time in Jordan. Overall, the affected animals were adults (3-5 years of age), all females, with variable degrees of facial and nasal deformities resulting in difficulty in respiration. Radiographic examination of the skull revealed soft tissue density mass originating in the nasal turbinate and invading the surrounding nasal structures. Cytological examination of fine needle aspirate indicated low-grade carcinoma. All animals were humanely euthanized and the nasal passages were explored. Variable size masses were removed and histopathological examination confirmed the diagnosis of enzootic nasal adenocarcinoma.