muramidase and Sinusitis

muramidase has been researched along with Sinusitis* in 25 studies

Trials

1 trial(s) available for muramidase and Sinusitis

ArticleYear
[Evaluation of the effect of lysozyme on chronic sinusitis. (2). Histological examination of the maxillary sinal mucosa treated by combined use with antibiotics].
    Jibi inkoka Otolaryngology, 1966, Volume: 38, Issue:7

    Topics: Adolescent; Adult; Anti-Bacterial Agents; Clinical Trials as Topic; Female; Humans; Male; Muramidase; Sinusitis

1966

Other Studies

24 other study(ies) available for muramidase and Sinusitis

ArticleYear
The Nasal Innate Immune Proteome After Saline Irrigation: A Pilot Study in Healthy Individuals.
    American journal of rhinology & allergy, 2023, Volume: 37, Issue:4

    Previous research has shown diminished nasal immune function following nasal saline irrigation (NSI), returning to baseline at 6 hours. The aim of this study was to examine the immune nasal proteome before and after 14 days of nasal irrigation.. Seventeen healthy volunteers received either isotonic (IsoSal) or low salt (LowNa) NSI. Nasal secretions were collected before and 30 min after NSI at baseline and again after 14 days. Specimens were analyzed using mass spectrometry to detect proteins of relevance to nasal immune function.. One thousand eight hundred and sixty-five proteins were identified with significant changes in 71 proteins, of which 23 were identified as part of the innate immune system. Baseline analysis demonstrated an increase of 9 innate proteins after NSI, most after IsoSal. After 14 days, a greater increase in innate peptides was present, with most now in the LowNa group. When NSI solutions were compared, a significant increase in 4 innate proteins, including a 211% in lysozyme, was detected in the LowNa group.. LowNa NSI demonstrates evidence of improving the innate immune secretions, especially lysozyme, in healthy volunteers.

    Topics: Humans; Immunity, Innate; Muramidase; Nasal Lavage; Pilot Projects; Proteome; Rhinitis; Saline Solution; Sinusitis; Therapeutic Irrigation

2023
Enhanced expressions of lysozyme, SLPI and glycoprotein 340 in biofilm-associated chronic rhinosinusitis.
    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2014, Volume: 271, Issue:6

    Lysozyme, secretory leukocyte proteinase inhibitor (SLPI) and glycoprotein 340 (gp340) are important effectors of the innate immune system in sinonasal mucosa. Bacterial biofilms (BBF) are highly organized bacterial communities resistant to host defense systems. The aim of this study was to investigate the expression of lysozyme, SLPI and gp340 in sinus mucosa from chronic rhinosinusitis (CRS) patients with different BBF status. In this prospective cohort study, 63 CRS patients undergoing endoscopic sinus surgery and 20 controls were enrolled and their mucosal samples from ethmoid sinus were obtained. Biofilms were examined by confocal scanning laser microscopy (CSLM), and the expressions of lysozyme, SLPI and gp340 in mRNA and protein levels were detected using reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry and Western blot assay, respectively. As a result, 35/63 (55.6%) of the patients were BBF positive in the CRS group and none in controls. Both mRNA and protein levels of lysozyme, SLPI and gp340 in patients with CRS were significantly higher than those in controls. When sub-classified according to BBF status, the CRS patients with BBF revealed the significantly enhanced mRNA and protein levels of lysozyme, SLPI and gp340. In conclusion, our study demonstrates that lysozyme, SLPI and gp340 are constitutively expressed in sinus mucosa and their up-regulated expressions on both the mRNA and protein levels are associated with BBF in CRS patients. These findings may offer an insight into the interaction between BBF and the innate immune system.

    Topics: Adult; Biofilms; Case-Control Studies; Chronic Disease; Ethmoid Sinus; Female; Gene Expression Profiling; Humans; Immunity, Innate; Male; Microscopy, Confocal; Middle Aged; Muramidase; Receptors, Immunologic; Respiratory Mucosa; Reverse Transcriptase Polymerase Chain Reaction; Rhinitis; RNA, Messenger; Secretory Leukocyte Peptidase Inhibitor; Sinusitis; Young Adult

2014
Lysozyme expression is increased in the sinus mucosa of patients with chronic rhinosinusitis.
    Rhinology, 2012, Volume: 50, Issue:2

    The presence of fungi and bacteria in the paranasal sinuses may contribute to ongoing inflammation. Lysozyme is an innate immune peptide with bactericidal and fungicidal activity. The expression of lysozyme in chronic rhinosinusitis (CRS) is poorly understood and deficiencies in lysozyme expression may contribute to the ongoing inflammation in CRS patients.. Determine lysozyme expression in sinus mucosa of normal and CRS patients with (CRSwNP) and without (CRSsNP) nasal polyps.. Sinus mucosa specimens (n = 82) were processed for standard histology, immunohistochemical localisation of lysozyme, immunofluorescent localisation of fungi, and qPCR analysis of lysozyme expression.. CRS specimens displayed high-levels of lysozyme immunoreactivity in many of the abundant serous cells. Moderate levels were detected in some epithelial cells and inflammatory cells. Low levels were detected in some subepithelial glands of control specimens. No difference in immunoreactivity was detected between CRSwNP and CRSsNP specimens. Fungal elements were not visualised in any sinus specimen. qPCR analysis demonstrated variable lysozyme expression between individuals.. Lysozyme protein expression is increased in patients with CRS, suggesting a defect in lysozyme expression is not responsible for the microbial colonisation often associated with CRS. The functional activity of lysozyme in CRS patients needs to be further investigated.

    Topics: Antimicrobial Cationic Peptides; Chronic Disease; Humans; Immunohistochemistry; Mucous Membrane; Muramidase; Paranasal Sinuses; Real-Time Polymerase Chain Reaction; Rhinitis; Sinusitis

2012
Neuropathology in rhinosinusitis.
    American journal of respiratory and critical care medicine, 2005, Jan-01, Volume: 171, Issue:1

    Pathophysiologic differences in neural responses to hypertonic saline (HTS) were investigated in subjects with acute sinusitis (n = 25), subjects with chronic fatigue syndrome (CFS) with nonallergic rhinitis (n = 14), subjects with active allergic rhinitis (AR; n = 17), and normal (n = 20) subjects. Increasing strengths of HTS were sprayed into their nostrils at 5-minute intervals. Sensations of nasal pain, blockage, and drip increased with concentration and were significantly elevated above normal. These parallels suggested activation of similar subsets of afferent neurons. Urea and lysozyme secretion were dose dependent in all groups, suggesting that serous cell exocytosis was one source of urea after neural stimulation. Only AR and normal groups had mucin dose responses and correlations between symptoms and lysozyme secretion (R(2) = 0.12-0.23). The lysozyme dose responses may represent axon responses in these groups. The neurogenic stimulus did not alter albumin (vascular) exudation in any group. Albumin and mucin concentrations were correlated in sinusitis, suggesting that nonneurogenic factors predominated in sinusitis mucous hypersecretion. CFS had neural hypersensitivity (pain) but reduced serous cell secretion. HTS nasal provocations identified significant, unique patterns of neural and mucosal dysregulation in each rhinosinusitis syndrome.

    Topics: Acute Disease; Administration, Intranasal; Adult; Albumins; Dose-Response Relationship, Drug; Fatigue Syndrome, Chronic; Female; Humans; Male; Middle Aged; Mucins; Mucus; Muramidase; Nasal Lavage Fluid; Nasal Mucosa; Nasal Provocation Tests; Neurons, Afferent; Pain; Rhinitis; Saline Solution, Hypertonic; Sinusitis; Urea

2005
Analysis of the sinusitis nasal lavage fluid proteome using capillary liquid chromatography interfaced to electrospray ionization-quadrupole time of flight- tandem mass spectrometry.
    Electrophoresis, 2004, Volume: 25, Issue:9

    The nasal lavage fluids (NLFs) from four subjects with acute sinusitis were analyzed to investigate the amount of proteins expressed in this pathology at the beginning of the event (day 1) and after 6 days of treatment with antibiotics and a nasal steroid spray. The protein identification was performed with capillary liquid chromatography-electrospray-quadrupole time of flight-(LC-ESI-Q-TOF)-mass spectrometry. The samples collected on the first day contained high-abundant plasma proteins, such as albumin and immunoglobulins, glandular serous cell proteins (lysozyme, lactoferrin, and polymeric immunoglobulin receptor), epithelial keratins, and inflammatory cell proteins (myeloperoxidase, IL-16, and IL-17E). After six days of therapy, the complexity of the proteome was reduced to plasma proteins and lysozyme with no inflammatory markers. The presence of hemoglobin, however, suggested that significant squamous metaplasia with breaches in the epithelial barrier, or nasal steroid-related bleeding, had occurred. The proteomic approach presented here allowed us to identify, in the high complexity of acute sinusitis nasal secretions, the proteins that respond to a pharmacological treatment and that could be suitable as markers of this pathology.

    Topics: Adult; Anti-Bacterial Agents; Blood Proteins; Chromatography, Liquid; Cytokines; Female; Hemoglobins; Humans; Interleukin-16; Interleukin-17; Male; Middle Aged; Muramidase; Nasal Lavage Fluid; Peroxidase; Proteome; Sinusitis; Spectrometry, Mass, Electrospray Ionization

2004
Lysozyme levels in the nasal secretions of patients with perennial allergic rhinitis and recurrent sinusitis.
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2004, Volume: 93, Issue:3

    The association of perennial allergic rhinitis (PAR) with recurrent sinusitis (RS) is well recognized. Anatomic abnormalities at the osteomeatal complex or ciliary dysfunction may play a significant role in some patients. However, for most patients with allergy, the determinants of RS are unknown.. To determine whether altered concentrations of antimicrobial peptides and proteins, such as lysozyme, lactoferrin, human beta-defensin-2 (HBD-2), and human neutrophil peptides 1 to 3 (HNP-1 to 3), contribute to the development of RS in patients with PAR.. Nasal secretions were collected by vacuum aspiration from 15 individuals with PAR+RS, 16 with PAR alone, and 16 controls. Lysozyme and lactoferrin levels were determined in nasal secretions by using quantitative enzyme-linked immunosorbent assay, and HBD-2 and HNP-1 to 3 levels were determined in nasal secretions by using semiquantitative Western blot analysis. Eosinophil-derived neurotoxin (EDN) levels were measured by using enzyme-linked immunosorbent assay as a marker of nasal eosinophilia in all 3 groups.. Levels of EDN were elevated significantly in patients with PAR+RS compared with controls. Lysozyme levels were decreased significantly in patients with PAR+RS compared with PAR alone or controls. Mean lysozyme levels were significantly lower in patients with EDN levels greater than 1,000 ng/mL vs those with levels of 1,000 ng/mL or less in the PAR+RS group. There were no statistically significant differences in lactoferrin, HBD-2, and HNP-1 to 3 levels among the 3 groups.. The presence of eosinophils and their products and reduced lysozyme concentrations may be critical factors that predispose the airways of patients with PAR to RS.

    Topics: Adult; alpha-Defensins; beta-Defensins; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Eosinophil-Derived Neurotoxin; Eosinophilia; Female; Humans; Lactoferrin; Male; Muramidase; Nasal Lavage Fluid; Recurrence; Rhinitis, Allergic, Perennial; Ribonucleases; Sinusitis; Skin Tests

2004
Eosinophilia and cell activation mediators in nasal secretions.
    The Laryngoscope, 2002, Volume: 112, Issue:1

    In rhinologic disorders such as polyposis or rhinitis, nasal cytology allows differentiation between patients according to the degree of eosinophilia in nasal secretions. The egress of eosinophil and/or neutrophil polymorphonuclears from the underlying mucosa might correlate with the release of soluble mediators of cell activation such as the chemokine IL-8, and such molecules of the innate immunity as the LPS-receptor CD14 or lysozyme. We assayed the levels of these three molecules in nasal secretions in correlation with cytologic findings and especially the degree of eosinophilia.. Fifty-four patients from a prospective study of nasal secretions were enrolled in this work. They constituted two groups of 27 patients each, respectively, with or without more than 20% eosinophils in nasal secretions. Nasal secretions were collected by aspiration, weighed and diluted in a fixed amount of buffer. Classic cytologic analyses were performed on the pelleted cells and IL-8, sCD14, and lysozyme levels were assayed in the cell-free supernatants.. Cytologic analyses included cell-enumeration in Neubauer's chambers, and differentials performed on May-Grünwald Giemsa-stained cytospins. ELISA tests were used to assay the levels of IL-8 and sCD14. Lysozyme concentrations were assayed in immuno-nephelometry.. Significantly lower levels of IL-8 and sCD14 were observed in patients with eosinophilia than in patients with a predominance of neutrophils, whereas no difference was observed in lysozyme concentrations.. These data show that the egress of neutrophils in nasal secretions is associated with high levels of IL-8 and sCD14.

    Topics: Adolescent; Adult; Aged; Eosinophilia; Female; Humans; Inflammation Mediators; Interleukin-8; Leukocyte Count; Lipopolysaccharide Receptors; Male; Middle Aged; Muramidase; Nasal Lavage Fluid; Nasal Mucosa; Nasal Polyps; Neutrophils; Reference Values; Rhinitis; Sinusitis

2002
[Lysozyme and lactoferrin in human uncinate process mucosa during chronic sinusitis].
    Zhonghua er bi yan hou ke za zhi, 1998, Volume: 33, Issue:4

    To study the local protective role of lysozyme(LZ) and lactoferrin(LF) in the uncinate process mucosa during chronic sinusitis.. Expression of LZ and LF was determined in 17 samples from normal subjects and 70 samples from chronic sinusitis patients with ABC immunohistochemical method. According to the presence or absence of nasal polyps, patients were divided into two groups.. Serous cells of submucosal glands displayed a strongly positive staining reaction to both LZ and LF in the normal uncinate process mucosa and mucosa from patients with chronic sinusitis. A positive though weak staining for LZ could also be found frequently within mucous cells of submucosal mixed glands and occasionally within goblet cells. In the mucosa from patients without nasal polyps, the staining reaction to LZ appeared to be intensified in goblet cells when compared with normal controls (P < 0.05). In patients with nasal polyps, the staining reaction to LZ appeared to be intensified in submucosal glands when compared with normal controls (P < 0.01) and patients without nasal polyps (P < 0.05). For LF, the staining reaction from patients with nasal polyps was stronger than that in normal controls (P < 0.01). The epithial cells stained negatively for LZ and LF.. It suggests that the observed increase in LZ and LF secreting activity of goblet cells and submucosal mixed glands may play a part role in the defense mechanism of uncinate process mucosa during the course of chronic sinusitis.

    Topics: Adolescent; Adult; Child; Chronic Disease; Ethmoid Sinus; Female; Humans; Lactoferrin; Male; Middle Aged; Muramidase; Nasal Mucosa; Nasal Polyps; Sinusitis

1998
Mucoglycoprotein hypersecretion in allergic rhinitis and cystic fibrosis.
    The American journal of physiology, 1997, Volume: 273, Issue:6

    There is little information about specific changes in submucosal gland exocytosis in diseases such as allergic rhinitis (AR), nonallergic rhinitis (NAR), and cystic fibrosis (CF). Nasal lavage fluids were collected from normal, AR, NAR, and CF subjects. Concentrations of lysozyme, Alcian blue-staining mucoglycoconjugate material (AB + m), and human high-molecular-weight mucoglycoconjugates recognized by the 7F10 murine monoclonal antibody [7F10-immunoreactive mucoglycoconjugates (7F10-irm)] were measured. AB + m and 7F10-irm were characterized by Sepharose-2B column chromatography and glycosidase digestion. 7F10-irm was increased in CF (2.4-fold; P = 0.001) and AR (12.7-fold; P = 0.00007) subjects. AB + m was increased in CF (1.8-fold; P = 0.049) and AR (1.2-fold; P = 0.07) subjects. There were no changes in NAR subjects. On Sepharose-2B columns, AB + m peaks were at 1.3-3.0 x 10(6) and 0.36-0.65 x 10(6) Da. 7F10-irm showed four distinct peaks at 1.5, 1.2, 0.85, and 0.53 x 10(6) Da that were nearly identical in both normal and CF samples. Sialic acid was present in both 7F10-irm and AB + m. 7F10-irm and AB + m are mutually exclusive sialylated mucoglycoproteins that are significantly induced in AR and CF but not in NAR.

    Topics: Animals; Antibodies, Monoclonal; Cattle; Chromatography, Ion Exchange; Cystic Fibrosis; Enzyme-Linked Immunosorbent Assay; Fibromyalgia; Glycoconjugates; Glycoside Hydrolases; Humans; Mucins; Mucoproteins; Muramidase; Nasal Mucosa; Neuraminidase; Rhinitis; Sinusitis; Submandibular Gland; Therapeutic Irrigation

1997
Abnormal nasal glandular secretion in recurrent sinusitis.
    The Journal of allergy and clinical immunology, 1990, Volume: 86, Issue:1

    Recurrent sinusitis (RS) is a very common clinical problem for which no underlying cause can generally be ascertained. We examined nasal mucosal responses in 14 patients with RS to determine if a relative deficiency in secretion of glandular antimicrobial factors might play a role. Twenty-four subjects with no history of sinusitis were studied concurrently as normal control (NC) subjects. RS was defined by two or more episodes of acute sinusitis per year for 2 or more years. After provocation with 25 mg of methacholine or 1 mg of histamine, nasal washings were analyzed for total proteins: the plasma protein albumin, IgG, and nonsecretory IgA (nsIgA), and the glandular proteins secretory IgA (sIgA), lactoferrin (LFN), and lysozyme (LZM). Although baseline secretions in patients with RS were relatively enriched with LFN and LZM as compared to that of secretions in NC subjects, patients with RS had a blunted cholinergic response with decreased secretion of albumin, IgG, nsIgA, sIgA, and LZM. Histamine responses were equivalent in both patients with RS and NC subjects. After 4 to 12 months of medical treatment, the abnormal cholinergic responses improved on repeat methacholine challenge in all eight subjects with RS rechallenged. Thus, patients with RS have a reversible reduction in nasal mucosal secretory responses to cholinergic stimulation. Since glandular secretions are rich in antimicrobial factors, such as LFN, LZM, and sIgA, it appears possible that the inability to secrete glandular proteins normally may predispose to recurrent infections.

    Topics: Acute Disease; Adult; Female; Humans; Immunoglobulin A; Immunoglobulin A, Secretory; Immunoglobulin G; Lactoferrin; Male; Middle Aged; Muramidase; Nasal Mucosa; Nasal Provocation Tests; Recurrence; Serum Albumin; Sinusitis

1990
Evaluation of the effects of antigen specific immunotherapy on chronic sinusitis in children with allergy.
    Auris, nasus, larynx, 1990, Volume: 17, Issue:1

    The purpose of this study is to evaluate the clinical significance of allergy in children with chronic sinusitis. After allergic examinations, 52 sinusitis children were divided into allergic and non-allergic groups: 37 allergic children were treated with either the combination of antigen specific immunotherapy and medication with lysozyme chloride preparation (AI group, n = 20) or medication alone (AM group, n = 17); 15 non-allergic patients were also treated with lysozyme chloride preparation (NAM group). The treatment results including the radiographic improvements were significantly better in the AI group than in the AM or NAM group. The clinical effects of lysozyme chloride preparation tended to be better in the NAM group than in the AM group.

    Topics: Allergens; Antigens; Child; Chronic Disease; Humans; Hypersensitivity; Immunotherapy; Muramidase; Nasal Provocation Tests; Radioallergosorbent Test; Sinusitis; Skin Tests

1990
An immunohistological study of nasal and paranasal mucosa of patients with relapsing chronic sinusitis.
    Rhinology, 1984, Volume: 22, Issue:2

    Mucosal specimens from patients with chronic sinusitis have been immunohistologically investigated. Secretory IgA was found decreased in type 1 (relapsing type sinusitis) whereas C3 was increased. Lysozyme was decreased or deplated in longstanding cases (type 2). Fibronectin was found both in type 1 and type 2 chronic sinusitis. It was concluded that depletion of IgA and lysozyme with activation of C3 and fibronectin interferes with the successful treatment of sinusitis.

    Topics: Chronic Disease; Complement C3; Fibronectins; Humans; Immunoglobulin A, Secretory; Muramidase; Nasal Mucosa; Paranasal Sinuses; Recurrence; Sinusitis

1984
[Simultaneous determination of peroxidase, lysozyme and low molecular proteinase inhibitor in human nasal secretion].
    Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde, 1972, Volume: 203, Issue:2

    Topics: Chymotrypsin; Humans; Leukocytes; Methods; Molecular Weight; Muramidase; Nasal Mucosa; Peroxidases; Protease Inhibitors; Sinusitis; Trypsin Inhibitors

1972
[Histochemistory and clinical aspect of chronic sinusitis].
    Jibi inkoka Otolaryngology, 1971, Volume: 43, Issue:8

    Topics: Adolescent; Adult; Chondroitin; Chronic Disease; Female; Glycosaminoglycans; Histocytochemistry; Humans; Hyaluronoglucosaminidase; Injections; Male; Muramidase; Oleandomycin; Radiography; Sinusitis; Tetracycline

1971
[State of some immunity indices in various diseases of staphylococcal etiology].
    Zhurnal mikrobiologii, epidemiologii i immunobiologii, 1971, Volume: 48, Issue:6

    Topics: Abscess; Adolescent; Adult; Antitoxins; Blood Bactericidal Activity; Cellulitis; Complement System Proteins; Humans; Middle Aged; Muramidase; Osteomyelitis; Otitis; Phagocytosis; Sinusitis; Staphylococcal Infections; Surgical Wound Infection; Tonsillitis; Ulcer

1971
[Enzymatic evaluation of diseases in otorhinolaryngology].
    Nihon Jibiinkoka Gakkai kaiho, 1970, Volume: 73, Issue:10

    Topics: Adolescent; Adult; Aged; Epistaxis; Female; Fibrinolysin; Fibrinolysis; Humans; Male; Meniere Disease; Middle Aged; Muramidase; Otitis; Otorhinolaryngologic Diseases; Sinusitis

1970
[Sinobronchitis in children and its treatment with an anti-inflammatory enzyme].
    Nihon rinsho. Japanese journal of clinical medicine, 1970, Volume: 28, Issue:2

    Topics: Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Blood Sedimentation; Bronchitis; Child; Child, Preschool; Female; Humans; Male; Muramidase; Paranasal Sinuses; Radiography; Sinusitis

1970
[Drug allergy from lysozyme preparations].
    Jibi inkoka Otolaryngology, 1969, Volume: 41, Issue:3

    Topics: Adolescent; Chronic Disease; Drug Hypersensitivity; Humans; Male; Muramidase; Sinusitis

1969
[Therapeutic competence of enzymes in chronic sinusitis].
    Nihon Jibiinkoka Gakkai kaiho, 1968, Volume: 71, Issue:2

    Topics: Animals; Chronic Disease; Humans; In Vitro Techniques; Muramidase; Nasal Mucosa; Peptide Hydrolases; Rabbits; Sinusitis

1968
[Clinical application of a lysozyme, Leftose, in chronic sinusitis].
    Jibi inkoka Otolaryngology, 1967, Volume: 39, Issue:7

    Topics: Adolescent; Adult; Child; Chronic Disease; Female; Humans; Male; Muramidase; Sinusitis

1967
[Treatment of chronic sinusitis by oral administration of Neuzym (catabolic agent for mucopolysachride)].
    Jibi inkoka Otolaryngology, 1966, Volume: 38, Issue:7

    Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Muramidase; Sinusitis

1966
[Histo-pathological studies of mucopolysaccharidase treatment on chronic sinusitis].
    Jibi inkoka Otolaryngology, 1966, Volume: 38, Issue:2

    Topics: Humans; Maxillary Sinus; Muramidase; Sinusitis

1966
[The action of lysozyme upon inflammatory sinus mucous membrane].
    Jibi inkoka Otolaryngology, 1966, Volume: 38, Issue:8

    Topics: Humans; Muramidase; Sinusitis

1966
[Lysozyme in sinusitis, sinus diseases and sinutosis].
    La Semana medica, 1961, Sep-25, Volume: 119

    Topics: Antiviral Agents; Dermatologic Agents; Humans; Muramidase; Paranasal Sinus Diseases; Sinusitis

1961