Search Results (4)

We develop a new approach that resolves cloud area distributions of single-layer shallow cumuli from ground-based observations. Our simple and computationally inexpensive approach uses images obtained from a Total Sky Imager (TSI) and complementary information on cloud base height provided by lidar measurements to estimate cloud equivalent diameter (CED) over a wide range of cloud sizes (about 0.01–3.5 km) with high temporal resolution (30 s). We illustrate the feasibility of our approach by comparing the estimated CEDs with those derived from collocated and coincident high-resolution (0.03 km) Landsat cloud masks with different spatial and temporal patterns of cloud cover collected over the Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site. We demonstrate that (1) good (~7%) agreement between TSI and Landsat characteristic cloud size can be obtained for clouds that fall within the region of the sky observable by the TSI and (2) large clouds that extend beyond this region are responsible for noticeable (~16%) underestimation of the TSI characteristic cloud size. Our approach provides a previously unavailable dataset for process studies in the convective boundary layer and evaluation of shallow cumuli in cloud-resolving models. Full article

Introduction: Bioabsorbable steroid-eluting implants are available as an adjunct for endoscopic sinus surgery (ESS) in the treatment of chronic rhinosinusitis (CRS). It is unclear which patients are most likely to benefit from this technology. We sought to determine if the severity of preoperative sinonasal inflammation influences the postoperative changes in patient-reported quality of life (QOL) and endoscopic appearance following ESS with implant placement; Methods: Consecutive adult patients undergoing ESS for CRS with ethmoidectomy and placement of a steroid-eluting implant over an 18-month period were prospectively included for study. Pre-operative sinus computed tomography (CT) opacification was evaluated using the Lund-Mackay score (LMS). Sinonasal Outcome Test (SNOT-22) scores and Lund-Kennedy endoscopic scores (LKES) for each patient were collected preoperatively and at three- and six-month intervals postoperatively. Serum eosinophilia (>6.0% on peripheral smear) and sinus tissue eosinophilia were recorded; Results: One hundred and thirty-six patients were included for analysis. Of these, 36.7% had polyposis, 15.4% had serum eosinophilia and 64.0% had tissue eosinophilia. The mean (standard deviation) SNOT-22 score was 45.5 (19.4) preoperatively, which improved postoperatively to 18.8 (14.1) at three months (p < 0.001) and 16.5 (14.0) at six months (p < 0.001). Similar results were found when stratified by the presence of polyposis, serum eosinophilia, tissue eosinophilia or high-grade CT findings (LMS > 6). Higher baseline LKES was observed for patients with eosinophilia or high-grade LMS, but these differences normalized at six months postoperatively; Conclusions: Patient-reported QOL and endoscopic appearance show improvement six months after placement of a steroid-eluting implant during ESS, irrespective of the presence of polyposis or eosinophilia. Full article

Background: Primary ciliary dyskinesia (PCD) may be an underlying factor in some cases of refractory chronic rhinosinusitis (CRS). However, clinical management of this condition is not well defined. This systematic review examines the available evidence for the diagnosis and management of CRS in adults with PCD. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pubmed, EMBASE, and Cochrane database were queried for studies pertinent to treatment of PCD in adults. Two investigators performed eligibility assessment for inclusion or exclusion in a standardized manner. Results: Of the 278 articles identified, six studies met the criteria for analysis. These studies had a predominately low level of evidence. Medical therapy included oral antibiotics and nasal saline rinses. Endoscopic sinus surgery (ESS) was described in three of six studies. Outcomes measures were limited and included non-validated questionnaires, subjective reporting of CRS symptoms, and decreased preciptins against pseudomonas following ESS. Recommendation for a standardized therapeutic strategy was not possible with the available literature. Conclusion: A paucity of evidence is available to guide the treatment of PCD in the adult population. Further prospective studies are needed to determine the optimal diagnostic and management strategy for this condition. Full article

The relationship between paranasal sinus pneumatization and chronic rhinosinusitis (CRS) without cystic fibrosis is not well understood. Previous investigations have confirmed sinus hypoplasia in cystic fibrosis (CF) patients. This study compares paranasal sinus pneumatization of CRS patients to unaffected controls to determine if there is an analogous effect to that seen in CF. 591 sinus computed tomography (CT) scans, comprised of 303 adolescents (age 13–18) and 288 adults (age > 18), were analyzed for Lund-MacKay and Assessment of Pneumatization of the Paranasal Sinuses (APPS) scores. The APPS score is validated for measuring the extent of sinus pneumatization. A diagnosis of CRS and CRS phenotype was determined from the medical record. The mean APPS score for patients with a diagnosis of CRS was 10.61 (n = 111) compared to 9.62 (n = 448) for unaffected controls (p = 0.001). This was significant in adult (p = 0.021) and adolescent subgroups (p = 0.035). Sinus pneumatization did not differ according to CRS phenotype (p = 0.699). This suggests that there is not analogous anatomical sinus variation between CRS and CF, and that the mechanisms underlying sinus hypoplasia in CF may not be universal in patients with other types of sinus inflammation. Full article