Reviewer's report 
 A Connection between Chronic Sinusitis and Ulcerative Colitis Title: 
 1  3 November 2004 Version: Date: 
 gabriele mazzacca Reviewer: 
Reviewer's report: 
The paper of Yang et al. claims to disclose a connection between chronic sinusitis and ulcerative 
colitis. The authors tempt to show the connection either clinically or experimentally. 
However the clinical part of the study appears to be completely unsatisfactory. Two groups of 
patients with ulcerative colitis are compared. The patients of one of the two groups were affected 
also by chronic sinusitis, successfully treated with functional endoscopic sinus surgery. The authors 
state that ulcerative colitis improved in this group at 6 months after the sinusitis treatment either clinically or endoscopically, even if patients did not receive any treatment for colitis. 
Nothing is indicated with regard to sex, age, duration and extension of colitis in both groups of 
patients. Nothing is indicated about the "routine" treatment which is stated to be administered to the 
group without sinusitis ( control group ). It is very difficult to agree with the choice of the authors who 
did not prescribe any specific colitis treatment in colitis patients after sinus surgery despite the fact 
that most of them had severe-moderate colitis, according to the description of the authors. 
In conclusion this part of the study is completely unsatisfactory. 
With regard to the experimental part of the study methods and discussion of the results are not 
acceptable. Experimental colitis was induced in mice by peritoneal injection of sinus wash fluid from patients with sinusitis. The fact that the injection of the sinus wash fluid elicited colitis in the mice is claimed to disclose a connection between sinusitis and ulcerative colitis. The authors in their 
conclusion failed to consider an important aspect, that is the mice colitis induced in their study is not 
comparable to human ulcerative colitis. 
Reviewer's report 
 A Connection between Chronic Sinusitis and Ulcerative Colitis Title: 
 1  3 November 2004 Version: Date: 
 gabriele mazzacca Reviewer: 
Reviewer's report: 
The paper of Yang et al. claims to disclose a connection between chronic sinusitis and ulcerative 
colitis. The authors tempt to show the connection either clinically or experimentally. 
However the clinical part of the study appears to be completely unsatisfactory. Two groups of 
patients with ulcerative colitis are compared. The patients of one of the two groups were affected 
also by chronic sinusitis, successfully treated with functional endoscopic sinus surgery. The authors 
state that ulcerative colitis improved in this group at 6 months after the sinusitis treatment either clinically or endoscopically, even if patients did not receive any treatment for colitis. 
Nothing is indicated with regard to sex, age, duration and extension of colitis in both groups of 
patients. Nothing is indicated about the "routine" treatment which is stated to be administered to the 
group without sinusitis ( control group ). It is very difficult to agree with the choice of the authors who 
did not prescribe any specific colitis treatment in colitis patients after sinus surgery despite the fact 
that most of them had severe-moderate colitis, according to the description of the authors. 
In conclusion this part of the study is completely unsatisfactory. 
With regard to the experimental part of the study methods and discussion of the results are not 
acceptable. Experimental colitis was induced in mice by peritoneal injection of sinus wash fluid from patients with sinusitis. The fact that the injection of the sinus wash fluid elicited colitis in the mice is claimed to disclose a connection between sinusitis and ulcerative colitis. The authors in their 
conclusion failed to consider an important aspect, that is the mice colitis induced in their study is not 
comparable to human ulcerative colitis. 
Please review this paper.
user
Reviewer's report 
 A Connection between Chronic Sinusitis and Ulcerative Colitis Title: 
 1  3 November 2004 Version: Date: 
 gabriele mazzacca Reviewer: 
Reviewer's report: 
The paper of Yang et al. claims to disclose a connection between chronic sinusitis and ulcerative 
colitis. The authors tempt to show the connection either clinically or experimentally. 
However the clinical part of the study appears to be completely unsatisfactory. Two groups of 
patients with ulcerative colitis are compared. The patients of one of the two groups were affected 
also by chronic sinusitis, successfully treated with functional endoscopic sinus surgery. The authors 
state that ulcerative colitis improved in this group at 6 months after the sinusitis treatment either clinically or endoscopically, even if patients did not receive any treatment for colitis. 
Nothing is indicated with regard to sex, age, duration and extension of colitis in both groups of 
patients. Nothing is indicated about the "routine" treatment which is stated to be administered to the 
group without sinusitis ( control group ). It is very difficult to agree with the choice of the authors who 
did not prescribe any specific colitis treatment in colitis patients after sinus surgery despite the fact 
that most of them had severe-moderate colitis, according to the description of the authors. 
In conclusion this part of the study is completely unsatisfactory. 
With regard to the experimental part of the study methods and discussion of the results are not 
acceptable. Experimental colitis was induced in mice by peritoneal injection of sinus wash fluid from patients with sinusitis. The fact that the injection of the sinus wash fluid elicited colitis in the mice is claimed to disclose a connection between sinusitis and ulcerative colitis. The authors in their 
conclusion failed to consider an important aspect, that is the mice colitis induced in their study is not 
comparable to human ulcerative colitis. 
assistant