Effect of heavy smoking on the mucosa of the upper respiratory tract

This study was conducted on 30 individuals; their ages ranged between 20 and 60 years. The patients were divided into two groups: Group A composed of 15 individuals who were heavy smokers, i.e. they used to smoke at least 20 cigarettes per day for at least 10 years duration, and group B [control]composed of 15 individuals who were non-smokers. 73% of smokers had postnasal discharge, hyperemia of mucosa of nasopharynx and lymphoid tissue aggregation on the posterior pharyngeal wall in contrast to 13.3%, 13.3% and 20% in non-smokers, respectively. In the present work, the histopathological examination of nasal biopsies showed a high percentage of pathological abnormalities among the smokers group including squamous metaplasia of respiration epithelium [73.3%], thickening of basement membrane [53.3%], edema of submucosa [40%], patchy fibrosis of submucosa [60%], congested blood vessels [66.7%], seromucinous gland hyperplasia [60%], lymphocyte [66.7%], plasma cells [66.7%] and mast cellinfiltration [36.7%]. These findings were less among non-smokers, i.e. 0%, 26.7%, 0%, 2%, 26.7% 6.7%, 26.7% 13.3% and 26.7%, respectively. Smokers had a statistically significant higher percentage of all abnormalities, except thickening of basement membrane where the difference was not statistically significant

Histo-pathological study of the oropharynx in snoring and obstructive sleep apnea patients

Obstructive sleep apnea [OSA] is characterized by repetitive episodes of upper airway occlusion during sleep. The purpose of this work is to study the histopathological alterations of the oropharyngeal tissues in patients with snoring and OSA. The study was carried out on two groups of patients, selected from ENT outpatients clinics of Al-Azhar University hospitals from November 2001 to June 2002. The first group, includes 30 patients, 10 snorers and 20 with OSA. They underwent uvulopalatopharyngoplasty [UPPP] and the pharyngeal specimens were taken from the distal soft palate [uvula, anterior and posterior pillars]. The second group, [control] includes 7 persons with chronic tonsillitis and underwent tonsillectomy and the control pharyngeal specimens were taken from very small parts of the anterior and posterior tonsillar pillars excised during tonsillectomy. The study revealed that obstructive sleep apnea patients were commonly obese, male, and older than the other patients. Histopathological examination showed extensive edema in the lamina propria of the distal soft palate in snorers and OSA patients and also, extensive fatty infiltration in these patients which may play a role in etiopathogenesis of OSA. There was a significant correlation between the degree of pharyngeal fatty infiltration and, the apnea index and the neck circumference but no, significant correlation with the body mass index was found. Vascular engorgement, interstitial haemorrhage, chronic inflammatory cell infiltration, and glandular hyperplasia were observed in a portion of patients with snoring and OSA, and in some controls, also lymphangectasia was found in 3 obese patients with severe OSA. So, these pathologic changes may reflect the sequel of airway obstruction rather than its cause

Testicular swellings simulating malignancy. Clinical pitfalls, sonographic and histopathological correlation

The final diagnosis of twenty-eight consecutive male patients presented with unilateral testicular swelling, underwent inguinal orchiectomy due to suspected testicular malignancy was correlated with the results of the clinical and sonographic examinations. A high index of suspicion arose primarily from the patients history, clinical examination of the swelling and its appearance on scrotal ultrasonography. Histopathological examination proved the existence of testicular malignancy in 2 cases [7.1%]. The final diagnosis of the remaining 26 cases, based on histopathological examination, was tuberculosis in one case [3.6%], testicular infarction in 2 cases [7.1%], neglected torsion in 6 cases [21.4%], filariasis in one case [3.6%], chronic nonspecific orchitis in 9 cases [32.1%] and granulomatous orchitis in 7 cases [25%]. All were found to simulate malignant tumors either in their clinical presentation, local examination or ultrasonographic appearance. Benign testicular swellings simulating malignancy are not rare and hence differential diagnosis of testicular tumors should be expanded to include chronic and granulomatous orchitis, testicular infarction, neglected torsion as well as tuberculosis and filariasis. The decision of orchiectomy should be properly judged in view of the under-estimated incidence of benign swellings simulating malignancy

Effects of ovariectomy and estrogen replacement therapy on the femur and lumbar vertebrae of albino rat

Thirty adult female albino rats were used in this study. They were divided into three groups: group I [9 rats] were sham-operated and used as control. Group II [9 rats] were bilaterally ovariectomized. Group III [12 rats] were bilaterally ovariectomized; 9 animals were given estrongen the day after the operation and three were given estrogen after eight weeks for four weeks. Three rats from each group were sacrificed after six, eight or twelve weeks. Morphometric measurements of the left femora of rats of all groups were obtained from their radiographs, the ash and calcium content were measured. The right femora and lumbar vertebrae were decalcified and paraffin embedded. Lognitudinal and transverse sections of the femora and longitudinal sections of the lumbar vertebrae were stained with Hx and E, Mallory or Masson's trichrome stains. The results revealed an age-related increase in length, mid-shaft width, cortical thickness, medullary width, ash and calcium content of femora of the control rats. The femora of ovariectomized rats showed increased length, medullary width, decreased cortical thickness, femur score, ash and calcium content compared to those of their age-matched controls. Histologically, the femora of this group showed progressive widening of the epiphyseal plat, decrease in thickness and number of trabeculae, decrease in thickness of the cortex of the neck and shaft of the femur. Their lumber vertebrae showed thinning of their cortices and trabeculae which were also reduced in number. Defects in the hyaline articular cartilage and herniation of the intervertebral disc occurred. Femora of estrogen treated rats were shorter than those of the control rats but their other morphometric measurements, ash and calcium content were normalized to control values. Histologically the femora of this group showed normalization of the thickness of cortex of neck, shaft and trabeculae which increase in number after twelve weeks. The lumbar vertebrae of estrogen treated rats showed normal thickness of the trabeculae and cortex. The femora and lumbar vertebrae of ovariectomized rats given estrogen after eight weeks of ovariectomy showed better values and structure than untreated ovariectomized rats, but were worse than those the control and of rats given estrogen the day after the operation. It is concluded that estrogen has a protective effect on the skeleton of ovarectomized rats, but delay in treatment could not restore the lost bone. It is recommended that estrogen treatment in postmenopausal women in the proper time would prove effective in preventing postmenopausal osteoporosis and fractures