Immunological study of otitis media with effusion in children

Otistis media with effusion [OME] is one of the most common health problems seen in children [Kirglu et al., 2003].This study was undertaken to evaluate beta2-M levels in serum and effusion of the middle ear in patients with OME to determine whether there was any alterations which may shed a light on the pathogenesis of this disease. The present study was carried out on 30 patients [36 ears] with otitis media with effusion [OME] who were admitted to ENT Departments of Al-Azhar University Hospitals. The patients were given an interval of 3 weeks after diagnosis and before surgical interference to give them a chance for resolution with medical treatment. Those with persistent effusion were selected for the study. Diagnosis was done by a complete case history, clinical examination and audiological examination. Determination of beta2-M in the sera and MEE of patients with OME and the sera of normal controls showed that their mean values +/- SD were: 1.85 +/- 0.9, 3.57 +/- 2.41, 1.73 +/- 0.67 mg/l respectively. The mean concentration of beta2-M in serum of normal controls, serum and "MEE" of preschool age: 1.48 +/- 0.55, 1.5 +/- 0.58 and 3.18 +/- 2.1 mg/l respectively. The mean beta2-M value in serum and middle ear effusion in children with mucoid type were: 1.91 +/- 0.93 and 2.68 +/- 1.91 mg/l respectively. There was no correlation of the beta2-M levels with respect to the patients age, sex or MEE type. [2-M was detected in 100% of "MEE" samples and serum samples

Role of tumor markers in the follow-up of pharyngeal cancer

To evaluate the squamous cell carcinoma antigen [SCCA] and tissue polypeptide antigen [FPA] in pharyngeal carcinoma, the serum concentration in 15 patients [clinically, radiologically, endoscopically and histopathologically diagnosed] with 5 apparently healthy controls were studied. The results of pretreatment pharyngeal carcinoma patients were compared to both controls and 1, 6 and 12 months post-treatment. Also, pretreatment results were correlated to the primary tumor, lymph node, clinical stages and histologic grades. SCCA was sensitive in 50% of patients, while TPA was sensitive in 63.3%. Combined determination of the 2 markers increased the sensitivity to 76.6%. Thus, the 2 markers have good monitoring value in the follow up of patients with pharyngeal carcinoma, as well as can extend and expand the diagnostic possibilities for therapy monitoring and early detection of recurrence

Electrophoretic changes in both rhinoscleroma and allergic rhinitis patients

The goal of this study was throw some light on the changes of the electrophoretic pattern in the patients with rhinoscleroma and allergic rhinitis and on the possible changes of the serum iron and copper in the same patients. This study was carried on forty patients as a study group which subdivided into two groups: group [A] twenty patients suffering from rhinoscleroma and group [B] twenty patients suffering from allergic rhinitis, this group was picked up from E.N.T clinic. Ten normal persons were taken as a control group which matched with the diseased group. The results of this study demonstrated that in the rhinoscleroma group [Group A], there was highly significant increase in the mean level of alpha globulin in about of 70% of cases rather than the control group and also there was decrease in the mean level of gamma glublin in about of 40% of cases in comparison with the control group and insignificant increase of beta glublin and there was no statistically difference between protein, albumin and alpha 2. Also this results showed that in the allergic rhinitis group [Group B], there was highly significant increase in the mean level of alpha 2 in about of 75% of cases of also increase of alpha 1 in about 30% of cases and decrease of level of beta in about of 30% of cases with no significant difference between group [B] and the control group in the mean level of the total protein, albumin and gamma globulin. This study found that the mean level of iron was decreased in the group of rhinoscleroma than the control group but present in around of its normal level in the group of allergic rhinitis. On the other hand, this study found that the mean of serum copper was increased in both groups than the control group

Effect of tonsillectomy operation on the body immunological mechanism

The palatine tonsils play an important role in immunologic surveillance and resistance to infection in the upper aerodigestive tract [Gorfien et al., 2001]. T and B lymphocytes were quantitatively estimated in the peripheral blood of 50 patients pretonsillectomy and 3 months postoperatively by E-rosette and E-A rosette tests respectively. There was statistically significant decrease in E-rosette and E-A rosette percent postoperatively. Age and sex of patients had no statistical significant effects on the result. These results may give an idea about the importance of the tonsils as a tissue sharing in the immunological mechanism of the body. In a review of long-term follow-up studies, the authors showed that while tonsillectomy may lead to certain changes in the cellular and humoral immune system, these alterations are clinically insignificant and no increased frequency of immunomodulated diseases should be expected [PouLussen, et al., 2000]

Chemical and bacteriological survey in some cases of otitis media with effusion

Otitis media with effusion is one of the most common chronic conditions of childhood [Postsic et al., 1997]. Management of Otitis media with effusion [OME], consists of adenoidectomy, middle ear irrigation and post operative antibiotics, with Grommet Tube insertion gave a significant better cure rate of OME than using only one of these three methods with Grommet tube insertion or performing Grommet tube insertion alone. This were evaluated clinically and bacteriologically in 25 children with OME and found a significant relationship between positive bacterial cultures and endotoxin

Some haematological findings in allergic rhinitis patients

To investigate the hematological changes in allergic rhinitis as electrophoretic pattern, serum iron and copper, 20 patients suffered from allergic rhinitis with polyps and 10 healthy subjects as controls with matched age and sex were selected for this study. A highly significant increase in the mean level of alpha 2 in about 75% of the cases and an increase in alpha 1 in about 30% of the cases with no significant difference between the mean level of total protein, albumin and gamma globulin in both groups were found. The mean serum level iron was decreased, while the mean serum level of copper was increased in all allergic patients compared with the controls. Thus, it was concluded that electrophoretic changes as well as serum iron and copper levels changes could have a role in the diagnosis of allergic rhinitis with polyps

Some biochemical, immunological and electron microscopy findings in rhinoscleroma

To investigate the immunological and biochemical aspects with cellular changes in rhinoscleroma, 40 patients and matched 10 apparently healthy controls were studied. Results of tuberculin testing, total rosette test, active rosette test and leukocyte migration inhibition test were lower than controls and were statistically significant. The mean serum levels of zinc and iron were decreased, while mean serum copper level was increased and these were statistically significant, specially in late cases. Mikulicz cells, Russel bodies and fibroblasts were detected by electron microscopy examination. Thus, the cell-mediated immunity condition and trace elements levels should be evaluated in every rhinoscleroma patient

Nasopharyngeal pathogens in otitis media in children

To compare the potential pathogens and aerobic and anaerobic interfering organisms of nasopharyngeal flora in 36 children with otitis media [clinically diagnosed and confirmed by tympanometry] with matched 18 apparently healthy controls. The commonest potential pathogens were: M. catarrhalis [33%], S. pneumoniae [22%], H. influenzae [18%] and Strept. pyogenes [11%] with less interfering aerobic and anaerobic organisms compared to controls. Tonsilloadenoidectomy should be done in children with recurrent otitis media and further studies to investigate whether maintaining normal nasopharyngeal flora would be beneficial in those children are recommended

Tumor necrosis factor alpha in allergic rhinitis

To evaluate the role of tumor necrosis factor alpha [TNF alpha] in the pathogenesis of allergic rhinitis [AR], serum TNF alpha level was determined in 45 patients with AR clinically diagnosed compared to 10 healthy controls. The mean serum TNF alpha levels in AR patients were significantly higher than controls, more in severe followed by moderate then mild AR patients. Significant difference was found between the mean serum TNF alpha level in severe and moderate AR patients, respectively, compared to controls with no significant difference as regards mild AR patients compared to controls. Thus, TNF alpha could be considered as a valuable parameter in the pathogenesis of AR as well as in relation to the severity of this condition