Effects of polymeric zinc propylen-bis-dithiocarbamate (propineb) on nasal mucosa in rats / Efectos de los polímeros del zinc propileno-bis-ditiocarbamato (propineb) en la mucosa nasal de ratas

The objective of this study was to evaluate the histopathologic and immunohistochemical effects of propineb on rat nasal mucosa. Twenty adult Sprague-Dawley rats weighing 180­220 g, were used as experimental animals. The rats were divided into propineb and control groups. The control group received distilled water with spray at the same time period. The experiment was terminated after three weeks. In each case, sections of the nosewere taken. In experimental group, microscopic examination of nasal respiratory mucosa revealed that degenerative changes in epithelium were observed in sections of propineb-treated group. There were also leukocyte infiltration and vascular dilatation detected in the connective tissue.We detected CD34-immunoreactive mononuclear cells and endothel cells in the lamina propria of propineb group. In propineb group compared to the control group, the respiratory epithelium, goblet and basal cell nuclei were stained positive for PCNA. Propineb inhalation may be irritating to the nasal mucosa.

El objetivo de este estudio fue evaluar los efecto histopatológicos e inmunohistoquímicos del Propineb en la mucosa nasal de 20 ratas Sprague-Dawley adultas con un peso de 180-220 g, las que fueron utilizadas como animales de experimentación. Las ratas se dividieron en grupos Propineb y Control. El grupo control recibió agua destilada en aerosol nasal en el mismo período de tiempo que el grupo Propineb. El experimento duró tres semanas. Posteriormente, en cada caso se tomaron muestras de la mucosa nasal. En el grupo experimental, tratado con Propineb, el examen microscópico de la mucosa respiratoria nasal reveló cambios degenerativos en el epitelio. Se detectó también infiltración de leucocitos y dilatación vascular en el tejido conectivo, junto con células mononucleares CD34 inmunorreactiva y células endoteliales en la lámina propia. En el grupo Propineb, en comparación con el grupo control, los núcleos de la porción respiratoria, las células caliciformes y basales resultaron positivas a la tinción del antígeno nuclear de proliferación celular (PCNA). La inhalación de Propineb puede ser un irritante para la mucosa nasal.

Biofilme em rinossinusite crônica com polipose nasossinusal: estudo piloto / Biofilm in chronic sinusitis with nasal polyps: pilot study

Apatogenia da rinossinusite crônica não está completamente estabelecida e existem algumas explicações para essa doença, como a osteíte, os superantígenos, a hipersensibilidade mediada por fungos e, mais recentemente, o biofilme. Não existem publicações na língua portuguesa sobre biofilmes na rinossinusite crônica. Objetivo: Reproduzir um método para evidenciar a presença de biofilmes em pacientes com rinossinusite crônica com polipose nasossinusal. Material e método: Amostras de bula etmoidal de nove pacientes com rinossinusite crônica com polipose nasossinusal sem resposta ao tratamento clínico submetidos à cirurgia foram analisadas com microscopia eletrônica de varredura para evidenciar o biofilme. Desenho do estudo: Estudo de coorte contemporânea com corte transversal. Resultados: Observamos o biofilme em 55,56 por cento (5/9) dos pacientes, através da visualização da estrutura tridimensional, de estruturas esféricas envolvidas por uma matriz amorfa e dos canais de água. Conclusão: Reproduzimos um método de visualização de biofilme bacteriano através da microscopia eletrônica de varredura e evidenciamos a sua presença nos pacientes com rinossinusite crônica com polipose nasossinusal.

Chronic rhinosinusitis pathogenesis is not completely established and there are some explanations for this disease, such as osteitis, superantigens, fungal-mediated hypersensitivity and, more recently, biofilms. There are no reports in Portuguese about biofilms in chronic rhinosinusitis. AIM: To reproduce a method for visualization of biofilms in patients with chronic rhinosinusitis and nasal polyps. Patients and methods: Samples of ethmoid bulla of nine patients with chronic rhinosinusitis with nasal polyps without response to clinical treatment who underwent surgery were analyzed with scanning electron microscopy to evidence bacterial biofilms. Study design: A contemporary cross-sectional cohort study Results: In 55.56 percent (5/9) of the patients we observed biofilms by seeing three-dimensional structures, spherical structures surrounded by an amorphous matrix and water-channels. Conclusion: We reproduced a method for visualization of bacterial biofilms by scanning electron microscopy and evidenced its presence in chronic rhinosinusitis with nasal polyps.

Preoperative computed tomographic evaluation of inferior nasal concha hypertrophy and its role in deciding surgical treatment modality in patients with deviated nasal septum / Evaluación preoperatoria con tomografía computada de la hipertrofia de la concha nasal inferior y su rol en la decisión de la modalidad de tratamiento quirúrgico en pacientes con tabique nasal desviado

Deviated nasal septum is associated with compensatory hypertrophy of the inferior nasal concha on the contralateral side. In the past conventional septoplasty was done for the deviated septum, which would improve the patency on the side of deviation but would worsen it on the opposite side due to reallocation of the septum to the midline. The present study of 50 patients unfolds the anatomical composition of the inferior nasal concha based on the computed tomographic scan and help the otolaryngologist to determine whether to add turbinoplasty to standard septoplasty procedure or not.

Un tabique nasal desviado está asociado con una hipertrofia compensatoria de la concha nasal inferior del lado contra lateral. En el pasado se realizaba septoplastía convencional para el tabique desviado, lo que mejoraraba la permeabilidad en el lado de la desviación, pero agravaba ésta en el lado opuesto, debido a la reacomodación del tabique en el plano mediano. En el presente estudio se evaluó en 50 pacientes la composición anatómica de las conchas nasales inferiores, basado en la exploración a través de tomografía computarizada, y de esta manera ayudar al otorrinolaringólogo a determinar si es necesario o no, añadir la plastía de la concha nasal inferior al procedimiento de septoplastía estándar.

Disquinesia ciliar: diagnóstico ultraestructural, evolución clínica y alternativas de tratamiento / Clinical and ultrastructural features of ciliary dyskinesia

Background: Ciliary dyskinesia (CD) is a low incidence genetic illness, that presents with a wide clinical spectrum. Also, there are transitory conditions that present with ciliary anomalies, secondary to infectious diseases of the airways. Aim: To descube clinical and ultrastructural findings and clinical and therapeutic evolution of these patients. Patients and Methods: Retrospective review of medical records and electron microscopy findings of 33 patients (aged 1 to 21 years, 14 females) with ultrastructural diagnosis of CD. To obtain follow up information, a telephone survey was done. Results: In 30 patients (90 percent) the inner dynein arm (IDA) was absent in 50 or more percent of the cilia. Twenty two (66 percent) had absence of the outer dynein arm. Before diagnosis of CD, 19 patients (57 percent) presented recurrent otitis media, 25 patients (77 percent), three or more episodes of rhinosinusitis and 18 patients (56 percent) had recurrent pneumonia. Middle ear ventilation tubes were placed in 19 patients (57 percent), and during its use, 12 (68 percent) remained without othorrea. Sixteen patients (48 percent) with recurrent episodes of rhinosinusitis required adenoidectomy Seven (21 percent) required a functional endoscopic sinus surgery (FESS), and 6 (86 percent) improved after FESS. Conclusions: Our patients with CD presented recurrent infections in different airway locations. In those with a diagnosis of CD and recurrent otol¢gica! and rhinosinusal infections, IDA was absent in a high percentage of cilia. FESS and the use of ventilation tubes may have a beneficial role in a subgroup of patients with CD.

Estudo clínico e ultraestrutural pós-turbinectomia inferior parcial / Clinical and ultrastructural study after partial inferior turbinectomy

O presente trabalho refere-se ao estudo dos resultados clínicos e histológicos obtidos após a turbinectomia inferior parcial (TIP), cirurgia indicada no tratamento da obstrução nasal crônica causada pela hipertrofia das conchas nasais inferiores. MATERIAL E MÉTODOS: Foram estudados vinte pacientes, divididos em dois grupos de dez cada (grupos A e B), submetidos à TIP, associada à septoplastia ou não. Os pacientes foram reavaliados clinicamente e histologicamente (com biópsia das áreas regeneradas das conchas inferiores), em dois períodos pós-operatórios diferentes: um grupo após oito a doze meses (grupo A) e outro após dois anos de TIP (grupo B). RESULTADOS: Os resultados clínicos mostraram-se satisfatórios para o alívio da obstrução nasal no grupo A, e insatisfatórios no grupo B. Entretanto, melhores resultados histológicos, com maior recuperação e diferenciação epitelial da mucosa regenerada das conchas inferiores após a TIP foram observados no grupo B, com sua ultraestrutura ciliar normal. CONCLUSÕES: A cirurgia revelou ser eficaz a curto, mas não em médio prazo, apesar da recuperação histológica ter sido importante.

We report clinical and histological results obtained after partial inferior turbinectomy (PIT), surgery indicated for the treatment of chronic nasal obstruction. METHODS: Twenty patients were divided into two groups submitted to PIT plus septoplasty and PIT alone. The patients were reassessed clinically and histologically by means of a biopsy of the regenerated areas in the inferior turbinates at two different times after PIT, i.e., after 8 to 12 months (group A) and after two years (group B). RESULTS: The clinical results proved to be satisfactory for the relief of nasal obstruction in group A and unsatisfactory in group B. However, better histological results with better recovery and epithelial differentiation of the regenerated mucosa of the inferior turbinates after PIT were observed in group B. CONCLUSION: Surgery proved to be effective on a short-term but not on a long-term basis, and histological recovery did not accompany improvement of clinical signs and symptoms.

Nasal mucosal morphology after altera tion of air stream

The nocturnal application of nasal continuous positive airway pressure is used for treatment of sleep apnoea. The study of the histopathological changes that accompany its application is needed for proper evaluation. Fifteen adult rabbits were used in this study, 14 were the subject of the experiments and one animal used as control. Under combined general and local anaesthesia, ring of skin and epithelium was removed from the left nostril, the margins of the wound were undermined, averted and brought together with mattress sutures, effectively closing the nostril. The animals were sacrified at intervals. The duration of surgical closure of one nostril was four days in 7 animals and three months in 7 others. Strip of bony and cartilaginous septum was removed after marking the closed side with a silk stitch. In each interval 4 animals were used for transmission electron microscope [TEM] and 3 for scanning electron microscope [SEM. On the side with sealed nostril the number of goblet cells increased, while the number of ciliated cells decreased. In contrast, on the open side of the nose disappearance of the ciliated cells and a transformation of the respiratory epithelium into thickened multilayered squamous epithelium with no goblet cells

Effects of longterm intranasal administration of benzalkonium chloride on rat nasal respiratory mucosa: a histological study

The preservative benzalkonium chloride [BZC] is widely used, not only for nasal drops, but also for eye drops and cosmetics, the objective of this study was to evaluate the histological changes after long-term administration of BZC on rat nasal respiratory mucosa. Sixty-six rats were used. Six were used as a control group and received saline nasal drops, the rest were divided into four groups, fifteen in each. The first group received nasal drops of a low concentration of BZC [0.025%] that is commonly used in nasal drops and sprays. The second group received steroid-mixed [0.15%] low concentration BZC solution. The third group received a high concentration of BZC solution [0.1%] that was reported to induce dermatitis. The fourth group received a steroid-mixed [0.15%] high concentration solution. Symptomatic changes were observed. After 1, 2 and 4 weeks of administrations, five animals from each group were sacrificed by decapitation. Small specimens were taken from the anterior part of the nasal septum for electron microscopy and the heads were decalcified. Noses were cut perpendicular to the hard palate into three levels: anterior, middle and posterior. Sections were stained with H and E. Epithelial height was measured using the image analysr. Sneezing and rubbing the nose with the forelegs were observed in the experimental groups. Light microscopic study revealed histological changes in the anterior level in all groups. After the first week, there was proliferation of goblet cells, degeneration and squamous metaplasia. After the second week, intraepithelial glands were formed together with cellular infiltration and vascular congestion. After the fourth week, tubular glands developed invading the lamina propria. Epithelial height of the anterior level demonstrated significant increase in all groups when compared to the control group. Electron microscopic study revealed the presence of abnormal spaces between epithelial cells. So, it could be concluded that BZC, even in low concentration and mixed with steroid, could produce nasal lesions, together with symptomatic changes. Hence, there is a strong need to develop a preservative without side effects or nasal applications without preservatives

Effects of oxymetazoline on the nasal mucosa of rats: an ultrastructural study

It is recommended that decongestant nasal drops should not be used for more than 10 days. However, overuse or misuse of these medications occurs commonly, which may lead to injurious effects on the nasal mucosa. Ten male rats receiving either oxymetazoline or saline nasal drops were killed after 8 weeks. Respiratory and olfactory nasal mucosae were dissected and processed for light and electron microscopic study. Nasal respiratory mucosa showed multi-focal areas of proliferation, metaplasia and degeneration accompanied by ciliary loss. The olfactory mucosa revealed disorganization, degenerative changes with atypical nuclei. Prolonged administration of oxymetazoline topical nasal drops can result in structural and functional alterations in the rat nasal respiratory and olfactory mucosae, presumably due to the combination of the chronic hypoxic effect of the reduced blood flow and the impairment of the mucociliary clearance

Tiempo de tránsito nasal de sacarina en escolares sanos / Nasal transit time determined with the saccharine test in healthy children

Introducción. La prueba de tránsito nasal de sacarina es un medio simple, no invasivo e indoloro para evaluar la depuración mucociliar nasal. Ha sido empleada en varias condiciones como en la evaluación de los efectos de intervenciónes quirúrgicas y medicamentosas directas en la región aérea nasal y también de aquéllas que sin estar directamente relacionadas alternan la depuración mucociliar nasal. Sin embargo, existe muy poca información acerca de los valores de dicha prueba en la edad pediátrica. El objetivo de este estudio fue determinar los valores de tiempo de tránsito nasal de sacarina en escolares sanos. Material y métodos. Este estudio se realizó en escolares sanos. La sacarina sódica en polvo fue colocada en el cornete inferior y se computó el tiempo transcurrido hasta que los niños relataban la aparición de un sabor dulce en la lengua. El análisis estadístico de los tiempos de tránsito nasal de sacarina, según edad y sexo, se realizó mediante pruebas no paramétricas (ANOVA), chi cuadrada y la regresión lineal. Resultados. Se estudiaron 84 niños, con edades entre 4 y 14 años. El tiempo promedio de tránsito nasal de sacarina fue de 16.7 ñ 9.2 min y se observó una tendencia significativa del tiempo de sacarina a ser mayor con el aumento de la edad y en niñas (P< 0.05). Conclusión. Los valores descritos en el presente estudio se encuentran dentro del límite referido en publicaciones de otros países y contribuyen a aumentar la escasa información disponible aceraca de los valores de tiempo de tránsito nasal de sacarina en escolares sanos

Electron microscopic study of nasal secretory glands and epithelium in perennial rhinitis

The morphology of nasal secretory glands and epithelium was studied using the electron microscope in ten patients with perennial rhinitis. Marked predominance of the serous type over mucous acini was the most conspicious feature. The cells were full of zymogen granules. Thickening and hyperplasia of the epithelium with marked ciliary loss was notified

therapeutic role of sodium cromoglycate 4% in perennial allergic rhinitis: an ultrastructural and morphometrical study

Fifteen patients with perennial allergic rhinitis [PAR] were treated for a month with intranasal sodium cromoglycate [SCG]. The ultrasturctural changes of the nasal mucosa, were studied by transmission electron microscope [TEM], and were compared to those of five normal controls. Particular attention was focused on tracing the degranulation process implemented by the mast cell and basophil. After the treatment period, the allergic mucosa restored mast cell and basophil. After the treatment period, the allergic mucosa restored most of its normal features. This was referred to the stabilizing effect of SCG on mast cells and probably its same ability on basophils. Both of these cells showed quiescent state as defined by retention of their cytoplasmic granules. Also, the study demonstrated the of migration of the mast cells from the epithelium to lamina propria under the effect of SCG. SCG induced true decrease in the number of eosinophils and basophils and false decrease of the mast cells in the allergic nasal mucosa. The resulted improvement in the patient's allergic rhinitis was verified both clinically and by light microscopy

Allergic rhinitis with and without nasal polypi [Electron microscopic study]

Allergic nasal polyposis is an agonizing problem in the practice of otorhinolaryngology. The exact etiology and pathogenesis are still a matter of controversy. The present work aimed to clarify the sequence of events in the pathogenesis of nasal allergy and to throw a light on the initiating factors that predispose to polypoidal formation. Nasal biopsies were taken from selected twenty male patients with allergic rhinitis [10 patients without polypi and 10 with polypi]. The associated polypus tissue was studied. Biopsies were taken also from five volunteers used as a control. Electron microscopic study of the allergic nasal mucosa showed thickening and metaplasia of the lining epithelium with thickening of their basement membrane. The lamina propria manifested cellular infiltration especially those of fibroblast, lymphocytes, plasma cells, macrophages and mast cells which depicted a degree of degranulation more in cases with polyposis. The glandular structures showed hyperactivity of the serous element with loss of their microvilli and cilia. Zymogen granules appeared more numerous and of more electron density. There was increased vasculature with hypertrophy and gaping of the endothelial lining cells and thickening of the basal lamina of blood capillaries. Polypus tissue showed a structure similar to that of allergic nasal mucosa. Their epithelial cells were widely separated and the stroma was edematous. The vasculature and glandular elements were greatly reduced. The ultrastructural changes in allergic rhinitis with elements were greatly reduced. The ultrastructural changes in allergic rhinitis with and without polyposis were more or less the same. The changes were more marked in cases with polyposis. This might be due to difference in the degree of tissue reaction to allergen which may be due to the variability in the initial site that provoke it

Análisis al microscopio electrónico de la mucosa nasal de pacientes ex-adictos a la cocaína / Electron microscopy analysis of the nasal mucosa in ex-cocaine addict patients

Normal and pathological human nasal mucous biopsies were used and obtained surgically. Pathological one were taken from cocaine addicted patients who had been using this drug during many years mainly by snorting via. From the clinical point of view all patients presented similar symptoms among which the most common were acute and chronic rhinitis, sneeze and bleeding. All cases include showed evident tissue disorganization that ultrastructurally present partial or total lost of cillia as well as disruption between epithelia and basal lamina. Although, normal tissue was substituted by abundant fibrous tissue explaining why this tissue lost its normal function. All described alterations were analyzed by ransmission electron microscope and scanning electron microscope

Ultraestructura de la mucosa nasal y su aplicación clínica / Ultrastructure of nasal mucosa and its clinical application

Se presenta un estudio en donde se hace la correlación clínica y anatomopatológica de la mucosa nasal. Las muestras fueron tomadas de las áreas clínicas nasales descritas por Cottle, y revisadas bajo microscopía electrónica. Se hace un análisis de la diferencia de epitelio de las distintas áreas y se concluye que existe gran variabilidad en la conformación del epitelio dependiendo del área examinada. Los complejos de unión en las zonas estudiadas sugieren un papel activo de éstos en el paso de substancias. El encontrar epitelio escamosos en las áreas II y III debe considerarse como normal y no interpretarlo como metaplasia escamosa. Cuando se desee investigar el epitelio ciliado, debe obtenerse la biopsia de las regiones más posteriores de las fosas nasales. El hallazgo de cilios con doble axonema, tiene que valorarse cuidadosamente antes de interpretarse como patológico. Finalmente se enfatiza que el estudio ultraestructural de estos epitelios, es de gran ayuda en el entendimiento de su comportamiento en estado normal y patológico

Rinoescleroma / Rhinoescleroma

Se presentan 59 casos de rinoescleroma. Se comenta la etiopatogenia y la patologia de la enfermedad. Se analizan sus factores inmunologicos y se actualiza el tratamiento