RESUMO
BACKGROUND AND OBJECTIVES: The in vitro effects of pneumococcal neuraminidase and staphylococcal beta-toxin on ciliary activity were investigated at different concentrations and lengths of exposure. MATERIALS AND METHODS: The ciliated epithelial cells were taken from the maxillary sinus mucosa of rabbits. Ciliary beat frequency (CBF) was measured at concentrations of 0.01, 0.1 and 1.0 U/mL of neuraminidase and 0.1, 1.0, 2.0, 5.0 and 10 U/mL of beta-toxin using a video-computerized analysis technique. The CBF was measured 2, 4, 6, 12, 24 and 48 hours after administration of the neuraminidase and beta-toxin. In the control group, normal saline was percutaneously applied to the right maxillary sinus. In the experimental group, 2 U/mL of beta- toxin was applied to the left maxillary sinus using the same technique. At 7 days, all of the mucosae were taken from the inferomedial wall of the maxillary sinus for light microscopy. RESULTS: There was no change in CBF during a 48-hour incubation at 0.01, 0.1 and 1.0 U/mL of neuraminidase. However, the CBF dropped significantly after an 8-hour incubation at 2.0 U/mL of beta-toxin (p<0.05, repeated measures ANOVA). No ciliary activity was observed after a 12-hour incubation at 10 U/mL of beta-toxin. The mucoid, purulent discharge was observed in the maxillary sinuses of the experimental group. Prominent epithelial disruption and infiltration of inflammatory cells into the epithelium and lamina propria were observed in the beta-toxin-applied group. CONCLUSION: The results of this study suggest that staphylococcal beta-toxin may reduce ciliary activity and induce sinusitis without occlusion of the natural ostium of the maxillary sinus in rabbits. This study provides another animal model of sinusitis for understanding the pathogenesis of sinusitis caused by bacterial exotoxins.
Assuntos
Coelhos , Células Epiteliais , Epitélio , Exotoxinas , Seio Maxilar , Microscopia , Modelos Animais , Mucosa , Neuraminidase , Sinusite , Staphylococcus aureus , Staphylococcus , Streptococcus pneumoniae , StreptococcusRESUMO
BACKGROUND: Due to the antibiotic therapy and the appropriate treatment, the incidence of the infections of the neck decreased. But during last 5 years in the Red Cross hospital, there were the hundred cases. And a few significant complications were still experienced. OBJECTIVES: For the early treatment and the prevention of the infection of the neck, it is necessary to study the characteristics, the diagnosis, and the treatment. MATERIALS AND METHODS: The hundred cases of the infections of the neck in the Red Cross hospital from January in 1992 to December in 1996 were analyzed about the age and sex distribution related to spaces involved, the location of cellulitis and abscess, the side of lesion, the symptoms and signs, the etiologic events, the associated conditions, the results of culture, the special diagnostic methods, the treatments, and the complications. RESULTS: In the infections of the neck, the following contents were more frequent: male(sex), the third decade(age), pain and fever(symptoms and signs), acute tonsillitis and odontogenic origin(etiologic events), Diabetes Mellitus(associated condition), hemolytic Streptococcus and Bacteroides(the results of culture), and Computerized Tomography(the special diagnostic methods). There was no significant difference in the side of lesion. The useful treatment in the peritonsillar space infection was the incision and drainage and then tonsillectomy two or three weeks after the recovery of the infection, and in the deep neck space infection, only antibiotic therapy or the incision and drainage with the antibiotic therapy were useful. The complications were four cases with two cases of sepsis, one cases of mediastinitis, and one cases of internal jugular vein thrombosis. CONCLUSION: In spite of the antibiotic therapy and the appropriate treatment, there were some complications experieced. So, we must know the characteristics of the infection of the neck well, and the systemic and active attitude is necessary.