ABSTRACT
Background: Helicobacter pylori is assumed to cause many gastric and extragastric diseases. We aimed to assess the possible association role of H. pylori in Otitis media with effusion (OME), nasal polyps and adenotonsillitis. Patients and Methods: A total of 186 patients with various ear, nose and throat diseases were included. The study comprised 78 children with chronic adenotonsillitis, 43 children with nasal polyps and 65 children with OME. OME patients were assigned to two subgroups: those who have and those who did not have adenoid hyperplasia. Among the patients with bilateral nasal polyps, 20 individuals had recurrent nasal polyps and 23 had de novo nasal polyps. Patients who have chronic adenotonsillitis were divided into three groups: those with chronic tonsillitis and those who underwent tonsillitis, those with chronic adenoiditis and adenoidectomy was performed, and those with chronic adenotonsillitis and underwent adenotonsillectomy. In addition to examination of H. pylori antigen in stool samples of all included patients, real-time polymerase chain reaction (RT-PCR) for detection of H. pylori in the effusion fluid was performed, additionally, Giemsa stain was used for detection of H. pylori organism within the tissue samples when available. Results: Frequency of H. pylori in effusion fluid was 28.6% in patients with OME and adenoid hyperplasia, while in those with OME it was only 17.4% with a p value of 0.2. Nasal polyp biopsies were positive in 13% patients of denovo, and 30% patients with recurrent nasal polyps, p=0.2. De novo nasal polyps were more prevalent in the positive stools than recurrent ones, p=0.7. All adenoid samples were negative for H. pylori, only two samples of tonsillar tissue (8.3%) were positive for H. pylori, and stool analysis was positive in 23 patients with chronic adenotonsillitis. Conclusion: Lack of association between Helicobacter pylori and occurrence of OME, nasal polyposis or recurrent adenotonsillitis.
ABSTRACT
To develop a molecular pattern that might help in understanding carcinogenesis of postcricoid carcinoma (PCC) on top of Plummer-Vinson syndrome (PVS) in a prospective controlled study. Twenty-four patients with PVS were diagnosed and followed up over a 4 year period, during which eight of them showed malignant change to PCC. Twenty volunteers free of neoplastic diseases were included as a control group. In the two groups, DNA extraction from mononuclear peripheral blood cells, and analysis of loss of heterozygosity (LOH) and microsatellite instability (MSI) using six paired simple tandem repeats (STRs) primers were done. The molecular weight of each STRs locus was scored and statistical correlations were performed. LOH occurred in 55.6 and 72.9% of PVS and PCC cases compared to 25% of control group. At loci D17S695, D9S753 and D9S171, LOH occurred in 54.2, 66.7, and 70.8% of PVS cases; and in 62.5% of PCC cases for each locus compared to 15, 25 and 45% of control cases. D3S1286 and CFS1-R displayed the highest frequency of LOH in PCC (100% for each) while recorded in 58.3 and 33.3% in PVS compared to 30 and 0% in control cases. Certain genetic events tend to occur as early and late events in malignant change of PVS to PCC. Detection of these events may help in understanding carcinogenesis and in early detection of malignancy. CFS1-R is the most informative marker of tumor progression.
ABSTRACT
OBJECTIVE: Several studies have shown a reduction in pulmonary artery pressure (PAP) after adenoidectomy in children suffering form upper airway obstruction caused by adenoid hypertrophy (AH). However, it is not clear whether this would be significantly reflected on right ventricle output (RVO). METHODS: Our aim was to determine if there were any detectable changes in RV performance parameters after adenoidectomy in children with AH. Thirty children with AH (female/male: 11/19) aged between 2.5 and 12 years (median: five years) were included in this study. Adenoidectomy was performed under sinuscopic guide using adenoid curette and microdebrider. All children were examined by echocardiography one day before and one month after adenoidectomy. Velocity time integral of tricuspid valve flow (VTItv) and pulmonary valve flow (VTIpa); E/A ratio of tricuspid valve flow; RV end-diastolic diameter (RVEDd) and left ventricle fraction shortening (FS) were measured. Heart rate (HR) was also recorded. RESULTS: Preoperatively VTItv, VTIpa, E/A ratio, RVEDd, FS, and HR were 18.6+/-3.0 cm, 20.8+/-3.1 cm, 1.21+/-0.31, 11.5+/-2.1 mm, 35.1+/-4.3%, and 112+/-19, respectively. Postoperatively VTItv, VTIpa, E/A ratio, RVEDd, FS, and HR were 21.5+/-2.5 cm, 24.4+/-4.3 cm, 1.44+/-0.32, 9.3+/-2.6 mm, 33.9+/-3.5%, and 104+/-28, respectively. There were significant differences between preoperative and postoperative VTItv (p=0.03), VTIpa (p=0.01), E/A ratios (p=0.04), and RVEDd (p=0.01). FS and HR were not significantly different. CONCLUSIONS: This study illustrated that in children suffering from AH, relieving upper airway obstruction by adenoidectomy may result in improvement of RV filling and RVO, associated with the reduction in PAP.
