MgNd2 alloy in contact with nasal mucosa: an in vivo and in vitro approach.

Biodegradable and biocompatible magnesium alloys appear to be very promising not only for temporary clinical application but also for developing deformable and degradable medical implants. This study analyzes the in vivo degradation behavior and the impact on the paranasal sinuses of the highly ductile Mg-2 wt%Nd alloy (MgNd2) in order to provide a basis for a satisfying stent system for the therapy of a chronic sinusitis. Moreover, in vitro tests were carried out on primary porcine nasal epithelial cells (PNEC). For the in vivo tests, cylindrical MgNd2 specimens were implanted into the sinus' mucosa of minipigs. During and after a total period of 180 days the long-term biodegradation and biocompatibility properties after direct contact with the physiological tissue were analyzed. Biodegradation was investigated by measuring the mass and volume losses of the MgNd2 specimens as well as by performing element analyses to obtain information about the degradation layer. The influence on the surrounding tissue of paranasal sinuses was evaluated by endoscopic and histopathological examinations of the mucosa. Here, only a locally unspecific chronic infection was found. The degradation rate showed a maximum after 45 days postsurgery and was determined to decrease subsequently. In vitro experiments using PNEC showed adequate biocompatibility of MgNd2. This study demonstrates a good in vivo biocompatibility for MgNd2 in the system of paranasal sinuses and underlines the promising properties of alloy MgNd2 for biodegradable nasal stent applications.

[Significance of local pain syndrome in patients with frontitis].

The diagnostic value of local pain symptom as a key sign of frontitis is currently regarded as rather low. It occurred only in 69 (14%) of the 487 patients with this disease examined in the present study. Patients presenting with ambiguous symptoms of uncomplicated unilateral frontitis were studied by rheofrontography using coefficient of asymmetry as a diagnostic criterion (its value in excess of 24% indicates the presence of exudate in the sinus cavity. The electron microscopic study demonstrated the presence of morphologically different cells in frontal sinus mucosa of patients with uncomplicated frontitis with and without local pain symptom. These findings are in excellent agreement with the data on the relationship between immunological and neurogenic components of the inflammatory reaction in patients with diseases of the upper respiratory tract.

In vivo model for frontal sinus and calvarial bone defect obliteration with bioactive glass S53P4 and hydroxyapatite.

An in vivo model was developed to investigate the usability of a frontal sinus and a calvarial bone defect obliteration with bioactive glass S53P4 (BG) and hydroxyapatite (HA) granules. Roofs of 21 Elco rabbit frontal sinuses were drilled open from 4 separate holes using a standard method, and the sinuses, located in pairs, in frontal bone were filled with BG on one side and with HA on the other side. Two parallel posterior defects were covered with a pedicled periosteum flap, and 2 anterior defects with a free flap. The stability of materials, new bone, and connective tissue formation were observed with histomorphometry, scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDXA), and X-ray pictures at 1, 3, 6, and 12 months postoperatively. The results showed more rapid resorption of filling material (p = 0.019) and new bone formation (p = 0.0001) in the defects filled with BG than in the corresponding HA-filled defects studied by histomorphometry throughout the study. New bone formation and resorption of materials were faster in defects covered by a pedicled flap than by a free periosteum flap. The results were supported by SEM histomorphometric and radiologic analysis. Both bioactive materials studied were well tolerated in frontal sinuses and in calvarial bone defects. The experimental model showed the influence of early periosteum vascularization on accurate frontal sinus filling and the healing process in rabbit frontal sinuses.

Chondrogenic differentiation in cultures of embryonic rat mesenchyme.

The morphology and fine structure of day 12 rat embryonic mesenchyme from forelimb bud, mandibular arches, and frontonasal prominence is described as the cells undergo chondrogenesis in high density, micromass culture. The cultures began as a multilayered "pavement" of flattened mesenchymal cells, 3-4 deep, with moderate intercellular space but little identifiable electron-dense extracellular matrix. Pre-cartilage condensations, which consisted of aggregates of cells which had rounded up, displaying little or no intercellular space, formed within the first 24 h in limb mesenchyme and after an additional 24 h in mandibular and frontonasal cultures. Gap junctions occur between these cells, indicating a phase of direct cell-cell communication. Chondrogenesis within these aggregates began within the next 24 h in limb cultures but was delayed an additional 24-48 h in the frontonasal and especially in mandibular cultures. The aggregates in both limb and mandibular mesenchyme form discrete nodules bordered by a perichondrium consisting of 2-3 layers of flattened cells. Evidence from late stage mandibular cultures suggests that chondroblasts are added to the nodules from the perichondrium, as occurs in vivo. By contrast, the frontonasal cartilage is initially unbordered and forms anastomosing trabecular arrays. Some of these arrays fuse into larger structures with time, but others become surrounded by a single, flattened perichondrium, resulting in the stacking of these trabeculae as chondrification proceeds. The sequence of cartilage matrix production, as revealed in long-term facial cultures, appears to occur in three stages, an early phase in which the extracellular matrix consists primarily of proteoglycans, followed by a phase of homogeneous collagen-proteoglycan matrix and a mature, territorial matrix. In all three cultures the cartilage ultimately produced resembles mature rat hyaline cartilage with chondroblasts surrounded by a territorial matrix of type II collagen and proteoglycan granules.

[Schwannoma of the nose and paranasal sinuses]. / Schwannom der Nase und der Nasennebenhöhlen.

A rare case of a Schwannoma (neurinoma) of the frontal sinus of a 75-year old male patient was examined clinically, histologically, and by electron microscopy. The fine structure of neurinomas occurs in two forms: Type Antoni A is composed of Schwann cells whose nuclei are arranged in palisading rows with greatly attenuated cytoplasmic processes extending from the Schwann cells in parallel alignment; Antoni B is characterized by loosely arranged Schwann cells set in meshwork of macrocysts and reticular fibers. It may be a degenerative form of Antoni A. In the present case Antoni A was the dominating pattern. A prominent basal lamina enveloping Schwann cells, as well as desmosome-like junctions between them, were identified. Furthermore, myelin figures, lysosomal bodies, intranuclear unmyelinated axons and concentric laminated inclusions, and annulate lamellae were found in Schwann cells. Luse bodies appeared in the tumour matrix. It is suggested that annulate lamellae may play a significant role in cell differentiation and tumour growth. No other ultrastructural signs of malignancy were seen.