Diode laser-assisted inferior turbinoplasty in resistant cases of allergic rhinitis: a clinical and histopathological study.

Chronic nasal obstruction owed to inferior nasal turbinate hypertrophy is one of the most common problems encountered in rhinology. When medical management fails, surgical reduction of hyperplastic inferior nasal turbinate is often used. Diode laser is appropriate for the use in the nasal turbinate. This study was designed to define the histopathologic changes in the inferior turbinate post diode laser turbinoplasty and evaluate the outcome in patients having allergic inferior turbinate hypertrophy that has not responded to the medical treatment. A prospective single-cohort study was carried out. Under general anesthesia, 18 patients underwent inferior turbinoplasty using diode laser 980 nm in the contact mode submucosally under guidance of a 4-mm nasal endoscope 0°. Inferior turbinate mucosa biopsy specimens were taken at the time of surgery, and after 3 months, they were histopathologically examined with assessment of the patients' symptoms. At 3 months postoperatively, histopathologic assessment demonstrated marked structural changes in diode laser-treated inferior turbinates including the predominance of fibrous tissue with diminution of seromucinous glands, venous sinusoids, and inflammatory cell infiltrate. Concurrently, 16 patients (89%) had no nasal obstruction, 15 patients (83%) had moderate-to-good improvement of rhinorrhea, whereas 13 patients (72%) had moderate-to-good improvement of sneezing. Diode laser produces histopathologic changes in the inferior turbinate soft tissues, providing excellent ablation of the soft tissue with controllable performance and good hemostasis. Therefore, it is a safe, minimally invasive, and effective procedure in relieving nasal obstruction secondary to inferior turbinate hypertrophy as well as other symptoms of allergic rhinitis.

Paeoniflorin in experimental BALB/c mansoniasis: A novel anti-angiogenic therapy.

Chronic hepatic schistosomiasis causes portal hypertension, fibrosis and lethal hepatosplenic complications. Previous studies focused mainly on schistosomicidal drugs and neglected the therapeutic approaches against the vascular complications after portal hypertension. Investigating a novel anti-angiogenic therapy is an urgent. The current study is to evaluate the performance of Paeoniflorin (PAE) as an anti-angiogenic therapy, being a powerful anti-fibrotic, compared to artemether (ART) and praziqantel (PZQ) in schistosomiasis mansoni BALB/c mice. Thirty two laboratory bred male BALB/c Swiss albino mice. The mice were classified into four groups (8 mice each), control infected (CI), PZQ (300 mg/kg/12 h), ART (0.1 ml/mg/d) and PAE (50 mg/kg/d) treated groups for one month. All mice groups were sacrificed 15 weeks post infection for assessment of the drugs' efficacy by parasitological, histopathological and immunohistochemical studies. Our results in PAE group showed marked reduction in the mean egg count/gram stool, worm burden, egg count/gram liver tissue, granuloma diameter and pro-angiogenic factors as vascular endothelial growth factor (VEGF), Proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (α-SMA) and CD34; conversely, there was an augmentation of the tissue inhibitor metalloproteinases-2 (TIMP-2) as an anti-angiogenic expression that was exceeded ART and PZQ treated groups compared to CI group (p˂0.001). Conclusively, PAE has an anti-angiogenic impact with no vascular proliferative activity or recanalization, no micro-vessel density (MVD) changes, granuloma resolution and fibrosis regression. PAE is predicted to be a potential therapy for chronic hepatic diseases associated with fibrosis and angiogenesis, hopeful in protecting from advanced serious complications; cancer and metastasis.