The effect of streptomycin and irradiation on rhinoscleroma (electron microscopic study).

Irradiation of scleromatous lesions produces its effect by destroying the organisms, whereas Streptomycin improves the mucosal defence mechanisms. A combination of both lines of treatment seems to be indicated for the arrest of the pathological process.

The skin window test in rhinoscleroma.

The skin window test was applied to evaluate the state of immunity in patients with rhinoscleroma. The use of the patient's own Klebsiella micro-organisms as antigen led to a negligible change in the percentage of lymphoblasts, whereas the use of foreign Klebsiella micro-organisms as antigen resulted in a pronounced change. This finding indicates an impaired cellular immune response. Application of Klebsiella microorganisms as antigen to normal subjects led to a comparatively high percentage of lymphoblastic transformation. This finding suggests the possible use of a standard Klebsiella antigen as a vaccine. The possible use of the skin window test to identify people with deficient T lymphocyte function is discussed as well as its use in monitoring the efficacy of such a vaccine in influencing the cellular immune response.

The normal human maxillary sinus mucosa. An electron microscopic study.

The fine structure of the maxillary antral mucosa was studied in 5 cases. The findings revealed the similarity of the nasal and paranasal sinus mucosae. Certain differences were recorded denoting relative diminished activity of the seromucinous glands, diminished exchange between tissue fluid and blood, diminished number of cilia, delicacy and loosening of the epithelium. Thus, in inflammation there is lower resistance of the sinus mucosa to infection and easier penetration for microorganisms, requiring early systemic administration of antibiotics with postural drainage and antral irrigation subsequently in treatment.

The role of plasma cells in scleroma. Electron-microscopic study.

Three cases of rhinoscleroma in the granulomatous stage were examined under the electrom microscope. The rough endoplasmic reticulum of plasma cells in scleroma displayed cisternal dilatations forming Russell bodies and cytoplasmic vacuolations containing viable and degenerated bacilli forming Mikulicz cells. Thus, they play a double role, producing antibodies and providing protection for the intracellular bacilli. New ultrastructural findings of Klebsiella rhinoscleromatic bacilli were described.

The allergic nasal mucosa following vidian neurectomy. Electron microsopic study.

The fine structure of the allergic nasal mucosufollowing vidian neurectomy was studied in 15 patients. The structure of the mucous glands, venules, arterioles and tunical cellular elements returned to normal 1 month after the operation, while that of the epithelium and of the capillaries only 3 months post-operatively. The effect of interrupting the hyperactive cholinergic nerve impulses on the various constituents of the nasal mucosa is described.

Human nasal blood vessels after permanent tracheostomy. Electron-microscopic study.

Biopsy specimens from the inferior turbimate of 13 permanently tracheostomized patients were examined by the electron microscope. Variations from the normal were recorded, as proliferation of capillaries, venous congestion and arteriolar contraction. The relation of shunting air away to these changes is discussed.

Tunica propria in chronic allergic rhinitis. Electron-microscopic study II. The sero-mucinous glands.

The fine structure of human nasal sero-mucinous glands was studied in 15 chronic allergic patient. There was total absence of the mucous glands, and proliferation of seroud elements, with hugely dilated lumina containing large numbers of intact zymogen granules, and absence of microvilli. The relation between the goblet cells and the nasal glands was discussed. An interchange between the serous and mucous elements was deduced.

Tunica propria in chronic allergic rhinitis. Electron-microscopic study. I. The nasal blood vessels.

The fine structure of human nasal blood vessels was studied in 15 chronic allergic patients. The venules showed gaping of the interendothelial junctions and lamination of the basal lamina. The capillaries displayed numerous endothelial cytoplasmic processes. The arteriolar walls showed thinning and destructive changes. A reciprocal relation between the vascular endothelium and its basal lamina was deduced.

Human nasal epithelium and cellular elements in chronic allergic rhinitis. Electron-microscopic study.

The fine structure of human nasal respiratory epithelium and tunical cellular elements was studied in 15 chronic allergic patients. The epithelium showed characteristic morphological details suggestive of oedematous infiltration occurring in these cases. Eosinophils, mast cells and plasma cells showed ultrastructural changes explaining the role played by each of them in allergic rhinopathies.