Relation between adenoid size and otitis media with effusion.

AIMS: This study compares the efficacy of adenoidectomy on otitis media with effusion (OME) in patients with different size of adenoids and the connection between differently sized adenoids and middle ear effusion. MATERIAL AND METHODS: Children with a history of at least 3 months' OME underwent adenoidectomy and myringotomy without the insertion of a tympanostomy tube. Treatment assignment was stratified by adenoids' size causing choanal obstruction (grade I-III) and according to Eustachian tube ostium obstruction (grade A-C). The subjects were followed for 12 months. RESULTS: Adenoidectomy was significantly more effective in children with adenoids in contact with torus tubarius (grade B, C) compared to those with small adenoids without contact (P<0.001). The volume of the adenoids was irrelevant (P=0.146). The size of adenoids did not affect the viscosity of the middle ear secretion. The distribution of mucous and serous secretion was not dependent on the size of adenoids; the efficacy of adenoidectomy was 82% in mucous as well as serous secretion. CONCLUSION: The relation between adenoids and torus tubarius is more important than the volume of the adenoids. The viscosity of middle ear fluids (serous or mucous) did not influence the rate of treatment efficacy.

Iron deprivation induces apoptosis independently of p53 in human and murine tumour cells.

Iron deprivation induces apoptosis in some sensitive cultured tumour cells, while other cells are resistant. In order to elucidate the mechanisms involved in apoptosis induction by iron deprivation, we studied the expression of p53 and the expression of selected p53-regulated genes. To discriminate between changes coupled only with iron deprivation and changes involved in apoptosis induction by iron deprivation, we compared the expression of the genes in sensitive (human Raji, mouse 38C13) versus resistant (human HeLa, mouse EL4) cells under iron deprivation. Iron deprivation was achieved by incubation in a defined iron-free medium. The level of p53 mRNA decreased significantly under iron deprivation in sensitive cells, but it did not change in resistant cells. On the contrary, the level of the p53 protein under iron deprivation was slightly increased in sensitive cells while it was not changed in resistant cells. The activity of p53 was assessed by the expression of selected p53-regulated targets, i.e. p21(WAF1/CIP1) gene, mdm2, bcl-2 and bax. We did not detect any relevant change in mRNA levels as well as in protein levels of these genes under iron deprivation with the exception of p21(WAF1/CIP1). We detected a significant increase in the level of p21 mRNA in both (sensitive and resistant) mouse cell lines tested, however, we did not find any change in both (sensitive and resistant) human cell lines. Moreover, the p21(WAF1/CIP1) protein was accumulated in mouse-sensitive 38C13 cells under iron deprivation while all other cell lines tested, including human-sensitive cell line Raji, did not show any accumulation of p21(WAF1/CIP1) protein. It seems that the p21(WAF1/CIP1) mRNA, as well as protein accumulation, is not specifically coupled with apoptosis induction by iron deprivation and that it is rather cell-line specific. Taken together, we suggest that iron deprivation induces apoptosis at least in some cell types independently of the p53 pathway.

Apoptosis induction in lymphoma cells: thiol deprivation versus thiol excess.

We studied the effects of thiol availability on apoptosis induction in B-cell lymphoma 38C13, T-cell lymphoma EL4, and also other cells. Compounds with a free SH group are required for survival and growth of 38C13 cells but not of EL4 cells. Thiol deprivation (2-mercaptoethanol concentrations about 0.3 microM and lower) induced apoptosis in 38C13 cells. On the other hand, thiol excess (2-mercaptoethanol concentrations higher than 300 microM) induced apoptosis in 38C13 cells and EL4 cells as well as in other cells (e.g. Raji, HeLa). L-cystine and non-thiol antioxidant ascorbic acid were unable to support survival of 38C13 cells. Ascorbic acid induced cell death at concentrations higher than 600 microM. Thiol cross-linking compound diamide (100 microM and higher) abrogated the survival-supporting effect of 2-mercaptoethanol (50 microM). Apoptosis induction by thiol deprivation and by thiol excess was not directly related to a specific significant change in the p53 level or p53 activation. Apoptosis induction by thiol excess was associated with a certain decrease in the Bcl-2 level while the Bax level did not change. We conclude that both thiol deprivation and thiol excess can induce apoptosis in lymphoma cells. Apoptosis induction by thiol deprivation is specifically related to the presence of a free SH group. However, apoptosis induction by thiol excess does not seem to be specifically related to the presence of a free SH group. It probably results from the excess of a reductant. Apoptotic control protein p53 does not seem to play a significant role in apoptosis induction either by thiol deprivation or by thiol excess.

Differing sensitivity of tumor cells to apoptosis induced by iron deprivation in vitro.

We studied the sensitivity of tumor cells to the induction of apoptosis by iron deprivation. Iron deprivation was achieved by the employment of a defined iron-deficient culture medium. Mouse 38C13 cells and human Raji cells die within 48 and 96 h of incubation in iron-deficient medium, respectively. On the contrary, mouse EL4 cells and human HeLa cells are completely resistant to the induction of death under the same experimental arrangement. Deoxyribonucleic acid fragmentation analysis by agarose gel electrophoresis as well as flow cytometric analysis after propidium iodide staining detected in 38C13 and Raji cells, but not in EL4 and HeLa cells, changes characteristic to apoptosis. The 38C13 cells, sensitive to iron deprivation, also displayed a similar degree of sensitivity to apoptosis induction by thiol deprivation (achieved by 2-mercaptoethanol withdrawal from the culture medium) as well as by rotenone (50 nM), hydroxyurea (50 microM), methotrexate (20 nM), and doxorubicin (100 nM). Raji cells shared with 38C13 cells a sensitivity to rotenone, methotrexate, doxorubicin, and, to a certain degree, to hydroxyurea. However, Raji cells were completely resistant to thiol deprivation. EI4 and HeLa cells, resistant to iron deprivation, also displayed a greater degree of resistance to most of the other apoptotic stimuli than did their sensitive counterparts. We conclude that some tumor cells in vitro are sensitive to apoptosis induction by iron deprivation, while other tumor cells are resistant. All the tumors found to be sensitive to iron deprivation in this study (four cell lines) are of hematopoietic origin. The mechanism of resistance to apoptosis induction by iron deprivation differs from the mechanism of resistance to thiol deprivation.