Another CT sign of sinonasal polyposis: truncation of the bony middle turbinate

In order to study the features of sinonasal polyposis (SNP) on CT, 100 consecutive coronasal sinus CT examinations done for chronic inflamamtory sinonasal disease were reviewed. The CT findings of the 27 fully documented SNPs were analyzed. All our SNPs were bilateral. There was a strong tendency for extensive involvement. Nasal polyps were seen in 22 of 27 (81%); bony trabecular deossification in 23 of 27 (85%); widening of infundibulum in 26 of 27(96%). We discovered a new sign truncation of the bony middle turbinate, where the bulbous part of bony middle turbinate was missing, in 51 of 26 (58 %) of SNP patients without a previous history of middle turbinectomy, 12 of 15(80%) were bilateral. The one SNP patient (1 of 27) with previous middle turbinectomy was not regarded to be real truncation. Truncation of the bony middle turbinate is a characteristic and easily recognizable ancillary sign, and is not seen in other patterns of sinusitis. Together with other features on coronal sinus CT, this adds diagnostic confidence in diagnosing sinonasal polyposis. Correspondence to: E. Y. Liang     

Heterotopic brain tissue in the submandibular region and lung

Summary Two cases of extracranial heterotopia of the brain are reported. Case 1, in an otherwise normal female baby, had a brain heterotopia in the submandibular region. Case 2, in a still-born female baby with anencephaly, had the heterotopia in the lung. The lesion in case 1 is believed to be an encephalocele that has been pinched off through a cleft in the bone or through a foramen of the skull; the pathogenesis is similar to that of the so-called nasal glioma. Concerning the pathogenesis of case 2, contrary to the generally supported embolism theory, observation of serial sections of the tumor in the lung favors the aspiration theory according to which amniotic brain tissue fragments, which are dislocated into the amnion because of nonclosure of the ventricle or following destruction of the fetal brain, are aspirated by fetal respiratory movements in the 4th to 6th month of intrauterine life.     

Active transport of polypeptides in rabbit nasal mucosa: Possible role in the sampling of potential antigens

Transepithelial pathways of macromolecule transport have been studied in vitro in rabbit nasal respiratory mucosa, maintained at 27° C. Transepithelial electrical potential difference, short-circuit current and resistance were 3.4±0.5mV (submucosa positive), 65.0±6.7 A cm^–2 and 52.1±5.6 cm^–2 respectively (n=15). These electrical characteristics are those of a leaky epithelium allowing macromolecules to permeate paracellularly. A detailed permeation study of a polypeptide (elcatonin, M _w=3362) was also undertaken. Elcatonin mucosa-submucosa (J _ms) and submucosa-mucosa (J _sm) fluxes were measured by radioimmunoassay. With 10 g/ml elcatonin, J _ms was significantly larger than J _sm for the whole 120-min period of observation; net flux showed a maximum in the first 30 min (J _ms=13.6±1.0 ng cm^–2 h^–1, J _sm=1.4±0.1 ng cm^–2 h^–1, n=10). J _ms fell towards the value of J _sm if the temperature was reduced to 4°C or if the mucosa was simultaneously treated with 0.1 mM dinitrophenol and 3 mM monoiodoacetate. J _ms and J _net followed saturation kinetics with increasing elcatonin concentrations. Adrenocorticotropic hormone (M _r=4500) produced a similar pattern to elcatonin. However, J _ms and J _sm were not significantly different from each other at any time either for [³H]sucrose (M _w=342) or for [¹⁴C]polyethyleneglycol-4000 (M _w=4000) when present in the bathing medium at 500 M concentration. The results show active transport of polypeptides in parallel with passive permeation (possibly through leaky intercellular junctions). Active transport does not appear to be related to nonspecific pinocytosis but to receptor-mediated endocytosis. The latter may be important for the sampling of potential antigens from the nasal lumen.     

鼻腔应用丙酸氟替卡松对鼻息肉组织中水通道蛋白-2表达的影响

目的 :探讨鼻腔局部应用丙酸氟替卡松 (FP)喷雾剂对鼻息肉组织中水通道蛋白 2 (AQP 2 )表达的影响及类固醇激素治疗鼻息肉的作用机制。方法 :将 2 6例慢性鼻窦炎鼻息肉患者分为Ⅱ型组 (3期Ⅱ型 14例 )和Ⅲ型组 (Ⅲ型 12例 ) ;Ⅱ型组又分为FP组 (7例 )和对照组 (7例 ) ,Ⅲ型组亦分为FP组 (6例 )和对照组 (6例 )。Ⅱ型组和Ⅲ型组中的FP组术前应用FP喷雾剂喷鼻 7d ,对照组术前鼻腔不予任何处理。术中取 2 6例患者的鼻息肉组织 ,采用SP免疫组化技术检测鼻息肉组织中AQP 2的表达。结果 :Ⅱ型组和Ⅲ型组中的FP组鼻息肉体积明显缩小 ,鼻息肉组织中AQP 2表达的阳性细胞数和面密度值均明显低于对照组 (均P <0 .0 1)。结论 :在FP作用下鼻息肉水肿减轻、体积缩小 ,可能与AQP 2表达减少有关 ,这为类固醇激素治疗鼻息肉作用机制的阐明提供了新的方向     

Tuberculous granuloma in haemangiomatous nasal polyp

Tuberculosis of upper respiratory tract is quite infrequent especially the nasal involvement. Isolated cases have been reported by certain authors. A ease of nasal tubercolosis is being presented for its rare site and its association with haemangioma.     

鼻塞对阻塞性睡眠呼吸暂停综合征发病影响的研究

目的:探讨鼻塞对阻塞性睡眠呼吸暂停综合征(OSAS)发病的影响。方法:对18例诊断为鼻塞和腭咽平面阻塞的OSAS患者,单纯行鼻腔手术改善通气,6个月后复诊。结果:12例睡眠阻塞症状缓解,其中4例效果明显;6例无效。睡眠呼吸紊乱指数(AHI)由术前的29.9±2.1降至22.8±2.7;夜间最低血氧饱和度由(75.0±2.9)％升至(83.4±2.3)％;而体重指数无明显差异。无效组与有效组的术前AHI值差异有显著性意义。结论:鼻塞是OSAS的重要致病因素,早期治疗解除鼻塞是预防OSAS发病的重要措施之一;长期鼻塞引发的OS-AS患者,早期通过鼻腔手术解除鼻塞是治疗OSAS的有效方法之一。     

白细胞介素-5与嗜酸性粒细胞阳离子蛋白在鼻息肉发病中的意义及相互关系

目的：探讨白细胞介素—5(IL—5)及嗜酸性粒细胞阳离子蛋白(ECP)在鼻息肉发病中的作用及相互关系。方法：采用pharmacia CAP荧光免疫系统和ELISA双抗体夹心法对30例鼻息肉患者(鼻息肉组)和8例鼻中隔偏曲或阻塞性睡眠呼吸暂停综合征(OSAS)患者(对照组)分别进行血清中ECP及组织匀浆中ECP、IL—5的检测。结果：鼻息肉组匀浆中IL—5的水平明显高于对照组，其差异有显著性意义(P＜0．05)；鼻息肉组血清与匀浆中的ECP含量明显高于对照组，其差异亦有显著性意义(P＜0．05)。鼻息肉组匀浆中IL—5与血清中ECP水平呈明显正相关(r＝0．598，P＜0．05)；与匀浆中的ECP水平也呈正相关(r＝0．451，P＜0．05)。结论：ECP是嗜酸性粒细胞活化的标志，也是导致鼻腔炎症发生的重要因子；IL—5在鼻息肉组织中高表达，并与血清和组织中ECP水平密切相关，共同促进鼻腔炎症过程的不断加重。     

转化生长因子-β1和胰岛素对人鼻中隔软骨细胞增殖和分化影响的研究

目的 了解转化生长因子-β1(transforminggrowth factor-beta 1,TGF-β1)和胰岛素对人鼻中隔软骨细胞增殖和分化的影响。方法 体外培养人鼻中隔软骨细胞,采用四甲基偶氮唑蓝(MTT)代谢和35S-Na2SO4掺入的检测比较不同浓度TGF-β1和胰岛素对人鼻中隔软骨细胞的增殖以及软骨基质蛋白多糖合成的影响,观察TGF-β1和胰岛素对软骨细胞表型的影响。结果在15％血清的培养条件下,TGF-β1和胰岛素均能显著促进软骨细胞增殖,且在各自一定的浓度范围内呈量效关系,联合作用效果累加;TGF-β1、TGF-β1和胰岛素联合作用促使软骨基质蛋白多糖的合成量明显提高;TGF-β1使传代软骨细胞去分化提前。结论一定浓度的TGF-β1、胰岛素和TGF-β1 胰岛素对体外培养的人鼻中隔软骨细胞具有显著的促增殖作用。     

鼻腔神经部分切断术及下鼻甲粘骨膜下剥离术治疗变应性鼻炎18例临床分析

目的：观察鼻腔神经部分切断术和下鼻甲粘骨膜下血管神经离断术对变应性鼻炎的疗效。方法：对18例常年性变应性鼻炎患者进行鼻腔神经部分切断术与下鼻甲粘骨膜下血管神经离断术。所有病例随访12个月，评价其临床效果。结果：10例临床症状消失，体征明显改善；7例临床症状明显缓解，体征改善；1例无效。总有效率94．4％。结论：鼻腔神经部分切断和下鼻甲粘骨膜下血管神经离断术治疗常年性变应性鼻炎效果显著。     

大豆黄酮对卵巢切除大鼠鼻黏膜上皮细胞凋亡的保护作用

目的　观察双侧卵巢切除诱导大鼠鼻黏膜上皮细胞凋亡 ,研究尼尔雌醇、大豆黄酮对此的保护作用。方法　将 60只大鼠随机分为 4组 :健康对照组 ,卵巢切除组 ,卵巢切除 +尼尔雌醇组 ,卵巢切除 +大豆黄酮组。各组动物分期分 3批处死 ,流式细胞仪检测各组动物鼻中隔黏膜的早期凋亡细胞。结果　双侧卵巢切除后 ,大鼠鼻黏膜的早期凋亡细胞百分数增高 ,术后 60d达到新的平衡。大豆黄酮、尼尔雌醇干预组与健康组比较 ,早期凋亡细胞无明显改变。结论　雌激素替代和大豆黄酮可通过减少凋亡细胞而保护鼻黏膜免受雌激素缺乏的损害