The effect of cold water immersion on the nasal mucosa.

The response of the nasal mucosa to cold water immersion is not well known. We have attempted to document this response in normal individuals. Seventeen individuals with no history of nasal disease or allergy were studied. All subjects were asked to perform sustained cold water (15 degrees C) immersion of their hand and forearm on the side of the obstructed nostril for a period of 5 min. The nasal cross-sectional area was measured on both sides of the nose using an acoustic rhinometer. The individuals were then rested for at least 30 min and the test repeated with immersion of the opposite hand. There was a significant fall in nasal cross-sectional area on the side of immersion (median change = 0.32 cm2, P = 0.0003) with a significant rise in nasal cross-sectional area on the none test side (median change = 0.35 cm2, P = 0.0003). There were no significant differences between these results and those obtained by immersion on the opposite side. The results indicate that cold water immersion produces nasal obstruction and that both afferent and efferent arms of this reflex are side-specific.     

The nasal response to axillary pressure

The changes in ipsilateral sympathetic tone in response to axillary pressure are well known. However, the response of the nasal mucosa is less well documented. We have attempted to demonstrate this response in normal individuals. Ten individuals with no history of nasal disease or allergy were studied. All subjects were exposed to sustained pressure, using a crutch, for a period of 5 min. Nasal cross-sectional area was measured on both sides of the nose using an acoustic rhinometer along with pulse and blood pressure. The individuals were then rested for at least 30 min and the test repeated with pressure applied to the opposite side. Statistical analysis was performed by non-parametric methods. There was a significant fall in nasal cross-sectional area on the side of pressure (median change = 0.09 cm², P < 0.01) while cross-sectional area in the contralateral nasal passage increased (median change = 0.35 cm², P = 0.01). There were no significant differences between these results and those obtained by axillary pressure on the opposite side. Pulse and diastolic blood pressure rose with axillary pressure while systolic blood pressure remained unaltered. There was no difference in the laterality in the blood pressure response. The results indicate that axillary pressure produces nasal congestion and both afferent and efferent arms of this reflex are side-specific.     

The nasal response to isometric exercise

The cardiovascular response to isometric exercise is well understood. However, the response of the nasal mucosa is less well known. We have attempted to document this response in normal individuals. Ten individuals with no history of nasal disease or allergy were studied. All subjects were asked to perform sustained handgrip on the side of the obstructed nostril for a period of 5 min at 30% of maximum voluntary effort. Nasal cross-sectional area was measured on both sides of the nose using an acoustic rhinometer. The individuals were then rested for at least 30 min and the test repeated with pressure applied by the opposite hand. Statistical analysis was performed by non-parametric methods. There was a significant fall in nasal cross-sectional area on the side of exercise median change = 0.09 cm², P < 0.01) while cross-sectional area in the contralateral nasal passage increased (median change = 0.35 cm², p= 0.01). There was no significant differences between these results and those obtained by handgrip on the opposite side. The results indicate that isometric exercise produces nasal obstruction (isotonic exercise) and both afferent and efferent arms of this reflex are side-specific.     

Effects of cocaine on human nasal mucosa

Summary The effects of cocaine on the contractile response of isolated human nasal mucosal blood vessels to field stimulation and methoxamine were investigated. Results showed that cocaine antagonized methoxamine and inhibited field stimulation. The drug increased resting tension in human nasal mucosa in vitro through direct actions and potentiated mucosal contractions by norepinephrine and epinephrine. The study indicated that high concentrations of cocaine may actually antagonize -adrenoceptors, but these concentrations are not necessary in eliciting desired degrees of vasoconstriction in nasal blood vessels while being applied as a local anesthetic.     

Variations in congestion of the nasal mucosa in man

Congestion of one side of the nose is accompanied by decongestion of the other side. This is called the nasal cycle. The nasal cycle does not seem to be present in all subjects and it has not been shown with rhinostereometry. There are very few studies showing whether there are spontaneous day-to-day variations in nasal mucosal congestion and no studies showing differences in nasal mucosal congestion between morning and afternoon. This, however, may be very important in studies covering a longer period. In the present study, data from four healthy volunteers were recorded 18 or 19 times in the mornings and afternoons on different days. Measurements were made with rhinostereometry, a peak flow meter (PNIF) and by symptom scores. A nasal cycle was found in some subjects. There was no difference in total nasal mucosal swelling in the mornings and in the afternoons and no day-to-day variation in the total nasal mucosal swelling.     

鼻内类固醇激素对变应性鼻炎动物模型鼻腔黏膜的影响

目的:通过变应性鼻炎(AR)动物模型观察鼻内类固醇激素对鼻腔黏膜的影响。方法:36只SD大鼠随机分为3组:鼻内类固醇激素组(A组),AR模型组(B组)和正常对照组(C组)。A、B组以卵清蛋白建立大鼠AR模型,C组用生理盐水代替卵清蛋白。然后A组以鼻内类固醇激素喷鼻,B、C组以生理盐水代替。末次激发后观察动物鼻部症状和体征,并取鼻黏膜行苏木精-伊红染色计数鼻黏膜内嗜酸粒细胞(EOS)数,阿辛蓝-过碘酸-希夫染色观察杯状细胞变化,扫描电镜下观察各组鼻黏膜超微结构的改变。结果:鼻内类固醇激素能明显减轻AR鼻部症状,其评分与B组差异有统计学意义(P<0.01);其鼻腔黏膜内EOS数和杯状细胞数明显降低,与B组相比差异有统计学意义(P<0.01),而与C组差异无统计学意义(P>0.05);扫描电镜检查结果显示A组鼻黏膜纤毛结构与C组相似,而B组纤毛倒伏、排列紊乱、缠绕集结、大量分泌物附着等。结论:鼻内类固醇激素能明显缓解AR症状及鼻黏膜炎性反应状态,并对受损纤毛有明显修复作用。     

The expression of vimentin in epithelial cells from human nasal mucosa

Summary The results of an immunohistological study of the normal human nasal mucosa show that there are frequently vimentin-positive cells detectable in addition to cytokeratins in the respiratory epithelium. The vimentin cells are probably ciliated and/or goblet type in origin. Furthermore, some co-expressing cells were found in basal parts of the submucous glands.     

The role of the temperature of the nasal lining in the sensation of nasal patency

The receptors and neural pathways involved in the common symptom of nasal blockage are of great interest. Studies to date suggest that the sensation of nasal patency may be related to the temperature of the nasal passages. Sixty-two subjects were asked to assess their own nasal patency subjectively and indicate this on a visual analogue scale. The temperature of the nasal lining was continuously recorded during quiet nasal repiration using a non-contact infrared themometer. The cooler the nasal lining, the clearer the nose felt, and the greater the drop in temperature on inspiration again the clearer the nose felt. The study supports the previously proposed hypothesis that the sensation of nasal airflow is derived from a cooling of the nasal lining on inspiration, and this is probably detected by cold thermoreceptors in the mucosa.     

鼻炎冲剂对变应性鼻炎鼻粘膜的影响

观察鼻炎冲剂对应性鼻炎患者鼻粘膜的影响,证实对ＡＲ的治疗,方法：选用健康豚鼠２９只,随机分成剂组,阳性对照组,阴性对照组和空白对照组,冲剂组采用鼻炎冲剂治疗。结果冲剂组鼻痒,喷嚏计分明显低于其他组。结论鼻炎冲剂可以改善ＡＲ患者鼻粘膜的炎症变状态,从组织学证明其对ＡＲ具有明显的治疗作用。     

炎性细胞在变应性鼻炎患者鼻黏膜中的观察

目的 探讨变应性鼻炎患者鼻黏膜组织中炎性细胞的变化及与变应性鼻炎的关系。方法 选择55例发作期变应性鼻炎患者及123例健康者，采用刮匙在下鼻甲黏膜处刮拭涂片，用Wright染色，进行细胞学检测，并进行统行学分析。结果变应性鼻炎发作期患者黏膜细胞发生了显著变化，中性粒细胞及嗜酸粒细胞的数量显著增加（P〈0．001），淋巴细胞明显增加（P〈0.05），而脱落上皮细胞显著减少（P〈0．001）。结论 炎性细胞是变应性鼻炎发病机制中诸多因素之一，深入了解这一作用对于指导临床治疗有重要的意义。     

鼻腔应用类固醇激素对鼻黏膜辐射性损伤组织形态学变化的影响

目的：观察辐射后鼻腔应用类固醇激素对鼻黏膜辐射性损伤组织形态学变化的影响,探讨鼻腔应用类固醇激素在鼻黏膜辐射性损伤中的作用。方法：选用健康豚鼠50只,用医用直线加速器进行鼻部照射,照射剂量为5Gy,每周1次,共3周,在完成辐射后随机分为对照组及用药组,每组25只,用药组在照射完成后第2天开始鼻腔应用类固醇激素。各组分别于照射后1周及1、2、3、4个月各随机处死5只动物,光镜及电镜下观察鼻黏膜的病理学变化及显微图像学分析。结果：照射后喷药,豚鼠鼻黏膜早期炎症反应减轻,并随喷药时间延长,损伤的上皮细胞修复加快,4个月后纤毛覆盖率达72．9％,比单纯照射豚鼠鼻黏膜纤毛覆盖率50．2％明显升高,且黏膜下腺体萎缩减轻,表现出一定的分泌功能。结论：鼻腔应用类固醇激素减轻了鼻黏膜辐射性损伤,在鼻黏膜组织辐射性损伤中起到了一定的保护作用。     

Distribution of noradrenergic nerve fibers in canine nasal mucosa following selective neurectomies

Summary In this study, we have used noradrenergic histofluorescence and selective neurectomies of the vidian, ethmoid and caudal nasal nerves to evaluate the distribution of postganglionic sympathetic fibers in the canine nasal mucosa. In conjunction with the histochemical localization of the noradrenergic fibers in the nasal mucosa after vidian neurectomy, the norepinephrine content of the mucosa was also evaluated using high-performance liquid chromatography. Unilateral neurectomy of the superior cervical ganglion (SCG) resulted in the unilateral disappearance of all noradrenergic histofluorescence in the nasal mucosa, while no morphological changes in noradrenergic fibers could be identified after neurectomy of the cervical sympathetic trunk 1 cm below the SCG. Ethmoid neurectomy caused the disappearance of noradrenergic fibers of the upper third of the nasal mucosa, while vidian neurectomy resulted in a partial loss of noradrenergic fibers in the lower two-thirds of the nasal mucosa. The loss was chiefly in the area adjacent to venous sinusoids and was responsible for 50% of the norepinephrine content of this tissue. We concluded that all the postganglionic sympathetic fibers are from the ipsilateral SCG. Some of them travel via the ethmoid nerve and innervate the upper third of the nasal mucosa. The remaining fibers travel via the vidian nerve and perhaps the vessel walls of the supplying arteries and innervate the lower two-thirds of the nasal mucosa. The vidian nerve chiefly innervates the venous sinusoids of the lower two-thirds of the nasal mucosa.     

家兔鼻中隔黏膜瓣血供的实验研究

目的：研究家兔鼻中隔黏膜瓣的血供,为进一步制作鼻中隔带蒂黏膜瓣修复鼻腔及颅内缺损提供理论和实验依据。方法：以20只新鲜家兔尸体为实验对象,向其颈外动脉注射5ml纯蓝染色剂,沿家兔头部近正中纵行切开,观察鼻中隔黏膜瓣的血供。结果：家兔鼻中隔黏膜瓣的血供大部分来源于鼻中隔后下端的血管。结论：制作带蒂鼻中隔黏膜瓣时保留其后下端的血管可保证黏膜的血供,提高鼻中隔带蒂黏膜瓣的存活率。     

Human papillomavirus (HPV) is rarely present in normal oral and nasal mucosa

The association between human papillomavirus (HPV) and cervical carcinomas is well known. HPV has been found in oral carcinomas and paranasal papillomas, and the question of a causal role of HPV has yet to be answered. Reports on the frequency of HPV in oral and paranasal sinus tumours should be considered in relation to the frequency of HPV in normal oral and nasal mucosa. In the present study 61 normal individual had oral smears taken and 48 had nasal smears. These were examined for HPV by DNA amplification with HPV consensus primers. HPV was not found in the oral mucosa, while a single individual harboured HPV in the nasal mucosa. It is concluded that HPV is rarely present in normal oral and nasal mucosa.     

The relief of snoring by nasal surgery

Patients with nasal obstruction may also complain of snoring. It is uncertain whether surgery which relieves the nasal obstruction will also relieve the snoring. We have reviewed 126 patients who complained of both nasal obstruction and snoring and who underwent nasal surgery. Snoring was completely relieved in 39 patients (31%), was less loud in a further 72 patients (57%), unchanged in 11 and louder in 4. It occurred on fewer nights post-operatively in 61, on the same number in 24 and more frequently in 2. Patients who had nasal polypectomy as part of their nasal surgery obtained the greatest snoring relief. This study suggests that when snoring and nasal obstruction coexist nasal surgery should be considered as the first line of surgical treatment.     

Expression and distribution patterns of the stem cell marker,nestin, and the stem cell renewal factor,BMI-1, in normal human nasal mucosa and nasal polyps

Conclusions: These results suggest that nestin and BMI-1 are candidates for stem cell markers and renewal factors in human nasal mucosa, may contribute to tissue homeostasis and differentiation in the epithelium and submucosal glands of normal nasal mucosa, and may play a role in proliferation of nasal polyps. Objectives: The stem cell marker, nestin, and the stem cell renewal factor, BMI-1, have been identified in a variety of inflammatory and normal tissues, implicating these markers in tissue regeneration. Materials and methods: We investigated the expression and distribution of nestin and BMI-1 in normal nasal mucosa and nasal polyps, using RT-PCR, immunohistochemistry, and Western blotting. Results: Nestin and BMI-1 were localized to the epithelium and submucosal glands of normal nasal mucosa and nasal polyps. The expression of nestin was confined to the plasma membrane and cytoplasm, whereas BMI-1 showed a nuclear staining pattern. In normal nasal mucosa and nasal polyps, nestin and BMI-1 expression was strongest in the basal portion of the epithelial layer, and decreased toward the upper portion. In the submucosal glands, weak to strong expression was commonly detected in the glandular acini. There was no significant difference in the level of expression of nestin and BMI-1 between normal nasal mucosa and nasal polyps.     

抗原长期刺激致变应性鼻炎豚鼠模型鼻黏膜重塑的研究

目的:观察抗原长期刺激致变应性鼻炎豚鼠模型鼻黏膜重塑的特点。方法:Hartley豚鼠48只,随机分为6组(每组8只),即实验组用卵清蛋白(OVA)激发(OVA2W组、OVA6W组和OVA12W组),对照组用生理盐水激发(Sal2W组、Sal6W组和Sal12W组)。OVA制备变应性鼻炎动物模型,抗原刺激分别持续2W、6W和12W,在最后一次激发24h后行鼻腔灌洗、取鼻黏膜组织。ELISA法检测鼻腔灌洗液中OVA特异性免疫球蛋白(OVA-sIgE)、嗜酸粒细胞阳离子蛋白(ECP)含量;鼻黏膜组织切片采用苏木精-伊红、AB-PAS和MT法染色,计数鼻黏膜上皮杯状细胞数量,测量上皮细胞损伤程度、基膜胶原含量;免疫组织化学法检测鼻黏膜组织转移生长因子β1(TGF-β1)的表达。结果:①OVA6W、OVA12W组与OVA2W组比较,OVA-sIgE含量均差异有统计学意义(均P<0.05),而ECP含量在3个实验组中无明显差别;实验组与相应的对照组比较,OVA-sIgE、ECP含量均差异有统计学意义(均P<0.01)。②OVA6W、OVA12W组与OVA2W组比较,0级、1级上皮细胞损伤均差异有统计学意义(均P<0.01);实验组0级、1级上皮损伤与相应的对照组相比差异有统计学意义(均P<0.05)。③鼻黏膜杯状细胞增生和基膜胶原沉积,OVA6W、OVA12W组与OVA2W组比较均差异有统计学意义(均P<0.01);对照组杯状细胞数均较相应的实验组明显减少(均P<0.05);Sal6W、Sal12W组基膜胶原沉积均较相应的实验组明显减少(均P<0.05)。④OVA6W、OVA12W组与OVA2W组比较,TGF-β1的表达均差异有统计学意义(均P<0.01);实验组与相应的对照组比较,TGF-β1的表达均差异有统计学意义(均P<0.01)。结论:鼻黏膜上皮细胞损伤、杯状细胞增生和细胞外基质胶原沉积是变应性鼻炎鼻黏膜组织重塑的特点;在抗原激发早期,表现为上皮损伤,与重塑相关的细胞因子表达增强,随着抗原刺激延长,表现出腺体增生和胶原沉积的特征越明显。     

The influence of the normal turbinate mucosa on nasal airflow

Summary In an attempt to determine the influence of the turbinate mucosa on nasal airflow resistance, we measured the nasal resistances in seven patients who had no lateral walls on one side of their nasal cavities because of unilateral operative removal of maxillary tumors. We compared resistances on the operated side with the normal unoperated side. No significant differences were found either on inspiration or expiration. Additionally, no significant influence of the turbinate mucosa on nasal airflow resistance was detected in sitting subjects.