Bactrim reduces the inflammatory response in a murine model of acute rhinosinusitis

OBJECTIVE: To determine whether treatment with an antibiotic (trimethoprim-sulfamethoxazole) reduced the inflammatory response in a murine form of Streptococcus pneumoniae-induced rhinosinusitis. DESIGN: We randomized 18 C57BL/6 mice to either treatment with intraperitoneal trimethoprim-sulfamethoxazole (Bactrim, 30 mg/kg) or no treatment (control). After 2 days, we inoculated all C57BL/6 mice intranasally with a Bactrim-susceptible strain of Streptococcus pneumoniae, ATCC 49619, suspended in Trypticase soy broth. At day 5 after bacterial inoculation, we sacrificed the mice and prepared histopathologic sections of their sinuses after culturing their nasal cavities by lavage. SETTING: Animal care facility at a tertiary, academic institution. METHODS: The histopathologic sections of the sinuses were examined in a blind manner for the percent of sinus cavity area occupied by neutrophil clusters, and for the number of neutrophils per square millimeter of sinus mucosa. RESULTS: The Bactrim group had a significantly smaller sinus area occupied by neutrophil clusters (1.58% +/- 1.13 vs 4.38% +/- 3.41; P < 0.05), significantly fewer neutrophils infiltrating the mucosa (58.81 +/- 29.63/mm2 vs 105.85 +/- 48.49/mm2; P < 0.05), and significantly less growth of Streptococcus pneumoniae colonies in the intranasal cultures (8 few and 1 moderate vs 3 few, 3 moderate, and 1 many; P = 0.05) compared to the control group. CONCLUSION: In our murine model of acute rhinosinusitis, Bactrim decreased the number of neutrophil clusters in the sinus cavities, the number of neutrophils infiltrating the sinus mucosa, and the growth of Streptococcus pneumoniae. We propose that our murine model can be used for the study of the pathophysiology and treatment of acute rhinosinusitis.     

Effect of genetic background on the response to bacterial sinusitis in mice

OBJECTIVE: To study the importance of ongoing allergen exposure and TH1/TH2 genetic background in augmented bacterial and inflammatory responses in allergic and infected mice. DESIGN: BALB/c and C57BL/6 mice were made allergic to ovalbumin. After 1 day of intranasal allergen exposure, they were inoculated intranasally with Streptococcus pneumoniae. The numbers of bacteria and inflammatory cells in the sinuses were determined, and nasal responsiveness to histamine was assessed. RESULTS: Infected BALB/c and C57BL/6 mice that received ongoing ovalbumin challenge following intraperitoneal sensitization showed significantly greater bacterial load and phagocyte level compared with the infected-only mice. Differences were diminished after the allergen challenge was stopped. Allergic and infected C57BL/6 mice showed fewer bacteria and phagocytes compared with the allergic and infected BALB/c mice. Surprisingly, in contrast to the nonallergenic C57BL/6 mice, the infected BALB/c mice showed a larger number of bacteria 28 days after infection. CONCLUSIONS: Ongoing allergic reaction augments bacterial load in both BALB/c and C57BL/6 mice and induces nasal hyperreactivity to histamine. Allergic and infected C57BL/6 mice show less allergic inflammation and bacterial load compared with allergic and infected BALB/c mice. Stopping allergen exposure reduces the response. Infected BALB/c mice, which favor a TH2 response, were less able to clear infection than C57BL/6 mice, which favor a TH1 response. Inflammation and bacterial load are affected by genetic background of mice and ongoing allergen stimulation.     

A comparative experimental study between recombinant active gene 1-deficient mice and C57BL/6 mice model of acute bacterial rhinosinusitis]

OBJECTIVE: To explore the infective course of acute bacterial rhinosinusitis in recombinent active gene 1 (Rag 1)-defecient mice (Rag1) and C57BL/6 mice (C57) and the difference between them after intranasal streptococcus pneumoniae inoculation. METHODS: Ten mice of each strain (Rag1 and C57) received Streptococcus pneumoniae strain T59, ATCC 49,619 suspended in trypticase soy broth, and controls (two mice for each strain) received trypticase soy broth alone. After 2, 5, 10 and 14 days, nasal lavage cultures were obtained and then the mice were killed. The heads were embedded with paraffin and serial sections were made for histological analysis. The percentage of sinus cavity occupied by neutrophil cluster (% cluster) and the number of polymorphonuclear leukocytes per square millimeter of sinus mucosa (PMN/mm2) were calculated by the use of a computer-aided microscope in conjunction with a reconstruction and image analysis system. RESULTS: % Cluster and PMN/mm2 in infected mice both of Rag1 and C57 appeared to peak on five and ten days separately, which were significantly heavier than those in controls(P < 0.05). The infection in C57 decreased by two weeks. But in contrast to C57, the infection in Rag1 had not been controlled and Streptococcus pneumoniae were still seen in the nasal lavage culture by two weeks. This difference between infected Rag1 and infected C57 was significant at P < 0.05. CONCLUSION: Acute bacterial rhinosinusitis in Rag1 and C57 mice were successfully induced by intranasal inoculation of streptococcus pneunoniae. This bacterial infection in C57 could be controlled completely and rapidly. In contrast, Rag1 failed to control rhinosinusitis and had a tendency to chronic inflammation, suggesting that T- and B-cell-dependent immunity was important for clearance of bacteria from rhinosinus and gene knockout mice was a convenient tool for investigation of the pathogenesis of experimental rhinosinusitis.     

重组活化基因1缺陷鼠和正常小鼠急性细菌性鼻窦炎模型的比较研究

目的　探讨C5 7BL/ 6J 重组活化基因 1(recombinantactivegene 1,Rag1)敲除鼠 (简称Rag1小鼠 )和C5 7BL/ 6 (C5 7)小鼠急性细菌性鼻窦炎的自然感染过程及二者之间的差别。方法　Rag1缺乏鼠和C5 7小鼠各 10只 ,采用鼻孔内接种肺炎链球菌T5 9,另外 4只接种大豆肉汤作对照。分别于接种2d(各 2只 )、5d(各 4只 )、10d(各 2只 )、14d(各 2只 )处死动物 ,对照组于第 5天处死。处死前作鼻腔灌洗培养 ,头颅石蜡包埋 ,连续切片 ,Luna染色 ,计算机辅助光镜观察 ,计算窦腔内中性粒细胞集落所占窦腔的百分率和每平方毫米窦腔黏膜中浸润的多形核白细胞数。结果　接种 5dRag1小鼠和C5 7小鼠窦腔感染均达到高峰 ,窦腔中白细胞集落和黏膜中白细胞数均明显高于对照组 (P <0 0 5 ) ,10d后C5 7小鼠窦腔感染逐渐减轻 ,14d后基本控制 ,而Rag1小鼠感染持续存在 ,与C5 7比较差异有显著性(P <0 0 5 ) ,14d后鼻灌洗液中仍培养出肺炎链球菌。结论　采用肺炎链球菌T5 9鼻内接种法成功地诱导出Rag1和C5 72种小鼠急性鼻窦炎 ,肺炎链球菌在C5 7小鼠鼻腔鼻窦内的感染可被完全、自主、快速控制 ,但Rag1小鼠则不能完全控制这种感染 ,并有演变成慢性炎症的倾向 ,提示T和B淋巴细胞依赖性免疫功能在清除细菌感染中起着关键的作用 ,基因敲除     

Evaluation of importance of Toll-like receptor 4 in acute Streptococcus pneumoniae sinusitis in mice

OBJECTIVES: To investigate the effect of RC-527, a synthetic toll-like receptor 4 (TLR4) agonist, on stimulating the immune response before acute Streptococcus pneumoniae sinusitis in a mouse model, and to determine the importance of TLR4 in modulating the response to S. pneumoniae. Toll-like receptor 4 agonists have been shown to induce protective innate immune responses when administered before some bacterial or viral challenges in mice. DESIGN: We intranasally inoculated BALB/c, TLR4 complex-deficient C3H/HeJ, and wild-type C3H/HeOuJ mice with S. pneumoniae 24 hours after treatment with 10 or 1 microg of RC-527 or vehicle. Bacterial counts from nasal lavage culture and the cell markers GR1, CD11b, CD3, CD4, and CD8 in sinus tissue were quantified at postinoculation days 2, 5, and 14. MAIN OUTCOME MEASURE: Immune response induced by RC-527. RESULTS: Treatment with RC-527 induced an immune response through TLR4, as demonstrated by recruitment of phagocytes in uninfected wild-type C3H/HeOuJ mice, but not in TLR4 complex-deficient C3H/HeJ mice. The immune response was also demonstrated by a significant increase of CD3+, CD4+, and CD8+ T cells in infected and uninfected wild-type C3H/HeOuJ mice, but not in TLR4 complex-deficient C3H/HeJ mice. However, the enhancement of the immune response induced by the TLR4 agonist showed a limited effect on bacterial clearance. CONCLUSIONS: Our studies in mice suggest that stimulation of TLR4 plays a minor role in the overall response to S. pneumoniae infection of the upper airway, and stimulating this receptor before infection does not significantly enhance the immune response of immunocompetent mice to clear S. pneumoniae infection.     

Survey anatomy of the paranasal sinuses in the normal mouse

OBJECTIVE: To provide researchers with a survey atlas of normal paranasal sinus anatomy in the mouse as well as to standardize the reporting of data within the murine nose and sinuses. STUDY DESIGN: Histologic and radiographic study in mice. METHODS: C57BL/6 mice were killed and their heads sectioned in the axial and coronal planes as well as imaged using a small animal micro-computed tomography (CT) scanner. Distinctive regions within the nose and paranasal sinuses were delineated and labeled A to G for identification. RESULTS: Definable regions within the normal murine nose and paranasal sinuses include A) the nasal airway, B) the superior nasal vault, C) the osteomeatal complex, D) the anterior ethmoid sinuses, E) the posterior ethmoid sinuses, F) the true maxillary sinus, and G) the secondary maxillary sinus. Mice also possess discernible sphenoid sinuses. CT scans confirmed the histologic plane of section. CONCLUSIONS: A survey atlas of normal murine sinonasal anatomy shall provide laboratories seeking to use mice in sinus research a reference for beginning their work. As new transgenic and gene knockout mice become available, phenotypic changes in sinonasal architecture can be more easily discerned using such a reference. Defining specific regions (A-G) within the sinuses will standardize the nomenclature used for reporting data.     

Chronic bacterial rhinosinusitis: description of a mouse model

OBJECTIVES: To survey normal murine sinonasal anatomy and to create a mouse model for chronic bacterial rhinosinusitis. DESIGN: Anatomic, histologic, and pathophysiologic study displaying normal murine sinonasal anatomy and surgically created unilateral sinonasal inflammation. SUBJECTS: Twenty-one 6-week-old, male C57BL/6 mice. INTERVENTIONS: Animals that underwent unilateral maxillary sinus ostial obstruction using Merocel nasal packing, animals with unilateral Bacteroides fragilis inoculation alone, and animals with both ostial obstruction and bacterial inoculation were examined at 4 weeks for histologic evidence of chronic sinonasal inflammation. Experimental interventions were compared with contralateral control sinuses within each animal and with normal and sham-operated controls. RESULTS: Normal mouse paranasal sinuses include maxillary sinuses, ethmoid air cells, and respiratory-type epithelium. In experimental animals, the lateral maxillary sinus wall, nasal septum, and superior turbinelle of the maxillary sinus were examined histologically. Epithelial thickening and disarray, goblet cell hyperplasia, inflammatory infiltrates, and sinonasal fibrosis were present in the experimental sinuses of animals packed with Merocel alone or Merocel with bacterial inoculation. Changes seen with Merocel and bacteria were more dramatic than those with Merocel alone. Sham-operated controls and sinuses inoculated with bacteria alone did not differ significantly from the sinuses of normal animals. CONCLUSION: Unilateral maxillary sinus ostial obstruction using Merocel nasal packing along with B fragilis inoculation results in a persistent, localized bacterial rhinosinusitis in mice.     

小鼠急性细菌性鼻及鼻窦炎模型

目的建立小鼠急性细菌性鼻及鼻窦炎模型。方法 179只BALB/c/小鼠,随机分为4组。A、B组BALB/c小鼠右侧鼻腔中塞入棉条。A组,以耐甲氧西林金黄色葡萄球菌（methicillin resistant Staphylococcus aureus,MRSA）COL菌悬液浸润棉条;B组,以无菌生理盐水浸润棉条;C组,只在小鼠鼻腔中滴入MRSA COL菌悬液;D组,对照组。动物分别于1、4、7、14 d处死。对鼻部组织做细菌培养和病理切片研究。死亡的3只小鼠（A组）未计人数据统计中。结果 A组小鼠全部诱导出急性细菌性鼻及鼻窦炎,B组小鼠可诱导出鼻腔炎症反应。炎症程度经统计学分析,A、B组有明显统计学差异。C、D组小鼠没有出现炎症反应。结论以植入膨胀海绵并滴入菌液的方式成功建立小鼠急性细菌性鼻及鼻窦炎模型。     

小鼠变应性鼻炎合并急性细菌性鼻窦炎的初步研究

目的 探讨变应性鼻炎动物模型合并急性细菌性鼻窦炎的方法.方法 清洁级C57BL6/J小鼠40只,随机分为4组:A组(卵清蛋白+肺炎链球菌);B组(卵清蛋白+生理盐水);C组[磷酸盐缓冲溶液(phosphate buffered solution,PBS)+肺炎链球菌];D组(PBS+生理盐水),每组各10只.①实验第1～9天,A组和B组每天腹腔注射200μl 10%卵清蛋白,第10～17天A、B组用6%卵清蛋白鼻腔局部激发建立变应性鼻炎模型,C组和D组用等量PBS替代,步骤同前;②于实验第13天A组和C组鼻腔接种肺炎链球菌ATCC 49619 200μl;B组和D组用等量生理盐水代替.接种后第6天处死动物,处死前各组动物行内眦静脉采血,以间接酶联免疫吸附试验检测血清白介素5水平.取鼻面骨,石蜡包埋,连续切片,行HE染色和0.5%甲苯胺蓝染色,计算机辅助显微镜下观察肥大细胞脱颗粒情况,并计算每平方毫米鼻窦黏膜中多形核中性粒细胞和嗜酸粒细胞的数量.结果 A组和B组分别有9只和8只动物变应性鼻炎建模成功,鼻部症状、黏膜水肿和黏膜下微血管明显扩张,C组症状轻微,D组无任何症状.A组鼻窦黏膜多形核中性粒细胞密度(-x±s)为(139.3±26.5)个/mm2,高于B组(70.7±16.7)个/mm2、C组(63.0±14.7)个/mm2和D组(40.2±14.1)个/mm2(P值均＜0.01);A组和B组嗜酸粒细胞密度和白介素5水平(-x±s)分别为(134.6±25.5)个/mm2、(48.2±13.9)pg/ml和(116.2±25.2)个/mm2、(40.8±7.8)pg/ml,均高于C组(16.7±2.7)个/mm2、(23.9±8.7)pg/ml(P值均＜0.05)和D组(13.4±4.9)个/mm2、(24.6±6.5)pg/ml(P值均＜0.05).结论 变应性鼻炎合并细菌性鼻窦炎造模成功.     

国产C57和BALB／c小鼠年龄相关性听力损失的畸变产物耳声发射检测

目的通过对国产C57和BALB/c近交系小鼠不同日龄时DPOAE的检测,探讨其听力随年龄变化的趋势.方法对不同日龄国产C57和BALB/c近交系小鼠进行DPOAE测试,设定初始音f1、f2(f1/f2=1.22),其强度L1=70dBSPL,L2=65dBSPL,在频率[(f1·     

Age-related loss of distortion product otoacoustic emissions in four mouse strains

Changes in cochlear function in four inbred strains of mice, CBA/CaJ (CBA), C57BL/6J (C57), BALB/cByJ (BALB), and WB/ReJ (WB), previously used to study age-related hearing loss, were evaluated serially as a function of age with 2f(1)-f(2) distortion-product otoacoustic emissions (DPOAEs). DPOAE levels in response to equilevel primary tones for geometric-mean (GM) frequencies from 5.6 to 48.5 kHz were recorded systematically as DP-grams and response/growth or input/output (I/O) functions at monthly intervals from about 2 to 15 months of age. Over the approximate 13-month measurement period, CBAs showed robust and unchanged DPOAEs for all tested frequencies, while BALBs, C57s, and WBs showed strain-specific, age-related decreases in DPOAEs that progressed systematically from the high to low frequencies. Specifically, for the youngest WBs at 2 months of age, no DPOAEs were recordable for GM frequencies > or = 32 kHz, while C57s and BALBs reached the identical stage of cochlear dysfunction by 5 and 8 months, respectively. The differential decline in DPOAE activity shown for WB, C57, and BALB mice supports the notion that they represent unique animal models of age-related changes in cochlear function. In contrast, the unchanging DPOAEs for CBAs over the same time period indicate that this strain makes an effective control for normal cochlear function in the mouse, at least, up to 15 months of age.     

Experimental study of Gougerot-Sj?gren disease in mice. Initial results]

The mouse was selected to provide an experimental model for Sj?gren's disease. A comparative study was made between the normal mouse (C 57 Bl 6) and the spontaneously auto-immune mouse (NZB) from an immunological and scintigraphic standpoint. The first immunological results involve study of the effects of sub-mandibulectomy on the thymus of the C 57 Bl 6 mouse. The are of little significance. First scintigraphic results show marked differences from the point of view of the uptake and excretion of Technetium 99 between normal old mice (17 months) (C 57 Bl 6) and those with spontaneous auto-immune behavior. Dynamic graphs of the uptake and excretion of Technetium 99 in the latter are closely similar to those found in mice after sub-mandibulectomy.     

C57BL/6J小鼠听力及耳蜗毛细胞活性的年龄相关性研究

目的 建立年龄相关性听力损失(age-related hearing loss,AHL)的小鼠动物模型,探讨C57BL/6J小鼠发生AHL与毛细胞活性变化的关系,并初步对C57BL/6J小鼠AHL模型进行AHL的病理分类.方法 按3、8、9、10、17、18月龄段分6组培育C57BL/6J小鼠,各组分别进行听性脑干反应(ABR)测试,对耳蜗毛细胞行琥珀酸脱氢酶染色并作基底膜硬铺片,观察各年龄段小鼠内外毛细胞线粒体琥珀酸脱氢酶的活性.结果 C57BL/6J小鼠随年龄增大,ABR阈值明显增高,在3月龄到9月龄期间ABR平均反应阈值增大比较缓慢,差异无统计学意义;在10月龄时,出现明显的听力下降,平均阈值比3月龄时约高18～23 dB,差异有统计学意义(click:t=5.78,P＜0.01;6 kHz:t =3.93,P＜0.01;8 kHz:t=3.01,P＜0.05).10月龄后小鼠听力继续下降,21月龄时平均阈值比3月龄时增高约60～68 dB,差异有显著统计学意义(click:t=31.23,P＜0.01;6 kHz:t=30.44,P＜0.01;8 kHz:t=33.83,P＜0.01).琥珀酸脱氰酶染色显示,随年龄增大,毛细胞线粒体活性丧失逐渐加重:先是底回外毛细胞活性下降,接着发生活性消失,并逐渐向顶回发展,最后累及内毛细胞.结论 C57BL/6J小鼠具有典型的年龄相关性听力损失特点,其听力下降的原因早期可能主要足外毛细胞及内毛细胞活性的丧失,晚期可能是由于基底膜结构混乱,导致电生理屏障消失,致耳蜗内电位(EP)不能维持而引起.C57BL/6J小鼠可作为感音型老年性听力损失动物模型.     

Reduction in Sharpness of Frequency Tuning but not Endocochlear Potential in Aging and Noise-Exposed BALB/cJ Mice

Schuknecht proposed categories for human age-related hearing loss (ARHL) based upon whether the primary degeneration involves the organ of Corti (sensory ARHL), spiral ganglion cells (neural), stria vascularis (strial), or a combination of these (mixed). Genetically standardized mouse ARHL models can help validate Schuknecht's framework and clarify the underlying cellular processes. Much recent work has focused on the mouse Ahl locus, which promotes both ARHL and noise-induced hearing loss. On the C57BL/6 inbred background, Ahl has been associated with degeneration of organ of Corti, afferent neurons, and stria vascularis/spiral ligament, suggesting that it promotes mixed (sensory/neural/strial) ARHL. Some cochlear degeneration in C57BL/6 mice could be caused by genes other than Ahl, however. The question of what constitutes Ahl-related pathology can be addressed by comparing C57BL/6 mice with other strains that carry the same allele, including BALB/c substrains. We examined the effects of aging and broadband noise exposure in inbred BALB/cJ mice (1.5–13.0 mos) using measures of frequency tuning (compound action potential tuning curves) (CAPTCs), strial function (endocochlear potential recording, EP), and light microscopy. Aging and noise led to generally similar physiological and anatomical changes. Reductions in sensitivity and sharpness of frequency tuning were not consistently linked to hair cell loss, reduction in the EP, or changes in the lateral wall. Instead they appeared best explained by alterations in supporting cells in the basal half of the cochlear and in the spiral limbus in the apex. These results emphasize the importance of cell types other than hair cells in cochlear pathology. They also indicate that Ahl does not necessarily promote a strial form of ARHL.     

Magnetic resonance imaging of the paranasal sinuses: incidental abnormalities and their relationship to patient symptoms.

OBJECTIVES: Magnetic resonance imaging (MRI) is able to demonstrate a wide range of abnormalities in the paranasal sinuses, which are often reported as incidental findings on scans performed for indications other than the evaluation of paranasal sinus pathology. However, the clinical significance of these findings remains undefined. We present a prospective study that determines the prevalence of abnormalities in the paranasal sinuses in a population undergoing MRI scans for suspected intracranial disease. These findings are correlated with clinical data pertaining to nasal and sinus symptoms. STUDY DESIGN: Prospective, cross-sectional study. METHODS: Patients undergoing MRI scans for suspected intracranial pathology were asked to complete a questionnaire pertaining to symptoms of nasal/sinus pathology. The T2-weighted scans of 86 patients (mean age = 51 years) were then reviewed for evidence of paranasal sinus pathology using a standardized method for evaluation and reporting of results. These results were then correlated with those obtained from the patient questionnaire. RESULTS: Radiologic abnormalities were found in the paranasal sinuses of 33 (38%) patients. Abnormalities were most commonly seen in the ethmoid sinuses (44.8%) followed by the maxillary (38%), sphenoid (14%), and frontal (3%) sinuses. Analysis of the clinical data revealed no significant relationship between the presence of clinical symptoms of nasal and sinus pathology and abnormalities on MRI scan. CONCLUSION: The assessment of inflammatory sinus pathology remains controversial. Based on the results of this study, incidental abnormalities of the paranasal sinuses detected on MRI scan do not appear to be related to clinical symptoms.     

Mucosal immunity of nasopharynx: an experimental study in TCR-transgenic (OVA23-3) mice

The ideal vaccine therapy has been warranted for activation of the mucosal immune response in the upper respiratory tract against various types of microbial infection. However, the precise study in regard to the mucosal route of vaccine administration and its mechanism of action remains to be further investigated. Therefore, to better understand the exact mechanism of nasopharyngeal mucosal immunology, from T-cell aspects, the antigen-specific antibody response was investigated in T cell receptor transgenic (OVA23-3) mice (Tg-mice) and wild type BALB/c mice, in comparison, which were stimulated with repeated nasal antigen challenges of ovalbumin (OVA) together with cholera toxin (CT) or OVA alone. OVA-specific IgA and IgG antibodies were not detected in nasal washings of BALB/c mice when these mice were intranasally stimulated with OVA alone. But they were detected in those of BALB/c mice stimulated with OVA and CT, as we have already reported. Interestingly, OVA-specific IgA and IgG antibodies were significantly higher in nasal washings of Tg-mice stimulated with OVA and CT or OVA alone rather than those of BALB/c mice stimulated with OVA and CT. In line with data of the antibody response, OVA-specific IgA and IgG antibody-producing cells significantly increased in number in nasal passage (NP), nasopharyngeal-associated lymphoreticular tissue (NALT), cervical lymph node (CLN), and spleen (SP) of these mice. In nasal washings of Tg-mice, interferon (IFN)-gamma and interleukin (IL)-4 was detected even with a small amount of antigen. To see the cytokine profile of NALT, NP, CLN, and SP of these mice, various cytokine concentrations were measured in supernatants of these cells cultured in vitro with OVA. As a result, IFN-gamma was detected at significantly higher levels in culture supernatants of lymphocytes sampled from NP, CLN, SP as well as NALT of mice having increased antibody titers in nasal washings. On the other hand, Th2 type cytokines such as IL-4, IL-6 and IL-13 were efficiently detected in culture supernatants of NP, CLN, and SP cells from Tg-mice mice, but not in those from NALT cells of those mice. All these data taken together indicate that helper T cells recruited into nasal mucosa and locally activated in an antigen-specific fashion, as well as NALT T cells, are essential for mounting local antigen-specific antibody responses.     

Evaluating the reproducibility of sinus lavages with a saline solution administered directly in the maxillary sinus of patients after endoscopic sinus surgery

INTRODUCTION: Chronic sinusitis is recognized as having a strong inflammatory component, and failures of endoscopic sinus surgery (ESS) are frequently attributed to persistent inflammation. A test that would allow rhinologists to evaluate the inflammatory state of a patient's sinuses would be helpful to evaluate cases refractory to therapy, determine appropriate medical therapy, and monitor the response to therapy. OBJECTIVES: The goal of this preliminary research is to assess the optimal method of collection and the reproducibility and specificity of sinus lavages. METHOD: Twelve patients who had undergone ESS were recruited. They were divided into two groups according to the persistence of their symptoms and the recurrence of acute sinusitis after ESS. The subjects were seen twice. Three successive lavages were collected from each maxillary sinus and were analyzed by cell count. RESULTS: Intrasession cell counts were most reproducible (Spearman rank correlation .7 for eosinophils and .6 for neutrophils) for the second lavage. Intersession cell counts were highly reproducible for eosinophils (r = .7) for the second lavage. The two-tailed t-test did not reveal any statistically significant differences between the good and the poor outcome groups. CONCLUSION: Assessment of eosinophil cell counts on sinus lavage is a feasible and reproducible method to evaluate the inflammatory state of a patient's sinuses in patients who have undergone ESS.     

Washout of 133-xenon as an objective assessment of paranasal sinus ventilation in endoscopic sinus surgery

Endoscopic sinus surgery (ESS) is today a common method for the treatment of chronic rhinosinusitis. Assessment of the results has been based mainly upon subjective evaluation, and only a few reports present objective measurements. In the present study, the 133-xenon washout technique was used for preoperative and postoperative evaluation of paranasal sinus ventilation in 12 patients selected for ESS. The postoperative half-times (T1/2) of 133-xenon washout were lower in the sinuses with abnormal preoperative half-times (T1/2), especially in the maxillary sinuses, where the postoperative T1/2 was 44 (22 to 150) minutes (median and quartiles, Q1-Q3) as compared with a preoperative T1/2 of 202 (94 to 278) minutes. The postoperative evaluation included a questionnaire and a follow-up visit with endoscopy and measurements of nasal nitric oxide. The results showed that patients who declared a marked reduction in symptoms exhibited significantly improved sinus ventilation. However, no direct correlation was found between improvement in ventilation and symptom improvement. Nine of the 12 patients showed improvement on endoscopy, and these patients also exhibited improved sinus ventilation. The postoperative nasal nitric oxide levels were within the normal range in 11 of the 12 patients; the other patient showed pathological T1/2 values for all paranasal sinuses. The 133-xenon washout technique is thus a method that can be used for objective evaluation of the ventilation of the paranasal sinuses before and after ESS procedures. However, the technique cannot be used to evaluate sinuses with totally obstructed ostia or postoperative sinuses with very wide neoostia, as rapid washout may lead to no activity remaining at the time of measurement.     

Epidemiologic analysis of 72 carcinomas of the nasal cavity and paranasal sinuses

ObjectiveThe aim of this study is to define the epidemiological aspects of carcinoma of the nasal cavity and paranasal sinusesMaterial and methodsWe performed a retrospective study of 72 carcinomas of the nasal cavity and paranasal sinuses. Various sites, age and sex distribution, drug consumption, TNM stage grouping and treatment were reported.ResultsThe average age was 63. Seventy- five percent of patients (54/72) were male and 25% (18/72) female. The site of origin was paranasal sinuses in 46 patients (64%), 30 in ethmoid sinus, 15 in maxillary sinus and 1 in sphenoid sinus. Twenty-six patients (36%) were located in nasal cavity.Squamous cell carcinoma was the most frequent histological type in both localizations. The 5-yea adjusted survival rate for all patients was 60% (IC: 54-66), 36% (IC: 28-44) for paranasal sinus carcinoma and 86% (IC: 79-93) for nasal cavity carcinoma. The 5-year adjusted survival rate according to the T distribution in 46 carcinomas paranasal sinus was 80% T2, 71% T3, 19% T4a and 6% T4b.(p=0.0002).ConclusionsCarcinoma of nasal cavity and paranasal sinuses represent a group of tumors that differ from the rest of carcinomas of the head and neck.     

Vulnerability to noise-induced hearing loss in 'middle-aged' and young adult mice: a dose-response approach in CBA, C57BL, and BALB inbred strains

Vulnerability of the cochlea to noise-induced permanent threshold shifts (NIPTS) was examined in young adult (1-2 months) and 'middle-aged' (5-7 months) CBA/CaJ, C57BL/6J, and BALB/cJ inbred mice. For each age and strain, a dose-response paradigm was applied, whereby groups of up to 12 animals were exposed to intense broadband noise (110 dB SPL) for varying durations. Exposure durations reliably associated with <10% and >90% probability of a criterion amount of NIPTS (determined 2 weeks post-exposure) were identified, and the minimum NIPTS exposure and the slope of the dose-response relation were then derived by numerical modeling. For all three strains, young adult mice were more susceptible to NIPTS than older adults; That is, a shorter exposure was able to cause NIPTS in the younger mice. Strain comparisons revealed that C57 mice were more susceptible than CBAs in the older age group only. At both ages examined, however, BALB mice were most susceptible to NIPTS. When animals with a similar amount of NIPTS were compared, outer hair cell loss in the cochlear base was more widespread in the younger animals. BALB mice appear particularly susceptible to noise-induced outer hair cell loss throughout life. Our data suggest that the mechanism or site of noise injury differs between young adults and older adults, and may depend on genetic background. The finding that both BALB and C57 mice, which show pronounced age-related hearing loss, are also especially vulnerable to noise supports the notion that genes associated with age-related hearing loss often act by rendering the cochlea susceptible to insults.