The Effects of Permeation Enhancers on the Surface Morphology of the Rat Nasal Mucosa: A Scanning Electron Microscopy Study

A rat model has been developed to compare relative morphological changes in the nasal mucosa after exposure to potential membrane permeation enhancers. Scanning electron microscopy was used to characterize gross structural and specific cellular changes following exposure. Micrographs of the rat nasal mucosa were scored in four categories: (1) mucosal surface integrity, (2) ciliary morphology, (3) mucus/extracellular debris, and (4) presence of red blood cells. The order of increasing morphological damage resulting from a 5-min exposure to each surfactant was 0.5% Solulan C-24 0.5% Solulan C-24/0.5% sodium tauro-24,25-dihydrofusidate (STDHF) < 0.5% STDHF < 1.0% STDHF 1.0% Laureth-9 < 1.0% sodium taurodeoxycholate 1.0% sodium deoxycholate. The changes observed in the mucosal morphology after exposure to the various surfactants are in general agreement with data in the literature. This model is able to compare rapidly the relative morphological effects on the mucosal membrane of different nasal formulations.     

影响鼻窦显微手术疗效因素的分析

目的 分析影响鼻窦显微手术疗效的因素。方法 鼻内筛窦手术,经上颌窦手术,上颌窦窦口扩大,中鼻道开窗。结果 ３５９侧鼻窦显微手术,术后１～４年（平均３６．４个月）,随访２８８侧,治愈１０８例（３７．５％）,显著进步８７例（３０．２％）,好转６５侧（２２．６％）,无效２８侧（９．７％）,良好率６７．７％,鼻内筛窦手术良好率６０．６％,经上颌窦手术良好率７２％,上颌窦窦口扩大未闭良好率６０．１％,中鼻开     

Acceptance and effects of nasal lavage in volunteer woodworkers

Wood dust is an irritant and is carcinogenic to the nasal mucosa. It inhibits its own clearance from the nose. It therefore makes sense to lavage retained wood dust from the nose following exposure. To our knowledge this is the second study conducted to determine whether the procedure of nasal lavage reduces nasal symptoms in woodworkers. Forty-six woodworkers from 150 approached volunteered to trial nasal lavage using gravity fed, home-made unbuffered isotonic saline for 2 months in a crossover trial and then be followed-up a year later. The group reported significantly decreased nasal symptoms and over half continued to use nasal lavage voluntarily after 1 year. Results support the findings of the previous study that nasal lavage improves nasal symptoms and supplements those findings with data indicating patterns of voluntary usage following the study's conclusion. It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.     

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.     

The effect of the H2 antagonist cimetidine on the numbers of CD4+ and CD8+ cells in the nasal mucosa of patients with allergic rhinitis

This paper reports the effects of the H₂ antagonist cimetidine on the number of CD4⁺ and CD8⁺ cells in nasal mucosa and the IgE level of nasal secretions in patients with allergic rhinitis. The results showed the numbers of CD4⁺ cells were greater than the numbers of CD8⁺ cells in nasal mucosa, both in the patients with allergic rhinitis and normal subjects, but the ratio of CD4⁺ : CD8⁺ cells was much higher in the patients with allergic rhinitis. After treatment with cimetidine locally for 4 weeks, the numbers of CD4⁺ cells fell and the numbers of CD8⁺ cells increased in the patients with allergic rhinitis. The high IgE level of nasal secretion of the patients with allergic rhinitis was much reduced after treatment with cimetidine. The results suggest that there are high numbers of CD4⁺ cells and lower numbers of CD8⁺ cells in the nasal mucosa and a high level of IgE in the nasal secretions of the patients with allergic rhinitis. Treatment with cimetidine locally may be of some value to relieve the clinical symptoms of allergic rhinitis.     

Is local anaesthesia actually beneficial in flexible fibreoptic nasendoscopy?

Although the application of a topical local anaesthetic before fibreoptic nasendoscopy is routine practice in many otolaryngological outpatients, the actual benefit to the patient of this procedure remains in doubt. Eighty-two patients were recruited in this double-blind randomized control trial which compared the patients’ experiences of fibreoptic nasendoscopy with nasal preparations of Xylocaine^® (lidocaine), normal saline, and no spray to the nose and throat. A visual analogue scoring system was used to determine scores for the overall unpleasantness of procedure, receiving a spray, and taste of the spray, and pain. This study has shown significantly worse overall experience (P = 0.001) and pain (P = 0.048) scores for Xylocaine^® spray versus no spray. It is concluded that the routine use of topical local anaesthetics within the nose before routine fibreoptic nasendoscopy is not only of no value, but actually makes the experience worse for the patient.     

Increased expression of α2-6 linked sialic acids by nasal mucins in allergic rhinitis

Mucins have a polypeptide backbone, oligosaccharide side-chains and peripheral structures that include sialic acids. Several pathogens have specific receptors for sialic acids, including human strains of influenza A virus which preferentially recognise and bind α2-6 linked rather than α2-3 linked sialic acids.¹ 1 NElson J., COuceiro S.S., PAulson J.C. & BAum L. (1993) Influenza virus strains selectively recognise sialyloligosaccharides on human respiratory epithelium; the role of the host cell in selection of haemagglutinin receptor specificity. The aim of this study was to identify possible disease-related changes in the expression of sialic acids in nasal mucins. Nasal mucosal samples were placed in organ culture. Metabolically-labelled mucins were purified by gel filtration, blotted on to nitrocellulose membranes and probed with the sialic acid-binding lectins Sambucus nigra and Maackia amurensis. Ninety-five mucosal samples were collected (49 turbinates, 31 nasal polyps, 15 samples from FESS). Lectin binding, expressed as optical density, showed significantly increased binding of S. nigra to cellular (P = 0.02; Kruskal–Wallis) and secreted (P = 0.045) mucin from allergic mucosa compared to non-allergic mucosa. No significant differences were found in the binding patterns of M. amurensis. This study has demonstrated increased expression of α2-6 linked sialic acids in the mucins synthesised and secreted by allergic compared to non-allergic nasal mucosa. This may cause a change in the way mucins and pathogens interact in allergic rhinitis, leading to altered susceptibility to upper respiratory tract infection.     

复发性鼻窦炎鼻息肉的修正性鼻内镜手术治疗

目的 总结修正性鼻内镜手术治疗复发性鼻窦炎鼻息肉的手术体会。方法 采用MesserKlinger技术对84例复发性鼻窦炎鼻息肉病人行筛窦、蝶窦开放，额窦、上颌窦窦口扩大等修正性手术治疗。结果 治愈51例，好转17例，无效16例。治愈率为60．7％，有效率为80．9％，无效率为19．1％。结论 修正性鼻内镜手术是治疗复发性鼻窦炎鼻息肉的有效方法。选择具有定向定位作用的解剖参照点是手术安全的基础；选择恰当的术式、实施精细的操作是手术成功的关键。结构变异、出血、鼻息肉病等因素是手术失败的原因。     

硅橡胶鼻假体用于唇裂继发鼻畸形术的护理

目的:探讨行硅橡胶鼻假体,矫正单侧唇裂继发鼻畸形术的护理.方法:通过延长鼻小柱,纠正鼻小柱和鼻中隔的偏斜,广泛游离患侧鼻翼软骨,分三点悬吊固定患侧鼻翼软骨,同期植入硅橡胶L型鼻假体整复单侧唇裂继发鼻畸形24例.结果:24例均一期愈合,随访3～12个月效果患者均满意.结论:采用硅橡胶L型鼻假体整复单侧唇裂继发鼻畸形,配合正确护理效果更佳.     

MRI and conservative treatment of locally advanced breast cancer

AIMS: The objectives of this study were to compare the efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the response of primary breast carcinoma to neoadjuvant chemotherapy compared to conventional imaging modalities, and to see how surgical outcome was influenced as a result of these findings. METHODS: Thirty-four patients with locally advanced primary breast cancer underwent conventional imaging and DCE-MRI following six cycles of neoadjuvant chemotherapy prior to surgery. Changes in surgical management based on the post-chemotherapy DCE-MRI findings were recorded. RESULTS: Prior to neoadjuvant chemotherapy, 22 of the 34 patients were assessed as requiring mastectomy and the remaining 12 were considered inoperable. Following chemotherapy two patients were still considered inoperable. In 11 of the 34 patients, the final decision to proceed to either mastectomy or non-surgical management was based primarily on pre-treatment disease status or patient choice. DCE-MRI findings, therefore, contributed to the operative decision in 21 of 34 patients. Two of these 21 patients were spared surgery as DCE-MRI demonstrated complete response to chemotherapy and one declined surgery. The remaining 18 were able to undergo wide local excision, with only two patients subsequently requiring mastectomy for involved margins. CONCLUSIONS: DCE-MRI is able to accurately predict those patients suitable for breast conserving surgery following neoadjuvant chemotherapy and should be the imaging modality of choice in assessing the response of patients with primary breast carcinoma to neoadjuvant chemotherapy.