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SEM and TEM electromicroscopic study of chronic inflammated mucosa and polyps
Otolaryngology– Head and Neck Surgery Volume 131 Number 2
R124 SEM and TEM Electromicroscopic Study of Chronic Inflammated Mucosa and Polyps Misko Radoslav Zivic, MD PhD Nis Serbia Yugoslavia
Problem: The subject of this research represents the scanning and electromicroscopic observing of the changes on the surface and morphological structures of the chronic inflammated mucosa and polyps of the paranasal cavities, as well as their ultra-structural changes (number of the goblet cells, their activity, and their ciliar structure). Methods: Clinical material used for the research comes from about 20 hospitalized patients from the Clinic for Otorhinolaryngology, Clinical Center, Nis, with the trepanation of the maxillary sinus procedure according to Caldwell-Lucc. Pieces of mucosa were first fixed in 2.5% of glutaralaldehyde for the transmisional electromicroscopia. The SEM was used in researching the cell shapes and surfaces of the tissues.The JOEL electron microscope, with magnification capacity of 400 –90,000 times, was used in the research and scanning. Results: There were an abnormally increased number of goblet cells compared to the cylindrical cells, which is not in keeping with the normal mucosa. The reduction of number, size, length, and distribution of the cilia is on the cylindrical cells. It is interesting that the goblet cells can also be researched in the deeper parts of lamina epithealis, in whose segments of the cells that are nearer to the surface multiphase of the secretorial activity can be observed and researched. Conclusion: (1) Denudation and reduction of the cell rows and metaplasia of the goblet cells have been observed. (2) These lead to the prevention of the expression of the secretorial IgA, which disturbs the mucosal immunity. (3) The syndrome of the immotile cilia causes the absence of the mucociliar transport. (4) This leads to the impossibility for the bacteria, fungi, viruses, and particles inhaled to be adequately and qualitatively removed at the same time, leading to con-
ditions for the genesis of the chronic infections of mucus of the sinuses. Significance: The presence of the denudation and reduction of the cell rows and the goblet cell metaplasia, which reduce the barrier function of mucosa, causes clinical symptoms including running and obstruction of the nose, etc. Support: None repored.
R125 Immunopathology of Nasal Polypi Bhalchandra P. Kolwadkar, MS (ENT); Nitin R. Ankale, MBBS MS(ENT); Kishore Bhat, MBBS.MD(micro); R.N. Patil, PhD; N D Zingade, MS (ENT); Joaquim Mullol, MD PhD Nagpur India; Belgaum India; Belgaum India; Belgaum India; Belgaum India; Barcelona Spain
Problem: To date the etiology of nasal polyposis is not clear. The present study was undertaken as an attempt to establish the role of immunoglobulins IgG, A, M, and E in the production of nasal polypi and to correlate this clinically with the histopathological findings in order to establish the etiology of nasal polypi. Methods: This was a case-control type of study carried out on 50 patients operated on for nasal polyposis. The part of the polyp specimen was sent for histopathology and from the rest polyp fluid was extracted and stored at ⫺20°C. Depending on histology, the patients were divided into an allergic and an inflammatory group with age- and sex-matched healthy individuals as a control group. IgE was estimated by ELISA whereas IgG, IgA, and IgM were quantitated via the single radial immunodiffusion technique. Results: The incidence of allergic polyps (68%) was greater compared to inflammatory (32%).The rise in the serum IgE level in the allergic polyp group was twice (P ⬍ 0.001) that of the control group and polyp fluid IgE levels were significantly high(P ⬍ 0.001) when compared to serum IgE levels in the allergic group. Polyp fluid IgA levels were high when compared with serum IgA levels in the inflammatory polyp group. Conclusion: IgE plays an important role in the etiology of nasal polyposis, since significantly high values of IgE have been found to be produced locally. The increased number of eosinophils in polyps are also evidenced to support the IgE mediated type I hypersensitive reaction. Significance: This study demonstrates that allergic processes acting locally on the mucous membrane of the nose, combined with infection are significant factors in the genesis of nasal polypi. Therefore in all patients of nasal polyposis, antiallergic treatment should be started before any surgical intervention and should be continued postoperatively to minimize the chances of recurrence. Daily nasal washes with saline should be encouraged. Support: None reported.
POSTERS
Results: The mRNAs for both peptides were detected in human turbinate mucosa and nasal polyp. In situ hybridization revealed that they were localized in the epithelial layer and submucosal glands of inferior turbinate mucosa and in the epithelial layer of nasal polyp. However, their expression was noted at low levels in the superficial epithelium of nasal polyp, compared with that of inferior turbinate mucosa. Conclusion: It is detected that the presence of mRNAs for the human guanylin and uroguanylin in human inferior turbinate mucosa and nasal polyp. Significance: Guanylin and uroguanylin in the nasal mucosa may participate in normal physiological processes, but also suggest that altered expression of these genes in nasal polyp may cause impaired electrolyte and water transport across the epithelial cells. Support: None reported.
Research Posters P191
R124 SEM and TEM Electromicroscopic Study of Chronic Inflammated Mucosa and Polyps Misko Radoslav Zivic, MD PhD Nis Serbia Yugoslavia
Problem: The subject of this research represents the scanning and electromicroscopic observing of the changes on the surface and morphological structures of the chronic inflammated mucosa and polyps of the paranasal cavities, as well as their ultra-structural changes (number of the goblet cells, their activity, and their ciliar structure). Methods: Clinical material used for the research comes from about 20 hospitalized patients from the Clinic for Otorhinolaryngology, Clinical Center, Nis, with the trepanation of the maxillary sinus procedure according to Caldwell-Lucc. Pieces of mucosa were first fixed in 2.5% of glutaralaldehyde for the transmisional electromicroscopia. The SEM was used in researching the cell shapes and surfaces of the tissues.The JOEL electron microscope, with magnification capacity of 400 –90,000 times, was used in the research and scanning. Results: There were an abnormally increased number of goblet cells compared to the cylindrical cells, which is not in keeping with the normal mucosa. The reduction of number, size, length, and distribution of the cilia is on the cylindrical cells. It is interesting that the goblet cells can also be researched in the deeper parts of lamina epithealis, in whose segments of the cells that are nearer to the surface multiphase of the secretorial activity can be observed and researched. Conclusion: (1) Denudation and reduction of the cell rows and metaplasia of the goblet cells have been observed. (2) These lead to the prevention of the expression of the secretorial IgA, which disturbs the mucosal immunity. (3) The syndrome of the immotile cilia causes the absence of the mucociliar transport. (4) This leads to the impossibility for the bacteria, fungi, viruses, and particles inhaled to be adequately and qualitatively removed at the same time, leading to con-
ditions for the genesis of the chronic infections of mucus of the sinuses. Significance: The presence of the denudation and reduction of the cell rows and the goblet cell metaplasia, which reduce the barrier function of mucosa, causes clinical symptoms including running and obstruction of the nose, etc. Support: None repored.
R125 Immunopathology of Nasal Polypi Bhalchandra P. Kolwadkar, MS (ENT); Nitin R. Ankale, MBBS MS(ENT); Kishore Bhat, MBBS.MD(micro); R.N. Patil, PhD; N D Zingade, MS (ENT); Joaquim Mullol, MD PhD Nagpur India; Belgaum India; Belgaum India; Belgaum India; Belgaum India; Barcelona Spain
Problem: To date the etiology of nasal polyposis is not clear. The present study was undertaken as an attempt to establish the role of immunoglobulins IgG, A, M, and E in the production of nasal polypi and to correlate this clinically with the histopathological findings in order to establish the etiology of nasal polypi. Methods: This was a case-control type of study carried out on 50 patients operated on for nasal polyposis. The part of the polyp specimen was sent for histopathology and from the rest polyp fluid was extracted and stored at ⫺20°C. Depending on histology, the patients were divided into an allergic and an inflammatory group with age- and sex-matched healthy individuals as a control group. IgE was estimated by ELISA whereas IgG, IgA, and IgM were quantitated via the single radial immunodiffusion technique. Results: The incidence of allergic polyps (68%) was greater compared to inflammatory (32%).The rise in the serum IgE level in the allergic polyp group was twice (P ⬍ 0.001) that of the control group and polyp fluid IgE levels were significantly high(P ⬍ 0.001) when compared to serum IgE levels in the allergic group. Polyp fluid IgA levels were high when compared with serum IgA levels in the inflammatory polyp group. Conclusion: IgE plays an important role in the etiology of nasal polyposis, since significantly high values of IgE have been found to be produced locally. The increased number of eosinophils in polyps are also evidenced to support the IgE mediated type I hypersensitive reaction. Significance: This study demonstrates that allergic processes acting locally on the mucous membrane of the nose, combined with infection are significant factors in the genesis of nasal polypi. Therefore in all patients of nasal polyposis, antiallergic treatment should be started before any surgical intervention and should be continued postoperatively to minimize the chances of recurrence. Daily nasal washes with saline should be encouraged. Support: None reported.
POSTERS
Results: The mRNAs for both peptides were detected in human turbinate mucosa and nasal polyp. In situ hybridization revealed that they were localized in the epithelial layer and submucosal glands of inferior turbinate mucosa and in the epithelial layer of nasal polyp. However, their expression was noted at low levels in the superficial epithelium of nasal polyp, compared with that of inferior turbinate mucosa. Conclusion: It is detected that the presence of mRNAs for the human guanylin and uroguanylin in human inferior turbinate mucosa and nasal polyp. Significance: Guanylin and uroguanylin in the nasal mucosa may participate in normal physiological processes, but also suggest that altered expression of these genes in nasal polyp may cause impaired electrolyte and water transport across the epithelial cells. Support: None reported.
Research Posters P191