Co-expression of the TGF-beta1 and TGF- beta2 isoforms in nasal polyps and in healthy mucosa.

BACKGROUND: The formation of nasal polyps is connected with a chronic inflammatory process with the activation of different cytokines. TGF-ss induces fibrosis and acts as a chemoattractant and proliferation factor for fibroblasts. The aim of the study was to evaluate the expression profiles of the genes coding TGF-ss isoforms in nasal polyps with predominately eosinophilic and neutrophilic infiltration and in healthy mucosa and to assess their mutual correlation with the levels of gene transcription. MATERIAL/METHODS: The study group consisted of 24 patients with nasal polyposis. On the basis of the histopathological evaluation there were 16 eosinophilic and 8 neutrophilic polyps. The control group constituted 9 healthy patients. The expression profiles of the genes coding the TGF-ss isoforms were detected using real-time RT-QPCR. RESULTS: TGF-beta1 and TGF-beta2 mRNAs were revealed in 10 patients with eosinophilic polyps. TGF-beta1 transcriptional activity was accompanied by TGF-beta2 transcriptional activity in nasal polyps. TGF-beta2 gene expression in tissues without mRNA for TGF-beta1 was silenced. There was positive correlation between the expressions of the TGF-beta1 and TGF-beta2 isoforms in nasal polyps. TGF-beta1 mRNA was present at higher levels in all control samples than in eosinophilic polyps. An increased TGF-beta1 mRNA expression was accompanied by an increased TGF-beta2 mRNA expression in healthy mucosa. TGF-beta3 showed the most intensive transcriptional activity among the TGF-ss isoforms in both nasal polyps and control tissues. There was no correlation between TGF-beta3 and TGF-beta1 nor between TGF-beta3 and TGF-beta2 transcriptional activity in nasal polyps and normal tissue.

[The profile of expression of transforming growth factor beta1 and TGFbetaRI, TGFbetaRII and TGFbetaRIII genes in nasal polyps]. / Profil ekspresji genów kodujacych TGF-beta1 i jego receptory TGFbetaRI, TGFbetaRII i TGFbetaRIII w polipach nosa.

BACKGROUND: Transforming growth factor beta (TGF-beta) plays an important role in cells proliferation and differentiation as well as in local immunological response. OBJECTIVES: An evaluation of genes expression profile for TGF-beta1 and its receptors TGF-betaRI, TGF-beta RII and TGF-beta betaRIII as well as their potential role in the pathogenesis of nasal polyps in eosynophilic and neutrophilic polyps and in normal nasal mucosa. MATERIAL: Material consisted of 22 patients. Nasal polyps were removed during standard polypectomy or FESS. In the histopathological evaluation there were 16 eosynophilic polyps and 5 neutrophilic ones. The control group consisted of 8 healthy patients from whom healthy nasal mucosa was taken during nasal septoplasty. METHODS: The expression of the genes coding TGF-beta and its receptors was evaluated with the use of RT-PCR technique. RESULTS: TGF-beta1 mRNA was present in 10 eosynophilic polyps out of 16. In neutrophilic polyps group (n = 6) mRNA TGFbeta-1 was present in 3 samples. TGFbeta-1 isoform was present in all the tissues of the control group. It was significantly larger expression of TGFbeta-1 gene in normal mucosa in comparison with eosinophilic and neutrophilic polyps (p < 0.05). The expression of genes coding TGFbetaRI, TGF-betaRII and TGF-betaRIII receptors was obtained in all the polyps and healthy tissues. There was no significant differences in the transcription activity of the receptors in polyps and in the healthy tissue. CONCLUSIONS: Considering regulative function of TGFbeta1 in inflammation processes, its low concentration in nasal polyps tissue may influence on migration and survival of inflammation cells. The high expression of genes coding TGFbetaRI, TGF-betaRII and TGF-betaRIII receptors in all the polyps and healthy tissues, show readiness to transduction of TGFbeta. It may suggest that, less intensive TGFbeta1 expression in nasal polyps may be connected with the presence of other than first TGFbeta isoforms. This problem needs further investigations to set precise role of individual TGFbeta isoforms and other growth factors in the pathogenesis of NSP as their interactions with local cytokines. It may help to work out more effective and specific therapeutic methods in nasal polyps therapy.

[Sepsis in the sphenoiditis patient]. / Posocznica u pacjentki z zapaleniem zatoki klinowej.

INTRODUCTION: We present a case of sepsis caused by isolated sphenoiditis. MATERIAL AND METHOD: The case being described concerns 61-year-old woman treated at the Department of Occupational Diseases of Wroclaw Medical University due to body temperature maintaining for 2 months at above 38 degrees C, leucocytosis reaching 14-16 thousand and weight loss of about 4 kg. Detailed diagnostics did not confirm the preliminary diagnosis of system or neoplastic disease. Bacteriological blood examination revealed the presence of staphylococcus aureus susceptible to Vancomycin and Tienam. The attempt of pharmacological treatment did not produced the expected effect. NMR examination of the facial skeleton proved partial shadowing of the Sphenoidal sinus. The patient was admitted for surgical treatment. After the sphenoidal sinus was cut open, mucopurulent contents was found inside. During microbiological examination, staphylococcus aureus with identical susceptibility was cultured from the mucopurulent contents. After 3-week guided antibiotic therapy, permanent temperature regression and permanent improvement of the patient's condition were achieved. RESULTS: Surgical treatment combined with intensive antibiotic therapy caused the complete regression of symptoms. CONCLUSION: Isolated sphenoiditis occurs rarely but it still is a serious diagnostic and therapeutic problem. Diagnosis delay and disease progress may lead to life-threatening complications.

[Malignant neoplasm of nose and paranasal sinuses in Lower Silesia in years 1992-2001]. / Nowotwory zlosliwe nosa i zatok przynosowych na terenie Dolnego Slaska w latach 1992-2001.

UNLABELLED: Malignant neoplasms of the nose and paranasal sinuses occur rarely but due to late diagnosis and poor treatment effects still remain a serious problem. The aim of the study was the analysis of all nose and paranasal sinus neoplasms treated at Lower Silesia in the years 1992-2001. MATERIAL AND METHODS: In the years 1992-2001 in Lower Silesia region there were 182 patients treated for malignant nose and paranasal sinus tumors. Males outnumbered females significantly with male : female ratio was 1.9:1. Principal management was combined therapy--surgery with radiotherapy in 84% of the cases. Radiotherapy alone was performed in 8.8% and chemotherapy as palliative treatment in 7.1%. Fifteen patients (8.2%) underwent radical neck dissection followed by radiotherapy. RESULTS: The analysed group constituted 79.6% patients with epithelial tumors and 20.4% with nonepithelial tumors. Cases T3-T4 predominated in the material in amount of 77.9% (113). There were 15 T2 cases (10.4%) and none of T1. Most of the tumors (57%) arose from middle segment of ethmomaxillary sinuses. Upper segment tumors constituted 18.6% of cases and lower segment--10.4%. Enlarged lymph nodes were diagnosed in 8.2%. Survival rate analysis in patient treated in the years 1992-2001 revealed 37.9% (69) of 3-year survival and 30.2% (55) of 5-year survival. CONCLUSIONS: Unsatisfactory results of treatment are an effect of a high advanced stage of the tumor while diagnosed. Its direct causes are: asymptomatic course of the disease, localization in complex anatomical structure, not enough experience among medical staff dealing with the disease very rarely.

[Expression of adhesive molecules, angiogenesis markers and protein products of suppressor genes in neoplasms of oral cavity and maxillary sinus]. / Ekspresja czastek adhezyjnych, wskazników angiogenezy i produktów bialkowych genów supresorowych w nowotworach jamy ustnej i zatok szczekowych.

INTRODUCTION: Adhesion molecules, angiogenesis markers and protein products of suppressor genes are potential prognostic indicators in different type of tumours. The purpose of this study was to analyze relations between expression of these markers and clinical as well as histological features of oral cavity and maxillary sinus tumours. MATERIAL AND METHODS: Measurements of expression of CD44, TP53, Nm23 oncoproteins and angiogenesis markers were performed. Forty-three patients treated in years 1985-2000 in the Department of Maxillofacial Surgery of the University Hospital in Wroclaw entered our study. Thirty-two of them were treated for oral cavity cancers. Remaining eleven patients were treated for maxillary sinus cancers. RESULTS: We have shown, there was a positive correlation between the number of the vessels and presence of the nodal metastases; between histological grading and VCAM expression; between CD44 expression and total surface area of the blood vessels. There was also correlation between total surface area of the blood vessels and patients' survival time.

[Malignant tumors of the nose and paranasal sinuses in the years 1992-2001]. / Nowotwory zlosliwe nosa i zatok przynosowych w latach 1992-2001.

On the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment of basic epidemiological data, including the localization of tumor, and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 10 years the trends to change the mentioned above parameters has been examined. The index of morbidity in this period was constant and compareable with figures published earlier. In the analyzed material there is a predominance of males and the sex ratio was 1.45. The majority of cases were between 50-69 years (55%). The most common histopathological diagnosis was carcinoma (58%). The majority of cases of malignant tumors of the nose and paranasal sinuses was diagnosed in the advanced stage T3-T4 (72.3%) with the highest percentage in the middle region. 90% of all cases were treated surgically, but in about 30% it was the only treatment (also in cases of stage T2-T4). In 56% of all patients the surgical procedure was completed by radiotherapy. This data suggest that indications for additional irradiation should be extended.

[Inverted papilloma of the nose and paranasal sinuses: diagnosis and treatment]. / Brodawczak odwrócony nosa i zatok przynosowych--diagnostyka i leczenie.

The authors present a retrospective study of 6 patients with inverted papilloma, which appeared in the material of ENT Clinic in Wroclaw in years 1996-2001. In the group of treated patients, we can recognize 5 men and one woman at the age between 42 to 82. Average age amounted to 62 years. At all the patients the papilloma inversum was diagnosed completely accidentally, during histopathological examination, after having polypectomy or Calwell-Luca operation. Operating treatment was proceeded by performing the CT or NMR test. In four cases the Denker's operation was done, in one case More's and in another one we performed the endoscopy operation (limited changes to ethmoidal labyrinth). The patients stay under the observation for 8 months to even 5 years. In one case we observed a relapse, which occurred after 8 months (patient after the Moure's operation). In all the rest cases a relapse was not identify.