Two unrelated families with variable expression of Fraser syndrome due to the same pathogenic variant in the FRAS1 gene.

We report on two unrelated families of Polish origin with variable expression of Fraser syndrome (FS; MIM#219000) due to homozygosity for the same pathogenic variant, c.6963_6964dup, of FRAS1. In one family, the disorder presented with perinatal and prenatal lethality. One affected female from family 2 who was followed-up for 32 years, represented a relatively favorable long-term outcome. She displayed the typical craniofacial dysmorphism, including right cryptophthalmos, cutaneous syndactyly, abnormalities of the stomathognatic system, bilateral atresia of the external ear canals resulting in conductive hearing loss, and malformations of the larynx, spleen, kidney, and genitourinary tract. Her intellectual capacities were normal. Our observations illustrate that expression and severity of FS, even when caused by the same pathogenic variant, may be quite different ranging from a lethal disorder to a condition with multiple physical malformations but normal psychomotor development. In addition, we propose that the FRAS1 c.6963_6964dup variant may be a founder mutation in the Polish population. Therefore, it would be reasonable to test specifically for this variant first in any FS1 patient of Polish ancestry.

Selected cytokines in hypertrophic adenoids in children suffering from otitis media with effusion.

OBJECTIVES: The aim of the current study was to assess the levels of MMP-8, MMP-9 and TIMP-1 in the group of children with adenoids who suffered from exudative otitis media. METHODS: The study included 20 patients (10 females and 10 males) with adenoid hypertrophy coexisting with otitis media with effusion. The reference group included 24 patients (10 females and 14 males) with adenoid hypertrophy without otitis media. The levels of MMP-8, MMP-9 and TIMP-1 were determined in supernatants obtained from phytohemagglutinin (PHA)-stimulated cell cultures of the tonsils, using commercial enzyme-linked immunosorbent assay kits (R@D Systems, USA). RESULTS: The median MMP-8, MMP-9 and TIMP-1 concentrations (220.8 ng/mL, 311.1 ng/mL, 53.5 ng/mL, respectively) in the study group were significantly higher (p = 0.000, p = 0.000, p = 0.048, respectively) than those in the reference group (93.5 ng/mL, 112.5 ng/mL, 36.95 ng/mL, respectively). ROC analysis revealed that the area under a curve (AUC) for both metalloproteinases MMP-8 and MMP-9 was 1 with a diagnostic sensitivity of 100% and diagnostic specificity of 95.8%, as compared to 0.690 for TIMP-1. Significant differences were found between the AUC for MMP-8 and TIMP-1 and MMP-9 and TIMP-1 (p < 0.001 for both comparisons). CONCLUSIONS: The changes in the concentrations of MMP-8, MMP-9 and TIMP-1 may indicate an increased remodeling of the extracellular matrix in children with adenoid hypertrophy and otitis media with effusion. The findings can have clinical as well as diagnostic utility. Determination of MMP-8 and MMP-9 may help qualify a child for adenoidectomy and differentiate pediatric patients affected by adenoid hypertrophy with and without otitis media.

Expression of collagens type I and V in healing rat's tympanic membrane.

OBJECTIVES: Our preliminary study performed on perforated rat's tympanic membrane (TM) using Rat Wound Healing RT2 Profiler PCR Array showed significantly increased levels of mRNA for collagens type I and V. Enhanced expression of those genes does not assure that their protein products are indeed present, and in what quantity. Therefore, this study was undertaken to analyze the collagen type I and V content in the healing TM. METHODS: Sixty rats were used, of which 10 served as controls and the others had their TM perforated. The experimental animals were divided into five subgroups on the basis of time points (03, 06, 09, 14, 20 day after injury). Videootoscopy and histology were employed to assess the morphology of the healing process. The expression of collagen type I and V was evaluated using Western blot analysis. Tissue localization of collagens was determined by the immunofluorescence method. RESULTS: The collagen type I expression was three times higher on the third day after injury and remained on that level for whole period of observation, up to day 20. The increase of the collagen type V expression was gradual, reaching the highest level on day 14 following injury. In comparison to the control TM statistically significant increase in the level of expression was observed starting from day 09 to the end of observation period. In healing TM immunofluorescent labeling of collagen type I and V was seen on the surface of remnants of previous lamina propria and in the loose proliferating fibrous tissue. On day 20 immunofluorescence was present mainly on the surface of thin connective tissue layers forming the scar in the place of previous perforation. CONCLUSION: Although the collagens type I and V are present only in subepithelial layer in the normal rat's TM they play significant role in TM healing process.

Lyophilized Cyclamen europaeum tuber extract in the treatment of rhinosinusitis.

Nasal and sinus mucositis is a significant health problem associated with significant organizational and financial burden for the health care system. In recent years, several important guidelines and positions of expert groups and scientific associations have been published with regard to the diagnostics and treatment of rhinosinusitis, including European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2012) [1] and Polish Standards for the Treatment of Rhinitis (PoSLeNN 2013) [2]. The management of viral and postviral rhinosinusitis involves systemic treatment including administration of plant origin products. The goal of this article is to present the current knowledge on the use of intranasal preparations containing natural saponin fractions from the rhizomes of Alpine cyclamen (Cyclamen europaeum). Saponins contained in the extract of Alpine cyclamen (Cyclamen europaeum) rhizomes are surface-active compounds that reduce the surface tension on the nasal mucosal cells while simultaneously stimulating the trigeminal nerve receptors leading to increased production of seromucous secretion and extensive drainage of the nasal and sinus cavities. The analysis of published studies on the efficacy and safety of intranasal products containing lyophilized extracts from Cyclamen europaeum tuber warrants the conclusion that these products are useful in the management of nasal and sinus mucositis due to their beneficial impact on the course of the treatment of acute rhinosinusitis. When used in patients with acute rhinosinusitis, an intranasal preparation containing lyophilized extracts from Cyclamen europaeum tuber efficiently reduces the symptoms, particularly the feeling of pressure and pain in the face. According to the authors of PROSINUS study, single-agent treatment using Cyclamen europaeum extracts is more efficient (in terms of the percentage of success) than other monotherapy or combination regimens.

Presentation, diagnosis and management of neck abscesses in children.

UNLABELLED: The aim of the study was to analyze the presenting signs and symptoms, diagnostic procedures, clinical course, pathogenic organisms and management of neck abscesses in children. MATERIALS AND METHODS: This retrospective medical records review comprised of 51 pediatric cases referred because of neck abscess from 2001 to 2014. Medical records of the patients were reviewed for demographic data, clinical presentation, treatment before referral, localization of the abscess, imaging evaluation, medical and surgical treatment, bacteriological data and complications. RESULTS: Average age of the patients was 4.9 years. 18 (35%) of the children were below one year of age. The submandibular was the most common area involved (41,2%). Contrast-enhanced computed tomography (CECT) was performed in 45% of patients mainly with deep neck abscesses. All CECT scans showed the fluid collections. In all but one of the patients treated surgically and diagnosed with ultrasound and/or CECT surgical intervention revealed presence of pus. The most common pathogen was Staphylococcus aureus- SA (78% of all isolates) of which 24% were methicillin resistant Staphylococcus aureus - MRSA. Clindamycin resistance was detected in 28% of all SA isolates and in 67% (4/6) of all MRSA isolates. All MRSA isolates were sensitive to vancomycin. CONCLUSIONS: CECT is reliable imaging technique for diagnosing deep neck abscesses in children. Infants with neck abscesses are at higher risk of having MRSA as offending pathogen which should be taken into consideration when considering empiric treatment. Vancomycin is recommended as empiric antibiotic therapy in newborns with neck abscess.

Enhanced expression of hepatocyte growth factor in the healing of experimental acute tympanic membrane perforation.

OBJECTIVES: The present study was performed to investigate the expression of hepatocyte (HGF), epidermal (EGF) and vascular endothelial (VEGF) growth factors in the course of healing of experimental tympanic membrane (TM) perforations in rats. The goal was to explain the role of these growth factors in the healing process of TM and to assess the possibility of their future application as healing promoters. METHODS: Seventy rats were used, of which 10 served as controls and the others had their TM perforated. The experimental animals were divided into six subgroups on the basis of time points (01, 03, 05, 07, 09, 15 day after injury). Videootoscopy and histology were employed to assess the morphology of the healing process. The expressions of HGF, EGF and VEGF were evaluated using Western blot analysis. Tissue localization of HGF was determined by the immunofluorescence method. RESULTS: HGF was hardly detectable in normal TM; however, a significant increase was noted in its expression starting from the third day after injury throughout the follow-up period, with the highest level on day 05. The analysis of HGF tissue localization with immunofluorescence revealed diffuse staining in the cytoplasm of proliferating epithelial cells. The expression of EGF was elevated on the first day after injury, not reaching statistical significance, and then returned to the level observed in the control TM. No significant differences were noted in the expression of VEGF. CONCLUSION: High expression of HGF during the healing process of acute TM perforations makes it a promising candidate for further studies oriented towards its possible use in augmentation of TM healing.

[The healing process of tympanic membrane perforations in rats]. / Proces gojenia perforacji blon bebenkowych u szczurów.

INTRODUCTION: Tympanic membrane (TM) perforations are commonly seen in clinical practice as a result of trauma or in the course of otitis media. The TM is a unique structure suspended in air which makes its healing processes different than in the skin wounds. The aim of the study was otoscopical and histological evaluation of the rat's TM healing process. MATERIAL AND METHODS: 56 male Wistar rats were used for the study. Fifty of them had TMs perforated bilaterally using CO2 laser, additional 6 served as a controls. The animals were sacrificed on either day 1, 2, 3, 6 and 10 post injury. Process of healing was assessed otoscopicaly, subsequently TM were dissected and processed for histological evaluation. RESULTS: At day 6 after perforation half and on day 10 all of TM were healed. On the first day, in histological evaluation, focal thickening of the epithelial layer was observed at some distance from the edge of perforation, on the side of annulus. On the following day proliferation of epithelium covering outer surface of TM on the side of the malleus handle and annulus was clearly visible. An eosinophilic mass containing macrophages and granulocytes was seen in front of the migrating epithelium. On day 3-6 migrating epithelium reached the edge of perforation. Proliferation of the connective tissue layer followed the epithelium. CONCLUSIONS: The present results indicate that the squamous epithelium covering the outer surface of TM constitutes the first layer which restores continuity of TM. The proliferation of the connective tissue occurs in the direct vicinity of the proliferating and migrating epithelium.

Expression of Toll-like receptors on peripheral blood white cells in acute otitis media.

OBJECTIVE: From 10 to 15% of children suffer from recurrent acute otitis media (AOM). An association between polymorphism in TLRs and their co-receptor CD14 with otitis media proneness has been described in children. Moreover, the experiments on animal models have shown that TLRs and their signaling molecules are critical for timely resolution of bacterial otitis. AIM: The aim of this study was to determine the expression of TLR1, TLR2 and TLR4 on lymphocytes, monocytes and granulocytes in peripheral blood in children with recurrent or persistent AOM. METHODS: The study was performed on a group of 25 children hospitalized for recurrent AOM, failures of previous treatments and/or acute mastoiditis. The results were compared to the control group of healthy children at the same age. The expression of TLRs on peripheral blood white cells was measured by flow cytometric analysis. The results were expressed as mean fluorescence intensity (MFI). The statistical analysis was performed using the Mann-Whitney U test. RESULTS: The highest expression of TLR was found on monocytes, the lowest on lymphocytes in both groups of children (AOM and the control one). The expression of TLR1 was the lowest and expression of TLR4 was the highest on all examined cells. The expression of all examined TLRs on monocytes was significantly higher in the AOM group. CONCLUSIONS: Peripheral blood monocytes are characterized by increased expression of TLRs in the course of recurrent AOM.

Analysis of gene expression profiles in tympanic membrane following perforation using PCR Array in rats--preliminary investigation.

OBJECTIVES: The goal of this work was to identify genes, known to be involved in the skin wound healing, that express differentially in the healthy and injured tympanic membrane (TM), and designate the molecules potentially beneficial for treatment of TM perforation. The molecular mechanisms controlling the course of TM regeneration are far from being elucidated. METHODS: Twenty rats had their tympanic membranes perforated, while four served as a control. Animals were sacrificed on either days 1, 2, 3, 5 and 10 post injury, and TMs were immediately dissected and frozen in liquid nitrogen. Total TM RNA was isolated and reversely transcribed. qPCR was performed using Rat Wound Healing RT(2) Profiler PCR Array (QIAGEN) containing primers for 84 genes. RESULTS: Statistically significant changes in the expression of 42 genes were found in various stages of TM healing. The increased expression of genes taking part in the inflammatory reaction (interleukin 6, granulocyte and macrophage chemotactic proteins) was observed from day 2. The expression of several genes of extracellular matrix components and their remodeling enzymes was also changed. Among growth factor genes: Vegfa, Igf1 and Hbegf showed increased expression at the beginning of the healing process, while Hgf expression was highest on day 3. CONCLUSIONS: Several changes in the expression of genes involved in remodeling of extracellular matrix point to important role of connective tissue in TM healing. The molecules accelerating this process, like HbEGF and HGF, seem to be good candidates for further evaluation of their possible use in clinical treatment.

[Keratinocyte growth factor and its receptor in middle-ear cholesteatoma]. / Czynnik wzrostu komórek rogowaciejacych i jego receptor w perlaku ucha srodkowego.

AIM: Etiology of middle ear cholesteatoma is far from beeing elicidated. Current concepts postulate that cholesteatoma is the result of disturbed wound healing process. Keratinocyte growth factor (KGF) plays important role in wound healing, so it seemed interesting to assess the expression of KGF and its receptor in the cholesteatoma. MATERIAL AND METHODS: 25 cholesteatoma and 7 retraction pockets specimens were obtained from the patients during middle ear surgery. The expression of KGF and FGFR2 was evaluated by immunohistochemical staining using polyclonal antibodies. The results were analyzed depending on clinical features such as: localization, number of anatomic sites involved and presence of purulent discharge. RESULTS: KGF expression was detected in the cells of subepithelial tissue. It was observed in 4/7 (57%) of the specimens of retraction pockets and 11/25 (44%) of cholesteatoma specimens. FGFR2 expression was observed mainly in the cells of spinous layer of epithelium in 4/7 (57%) specimens of retraction pockets and 19/25 (76%) of specimens of cholesteatoma. Statistically significant (p=0.011) relationship between the presence of KGF expression in the subepithelial tissue and the presence of FGFR2 expression in the epithelium was found. There were no differences in the expression of KGF and FGFR2 between retraction pocket and cholesteatoma specimens. Also, no differences in the expression, depending on localization, extend of the cholesteatoma and presence of purulent discharge were observed. CONCLUSION: KGF and its receptor seem to play an important role in paracrine regulation of cholesteatoma growth.

[Controversies in the treatment of acute otitis media]. / Kontrowersje w zakresie leczenia ostrego zapalenia ucha.

Acute otitis media (AOM) is one of the most frequent diseases in young children and also the most common indication for antibiotic prescribing. It impose substantial burden on pediatricians and general practitioners and leads to negative sequelae and complications in developing countries. Because of growing resistance to antibiotics of respiratory tract pathogens, and the great tendency of AOM to spontaneous resolution there is need for reduction of antibiotic treatment in this disease. The pros and cons of this therapy are presented in this paper. Indications for surgical interventions--adenoidectomy and tympanostomy tubes insertion in cases of recurrent acute otitis media are also presented.

[Influence of tympanic membrane changes on immittance and extended frequency audiometric findings]. / Wplyw zmian strukturalnych blony bebenkowej na wyniki audiometrii impedancyjnej i tonalnej w rozszerzonym zakresie czestotliwosci.

INTRODUCTION: The aim of the study is to analyze the relationship between otoscopic tympanic membrane abnormalities, results of impedanace and extended-high-frequency audiometry in subjects with history of treatment of secretory otitis media (SOM) and ventilation tube insertion. MATERIAL AND METHODS: 97 subjects treated because of SOM were examined in years 1999-2000. Videootoscopic examinations, extended-high-frequency audiometry and tympanometry with ispilateral acoustic reflex were performed in each patient. The results were analysed in three groups: no otoscopic abnormalities (BZO), retraction pockets (KR) and atrophy and myringosclerosis (AM). The results were compared to otologicaly healthy control group in the same age. RESULTS: The most common tympanic membrane abnormality were focal atrophy (64.7%) of ears and myringosclerosis (37.2%). Mean pure-tone audiometric threshold were significantly higher in groups KR and AM than in control and BZO groups. Low degree of positive correlation was found between the presence of myringosclerosis and atrophy and audiometric thresholds above 1 kHz. No such correlation was observed with the presence of retraction pockets. In the BZO group middle ear admittance was observed significantly higher than in control group. The absent ipsilateral stapedial reflex was observed in 10.8% ears in BZO group, 16.9% in AM and 33.3% in KR. No correlation was found between the parameters of tympanometric evaluation and results of extended-high-frequency audiometry. CONCLUSIONS: In ears treated because of SOM with ventilation tube insertion the middle ear compliance is higher. In the presence of myringosclerosis and atrophy higher audiometric thresholds are observed. Tympanic membrane abnormalities have been more clearly indicated by the absent ipsilateral stapedial reflex than tympanometry.

[Long term sequelae of otitis media with effusion during childhood]. / Trwale nastepstwa wysiekowego zapalenia ucha w wieku dzieciecym.

INTRODUCTION: Otitis media with effusion is the most common cause of hearing loss in children and myringotomy with tympanostomy tube insertion is recommended procedure to deal with the problem. The objective of the present study was to determine the results of treatment, incidence and prevalence of middle ear sequelae and hearing results among children with chronic otitis media with effusion who received standard treatment with tympanostomy tubes. MATERIAL AND METHODS: The group of 97 patients treated by tympanostomy tubes insertion in the years 1999-2001 was reevaluated after mean period of follow up 7.3 years. At the control examination videootoscopy and audiologic examinations were performed. Audiological assessment consisted of tympanometry and pure-tone thresholds of air and bone conduction. RESULTS: Recurrent otitis media with effusion requiring tube insertion occurred during follow up period in 23.7% of patients. At the control examination 16.5% of children had an ongoing otitis media or ventilation tube in place or tympanic membrane perforation. Most common tympanic membrane abnormality were focal atrophy (67.2% of ears) and myringosclerosis (39.5%) followed by retraction pockets of pars flaccida (29.9%) and tensa (9.6%). Mean pure-tone audiometric threshold were significantly higher in ears with tympanic membrane abnormality by the difference did not excide 5dB HL in ears with focal atrophy and myringosclerosis and 6.5 dB HL in ears with retraction pockets. CONCLUSIONS: As the percentage of recurrences after tympanostomy tubes insertion are not uncommon prolonged period of follow up of those children is recommended. Although ventilation tubes have proven very effective in improving hearing in short term, they have not proven effective in preventing long-term sequelae of tympanic membrane and some degree of hearing loss. The decision about surgical treatment should be taken cautiously taking into account the chance of spontaneous resolution.

[The status of contralateral ear in children with cholesteatoma]. / Stan ucha konralateralnego u dzieci z przewleklym zapaleniem ucha z perlakiem.

INTRODUCTION: Recently published data indicate that over 60% of patients with middle ear cholesteatoma (MEC) have concomitant changes in the contralateral ear (CE). Studies concerning the condition of the CE are few and rarely present the situation in the pediatric population. THE AIM OF THIS STUDY: was to assess the frequency of pathological changes occurring in the CE in children operated on MEC, as well as to determine their clinical evolution. MATERIAL AND METHOD: Retrospective analysis was performed on basis of medical records of 193 patients treated surgically for MEC in 1998-2008 at the Department of Pediatric Otolaryngology in Bialystok. The comparison of otoscopic evaluation before first operation with the latest examination was undertaken. The evolution of abnormalities was analyzed and the effect of age and type of cholesteatoma was assessed. RESULTS: The opposite ears were abnormal in 46.1% of patients. Most frequently observed changes in the CE were retraction pockets (23%). Cholesteatoma was found in 8 of 45 identified cases of retraction pocket. The incidence of abnormalities in the CE was not correlated with patients age or type of cholesteatoma. Cholesteatoma occurred on both sides in 9,3% of children. In these cases, the attic cholesteatoma was presented in 66.67%, tensa cholesteatoma in 16.67%. CONCLUSIONS: In patients with MEC contralateral ear should be systematically examined to detect early any abnormality, or to assess their evolution and take appropriate treatment.

[Clinical and pathological features of cholesteatoma in young children]. / Cechy kliniczne i patologiczne przewleklego zapalenia ucha z perlakiem u malych dzieci.

INTRODUCTION: Children cholesteatoma have been shown to demonstrate aggressive growth with greater extension and higher rates residual and recurrent disease compared with adults, due to anatomic and physiologic differences. AIM: This study aimed to determine the clinical and pathological features of cholesteatoma in young children less than 7 years of age. MATERIAL AND METHODS: Retrospective review of a group of 23 children (24 ears) who had cholesteatoma surgery between 1996 and 2004. Patients ages ranged from 1.8 to 7 years, follow up from 3.5 to 12 years (mean 7.4). Medical history (previous otorrhea, hearing loss) and contralateral ear status was analyzed. The extent of cholesteatoma and ossicular destruction for attic, pars tensa I and pars tensa II type and congenital of cholesteatoma was graded using of Saleh and Mills classification. Residual and recurrent disease depending on type of cholesteatoma, extent of the disease, type of surgery and contalateral ear status was assessed. RESULTS: Otorrhea and hearing loos are the most common clinical symptoms observed in 90% and 59% children. 70% of treated children had otitis media with effusion and/or its sequel in contralateral ear. 60% of acquired cholesteatomas were classified as S3 and S4 extension during surgery with ossicular destruction in 46% of attic cholestatoma. 75% operated ears had a signs of mucosa inflammation during surgery. Residual cholesteatoma was observed in 38.5% ears with attic cholesteatoma and in 25% with pars tensa I cholesteatoma. CONCLUSION: Acquired cholesteatoma in young children are diagnosed in the advanced stages with ossicular chain destruction. High rate of recidivism after surgery, particularly in attic cholesteatomas is observed. Most of operated ears have symptoms of inflammation of middle era mucosa during surgery and otitis media with effusion in contralateral ear and because of that need long-term follow up and constant observation.

[Propranolol for treatment of subglottic hemangioma]. / Zastosowanie propranololu w leczeniu naczyniaka podglosniowego.

Subglottic hemangiomas are extremely dangerous due to its location and rapid growth during the proliferative phase. Many different treatments are described but these methods are still not satisfactory. Recently propranolol has been used as a new option in hemangioma therapy. We describe a case of 6-week infant with subglottic hemangioma discovered direct laryngoscopy, presented with dyspnoea and inspiratory stridor. After oral propranolol administration all baseline airway symptoms had resolved and endoscopic examination demonstrated significant regression of the hemangioma. We suggest that the propranolol should be used as a first-line treatment in subglottic hemangiomas in children.

[Dendritic cells in hypertrophied adenoid at children with otitis media with effusion]. / Komórki dendrytyczne w tkance przeroslych migdalków gardlowych u dzieci chorych na wysiekowe zapalenie ucha srodkowego.

INTRODUCTION: The adenoids are organized as lymphoepithelial structures that play an important role in protecting both the upper respiratory and alimentary tract regions. This functions requires dendritic cells (DC) which are one of the major populations of immune cells. Due to the presence of specific receptors (DC) are able to respond to both intra- and extracellular antigens. Dendritic cells activating immunological response in tonsil contribute formation immunologic competent cells on necessity of rolling inflammatory process in middle ear. AIM OF STUDY: An investigation was executed in hypertrophied adenoids with or without otitis media with effusion. METHODS: By flow cytometry percentage of CD11c+ myeloid DC and 123+ plasmacytoid DC in hypertrophied adenoid and hypertrophied adenoid and otitis media with effusion was analyzed. RESULTS: The percentage of CD11c+ myeloid DC and 123+ plasmacytoid DC was similar in hypertrophied adenoid and otitis media with effusion compored to the control group. CONCLUSIONS: Our data show that part of dendritic cells has not on course of inflammatory process influence rolling in middle ear.

[Expression CD27 on T and B lymphocytes in hypertrophied adenoids at children with otitis media with effusion]. / Ekspresja receptora CD27 na limfocytach T i B w tkance przeroslych migdalków gardlowych u dzieci chorych na wysiekowe zapalenie ucha srodkowego.

INTRODUCTION: Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The mining of antigen CD27 on lymphocytes T and B in creation of memory cells is still unclear. AIM: CD27 on lymphocytes T and B has a crucial role in development of immune response against inflammatory state. Aim of this study was evaluation functions of lymhocytes with expression CD27 in hypertrophied adenoid in children with otitis media with effusion. MATERIAL AND METHODS: [corrected] We tested 24 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 29 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19, anty-CD3, anty-CD5 and anty-CD27 monoclonal antibodies to examinations. RESULTS: We showed the lowest percentage lymphocytes B CD5+ with expression of CD27 in subgroup older children with otitis media with effusion (O.M.E. 22.43 +/- 2.66%) in compartative to younger children in the same group (15.96 +/- 5.31%; p < 0.005) and to older comparative subgroup (H.A. 15.50 +/- 8.03; p < 0.001). Percentages of B CD5 cells with expression of CD27 was statistical lower in examinated group (7.25 +/- 3.81) than in comparative group (H.A. 16.26 +/- 5.82; p < 0.04). In group with hypertrophied adenoid showed higher percentages of CD5-CD27+CD19+ cells both in younger and older supgroup than in equivalent supgroups with O.M.E. CONCLUSIONS: Iteraction of CD27-CD70 regulates many functions of T and B lymphocytes. It seems that disorders humoral immunologucal answer in hypertrophied adenoids are supported to develop of otitis media with effusion.

[Expression of chosen chemokine receptors on the Th lymphocytes in children with hypertrophied adenoids with otitis media with effusion]. / Ekspresja wybranych receptorów chemokin na limfocytach Th przeroslych migdalków gardlowych w wysiekowym zapaleniu ucha srodkowego.

INTRODUCTION: Chemokine receptors play a crucial role in the recruitment of leucocytes into inflamed tissue from secondary lymphoid organs. AIM OF THIS STUDY: was evaluation of the percentage Th (CD4+) lymphocytes with expression of chemokine receptors: CCR3, CCR4, and CCR5 in hypertrophied adenois tissue in children with otitis media with effusion. MATERIAL AND METHODS: 36 children with otitis media with effusion and 25 children with hypertrophied adenoids were tested. Expression of chemokine receptors CCR3, CCR4 and CCR5 on T CD4 lymphocytes of hypertrophied adenoid's tissue was estimated by flow cytometry method. RESULTS: Average percentage of T CD4+ lymphocytes with expression CCR4 in hypertrophied adenoid in children group with otitis media with effusion (OME = 64.11%) was significantly higher than in comparative group with hypertrophied adenoid (HA = 75.05%, p < 0.04). We showed statistically lower percentage of CD3+CD4+ cells with expression CCR3 in examinated group (OME = 47.19%) than HA group (62.66%; p < 0.003). CONCLUSION: Results suggests that intensify of humoral immunological answer in hypertrophied adenoid depends on Th2 lymphocytes with expression CCR3 and CCR4 chemokine receptors in course of inflammatory state in middle ear.

[Evaluation of percentage of lymphocytes B with expression of co-receptors CD 40, CD22 and CD72 in hypertrophied adenoid at children with otitis media with effusion]. / Ocena odsetka limfocytów B z ekspresja koreceptorów CD40, CD22 i CD72 w przeroslych migdalkach gardlowych dzieci chorych na wysiekowe zapalenie ucha.

INTRODUCTION: In hypertrophied adenoid lymphocytes B make up about 60% all lymphocytes. When the lymphocytes B come in interaction with antigens this membranes signal be passed through their receptor (BCR) to interior of cell. This signal affect modulation on gene expression, activation from which depends activation, anergy or apoptosis of lymphocyte B. Accompany BCR co-receptors regulate his functions influence stimulate or inhibitive. To the most important co-receptors stepping out on lymphocyte B belong: CD40, CD22, CD72. AIM OF STUDY: The aim of study was evaluation of lymphocytes B (CD19) with co-expression with CD72 and CD40 receptors in hypertrophied adenoid with at children with otitis media with effusion. MATERIAL: An investigation was executed in hypertrophied adenoids with or without otitis media with effusion. METHODS: By flow cytometry percentage of lymphocytes B with co-receptors CD 40, CD22 and CD72 in was analyzed. RESULTS: The percentages of CD19+CD72+ lymphocytes in the group of children with adenoid hypertrophy and exudative otitis media were lower as compared to the reference group. However, the percentages of CD19+CD22+, CD19+CD40+ in the study group was approximate to the reference group. CONCLUSIONS: The lower percentage of lymphocytes B CD72 + near approximate percentages of lymphocytes B CD40+ and BCD22+ at children with otitis media with effusion can be the cause of incorrect humoral response in hypertrophied adenoid at children. Maybe it is cause reduced spontaneous production IgA and IgG through lymphocyte at children with otitis media with effusion.