[Sinonasal sarcoidosis]. / Sarkoidose der Nase und Nasennebenhöhlen.

BACKGROUND: The sinonasal system is rarely involved in the clinical picture of sarcoidosis. In the absence of pulmonary disease, sinonasal sarcoidosis is extremely rare. PATIENTS AND METHODS: Four patients with isolated sarcoidosis of the nose and the sinuses are reported; in one of these patients the histological evidence was found in the mucosa of the nasopharynx. RESULTS: None of these patients was found to have a pulmonary illness or any other extrapulmonary manifestation of sarcoidosis. Retrospectively, two patients fulfilled the more specific diagnostic criteria for sinonasal sarcoidosis reported in the literature. CONCLUSION: Sarcoidosis should be considered in the differential diagnosis of inflammatory sinonasal disease, especially if the mucosa shows signs of granulation, but it should also be considered when an incidental finding of rhinosinusitis is recorded. Rhinosurgical intervention seems to be an appropriate therapy in terms of improving the symptoms of the disease, despite the prolonged period of postoperative healing and the necessity for individual treatment with medication. Following histological confirmation of the diagnosis, adequate medication and further appropriate diagnostic procedures drawing on internal medicine are essential.

[Investigations on regulation of HCG by cortisol (prednisolon) in trophoblast cells in vitro]. / Untersuchungen zur Regulation von hCG durch Kortisol (Prednisolon) in der Trophoblastzelle in vitro.

OBJECTIVE: Trophoblast cells synthesize a variety of hormones, in which hCG plays a major role. On the strength of special enzymes they are capable of catalyzing the reaction cortisol <--> cortisone. In vitro experiments showed the influence on ACTH- and cortisol secretion by CRH, ACTH and prednisolon. In this study we describe the influence of cortisol (prednisolon) on hCG production of trophoblast cells in vitro. MATERIAL AND METHODS: Trophoblast cells were prepared from human term placentae by standard trypsin-DNAse dispersion of villous tissue followed by a percoll gradient centrifugation step. After adjusting the cell suspension to a defined cell concentration of 1 x 10 (6) cells/ml cells were cultivated. The addition of prednisolon followed every eight hours. The samples were collected after 24 hours for a total of 96 hours also from unstimulated cultures. Culture supernatants were assayed for hCG by enzyme-immunometric methods. RESULTS: The addition of prednisolon (50 microg/ml) stimulates the concentration of hCG in a time-depending manner. CONCLUSIONS: The trophoblast cell shows an increase in the concentration of hCG after stimulation with cortisol. For the first time an influence of cortisol (prednisolon) on hCG production could be demonstrated in cultured trophoblast cells.

[Investigations on regulation of CRH, ACTH and cortisol in trophoblast cells in vitro]. / Untersuchungen zur Regulation von CRH, ACTH und Kortisol in der Trophoblastzelle in vitro.

OBJECTIVE: Trophoblast cells synthesise CRH and ACTH, which are peptide hormones. On the strength of special enzymes they are capable of catalyzing the reaction cortisol <--> cortisone. In vitro experiments should give a proof of influence to ACTH- and cortisol secretion by CRH, ACTH and prednisolon. The basal rate of cortisol secretion was examined in a long term experiment. MATERIAL AND METHODS: Trophoblast cells were prepared from human term placentae by standard trypsin-DNAse dispersion of villous tissue followed by a percoll gradient centrifugation step. After adjusting the cell suspension to a defined cell concentration of 1 x 10(6) cells/ml the cells were cultivated. The addition of CRH, ACTH or prednisolon followed every eight hours. The samples collected 20 or 30 minutes later, also from unstimulated cultures, were assayed for ACTH and cortisol by enzyme-immunometric methods. RESULTS: The concentration of cortisol shows a rhythmical course in long term cell cultures. The addition of CRH (500 ng/ml, 1 microg/ml) stimulates the concentration of ACTH- and cortisol in a time-depending manner. The addition of ACTH (500 ng/ml-2 microg/ml) stimulates the concentration of cortisol in a time-depending manner. The addition of prednisolon stimulates the concentration of ACTH. CONCLUSIONS: The trophoblast cell shows a rhythmical course in the concentration of cortisol. For the first time a CRH-ACTH-cortisol feedback loop could be demonstrated in cultured trophoblast cells.