RESUMO
OBJECTIVE: To develop a model for sinonasal wounding and evaluation during healing in mice with chronic eosinophilic inflammation. DESIGN: Exploratory controlled study in which chronic eosinophilic nasal and sinus inflammation was established in mice followed by wounding of the sinonasal cavity. Histologic features and gene expression were then studied. SETTING: University of Utah Center for Comparative Medicine. SUBJECTS: Chronic eosinophilic inflammation was established in mice. They were then wounded and humanely killed at days 3, 7, and 14 after wounding. MAIN OUTCOME MEASURES: Inflammation was assayed by light microscopic examination. Polymerase chain reaction analysis of transforming growth factor-beta1b, insulinlike growth factor (IGF)-1, matrix metalloproteinase (MMP)-7, MMP-9, tissue inhibitor of metalloproteinase 1 (TIMP-1), and prostaglandin E receptor EP4 expression was performed as well. Uninflamed mice were wounded and examined using the same protocol. RESULTS: Chronically inflamed mice showed higher histologic inflammatory scores before and after wounding. Expression of IGF-1, TIMP-1, and MMP-9 was also higher prior to wounding and during healing. Continued stimulation appears necessary for the chronic eosinophilic inflammation to persist. CONCLUSIONS: We successfully constructed a model in which wound healing in a setting of chronic eosinophilic inflammation can be studied. In this exploratory pilot, we demonstrated the feasibility of reproducibly wounding the sinonasal cavity of chronically inflamed mice and examining histologic and gene expression effects of the inflammatory response after wounding.
Assuntos
Modelos Animais de Doenças , Eosinofilia/patologia , Estudos de Viabilidade , Sinusite Maxilar/patologia , Rinite/patologia , Cicatrização/fisiologia , Animais , Aspergillus fumigatus , Doença Crônica , Eosinofilia/genética , Feminino , Expressão Gênica/genética , Fator de Crescimento Insulin-Like I/genética , Metaloproteinase 7 da Matriz/genética , Metaloproteinase 9 da Matriz/genética , Sinusite Maxilar/genética , Camundongos , Camundongos Endogâmicos BALB C , Projetos Piloto , Reação em Cadeia da Polimerase , Rinite/genética , Inibidor Tecidual de Metaloproteinase-1/genética , Fator de Crescimento Transformador beta1/genética , Cicatrização/genéticaRESUMO
BACKGROUND: Juvenile nasopharyngeal angiofibromas (JNAs) are rare benign lesions that express hormonal receptors. This report describes a recurrence of a JNA 20 years after excision associated with exogenous testosterone therapy. METHODS: A 36-year-old man developed a sphenoid mass 20 years following resection of a JNA, shortly after initiating exogenous testosterone therapy for symptomatic low endogenous testosterone. RESULTS: The mass was subsequently excised and was histologically consistent with a JNA. The patient resumed his testosterone therapy postoperatively. Repeated imaging has demonstrated no recurrence after 3 years. CONCLUSION: This unique case adds further evidence to the role of testosterone in the pathogenesis of JNAs. Exogenous testosterone can cause tumor regrowth at any time, even decades following treatment. The patients with a history of JNA, even those without recurrence for years, should weigh the risk of recurrence before the use of exogenous testosterone.
Assuntos
Angiofibroma/fisiopatologia , Neoplasias Nasofaríngeas/fisiopatologia , Segunda Neoplasia Primária/fisiopatologia , Neoplasias dos Seios Paranasais/fisiopatologia , Seio Esfenoidal , Testosterona/fisiologia , Adulto , Angiofibroma/diagnóstico por imagem , Angiofibroma/cirurgia , Fossa Craniana Posterior/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/cirurgia , Invasividade Neoplásica , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Segunda Neoplasia Primária/diagnóstico por imagem , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Fossa Pterigopalatina/patologia , Neoplasias da Base do Crânio/patologia , Seio Esfenoidal/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
HYPOTHESIS: Computed tomographic (CT) imaging of stapes prostheses is inaccurate. BACKGROUND: Clinical situations arise in which it would be helpful to determine the depth of penetration of a stapes prosthesis into the vestibule. The accuracy of CT imaging for this purpose has not been defined. This study was aimed to determine the accuracy of CT imaging to predict the depth of intrusion of stapes prostheses into the vestibule. METHODS: The measurement of stapes prostheses by CT scan was compared with physical measurements in 8 cadaveric temporal bones. RESULTS: The depth of intrusion into the vestibule of the piston was underestimated in specimens with the fluoroplastic piston by a mean of 0.5 mm when compared with the measurements obtained in the temporal bones. The depth of penetration of the stainless steel implant was overestimated by 0.5 mm when compared with that in the temporal bone. CONCLUSION: The type of implant must be taken into consideration when estimating the depth of penetration into the vestibule using CT scanning because the imaging characteristics of the implanted materials differ. The position of fluoroplastic pistons cannot be accurately measured in the vestibule. Metallic implants are well visualized, and measurements exceeding 2.2 mm increase the suspicion of otolithic impingement. Special reconstructions along the length of the piston may be more accurate in estimating the position of stapes implants.