Different expressions of erbB1/2 and tight junction proteins in hypertrophic inferior turbinates and nasal polyps.

Both inferior turbinate hypertrophy and nasal polyp formation entail the enlargement of the nasal mucosa caused by rhinosinusitis, but their macro/microscopic and clinical findings differ markedly. This study aimed at investigating differences in the expressions of erbB1/2 and the tight junction proteins, claudin-1 and tricellulin, in the two tissues. Ten inferior turbinates and ten nasal polyps were collected. The expressions of erbB1/2, claudin-1, and tricellulin were examined by fluorescence immunohistochemistry and by quantitative real-time transcription-polymerase chain reaction (qRT-PCR). The eosinophil count and % of nasal gland area in the mucosa were also measured. The fluorescence intensities in the inferior turbinates were higher for erbB1/2 and lower for claudin-1 than those in the nasal polyps. The results of qRT-PCR were consistent with the immunohistochemical findings for erbB1/2. The quantity of tricellulin mRNA was significantly higher in the inferior turbinates than in the nasal polyps. The % of nasal gland area was significantly higher but the eosinophil count was significantly lower in the inferior turbinate than in the nasal polyp. These results suggest that the underlying pathogenesis of hypertrophic inferior turbinates and nasal polyps is likely to differ with respect to regeneration/proliferation and thus the remodeling process.

Synergism of Staphylococcus aureus colonization and allergic reaction in the nasal cavity in mice.

BACKGROUND: The aim of this study is to investigate the reciprocal effect of Staphylococcus aureus colonization and allergic rhinitis in an allergy model of mice. METHODS: BALB/c mice with intraperitoneal ovalbumin (OVA) sensitization and/or intranasal S. aureus inoculation were prepared. The following 4 groups were designed: an OVA-sensitized S. aureus-inoculated (AR-SA) group, an OVA-sensitized uninoculated (AR) group, a nonsensitized S. aureus-inoculated (SA) group, and a nonsensitized uninoculated (control) group. After intranasal OVA challenge, nasal lavage fluid, peripheral blood, and nasal mucosa were collected. Polymorphonuclear cells in the nasal lavage fluid were counted, serum OVA-specific IgE and IgG1 were measured by enzyme immunoassays, and IL-4, IL-5, and IFN-γ mRNAs in the nasal mucosa were assessed by quantitative real-time reverse transcription-PCR. The number of S. aureus in the nasal mucosa and lavage fluid was counted. RESULTS: Both eosinophil and neutrophil counts were larger in the AR-SA group than in the other groups. Both IgE and IgG1 levels were higher in the AR and AR-SA groups than in the SA and control groups, and the IgG1 level was higher in the AR-SA group than in the AR group. The expression of IL-4 mRNA was higher in the AR-SA group than in the other groups, and the expression of IL-5 mRNA was higher in the AR-SA group than in the SA group. The AR-SA group showed higher counts of S. aureus in the nasal mucosa than the SA group. CONCLUSION: These results indicate the mutually potentiating effect of S. aureus colonization and allergic rhinitis.

Expression of epidermal growth factors, erbBs, in the nasal mucosa of patients with chronic hypertrophic rhinitis.

PURPOSE: To investigate the expression of erbBs in the nasal mucosa of patients with chronic hypertrophic rhinitis. PROCEDURES: Inferior turbinates were collected from 12 turbinectomized patients with allergic and nonallergic chronic hypertrophic rhinitis. Differential cell counts in the peripheral blood and allergy tests were conducted before surgery. The expressions of erbB1, 2, 3 and 4 were examined by fluorescence immunohistochemistry and by quantitative real-time transcription polymerase chain reaction (qRT-PCR). Immunohistochemical fluorescence was quantitatively measured using image-analyzing software. Eosinophils infiltrated into the mucosa were counted in sections stained with Hansel solution. RESULTS: Each of the erbB types 1-4 was expressed in both epithelial cells and nasal gland cells. Immunoreactivity for erbB1 was strong and that for erbB2 and 3 was moderate, while that for erbB4 was faint. These findings were consistent with the results of qRT-PCR. The percentage of peripheral blood eosinophils was significantly correlated with the eosinophil count in the nasal mucosa and with immunoreactivity for erbB1 in the nasal gland. CONCLUSIONS: These results suggest a possible role of eosinophils in regulating erbB1 and thus in regulating mucosal hypertrophy in chronic hypertrophic rhinitis.

Prediction model for hearing outcome in patients with idiopathic sudden sensorineural hearing loss.

The aim of this study is to develop a regression model for predicting hearing outcome in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). A total of 174 consecutive patients with ISSNHL (average of the hearing levels at 250, 500, 1,000, 2,000, and 4,000 Hz was ≥40 dB; time from onset to treatment was ≤30 days) were retrospectively analyzed. They received steroid administration (400 mg/day of hydrocortisone sodium succinate followed by tapered doses) in combination with hyperbaric oxygen therapy. The hearing improvement rate compared to the unaffected contralateral ear was calculated. Correlations between the hearing improvement rate and four prognostic factors (patient's age, days from onset to treatment, initial hearing level, and the presence of vertigo) were examined by simple and multiple regression analyses. In the simple regression analysis, significant correlations were observed between the hearing improvement rate and all four prognostic factors. In the multiple regression analysis, the correlation was significant for patient's age, days from onset to treatment, and the presence of vertigo with partial correlation coefficients of -0.221, -0.324, and -0.329, respectively, but was not significant for the initial hearing level. We subsequently formulated a multiple regression equation for predicting the hearing improvement rate. The multiple correlation coefficient was 0.495 with a p value of 1.42 × 10(-9). Using this regression model, the hearing improvement rate is still difficult to predict with 95% probability, but is predictable with 70% probability.

A laryngographic and laryngoscopic study of Northern Vietnamese tones.

A laryngographic and laryngoscopic study of tone production in Northern Vietnamese, a language whose tones combine both fundamental frequency (f0) modulations and voice qualities (phonation types), was conducted with 5 male and 5 female speakers. Results show that the f0 contours of Northern Vietnamese tones are not only attributable to changes in vocal fold length and tension (partly through changes in larynx height), but that f0 drops are also largely caused by the glottal configurations responsible for the contrastive voice qualities associated with some of the tones. We also find that voice quality contrasts are mostly due to glottal constriction: they occasionally involve additional ventricular fold incursion and epiglottal constriction, but these articulations are usually absent.

Possible participation of acidic pH in bone resorption in middle ear cholesteatoma.

OBJECTIVES/HYPOTHESIS: The etiopathology of bone resorption in cholesteatoma is unclear. We studied pH in middle ear cholesteatoma tissue and the permeability of the cholesteatoma epithelium in an attempt to elucidate the mechanism of bone resorption in this disease. STUDY DESIGN: Laboratorial study. METHODS: Cholesteatoma tissue was collected from patients with primary acquired middle ear cholesteatoma. The pH of the keratin debris of cholesteatoma was measured using a pH meter. The cholesteatoma epithelium was examined under a confocal laser scanning microscope, and under a transmission electron microscope. Expression of filaggrin in the cholesteatoma tissue was explored by fluorescence immunohistochemistry and by quantitative reverse transcription-polymerase chain reaction. RESULTS: The pH of the keratin debris of cholesteatoma was acidic. The pH of the basal layer of the cholesteatoma epithelium was significantly lower than that of the antrum mucosa. Transmission electron microscope showed distinct penetration of lanthanum in the intercellular space of the basal, spinous, and granular layers of the cholesteatoma epithelium, but only a small amount of lanthanum in the granular layer in the normal skin. The expression of filaggrin mRNA was significantly lower in the cholesteatoma tissue than in the normal skin. CONCLUSIONS: These results indicate that acid leakage through the cholesteatoma epithelium probably participates in the resorption of the underlying bone structure. The increased permeability of the cholesteatoma epithelium may be explained by a decrease in filaggrin expression.

Thyroid gland cutaneous fistula secondary to a migratory fish bone: a case report.

INTRODUCTION: We report an extremely rare case of a migratory fish bone penetrating through the thyroid gland. CASE PRESENTATION: A 56-year-old Japanese woman presented with a two-month history of a painless cutaneous fistula in her anterior neck with pus discharge. Endoscopic examinations showed no abnormality, but computed tomography revealed a bone-density needle-shaped foreign body sticking out anteroinferior from the esophagus wall, penetrating through her left thyroid lobe and extending nearly to the anterior cervical skin. A migratory fish bone was suspected, and the foreign body was removed under general anesthetic, combined with a hemithyroidectomy. The injured esophageal mucosa was sutured and closed. Our patient's postoperative course was uneventful, and she was allowed oral food intake seven days after the surgery. No evidence of recurrence was seen over the postoperative follow-up period of 42 weeks. CONCLUSION: We should be aware that fish bone foreign bodies may migrate out of the upper digestive tract and lodge in the thyroid gland.

Efficacy of intratympanic steroid administration on idiopathic sudden sensorineural hearing loss in comparison with hyperbaric oxygen therapy.

OBJECTIVES/HYPOTHESIS: The efficacy of intratympanic steroid administration was examined in comparison with hyperbaric oxygen (HBO) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN: Retrospective study. METHODS: Two hundred seventy-six consecutive patients with ISSNHL (average hearing levels at 250, 500, 1,000, 2,000, and 4,000 Hz ≥ 40 dB; time from onset to treatment ≤30 days) were enrolled. All the patients were given intravenous hydrocortisone (400 mg/day) followed by tapered doses. In addition, 174 patients underwent HBO therapy (HBO group), and 102 patients received intratympanic dexamethasone injection (IT group). The hearing outcomes were evaluated by six indices; the cure rate, marked-recovery rate (percent of patients with hearing gains ≥30 dB), recovery rate (percent of patients with hearing gains ≥10 dB), hearing gain, hearing level after treatment, and hearing improvement rate compared to the unaffected contralateral ear. RESULTS: There was no significant difference in the cure rate, marked-recovery rate, hearing gain, hearing level after treatment, or hearing improvement rate between the two groups; however, the recovery rate was significantly higher in the IT group than in the HBO group (79.4% vs. 68.4%; P = .048). Multiple logistic regression analysis also showed that patients in the IT group were significantly more likely to recover than those in the HBO group (odds ratio: 2.045; 95% confidence interval: 1.097-3.812; P = .024). CONCLUSIONS: Systemic plus intratympanic steroid administration is more effective than systemic steroids plus HBO therapy, and can be a useful first-choice treatment for ISSNHL.