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G Rasp

Publications and source records attributed to G Rasp.

At least 19 recordsLinked to original sources

Immunocytochemical and biochemical identification of angiotensin II in human nasal tissue.

Angiotensin II (ANG II) was identified immunocytochemically and biochemically in biopsy samples of human nasal tissue. Staining for ANG II was predominantly found in structures similar to a string of pearls with consecutive short varicose areas, which is characteristic for neuronal tissue. The localization of ANG II in neurons was confirmed by positive staining of adjacent tissue sections with a specific antibody to neurofilament or doublestaining with both antibodies in one section. Likewise, ANG II-like material was also determined radioimmunologically in nasal tissue extracts. The concentrations of ANG II varied form 1.28 to 332.78 fmol/g wet tissue weight with an average concentration of 79.61+/-44.09 fmol ANG II/g wet tissue weight (mean+/-SEM, n=7). The ANG II-immunoreactive material was further characterized biochemically by HPLC on a reversed phase C(18) column in an acetonitrile and methanol gradient as Ile(5)-ANG II and ANG II metabolites such as Ile(4)-ANG III, Ile(3)-ANG II(3-8)hexapeptide and Ile(2)-ANG II(4-8)pentapeptide.

Angiotensin II↗

[Eosinophil inflammation of the nasal mucosa].

INTRODUCTION: Inflammatory diseases are very frequent and cause reasonable mortality. They are the major part in upper airway diseases in ENT. Eosinophil inflammation is a key feature in allergic rhinitis, asthma, nasal polyps and non-allergic rhinitis. The mechanism and the consequences of eosinophil inflammation are described in this review. METHODS AND RESULTS: Eosinophils mature in bone marrow, mainly under the influence of IL-5 and eotaxin. Once mobilised to circulation, they accumulate in inflammatory sites by specific adhesion. VCAM-1 and other adhesion molecules are involved in this process. In the tissue, eosinophils get activated by different stimuli like immunoglobulin receptors and cytokines like IL-5. Activated eosinophils release toxic proteins, mediators and cytokines and thus trigger further inflammatory response. This leads to the late phase reaction and continuing inflammatory reaction. Eosinophils also interact with virus infections and have effects on nerve endings with the M2 receptor. CONCLUSIONS: Eosinophil inflammation may be monitored via the determination of cationic proteins in nasal secretions. Corticosteroids are very effective in the treatment of eosinophil inflammation, and anti-IL-5 and anti-IL-4 antibodies seem to be effective, too.

Adrenal Cortex Hormones↗

[Mesenchymal stem cells--a new pathway for tissue engineering in reconstructive surgery].

INTRODUCTION: Mesenchymal stem cells (MSC) have the capacity to differentiate into chondrocytes with the synthesis of cartilage. This report presents the use of human adult bone marrow derived mesenchymal stem cells for tissue engineering of autologous cartilage grafts. METHODS: Human bone marrow aspirates were obtained from the iliac crest and fractionated on a Percoll gradient. The isolated hMSC were plated at 20 x 10 (6) cells per 100 mm (2) culture dish. After 21 days in culture at 37 degrees C with 5 % CO 2, the adherent multiplied MSC were trypsinized, counted, and tested for viability by trypan blue assay. The hMSCs were loaded into a sterile 15 ml polypropylene tube (0.5 Mio cells/ml) and centrifuged on the bottom of the tube at 500 g for 5 minutes. The MSC were cultivated for 3 weeks in vitro in a specific chondrogenetic medium composed of Dulbecco's Modified Eagles Medium-High Glucose supplemented with 10 ng/ml transforming growth factor-beta 1, 1 % ITS-Premix medium, 80 micro M ascorbic acid, and 100 nM dexamethasone. RESULTS: Histological and immunohistochemical studies performed after 3 weeks in three dimensional culture demonstrated the expression of cartilage specific collagen type II and X as well as proteoglycans. CONCLUSION: Human adult mesenchymal stem cells derived from bone marrow aspirates have the ability to differentiate into chondrocytes under specific culture conditions by growth factors. The use of adult mesenchymal stem cells may be a promising tool for tissue engineering of autologous cartilage grafts in reconstructive surgery in the future.

Adult↗

Immunohistological expression of interleukin 16 in human tonsils.

BACKGROUND: Interleukin 16 (IL-16) acts highly chemotactic on CD4-bearing cells. Besides chemotaxis, IL-16 has numerous immunomodulatory effects, and not only on T cells. OBJECTIVE: To determine IL-16 expression in human tonsils. METHODS: Tonsillar follicles were immunohistologically characterized to elicit a possible cellular source of IL-16 expression. RESULTS: The mantle zone of immature and mature B cells was CD22 immunoreactive (ir), whereas the germinal center of activated B cells was CD23-ir. Plasma cells that were CD38-ir were observed extrafollicularly beneath the epithelium and within the germinal center. T cells were found most frequently in the extrafollicular space, with a majority of CD4 cells. CD68-ir macrophages were predominantly found within the germinal center. Immunostaining of anti-IL-16 revealed strong cytoplasmatic reactivity of extrafollicular cells and of cells at the outer rim of the mantle zone. Numerous cells adherent to the stratified squamous epithelium were IL-16-ir as well. Double immunostaining identified CD4(+) T cells as the major cellular source of IL-16 expression. Furthermore, a population of CD22(+) B cells at the outer rim of the mantle zone expressed IL-16 as well. CONCLUSIONS: Interleukin 16 was mainly expressed in a typical CD4-like pattern in human tonsils. Our data strongly suggest that CD4(+) lymphocytes constitute the major cellular source for IL-16. We hypothesize that the double-immunostained CD4-ir and IL-16-ir cells represent activated T cells. Because CD22(+) B cells at the outer rim of the mantle zone expressed IL-16 as well, we conclude that this area might constitute the locus of IL-16-mediated B-cell differentiation.

Child↗

Nasopharyngeal epignathus causing nasal airway blocking in a 4-year old child.

Congenital oral teratoma or epignathus is a very rare lesion, especially in older children. We report on a 4-year old female infant presenting with nasal blocking, little watery discharge and recurrent otitis. First adenoids were suspected. An endoscopic examination of the nose and nasopharynx demonstrated an irregular mass in the nasopharynx, covered partly by mucosa. A MRI-scan (T1-weighted) showed fat-intensity. Histological examination revealed a teratomatous malformation. Although rare, teratoma should be included in the differential diagnosis of a nasopharyngeal mass in the paediatric age group.

Child, Preschool↗

Allergic rhinitis does not constitute a risk factor for obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is a condition characterized by recurrent episodes of obstruction of the upper airway. The aim of this study was to evaluate whether nasal obstruction due to allergic rhinitis constitutes a risk factor for OSAS. Patients (n = 119) presenting typical symptoms of sleep apnea were tested for OSAS using polysomnography. Additionally all patients were tested in vivo and in vitro (including nasal eosinophilic cationic protein) for allergic rhinitis. Examination for allergic rhinitis revealed that 88.3% of all patients had no allergic rhinitis, whereas only 11.7% were diagnosed as allergic. No significant differences in sleeping parameters were observed between allergic and non-allergic patients. Comparison of parameters indicative of relevant OSAS (apnea-hypopnea index [AHI] > 10) revealed that 60% of non-allergic patients had relevant OSAS, compared to only 50% of allergic patients. Investigation of allergic subgroups revealed similar results: no significant differences in sleeping parameters or elevated rates of relevant OSAS parameters were observed, especially in perennial allergic rhinitis due to house dust mites. No elevated rates of allergic rhinitis were observed in the studied cohort of patients suffering from sleep apnea or OSAS. Furthermore, no significant differences in sleeping behavior or polysomnography parameters were found on comparing allergic and non-allergic patients. In summary, our data rule out allergic rhinitis as a major risk factor for OSAS.

Electroencephalography↗

[Autologous rib cartilage harvesting: operative procedure and postoperative pain reduction].

INTRODUCTION: In reconstructive surgery there is a growing demand for cartilage grafts. For small amounts of autologous tissue, cartilage from the nasal septum or ear concha is a sufficient and reliable tissue, but in cases of extensive defects or higher mechanical load autologous rib cartilage is a commonly used transplant. Nevertheless, a serious donor-site morbidity, especially postoperative pain, has to be taken into consideration. We present a modified technique for harvesting rib cartilage with a consecutive local pain therapy. TECHNIQUE: In contrast to the commonly used incision through all layers of tissue the described technique follows the anatomical structures of skin tension-lines, the fascial and muscle fibers and tissue sliding-planes. Starting with a transversal skin incisions 1.5 cm above the costal arch, longitudinal splitting of the rectus abdominis fascia and muscle, the rib cartilage of the ribs 6 to 8 can be exposed. Grafts in the size of at least 3 to 8 cm can be harvested under preservation of the perichondrium. This technique causes a high degree of stability and good function of the abdominal wall. POSTOPERATIVE PAIN THERAPY: After harvesting rib cartilage most patients complain about extensive postoperative pain. For adequate treatment the local application of a long-lasting anesthetic substance close to the intercostal nerves is helpful. The introduction of a peridural catheter opens the feasibility of continuously applying a local anesthetic for 3 to 4 days directly into the donor-site. This procedure reduces the need for general anesthetics dramatically and prevents further complications. DISCUSSION: This modified technique for harvesting rib cartilage diminishes the donor-site morbidity by reducing the risk of pneumothorax, hernias and functional deficits. Moreover, the local pain therapy assures postoperative wellness and mobility.

Anesthetics, Local↗

[A new system for the classification of ethmoid polyposis. Effect of combined local and systemic steroid therapy].

BACKGROUND: Nasal polyps are a common disease with in the majority of cases unknown origin. Both the medical and surgical treatment of nasal polyps present a challenge in Otorhinolaryngology. METHODS: We developed a four-stage grading system for nasal polyps based on the endoscopic aspect of more than 300 patients. In a study of 37 patients, treated by systemically (Methylprednisolon 64 mg p.o., decreasing amounts for the first 11 days) and locally (Budesonid 400 micrograms intranasal) applied steroids for 90 days, this staging-system was tested. RESULTS: The mean stage of polyps decreased significantly (p < 0.01) from 2.8 at day 0 to 1.7 at day 7 and further to 1.2 and to 0.7 at day 28 and day 90 respectively. The mean nasal symptom score decreased equally from 1.14 on day 1 to 0.19 and to 0.14 on day 7 and day 28 respectively. To summarize, we observed a significant (p < 0.01) decrease in polyp stages of 75% respectively a significant (p < 0.01) reduction of symptom scores of 93%. CONCLUSIONS: Thus, we present a suitable new grading system for nasal polyps which we applied directly to assess the efficacy of combined local and systemic steroid therapy. It was shown that this treatment can reduce polyps and prevent their recurrence over the observed time.

Administration, Intranasal↗

Nasal interleukin-5, immunoglobulin E, eosinophilic cationic protein, and soluble intercellular adhesion molecule-1 in chronic sinusitis, allergic rhinitis, and nasal polyposis.

OBJECTIVE: To compare concentrations of interleukin-5 (IL-5), immunoglobulin E (IgE), eosinophilic cationic protein (ECP), and soluble intercellular adhesion molecule-1 (sICAM-1) in nasal secretion and serum of patients with chronic nonallergic sinusitis, allergic rhinitis, and nonallergic nasal polyposis to obtain information about the pathogenesis of these diseases. METHODS: Nasal secretion and serum were analyzed by routine enzyme-linked immunosorbent assay techniques. Nineteen patients with chronic nonallergic sinusitis, 24 patients with seasonal allergic rhinitis, and 18 patients with nonallergic nasal polyposis were included in the study. Eight healthy, nonallergic probands served as control subjects. RESULTS: Significantly elevated concentrations of IL-5 (5-fold, P < .05) and IgE (15-fold, P < .01) were detected in nasal secretion of patients with allergic rhinitis (IL-5, 51.8 +/- 13.2 pg/mL; IgE, 41.9 +/- 20.9 kU/L) or nonallergic nasal polyposis (IL-5, 57.9 +/- 36.9 pg(mL; IgE, 40.5 +/- 20.2 kU/L) compared with controls (IL-5, 10.6 +/- 7.8 pg/mL; IgE, 2.8 +/- 0.5 kU/L) or with patients with chronic nonallergic sinusitis (IL-5, 16.5 +/- 13.2 pg/mL; IgE, 5.4 +/- 3.1 kU/L). There were no significant differences between patients with allergic rhinitis and those with nonallergic nasal polyposis. Concentrations of ECP were significantly elevated (sixfold, P < .01) in patients with allergic rhinitis (297.8 ng/mL +/- 173.1) compared with controls (52.4 +/- 28.0 ng/mL) or patients with chronic nonallergic sinusitis (44.8 +/- 40.1 ng/mL), whereas twofold higher concentrations (not significant) of ECP were observed in patients with nonallergic nasal polyposis (107.1 +/- 26.6 ng/mL). Significantly elevated concentrations of sICAM-1 in nasal secretion (threefold, P < .05) were detected only in patients with chronic nonallergic sinusitis (79.4 +/- 45.6 ng/mL). The elevated sICAM-1 nasal secretion values in this group correlated significantly (P < .05) to the serum values. CONCLUSIONS: Equally elevated concentrations of IL-5 and IgE in patients with allergic rhinitis and nonallergic nasal polyposis implicated similar pathogenic processes in both diseases. Whereas the pathogenesis of allergic rhinitis is IgE-specific, the pathogenesis of nasal polyps is not as clear. IL-5 was suggested to play a pivotal role in tissue eosinophilia, which was confirmed by data in the present study. Elevated concentrations of ECP were suggested to result from tissue eosinophilia--a characteristic of both diseases. Elevated concentrations of sICAM-1 in patients with chronic nonallergic sinusitis pointed to its key role in the recruitment of neutrophils into the inflamed tissue, whereas an important role in eosinophil recruitment was ruled out.

Adult↗

Norm values for eosinophil cationic protein in nasal secretions: influence of specimen collection.

BACKGROUND: Eosinophil granulocytes play an important role in allergic inflammation of the nasal mucosa. Eosinophil cationic protein (ECP) is a specific eosinophil granule protein released upon activation of these cells. ECP concentration in nasal secretions has been demonstrated to be a good marker for the activity of eosinophilic nasal mucosal inflammation. The clinical use of such a marker requires defined values which are regarded as pathological or within normal range. In analyses of nasal secretion samples, the sampling method has an important influence on the data obtained. OBJECTIVE: We investigated ECP levels in nasal secretions (NS) of healthy volunteers obtained by seven different methods of sample collection to define norm values and to evaluate the clinical use of the different methods. METHODS: A total of 839 healthy individuals were evaluated using blowing the nose (Bl: n = 82), suction (Suc: n = 69), Okuda microsuction technique (MSuc: n = 93), absorbent cotton wool samplers (CWS: n = 156), rubber-foam samplers (RFS: n = 193), nasal lavage (Lav: n = 112) and nasal spray washing (NSW: n = 134). RESULTS: Missing values occurred in more than 60% in Bl, Suc and MSuc, so that no norm range was defined for these methods. Norm range for ECP in NS was 5-46 ng/mL for CWS, 7-41 ng/mL for RFS, 4-51 ng/mL for NSW, and 3-31 ng/mL for Lav. CONCLUSIONS: When comparing seven different methods used in this study to collect nasal secretions and determine ECP levels, the method based upon absorption or nasal washing was the best.

Adolescent↗

[Short-term immunotherapy--a survey of current studies].

Immunotherapy (IT) plays a central role in the therapy of allergic rhinitis as it was proved to be causal and preventive. IT induces humoral and cellular changes in the immune system, a reduction of symptoms and a prophylactic effect regarding a possible expansion of the allergene spectrum and of involved organ systems. Regular therapeutic schedules include allergen injections starting immediately after the pollen season and ending just before the expected beginning of a season. Additionally, perseasonal and perennial therapy schemes have been used. In all these, a phase of dose-increase is followed by an individually adjusted steady-state preservation-phase. In perseasonal and perennial scheme the injections are given during the pollen season. The preseasonal shortterm-immunotherapy is another schedule. The increase of the injected allergen-dose is made very fast (most commonly during seven weeks), so that the phase of dose-increase is shortened considerably, and a preservation-phase does not take place. This shortterm-immunotherapy has been developed for patients who consult their doctor shortly before the start of the pollen season. The preseasonal shortterm-immunotherapy has been shown to be efficient regarding allergic rhinitis caused by grass-, rye-, birch-, hazel- and alder-pollen. Clinical and experimental data of two placebo-controlled trials and one open study are presented and the role of this new immunotherapy approach is discussed.

Adult↗

Tree-pollen allergy is efficiently treated by short-term immunotherapy (STI) with seven preseasonal injections of molecular standardized allergens.

The efficacy and tolerance of short-term immunotherapy (STI) by seven preseasonal injections of tree-pollen allergens (ALK7 Frühblühermischung) was investigated in a double-blind, placebo-controlled, multicenter study with 111 rhinoconjunctivitis patients. Nasal and bronchial symptoms simultaneously analyzed, and nasal symptoms as a single end point, but not the overall score of nasal, bronchial, and conjunctival symptoms, showed a significantly lower increase with STI during birch-pollen exposure (both P=0.033, n=105, Mann-Whitney U-test). However, a selective analysis with patients from centers with high recruitment figures (n> or =10 patients, n=29 STI, n=32 placebo) showed a significantly lower increase of nasal, bronchial, and overall symptom score (STI 11.0 vs placebo 18.0, P=0.001, U-test). STI had equidirected effects on conjunctival, nasal, and bronchial symptoms analyzed as multiple end points, although conjunctival symptoms were not significantly different as a single end point. The seasonal increase in drug use was reduced by 62% in the STI group compared with placebo (P=0.032, t-test). Specific IgG4 increased only after STI (P<0.001); IgE was not significantly different. Eosinophil cationic protein remained unchanged with STI, but significantly increased with placebo in the pollen season (P=0.003). STI was well tolerated. In conclusion, STI was shown to be efficacious and safe for the treatment of patients with tree-pollen rhinoconjunctivitis.

Adolescent↗

Short-term immunotherapy: a prospective, randomized, double-blind, placebo-controlled multicenter study of molecular standardized grass and rye allergens in patients with grass pollen-induced allergic rhinitis.

BACKGROUND: Short-term immunotherapy (STI) can be beneficial for patients who are noncompliant with long-term specific immunotherapy. OBJECTIVE: The efficacy and tolerance of STI with seven preseasonal injections of molecular standardized allergens from grass and rye pollen has been investigated in a double-blind, placebo-controlled multicenter study with 87 patients at 12 German University hospitals. METHODS: Symptoms of the eyes, nose, and bronchi and use of symptomatic drugs were documented daily in diaries by patients with allergic rhinitis to grass and/or rye pollen and without bronchial asthma. Patients were monitored by skin prick test titration and measurement of levels of specific IgE and IgG4. RESULTS: The median nasal score for the 10 weeks with the strongest symptoms during the grass pollen season was significantly lower (p = 0.014) with 35.0 for STI (n = 41) versus 69.0 for placebo (n = 40); the overall symptom score was 54.0 for STI versus 97.5 for placebo (p = 0.020). Only STI-treated patients exposed to less than 40 pollen grains per cubic meter per week showed a significantly lower nasal symptom score of 39.0 versus 75.0 for placebo (p = 0.006); these patients also had fewer nasal symptoms and less use of topical nasal drugs (p < 0.001). The threshold dose in skin prick tests was significantly higher, being 9.06 histamine equivalent for skin prick test (HEP) for STI-treated patients who received the maximum dose (n = 22) versus 4.33 HEP for placebo (p = 0.005). Specific IgE levels were significantly higher, being 55.9 SU/ml for STI versus 39.2 SU/ml for placebo after seven injections (p = 0.006) and level of specific IgG4 was 5.36% for STI versus 1.28% for placebo (p < 0.001). No severe systemic reactions were observed. CONCLUSION: STI with seven preseasonal injections with molecular standardized allergens is effective and well tolerated.

Adolescent↗

[Cell activation markers in rhinitis and rhinosinusitis. 1: Eosinophilic cationic protein (ECP)].

BACKGROUND: The quantitative analysis of the migration and activation of inflammatory cells is standard in current diagnosis of inflammatory diseases of the nasal mucosa. Histological and cytological examinations are mostly used for this purpose. Development and validation of assays for specific marker proteins of the different cell populations make similar analyses possible from nasal secretion samples. Myeloperoxidase (MPO) or Elastase are important markers for neutrophil granulocytes as is Tryptase for mast cells, Lysozyme for macrophages/monocytes and Eosinophil Cationic Protein (ECP). Eosinophil Neurotoxin/Eosinophil Protein X (EDN/EPX) or Major Basic Protein (MBP) for eosinophil granulocytes. METHODS: We performed a prospective study on healthy volunteers and patients with different inflammatory nasal and paranasal sinus diseases and analysed such cell activation markers in nasal secretions. In the healthy volunteers, 183 nasal secretion samples were obtained. A total of 515 samples were obtained in patients with the diagnosis: chronic sinusitis (n = 49), allergic rhinitis to perennial allergens (n = 94), chronic sinusitis with additional allergic rhinitis to perennial allergens (n = 36), nasal polyps (n = 28), allergic rhinitis to seasonal allergens extraseasonally (n = 131), and allergic rhinitis to seasonal allergens during the pollen season (n = 177). RESULTS: In part I of this paper we describe the results for the Eosinophil Cationic Protein (ECP). In all patients with active inflammatory reactions significantly higher ECP levels than in the controls were found. Moreover, ECP levels differed between the diseases investigated. CONCLUSIONS: ECP nasal secretion level seem to be a valuable marker for the assessment of nasal eosinophilic inflammation and might become an adjunct to current diagnostic measures.

Adult↗