PubMed · 14943425
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F CAVAZZUTI. 1952. [Renal function following tonsillectomy].. https://pubmed.ncbi.nlm.nih.gov/14943425/
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The purpose of this research was to study the growth of the nasopharynx and adenoid development. Lateral cephalometric radiographs obtained from 320 white Brazilian subjects between 4 and 16 years of age were used. All the participants were nose breathers and none of them had previously undergone adenoidectomy. Tracings were made from the radiographs and cephalometric measurements were performed. The results showed that adenoid sagital thickness is larger in the age group 4 - 5 years and decreases progressively. There is a slight increase in the age group 10 - 11 years, but afterwards the decrease continues. However, the nasopharyngeal free airway space does not decrease in the age group 10 - 11 years, despite the increasing thickness of the adenoid. This is attributable to the downward displacement of the hard palate, resulting in an increase of the free airway space due to growth. Although the nasopharynx follows a growth pattern similar to that of the rest of the body, adenoid tissue does not. Adenoidal development seems to differ from that of other lymphatic tissues, showing a peculiar pattern that can be revealed when hypertrophy due to infections and allergies is eliminated.
BACKGROUND: The balance of CD28/CTLA4-derived signals and Fas-dependent apoptosis activity is determined by the peripheral defense mechanisms and might play a role in the pathogenesis of allergy. OBJECTIVES: The aim of the study was to investigate the expression of costimulatory and pro- and antiapoptotic molecules in adenoid T cells of children suffering from allergic rhinitis and to find out which of these molecules have a predictive value in the development of allergic rhinitis. METHODS: The adenoids of 60 children, removed because of nasal obstruction, chronic rhinitis and recurrent respiratory infection, were evaluated. Patients were divided into two groups: group 1, suffering from chronic allergic rhinitis, and group 2, suffering from chronic rhinitis, where no specific IgE was detected, including children with a positive family history of allergy (group 2a) and children with neither a personal nor a family history of allergy (group 2b). For immunohistochemical stainings anti-CD3, anti-CD19, anti-CD4, anti-CD8, anti-CD25, anti-CD28, anti-CTLA4 (CD152), anti-bcl-2, anti-Fas, and anti-FasL antibodies were used. The number of cells expressing these molecules was identified in adenoid interfollicular spaces. The results were then analyzed in allergic and nonallergic children. During a 24-month follow-up children were re-examined for allergy and results were compared to previous immunohistochemical evaluations. RESULTS: The expression of CD4, CD25, CD28, FasL, and CTLA4 was significantly increased in group 1 compared to group 2 (p < 0.05). However, the discriminant analysis confirmed that only CTLA4 and FasL expression fully discriminated allergic subjects from the others. During a 24-month period of observation 8 children from group 2a were also diagnosed with allergic rhinitis. All of them, especially those sensitized to mites, had an increased number of FasL+ and CTLA4+ in previously removed adenoids. CONCLUSION: An increased number of cells with intracellular expression of FasL and CTLA4, in interfollicular spaces of adenoids, seems to be a predictive factor of the development of allergic rhinitis.
OBJECTIVE: The cardiac complications of adenotonsillar hypertrophy (ATH) have been investigated by many scientists by using supplemental diagnostic modalities such as echocardiography. But, arrhythmia analysis has not been studied adequately in patients with ATH. This study aimed at evaluating the prevalence of arrhythmias, heart rate variability (HRV) and heart rate turbulence (HRT) analyses by means of 24 h Holter ECG monitoring in pre- and post-operative periods in children with ATH. METHODS: Twenty-five children with ATH consisting of 12 female and 13 male patients (mean age 66+/-15 months, range 24-108 months) included in this study. All children were assessed pre-operatively and at 1 month post-operatively with 24-h Holter monitoring and ECG analysis. The prevalence analysis of arrhythmias, heart rate variability and heart rate turbulence analysis was assessed. These data were compared. RESULTS: Although some ECG and holter findings such as sinusal tachycardia, Mobitz type 1 second-degree AV block improved after the operation, the prevalence of arrhythmias, HRV and HRT values were not changed significantly in post-operative period (p>0.05). CONCLUSION: Measurement of HRT and HRV are attractive and easily applicable ways of non-invasive risk prediction of cardiac complications. But, these parameters have not changed significantly in post-operative period. However, ECG and 24-h Holter monitoring of electrocardiography may be useful at evaluating the prevalence of arrhythmias and determining cardiac complications in pre-operative period.