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Quantification of interleukin-1 in nasal polyps from patients with chronic sinusitis.

We have measured interleukin-1 alpha (IL-1 alpha) and beta levels in nasal polyps (NP) from patients with chronic sinusitis (CS) in order to determine their significance in the pathogenesis of NP. NP in ten cases (five male and five female; age range, 17-63 years) were removed to separate mononuclear (M) and polymorphonuclear (PMN) fractions through Ficoll-Paque separation media. ELISA measurements of the M fraction showed that the mean value of IL-1 beta was 17.8 pg/ml per gram, which was significantly higher than that of IL-1 alpha (7.04 pg/ml per gram, P < 0.01, Wilcoxon test). In the PMN fraction, the mean value of IL-1 alpha was 8.79 pg/ml per gram and that of IL-beta was 7.85 pg/ml per gram, which was not significantly different. Mononuclear leukocytes, particularly activated monocytes, seem to be a major source of IL-1 in the NP taken from patients with CS.

Adolescent↗

Is antibiotic treatment of chronic sinusitis effective in children?

A double-blind randomized controlled trial on 79 patients aged between 2 and 12 years with chronic sinusitis showed no significant advantage of adding antibiotics to the treatment by sinus lavage. The prognosis after both 6 and 12 weeks was worse for patients with bilateral opaque sinus radiographs. Half of the Branhanmella catarrhalis cultured in this study were beta-lactamase producing organisms, therefore antibiotics prescribed for this group of children should be chosen bearing this in mind.

Cefaclor↗

Evaluation of the effects of antigen specific immunotherapy on chronic sinusitis in children with allergy.

The purpose of this study is to evaluate the clinical significance of allergy in children with chronic sinusitis. After allergic examinations, 52 sinusitis children were divided into allergic and non-allergic groups: 37 allergic children were treated with either the combination of antigen specific immunotherapy and medication with lysozyme chloride preparation (AI group, n = 20) or medication alone (AM group, n = 17); 15 non-allergic patients were also treated with lysozyme chloride preparation (NAM group). The treatment results including the radiographic improvements were significantly better in the AI group than in the AM or NAM group. The clinical effects of lysozyme chloride preparation tended to be better in the NAM group than in the AM group.

Allergens↗

Extradural haematoma secondary to chronic sinusitis: a case report.

The complications of frontal sinusitis are well-known. There is no record in the medical literature of an extradural haemorrhage resulting from pathology of the frontal sinus. I report a case of chronic frontal sinusitis with polyposis, resulting in an extradural haematoma.

Adult↗

Chronic sinusitis: the role of imaging.

In recent years, routine endoscopic examination of the nose and advances in medical imaging have led to a better understanding of the pathophysiology of chronic sinusitis and the development of "FESS". The CT san of the sinuses have superseded the conventional standard radiography in the evaluation of the paranasal sinuses as it offers more precise anatomic information to the surgeon on the complex anatomy of the sinus cavities and their drainage pathways, in particularly the ostiomeatal complex. The coronal plane is the best incidence because it most closely correlates with the surgical approach. The utilization of a high resolution bony algorithm is recommended. A window of intermediate type, 2500 with a center of 250 HU, is sufficient for nearly all diagnosis. Complementary direct axial sections are needed by the surgeon to guide the approach to the sphenoid sinus and the posterior ethmoidal cells. MRI plays a limited role in the evaluation of a non complicated sinusitis. But MRI has supplanted the CT scanner in the appreciation of intracranial and orbital complications of sinusitis because it provides better visualisation and differentiation of soft tissues than the CT scan. The injection of contrast is recommended in all cases of complicated sinusitis.

Algorithms↗

Quantitation and immunocytological identification of interleukin-1 in nasal polyps from patients with chronic sinusitis.

Immunoreactive interleukin-1 (IL-1) alpha and beta levels in nasal polyp (NP) extracts were measured from 22 adult patients with chronic sinusitis (CS) in order to determine their significance in the pathogenesis of NP. The NP sample was separated into mononuclear and polymorphonuclear fractions. In the mononuclear fraction, the mean value of IL-1 beta was 21.5 pg/ml/g, which was significantly higher than that of IL-1 alpha (8.4 pg/ml/g, p < 0.01). In younger adults, the IL-1 alpha and IL-1 beta levels were 21.2 and 59.4 pg/ml/g, which were significantly higher than those in older CS patients (p < 0.01). There was a significant reverse correlation between patient's age and IL-1 beta levels in the mononuclear fraction (r = -0.509, p < 0.01). Immunoreactive IL-1, mainly IL-1 beta, was identified in the cytoplasmic area of monocytes. A certain amount of immunoreactive IL-1 is produced in mononuclear leukocytes, particularly activated monocytes, and IL-1 beta production is greater than IL-1 alpha. In younger adult CS patients, NPs contain larger amounts of IL-1 beta in monocytes, compared to those of older patients.

Adolescent↗

Some risk factors for refractory chronic sinusitis: an immunohistochemical and electron microscopic study.

The goal of the present work was to investigate possible risk factors for the poor response of some cases of chronic sinusitis to endoscopic sinus surgery in spite of the precision of the surgical technique. Eleven adult patients who were scheduled for revision endoscopic sinus surgery underwent a complete allergy workup. At the time of surgery, a tiny biopsy was taken from the maxillary sinus mucosa close to the middle turbinate. The specimens were processed for histochemical and transmission electron microscopic examination. Six patients (55 per cent) proved to be allergic. Their sinus mucosa showed eosinophilic infiltration (6.1 cells/mm(2)), and mast cell degranulation. This proves that allergens can reach the sinus mucosa and have a direct impact on it. Another three patients (27 per cent) were non-allergic but exhibited mucosal eosinophilia (5.0 cells/mm(2)), and two of them showed mast cell degranulation. These patients were diagnosed as having nonallergic rhinosinusitis with eosinophilia (NARSE). The nasal mucosa of the remaining two patients did not reveal any characteristic pathological findings, and no pathologic diagnosis could be established for them. None of the patients showed electron microscopic evidence of purulent inflammatory changes, and the bacterial cultures recovered normal respiratory flora in nine patients (82 per cent). The present research spotlights the importance of allergy and nonallergic eosinophilic infiltration of the mucosa as possible risk factors that may degrade the results of endoscopic sinus procedures and discusses some pertinent pathological and clinical aspects.

Adult↗

[Chronic sinusitis].

Explore the source record for details and available documents.

Chronic Disease↗

[Aerobic and anaerobic bacterial flora in chronic sinusitis in adults].

The aim of the study was to analyse microbiologically samples obtained from 30 patients aged from 21 to 73 years treated for chronic sinusitis. Aerobic bacteria only were isolated in 16 patients (53%), and anaerobic organisms only in 5 patients (17%). Mixed aerobic and anaerobic isolates were recovered from 9 patients (30%). The isolated aerobic bacteria were as follows: streptococci from the species Streptococcus salivarius, Streptococcus anginosus, Streptococcus group C, Streptococcus sanguis, Staphylococcus aureus, Gram-negative rods from the genus Haemophilus and rods from the Enterobacteriaceae family, and strains of Moraxella catarrhalis. The isolated anaerobic microorganisms Gram-negative rods from the genus Prevotella, Bacteroides, Fusobacterium, Gram-positive cocci from the genus Peptostreptococcus. Other organisms from the genus Vailonella, Eubacterium and Actinomyces were isolated less frequently. In 15 patients only one isolate was recovered, in 15 patients isolated bacteria were mixed with other microorganisms.

Adult↗

[A study of infiltrated cells in the maxillary mucosa in nasal allergy and chronic sinusitis].

The cloudiness of the maxillary sinus in Waters-view is 37% in patients with nasal allergy. The pathogenesis of this cloudiness has not fully understood yet; is it due to the type- I allergic reaction, or secondary maxillary sinusitis? To clarify the pathology, we studied the infiltrated cells in 37 mucosae of the maxillary sinus in which X-ray revealed an abnormal shadow. Samples were also taken from 9 antrums with chronic sinusitis, and 18 and 4 nasal mucosae form the inferior turbinate with nasal allergy and sinusitis, respectively. Each specimen were fixed with Carnoy solution and formalin, and were stained with Hematoxylin & Eosin, and with Alcian blue & Safranin. Numbers of formalin sensitive and resistant mast cells and eosinophils were determined in the epithelium, and superficial and deep layers of the lamina propria, respectively. The population of both mast cells in each compartment was not different between nasal allergy and maxillary sinusitis both in the nasal and maxillary mucosae. The number of eosinophils in the maxillary and nasal epithelial significantly increased in nasal allergy compared with sinusitis. These results suggested that type-I allergic reaction might occur in the maxillary mucosa as well as nasal mucosa in patients with nasal allergy.

Cell Count↗

Prevalence and risk factors of chronic sinusitis in Korea: results of a nationwide survey.

From July through October 1991, a nationwide survey was conducted on the prevalence and risk factors of chronic sinusitis in Korea, using medical and family histories as well as physical examination. In all, 9,069 subjects were examined from 2,899 households residing in 60 different areas throughout the country. The overall prevalence of sinusitis was 1.01%. Casecontrol analysis was performed to determine possible risk factors for sinusitis. No significant differences were found in age groups or sexes. A significant geographic difference was seen in prevalence in the different provinces studied. Economic activity, crowding and allergy were significant risk factors. Other factors such as urban or rural residence, birth place, maternal and paternal age at birth, marriage, smoking history, education, social class, prior trauma, height and weight, and nasal septal deformities did not correlate with the occurrence of sinusitis.

Adolescent↗

[Chronic sinusitis and nasal polyp as the initial manifestation of cystic fibrosis].

We report the case of a fourteen years old girl suffering from cystic fibrosis of pancreas, whose first clinic symptoms were chronic sinusitis and nasal polyp. Her most characteristic features were normal height growth without manifestations of pancreatic insufficiency or chronic endobronchial infections. Normal spirometry. PC 20 histamine > or = 16 mEq/ml. Negative skin test (prick) to common inhalants and sweat chloride concentration ranging between 92 and 110 mmol/l.

Adolescent↗

Lateralized and bilateral olfactory function in patients with chronic sinusitis compared with healthy control subjects.

Results of this study demonstrated that a new olfactory test, the "Sniffin' Sticks," can be used to distinguish hyposmic patients with chronic sinusitis (n = 63) from control subjects. Dirhinic testing yielded improved olfactory sensitivity compared with monorhinic testing. However, dirhinic results were not significantly different from results obtained for the best nostril.

Adolescent↗