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PubMed1994

Presence of neuropeptides in human nasal polyps.

The pathophysiological effects of non-cholinergic, non-adrenergic neuropeptides are well known in the nasal mucosa, but unclear in the polyps. Since the pathophysiological roles of neuropeptides depend on their presence in the target tissue, specimens of nasal polyps were removed from 20 patients and examined for the presence of vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), dopamine-beta-hydroxylase (DBH), substance P (SP) and calcitonin gene-related peptide (CGRP). To visualize these neuropeptide fibers, immunohistochemical staining by the peroxidase-anti-peroxidase method and color reaction by Nickel enhancement of diaminobenzidine (DAB) were used. Fine varicose neuropeptides immunostained fibers were predominantly distributed in the pedicle of the polyps. No neuropeptides were found in the mucosal epithelium and subepithelium. NPY fibers were predominantly seen around the thick wall vessels, whereas the VIP fibers were mainly to be found in close proximity to the submucosal glands and fairly close to the vessels. SP or CGRP fibers were not found in the polyps. VIP and NPY in the pedicle of the polyps may be present in connection with mucosal inflammation, tissue edema and cystic degeneration of the glands in the early stage of polyp formation. Thus these neuropeptides may contribute to the development and growth of nasal polyps.

Calcitonin Gene-Related Peptide↗
PubMed1997

Inflammatory cytokine expression on nasal polyps developed in allergic and infectious rhinitis.

To investigate the expression of cytokine mRNAs in nasal polyps and the role of allergy in the pathogenesis of nasal polyposis, we studied the expression of IL-4, IL-5, and IFN-gamma mRNAs using the RT-PCR and Southern blot. Nasal polyp specimens were obtained from 14 patients with infectious rhinitis and 5 patients with perennial allergic rhinitis. Turbinate mucosa specimens were obtained from 10 patients with allergic rhinitis and from 10 healthy subjects as controls. IL-4, IL-5 and IFN-gamma mRNA were expressed in most specimens of allergic turbinate mucosa. The expression of these cytokines was less frequent in normal healthy turbinate mucosa. The density ratios of IL-4, IL-5 and IFN-gamma to beta-actin were individually determined in both polyp and turbinate tissues. The density ratio for each cytokine was relatively higher in polyp tissues than in healthy turbinate mucosa; however, there was no significant difference in the density ratios determined for polyps associated with allergic rhinitis as compared with polyps associated with infectious rhinitis. These findings indicate that nasal polyposis may differ from allergic rhinitis in the mechanism by which IL-4 and IL-5 are increased. It is concluded that allergy may have an insignificant role in the development of nasal polyps.

Adult↗
PubMed1985

Guaiac tests for detection of occult faecal blood loss in patients with endoscopically verified colonic polyps.

To evaluate the sensitivity of guaiac tests for colonic polyps, two tests were made on occult blood in faeces--Hemoccult II and Fecatwin-S--from 625 and 549 patients, respectively, referred for colonoscopy. Polyps were found in 212 and 194 patients, and these had one or more tests positive in 41% (Hemoccult II) and 48% (Fecatwin-S). The incidence of positive tests was greater for polyps situated in the transverse, descending, and sigmoid colon; for polyps with a stalk, villous elements, and dysplasia; and especially for large polyps. Although size was the most important factor for the bleeding tendency, at least one third of patients with polyps over 10 mm in diameter had no positive guaiac reactions. In patients at high risk of developing polyps, therefore, these tests cannot replace, but may well be supplementary to, radiography with double-contrast technique and colonoscopy.

Adolescent↗
PubMed1994

Epidemiology of gallbladder polyps: an ultrasonographic study of male self-defense officials in Japan.

The prevalence and risk factors of gallbladder polyps diagnosed by ultrasonography were investigated in 2739 male self-defense officials who received a retirement health examination at the Self-Defense Forces Fukuoka Hospital, Japan, between October 1986 and December 1990. Excluding 38 men whose gallbladder had been removed previously, 143 men were found to have gallbladder polyps. The overall prevalence of gallbladder polyps was 5.3%. The relation between gallbladder polyps and smoking, alcohol use, body mass index, glucose tolerance, and serum lipids was examined in 137 men with stoneless polyps and 2495 normal subjects. Whereas smoking tended to be inversely associated with gallbladder polyps, none of the other lifestyle and clinical variables were related to this condition. Thus the reported risk factors of gallstones had no relation to gallbladder polyps.

Alcohol Drinking↗
PubMed1998

IgE production from the nasal polyp tissue: comparison between atopic and non-atopic subjects.

OBJECTIVES AND METHODS: To confirm the local production of IgE antibody from the nasal polyp tissue, and to evaluate the difference between atopics and non-atopics, nasal polyp tissues were taken from both 10 atopic and 10 non-atopic subjects. The tissue total IgE (tlgE) level was measured by enzyme-linked immunosorbent assay (ELISA) and serum tlgE level by radio-immunoassay. The tissue albumin level was measured by nephelometry, and serum albumin level by Bromocresol green method. RESULTS: The polyp tissue tlgE/albumin as well as serum tlgE/albumin ratio were significantly higher in atopics than in non-atopics (p < 0.05), with no difference in the albumin level between the two groups (p > 0.05). Three non-atopic subjects had high polyp tissue tlgE/albumin (> 10). A significant correlation was noted between serum tlgE/albumin and polyp tlgE/albumin (r = 0.46, p = 0.04). The ratio of polyp tlgE/albumin to serum tlgE/albumin was greater than 1 in all of the non-atopic subjects and 7 of 10 atopic subjects. CONCLUSION: These findings support the hypothesis that IgE antibody could be locally produced from the nasal polyp tissue of non-atopic subjects as well as atopic subjects. The possibility of an isolated local production of IgE antibody was suggested.

Albumins↗
PubMed2006

[Eosinophil chemoattractants and related factors in nasal polyps].

OBJECTIVE: In vitro studies and animal experiments have shown that cytokines and chemokines are closely related to eosinophil migration, activation, and survival. It remains controversial, however, whether some chemokines or cytokines are actually responsible for the accumulation of eosinophils in nasal polyp tissues. We studied cytokines and chemokines in nasal polyp tissues taken from patients with chronic rhinosinusitis to clarify the pathogenesis of eosinophil accumulation. MATERIALS AND METHODS: Nasal polyp tissues obtained from 20 patients with chronic rhinosinusitis were studied. Concentrations of interleukin (IL-) 5, IL-13, eotaxin, regulated upon activation in normal T cell expressed and secreted (RANTES), and thymus and activation-regulated chemokine (TARC) in homogenates of polyp tissues were measured by ELISA. Nasal polyp tissues were stained by hematoxillin and eosin and were immunostained by an antibody against EG2. The numbers of eosinophils and immunopositive cells for EG2 in the submucosal layer were counted using a microscope. RESULTS: No significant differences were seen in the numbers of eosinophils and EG2-positive cells, or in the concentration of IL-5, eotaxin, TARC, RANTES in nasal polyp tissues between patients with and without atopic predisposition. Significant positive correlations existed, however, between the number of eosinophils and IL-5, eotaxin, and TARC concentration. IL-13 concentration was below detection in all patients. CONCLUSION: We hound that IL-5, eotaxin, and TARC may play an important role in the accumulation of eosinophils in nasal polyps regardless of the presence of atopic predisposition.

Adult↗
PubMed2000

Urinary cytologic findings in patients with benign and malignant adenomatous polyps of the prostatic urethra.

CONTEXT: Urethral adenomatous polyps with prostatic epithelium (also known as benign prostatic epithelial polyps [BPEPs]) are a documented cause of hematuria, dysuria, and hematospermia, conditions that may prompt cytologic evaluation of urine. DESIGN: The urine cytologic test findings in 5 cases of biopsy-proven BPEPs and in 1 case of prostatic ductal adenocarcinoma (PDA) that presented as a urethral polyp were retrospectively evaluated. Immunocytochemical stain for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and high-molecular-weight cytokeratin (34betaE12) were used in evaluation of the lesions. RESULTS: In 4 of 5 cases of BPEPs, clusters of bland columnar cells with uniform, oval nuclei were seen. Positive immunostaining for PSA and PAP confirmed the prostatic origin of the clusters in 2 cases. One urine sample contained abundant goblet cells and extracellular mucin, consistent with intestinal metaplasia coexisting in the bladder biopsy specimen. The urine sample in the fifth case of BPEPs contained no columnar cells. The last case had multiple urine cytologic evaluations that demonstrated PSA-positive, malignant-appearing clusters of columnar cells. A biopsy specimen of the polyps was described as a high-grade prostatic intraepithelial neoplasm in adenomatous polyp. However, in this patient, PDA was diagnosed on transurethral resection of the prostate specimen 4 years after the initial urine cytologic test. CONCLUSION: Benign prostatic epithelial polyps should be considered in the differential diagnosis of clusters of columnar cells in urine cytologic testing. Cells with malignant nuclear features should instigate a careful search for a (prostatic) neoplasm, which may present as urethral polyps (e.g., PDA). Stains for PSA or PAP are useful adjuncts in differential diagnosis of this condition.

Acid Phosphatase↗
PubMed1998

Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial.

BACKGROUND: Helicobacter pylori infection is common in patients with hyperplastic gastric polyps. OBJECTIVE: To study the effect of eradication of H. pylori on the clinical course of patients with hyperplastic gastric polyps. DESIGN: Single-blind, randomized, controlled trial. SETTING: University-based gastroenterology outpatient clinic. PATIENTS: 35 patients with H. pylori infection and hyperplastic gastric polyps at least 3 mm in diameter. INTERVENTION: Patients were randomly assigned to a treatment group (n = 17), which received a proton-pump inhibitor (omeprazole or lansoprazole), amoxicillin, and either clarithromycin or ecabet sodium, or to a control group (n = 18), which received no treatment. MEASUREMENTS: Patients underwent endoscopy before enrollment and 12 to 15 months after the end of treatment. Serum gastrin levels and titers of IgG to H. pylori were measured. RESULTS: In the treatment group, the polyps had disappeared by 3 to 15 months (average, 7.1 +/- 1.2 months) after the end of treatment in 12 of all 17 patients (71%) and in 12 of the 15 patients (80%) in whom H. pylori was eradicated. However, 12 to 15 months after the start of the study, no change in polyps or H. pylori status was seen in any controls (P < 0.001). Histologic findings of inflammation and activity, serum gastrin levels, and titers of IgG to H. pylori showed significant regression in the treatment group compared with the control group (P < 0.01). CONCLUSIONS: Most hyperplastic polyps disappeared after eradication of H. pylori. Thus, eradication should be attempted before endoscopic removal is done in patients with hyperplastic gastric polyps and H. pylori infection.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Gallbladder polyps: prospective study.

The aim of this study was to describe the natural history of gallbladder polyps. Thirty-eight subjects who had been previously identified as having gallbladder polyps in an epidemiologic study of gallstone prevalence in 627 diabetic subjects and matched controls were followed longitudinally. Follow-up sonograms were obtained on 33 and 22 of the 38 subjects at 2 and 5 years, respectively. Prevalence for gallbladder polyps in this population was 6.7%, with a marked male predominance (odds ratio 2.3). No statistical difference in prevalence was found between diabetic subjects and nondiabetic controls. Ninety percent of the polyps were less than 10 mm in diameter, with no polyp being larger than 12 mm. During the follow-up period no changes suggestive of malignant transformation were observed. In conclusion, we found that gallbladder polyps were relatively common and that few significant changes occurred over a 5 year period. In asymptomatic subjects in whom gallbladder polyps less than 10 mm in diameter are found incidentally, the likelihood of malignant transformation is low.

Adult↗
PubMed2002

Predicting atypia inside endometrial polyps.

OBJECTIVE: To evaluate the efficacy of color Doppler exploration for assessing atypia inside endometrial polyps. METHODS: A prospective study was conducted in a tertiary university hospital. Eight hundred six patients with endometrial polyps were studied with color Doppler sonography, and the resistive index inside the polyp stalk was obtained. The patients were then referred for hysteroscopic resection, and pathologic analysis was performed. RESULTS: Thirty-five polyps with sonographic indications of atypia were pathologically confirmed. Sonographic indications of atypia inside 16 polyps were not confirmed. Three nonquestionable endometrial polyps had atypia inside them. CONCLUSIONS: Low Doppler resistance is highly predictive of atypia inside endometrial polyps.

Endometrial Neoplasms↗
PubMed1997

[Analysis of the EGG waveform of vocal polyps].

To study the effect of vocal polyps on vocal vibration, the authors analysed the EGG waveform of 201 cases of vocal polyps of various location and shape. The results showed that the EGG waveform in opening phase appeared a notch for vocal polyps with pedicle, and appeared steep for vocal polyps with a wide base. Among the polyps whose waveform appearing a notch in closing phase, most of their base located below vocal cord. Whether the polyps were located in the anterior, middle or posterior of the vocal cord and whether the polyps were unilateral or bilateral there are no effect on the EGG waveform. EGG was the potential technique for studying vocal function.

Adolescent↗
PubMed1999

Dysplastic changes in gastric fundic gland polyps of patients with familial adenomatous polyposis.

BACKGROUND: Fundic gland polyps are the most common gastric lesion in patients with familial adenomatous polyposis and are traditionally considered a condition with no malignancy potential. However, some reports have recently questioned this view. AIMS: To prospectively evaluate their prevalence and the associated dysplastic/malignant changes in a series of affected patients. PATIENTS AND METHODS: Thirty-seven affected patients were carefully investigated by upper endoscopy over a three-year period. Multiple (at least 10) complete excisions of any representative polyp of the body-fundus were performed and a thorough pathological search for microscopic adenomatous/dysplastic changes carried out. RESULTS: Of 37 patients, 19 (51.3%) showed gastric fundic gland polyposis and 18 of them gave consent for polypectomies. Overall, 425 endoscopic polypectomies were performed, with a mean of 23.6 +/- 14.6 per patient. At pathology, all excised polyps of the body-fundus were found to be fundic glandular. Microscopic adenomatous changes within such polyps were identified in 8 (44.4%) patients. All the adenomatous foci revealed mild dysplasia with no case of severe atypia or carcinoma. Patients with microadenomas showed a significantly higher total number of gastric polyps compared with those without microadenomas (p < 0.03). No other differences between the two groups were observed. Two further patients presented microadenomas in apparently normal antral mucosa and one also showed a 6 mm antral adenoma with mild dysplasia. Finally, the search for Helicobacter pylori was always negative. CONCLUSIONS: Patients with familial adenomatous polyposis and gastric fundic gland polyps have a high prevalence of microscopic adenomatous foci within such lesions; nevertheless, these foci seem not to be associated with signs of severe atypia or carcinoma. Moreover, microadenomas are ubiquitous throughout the stomach, as well as in the rest of the gut, and their natural history is still undefined. Thus, their malignancy potential remains uncertain. More extensive follow-up is warranted to better investigate the long-term biological behaviour of these lesions but, at present, our data do not support the need for a change in the usual intervals of upper endoscopy surveillance in familial polyposis patients with or without gastric fundic glands polyps.

Adenomatous Polyposis Coli↗
PubMed2000

Allelic loss at SMAD4 in polyps from juvenile polyposis patients and use of fluorescence in situ hybridization to demonstrate clonal origin of the epithelium.

Juvenile polyposis syndrome (JPS; Online Mendelian Inheritance in Man2 174900) is a rare Mendelian disorder in which individuals have typical hamartomatous polyps within the gastrointestinal tract. The stromal element of the polyps has classically been thought to be the proliferative component, although epithelial malignancies (largely gastrointestinal cancers) occur more frequently than expected in JPS patients. Germ-line mutations in SMAD4 (DPC4) account for about a third of JPS cases. It has been postulated that the apparent paradox of a stromal lesion predisposing to epithelial malignancy can be resolved by the "landscaper" effect: an abnormal stromal environment affects the development of adjacent epithelial cells, and the resulting regeneration of damaged epithelium leads to an increased risk of cancer. We have found allele loss at the SMAD4 locus on 18q in polyps from JPS individuals with a germ-line SMAD4 mutation, showing that SMAD4 is acting as a tumor suppressor gene in JPS polyps, as it does in sporadic cancers of the gastrointestinal tract. Interphase fluorescence in situ hybridization showed deletion of one copy of SMAD4 in the epithelial component of JPS polyps, but not in the inflammatory infiltrate. Fluorescence in situ hybridization also suggested that a single copy of SMAD4 was present in stromal fibroblasts of JPS polyps. Thus, biallelic inactivation of SMAD4 occurs in both the epithelium and some of the stromal cells in these lesions, suggesting a common clonal origin. Epithelial malignancies almost certainly develop in juvenile polyposis through direct malignant progression of the epithelial component of the hamartomas. SMAD4/DPC4 probably acts as a "gatekeeper" tumor suppressor in juvenile polyps, and there is no need to invoke a "landscaper hypothesis."

Adenomatous Polyposis Coli↗
PubMed2000

Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding.

PURPOSE OF INVESTIGATION: To report our evaluation of the prevalence and malignant potentiality of endometrial polyps in women with abnormal uterine bleeding, as well as the efficacy of transvaginal ultrasonography and sonohysterography as diagnostic techniques. METHODS: Fractional dilatation and curettage (D&C) was performed in 1,415 patients aged 23-85 years treated in our clinic for abnormal uterine bleeding from 1986 to 1998. Transvaginal ultrasonography was performed prior to D&C on all patients. Sonohysterography was performed only on 157 patients. Diagnostic efficacy for both techniques was evaluated for the detection of endometrial polyps combined with hyperplasia due to sonographic and histologic difficulties in distinguishing them. RESULTS: The prevalence of endometrial polyps was 8.9% (126/1,415). From all 126 endometrial polyps found, 94 were benign, 30 (23.8%) were found with premalignant changes (complex and atypical hyperplasias) and two (1.5%) had undergone malignant degeneration. Transvaginal ultrasonography was of limited diagnostic value for polyps and hyperplasia in premenopausal women, while in postmenopausal women the method provided a greater yield. Sonohysterography was found to be a more effective diagnostic tool. CONCLUSION: Endometrial polyp prevalence rises by age and/or menopause. Malignant degeneration of endometrial polyps was observed only in postmenopausal women. Sonohysterography represents an improvement over conventional ultrasonography and both methods could be used for screening purposes especially when hysteroscopy can not be performed.

Adult↗
PubMedDate not supplied

Concentration of s-ICAM-1 in nasal polyps tissue.

INTRODUCTION: Polyps are a nasal condition considered to be inflammatory in nature. Pathophysiology of that disorder is not fully known. The role of ICAM-1 in inflammatory and immune response through its involvement in leukocyte adhesion dependent phenomena is proved to be important. The aim of the study was to establish the role of sICAM-1 in the inflammatory process in nasal polyps. MATERIAL AND METHODS: 27 patients (23 males and 4 females) with nasal polyposis and 12 (7 males and 5 females) controls with septal deviation were included in the study. All patients underwent routine surgical treatment (polypectomy, septoplasty). The collected tissues of polyps and nasal mucosa were homogenized, placed in 0.04M EDTA and centrifuged. sICAM-1 concentration in supernatant of polyps and nasal mucosa tissue were determined with the ELISA method (Genzyme, UK). RESULTS: In the polyps tissue we found a significantly higher concentration of sICAM-1 compared to the nasal mucosa of healthy subjects (6.74 +/- 5.31 ng/ml vs 0.28 +/- 0.13 ng/ml; p < 0.001). The elevated concentration of sICAM-1 was positively correlated with total tissue eosinophil count (r = 0.51; p < 0.01) and the duration of the disease (r = 0.628; p < 0.001). No correlation was found between sICAM concentration and the age of the patients subjected to examination. CONCLUSIONS: The increased level of sICAM-1 in polyps tissue indicates the role of the molecule in the development of chronic inflammation and probably in the patophysiology of nasal polyps.

Adult↗
PubMed2001

[A new variant of choanal polyps].

Seven cases of ethmochoanal polyps, a form of nasal polyps, originating from mucosa of the back ethmoidal labyrinth and lowering into the nasopharynx are described. Such polyps are diagnosed primarily by computed tomography and endoscopy of the nasal cavity. Histologically, ethmochoanal polyps are similar to other polyps from paranasal sinuses. Surgical treatment of ethmochoanal polyps is made under the control of endoscope via approach through the superior nasal passage. The polyp part situated in posterior compartment of the ethmoidal labyrinth was removed with a microdebrider. 1 to 3 year follow-up registered no cases of recurrence.

Adult↗
PubMed2002

Cyclooxygenase 2- and prostaglandin E(2) receptor EP(2)-dependent angiogenesis in Apc(Delta716) mouse intestinal polyps.

To investigate angiogenesis during intestinal polyp development, we determined the microvessel density (MVD) in polyps of Apc knockout (Apc(Delta716)) mice, a model for human familial adenomatous polyposis. We scored MVD also in several compound mutants carrying Apc(Delta716), namely, mice with an additional mutation in Smad4, in which the polyps progress into invasive adenocarcinomas; mice with a cyclooxygenase (COX)-2 gene (Ptgs2) mutation, in which adenoma growth is suppressed; and mice with prostaglandin E(2) EP receptor gene mutations. In both simple Apc(Delta716) and compound Apc(Delta716) Smad4 mutants, MVD increased in a polyp size-dependent manner only in the polyps expanded beyond a threshold of about 1 mm in diameter. These results indicate that tumor angiogenesis is stimulated only after tumors grow to a certain size, and this angiogenic switch is common to both benign adenomas and malignant adenocarcinomas. In Apc(Delta716) polyposis attenuated by the COX-2 gene mutation, in contrast, MVD did not increase even in polyps larger than 1 mm. The same phenomenon was observed in the compound mutant mice with Apc(Delta716) and the EP(2) receptor gene mutations, but not in other EP compound mutants. We also immunohistochemically studied COX-2 and angiogenic factors, vascular endothelial growth factor and basic fibroblast growth factor. Interestingly, expression of these proteins was also increased in polyps larger than 1 mm. These results suggest that, in both benign and malignant mouse intestinal tumors, stromal expression of COX-2 results in elevated prostaglandin E(2) levels that stimulate cell surface receptor EP(2), followed by induction of vascular endothelial growth factor that causes tumor angiogenesis.

Adenocarcinoma↗
PubMed2001

[Drug allergy among patients suffering from nasal polyps].

The study was performed in order to evaluate quantity and morphology of nasal polyps in patients with diagnosed drug allergy to aspirin, antibiotics, polocain, procain and other drugs. The study included 60 patients (27 females, 33 males aged between 18-69 years). Nasal polyp morphology was examined under electron microscope and light microscope. Morphological evaluation of epithelial and subepithelial structures was done under light microscope, taking not of inflammatory infiltration type, basal membrane, as well as degree of intestinal edema. Evaluation of epithelial cell type, their relative proportion, as well as area percentage covered by cilium, microvilli and squamous epithelium was done under electron microscope. Polyps in patients with idiosyncrasy to polish aspirin and sodium metamizole (12 patients) featured increased eosinophilic infiltration, thickened basal membrane, with elevated eosinophil percentage differential count. The epithelial percentage area was covered by squamous cells without villi. Polyps associated with idiosyncrasy to polish aspirin differed morphology compared to polyps originality from patients allergic to other medications. On the other hand polyps from patients allergic to other drugs, such as: penicillin, procainamide were morphologically (electron light microscope, light microscope) similar to those polyps caused by inflammatory factors.

Adult↗