The effects of systemic, topical, and intralesional steroid treatments on apoptosis level of nasal polyps.

PubMed

Kapucu, Burak; Cekin, Engin; Erkul, Bulent Evren; Cincik, Hakan; Gungor, Atila; Berber, Ufuk

2012-09-01

The purpose of this study was to compare the apoptotic responses to systemic, topical, and intrapolyp injection of glucocorticoid with no treatment in nasal polyps. Prospective, randomized controlled study. Tertiary training hospital. The study was performed on 48 patients with nasal polyposis in the Department of Otorhinolaryngology between 2008 and 2009. Patients were assigned to 1 of 4 groups of 12 patients. Group A was treated with oral methylprednisolone 1 mg/kg/d, and the dose was tapered gradually. Group B received 0.3 mL triamcinolone acetonide (40 mg/mL), which was injected into polyp tissue. Group C was treated with topical 55 µg triamcinolone acetonide 2 times daily for 1 month. Group D received no medication. Samples were collected endoscopically after the seventh day for groups A and B, the first month for group C, and the first visit for group D. Apoptotic indexes were determined using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method. Statistically significant differences in apoptotic index were found between each steroid-medicated group and the control group (P (D-A) = .0001; P (D-B) = .003; P (D-C) = .026) and between groups A and C (P (A-C) = .012). Group B did not differ significantly from either group A or C (P (A-B) = .11; P (B-C) = .75). The apoptotic index in nasal polyps treated with systemic, topical, and intrapolyp injection forms of glucocorticoids was higher than that in the control group. Systemic steroid treatment induced the most apoptosis.

Elevated expression of the chemokine CCL18 in chronic rhinosinusitis with nasal polyps

PubMed Central

Peterson, Sarah; Poposki, Julie A.; Nagarkar, Deepti R.; Chustz, Regina T.; Peters, Anju T.; Suh, Lydia A.; Carter, Roderick; Norton, James; Harris, Kathleen E.; Grammer, Leslie C.; Tan, Bruce K.; Chandra, Rakesh K.; Conley, David B.; Kern, Robert C.; Schleimer, Robert P.; Kato, Atsushi

2011-01-01

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with Th2-dominant inflammation including eosinophilia, in contrast to non-polypoid CRS (CRSsNP). Chemokine CCL18/PARC (pulmonary and activation regulated chemokine) is known to recruit naïve T cells, B cells, and immature dendritic cells, as well as activate fibroblasts. CCL18is thought to be involved in Th2-related inflammatory diseases including asthma and atopic dermatitis. Objectives The objective of this study was to investigate the expression of CCL18 in patients with CRS. Methods Using nasal polyp tissue (NP) and uncinate tissue (UT) from controls and patients with CRS, we examined the expression of CCL18 mRNA by real-time PCR and measured CCL18 protein by ELISA, western blot and immunofluorescence. Results Compared to UT tissue in control subjects, CCL18 mRNA was significantly increased in NP (p<0.001) and UT (p<0.05) from patients with CRSwNP but not in UT from patients with CRSsNP. Similarly, CCL18 protein was elevated in NP and UT from CRSwNP and levels were even higher in Samter’s triad patients. Immunohistochemical analysis revealed CCL18 expression in inflammatory cells and CCL18+ cells were significantly increased in NP. Immunofluorescence data showed co-localization of CCL18 in CD68+/CD163+/macrophage mannose receptor+ M2 macrophages and tryptase+ mast cells in NP. Levels of CCL18 correlated with markers of M2 macrophages but not with tryptase, suggesting that M2 macrophages are a major CCL18-producing cells in NP. Conclusion Overproduction of CCL18 might contribute to the pathogenesis of CRSwNP through its known activities, which include recruitment of lymphocytes and dendritic cells, activation of fibroblasts, and initiation of local inflammation. PMID:21943944

[The usefulness of evaluation of: ferritin, ultrasensitive CRP and tissue specific polypeptide 18th (TPS) in assessment of therapy efficacy in patients with nasal polyps].

PubMed

Pałac, Jacek; Bratek, Szczepan; Partyka, Robert; Misiołek, Maciej

2014-01-01

Chronic rhinosinusitis with nasal polyps is social, clinical and cost-effective problem, by reason of bothersome symptoms, chronic nature of the disease, tendency to recur and lack of satisfying treatment. The aim of this study is assessment of suitability of hsCRP, ferritin and blood levels in nasal polyps patients in evaluation of treatment efficacy. The study enrolled 38 patients between 20 and 68 years of age. Patients were divided into 2 groups. Levels of ultrasensitive CRP ferritin and TPS have been measured in all patients. The ultrasensitive CRP levels have been measured by chemiluminescence method. Ferritin levels have been measured by MEIA method. The TPS levels have been measured by chemiluminescence method. Comparison of mean ferritin levels in both study groups in each stage of observation shows the significant difference of mean values in only 6 weeks after surgery. Mean ferritin level is significantly lower in group I than in group II (p<0.05). Mean hsCRP levels vary from one corresponding to ferritin levels. Statistically significant difference between study groups in 2nd and 6th week after surgery has been ascertained (p<0.05). Similarly, like in ferritin levels, the TPS levels are significantly different in 6th week after surgery. Analysis of ferritin, hsCRP and TPS serum levels indicates that these may be useful in assessment of treatment efficacy in patients with nasal polyps. Rise of the chosen inflammatory state parameter level in the postoperative monitoring and anti-inflammatory treatment introduction in nasal polyps patients may inhibit the recurrence of the disease. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

[The efficacy and safety of budesonide inhalation suspension via transnasal nebulization compared with oral corticosteroids in chronic rhinosinusitis with nasal polyps].

PubMed

Lou, Hongfei; Wang, Chengshuo; Zhang, Luo

2015-05-01

To evaluate the efficacy and safety of a short course of nebulized budesonide via transnasal inhalation in chronic rhinosinusitis with nasal polyps. Fifty patients with severe eosinophilic nasal polyps were randomized devided into study group (n = 25) and control group (n = 25). The study group received budesonide inhalation suspension (1 mg twice daily) via transnasal nebulization for one week and the control group received oral prednisone (24 mg QD). Visual analogue scales (VAS) of nasal symptoms, endoscopic polyp scores (kennedy scores) and morning serum cortisol concentrations were assessed in both groups pre- and post-treatment. Operation time and surgical field bleeding were evaluated. Four subjects dropped out in control group. Budesonide transnasal nebulization caused a significant improvement in all nasal symptoms especially nasal obstruction (baseline: 8.25 ± 0.53; after treatment: 4.97 ± 0.97, P < 0.01) and reduced polyp size significantly (baseline: 4.64 ± 0.63; after treatment: 3.40 ± 0.76, P < 0.01) compared to pre-treatment. The patients treated with oral prednisone, however, showed more obvious improvement in nasal symptoms and polyp size, shorter operation time and better surgical field than budesonide group. Additionally, the morning serum cortisol concentration was mildly decreased after one week treatment in budesonide group [baseline (17.18 ± 2.83) μg/dl, after treatment (16.24 ± 2.93) μg/dl, P > 0.05], but all values were still located in normal range (normal range: 5-25 μg/dl). Conversely, the morning serum cortisol concentration in oral prednisone group was lower than normal limit [baseline (18.19 ± 2.81) μg/dl, after treatment (2.26 ± 0.70) μg/dl, P < 0.01]. Twice daily budesonide transnasal nebulization is an effective and safe treatment as evidenced by significant improvements in nasal symptoms and reduction in polyp size, coupled with an absence of hypothalamic-pituitary-adrenal axis suppression, which is safer than the

[Clinical analysis of nasal resistance and pulmonary function testing in patients with chronic nasal-sinusitis and nasal polyps].

PubMed

Liao, Hua; Shen, Ying; Wang, Pengjun

2015-05-01

To study the pulmonary function and nasal resistance characteristics of patients with chronic nose-sinusitis and nasal polyps (CRSwNP), to explore the evaluation role of nasal resistance in nasal ventilation function and the effect of endoscopic sinus surgery on pulmonary function in patients with CRSwNP. Fifty CRSwNP patients that met the study criteria were selected . The patients were performed endoscopic surgeries according to Messerklinger surgical procedures under general anesthesia. Extent of surgery was based on preoperative CT showing the range of the lesion of disease and endoscopic findings. Perioperative treatments contained intranasal corticosteroids, cephalosporin or penicillin antibiotics, nasal irrigation and other treatments. Main outcome measures included visual analog scale (VAS), endoscopic Lind-Kennedy scores, nasal resistence, pulmonary function in patientsone week before and after surgery, three months and six months after surgery. Pulmonary function includes forced expiratory volume in one second (FEV1), forced vital capacity FEV1/FVC and peak expiratory flow (PEF). The study found that there were significantly positive correlations among VAS score, Lund-Kennedy score and nasal resistance (P < 0.05) in CRSwNP patients, but there is a significantly negative correlation between VAS score, Lund-Kennedy score, nasal resistance and pulmonary function indexes of FEV1, FVC and PEF (P < 0.05). The VAS score, Lund-Kennedy score and nasal resistance values of CRSwNP patients were decreased significantly after comprehensive treatments with nasal endoscopic operation as the major one, the difference was statistically different (P < 0.05). And the pulmonary function indexs (FEV1, FVC, PEF) were significantly increased after surgery in CRSwNP patients. The nasal resistance can objectively and reliably reflect the degree of nasal congestion and the recovery of nasal function in CRSwNP patients after endoscopic sinus surgery. The detection method of nasal

Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps.

PubMed

Yu, Xue Min; Li, Chun Wei; Li, Ying Ying; Liu, Jing; Lin, Zhi Bin; Li, Tian Ying; Zhao, Li; Pan, Xin Liang; Shi, Li; Wang, De Yun

2013-11-01

The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 (EMP1) in the nasal mucosa of patients with nasal polyps (NP), and to determine what changes occur in response to glucocorticosteroid (GC) treatment. NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs (i.e. these 18 patients had NP biopsies taken before and after treatment). Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Quantitative PCR and immunohistochemistry were performed to determine the expression levels of EMP1. EMP1 mRNA expression was significantly lower (2.77-fold) in tissues from NP patients before GC treatment when compared to controls, but was increased in these patients after GC treatment. EMP1 staining in nasal epithelium co-localized with both basal (p63(+)) and differentiated (CK18(+)) epithelial cells. Their immunoreactivity was significantly greater in controls than NP patients. EMP1 mRNA levels were lower in the epithelium with severe hyperplasia (1.79-fold) or with metaplasia (1.85-fold) as compared to those with mild to moderate hyperplasia or non-metaplastic epithelium, respectively. Positive correlations between EMP1 and other epithelial cell-related gene (e.g. JUN, PTGS2, AREG etc.) mRNAs were observed. EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa (e.g. NP). © 2013 John Wiley & Sons Ltd.

Effect of Subcutaneous Dupilumab on Nasal Polyp Burden in Patients With Chronic Sinusitis and Nasal Polyposis: A Randomized Clinical Trial.

PubMed

Bachert, Claus; Mannent, Leda; Naclerio, Robert M; Mullol, Joaquim; Ferguson, Berrylin J; Gevaert, Philippe; Hellings, Peter; Jiao, Lixia; Wang, Lin; Evans, Robert R; Pirozzi, Gianluca; Graham, Neil M; Swanson, Brian; Hamilton, Jennifer D; Radin, Allen; Gandhi, Namita A; Stahl, Neil; Yancopoulos, George D; Sutherland, E Rand

2016-02-02

Dupilumab has demonstrated efficacy in patients with asthma and atopic dermatitis, which are both type 2 helper T-cell-mediated diseases. To assess inhibition of interleukins 4 and 13 with dupilumab in patients with chronic sinusitis and nasal polyposis. A randomized, double-blind, placebo-controlled parallel-group study conducted at 13 sites in the United States and Europe between August 2013 and August 2014 in 60 adults with chronic sinusitis and nasal polyposis refractory to intranasal corticosteroids with 16 weeks of follow-up. Subcutaneous dupilumab (a 600 mg loading dose followed by 300 mg weekly; n = 30) or placebo (n = 30) plus mometasone furoate nasal spray for 16 weeks. Change in endoscopic nasal polyp score (range, 0-8; higher scores indicate worse status) at 16 weeks (primary end point). Secondary end points included Lund-Mackay computed tomography (CT) score (range, 0-24; higher scores indicate worse status), 22-item SinoNasal Outcome Test score (range, 0-110; higher scores indicating worse quality of life; minimal clinically important difference ≥8.90), sense of smell assessed using the University of Pennsylvania Smell Identification Test (UPSIT) score (range, 0-40; higher scores indicate better status), symptoms, and safety. Among the 60 patients who were randomized (mean [SD] age, 48.4 years [9.4 years]; 34 men [56.7%]; 35 with comorbid asthma), 51 completed the study. The least squares (LS) mean change in nasal polyp score was -0.3 (95% CI, -1.0 to 0.4) with placebo and -1.9 (95% CI, -2.5 to -1.2) with dupilumab (LS mean difference, -1.6 [95% CI, -2.4 to -0.7]; P < .001). The LS mean difference between the 2 groups for the Lund-Mackay CT total score was -8.8 (95% CI, -11.1 to -6.6; P < .001). Significant improvements with dupilumab were also observed for the 22-item SinoNasal Outcome Test (LS mean difference between groups, -18.1 [95% CI, -25.6 to -10.6]; P < .001) and sense of smell assessed by UPSIT (LS mean difference, 14

Nasal polyps and the severity of asthma.

PubMed

Ceylan, Erkan; Gencer, Mehmet; San, Imran

2007-03-01

Upper airway pathologies often accompany asthma. Because this represents a single airway, the diagnosis, follow up and treatment of both upper and lower respiratory diseases is essential. Samter Syndrome (SS) is known to be associated with more severe asthma. The presence of nasal polyps (NPs) is also associated with asthma. However, the incidence of NPs in asthma and the effect of NPs on asthma severity are not well documented. Three hundred and forty-two asthma patients were evaluated by endoscopic nasal examination, pulmonary function test, skin prick tests and paranasal sinus tomography. Three hundred and eleven patients with asthma without NP, 19 asthma patients with NP and 12 patients with SS were included. It was found that 54.3% of patients without NPs, 63.2% with NP and 66.7% with SS were at step 3 on the Global Initiative for Asthma scale of severity, and 1.9%, 15.8% and 33.3% were at step 4, respectively. The presence of NPs in asthma patients is associated with an increase in asthma severity. In patients with asthma, the possibility of NPs should be investigated and treatment planned accordingly.

Age-related prevalence of chronic rhinosinusitis and nasal polyps and their relationships with asthma onset.

PubMed

Won, Ha-Kyeong; Kim, Young-Chan; Kang, Min-Gyu; Park, Han-Ki; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Chang, Yoon-Seok; Cho, Sang-Heon; Song, Woo-Jung

2018-04-01

Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity and can influence lower airway disease status in adults. However, its associations with adult asthma onset and activity have not been examined in detail in a general adult population. To investigate relationships between CRS with nasal polyps (CRSwNP) and asthma characteristics. A cross-sectional data set of 17,506 adult participants (≥18 years old) in the Korean National Health and Nutrition Examination Survey from 2010 through 2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscopy. Presence of asthma and its onset and current activity were assessed using structured questionnaires. CRS was significantly related to asthma, but the relationships were distinct by CRS and asthma status. CRSwNP was significantly associated with adult-onset asthma (onset after 18 years of age) or late-onset asthma (onset after 40 years of age), whereas CRS without nasal polyps was related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. The 2 CRS subgroups showed significant associations with current asthma but not with past asthma. However, the comorbid asthma rate was lower than 10% among subjects with CRS. This study found distinct age-related patterns of CRSwNP and asthma and demonstrated their significant associations in a general population. However, the low prevalence of asthma in CRSwNP is in sharp contrast to findings in Western populations, which warrants further investigation for ethnic or regional differences in relationships between CRSwNP and asthma. Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Micro124-mediated AHR expression regulates the inflammatory response of chronic rhinosinusitis (CRS) with nasal polyps.

PubMed

Liu, C C; Xia, M; Zhang, Y J; Jin, P; Zhao, L; Zhang, J; Li, T; Zhou, X M; Tu, Y Y; Kong, F; Sun, C; Shi, L; Zhao, M Q

2018-06-02

MicroRNAs represent a component of the innate immune responses that can restrain inflammatory signaling, miR124 is an important member of inflammation-associated miRNAs, and abnormal miR124 expression is observed in many inflammatory diseases and immune disorders. However, the role and signaling pathways of miR124 in chronic rhinosinusitis with nasal polyps (CRSwNPs) have not been studied in detail. The aryl hydrocarbon receptor (AHR) is a ligand-inducible transcription factor that is highly conserved in evolution and plays important roles in the inflammatory response process. In our study, we describe the role of miR124 in the inflammatory response of CRS with nasal polyps. We found that the expression of miR124 was decreased in nasal polyps, and negatively correlated with the expression of AHR. MiR124 can inhibit AHR expression by directly target 3' untranslated region (3'-UTR) of AHR. To further investigate the relationship between miR124, AHR and CRS inflammatory response, we transfect HNEpC cells with miR124 mimic, miR124 inhibitors or siRNA of AHR, then all the results showed that miR124 could regulates cellular inflammatory response through negatively regulating AHR expression. This study demonstrated that the regulation of AHR expression by miR124 is critical to the development of inflammatory response in CRSwNPs. Copyright © 2018. Published by Elsevier Inc.

Prevalence of human papillomavirus, Epstein-Barr virus, p21, and p53 expression in sinonasal inverted papilloma, nasal polyp, and hypertrophied turbinate in Hong Kong patients.

PubMed

Sham, C L; To, K F; Chan, Paul K S; Lee, Dennis L Y; Tong, Michael C F; van Hasselt, C Andrew

2012-04-01

The purpose of this study of human papillomavirus (HPV), Epstein-Barr virus (EBV), p21, and p53 in sinonasal inverted papilloma (IP) was to help elucidate its pathogenesis. Seventy-three IPs, 48 nasal polyps, and 85 hypertrophied turbinates were subjected to HPV polymerase chain reaction (PCR) study. Seventy-three IPs, 30 nasal polyps, and 32 hypertrophied turbinates were subjected to EBV in situ hybridization (ISH), p21, and p53 immunohistochemical (IHC) studies. HPV was positive in 3 of 73 IPs (4.1%). All specimens were EBV negative. In all, 99% of IPs showed strong and diffuse p21 nuclear reactivity. Most nasal polyps and hypertrophied turbinates showed weak to moderate immunoreactivity of the basal and parabasal cells. Only focal p53 immunoreactivity of the basal and parabasal cells was found in 19% of IPs and 40% of nasal polyps. HPV prevalence of our IP is low. EBV is not present in IP. High p21 and low p53 expression in IP suggests a non-p53-dependent regulation pathway. Copyright © 2011 Wiley Periodicals, Inc.

Pirfenidone inhibits transforming growth factor β1-induced extracellular matrix production in nasal polyp-derived fibroblasts.

PubMed

Shin, Jae-Min; Park, Joo-Hoo; Park, Il-Ho; Lee, Heung-Man

2015-01-01

Pirfenidone has been shown to have antifibrotic and anti-inflammatory effects in the lungs. The purpose of this study was to evaluate the inhibitory effects of pirfenidone on transforming growth factor (TGF)-β1-induced myofibroblast differentiation and extracellular matrix accumulation. We also determined the molecular mechanisms of pirfenidone in nasal polyp-derived fibroblasts (NPDF). NPDFs were isolated from nasal polyps from eight patients who had chronic rhinosinusitis with nasal polyp. Pirfenidone was used to treat TGF-β1-induced NPDFs. Cytotoxicity was evaluated by using a 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide assay. Fibroblast migration was evaluated with scratch assays. Expression levels of α-smooth muscle actin (SMA), fibronectin, and phosphorylated Smad2/3 were determined by Western blot and/or reverse transcription-polymerase chain reaction and immunofluorescent staining. Total collagen production was analyzed with the Sircol collagen assay and contractile activity was measured by a collagen gel contraction assay. Pirfenidone (0-2 mg/mL) has no significant cytotoxic effects in TGF-β1-induced NPDFs. Migration of NPDFs was significantly inhibited by pirfenidone treatment. The expression levels of α-SMA and fibronectin were significantly reduced in pirfenidone-treated NPDFs. Collagen contraction and production were also significantly decreased by pirfenidone treatment. Finally, pirfenidone significantly inhibited phosphorylation of the Smad2/3 pathway in TGF-β1-induced NPDFs. Pirfenidone has an inhibitory effect on TGF-β1-induced migration, myofibroblast differentiation (α-SMA), extracellular matrix accumulation, and collagen contraction by blocking the phosphorylation of Smad2/3 pathways in NPDFs. Thus, pirfenidone may inhibit TGF-β1-induced extracellular matrix by regulating Smad2/3.

5-Oxo-ETE from Nasal Epithelial Cells Upregulates Eosinophil Cation Protein by Eosinophils in Nasal Polyps in vitro.

PubMed

Lin, Lin; Chen, Zheng; Tang, Xinyue; Dai, Fei; Wei, Jinjin; Sun, Guangbin

2018-06-13

5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is a potent eosinophil chemoattractant and activator that is synthesized not only in inflammatory cells but also in bronchial epithelial cells. The purpose of this study is to clarify whether 5-oxo-ETE can promote the production of eosinophil cation protein (ECP) by eosinophils in nasal polyps (NP) in vitro, and whether normal nasal epithelial cells can produce this lipid mediator in response to oxidative stress. Nasal biopsy samples were obtained from normal subjects or subjects with chronic rhinosinusitis with NP. The infiltration of eosinophil in NP was detected and cultured. After that, concentrations of ECP in eosinophil and NP cultures were evaluated after the treatment of 5-oxo-ETE or 5-oxo-ETE + its receptor (OXER) antagonist, pertussis toxin (PT). Then we studied the synthesis of 5-oxo-ETE after H2O2 stimulation by normal nasal epithelial cells and by epithelial cells of NP alone in the cultures, and also determined the OXER expression in NP. The number of infiltrative eosinophils in NP was increased. The ECP levels in eosinophil and NP cultures were enhanced after the administration of 5-oxo-ETE, and decreased by the PT treatment. 5-Oxo-ETE was upregulated in the cultures of nasal epithelial cells in the presence of H2O2 and of NP epithelial cells alone. The OXER was expressed in inflammatory cells, and not in epithelial cells. 5-Oxo-ETE produced by nasal epithelial cells may play a role in the formation and development of NP. © 2018 S. Karger AG, Basel.

Eosinophil activation in the tissue: synthetic steroid, budesonide, effectively inhibits the survival of eosinophils isolated from peripheral blood but not nasal polyp tissues.

PubMed

Nonaka, R; Nonaka, M; Takanashi, S; Jordana, M; Dolovich, J

1999-01-01

We investigated the effect of a potent synthetic steroid, budesonide (BUD), on the survival of nasal polyp (NP) derived eosinophils (EOS). BUD, at the highest dose used, 10(-6) M, decreased this survival but only by approximately one third. We speculated that the relatively small inhibitory effect of budesonide on the survival of NP-EOS could be the result of these EOS being exposed to substantial amounts of GM-CSF, IL-5 or IL-3. In this regard, we detected 148 pg of GM-CSF per 150 mg of tissue, which approximately contained 106 of eosinophils, in the supernatant of NP explants for 24 h without any stimulation. Contents of both IL-5 and IL-3 were much less. We further studied survival of PB-EOS exposed to rhGM-CSF and found that 10(-6) M of BUD could only inhibit by less than one third the survival of PB-EOS exposed to an amount of rhGM-CSF, similar to that detected in the supernatant of NP explants. In addition, we exposed PB-EOS to 200 pg/ml of rhGM-CSF for a relatively long period of time (4 days) in order to mimic chronic exposure in the tissue and found that the survival of these cells was prolonged to the extent similar to that observed in NP-EOS. Our data suggests that the prolonged spontaneous survival of NP-EOS ex vivo is likely the result of sustained in vivo exposure to GM-CSF and budesonide has a smaller inhibitory effect in the survival of these eosinophils as compared to those from peripheral blood.

[The comparison of the expansion of polyps according to the Ki-67 and computed tomography scores].

PubMed

Aydin, Sedat; Sanli, Arif; Tezer, Ilter; Hardal, Umit; Barişik, Nagehan Ozdemir

2009-01-01

The disease extention in nasal polyps was compared by using the mitotic activity rates and the computed tomography scores. This study was conducted on 19 nasal polyposis patients (8 males, 11 females; mean age 40.0+/-13.7 years; range 20 to 63 years). The preoperative computed tomography records of the patients were evaluated according to the Lund-Mackay grading system. The polyp tissues of the same patients were stained with the Ki-67 antigen for immunohistochemical evaluation. The correlation between the radiologic results and the Ki-67 values was compared by means of the Spearman's correlation test. The mean computed tomography score was observed as 14.3+/-4.7 (range 7-24). The mean Ki-67 score resulting from the immunohistochemical staining was calculated as 24.3+/-18.5 (range 3.3-73.5%). A significant correlation was determined between the Ki-67 values and the computed tomography scores. ("Spearman's" correlation factor: 0.677; p<0.001). As the mitotic activity rate of nasal polyps increases, both the volume of the polyps and the computed tomography scores increase as a result of the blockage of the sinus ostiums by the increased polyp volume.

Effect of eosinophils activated with Alternaria on the production of extracellular matrix from nasal fibroblasts.

PubMed

Shin, Seung-Heon; Ye, Mi-Kyung; Choi, Sung-Yong; Kim, Yee-Hyuk

2016-06-01

Eosinophils and fibroblasts are known to play major roles in the pathogenesis of nasal polyps. Fungi are commonly found in nasal secretion and are associated with airway inflammation. To investigate whether activated eosinophils by airborne fungi can influence the production of extracellular matrix (ECM) from nasal fibroblasts. Inferior turbinate and nasal polyp fibroblasts were stimulated with Alternaria or Aspergillus, respectively, for 24 hours and ECM messenger RNA (mRNA) and protein expressions were measured. Eosinophils isolated from healthy volunteers were stimulated with Alternaria or Aspergillus for 4 hours then superoxide, eosinophil peroxidase, and transforming growth factor β1 were measured. Then activated eosinophils were cocultured with nasal fibroblasts for 24 hours, and ECM mRNA expressions were measured. Alternaria strongly enhanced ECM mRNA expression and protein production from nasal fibroblasts. Alternaria also induced the production of superoxide, eosinophil peroxidase, and transforming growth factor β1 from eosinophils, and activated eosinophils enhanced ECM mRNA expression when they were cocultured without the Transwell insert system. Eosinophils activated with Alternaria enhanced ECM mRNA expression from nasal polyp fibroblasts. Alternaria plays an important role in tissue fibrosis in the pathogenesis of nasal polyps by directly or indirectly influencing the production of ECM from nasal fibroblasts. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The role of human papilloma virus and herpes viruses in the etiology of nasal polyposis.

PubMed

Koçoğlu, Mücahide Esra; Mengeloğlu, Fırat Zafer; Apuhan, Tayfun; Özsoy, Şeyda; Yilmaz, Beyhan

2016-02-17

The aim of this study was to investigate the etiological role of human papilloma virus (HPV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus-6 (HHV-6) and -7 (HHV-7) in the occurrence of nasal polyposis. Nasal polyp samples from 30 patients with nasal polyposis and normal nasal mucosa from 10 patients without nasal polyps were obtained. DNA was extracted from tissues. Real-time polymerase chain reaction was performed for all runs. No HSV-1, HSV-2, or VZV was detected in the samples. Among the patient samples, EBV and HHV-7 DNA were detected in 18 (60%), HHV-6 was detected in 20 (66.7%), and HPV was detected in 4 (13.3%) samples. Among the controls, CMV DNA was positive in one (10%). EBV was positive in 5 (50%), HHV-6 and HHV-7 were positive in 7 (70%), and HPV was positive in 2 (20%) samples. No significant difference was found among the groups with any test in terms of positivity. The association of Herpesviridae and HPV with the pathogenesis of nasal polyps was investigated in this study and no relationship was found. Thus, these viruses do not play a significant role in the formation of nasal polyps.

Inhibitory effect of ginsenoside Rg1 on extracellular matrix production via extracellular signal-regulated protein kinase/activator protein 1 pathway in nasal polyp-derived fibroblasts.

PubMed

Cho, Jung-Sun; Moon, You-Mi; Um, Ji-Young; Moon, Jun-Hyeok; Park, Il-Ho; Lee, Heung-Man

2012-06-01

Nasal polyps are associated with chronic inflammation of the sinonasal mucosa and are involved in myofibroblast differentiation and extracellular matrix (ECM) accumulation. Ginsenoside Rg1, a compound derived from Panax ginseng, shows antifibrotic and anticancer effects. However, the molecular effects of Rg1 on myofibroblast differentiation and ECM production remain unknown. The aims of this study were to investigate the effect of Rg1 on transforming growth factor (TGF)-β1-induced myofibroblast differentiation and ECM production and to determine the molecular mechanism of Rg1 in nasal polyp-derived fibroblasts (NPDFs). NPDFs were isolated from nasal polyps of seven patients who had chronic rhinosinusitis with nasal polyp. NPDFs were exposed to TGF-β1 with or without Rg1. Expression levels of α-smooth muscle actin (SMA), fibronectin and collagen type Iα1 were determined by reverse transcription polymerase chain reaction, Western blot and immunofluorescent staining. TGF-β1 signaling molecules, including Smad2/3, extracellular signal-regulated protein kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 were analyzed by Western blotting. Transcription factors involved with TGF-β1 signaling, nuclear factor (NF)-κB and activator protein 1 (AP-1) were also assessed by Western blot. The cytotoxic effect of Rg1 was measured by an established viability assay. The mRNA and protein expression levels of α-SMA, fibronectin and collagen type Iα1 were increased in TGF-β1-induced NPDFs. Rg1 inhibited these effects. The inhibitory molecular mechanism of Rg1 was involved in the ERK pathway. Rg1 inhibited the transcription factor activation of AP-1. Rg1 itself was not cytotoxic. The ginsenoside Rg1 has inhibitory effects on myofibroblast differentiation and ECM production. The inhibitory mechanism of Rg1 is involved with the ERK and AP-1 signaling pathways. Rg1 may be useful as an inhibitor of ECM deposition, and has potential to be used as a novel treatment option for nasal

Effect of [6]-gingerol on myofibroblast differentiation in transforming growth factor beta 1-induced nasal polyp-derived fibroblasts.

PubMed

Park, Sook A; Park, Il-Ho; Cho, Jung-Sun; Moon, You-Mi; Lee, Seung Hoon; Kim, Tae Hoon; Lee, Sang Hag; Lee, Heung-Man

2012-01-01

[6]-Gingerol is one of the major pungent principles of ginger and has diverse effects, including anti-inflammatory, and antioxidative effects. Reactive oxygen species (ROS) are released during the phenotypic transformation of fibroblasts to myofibroblasts, a process that is involved in the growth of nasal polyps by inducing extracellular matrix (ECM) accumulation. The purpose of this study was to determine the effect of [6]-gingerol on myofibroblast differentiation and collagen production of nasal polyp-derived fibroblasts (NPDFs) and to determine if the effect of [6]-gingerol is linked to an antioxidant effect. NPDFs were incubated and treated with transforming growth factor (TGF) beta 1. The ROS generated by NPDFs were determined using 2″,7″-dichlorfluorescein-diacetate. The fluorescence was captured by a fluorescent microscope and measured using a fluorometer. The expression of alpha-smooth muscle actin (SMA) and collagen type IV mRNA was determined by a reverse transcription-polymerase chain reaction, and the expression of α-SMA protein and pSmad2/3 was determined by immunofluorescence microscopy and or Western blotting. The amount of total soluble collagen production was analyzed by the SirCol collagen dye-binding assay. TGF-beta 1 stimulation increased ROS production by NPDFs. [6]-Gingerol decreased the production of ROS in TGF-beta 1-induced NPDFs. Myofibroblast differentiation, collagen production, and phosphorylation of Smad2/3 were prevented by [6]-gingerol and inhibition of ROS generation with antioxidant such as diphenyliodonium, N-acetylcysteine, and ebselen. These results suggest the possibility that [6]-gingerol may play an important role in inhibiting the production of the ECM in the development of nasal polyps through an antioxidant effect.

Use of laser rhinoscopy to treat a nasal obstruction in a captive California sea lion (Zalophus californianus).

PubMed

Sherrill, Johanna; Peavy, George M; Kopit, Mark J; Garner, Michael M; Gardiner, Chris H; Adams, Lance M

2004-06-01

Laser rhinoscopy was used to treat a nasal obstruction in a captive California sea lion (Zalophus californianus). The rehabilitated, adult, female sea lion developed mucopurulent, intermittent, bilateral nasal discharge and functional nasal obstruction 20 mo after acquisition by the Aquarium of the Pacific in Long Beach, California. A 3-mm-thick soft tissue structure spanning the region between the soft and hard palates, a deviated nasal septum, and several nasopharyngeal polyps were identified. Biopsies and cultures of the obstructive web showed ulcerative granulation tissue with suppurative inflammation, bacterial infection, and a partial section of an arthropod larva (not speciated). Laser rhinoscopy was performed to relieve the caudal nasopharyngeal obstruction and ablate the polyps. The sea lion appeared to breathe through the nares with lessened nasal discharge for a period of 6 wk after laser therapy, but within 8 wk the mucopurulent nasal discharge returned, the obstruction had reformed, and the sea lion was euthanized. Postmortem examination confirmed antemortem diagnoses of caudal nasopharyngeal obstruction secondary to inflammatory tissue; however, no additional sections of arthropod parasites were located microscopically.

Herpes viruses and human papilloma virus in nasal polyposis and controls.

PubMed

Ioannidis, Dimitrios; Lachanas, Vasileios A; Florou, Zoe; Bizakis, John G; Petinaki, Efthymia; Skoulakis, Charalampos E

2015-01-01

Chronic rhinosinusitis with nasal polyps is a multifactorial disease entity with an unclear pathogenesis. Contradictory data exist in the literature on the potential implication of viral elements in adult patients with chronic rhinosinusitis. To compare the prevalence of human herpes viruses (1-6) and Human Papilloma Virus in adult patients with chronic rhinosinusitis with nasal polyps and healthy controls. Viral DNA presence was evaluated by real-time polymerase chain reaction application to nasal polyps specimens from 91 chronic rhinosinusitis with nasal polyps patients and nasal turbinate mucosa from 38 healthy controls. Epstein-Barr virus positivity was higher in nasal polyps (24/91; 26.4%) versus controls (4/38; 10.5%), but the difference did not reach significance (p=0.06). Human herpes virus-6 positivity was lower in nasal polyps (13/91; 14.29%) versus controls (10/38; 26.32%, p=0.13). In chronic rhinosinusitis with nasal polyps group, 1 sample was herpes simplex virus-1-positive (1/91; 1.1%), and another was cytomegalovirus-positive (1/91; 1.1%), versus none in controls. No sample was positive for herpes simplex virus-2, varicella-zoster virus, high-risk-human papilloma viruses (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) and low-risk-human papilloma viruses (6, 11). Differences in Epstein-Barr virus and human herpes virus-6 positivity among patients with chronic rhinosinusitis with nasal polyps and healthy controls are not statistically significant, weakening the likelihood of their implication in chronic rhinosinusitis with nasal polyps pathogenesis. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Phaeohyphomycosis of the nasal sinuses caused by a new species of Exserohilum.

PubMed Central

Padhye, A A; Ajello, L; Wieden, M A; Steinbronn, K K

1986-01-01

A 27-year-old man with a 6-year history of allergies developed nasal polyps that occluded his nose and prevented visual examination beyond the nasal vestibules. Histological examination of the polyps and bony tissue revealed septate, dematiaceous hyphae invading the bone trabeculae. A dematiaceous fungus was isolated in pure culture from the diseased tissue. Detailed mycological examination of the isolate showed that it produced numerous, distinctive poroconidia from erect, geniculate, sympodial conidiophores. The conidia were straight and cylindroellipsoidal, had 8 to 13 distosepta, and had protruding hila. The outer cell walls of the conidia, which were initially smooth, became unevenly roughened on aging. Comparison with other Exserohilum species revealed that the isolate represented an undescribed species; it is named Exserohilum mcginnisii sp. nov. Images PMID:3745422

Bipolar microdebrider may reduce intraoperative blood loss and operating time during nasal polyp surgery.

PubMed

Kumar, Nishant; Sindwani, Raj

2012-08-01

Bleeding during endoscopic sinus surgery (ESS) can interrupt the flow of the procedure and increase the risk of complications. Advances in microdebrider design now allow for bleeding to be controlled by bipolar energy during the suctioning and shaving of polyps. We conducted a retrospective study to examine the effects of this technology on blood loss and operating times during ESS for chronic rhinosinusitis with nasal polyps (CRS+P). Our patient population was made up of 80 patients who had undergone ESS for CRS+P by the same surgeon from January 2007 through May 2008. All surgeries were performed with either the PK diego bipolar microdebrider (Gyrus ACMI, ENT Division; Bartlett, Tenn.) or a standard microdebrider. There were 40 patients in each group. The PK group was made up of 23 males and 17 females, aged 14 to 66 years (mean: 43.1), and the control group included 21 males and 19 females, aged 17 to 71 years (mean: 43.1); there were no statistically significant differences between the two groups in terms of sex and age. In addition to demographic data, the charts were reviewed for comorbidities and operative variables; the latter included blood loss, operating room (OR) time, and complications. The preoperative treatment and anesthesia protocols were similar for all patients, and all patients demonstrated a similar disease burden on imaging (mean Harvard CT stage: 3.12 for the PK group and 3.15 for the controls; p > 0.05). We found that during ESS, the PK group experienced significantly less intraoperative blood loss than did the controls (means: 86.0 and 123.0 ml, respectively; p = 0.015). In addition, the PK device was associated with significantly shorter OR times (means: 88.9 and 101.4 min, respectively; p = 0.026). There were no complications in either group. We conclude that using a microdebrider with bipolar capabilities during ESS may offer the advantages of less blood loss and shorter operating times in patients with nasal polyps.

Gel-Sinuplasty for Chronic Rhinosinusitis With and Without Nasal Polyposis

ClinicalTrials.gov

2018-03-13

Chronic Sinusitis, Ethmoidal; Chronic Sinusitis - Ethmoidal Anterior; Chronic Sinusitis; Chronic Sinusitis - Ethmoidal, Posterior; Chronic Sinusitis, Sphenoidal; Chronic Sinusitis - Frontoethmoidal; Nasal Polyps; Nasal Polyp - Posterior

Beclomethasone Nasal Spray

MedlinePlus

... the lining of the nose) after nasal polyp removal surgery. Beclomethasone nasal spray should not be used ... room temperature and away from excess heat and moisture (not in the bathroom).Unneeded medications should be ...

Doxycycline inhibits TGF-β1-induced extracellular matrix production in nasal polyp-derived fibroblasts.

PubMed

Shin, Jae-Min; Park, Joo-Hoo; Park, Il-Ho; Lee, Heung-Man

2016-03-01

Doxycycline has been shown to have antibacterial and anti-inflammatory effects and suppresses collagen biosynthesis. The purpose of this study was to evaluate the effects of doxycycline on transforming growth factor (TGF)-β1-induced myofibroblast differentiation and extracellular matrix production in nasal polyp-derived fibroblasts (NPDFs). We also determined the molecular mechanisms of action for doxycycline. NPDFs were isolated from nasal polyps from 8 patients. Doxycycline was used to pretreat TGF-β1-induced NPDFs. Cytotoxicity was evaluated using a 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide assay. Expression levels of α-smooth muscle actin (SMA) and fibronectin were measured using Western blot, reverse-transcription polymerase chain reaction, and immunofluorescence staining. Total collagen production was analyzed with the Sircol collagen assay, while mitogen-activated protein kinase (MAPK) and NF-κB activation were determined using Western blot analysis. Luciferase assay was used to evaluate the transcriptional activity of NF-κB. Although doxycycline (0 to 40 μg/mL) had no significant cytotoxic effects in TGF-β1-induced NPDFs, it significantly reduced the expression levels of α-SMA, fibronectin, and collagen in TGF-β1-induced NPDFs in a dose-dependent manner. Doxycycline also inhibited the TGF-β1-induced activation of p38, c-Jun NH2 -terminal kinase (JNK), and NF-κB, and its inhibitory effects were similar to those of the specific inhibitors for each. Doxycycline has an inhibitory effect on TGF-β1-induced myofibroblast differentiation and extracellular matrix production via the p38 and JNK/NF-κB signal pathways in NPDFs. © 2015 ARS-AAOA, LLC.

MUC4 impairs the anti-inflammatory effects of corticosteroids in patients with chronic rhinosinusitis with nasal polyps.

PubMed

Milara, Javier; Morell, Anselm; Ballester, Beatriz; Armengot, Miguel; Morcillo, Esteban; Cortijo, Julio

2017-03-01

Current evidence suggests that membrane-tethered mucins could mediate corticosteroid efficacy, interacting with glucocorticoid receptor (GR) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Mucin 4 (MUC4)-tethered mucin is expressed in nasal polyp (NP) epithelial cells and upregulated under inflammatory conditions. Moreover, MUC4β has the capacity to interact with other intracellular proteins. We hypothesized that MUC4 modulates corticosteroid efficacy of patients with CRSwNP. We sought to analyze the role of MUC4 in corticosteroid effectiveness in different cohorts of patients with CRSwNP and elucidate the possible mechanisms involved. Eighty-one patients with CRSwNP took oral corticosteroids for 15 days. Corticosteroid resistance was evaluated by using nasal endoscopy. Expression of MUC4 and MUC4β was evaluated by means of real-time PCR, Western blotting, and immunohistochemistry. BEAS-2B knockdown with RNA interference for MUC4 (small interfering RNA [siRNA]-MUC4) was used to analyze the role of MUC4 in the anti-inflammatory effects of dexamethasone. Twenty-two patients had NPs resistant to oral corticosteroids. MUC4 expression was upregulated in these patients. In siRNA-MUC4 BEAS-2B airway epithelial cells dexamethasone produced higher anti-inflammatory effects, increased inhibition of phospho-extracellular signal-regulated kinase 1/2, increased mitogen-activated protein kinase phosphatase 1 expression, and increased glucocorticoid response element activation. Immunoprecipitation and immunofluorescence experiments revealed that MUC4β forms a complex with GRα in the nuclei of NP epithelial cells from corticosteroid-resistant patients. MUC4β participates in the corticosteroid resistance process, inhibiting normal GRα nuclear function. The high expression of MUC4 in patients with CRSwNP might participate in corticosteroid resistance. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

Expression of membrane-bound mucins in human nasal mucosa: different patterns for MUC4 and MUC16.

PubMed

Woo, Hyun-Jae; Bae, Chang Hoon; Song, Si-Youn; Lee, Heung-Man; Kim, Yong-Dae

2010-06-01

To acquire basic information concerning the function of the membrane-bound mucin MUC16 in nasal mucosa compared with the best-characterized membrane-bound mucin, MUC4. In vitro study using semiquantatitive reverse transcription-polymerase chain reaction analysis and immunoassay. Yeungnam University College of Medicine. We examined the nasal polyps obtained during endoscopic sinus surgery in 10 patients, the normal ethmoid sinus mucosa obtained from 10 patients, and human nasal polyp epithelial (HNPE) cells. Gene expression of MUC4 and MUC16 in nasal polyps and normal nasal mucosa. In addition, we evaluated the effect of 4 physiologically relevant agents, including retinoic acid, interleukin 1beta, phorbol 12-myristate 13-acetate (PMA), and dexamethasone, on the expression of MUC4 and MUC16 in HNPE cells at the gene and protein levels. In nasal polyps, MUC4 was upregulated compared with normal nasal mucosa (P = .009), whereas MUC16 expression did not differ between nasal polyps and normal nasal mucosa. Retinoic acid and interleukin 1beta increased MUC4 expression at the gene and protein level in HNPE cells, whereas MUC16 expression was not affected. Unlike retinoic acid and interleukin 1beta, PMA and dexamethasone increased MUC16 expression, whereas they had no significant effect on MUC4 expression. Expression of MUC4 and MUC16 are regulated differently in nasal mucosa. Dexamethasone and PMA are potent mediators for the expression of MUC16 in nasal polyps.

Inflammatory nasal polyps: an unusual late complication of Silastic sheet repair of orbital floor fracture.

PubMed

Andrews, A E; Hicklin, L

2006-02-01

Silastic implants are very widely used in surgical practice and are considered to be relatively inert. They do however present with complications, including infection, local foreign body inflammatory response,calcification, migration and failure of repair of the defect, which sometimes may necessitate explantation. Head and neck implants do present a special case, as complications can cause obstruction and disruption of function in small cavities. A pertinent history, clinical review and computed tomography scan are usually invaluable in obtaining a diagnosis. We present a rare case of migrated Silastic orbital sheet, presenting as a nasal polyp and causing maxillary antral pain and infection. A detailed search of the medical literature revealed no other such case.

[The standardized perioperative treatment of chronic rhinosinusitis with nasal polyps and asthma].

PubMed

Li, Tingting; Ju, Jianbao; Yu, Hailing; Xie, Daoyu

2015-04-01

To discuss the perioperative treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. Retrospective analysis of perioperative clinical data of 43 cases with CRSwNP and asthma. The admitted and under endoscopic surgery. Patients with preventing perioperative asthma attacks and corresponding standardized treatment were Observed. Thirty-five cases were stable during perioperative period and without asthma. Seven patients diagnosed as mild and moderate asthma attacks because of low pulse oximetry (SpO2 92%-95%) and scattered wheeze heard in the lungs. So these patients were sent to ICU for the treatment. They went back to ward after their conditions turned to stable and no asthma during perioperative. One patient diagnosed as severe asthma attack, because irritability and suffocation happened, SpO2 decreased from 99% to 84%-81%, diffuse wheeze could be heard in the whole lung . So we give him tracheal intubation and sent him to ICU for advanced treatment after breathing smooth. Five days later the patient retuned to the ward in stable condition and with no asthma attack again. Before operation the patients should be give some corresponding standardized comprehensive treatment according to the nasal symptoms and the degree of asthma attack, such as the application of topical steroid and antiallergic medicine. And some special treatment should be given to reduce airway hyperresponsiveness mucosa during anesthesia. These methods can reduce the risk of the asthma attacks and improve perioperative safety, prevent serious complications.

Rhinovirus inactivation by nasal tissues treated with virucide.

PubMed

Hayden, G F; Gwaltney, J M; Thacker, D F; Hendley, J O

1985-04-01

Rhinovirus colds may be transmitted by hand-to-hand contact followed by self-inoculation of nasal and/or conjunctival mucosa with virus contaminating the fingertips. The purpose of this study was to determine whether impregnation of nasal tissues with virucidal compounds could prevent rhinovirus from passing through the tissue and thus provide a means of preventing hand contamination during nose blowing. Paper tissues treated with a combination of citric acid, malic acid, and sodium laruryl sulfate were compared to placebo tissues containing sodium saccharin. Recovery of infectious virus was significantly reduced by passage of the virus-containing medium through virucidal versus placebo tissue (1/18 vs. 17/18 respectively, P less than 0.001, Fisher exact test). The virucidal effect of treated tissues was demonstrated for multiple rhinovirus serotypes suspended in either cell culture medium or nasal mucus. Virus contained in mucus from infected volunteers was also inactivated.

Evidence-based management of nasal polyposis by intranasal corticosteroids: from the cause to the clinic.

PubMed

Bachert, Claus

2011-01-01

Nasal polyposis is an inflammatory disorder involving the mucosa of the nose and paranasal sinuses and affecting approximately 2-4% of the general population. A literature search of Medline and Embase was conducted to obtain an overview of the epidemiology, pathophysiology, and current treatment of nasal polyposis, focusing on evidence-based efficacy of intranasal corticosteroids (INSs) as primary and postoperative therapy. Recent research on INSs in nasal polyp treatment, along with notable historic findings, was reviewed. Nasal polyps are mostly characterized by eosinophil infiltration, a complex inflammation of nasal mucosa, and possibly production of polyclonal IgE. Current treatment modalities include INSs, oral corticosteroids, and surgery; surgery is generally limited to those with an insufficient response to medical treatment. Because of their effects on eosinophil-dominated inflammation, INSs and oral corticosteroids are the primary medical treatment strategies. The very low (≤1%) systemic bioavailability of newer INSs minimizes the systemic adverse effects seen with oral corticosteroids. Based on randomized, controlled trials, guidelines recommend INSs as first-line therapy for nasal polyps and for care after polypectomy. Clinical data suggest INSs are effective in reducing polyp size and relieving nasal symptoms. INS treatment has also reduced nasal polyp recurrence in patients undergoing functional endoscopic sinus surgery. Treatment with these mainstay options has been found to improve quality of life, which, along with symptom improvement, is a key factor in disease treatment. Copyright © 2011 S. Karger AG, Basel.

Nasal polyps in patients with asthma: prevalence, impact, and management challenges

PubMed Central

Langdon, Cristobal; Mullol, Joaquim

2016-01-01

Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have coexisting asthma under the concept of “United Airway Disease”, being the combination of both diseases, which is one of the most challenging phenotypes to treat. Although clinicians have recognized this difficult-to-treat phenotype for many years, it remained poorly characterized. There is increasing epidemiological evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and the combined management is still lacking. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis, while asthmatic patients have a greater prevalence of CRSwNP than patients without asthma. The effect of CRSwNP treatment, whether medical or surgical, in asthma is today less controversial after some studies have shown improvement of asthma after medical and/or surgical treatment of CRSwNP. However, direct comparisons between surgical and medical treatments are limited. Further randomized clinical trials are, however, still needed to better understand the management when both asthma and CRSwNP occur together. This review aims at summarizing the prevalence, impact, and management challenges regarding both asthma and CRSwNP. PMID:27042129

A comparative and descriptive study of asthma in chronic rhinosinusitis with nasal polyps.

PubMed

Håkansson, Kåre; Thomsen, Simon Francis; Konge, Lars; Mortensen, Jann; Backer, Vibeke; von Buchwald, Christian

2014-01-01

Chronic rhinosinusitis (CRS) is a common health problem that is subclassified as CRS with nasal polyps (CRSwNPs) or CRS without NPs (CRSsNP). In accordance with the united airways concept, CRSwNPs frequently coexists with asthma but to date, this association remains unexplained and its strength is uncertain. Here, we aimed to examine the association between CRSwNPs and asthma in collaboration between the neighboring specialities: otorhinolaryngology and respiratory medicine. A prospective clinical study was performed comprising 40 CRS patients scheduled for functional endoscopic sinus surgery and 21 control persons. We performed nasal endoscopy, peak expiratory flow, spirometry, and bronchodilation tests. In selected cases, additional pulmonary tests were performed. Atopy was assessed by skin-prick test or by measuring specific IgE in serum. Asthma was diagnosed in 26 patients with CRSwNPs (65%; odds ratio = 5.9 [1.79, 19.65]; p = 0.003), and 5 control persons (24%). Twenty-five percent of the CRSwNP patients had undiagnosed asthma. Atopy was not significantly associated with CRSwNPs (p = 0.39) or with coexisting asthma within the CRSwNP group (p = 0.50). Compared with previous studies, we found a very high prevalence of asthma and, frequently, asthma was undiagnosed. Furthermore, CRSwNPs was associated with chronic bronchitis and, in those with asthma, lower airway obstruction. These results call for a closer collaboration between otorhinolaryngology and respiratory medicine in relation to patients with CRSwNPs, in research as well as in clinical practice.

Downregulation of peroxisome proliferator-activated receptors (PPARs) in nasal polyposis

PubMed Central

Cardell, Lars-Olaf; Hägge, Magnus; Uddman, Rolf; Adner, Mikael

2005-01-01

Background Peroxisome proliferator-activated receptor (PPAR) α, βδ and γ are nuclear receptors activated by fatty acid metabolites. An anti-inflammatory role for these receptors in airway inflammation has been suggested. Methods Nasal biopsies were obtained from 10 healthy volunteers and 10 patients with symptomatic allergic rhinitis. Nasal polyps were obtained from 22 patients, before and after 4 weeks of local steroid treatment (fluticasone). Real-time RT-PCR was used for mRNA quantification and immunohistochemistry for protein localization and quantification. Results mRNA expression of PPARα, PPARβδ, PPARγ was found in all specimens. No differences in the expression of PPARs were obtained in nasal biopsies from patients with allergic rhinitis and healthy volunteers. Nasal polyps exhibited lower levels of PPARα and PPARγ than normal nasal mucosa and these levels were, for PPARγ, further reduced following steroid treatment. PPARγ immunoreactivity was detected in the epithelium, but also found in smooth muscle of blood vessels, glandular acini and inflammatory cells. Quantitative evaluation of the epithelial immunostaining revealed no differences between nasal biopsies from patients with allergic rhinitis and healthy volunteers. In polyps, the PPARγ immunoreactivity was lower than in nasal mucosa and further decreased after steroid treatment. Conclusion The down-regulation of PPARγ, in nasal polyposis but not in turbinates during symptomatic seasonal rhinitis, suggests that PPARγ might be of importance in long standing inflammations. PMID:16271155

Downregulation of peroxisome proliferator-activated receptors (PPARs) in nasal polyposis.

PubMed

Cardell, Lars-Olaf; Hägge, Magnus; Uddman, Rolf; Adner, Mikael

2005-11-07

Peroxisome proliferator-activated receptor (PPAR) alpha, betadelta and gamma are nuclear receptors activated by fatty acid metabolites. An anti-inflammatory role for these receptors in airway inflammation has been suggested. Nasal biopsies were obtained from 10 healthy volunteers and 10 patients with symptomatic allergic rhinitis. Nasal polyps were obtained from 22 patients, before and after 4 weeks of local steroid treatment (fluticasone). Real-time RT-PCR was used for mRNA quantification and immunohistochemistry for protein localization and quantification. mRNA expression of PPARalpha, PPARbetadelta, PPARgamma was found in all specimens. No differences in the expression of PPARs were obtained in nasal biopsies from patients with allergic rhinitis and healthy volunteers. Nasal polyps exhibited lower levels of PPARalpha and PPARgamma than normal nasal mucosa and these levels were, for PPARgamma, further reduced following steroid treatment. PPARgamma immunoreactivity was detected in the epithelium, but also found in smooth muscle of blood vessels, glandular acini and inflammatory cells. Quantitative evaluation of the epithelial immunostaining revealed no differences between nasal biopsies from patients with allergic rhinitis and healthy volunteers. In polyps, the PPARgamma immunoreactivity was lower than in nasal mucosa and further decreased after steroid treatment. The down-regulation of PPARgamma, in nasal polyposis but not in turbinates during symptomatic seasonal rhinitis, suggests that PPARgamma might be of importance in long standing inflammations.

[Pathogenetic correction of postoperative inflammation in modern rhinosurgery].

PubMed

Kim, I A; Nosulia, E V

2010-01-01

This study included 20 patients presenting with polypous rhinosinusitis examined before and after endoscopic intervention in the nasal cavity and paranasal sinuses. Nitric oxide (NO) content in nasal secretion and polypoid tissue was estimated from the concentration of nitrates that, together with nitrites, are the final products of oxidation of nitric oxide and serve as markers of endogenous NO. Nitrates in the nasal secretion, endonasal mucosa, and polypous tissue were determined by the ionometric technique. Their content was additionally measured in 12 subjects without polypous rhinosinusitis. The nasal secretion and polypous tissue of PRS patients were found to contain nitrates at a higher concentration compared with healthy subjects. Nitrate concentrations in the nasal secretion and polypous tissue of PRS patients were not significantly different. Mean saccharine transport time in the nasal cavity of the patients with an elevated level of nitrates in the nasal secretion was significantly higher than in PRS patients with the lowered nitrate levels. It means that high concentrations of nitric oxide markers in the nasal secretion and polypous tissue of the patients with polypous rhinosinusitis have negative effect on the efficiency of mucociliary transport. In addition, results of the study confirm the possibility of anti-inflammatory therapy with Erespal (fenspirid) for the correction of inflammatory changes during the postoperative period.

The effect of endoscopic olfactory cleft polyp removal on olfaction.

PubMed

Kuperan, Arjuna B; Lieberman, Seth M; Jourdy, Deya N; Al-Bar, Mohammad H; Goldstein, Bradley J; Casiano, Roy R

2015-01-01

The presence of olfactory cleft polyps in chronic rhinosinusitis with nasal polyposis is well documented, but the effect of endoscopic olfactory cleft polyp surgery on olfaction, versus observation, has not been well studied. This analysis assessed if microdebridement of olfactory cleft polyps yields significant objective smell improvements in those with anosmia or hyposmia. A randomized prospective single-blinded study was performed on patients undergoing bilateral endoscopic sinus surgery with profound bilateral nasal polyposis, excluding those younger than 18 years or without olfactory polyps. A preoperative University of Pennsylvania Smell Identification Test (UPSIT), visual analog scale (VAS), and sinonasal outcomes 20 score (SNOT-20), and a follow-up at 6 months was performed. Two cohorts were created, including one with cleft polyp removal (group A) and one with cleft polyps left in place (group B). There were 10 patients in group A and 7 in group B. By using the Wilcoxon signed rank test, the two groups were individually analyzed for changes in the preoperative UPSIT, VAS, and SNOT-20 versus the 6-month test results. In group A, the improvement in the UPSIT, VAS, and SNOT-20 were statistically significant at p < 0.05. For group B only the improvement in the VAS was statistically significant, at p < 0.05. There was a statistically significant difference in clinical smell improvement between group A and B at 6 months (p = 0.00512). Evidence exists that olfactory cleft polyp surgery improves olfactory function outcomes. Long-term data beyond 6 months is needed to further validate these early promising outcomes.

Prevalence of human papilloma virus and human herpes virus types 1-7 in human nasal polyposis.

PubMed

Zaravinos, Apostolos; Bizakis, John; Spandidos, Demetrios A

2009-09-01

This study aimed to investigate the prevalence of human papilloma virus (HPV), herpes simplex virus-1/-2 (HSV-1/-2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus-6/-7 (HHV-6/-7) in 23 human nasal polyps by applying PCR. Two types of control tissues were used: adjacent inferior/middle turbinates from the patients and inferior/middle turbinates from 13 patients undergoing nasal corrective surgery. EBV was the virus most frequently detected (35%), followed by HPV (13%), HSV-1 (9%), and CMV (4%). The CMV-positive polyp was simultaneously positive for HSV-1. HPV was also detected in the adjacent turbinates (4%) and the adjacent middle turbinate (4%) of one of the HPV-positive patients. EBV, HSV, and CMV were not detected in the adjacent turbinates of the EBV-, HSV- or CMV-positive patients. All mucosae were negative for the VZV, HHV-6, and HHV-7. This is the first study to deal with the involvement of a comparable group of viruses in human nasal polyposis. The findings support the theory that the presence of viral EBV markedly influences the pathogenesis of these benign nasal tumors. The low incidence of HPV detected confirms the hypothesis that HPV is correlated with infectious mucosal lesions to a lesser extent than it is with proliferative lesions, such as inverted papilloma. The low incidence of HSV-1 and CMV confirms that these two herpes viruses may play a minor role in the development of nasal polyposis. Double infection with HSV-1 and CMV may also play a minor, though causative, role in nasal polyp development. VZV and HHV-6/-7 do not appear to be involved in the pathogenesis of these mucosal lesions.

IL-33-responsive innate lymphoid cells are an important source of IL-13 in chronic rhinosinusitis with nasal polyps.

PubMed

Shaw, Joanne L; Fakhri, Samer; Citardi, Martin J; Porter, Paul C; Corry, David B; Kheradmand, Farrah; Liu, Yong-Jun; Luong, Amber

2013-08-15

Chronic rhinosinusitis (CRS) without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP) are associated with Th1 and Th2 cytokine polarization, respectively; however, the pathophysiology of CRS remains unclear. The importance of innate lymphoid cells in Th2-mediated inflammatory disease has not been clearly defined. The objective of this study was to investigate the role of the epithelial cell-derived cytokine IL-33 and IL-33-responsive innate lymphoid cells in the pathophysiology of CRS. Relative gene expression was evaluated using quantitative real-time polymerase chain reaction. Innate lymphoid cells in inflamed ethmoid sinus mucosa from patients with CRSsNP and CRSwNP were characterized using flow cytometry. Cytokine production from lymphoid cells isolated from inflamed mucosa of patients with CRS was examined using ELISA and intracellular cytokine staining. Elevated expression of ST2, the ligand-binding chain of the IL-33 receptor, was observed in inflamed sinonasal mucosa from CRSwNP compared with CRSsNP and healthy control subjects. An increased percentage of innate lymphoid cells was observed in inflamed sinonasal mucosa from CRSwNP compared with CRSsNP. ST2(+) innate lymphoid cells are a consistent source of IL-13 in response to IL-33 stimulation. Significant induction of IL-33 was observed in epithelial cells derived from patients with CRSwNP compared with patients with CRSsNP in response to stimulation with Aspergillus fumigatus extract. These data suggest a role for sinonasal epithelial cell-derived IL-33 and an IL-33-responsive innate lymphoid cell population in the pathophysiology of CRSwNP demonstrating the functional importance of innate lymphoid cells in Th2-mediated inflammatory disease.

Naive and effector B-cell subtypes are increased in chronic rhinosinusitis with polyps.

PubMed

Miljkovic, Dijana; Psaltis, Alkis; Wormald, Peter-John; Vreugde, Sarah

2018-01-01

Recent studies demonstrated that B cells and their chemoattractants are elevated in the nasal mucosa of patients with chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP). However, the presence of naive B cells and of plasmablasts and memory B-cell subsets in the mucosa and periphery of the same patient with CRS is yet to be characterized. Here we sought to quantify naive, plasmablasts, and memory B cells in mucosal tissue and peripheral blood of patients with CRSwNP, patients with CRS without nasal polyps (CRSsNP), and control patients. Polyps, mucosa, and peripheral blood samples were prospectively collected from the patients with CRS and from the non-CRS controls. We used flow cytometry to distinguish among naive, plasmablast, and memory B cells in sinus tissue and peripheral blood. A total of 45 patients were recruited for the study. The patients with CRSwNP had significantly increased mucosal B-cell numbers versus the controls (3.39 ± 4.05% versus 0.39 ± 1.05% of live cells; p < 0.01, Kruskal-Wallis test), which included naive B cells (0.61 ± 0.94 versus 0.11 ± 0.24% of live cells; p < 0.03, Kruskal-Wallis test), plasmablasts (0.06 ± 0.26 versus 0.00 ± 0.00% of live cells; p < 0.055, Kruskal-Wallis test), and memory B cells (0.62 ± 1.26 versus 0.05 ± 0.15% of live cells; p < 0.02, Kruskal-Wallis test). Our study identified increased frequencies of different B-cell subtypes in the mucosa of patients with CRSwNP but not in the peripheral blood. We also found that patients with CRSwNP had significantly increased B-cell subtypes compared with the patients with CRSsNP and the controls. These results implied a potential role for mucosal B cells in the ongoing inflammation in patients with CRSwNP.

Signal transduction and oxidative processes in sinonasal polyposis.

PubMed

Cannady, Steven B; Batra, Pete S; Leahy, Rachel; Citardi, Martin J; Janocha, Allison; Ricci, Kristin; Comhair, Suzy A A; Bodine, Melanie; Wang, Zeneng; Hazen, Stanley L; Erzurum, Serpil C

2007-12-01

Nasal polyposis is characterized by impaired regulation of nasal tissue growth and is associated with chronic inflammation, sinus infections, and low levels of nitric oxide (NO). Based on its critical role in mediating cell growth and antimicrobial function, decrease of NO levels has been implicated in the pathogenesis of nasal polyposis. We sought to evaluate mechanisms for the low NO level in polyposis, including factors regulating NO synthase (NOS) expression and activity and NO consumptive processes in nasal epithelial cells and nasal lavage fluid. Eighteen patients with nasal polyposis and 8 healthy control subjects were studied. Nasal brushings, nasal lavage fluid, and nasal biopsy specimens were collected and analyzed. NO metabolite levels (nitrite and nitrate) in nasal lavage fluid from patients with polyps were less than those in control subjects, but activation of signal transduction and inducer of transcription 1, which regulates inducible NOS gene expression and protein expression, was present at higher levels in polyp than in healthy control tissue. Levels of arginine, methylarginine, and endogenous NOS inhibitors were similar between polyp and control tissue. In contrast, superoxide dismutase activity of polyp tissues was lower than that seen in control tissue and associated with increased nitrotyrosine, a biomarker of oxidant consumptive products of NO. Taken together, these data suggest that the nasal polyp environment is characterized by abnormalities in NO metabolism that might predispose to altered regulation of tissue growth and infection. Identification of NO metabolic abnormalities might lead to novel treatments for sinonasal polyposis targeted against the pathways identified within this study.

[Hemangiopericytoma in nasal cavity: a case report].

PubMed

Hu, Honghai; Shi, Qifeng; Chen, Jidong

2015-05-01

We report a case of a 46 year old female patient with nasal hemangiopericytoma. She complained of left nasal congestion, pus snot for 10 years, sometimes with left nasal bleeding. Physical examination: in the left nasal tract saw red soft neoplasm, roughness surface, easy bleeding when touched. Sinus CT shows: bilateral maxillary sinus, ethmoid sinus, sphenoid sinus and the left posterior nasal cavity lesions, considering inflammation with the formation of polyps, tumor not excluded. The left nasal cavity neoplasm biopsy shows: hemangioma of left nasal cavity. After admission in general anesthesia, we do transnasal endoscopic sinus openning operation and the left nasal cavity neoplasm resection. Postoperative pathological examination shows: the left nasal cavity hemangiopericytoma. Immunohistochemical showed: Vimentin(+), Smooth muscle actin(+), Desmin(-), endothelial cells CD31(-) and CD34(-). No postoperative radiotherapy or chemotherapy, no tumor recurrence. After one year of follow-up, the contact was lost.

Expression of pituitary adenylate cyclase-activating polypeptide 1 and 2 receptor mRNA in gallbladder tissue of patients with gallstone or gallbladder polyps.

PubMed

Zhang, Zhen-Hai; Wu, Shuo-Dong; Gao, Hong; Shi, Gang; Jin, Jun-Zhe; Kong, Jing; Tian, Zhong; Su, Yang

2006-03-07

To detect the expression of pituitary adenylate cyclase-activating polypeptide receptor 1 (VPCAP1-R)and VPCAP2-R mRNA in gallbladder tissues of patients with gallstone or gallbladder polyps. The expression of VPCAP1-R and VPCAP2-R mRNA in gallbladder tissues was detected in 25 patients with gallstone,8 patients with gallbladder polyps and 7 donors of liver transplantation by reverse transcription polymerase chain reaction (RT-PCR). The VPCAP2-R mRNA expression level in the control group (1.09+/-0.58) was lower than that in the gallbladder polyp group (1.64+/-0.56) and the gallstone group (1.55+/-0.45) (P<0.05) while the VPCAP1-R mRNA expression level in the control group (1.15+/-0.23) was not apparently different from that in the gallbladder polyp group (1.28+/-0.56) and the gallstone group (1.27+/-0.38). The abnormal expression of VPCAP2-R mRNA in gallbladder tissue may play a role in the formation of gallbladder stone and gallbladder polyps.

Naive and effector B-cell subtypes are increased in chronic rhinosinusitis with polyps

PubMed Central

Miljkovic, Dijana; Psaltis, Alkis; Wormald, Peter-John

2018-01-01

Background: Recent studies demonstrated that B cells and their chemoattractants are elevated in the nasal mucosa of patients with chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP). However, the presence of naive B cells and of plasmablasts and memory B-cell subsets in the mucosa and periphery of the same patient with CRS is yet to be characterized. Objective: Here we sought to quantify naive, plasmablasts, and memory B cells in mucosal tissue and peripheral blood of patients with CRSwNP, patients with CRS without nasal polyps (CRSsNP), and control patients. Methods: Polyps, mucosa, and peripheral blood samples were prospectively collected from the patients with CRS and from the non-CRS controls. We used flow cytometry to distinguish among naive, plasmablast, and memory B cells in sinus tissue and peripheral blood. Results: A total of 45 patients were recruited for the study. The patients with CRSwNP had significantly increased mucosal B-cell numbers versus the controls (3.39 ± 4.05% versus 0.39 ± 1.05% of live cells; p < 0.01, Kruskal-Wallis test), which included naive B cells (0.61 ± 0.94 versus 0.11 ± 0.24% of live cells; p < 0.03, Kruskal-Wallis test), plasmablasts (0.06 ± 0.26 versus 0.00 ± 0.00% of live cells; p < 0.055, Kruskal-Wallis test), and memory B cells (0.62 ± 1.26 versus 0.05 ± 0.15% of live cells; p < 0.02, Kruskal-Wallis test). Conclusion: Our study identified increased frequencies of different B-cell subtypes in the mucosa of patients with CRSwNP but not in the peripheral blood. We also found that patients with CRSwNP had significantly increased B-cell subtypes compared with the patients with CRSsNP and the controls. These results implied a potential role for mucosal B cells in the ongoing inflammation in patients with CRSwNP. PMID:29336281

Prostaglandin E2 Induces IL-6 and IL-8 Production by the EP Receptors/Akt/NF-κB Pathways in Nasal Polyp-Derived Fibroblasts.

PubMed

Cho, Jung-Sun; Han, In-Hye; Lee, Hye Rim; Lee, Heung-Man

2014-09-01

Interleukin 6 (IL-6) and IL-8 participate in the pathogenesis of chronic rhinosinusitis with nasal polyps, and their levels are increased by prostaglandin E2 (PGE2) in different cell types. The purposes of this study were to determine whether PGE2 has any effect on the increase in the levels of IL-6 and IL-8 in nasal polyp-derived fibroblasts (NPDFs) and subsequently investigate the possible mechanism of this effect. Different concentrations of PGE2 were used to stimulate NPDFs at different time intervals. NPDFs were treated with agonists and antagonists of E prostanoid (EP) receptors. To determine the signaling pathway for the expression of PGE2-induced IL-6 and IL-8, PGE2 was treated with Akt and NF-κB inhibitors in NPDFs. Reverse transcription-polymerase chain reaction for IL-6 and IL-8 mRNAs was performed. IL-6 and IL-8 levels were measured byenzyme-linked immunosorbent assay (ELISA). The activation of Akt and NF-κB was evaluated by western blot analysis. PGE2 significantly increased the mRNA and protein expression levels of IL-6 and IL-8 in NPDFs. The EP2 and EP4 agonists and antagonists induced and inhibited IL-6 expression. However, the EP4 agonist and antagonist were only observed to induce and inhibit IL-8 expression level. The Akt and NF-κB inhibitors significantly blocked PGE2-induced expression of IL-6 and IL-8. PGE2 increases IL-6 expression via EP2 and EP4 receptors, and IL-8 expression via the EP4 receptor in NPDFs. It also activates the Akt and NF-κB signal pathways for the production of IL-6 and IL-8 in NPDFs. These results suggest that signaling pathway for IL-6 and IL-8 expression induced by PGE2 might be a useful therapeutic target for the treatment of nasal polyposis.

Expression of pituitary adenylate cyclase-activating polypeptide 1 and 2 receptor mRNA in gallbladder tissue of patients with gallstone or gallbladder polyps

PubMed Central

Zhang, Zhen-Hai; Wu, Shuo-Dong; Gao, Hong; Shi, Gang; Jin, Jun-Zhe; Kong, Jing; Tian, Zhong; Su, Yang

2006-01-01

AIM: To detect the expression of pituitary adenylate cyclase-activating polypeptide receptor 1 (VPCAP1-R) and VPCAP2-R mRNA in gallbladder tissues of patients with gallstone or gallbladder polyps. METHODS: The expression of VPCAP1-R and VPCAP2-R mRNA in gallbladder tissues was detected in 25 patients with gallstone, 8 patients with gallbladder polyps and 7 donors of liver transplantation by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The VPCAP2-R mRNA expression level in the control group (1.09±0.58) was lower than that in the gallbladder polyp group (1.64 ± 0.56) and the gallstone group (1.55±0.45) (P < 0.05) while the VPCAP1-R mRNA expression level in the control group (1.15 ± 0.23) was not apparently different from that in the gallbladder polyp group (1.28±0.56) and the gallstone group (1.27 ± 0.38). CONCLUSION: The abnormal expression of VPCAP2-R mRNA in gallbladder tissue may play a role in the formation of gallbladder stone and gallbladder polyps. PMID:16552823

Central nervous system tissue heterotopia of the nose: case report and review of the literature

PubMed Central

Altissimi, G; Ascani, S; Falcetti, S; Cazzato, C; Bravi, I

2009-01-01

Summary The Authors present a case of heterotopic central nervous system tissue observed in an 81-year-old male in the form of an ethmoidal polyp. A review of the literature indicates that this is a rare condition characterised by a connective tissue lesion with astrocytic and oligodendrocytic glial cells, which may be located outside the nasal pyramid in some cases and inside the nasal cavity in others. The most important diagnostic aspect involves differentiating these from meningoencephalocele, which maintains an anatomical connection with central nervous system tissue. Contrast-enhanced imaging is essential for diagnosis, as in cases of heterotopic central nervous system tissue, it will demonstrate that there are no connections with intra-cranial tissue. Endoscopic excision is the treatment of choice. PMID:20161881

Characterization of interleukin-4-stimulated nasal polyp fibroblasts.

PubMed

Steinke, John W; Crouse, Charles D; Bradley, Dewayne; Hise, Kathleen; Lynch, Kevin; Kountakis, Stilianos E; Borish, Larry

2004-02-01

Chronic hyperplastic eosinophilic sinusitis is an inflammatory disease that results in the accumulation of eosinophils, fibroblasts, mast cells, and goblet cells at the site of injury. A common feature of this disease is the presence of nasal polyposis (NP). The current studies were designed to assess the contribution of interleukin (IL)-4 to fibroblast-mediated inflammation in chronic hyperplastic eosinophilic sinusitis/NP. In addition, we hypothesized that cysteinyl leukotrienes (CysLT) may directly influence fibroblast-mediated fibrotic and remodeling pathways in this disorder. Fibroblasts were isolated from NP tissue. All fibroblast lines expressed the IL-4 receptor. IL-4 induced changes in mRNA and protein expression of fibrotic (transforming growth factor-beta1 and -beta2) and inflammatory cytokines and chemokines (IL-6 and CCL11) by fibroblasts as measured by semiquantitative and quantitative polymerase chain reaction, RNase protection assay, and enzyme-linked immunosorbent assay. The expression of CysLT and other proinflammatory lipid receptors on fibroblasts was evaluated. CysLT1 and CysLT2 receptors were not expressed on fibroblasts; however, LPA(1) receptor was constitutively expressed and LPA(2) receptor expression was upregulated by IL-4. The metabolic cascade involved in CysLT synthesis was not expressed in fibroblasts and could not be induced by IL-4 treatment.

A review of nasal polyposis

PubMed Central

Newton, Jonathan Ray; Ah-See, Kim Wong

2008-01-01

Nasal polyps are common, affecting up to four percent of the population. Their etiology remains unclear, but they are known to have associations with allergy, asthma, infection, cystic fibrosis, and aspirin sensitivity. They present with nasal obstruction, anosmia, rhinorrhoea, post nasal drip, and less commonly facial pain. Clinical examination reveals single or multiple grey polypoid masses in the nasal cavity. Computerized tomography allows evaluation of the extent of the disease and is essential if surgical treatment is to be considered. Management of polyposis involves a combination of medical therapy and surgery. There is good evidence for the use of corticosteroids (systemic and topical) both as primary treatment and as postoperative prophylaxis against recurrence. Surgical treatment has been refined significantly over the past twenty years with the advent of endoscopic sinus surgery and, in general, is reserved for cases refractory to medical treatment. Recurrence of the polyposis is common with severe disease recurring in up to ten percent of patients. PMID:18728843

Breathing life into dinosaurs: tackling challenges of soft-tissue restoration and nasal airflow in extinct species.

PubMed

Bourke, Jason M; Porter, W M Ruger; Ridgely, Ryan C; Lyson, Tyler R; Schachner, Emma R; Bell, Phil R; Witmer, Lawrence M

2014-11-01

The nasal region plays a key role in sensory, thermal, and respiratory physiology, but exploring its evolution is hampered by a lack of preservation of soft-tissue structures in extinct vertebrates. As a test case, we investigated members of the "bony-headed" ornithischian dinosaur clade Pachycephalosauridae (particularly Stegoceras validum) because of their small body size (which mitigated allometric concerns) and their tendency to preserve nasal soft tissues within their hypermineralized skulls. Hypermineralization directly preserved portions of the olfactory turbinates along with an internal nasal ridge that we regard as potentially an osteological correlate for respiratory conchae. Fossil specimens were CT-scanned, and nasal cavities were segmented and restored. Soft-tissue reconstruction of the nasal capsule was functionally tested in a virtual environment using computational fluid dynamics by running air through multiple models differing in nasal soft-tissue conformation: a bony-bounded model (i.e., skull without soft tissue) and then models with soft tissues added, such as a paranasal septum, a scrolled concha, a branched concha, and a model combining the paranasal septum with a concha. Deviations in fluid flow in comparison to a phylogenetically constrained sample of extant diapsids were used as indicators of missing soft tissue. Models that restored aspects of airflow found in extant diapsids, such as appreciable airflow in the olfactory chamber, were judged as more likely. The model with a branched concha produced airflow patterns closest to those of extant diapsids. These results from both paleontological observation and airflow modeling indicate that S. validum and other pachycephalosaurids could have had both olfactory and respiratory conchae. Although respiratory conchae have been linked to endothermy, such conclusions require caution in that our re-evaluation of the reptilian nasal apparatus indicates that respiratory conchae may be more widespread

Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps.

PubMed

Pinto Bezerra Soter, A C; Bezerra, T F; Pezato, R; Teles Abdo, T R; Pilan, R M; Pinna, F R; Gevaert, P; van Zele, T; Bachert, C; Voegels, R L

2017-06-01

This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation. The main outcome measure was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Other outcome measures were the SNOT-20, NOSE, and Lund-Kennedy scores. The following parameters were also analyzed: asthma, rhinitis, non-steroidal-exacerbated respiratory disease (NERD), and baseline serum IgG, IgA, IgE, IgM, ANCA, and eosinophil count. There was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Patients who received doxycycline also had significantly better outcomes regarding SNOT-20, NOSE, and Lund-Kennedy scores. There was a negative association among a clinically significant improvement of SNOT-20 and presence of asthma, NERD, and elevated serum IgE levels before treatment. These findings suggest that doxycycline may have a beneficial role for CRSwNP patients, especially for patients without asthma, NERD or high levels of serum IgE before treatment.

Bone and Soft Tissue Nasal Angles Discrepancies and Overlying Skin Thickness: A Computed Tomography Study.

PubMed

Alharethy, Sami; Alohali, Sama; Alquniabut, Ibrahim; Jang, Yong Ju

2018-04-11

The aim of this study was to derive the normal values for bone and soft tissue nasal angles as well as the overlying skin thickness and to attempt to determine the correlation between differences in bone and soft tissue angles and overlying skin thickness in Middle Eastern patients. Three-dimensional cephalometric analysis was performed for 100 patients who underwent computed tomography of the paranasal sinuses. The nasofrontal angle, pyramidal angle-nasal root, pyramidal angle-tip of the nasal bone, and overlying skin thickness were measured, and the results were analyzed according to sex, age, and body mass index (BMI). All soft tissue angles were significantly larger than the bone angles, with the mean difference being 11.62°, 30.80°, and 27.05° for the nasofrontal angle (P = 0.000), pyramidal angle-nasal root (P = 0.000), and pyramidal angle-tip of the nasal bone (P = 0.000), respectively. The mean overlying skin thickness was 3.89 ± 1.48 mm at the nasion, 1.16 ± 0.6 mm at the rhinion, and 2.93 ± .97 mm at the nasal tip. Differences in the nasofrontal angle were strongly correlated with the skin thickness at the nasion (P = 0.001). A simple clinical exam of the soft tissue nasal angles does not reflect the underlying bone angles that will be encountered during rhinoplasty. BMI does not influence nasal shape, and rhinoplasty surgery should take into account the ethnic group, age, and sex of the patient. Surgeons should leave a minor skeletal hump at the end of the nasal bone for Middle Eastern patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Mechanism of action of glucocorticoids in nasal polyposis.

PubMed

Fernandes, Atílio Maximino; Valera, Fabiana Cardoso Pereira; Anselmo-Lima, Wilma T

2008-01-01

Glucocorticoids (GC) are the drugs of choice for the clinical treatment of nasal polyposis, according to the medical literature. Its mechanism of action in the regression of clinical symptoms and polyps, however, is not fully understood. The topical and/or systemic use of glucocorticoids lead to variable expression of cytokines, chemokines and lymphokines, as well as changes in cells. It is known that GC suppresses the expression of pro-inflammatory cytokines, chemokines and adhesion molecules such as ICAM-1 and E-selectin; GC also stimulate the transcription of anti-inflammatory cytokines such as TGF-b. GC suppress pro-fibrotic cytokines related to polyp growth, such as IL-11, the basic fibroblast growth factor (b-FGF), and the vascular endotelial growth factor (VEGF). The action of GC depends fundamentally on their interaction with receptors (GR); certain subjects have a degree of resistance to its effect, which appears to be related with the presence of a b isoform of GR. GC also act variably on the genes involved in immunoglobulin production, presentation, and antigen processing. We present a review of the literature on the mechanisms of GC action in nasal polyosis. Understanding the mechanism of action of GC in nasal polyposis will aid in the development of new, more efficient, drugs.

Peak nasal inspiratory flow correlates with quality of life in functional endoscopic sinus surgery.

PubMed

Whitcroft, K L; Andrews, P J; Randhawa, P S

2017-12-01

Whilst nasal function and airflow improve subjectively following functional endoscopic sinus surgery (FESS), a clinically useful and objective tool for quantifying such improvement is lacking. The peak nasal inspiratory flow (PNIF) metre offers convenient and objective measures of nasal patency. However, it has not yet been established whether changes in PNIF after surgery reflect changes in subjective disease burden. In this study we aimed to determine whether changes in PNIF correlate with commonly used subjective symptom and quality of life outcome measures following FESS for chronic rhinosinusitis (CRS). Prospective cohort. Royal National Throat Nose and Ear Hospital. Thirty-seven patients undergoing FESS for CRS, with or without polyps (21 male, mean age 48.8). PNIF, "SNOT-22", "NOSE" and "VAS" questionnaires were performed before and after surgery. In all patients, there was a strong negative correlation between change in PNIF and change in "SNOT-22" score following surgery (Pearson r=-.64, P<.0001). Strong negative correlations were also seen during subgroup analysis of patients with and without polyps (r=-.57, P=.006 and r=-.67, P=.005, respectively). Change in PNIF correlated significantly with change in "NOSE" score following surgery in all patients and those without polyps (r=-.54, P=.0005 and r=-.68, P=.003). There were no significant correlations between PNIF and VAS (nasal obstruction). Changes in PNIF after FESS appear to best reflect improvements in quality of life in CRS as measured using the "SNOT-22" questionnaire. © 2017 John Wiley & Sons Ltd.

Implications of Airflow Dynamics and Soft-Tissue Reconstructions for the Heat Exchange Potential of Dinosaur Nasal Passages

NASA Astrophysics Data System (ADS)

Bourke, Jason Michael

This study seeks to restore the internal anatomy within the nasal passages of dinosaurs via the use of comparative anatomical methods along with computational fluid dynamic simulations. Nasal airway descriptions and airflow simulations are described for extant birds, crocodylians, and lizards. These descriptions served as a baseline for airflow within the nasal passages of diapsids. The presence of shared airflow and soft-tissue properties found in the nasal passages of extant diapsids, were used to restore soft tissues within the airways of dinosaurs under the assumption that biologically unfeasible airflow patterns (e.g., lack of air movement in olfactory recess) can serve as signals for missing soft tissues. This methodology was tested on several dinosaur taxa. Restored airways in some taxa revealed the potential presence and likely shape of nasal turbinates. Heat transfer efficiency was tested in two dinosaur species with elaborated nasal passages. Results of that analysis revealed that dinosaur noses were efficient heat exchangers that likely played an integral role in maintaining cephalic thermoregulation. Brain cooling via nasal expansion appears to have been necessary for dinosaurs to have achieved their immense body sizes without overheating their brains.

Marine Collagen Scaffolds for Nasal Cartilage Repair: Prevention of Nasal Septal Perforations in a New Orthotopic Rat Model Using Tissue Engineering Techniques

PubMed Central

Bermueller, Christian; Elsaesser, Alexander F.; Sewing, Judith; Baur, Nina; von Bomhard, Achim; Scheithauer, Marc; Notbohm, Holger; Rotter, Nicole

2013-01-01

Autologous grafts are frequently needed for nasal septum reconstruction. Because they are only available in limited amounts, there is a need for new cartilage replacement strategies. Tissue engineering based on the use of autologous chondrocytes and resorbable matrices might be a suitable option. So far, an optimal material for nasal septum reconstruction has not been identified. The aim of our study was to provide the first evaluation of marine collagen for use in nasal cartilage repair. First, we studied the suitability of marine collagen as a cartilage replacement matrix in the context of in vitro three dimensional cultures by analyzing cell migration, cytotoxicity, and extracellular matrix formation using human and rat nasal septal chondrocytes. Second, we worked toward developing a suitable orthotopic animal model for nasal septum repair, while simultaneously evaluating the biocompatibility of marine collagen. Seeded and unseeded scaffolds were transplanted into nasal septum defects in an orthotopic rat model for 1, 4, and 12 weeks. Explanted scaffolds were histologically and immunohistochemically evaluated. Scaffolds did not induce any cytotoxic reactions in vitro. Chondrocytes were able to adhere to marine collagen and produce cartilaginous matrix proteins, such as collagen type II. Treating septal cartilage defects in vivo with seeded and unseeded scaffolds led to a significant reduction in the number of nasal septum perforations compared to no replacement. In summary, we demonstrated that marine collagen matrices provide excellent properties for cartilage tissue engineering. Marine collagen scaffolds are able to prevent septal perforations in an autologous, orthotopic rat model. This newly described experimental surgical procedure is a suitable way to evaluate new scaffold materials for their applicability in the context of nasal cartilage repair. PMID:23621795

A retrospective study of chronic nasal disease in 75 dogs.

PubMed

Lobetti, R G

2009-12-01

Chronic nasal disease is a common problem in dogs. To determine the aetiology, a retrospective study in 75 dogs with persistent and chronic nasal disease was done. All dogs were evaluated by means of survey nasal radiographs, antegrade and retrograde rhinoscopy, bacterial and fungal cultures, and histopathology. A definitive diagnosis was made in 74/75 cases (98.6%). Nasal neoplasia was the most common diagnosis (46.7%), median age 108 months, followed by lympho-plasmacytic rhinitis (20%), median age 112 months, and fungal rhinitis (10.7%), median age 53.5 months. Other diagnoses included nasal foreign body (5.3%), median age 51 months, and primary bacterial rhinitis (6.7%), median age 116.5 months. Rare aetiologies identified were nasal polyps, granulomatous rhinitis, oro-nasal fistula and naso-pharyngeal stenosis. This study showed that by using a structured combination of survey radiography, rhinoscopy, cultures and histopathology, a diagnosis could be made in dogs with chronic nasal disease.

Changes in the palatal dimensions of mouth breathing children caused by nasal obstruction

NASA Astrophysics Data System (ADS)

Indiarti, I. S.; Setyanto, D. B.; Kusumaningrum, A.; Budiardjo, S. B.

2017-08-01

During children’s growth and development, the breathing process plays an important role in craniofacial growth, especially of the palate. Nose breathing can stimulate the lateral growth of the maxilla, thus making the palate flat. Disturbances in nose breathing caused by nasal obstruction such as allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea can lead to a mouth breathing habit in children. This habit can cause palatal dimension changes such as a narrow V-shaped maxillary arch and a high palatal vault. This study analyzed the relationship between the mouth breathing habit in children who have nasal obstruction and palatal dimension changes. A cross-sectional descriptive study was conducted with a consecutive sampling method on children 7-18 years old with a history of allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea in the Pediatric Respirology and Pediatric Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at Cipto Mangunkusumo Hospital in Jakarta. The palatal dimensions were measured by the height and transversal width of the hard palate of castings of each child’s upper dental arch using vernier calipers. Palatal dimension changes were found in children with a mouth breathing habit due to nasal obstruction.

Comparison of serologic evaluation via agar gel immunodiffusion and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs.

PubMed

Pomrantz, Jill S; Johnson, Lynelle R; Nelson, Richard W; Wisner, Erik R

2007-05-01

To compare the sensitivity and specificity of serologic evaluation and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs. Prospective study. 58 dogs with nasal discharge and 26 healthy dogs. Dogs with nasal discharge were anesthetized and underwent computed tomography and rhinoscopy; nasal tissues were collected for histologic examination and fungal culture. Sera were assessed for antibodies against Aspergillus spp (healthy dog sera were used as negative control specimens). Nasal aspergillosis was diagnosed in dogs that had at least 2 of the following findings: computed tomographic characteristics consistent with aspergillosis, fungal plaques detected during rhinoscopy, and histologically detectable fungal hyphae in nasal tissue. Histologic characteristics of malignancy were diagnostic for neoplasia. Without evidence of neoplasia or fungal disease, nonfungal rhinitis was diagnosed. Among the 58 dogs, 21 had nasal aspergillosis, 25 had nonfungal rhinitis, and 12 had nasal neoplasia. Fourteen aspergillosis-affected dogs and 1 dog with nonfungal rhinitis had serum antibodies against Aspergillus spp. Fungal culture results were positive for Aspergillus spp only for 17 dogs with aspergillosis. With regard to aspergillosis diagnosis, sensitivity, specificity, and positive and negative predictive values were 67%, 98%, 93%, and 84%, respectively, for serum anti-Aspergillus antibody determination and 81%, 100%, 100%, and 90%, respectively, for fungal culture. Results suggest that seropositivity for Aspergillus spp and identification of Aspergillus spp in cultures of nasal tissue are highly suggestive of nasal aspergillosis in dogs; however, negative test results do not rule out nasal aspergillosis.

Polyp measurement with CT colonography: multiple-reader, multiple-workstation comparison.

PubMed

Young, Brett M; Fletcher, J G; Paulsen, Scott R; Booya, Fargol; Johnson, C Daniel; Johnson, Kristina T; Melton, Zackary; Rodysill, Drew; Mandrekar, Jay

2007-01-01

The risk of invasive colorectal cancer in colorectal polyps correlates with lesion size. Our purpose was to define the most accurate methods for measuring polyp size at CT colonography (CTC) using three models of workstations and multiple observers. Six reviewers measured 24 unique polyps of known size (5, 7, 10, and 12 mm), shape (sessile, flat, and pedunculated), and location (straight or curved bowel segment) using CTC data sets obtained at two doses (5 mAs and 65 mAs) and a previously described colonic phantom model. Reviewers measured the largest diameter of polyps on three proprietary workstations. Each polyp was measured with lung and soft-tissue windows on axial, 2D multiplanar reconstruction (MPR), and 3D images. There were significant differences among measurements obtained at various settings within each workstation (p < 0.0001). Measurements on 2D images were more accurate with lung window than with soft-tissue window settings (p < 0.0001). For the 65-mAs data set, the most accurate measurements were obtained in analysis of axial images with lung window, 2D MPR images with lung window, and 3D tissue cube images for Wizard, Advantage, and Vitrea workstations, respectively, without significant differences in accuracy among techniques (0.11 < p < 0.59). The mean absolute error values for these optimal settings were 0.48 mm, 0.61 mm, and 0.76 mm, respectively, for the three workstations. Within the ultralow-dose 5-mAs data set the best methods for Wizard, Advantage, and Vitrea were axial with lung window, 2D MPR with lung window, and 2D MPR with lung window, respectively. Use of nearly all measurement methods, except for the Vitrea 3D tissue cube and the Wizard 2D MPR with lung window, resulted in undermeasurement of the true size of the polyps. Use of CTC computer workstations facilitates accurate polyp measurement. For routine CTC examinations, polyps should be measured with lung window settings on 2D axial or MPR images (Wizard and Advantage) or 3D

Soft tissue nasal asymmetry as an indicator of orofacial cleft predisposition.

PubMed

Zhang, Charles; Miller, Steven F; Roosenboom, Jasmien; Wehby, George L; Moreno Uribe, Lina M; Hecht, Jacqueline T; Deleyiannis, Frederic W B; Christensen, Kaare; Marazita, Mary L; Weinberg, Seth M

2018-06-01

The biological relatives of offspring with nonsyndromic orofacial clefts have been shown to exhibit distinctive facial features, including excess asymmetry, which are hypothesized to indicate the presence of genetic risk factors. The significance of excess soft tissue nasal asymmetry in at-risk relatives is unclear and was examined in the present study. Our sample included 164 unaffected parents from families with a history of orofacial clefting and 243 adult controls. Geometric morphometric methods were used to analyze the coordinates of 15 nasal landmarks collected from three-dimensional facial surface images. Following generalized Procrustes analysis, Procrustes ANOVA and MANOVA tests were applied to determine the type and magnitude of nasal asymmetry present in each group. Group differences in mean nasal asymmetry were also assessed via permutation testing. We found that nasal asymmetry in both parents and controls was directional in nature, although the magnitude of the asymmetry was greater in parents. This was confirmed with permutation testing, where the mean nasal asymmetry was significantly different (p < .0001) between parents and controls. The asymmetry was greatest for midline structures and the nostrils. When subsets of parents were subsequently analyzed and compared (parents with bilateral vs. unilateral offspring; parents with left vs. right unilateral offspring), each group showed a similar pattern of asymmetry and could not be distinguished statistically. Thus, the side of the unilateral cleft (right vs. left) in offspring was not associated with the direction of the nasal asymmetry in parents. © 2018 Wiley Periodicals, Inc.

A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

PubMed

Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

2015-01-01

To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p < .01). Results for complete polypectomy time favored the TRUCLEAR System at 3 minutes 7 seconds over the VERSAPOINT System at 8 minutes 25 seconds (p < .01). If a successful procedure is predicated on access to cavity, visualization, and complete resection and excision of endometrial polyp, the mechanical TRUCLEAR Tissue Removal System shows a higher success rate than the VERSAPOINT Bipolar Electrosurgery System at 92% and 77%, respectively. Analysis of pain using the visual analog scale revealed no significant differences between the 2 techniques (p > .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being

Translation, cross-cultural adaptation and validation of SinoNasal Outcome Test (SNOT): 22 to Brazilian Portuguese.

PubMed

Kosugi, Eduardo Macoto; Chen, Vitor Guo; Fonseca, Viviane Maria Guerreiro da; Cursino, Milena Martins Pellogia; Mendes Neto, José Arruda; Gregório, Luís Carlos

2011-01-01

Quality of life questionnaires have been increasingly used in clinical trials to help establish the impact of medical intervention or to assess the outcome of health care services. Among disease-specific outcome measures, SNOT-22 was considered the most suitable tool for assessing chronic rhinosinusitis and patients with nasal polyps. To perform translation, cross-cultural adaptation and validation of the SNOT-22 to Brazilian Portuguese. Prospective study involving eighty-nine patients with chronic rhinosinusitis or nasal polyps submitted to functional endoscopic sinus surgery, who answered the questionnaire before and after surgery. Furthermore, 113 volunteers without sinonasal disease also answered the questionnaire. Internal consistency, test-retest reliability, measure validity, responsiveness and clinical interpretability were assessed. Mean preoperative, postoperative and no sinonasal disease scores were 62.39, 23.09 and 11.42, respectively (p<0.0001); showing validity and responsiveness. Internal consistency was high (Cronbach's alpha = 0.9276). Reliability was sufficiently good, considering inter-interviewers (r=0.81) and intra-interviewers within a 10 to 14 day-interval (r=0.72). Surgery effect size was 1.55. Minimally important difference was 14 points; and scores up to 10 points were considered normal. The Brazilian Portuguese SNOT-22 version is a valid instrument to assess patients with chronic rhinosinusitis and nasal polyps.

Recurrent giant fibrovascular polyp of the esophagus

PubMed Central

Lee, Ser Yee; Chan, Weng Hoong; Sivanandan, Ranjiv; Lim, Dennis Teck Hock; Wong, Wai Keong

2009-01-01

Giant fibrovascular polyps of the esophagus and hypopharynx are rare benign esophageal tumors. They arise most commonly in the upper esophagus and may, rarely, originate in the hypopharynx. They can vary significantly in size. Even though they are benign, they may be lethal due to either bleeding or, rarely, asphyxiation if a large polyp is regurgitated. Patients commonly present with dysphagia or hematemesis. The polyps may not be well visualized on endoscopy and imaging plays a vital role in aiding diagnosis as well as providing important information for pre-operative planning, such as the location of the pedicle, the vascularity of the polyp and the tissue elements of the mass. They can also be recurrent in rare cases, especially if the resection margins of the base are involved. We review the recent literature and report a case of a 61-year-old man with a recurrent giant esophageal fibrovascular polyp with illustrative contrast barium swallow, CT and intra-operative images, who required several surgeries via a combination of endoscopic, trans-oral, trans-cervical, trans-thoracic and trans-abdominal approaches. PMID:19653354

Whole blood and tissue fungal DNA quantification in the diagnosis of canine sino-nasal aspergillosis.

PubMed

Peeters, Dominique; Peters, Iain R; Helps, Chris R; Dehard, Sandrine; Day, Michael J; Clercx, Cécile

2008-04-01

Various combinations of tests are used to confirm the diagnosis of canine sino-nasal aspergillosis (SNA) because false-positive and false-negative results can occur with each test. Therefore, the aim of this study was to evaluate whether detection of fungal DNA in blood and nasal tissue samples was of value in the clinical diagnosis of this disease. Four groups were included in the study (dogs with SNA, lymphoplasmacytic rhinitis or nasal neoplasia, and control animals). Real-time PCR assays detecting DNA from all Penicillium and Aspergillus species (PenAsp assay) or species-specific DNA from A. fumigatus, A. terreus, A. flavus and A. niger were applied to whole blood and nasal tissue samples. Results obtained by PCR were compared between the groups. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) for fungal DNA detection were compared with those for alternative diagnostic procedures including histopathology, serology and fungal culture. Significantly more fungal DNA was detected by the PenAsp assay in tissue biopsies from dogs with SNA than in the three other groups. Sensitivity, specificity, PPV and NPV for this method were 1.00, 0.06, 0.32 and 1.00. A. fumigatus DNA was detected in seven tissue biopsies from dogs with SNA and in one biopsy from a dog with a nasal tumour. Sensitivity, specificity, PPV and NPV for this diagnostic test were 0.50, 0.97, 0.87 and 0.82. No significant difference was found between the groups with respect to the amount of DNA detected in blood by the PenAsp assay. Sensitivity, specificity, PPV and NPV for this method were 0.71, 0.24, 0.31 and 0.64. A. fumigatus DNA was detected in the blood of three dogs with SNA and sixteen dogs without SNA. Sensitivity, specificity, PPV and NPV for this diagnostic tool were 0.21, 0.45, 0.15 and 0.54. Detection of A. fumigatus DNA in nasal tissue had the highest specificity, PPV and NPV but sensitivity of this method was low. Detection of fungal DNA in whole blood was of

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance.

PubMed

Ari, Seyhmus; Kürşat Cingü, Abdullah; Sahin, Alparslan; Gün, Ramazan; Kiniş, Vefa; Caça, Ihsan

2012-01-01

To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocystorhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance

PubMed Central

Ari, Şeyhmus; Kürşat Cingü, Abdullah; Şahin, Alparslan; Gün, Ramazan; Kiniş, Vefa; Çaça, İhsan

2012-01-01

AIM To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocystorhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. METHODS Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. RESULTS Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). CONCLUSION Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates. PMID:22762058

Lymphangiomatous Polyp of Tonsil: A Case Report.

PubMed

Sayar, Hamide; Sayar, Çağdaş; Adamhasan, Fulya; Uğuz, Aysun

2016-01-01

Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. Histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically.

Biopsy forceps is inadequate for the resection of diminutive polyps.

PubMed

Efthymiou, M; Taylor, A C; Desmond, P V; Allen, P B; Chen, R Y

2011-04-01

Cold biopsy forceps polypectomy (CBP) is often used for the removal of diminutive polyps. The efficacy of the technique has not been thoroughly assessed. The aim of this study was to prospectively assess the efficacy of CBP for removing diminutive polyps. This was a prospective study from St Vincent's Hospital, a tertiary referral hospital in Melbourne, Australia. A total of 143 patients were screened and 52 patients with ≥ 1 diminutive polyps were enrolled. CBP was used to resect diminutive polyps until no polyp tissue was visible. The polyp base was then resected using endoscopic mucosal resection (EMR) with a 1 - 2-mm margin. The CBP and EMR samples were compared to assess completeness of the resection. Overall 39 % (21 / 54) of diminutive polyps were completely resected using CBP. After binary logistic regression analysis, polyp histology was found to be predictive of resection, with complete resection of 62 % (13 / 21) for adenomas and 24 % (8 / 33) for hyperplastic polyps (odds ratio 5.1; P = 0.008). The size and number of bites taken with the forceps were not predictive of complete response. Within the limitations of a modest sample size, CBP appears to be inadequate treatment for the removal of diminutive polyps. © Georg Thieme Verlag KG Stuttgart · New York.

Time Lapse to Colorectal Cancer: Telomere Dynamics Define the Malignant Potential of Polyps.

PubMed

Druliner, Brooke R; Ruan, Xiaoyang; Johnson, Ruth; Grill, Diane; O'Brien, Daniel; Lai, Tsung-Po; Rashtak, Shahrooz; Felmlee-Devine, Donna; Washechek-Aletto, Jill; Malykh, Andrei; Smyrk, Thomas; Oberg, Ann; Liu, Hongfang; Shay, Jerry W; Ahlquist, David A; Boardman, Lisa A

2016-09-01

Whereas few adenomas become cancer, most colorectal cancers arise from adenomas. Telomere length is a recognized biomarker in multiple cancers, and telomere maintenance mechanisms (TMM) are exploited by malignant cells. We sought to determine whether telomere length and TMM distinguish cancer-associated adenomas from those that are cancer-free. Tissues were identified as cancer-adjacent polyp (CAP)-residual adenoma contiguous with cancer-and cancer-free polyp (CFP)-adenomas without malignancy. Telomere length, TMM, and expression were measured in 102 tissues including peripheral blood leukocytes (PBLs), normal colon epithelium, adenoma, and cancer (in CAP cases) from 31 patients. Telomere length was measured in a separate cohort of 342 PBL from CAP and CFP patients. The mean differences in telomere length between normal and adenoma were greater in CAP than in CFP cases, P=0.001; telomere length in PBL was 91.7 bp greater in CAP than in CFP, P=0.007. Each 100 bp telomere increase was associated with a 1.14 (1.04-1.26) increased odds of being a CAP, P=0.0063. The polyp tissue from CAP patients had shorter telomeres and higher Telomerase reverse transcriptase (hTERT) expression compared with polyps from CFP patients, P=0.05. There was a greater degree of alternative lengthening of telomere (ALT) level difference in CFP polyps than in CAP polyps. The polyp telomere lengths of aggressive CAPs were significantly different from the polyps of non-aggressive CAPs, P=0.01. Adenomas that progress to cancer exhibit distinct telomere length and TMM profiles. We report for the first time that PBL telomeres differ in patients with polyps that become malignant, and therefore may have clinical value in adenoma risk assessment and management.

[Intestinal polyp of the umbilical cord].

PubMed

Guschmann, M; Janda, J; Wenzelides, K; Vogel, M

2002-02-01

The morphology, pathogenesis, complications and differential diagnosis of an intestinal polyp of the umbilical cord are presented. The polyp were detected postnatal on the umbilical cord in an healthy male newborn. The presents of intestinal tissue upon the umbilical cord ist possible about the persistence from remnants of the ductus omphalomesentericus with prolapse and differentiation of the intestinal cells. The ductus omphalomesentericus is a tubular structure, a communication between the developing embryonic gut and the yolk sac, forming during the early embryonic life. Obliteration of the omphalomesenteric duct is usually complete by the 10(th) week of gestation. Various portions of the duct may persist, however, giving rise to polyps, fistulas or cysts of the umbilical cord with potentially dangerous clinical consequences. Other tumors of the umbilical cord are myxoma, angioma and teratoma are differential diagnosis.

Genetic polymorphism of antioxidant enzymes in eosinophilic and non-eosinophilic nasal polyposis.

PubMed

Akyigit, Abdulvahap; Keles, Erol; Etem, Ebru Onalan; Ozercan, Ibrahim; Akyol, Hatice; Sakallioglu, Oner; Karlidag, Turgut; Polat, Cahit; Kaygusuz, Irfan; Yalcin, Sinasi

2017-01-01

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the paranasal sinuses, and its pathophysiology is not yet precisely known. It is suggested that oxygen free radicals play an important role in the pathogenesis of nasal polyposis. This study aimed to identify genetic polymorphisms of superoxide dismutase (SOD 2), catalase (CAT), and inducible nitric oxide synthase (iNOS) enzymes in eosinophilic CRSwNP and non-eosinophilic CRSwNP patients; the study also aimed to evaluate the effect of genetic polymorphism of antioxidant enzymes on CRSwNP etiopathogenesis. One hundred thirty patients, who received endoscopic sinus surgery due to CRSwNP, and 188 control individuals were included in this study. Nasal polyp tissues were divided into two groups histopathologically as eosinophilic CRSwNP and non-eosinophilic CRSwNP. Venous blood samples were taken from the patient and control groups. Polymorphisms in the Ala16Va1 gene, which is the most common variation of SOD-2 gene, and 21 A/T polymorphisms in catalase gene were evaluated with the restriction fragment length polymorphism method and -277 C/T polymorphism in the iNOS gene was evaluated with the DNA sequencing method. The GG genotype distribution for the (-277) A/G polymorphism in the iNOS gene was a statistically significant difference between eosinophilic CRSwNP and control groups (p < 0.05). The CC genotype distribution for the SOD2 A16V (C/T) polymorphism was not statistically significant in all groups (p > 0.05). The TT genotype distribution for the A/T polymorphism in catalase gene at position -21 was statistically significant differences in eosinophilic CRSwNP and control groups (p < 0.05). Increased free oxygen radical levels, which are considered effective factors in the pathogenesis of CRSwNP, can occur due to genetic polymorphism of enzymes in the antioxidant system and genetic polymorphism of antioxidant enzymes in eosinophilic CRSwNP patients might contribute to the

[Factors associated with malignancy in gallbladder polyps without gallbladder stone].

PubMed

Lee, Jae Seung; Lee, Kyu Taek; Jung, Jae Hong; Ok, Sung Wook; Choi, Sung Chul; Lee, Kwang Hyuck; Lee, Jong Kyun; Heo, Jin Seok; Choi, Seong Ho; Rhee, Jong Chul

2008-08-01

The purpose of this study was to find the factors predicting the neoplastic polyp of gallbladder and analyze the size criteria associated with malignancy. A total of 354 subjects with gallbladder polyps confirmed by tissue pathology were included for the analysis. The clinical and radiological features of the polyps were compared between the two groups (neoplastic vs. non-neoplastic) and in the three groups (non-neoplastic vs. adenoma vs. adenocarcinoma). The independent factors associated with malignancy were studied. Of 354 patients, non-neoplastic polyps were observed in 229 (64.7%) patents, adenoma in 85 (24.0%) and adenocarcinoma in 40 (11.3%). The mean diameter of non-neoplastic polyp, adenoma, and adenocarcinoma were 11.3+/-2.8 mm, 16.0+/-7.2 mm, and 27.0+/-8.9 mm, respectively. The mean age of patients with non-neoplastic polyp, adenoma, and adenocarcinoma were 44.8+/-11.3, 49.9+/-12.5, and 60.8+/-9.6, respectively. Age, size of polyp, number of polyp, presence of diabetes, and presence of symptom showed statistically significant difference between the neoplastic polyp and non-neoplastic polyp groups. But only age, size of polyp, number of polyp were statistically independent factors associated with neoplastic polyp (p<0.05). To predict the neoplastic polyp, sensitivity was 94.4%, but specificity was 18.3% on the basis of 10 mm criteria. whereas sensitivity and specificity was 76.0% and 55.5% on the 12 mm-criteria. On the basis of our analysis, the size of polyp is the most important factor to predict the malignancy. In the 10 mm criteria, sensitivity is satisfactory but specificity is very low. Therefore 10 mm size should not be considered to be the absolute size-criterion for surgery.

[Polyps of the gallbladder].

PubMed

Oestmann, A

2012-04-25

Gallbladder polyps are a common incidental finding in ultrasound. They may be clinically significant, because adenomas have a malignant potential, in contrast to the benign cholesterol polyps occuring more frequently. As non-neoplastic polyps and neoplastic polyps cannot be morphologically discriminated in ultrasound, maximal diameter of a polyp has proven to be the best predictor for malignancy. Cholecystectomy is widely accepted as the treatment of choice for patients with polyps >1 cm. Patients with polyps <1 cm should have a follow-up check for a longer period of time (with the exception of very small polyps).

[The effect of laryngoscopic surgery combined with nasal endoscopic system for the treatment of vocal cords benign lesions].

PubMed

Wang, Weian; Lu, Rong

2013-06-01

To investigate the effect of laryngoscopic surgery combined with nasal endoscopic system for the treatment of vocal cords benign lesions. Fifty-two patients admitted to our department with vocal cords benign lesions (including vocal polyps, vocal nodules, vocal cord cyst) underwent laryngoscopic surgery combined with nasal endoscopic system. All patients were treated successfully once and for all without any significant postoperative complication. The laryngoscopic surgery combined with nasal endoscopic system is a safe, minimally invasive and simple method for the treatment of benign lesions of vocal cords.

Risk factor assessment of endoscopically removed malignant colorectal polyps

PubMed Central

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schonegg, R; Maurer, C; Husler, J; Halter, F; Schmassmann, A

1998-01-01

Background—Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. 
Aims—To determine the significance of histological findings of patients with malignant polyps. 
Methods—Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67months). 
Results—Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16(42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. 
Conclusion—As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk. 

 Keywords: malignant polyps; colon cancer; colonoscopy; polypectomy; histology PMID:9824349

Risk factor assessment of endoscopically removed malignant colorectal polyps.

PubMed

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schönegg, R; Maurer, C; Hüsler, J; Halter, F; Schmassmann, A

1998-11-01

Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. To determine the significance of histological findings of patients with malignant polyps. Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67 months). Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16 (42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk.

Non-Eosinophilic Nasal Polyps Shows Increased Epithelial Proliferation and Localized Disease Pattern in the Early Stage.

PubMed

Kim, Dong-Kyu; Jin, Hong Ryul; Eun, Kyoung Mi; Mutusamy, Somasundran; Cho, Seong H; Oh, Sohee; Kim, Dae Woo

2015-01-01

Non-eosinophilic nasal polyps (NPs) show less inflammatory changes and are less commonly associated with lower airway inflammatory disorders such as asthma, compared with eosinophilic NPs. However, the development of non-eosinophilic NPs which is a predominant subtype in Asian population still remains unclear. A total of 81 patients (45 with non-eosinophilic NPs and 36 with eosinophilic NPs) were enrolled. Clinical information and computed tomography (CT), endoscopic, and histological findings were investigated. Tissue samples were analyzed for total IgE levels and for mRNA expression levels of interleukin (IL)-4, IL-5, IL-13, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-17A, IL-22, IL-23p19, transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, and periostin. Immunostaining assessment of Ki-67 as a proliferation marker was performed. We found that epithelial in-growing patterns such as pseudocysts were more frequently observed in histological and endoscopic evaluations of non-eosinophilic NPs, which was linked to increase epithelial staining of Ki-67, a proliferating marker. Eosinophilic NPs were characterized by high infiltration of inflammatory cells, compared with non-eosinophilic NPs. To investigate the developmental course of each subtype, CT was analyzed according to CT scores and subtypes. Non-eosinophilic NPs showed more localized pattern and maxillary sinus involvement, but lesser olfactory involvement in early stage whereas eosinophilic NPs were characterized by diffuse ethmoidal and olfactory involvement. In addition, high ethmoidal/maxillary (E/M) CT scores, indicating ethmoidal dominant involvement, were one of surrogate markers for eosinophilic NP. E/M CT scores was positively correlated with levels of TH2 inflammatory markers, including IL-4, IL-5, periostin mRNA expression and total IgE levels in NPs, whereas levels of the TH1 cytokine, IFN- γ were inversely correlated. Moreover, if the combinatorial algorithm meet the three of the

Incidence of Staphylococcus aureus nasal colonization and soft tissue infection among high school football players.

PubMed

Lear, Aaron; McCord, Gary; Peiffer, Jeffrey; Watkins, Richard R; Parikh, Arpan; Warrington, Steven

2011-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections have been documented with increasing frequency in both team and individual sports in recent years. It also seems that the level of MRSA skin and soft tissue infections in the general population has increased. One hundred ninety athletes from 6 local high school football teams were recruited for this prospective observational study to document nasal colonization and the potential role this plays in skin and soft tissue infections in football players and, in particular, MRSA infections. Athletes had nasal swabs done before their season started, and they filled out questionnaires regarding potential risk factors for skin and soft tissue infections. Those enrolled in the study were then observed over the course of the season for skin and soft tissue infections. Those infected had data about their infections collected. One hundred ninety of 386 available student athletes enrolled in the study. Forty-four of the subjects had nasal colonization with methicillin-susceptible S. aureus, and none were colonized with MRSA. There were 10 skin and soft tissue infections (8 bacterial and 2 fungal) documented over the course of the season. All were treated as outpatients with oral or topical antibiotics, and none were considered serious. Survey data from the preseason questionnaire showed 21% with skin infection, 11% with methicillin-susceptible S. aureus, and none with MRSA infection during the past year. Three reported a remote history of MRSA infection. We documented an overall skin infection rate of 5.3% among high school football players over a single season. Our results suggest that skin and soft tissue infection may not be widespread among high school athletes in northeast Ohio.

Inflammatory myoglandular polyp--a rare but distinct type of colorectal polyps.

PubMed

Becheanu, Gabriel; Stamm, Bernhard

2003-01-01

The aim of this paper was to report another example of a rare type of colorectal polyps, the inflammatory myoglandular polyp, and to reaffirm this type of polyp as a distinct entity. This solitary pedunculated polyp was detected after a single episode of rectal bleeding. It was situated in the sigmoid colon, measured 2.5 cm in greatest diameter, and was composed almost exclusively of smooth muscles and hyperplastic glands. The patient had neither chronic colitis nor diverticula. Clinical presentation, localization, and histology give this type of polyp a unique appearance and justify its designation as a separate entity.

Polyp on ultrasound: now what? The association between gallbladder polyps and cancer.

PubMed

Donald, Graham; Sunjaya, Dharma; Donahue, Timothy; Hines, O Joe

2013-10-01

The association between gallbladder polyps (GBP) and gallbladder cancer (GBC) is unclear. We sought to determine the association between preoperative diagnosis of GBP on imaging and GBC. A retrospective review of patients over 9 years was conducted using International Classification of Diseases, 9th Revision codes for GBP and GBC who underwent cholecystectomy at our institution. Demographics, imaging findings, and pathology results were recorded. A total of 2416 patients underwent cholecystectomy during the study period. Twenty-seven had an operation for GBP either as a result of concern for size or symptoms. Polyp sizes were categorized as less than 1 cm, 1 to 2 cm, or 2 cm or greater. Twenty-four patients in this group (88.9%) had no evidence of high-grade dysplasia or cancer and all of these benign polyps were 2 cm or less on imaging. One patient with a 2.4-cm polyp had high-grade dysplasia, and two patients with polyps over 3 cm had adenocarcinoma. During the same period, 20 patients had an operation for GBC with two patients common to the polyp group. The group of patients with noncancerous polyps was significantly younger than the cancer group (polyps and no polyps). The cancer group was more likely to be symptomatic. Therefore, polyps over 2 cm should be removed given the risk of high-grade dysplasia and cancer above this size. Polyps less than 2 cm were not associated with high-grade dysplasia or cancer and thus surgery may not be required. Intermediate- and small-sized polyps can be monitored with serial ultrasound, especially in younger, asymptomatic patients in whom the risk of malignancy is low.

Association Between Visceral Adiposity and Colorectal Polyps on CT Colonography

PubMed Central

Summers, Ronald M.; Liu, Jiamin; Sussman, Daniel L.; Dwyer, Andrew J.; Rehani, Bhavya; Pickhardt, Perry J.; Choi, J. Richard; Yao, Jianhua

2012-01-01

OBJECTIVE To determine if there is an association between visceral adiposity measured on CT colonography (CTC) and colorectal polyps. MATERIALS AND METHODS The study was HIPAA-compliant and approved by our Institutional Review Board and Office of Human Subjects Research. 1186 patients who underwent CTC and same day optical colonoscopy were analyzed. Visceral adipose tissue volumes (VAV) and volume percents relative to total internal body volume (VAV%) were measured on slices in the L2–L3 regions on supine CTC scan with validated fully-automated software. Student t-test, odds ratio (OR), logistic regression and receiver operating characteristic analyses were performed. RESULTS For subjects with and without adenomatous polyps, means and s. d. of VAV% were 31.2 ± 10.8% (n=345) and 28.2% ± 11.3% (n=841) (p<0.0001), respectively. For subjects with and without hyperplastic polyps they were 31.8% ± 10.7% (n=244) and 28.3% ± 11.2% (n=942) (p<0.0001), respectively. Comparing the lowest and highest quintiles of VAV%, the ORs for having at least one adenomatous polyp or hyperplastic polyp versus no polyp were 2.06 (95% CI: 1.36–3.13) and 1.71 [1.08, 2.71] and the prevalence of having adenomatous polyps or hyperplastic polyps increased 14% and 8%, respectively. CONCLUSION Subjects with higher visceral adiposity measurements on CTC have a greater risk for the presence of colonic polyps. PMID:22733893

Glycyrrhetinic acid suppressed hmgb1 release by up-regulation of Sirt6 in nasal inflammation.

PubMed

Chen, D; Bellussi, L M; Cocca, S; Wang, J; Passali, G C; Hao, X; Chen, L; Passali, D

2017-01-01

To extend our understanding of previous studies on the pathogenesis and mechanism of high mobility group box 1 (HMGB1) in chronic rhinosinusitis with nasal polyps (CRSwNP), here we show that Sirtuin 6 (Sirt6), one of the Sirtuin family members which are widely studied in aging, DNA repair, metabolism, inflammation and cancer, was expressed in normal nasal mucosa using immunohistochemical staining and Western blot assay. Sirt6 expression levels were decreased in CRSwNP tissue. Sirt6 expression levels were modulated by small interfering RNA transfection in human nasal epithelial cells (HNE). We found that depletion of Sirt6 suppressed the number of human nasal epithelial cell cilia, and dramatically induced HMGB1 translocation from nucleus to cytoplasm in the HNE cells. Glycyrrhizic acid (GA) and glycyrrhetinic acid (GTA) are specific chemical compounds that may be isolated from the licorice plant. GTA has been shown to have anti-inflammatory and anti-allergic activity: it binds selectively to HMGB1 protein released extra-cellularly and inhibits its cytokine activities through a scavenger mechanism on the protein accumulation. In an in vitro study we used the 18-β-stereoisomer of GTA to enhance Sirt6 expression levels, inhibiting through this mechanism the translocation of HMGB1 protein from nucleus and reversing its extracellular accumulation stimulated by lipopolysaccharides. These findings reveal a previously unknown role for nasal mucosa steady-state conditions in the control of Sirt6 activity, and provide evidence for a relationship between HMGB1 and Sirt6 in CRSwNP, and promising benefits of glycyrrhetinic acid for CRSwNP patients.

Systems approaches evaluating the perturbation of xenobiotic metabolism in response to cigarette smoke exposure in nasal and bronchial tissues.

PubMed

Iskandar, Anita R; Martin, Florian; Talikka, Marja; Schlage, Walter K; Kostadinova, Radina; Mathis, Carole; Hoeng, Julia; Peitsch, Manuel C

2013-01-01

Capturing the effects of exposure in a specific target organ is a major challenge in risk assessment. Exposure to cigarette smoke (CS) implicates the field of tissue injury in the lung as well as nasal and airway epithelia. Xenobiotic metabolism in particular becomes an attractive tool for chemical risk assessment because of its responsiveness against toxic compounds, including those present in CS. This study describes an efficient integration from transcriptomic data to quantitative measures, which reflect the responses against xenobiotics that are captured in a biological network model. We show here that our novel systems approach can quantify the perturbation in the network model of xenobiotic metabolism. We further show that this approach efficiently compares the perturbation upon CS exposure in bronchial and nasal epithelial cells in vivo samples obtained from smokers. Our observation suggests the xenobiotic responses in the bronchial and nasal epithelial cells of smokers were similar to those observed in their respective organotypic models exposed to CS. Furthermore, the results suggest that nasal tissue is a reliable surrogate to measure xenobiotic responses in bronchial tissue.

Systems Approaches Evaluating the Perturbation of Xenobiotic Metabolism in Response to Cigarette Smoke Exposure in Nasal and Bronchial Tissues

PubMed Central

Iskandar, Anita R.; Martin, Florian; Talikka, Marja; Schlage, Walter K.; Mathis, Carole; Hoeng, Julia; Peitsch, Manuel C.

2013-01-01

Capturing the effects of exposure in a specific target organ is a major challenge in risk assessment. Exposure to cigarette smoke (CS) implicates the field of tissue injury in the lung as well as nasal and airway epithelia. Xenobiotic metabolism in particular becomes an attractive tool for chemical risk assessment because of its responsiveness against toxic compounds, including those present in CS. This study describes an efficient integration from transcriptomic data to quantitative measures, which reflect the responses against xenobiotics that are captured in a biological network model. We show here that our novel systems approach can quantify the perturbation in the network model of xenobiotic metabolism. We further show that this approach efficiently compares the perturbation upon CS exposure in bronchial and nasal epithelial cells in vivo samples obtained from smokers. Our observation suggests the xenobiotic responses in the bronchial and nasal epithelial cells of smokers were similar to those observed in their respective organotypic models exposed to CS. Furthermore, the results suggest that nasal tissue is a reliable surrogate to measure xenobiotic responses in bronchial tissue. PMID:24224167

Increase of poorly proliferated p63+ /Ki67+ basal cells forming multiple layers in the aberrant remodeled epithelium in nasal polyps.

PubMed

Zhao, L; Li, Y Y; Li, C W; Chao, S S; Liu, J; Nam, H N; Dung, N T N; Shi, L; Wang, D Y

2017-06-01

Aberrant epithelial remodeling with the ectopic expression of p63 (basal cell markers) is an important pathologic phenomenon seen in chronically inflamed airway epithelium such as in nasal polyps (NPs). Biopsies were obtained from 55 NP patients and 18 healthy controls (inferior turbinate). Among NP patients, 15 were treated with oral and nasal steroids, so that two sets of NP biopsies were taken before and after the treatments. p63, Ki67, type IV β-tubulin, and cell cycle markers were investigated in these specimens. The number of p63 + cells is significantly higher in both hyperplastic (1.53-fold, P < 0.0001) and squamous metaplastic (2.02-fold, P < 0.0001) epithelium from NPs than from healthy controls. There are three types of proliferative basal cells (p63 + /Ki67 + ) which are in different phases of the cell cycle, such as G1 phase (type I cells), S to G2 phase (type II cells), and mitosis (type III cells). Of importance, some type I cells may arrest after proliferation although they may still be p63 + /Ki67 + . In healthy epithelium, the ratio of the type I and II cells is almost 50:50. However, less type II cells are found in hyperplastic epithelium (34.85%, P = 0.012) and in squamous metaplastic epithelium (30.77%, P = 0.02) together with the presence of type III cells (3.45%, P = 0.01). These findings were not changed after steroid treatments. An increase of poorly proliferated basal cells forming multiple layers, which may stain for basal cell markers but does not form a proper epidermal barrier, is an important histopathologic phenomenon in aberrant remodeled epithelium of NPs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Snaring large serrated polyps.

PubMed

Liang, Jennifer; Kalady, Matthew F; Church, James

2013-05-01

Serrated polyps of the large bowel are potentially premalignant, difficult to see, but important to remove. Few studies describe the technique or outcomes of serrated polypectomy. We sought to present outcomes of a series of polypectomies of large serrated polyps in comparison to a series of endoscopic resections of large adenomas. This retrospective, comparative, single endoscopist study was performed in an outpatient colonoscopy department of a tertiary referral medical center. Patients had outpatient colonoscopy where a large (≥2 cm) serrated polyp or adenoma was removed. Outcomes were completeness of excision and complications of polypectomy. A database of endoscopic polypectomies was reviewed. Polypectomy of large serrated polyps was compared with polypectomy of large adenomas. There were 132 large serrated polyps in 112 patients and 563 adenomas in 428 patients. More serrated polyps were right sided (120 of 130, 92.3 %, vs. 379 of 563, 67 %) (p < 0.0001). The serrated polyps were smaller than the adenomas (mean 25.5 ± 7.9 mm standard deviation) versus 36.8 ± 16.9 mm standard deviation (p < 0.001). There were four complications of serrated polypectomy in four patients (4 % of polyps, 5 % of patients): three postpolypectomy bleeds and one postpolypectomy syndrome. There were 33 complications of adenoma removal (31 postpolypectomy bleeding and two postpolypectomy syndrome) (6.9 % of polyps, p = 0.376, 8.4 % of patients, p = 0.371). On follow-up, 36 of 51 patients (71 %) with serrated polyps had metachronous lesions compared to 133 of 298 patients (45 %) with adenomas (p < 0.0001). There were fewer residual polyps in the serrated group (4 of 47 vs. 64 of 298, p = 0.001). Removal of large serrated colorectal polyps is no more complicated than polypectomy of similarly sized adenomas. However, large serrated polyps have a higher rate of metachronous polyps than similarly sized adenomas and surveillance should be adapted to reflect these findings.

Targeted delivery of antigen to hamster nasal lymphoid tissue with M-cell-directed lectins.

PubMed Central

Giannasca, P J; Boden, J A; Monath, T P

1997-01-01

The nasal cavity of a rodent is lined by an epithelium organized into distinct regional domains responsible for specific physiological functions. Aggregates of nasal lymphoid tissue (NALT) located at the base of the nasal cavity are believed to be sites of induction of mucosal immune responses to airborne antigens. The epithelium overlying NALT contains M cells which are specialized for the transcytosis of immunogens, as demonstrated in other mucosal tissues. We hypothesized that NALT M cells are characterized by distinct glycoconjugate receptors which influence antigen uptake and immune responses to transcytosed antigens. To identify glycoconjugates that may distinguish NALT M cells from other cells of the respiratory epithelium (RE), we performed lectin histochemistry on sections of the hamster nasal cavity with a panel of lectins. Many classes of glycoconjugates were found on epithelial cells in this region. While most lectins bound to sites on both the RE and M cells, probes capable of recognizing alpha-linked galactose were found to label the follicle-associated epithelium (FAE) almost exclusively. By morphological criteria, the FAE contains >90% M cells. To determine if apical glycoconjugates on M cells were accessible from the nasal cavity, an M-cell-selective lectin and a control lectin in parallel were administered intranasally to hamsters. The M-cell-selective lectin was found to specifically target the FAE, while the control lectin did not. Lectin bound to M cells in vivo was efficiently endocytosed, consistent with the role of M cells in antigen transport. Intranasal immunization with lectin-test antigen conjugates without adjuvant stimulated induction of specific serum immunoglobulin G, whereas antigen alone or admixed with lectin did not. The selective recognition of NALT M cells by a lectin in vivo provides a model for microbial adhesin-host cell receptor interactions on M cells and the targeted delivery of immunogens to NALT following intranasal

Nasal polyposis (or chronic olfactory rhinitis).

PubMed

Jankowski, R; Rumeau, C; Gallet, P; Nguyen, D T

2018-06-01

The concept of chronic rhinosinusitis with or without polyps is founded on the structural and functional unicity of the pituitary mucosa and its united response to environmental aggression by allergens, viruses, bacteria, pollution, etc. The present review sets this concept against the evo-devo three-nose theory, in which nasal polyposis is distinguished as specific to the olfactory nose and in particular to the non-olfactory mucosa of the ethmoid, which is considered to be not a sinus but rather the skull-base bone harboring the olfactory mucosa. The evo-devo approach enables simple and precise positive diagnosis of nasal polyposis and its various clinical forms, improves differential diagnosis by distinguishing chronic diseases of the respiratory nose and those of the paranasal sinuses, hypothesizes an autoimmune origin specifically aimed at olfactory system auto-antigens, and supports the surgical concept of nasalization against that of functional sinus and ostiomeatal-complex surgery. The ventilation function of the sinuses seems minor compared to their production, storage and active release of nitric oxide (NO) serving to oxygenate arterial blood in the pulmonary alveoli. This respiratory function of the paranasal sinuses may indeed be their most important. NO trapped in the ethmoidal spaces also accounts for certain radiographic aspects associated with nasal polyposis. Copyright © 2018. Published by Elsevier Masson SAS.

Stomach Polyps

MedlinePlus

... polyps are: Chronic stomach inflammation. Also known as gastritis, this condition can cause the formation of hyperplastic ... pylori) bacteria are a common cause of the gastritis that contributes to hyperplastic polyps and adenomas. Familial ...

Expression of Clara cell 10-kDa protein and trefoil factor family 1 in patients with chronic rhinosinusitis and nasal polyps

PubMed Central

Wang, Yuanyuan; Wang, Zong-Feng; Zhang, Zhili; Su, Yi

2018-01-01

The current study measured the expression of Clara cell 10-kDa protein (CC10) and trefoil factor family 1 (TFF1) in the sinus mucosa of patients exhibiting chronic rhinosinusitis (CRS) and nasal polyps (NP). CC10 and TFF1 expression in the sinus mucosa of the control group and patients with CRS and NP was determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), western blotting and immunohistochemistry. The correlation between CC10 and TFF1 expression was further analyzed using Spearman's correlation analysis. The expression of TFF1 was significantly increased in the sinus mucosa of patients with CRS and NP, whereas CC10 expression was significantly decreased compared with controls. Spearman's correlation analysis identified a negative correlation between CC10 and TFF1 expression in the sinus mucosa of patients with CRS and NP. The results of immunohistochemistry and RT-qPCR were consistent with each other. Hematoxylin and eosin staining revealed notable lesions in the mucous membranes, goblet cells and cilia of sinus mucosa samples from patients with CRS and NP. The negative correlation between CC10 and TFF1 expression during the progression of CRS and NP suggest that CC10 and TFF1 may serve important roles in its pathogenesis. PMID:29456658

Endoscopic Features of Mucous Cap Polyps: A Way to Predict Serrated Polyps.

PubMed

Moy, Brian T; Forouhar, Faripour; Kuo, Chia-Ling; Devers, Thomas J

2018-04-27

The aims of the study were to identify whether a mucous-cap predicts the presence of serrated polyps, and to determine whether additional endoscopic findings predict the presence of a sessile serrated adenomas/polyp (SSA/P). We analyzed 147 mucous-capped polyps with corresponding histology, during 2011-2014. Eight endoscopic features (presence of borders, elevation, rim of debris, location in the colon, size ≥10 mm, varicose vessels, nodularity, and alteration in mucosal folds) of mucous-capped polyps were examined to see if they can predict SSA/Ps. A total of 86% (n=126) of mucous-capped polyps were from the right sided serrated pathway (right-sided hyperplastic [n=83], SSA/Ps [n=43], traditional serrated adenoma [n=1]), 10% (n=15) were left-sided hyperplastic polyps, and 3% (n=5) were from the adenoma-carcinoma sequence. The presence of a mucous cap combined with varicose vessels was the only significant predictor for SSA/Ps. The other seven characteristics were not found to be statistically significant for SSA/Ps, although location in the colon and the presence of nodularity trended towards significance. Our study suggests that mucous-capped polyps have high predictability for being a part of the serrated pathway. Gastroenterologists should be alert for a mucous-capped polyp with varicose veins, as these lesions have a higher risk of SSA/P.

Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease.

PubMed

Stevens, Whitney W; Peters, Anju T; Hirsch, Annemarie G; Nordberg, Cara M; Schwartz, Brian S; Mercer, Dione G; Mahdavinia, Mahboobeh; Grammer, Leslie C; Hulse, Kathryn E; Kern, Robert C; Avila, Pedro; Schleimer, Robert P

Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. The prevalence of AERD among patients with CRSwNP was 16%. Patients with AERD had undergone 2-fold more sinus surgeries (P < .001) and were significantly younger at the time of their first surgery (40 ± 13 years) than were patients with CRSwNP (43 ± 14 years; P < .05). Atopy was significantly more prevalent in patients with AERD (84%) or asthma (85%) than in patients with CRSwNP (66%, P < .05). More patients with AERD (13%) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4%, P < .01) or asthma (1%, P < .001). AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Cervical polyps

MedlinePlus

... on the cervix during a pelvic exam. A cervical biopsy will be performed. Most of the time, the biopsy will show cells that are consistent with a benign polyp. Rarely, there may be abnormal, precancerous, or cancer cells in a polyp. Treatment The provider can ...

[Expression and role of IL-18 in chronic rhinosinusitis].

PubMed

Liu, R W; Du, J T; Liu, Y F; Liu, S X

2018-04-01

Objective: To study the expression and role of interleukin-18 (IL-18) in different clinical phenotypes of chronic rhinosinusitis(CRS)and in different subtypes of CRS with nasal polyps (CRSwNP). Method: During nasal endoscopic surgery, inferior turbinates were obtained from 13 patients with nasal septum deviation (control group),uncinate processes were obtained from 10 patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and nasal polyp tissues were obtained from 36 patients with CRSwNP, respectively. IL-5 expression in CRSwNP was detected by ELISA, and the expression of IL-18 mRNA and protein in different subtypes of CRS were assessed by real-time PCR, ELISA and immunohistochemistr. Result: CRSwNP was divided into 12 cases of IL-5 positive nasal polyps (IL-5+NP)group and 24 cases of IL-5 negative nasal polyps (IL-5-NP)group. The expression of IL-18 mRNA and protein in all CRSsNP,IL-5+NP and IL-5-NP groups were higher than that in control group ( P <0.01 or P <0.05),but no significant difference existed between IL-5+NP and IL-5-NP ( P >0.05) group. IL-18 also expresses in epithelial cells of normal nasal mucosa. Conclusion: CRSwNP can be divided into two main subtypes: IL-5+NP and IL-5-NP. The increasing expression of IL-18 in CRSsNP, IL-5+NP and IL-5-NP compared with control group indicates that IL-18 may play a key role in the pathogenesis of CRS, and IL-18 expression in nasal polyps is not affected by the type of inflammation. The possible presence of balance between IL-18 and IL-18 binding protein in normal nasal mucosa provides a new way for research and treatment of CRS. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Ultrasound diagnosis of gallbladder polyps.

PubMed

Tomić, Dragan V; Marković, Aleksandra R Pavlović; Alempijević, Tamara M; Davidović, Dragana B; Prsić, Daliborka R; Vucković, Maja S

2011-01-01

The most frequent benign gallbladder polyps are cholesterol polyps. Next in frequency were adenomas, which may have malignant potential. The aim of this study was to assess the possibility of ultrasonography in the diagnosis and differential diagnosis of cholesterol polyps compared to adenomas. Patients were examined during the period from October 2006. to December 2008. In Department of Ultrasound, Clinic for Gastroenterology and Hepatology, Belgrade. The group of 54 patients analyzed consisted of 30 women (56%) and 24 men (44%). Most (59%) had solitary polyps. In 92.6% of patients the size of polyps was below 10 mm. 74% of respondents were over 50 years. Ultrasonography is the method of choice and gold standard in diagnosis of gallbladder polyps. Based on echoic properties cholesterol polyps can not be distinguished from adenomas. Malignant alteration of polyps also could not be detected. Appropriate ultrasonographic characteristics such as size of polyps, appearance of a broad base that sits on the wall, concomitant lithiasis findings and patient age may be indicative for malignancy.

Suppression of Matrix Metalloproteinase Production in Nasal Fibroblasts by Tranilast, an Antiallergic Agent, In Vitro

PubMed Central

Shimizu, Toshiyuki; Kanai, Kenichi; Asano, Kazuhito; Hisamitsu, Tadashi; Suzaki, Harumi

2005-01-01

Allergic rhinitis is an inflammatory disease characterized by nasal wall remodeling with intense infiltration of eosinophils and mast cells/basophils. Matrix metalloproteinases (MMPs), MMP-2 and MMP-9, are the major proteolytic enzymes that induce airway remodeling. These enzymes are also important in the migration of inflammatory cells through basement membrane components. We evaluated whether tranilast (TR) could inhibit MMP production from nasal fibroblasts in response to tumor necrosis factor-α (TNF-α) stimulation in vitro. Nasal fibroblasts (NF) were established from nasal polyp tissues taken from patients with allergic rhinitis. NF (2 × 105 cells/mL) were stimulated with TNF-α in the presence of various concentrations of TR. After 24 hours, the culture supernatants were obtained and assayed for MMP-2, MMP-9, TIMP-1, and TIMP-2 levels by ELISA. The influence of TR on mRNA expression of MMPs and TIMPs in cells cultured for 12 hours was also evaluated by RT-PCR. TR at more than 5 × 10−5 M inhibited the production of MMP-2 and MMP-9 from NF in response to TNF-α stimulation, whereas TIMP-1 and TIMP-2 production was scarcely affected. TR also inhibited MMP mRNA expression in NF after TNF-α stimulation. The present data suggest that the attenuating effect of TR on MMP-2 and MMP-9 production from NF induced by inflammatory stimulation may underlie the therapeutic mode of action of the agent in patients with allergic diseases, including allergic rhinitis. PMID:16106101

A prospective, multicentre study of moxifloxacin concentrations in the sinus mucosa tissue of patients undergoing elective surgery of the sinus.

PubMed

Gehanno, P; Darantière, S; Dubreuil, C; Chobaut, J C; Bobin, S; Pages, J C; Renou, G; Bobin, F; Arvis, P; Stass, H

2002-05-01

A pharmacokinetic study was carried out to determine moxifloxacin concentrations in sinus tissue, after oral moxifloxacin 400 mg once daily for 5 days to patients with chronic sinusitis, undergoing elective sinus surgery. Patients were randomly allocated to one of seven treatment groups, in which tissues were sampled 2, 3, 4, 6, 12, 24 or 36 h post-dose. A control group with non-infected nasal polyps was also included. Forty-eight patients (13 female, 35 male, mean age 47.1 years) were allocated to one of each active treatment group (n = 42) or to the control group (n = 6). Tissue and plasma samples were taken simultaneously and stored frozen until assayed by HPLC. Thirty-nine patients were fully valid for pharmacokinetic analysis. The geometric mean moxifloxacin plasma concentration increased from 2.32 mg/L at 2 h to a maximum of 3.37 mg/L at 4 h post-dose, decreasing to 0.37 mg/L at 36 h post-dose. The moxifloxacin concentration in sinus mucosa was consistently greater than that in plasma being 4.56-5.73 mg/kg from 2 to 6 h and 2.81-1.25 mg/kg from 12 to 36 h post-dose. The elimination rates in plasma and sinus tissues were similar. The tissue/plasma ratio was c. 200% between 2 and 6 h, and up to 328.9% at 36 h. Results were similar whatever the site of tissue sampling (maxillary sinus, anterior ethmoid sinus or nasal polyps). Tissue levels exceeded the MIC(90) of all pathogens commonly causing acute sinusitis (e.g. 5-30 x MIC for Streptococcus pneumoniae: 0.25 mg/L). These results sup-port the use of moxifloxacin 400 mg once daily as a regimen for the treatment of sinus infections.

Associations among Pericolonic Fat, Visceral Fat, and Colorectal Polyps on CT Colonography

PubMed Central

Liu, Jiamin; Pattanaik, Sanket; Yao, Jianhua; Dwyer, Andrew J.; Pickhardt, Perry J.; Choi, J. Richard; Summers, Ronald M.

2014-01-01

OBJECTIVE To determine the association between pericolonic fat and colorectal polyps using CT colonography (CTC). METHODS 1169 patients who underwent CTC and same day optical colonoscopy were assessed. Pericolonic fat was measured on CTC in a band surrounding the colon. Visceral adipose tissue volume was measured at the L2-L3 levels. Student t-tests, odds ratio, logistic regression, binomial statistics and weighted-kappa were performed to ascertain associations with the incidence of colorectal polyps. RESULTS Pericolonic fat volume fractions (PFVF) were 61.5±11.0% versus 58.1±11.5%, 61.6 ±11.1% versus 58.7±11.5%, and 62.4±10.6% versus 58.8±11.5% for patients with and without any polyps, adenomatous polyps, and hyperplastic polyps, respectively (p<0.0001). Similar trends were observed when examining visceral fat volume fractions (VFVF). When patients were ordered by quintiles of PFVF or VFVF, there were 2.49, 2.19 and 2.39-fold increases in odds ratio for the presence of any polyp, adenomatous polyps, or hyperplastic polyps from the first to the fifth quintile for PFVF, and 1.92, 2.00 and 1.71-fold increases in odds ratio for VFVF. Polyps tended to occur more commonly in parts of the colon that had more PFVF than the spatially-adjusted average for patients in the highest quintile of VFVF. CONCLUSION Pericolonic fat accumulations, like visceral fat, are correlated with an increased risk of adenomatous and hyperplastic polyps. PMID:25558027

The efficacy and safety of argon plasma coagulation (APC) in the management of polyp remnants in stomach and colon.

PubMed

Neneman, B; Gasiorowska, A; Małecka-Panas, E

2006-01-01

Endoscopic treatment of sessile and semipedunculated polyps remains controversial. Residual tissue remains frequently after endoscopic snare polypectomy. The aim of the study was to assess the outcome and safety of argon plasma coagulation (APC) in the management of gastric and colorectal polyp remnants after polypectomy, and to search for clinical parameters useful in predicting the efficacy of this technique. This prospective study comprised 18 patients with gastric polyps and 29 with colonic polyps found in upper and lower GI endoscopy. Overall 22 gastric polyps and 58 colonic polyps have been detected. All those polyps were removed at colonoscopy with the diathermic snare and the polyp remnants were destroyed with APC using Argon Beamer source (Erbe, Germany). Follow-up endoscopies have been performed 1, 3 and 6 months after the treatment completion. Pathologic examination revealed 10 hyperplastic polyps and 12 tubular adenomas of the stomach. Effective destruction of polyp remnants was achieved in 20 (90.9%) gastric polyps in 16 (88.9%) patients. Significant positive correlation was demonstrated between the power output, APC sessions number and polyp location in the prepyloric part, its size and adenomatous content. Among colonic polyps there were: 17 hyperplastic, 26 tubular, 8 tubulo-villous, 4 villous adenomas and 3 inflammatory pseudopolyps. Effective destruction of remnant polyp tissue was obtained in 56 (96.4%) polyps in 27 (93.1%) patients. A significant positive correlation between the power output and the size, distal location and villous texture of the polyp has been demonstrated. No complications other than mild abdominal distention have been encountered. APC is an effective and safe method in the management of polyp remnants in the stomach and colon. The application of higher electric power and numerous APC sessions are necessary to remove residues of large gastric polyps located in the prepyloric part and of with adenomatous content. In the case

A hitherto undescribed benign mesenchymal polyp of the gallbladder: edematous angiomyolipoma-like polyp.

PubMed

Arcega, R; Wu, J X; Magaki, S; Donahue, T R; Wang, H L

2016-01-01

We report a case of two peculiar gallbladder polyps in a sixty-four year old male who presented with symptomatic cholelithiasis. Cholecystectomy was performed, which revealed two polyps measuring 0.6 cm and 1.9 cm, located in the body of the gallbladder. Microscopic examination of the polyps showed composite mesenchymal lesions with vascular proliferation of small-to-medium sized arterioles, myoid stroma, and lipomatous periphery. The myoid component was characterized by wisps of bland smooth muscle fibers loosely separated by proteinaceous and focally myxoid matrix. The surface of the polyps was lined by a single layer of bland epithelial cells. The unique histomorphologic features differentiate the lesions from other known mesenchymal polyps of the gallbladder. We propose the name "edematous angiomyolipoma-like polyp" for these rare lesions given their histomorphologic similarity to angiomyolipoma. (Acta gastroenterol. belg., 2016, 79, 371-374). © Acta Gastro-Enterologica Belgica.

[Gallbladder polyps: prevalence and risk factors].

PubMed

Kratzer, W; Schmid, A; Akinli, A S; Thiel, R; Mason, R A; Schuler, A; Haenle, M M

2011-01-01

The objective of the present study was to investigate the prevalence of gallbladder polyps and possible risk factors in a random population sample of an urban population. A total of 2099 subjects (1072 women, 1027 men; aged 19 - 65 years, mean age 42.1 (SD ± 12.8 years) were prospectively examined using ultrasound, a standardized questionnaire and laboratory studies. Gallbladder polyps were identified in 6.1 % (128 / 2099) of all subjects (women: 6.1 % [63 / 1027]); men: 6.1 % [65 / 1072]). Solitary polyps were found in 52.4 % (65 / 124), two polyps in 16.1 % (20 / 124), three polyps in 6.5 % (8 / 124), several polyps in 22.6 % (28 / 124) and multiple polyps in 2.4 % (3 / 124) of subjects. The mean polyp diameter was 4.7 mm (SD ± 2.2; range 2 - 20 mm). The polyp diameter was ≤ 7 mm in 94.5 % of subjects. The polyps were described as pedunculate in 82.3 % (102 / 124). The polyps were broad-based in 11.3 % of subjects (14 / 124; men: 18 % women: 4.8 %). The polyps were homogeneously echogenic in 100 % of cases and with irregular contours in only one male subject. Multiple logistic regression failed to demonstrate an influence on the increased occurrence of gallbladder polyps for the risk factors of male sex, age, body-mass index (BMI), alcohol, nicotine or caffeine consumption or diabetes mellitus. The prevalence of gallbladder polyps reported in the present study (6.1 %) is higher than figures previously published for populations in Germany or Europe. The majority of polyps were pedunculate and solitary. A typical risk factor profile for gallbladder polyps could not be identified in the present population sample. © Georg Thieme Verlag KG Stuttgart · New York.

Functional anatomy of the nasal bones and adjacent structures. Consequences for nasal surgery.

PubMed

Popko, M; Verlinde-Schellekens, S A M W; Huizing, E H; Bleys, R L A W

2018-03-01

The periosteum of the nasal bones, the periosteal-perichondrial nasal envelope, and the cartilaginous support of the bony vault were studied in serial coronal sections of four human cadaver noses. To differentiate between the various tissue components, the sections were stained according to Mallory-Cason and Verhoeff-Van Gieson stain. The results demonstrated: 1. the presence of clearly distinguishable layers of the periosteum covering the nasal bones; 2. the presence of a continuous periosteal-perichondrial covering of the bony and cartilaginous nasal vaults; 3. the way the cartilaginous support of the bony vault is constructed. The findings described in the present study may have clinical relevance in nasal surgery.

Nasal chondrocyte-based engineered autologous cartilage tissue for repair of articular cartilage defects: an observational first-in-human trial.

PubMed

Mumme, Marcus; Barbero, Andrea; Miot, Sylvie; Wixmerten, Anke; Feliciano, Sandra; Wolf, Francine; Asnaghi, Adelaide M; Baumhoer, Daniel; Bieri, Oliver; Kretzschmar, Martin; Pagenstert, Geert; Haug, Martin; Schaefer, Dirk J; Martin, Ivan; Jakob, Marcel

2016-10-22

Articular cartilage injuries have poor repair capacity, leading to progressive joint damage, and cannot be restored predictably by either conventional treatments or advanced therapies based on implantation of articular chondrocytes. Compared with articular chondrocytes, chondrocytes derived from the nasal septum have superior and more reproducible capacity to generate hyaline-like cartilage tissues, with the plasticity to adapt to a joint environment. We aimed to assess whether engineered autologous nasal chondrocyte-based cartilage grafts allow safe and functional restoration of knee cartilage defects. In a first-in-human trial, ten patients with symptomatic, post-traumatic, full-thickness cartilage lesions (2-6 cm 2 ) on the femoral condyle or trochlea were treated at University Hospital Basel in Switzerland. Chondrocytes isolated from a 6 mm nasal septum biopsy specimen were expanded and cultured onto collagen membranes to engineer cartilage grafts (30 × 40 × 2 mm). The engineered tissues were implanted into the femoral defects via mini-arthrotomy and assessed up to 24 months after surgery. Primary outcomes were feasibility and safety of the procedure. Secondary outcomes included self-assessed clinical scores and MRI-based estimation of morphological and compositional quality of the repair tissue. This study is registered with ClinicalTrials.gov, number NCT01605201. The study is ongoing, with an approved extension to 25 patients. For every patient, it was feasible to manufacture cartilaginous grafts with nasal chondrocytes embedded in an extracellular matrix rich in glycosaminoglycan and type II collagen. Engineered tissues were stable through handling with forceps and could be secured in the injured joints. No adverse reactions were recorded and self-assessed clinical scores for pain, knee function, and quality of life were improved significantly from before surgery to 24 months after surgery. Radiological assessments indicated variable degrees of

Polyp Prevention Trial

Cancer.gov

The primary objective of the Polyp Prevention Trial (PPT) is to determine whether a low fat, high fiber, high vegetable and fruit eating plan will decrease the recurrence of adenomatous polyps of the large bowel.

Role of CD146 Enrichment in Purification of Stem Cells Derived from Dental Pulp Polyp.

PubMed

Tavangar, Maryam Sadat; Hosseini, Seyed-Mojtaba; Dehghani-Nazhvani, Ali; Monabati, Ahmad

2017-01-01

Hyperplastic pulpitis (pulp polyp) tissues contains cells with stem cell properties similar to that of the dental pulp stem cells (DPSCs). It has also been shown that CD146 enrichment can homogenize the cultures of DPSCs and enhance the colony forming potentials of their cultures. This study determines whether CD146 enrichment can help purifying the stem cells from heterogeneous cultures of the pulp polyp derived stem cells (PPSCs). Healthy dental pulps and pulp polyp tissues were enzymatically digested and the harvested single cells were sorted according to the presence of CD146 marker. The sorted cells were seeded directly for colony forming unit (CFU) assays of the negative and positive portions. Flowcytometric antigen panel and differentiation assays were used to see if these cells conform with mesenchymal stems cells (MSCs) definition. Differences between the between groups was assessed using independent t-test. The level of significance was set at 0.05. Normal pulp tissue derived cells formed higher colonies (42.5±16.8 per 10 4 cells) than the pulp polyp (17.75±8.9 per 10 4 cells) ( P =0.015). The CD146 positive portion of the polyp derived cells formed an average of 91.5±29.7 per 10 4 cells per CFU. On the other hand, CD146 negative portion did not show any colonies ( P <0.001). Both resources showed cells with flowcytometric antigen panel and differentiation potentials conforming to MSC definition. The entire CFU of PPSCs were formed within CD146 enriched portion. It seems that CD146 enrichment may reduce the number of possible fibroblasts of the pulp polyps and may further homogenize the culture of the PPSCs.

The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study

PubMed Central

2015-01-01

Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids. PMID:26327901

The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study.

PubMed

Woźniak, Sławomir

2015-06-01

Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids.

Nilotinib Induced Recurrent Gastric Polyps: Case Report and Review of Literature.

PubMed

Kassem, Nancy; Ismail, Omar M; Elomri, Halima; Yassin, Mohamad A

2017-07-14

BACKGROUND Tyrosine kinase inhibitors (TKIs) are currently an important targeted drug class in the treatment of chronic myeloid leukemia (CML). Imatinib was the first approved TKI for CML in 2001. Nilotinib is a second-generation TKI, approved in 2007; it inhibits BCR-ABL, PDGFR, and c-KIT, and is 30 times more potent than imatinib. Tyrosine kinase enzymes are expressed in multiple tissues and are involved in several signaling pathways; they have been shown to have several off-target side effects. CASE REPORT We report a case of an elderly male with CML and no history of gastrointestinal diseases, treated with nilotinib, and developed recurrent gastric polyps after three years of treatment. We excluded common causes of gastric polyps and therefore considered nilotinib as a probable cause of recurrent gastric polyps. CONCLUSIONS Recurrent gastric polyps could be a potential side effect of nilotinib treatment. Careful long-term monitoring of patients on TKI therapy is necessary and further long-term studies of TKI side effects are needed.

Gallbladder polyps: Factors affecting surgical decision

PubMed Central

Sarkut, Pinar; Kilicturgay, Sadik; Ozer, Ali; Ozturk, Ersin; Yilmazlar, Tuncay

2013-01-01

AIM: To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP). METHODS: Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ2 tests were used for the statistical evaluation of the data. RESULTS: The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P < 0.0001). Of 138 patients in whom surgery were performed, 112 had ultrasonographic polyps with diameters < 10 mm. Of the other 26 patients who also had polyps with diameters > 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P < 0.0001); however it was only 66% in polyps with diameters < 10 mm. CONCLUSION: The risk of malignancy was high in the patients over 50 years old who had single polyps with diameters > 10 mm. PMID:23901228

Gallbladder polyps: factors affecting surgical decision.

PubMed

Sarkut, Pinar; Kilicturgay, Sadik; Ozer, Ali; Ozturk, Ersin; Yilmazlar, Tuncay

2013-07-28

To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP). Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ(2) tests were used for the statistical evaluation of the data. The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P < 0.0001). Of 138 patients in whom surgery were performed, 112 had ultrasonographic polyps with diameters < 10 mm. Of the other 26 patients who also had polyps with diameters > 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P < 0.0001); however it was only 66% in polyps with diameters < 10 mm. The risk of malignancy was high in the patients over 50 years old who had single polyps with diameters > 10 mm.

"Difficult" Colorectal Polyps - Therapeutic Approach.

PubMed

Alecu, M; Simion, L; Ionescu, S; Brătucu, E; Straja, N D

2015-01-01

Endoscopic polypectomy is the gold standard in the treatment of colorectal polyps. The importance of polypectomy rests primarily on the fact that polyp-type lesions present a high risk of malignant degeneration, colorectal polyps being able, if left unattended therapeutically, to generate a colorectal cancer (CRC) - a lesion with a far more negative prognosis. Although preferable, endoscopic polypectomy of colorectal polyps is not always possible, multiple factors generating difficulties in performing this therapeutic measure. We performed a retrospective study in the First Surgical Clinic of the "Prof. Dr. Alexandu Trestioreanu" Bucharest Oncology Institute, spanning a period of 3 years (2008-2011), in which time 224 patients were diagnosed by colonoscopy with colorectal polyps, of whom 222 patients benefited from endoscopic polypectomy. The aim of the study was to identify "difficult" polyps and to identify the criteria for endoscopic surgery versus classic surgery as a therapeutic indication. Presence of "difficult" polyps was observed in 37.56% of the patients diagnosed with colorectal polyps. In over 88% of cases endoscopic polypectomy was possible, and for the remaining patients classic surgery was the therapeutic solution opted for. Presence of "difficult" polyps generates inconveniences in performing endoscopic polypectomy, increasing the risk of postoperative complication occurrence, as well as the duration of the operation. If the criteria for characterizing polyps as "difficult" are relatively well-established, the choice between endoscopic and classic surgery as a therapeutic measure is left at the free will of the operating surgeon, with the exception of situations in which classic surgery is resorted to for oncological reasons. Celsius.

Breakdown of coral colonial form under reduced pH conditions is initiated in polyps and mediated through apoptosis

PubMed Central

Kvitt, Hagit; Kramarsky-Winter, Esti; Maor-Landaw, Keren; Zandbank, Keren; Kushmaro, Ariel; Rosenfeld, Hanna; Fine, Maoz; Tchernov, Dan

2015-01-01

Certain stony corals can alternate between a calcifying colonial form and noncalcifying solitary polyps, supporting the hypothesis that corals have survived through geologic timescale periods of unfavorable calcification conditions. However, the mechanisms enabling this biological plasticity are yet to be identified. Here we show that incubation of two coral species (Pocillopora damicornis and Oculina patagonica) under reduced pH conditions (pH 7.2) simulating past ocean acidification induce tissue-specific apoptosis that leads to the dissociation of polyps from coenosarcs. This in turn leads to the breakdown of the coenosarc and, as a consequence, to loss of coloniality. Our data show that apoptosis is initiated in the polyps and that once dissociation between polyp and coenosarc terminates, apoptosis subsides. After reexposure of the resulting solitary polyps to normal pH (pH 8.2), both coral species regenerated coenosarc tissues and resumed calcification. These results indicate that regulation of coloniality is under the control of the polyp, the basic modular unit of the colony. A mechanistic explanation for several key evolutionarily important phenomena that occurred throughout coral evolution is proposed, including mechanisms that permitted species to survive the third tier of mass extinctions. PMID:25646434

Deep learning of contrast-coated serrated polyps for computer-aided detection in CT colonography

NASA Astrophysics Data System (ADS)

Näppi, Janne J.; Pickhardt, Perry; Kim, David H.; Hironaka, Toru; Yoshida, Hiroyuki

2017-03-01

Serrated polyps were previously believed to be benign lesions with no cancer potential. However, recent studies have revealed a novel molecular pathway where also serrated polyps can develop into colorectal cancer. CT colonography (CTC) can detect serrated polyps using the radiomic biomarker of contrast coating, but this requires expertise from the reader and current computer-aided detection (CADe) systems have not been designed to detect the contrast coating. The purpose of this study was to develop a novel CADe method that makes use of deep learning to detect serrated polyps based on their contrast-coating biomarker in CTC. In the method, volumetric shape-based features are used to detect polyp sites over soft-tissue and fecal-tagging surfaces of the colon. The detected sites are imaged using multi-angular 2D image patches. A deep convolutional neural network (DCNN) is used to review the image patches for the presence of polyps. The DCNN-based polyp-likelihood estimates are merged into an aggregate likelihood index where highest values indicate the presence of a polyp. For pilot evaluation, the proposed DCNN-CADe method was evaluated with a 10-fold cross-validation scheme using 101 colonoscopy-confirmed cases with 144 biopsy-confirmed serrated polyps from a CTC screening program, where the patients had been prepared for CTC with saline laxative and fecal tagging by barium and iodine-based diatrizoate. The average per-polyp sensitivity for serrated polyps >=6 mm in size was 93+/-7% at 0:8+/-1:8 false positives per patient on average. The detection accuracy was substantially higher that of a conventional CADe system. Our results indicate that serrated polyps can be detected automatically at high accuracy in CTC.

Thiolated polycarbophil as an adjuvant for permeation enhancement in nasal delivery of antisense oligonucleotides.

PubMed

Vetter, A; Martien, R; Bernkop-Schnürch, A

2010-03-01

The purpose of this study was to investigate the effect of thiolated polycarbophil as an adjuvant to enhance the permeation and improve the stability of a phosphorothioate antisense oligonucleotide (PTO-ODN) on the nasal mucosa. Polycarbophil-cysteine (PCP-Cys) was synthesized by the covalent attachment of L-cysteine to the polymeric backbone. Cytotoxicity tests were examined on human nasal epithelial cells from surgery of nasal polyps confirmed by histological studies. Deoxyribonuclease I activity in respiratory region of the porcine nasal cavity was analyzed by an enzymatic assay. The enzymatic degradation of PTO-ODNs on freshly excised porcine nasal mucosa was analyzed and protection of PCP-cysteine toward DNase I degradation was evaluated. Permeation studies were performed in Ussing-type diffusion chambers. PCP-Cys/GSH did not arise a remarkable mortal effect. Porcine respiratory mucosa was shown to possess nuclease activity corresponding to 0.69 Kunitz units/mL. PTO-ODNs were degraded by incubation with nasal mucosa. In the presence of 0.45% thiolated polycarbophil and 0.5% glutathione (GSH), this degradation process could be lowered. In the presence of thiolated polycarbophil and GSH the uptake of PTO-ODNs from the nasal mucosa was 1.7-fold improved. According to these results thiolated polycarbophil/GSH might be a promising excipient for nasal administration of PTO-ODNs. 2009 Wiley-Liss, Inc. and the American Pharmacists Association

Specialist Endoscopists Are Associated with a Decreased Risk of Incomplete Polyp Resection During Endoscopic Mucosal Resection in the Colon.

PubMed

Tavakkoli, Anna; Law, Ryan J; Bedi, Aarti O; Prabhu, Anoop; Hiatt, Tadd; Anderson, Michelle A; Wamsteker, Erik J; Elmunzer, B Joseph; Piraka, Cyrus R; Scheiman, James M; Elta, Grace H; Kwon, Richard S

2017-09-01

Endoscopic experience is known to correlate with outcomes of endoscopic mucosal resection (EMR), particularly complete resection of the polyp tissue. Whether specialist endoscopists can protect against incomplete polypectomy in the setting of known risk factors for incomplete resection (IR) is unknown. We aimed to characterize how specialist endoscopists may help to mitigate the risk of IR of large sessile polyps. This is a retrospective cohort study of patients who underwent EMR at the University of Michigan from January 1, 2006, to November 15, 2015. The primary outcome was endoscopist-reported polyp tissue remaining at the end of the initial EMR attempt. Specialist endoscopists were defined as endoscopists who receive tertiary referrals for difficult colonoscopy cases and completed at least 20 EMR colonic polyp resections over the study period. A total of 257 patients with 269 polyps were included in the study. IR occurred in 40 (16%) cases. IR was associated with polyp size ≥ 40 mm [adjusted odds ratio (aOR) 3.31, 95% confidence interval (CI) 1.38-7.93], flat/laterally spreading polyps (aOR 2.61, 95% CI 1.24-5.48), and difficulty lifting the polyp (aOR 11.0, 95% CI 2.66-45.3). A specialist endoscopist performing the initial EMR was protective against IR, even in the setting of risk factors for IR (aOR 0.13, 95% CI 0.04-0.41). IR is associated with polyp size ≥ 40 mm, flat and/or laterally spreading polyps, and difficulty lifting the polyp. A specialist endoscopist initiating the EMR was protective of IR.

[Secretion analysis of pathogenic bacteria culture in 115 rural chronic nasal-sinusitis patients].

PubMed

Zhang, Xiaoyuan; Sun, Jingwu; Chu, Shu

2014-05-01

To investigate the bacteria distribution, drug bacterial sensitivity characteristics of the rural chronic rhinosinusitis (CRS). And to explore the effect of antibiotic on pathogenic bacteria culture. Choose nasal sinus secretions from 115 CRS patients living in rural areas. Aerobic bacteria culture, anaerobic bacteria culture and drug sensitive test were procedured for each sample. At the same time the use of antibiotics nearly 2 months and nearly 2 weeks were collected. Among one hundred and fifteen specimens, 17 kinds of germs were detected in 37 cases, the positive rate of aerobic bacteria was 32.17%. Staphylococcus aureus and epidermis staphylococcus aureus the most common type of aerobe in CRS patients at rural areas. There was negative result in the anaerobic bacteria culture of 17 maxillary sinus specimen. The cases of using antibiotics nearly 2 months was up to 90, accounting for 78.26%. Nearly 2 weeks, 73 cases, accounting for 63.48%. The chi-square analysis showed high bacterial culture rate, in chronic rhinosinusitis with nasal polyps (CRSwNP group), which revealed correlation between bacterial infection factors and nasal polyps formation. For CRS patients with positive result of bacterial culture, they were sensitive to ofloxacin, cefotaxime, organism, ciprofloxacin, magnitude cephalosporin, and were drug fast to penicillin G, ampicillin, erythromycin. No specific differences was found in the bacteria distribution of rural CRS. antibiotics abusage in rural CRS patients and the anaerobic bacteria culture techniques is the main factor resulting in low culture rate. Rational use of antimicrobial agents should be established on the basis of the bacterial culture and drug sensitive test.

Evaluation of promoter methylation status of MLH1 gene in Iranian patients with colorectal tumors and adenoma polyps.

PubMed

Zarandi, Ashkan; Irani, Shiva; Savabkar, Sanaz; Chaleshi, Vahid; Ghavideldarestani, Maryam; Mirfakhraie, Reza; Khodadoostan, Mahsa; Nazemalhosseini-Mojarad, Ehsan; Asadzadeh Aghdaei, Hamid

2017-01-01

The aim of this study was to evaluate the methylation status of the promoter region of MLH1 gene in colorectal cancer (CRC) and its precursor lesions as well as elucidate its association with various clinicopathological characteristics among Iranian population. Epigenetic silencing of mismatch repair genes, such as MLH1 , by methylation of CpG islands of their promoter region has been proved to be an important mechanism in colorectal carcinogenesis. Fifty colorectal cancer and polyp tissue samples including 13 Primary colorectal tumor and 37 Adenoma polyp samples were enrolled in this study. Methylation-specific polymerase chain reaction (MSP) was performed to find the frequency of MLH1 Promoter Methylation. Promoter methylation of MLH1 gene was detected in 5 out of 13 tumor tissues and 4 out of 37 adenoma polyp. The frequency of MLH1 methylation in tumor samples was significantly higher compared to that in polyp tissues (P= 0.026). No significant association was observed between MLH1 promoter methylation and clinicopathological characteristics of the patients. The frequency of  MLH1  promoter methylation in CRC and colon polyp was 18%. Our findings indicated that methylation of MLH1 promoter region alone cannot be considered as a biomarker for early detection of CRC.

Inflammatory myoglandular colorectal polyps: a series of seven cases and review of literature.

PubMed

Becheanu, G; Gheorghe, C; Dumbravă, M; Serban-Barbu, V; Diculescu, M

2011-01-01

Inflammatory myoglandular polyp is an unusual but distinct, non-neoplastic type of colorectal polyp, commonly with a distal localization at the recto-sigmoidian level. It was first described in 1992 by Nakamura and his colleagues and it is considered to have few particular histological features. We report a series of seven cases (two male and five female patients) of myoglandular polyps with different localization from 15 to 40 cm from anus. Only four out of seven cases presented with rectal bleeding, the others polyps we incidentally discovered. The polyps varied between 4 and 30 mm in the maximum diameter. Grossly, they had firm consistency and smooth reddish surface. Histological examination of the specimens revealed hyperplastic glands with occasional cystic dilatation, proliferation of smooth muscle with no regular distribution, a variable amount of granulation tissue (usually minimal) and no evidence of epithelial dysplasia. All the lesions were removed endoscopically without any complications. Inflammatory myoglandular polyps are distinct histopathological entities, with insufficiently investigated pathogenesis that can include local trauma, mucosal prolapse or ischemia. Being benign they can be removed endoscopically, surgical treatment being reserved in selected cases.

Diagnosis and management of gallbladder polyps.

PubMed

Andrén-Sandberg, Ake

2012-05-01

Gallbladder cancer is a rather uncommon disease, when it gives symptoms it has usually reached an incurable stage. Therefore, every attempt must be made to find the asymptomatic stages and look for premalignant gallbladder polyps. Even if gallbladder cancer is a rare disease, gallbladder polyps are common, only a few polyps develop to cancer. This makes gallbladder polyps another problem: which are the polyps that must be surgically removed, which shall be followed-up, or for how long? The author used the keyword "gallbladder polypsn" in PubMed and reviewed the scientific literatures published from January 2000 to December 2011. The present review article has summarized almost all respects of gallbladder polyp, including the risk factors, clinical diagnosis and management, and comments made from the author, in which clinical treatments are recommended. It is author's purpose that the 11-year-knowledge about gallbladder polyps summarized from all worlds' literatures is enough to know how clinicians will handle the next patient with gallbladder polyp.

Diagnosis and Management of Gallbladder Polyps

PubMed Central

Andrén-Sandberg, Åke

2012-01-01

Gallbladder cancer is a rather uncommon disease, when it gives symptoms it has usually reached an incurable stage. Therefore, every attempt must be made to find the asymptomatic stages and look for premalignant gallbladder polyps. Even if gallbladder cancer is a rare disease, gallbladder polyps are common, only a few polyps develop to cancer. This makes gallbladder polyps another problem: which are the polyps that must be surgically removed, which shall be followed-up, or for how long? The author used the keyword “gallbladder polypsn” in PubMed and reviewed the scientific literatures published from January 2000 to December 2011. The present review article has summarized almost all respects of gallbladder polyp, including the risk factors, clinical diagnosis and management, and comments made from the author, in which clinical treatments are recommended. It is author's purpose that the 11-year-knowledge about gallbladder polyps summarized from all worlds’ literatures is enough to know how clinicians will handle the next patient with gallbladder polyp. PMID:22655278

Photoacoustic Imaging for Differential Diagnosis of Benign Polyps versus Malignant Polyps of the Gallbladder: A Preliminary Study.

PubMed

Chae, Hee-Dong; Lee, Jae Young; Jang, Jin-Young; Chang, Jin Ho; Kang, Jeeun; Kang, Mee Joo; Han, Joon Koo

2017-01-01

To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421-647 nm and 692-917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging.

Ocular surface reconstruction with a tissue-engineered nasal mucosal epithelial cell sheet for the treatment of severe ocular surface diseases.

PubMed

Kobayashi, Masakazu; Nakamura, Takahiro; Yasuda, Makoto; Hata, Yuiko; Okura, Shoki; Iwamoto, Miyu; Nagata, Maho; Fullwood, Nigel J; Koizumi, Noriko; Hisa, Yasuo; Kinoshita, Shigeru

2015-01-01

Severe ocular surface diseases (OSDs) with severe dry eye can be devastating and are currently some of the most challenging eye disorders to treat. To investigate the feasibility of using an autologous tissue-engineered cultivated nasal mucosal epithelial cell sheet (CNMES) for ocular surface reconstruction, we developed a novel technique for the culture of nasal mucosal epithelial cells expanded ex vivo from biopsy-derived human nasal mucosal tissues. After the protocol, the CNMESs had 4-5 layers of stratified, well-differentiated cells, and we successfully generated cultured epithelial sheets, including numerous goblet cells. Immunohistochemistry confirmed the presence of keratins 3, 4, and 13; mucins 1, 16, and 5AC; cell junction and basement membrane assembly proteins; and stem/progenitor cell marker p75 in the CNMESs. We then transplanted the CNMESs onto the ocular surfaces of rabbits and confirmed the survival of this tissue, including the goblet cells, up to 2 weeks. The present report describes an attempt to overcome the problems of treating severe OSDs with the most severe dry eye by treating them using tissue-engineered CNMESs to supply functional goblet cells and to stabilize and reconstruct the ocular surface. The present study is a first step toward assessing the use of tissue-engineered goblet-cell transplantation of nonocular surface origin for ocular surface reconstruction. ©AlphaMed Press.

Multiple polyps and colorectal cancer.

PubMed

Alecu, M; Simion, L; Straja, Nd; Brătucu, E

2014-01-01

Malignant degeneration as a possible course of evolution of colorectal polyps renders their diagnosis and therapeutic management a prophylactic act in the prevention of colorectal cancer (CRC). The study was conducted over a period of 3 years (2008-2011), during which 1,368 colonoscopies were performed in our service. The aim of the study was to identify patients presenting multiple colorectal polyps and to determine their risk factors for developing CRC, as well as to establish the appropriate therapeutic conduct. Presence of multiple polyps was recorded in over 40% of the patients identified with colorectal polyps of any kind. Dysplastic modifications observed during the histopathology exam presented a high incidence in the case of patients with multiple polyps, ranging from low-grade dysplasia to incipient CRC. Dysplastic modifications and carcinomatous foci were identified mostly among patients with multiple polyps.Only benign lesions or in situ carcinomas benefited from endoscopic treatment, poorly differentiated carcinomas or those invading the submucosa being treated by conventional surgery. Patients diagnosed with colorectal polyps require a rigorous post-therapy follow-up protocol, able to identify any eventual polyposis recurrence. Celsius.

Photoacoustic Imaging for Differential Diagnosis of Benign Polyps versus Malignant Polyps of the Gallbladder: A Preliminary Study

PubMed Central

Chae, Hee-Dong; Jang, Jin-Young; Chang, Jin Ho; Kang, Jeeun; Kang, Mee Joo; Han, Joon Koo

2017-01-01

Objective To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. Materials and Methods A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421–647 nm and 692–917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. Results A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). Conclusion These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging. PMID:28860899

Long-term follow up of gallbladder polyps.

PubMed

Park, Jeong Youp; Hong, Sung Pil; Kim, Yoon Jae; Kim, Hong Jeoung; Kim, Hee Man; Cho, Jae Hee; Park, Seung Woo; Song, Si Young; Chung, Jae Bock; Bang, Seungmin

2009-02-01

The management of gallbladder polyps (GBP) is directly linked to the early diagnosis of gallbladder cancer (GBC). This study aimed to evaluate the malignant risk of GBP. In total, 1558 patients diagnosed with GBP were followed. Neoplastic polyps were defined as GBC and its premalignant lesions. The risk for malignancy was estimated with the cumulative detection rate of neoplastic polyps. Thirty-three cases (2.1%) were diagnosed with neoplastic polyps. The cumulative detection rates of neoplastic polyps were 1.7% at 1 year, 2.8% at 5 years, and 4% at 8 years after diagnosis. The size of GBP and the presence of gallstones were risk factors for neoplastic polyps. Polyps > or = 10 mm had a 24.2 times greater risk of malignancy than polyps < 10 mm. However, 15 of 33 neoplastic polyps (45.5%) were < 10 mm at the time of diagnosis of GBP. During follow up in 36 (3.5%) of 1027 cases, an increase in size was detected; of these, nine (25%) had neoplastic polyps. Even small polyps have a risk of malignancy, and careful long-term follow up of GBP will help detect and treat early GBC.

Diagnosis and management of gallbladder polyps.

PubMed

Gallahan, William C; Conway, Jason D

2010-06-01

Gallbladder polyps are frequently encountered on cross-sectional imaging, often in asymptomatic patients. Most are benign and of little clinical importance. However, some polyps do have a malignant potential. This article discusses the clinical presentation, diagnosis, and natural history of gallbladder polyps and risk factors for malignant polyps and indications for cholecystectomy. Copyright 2010 Elsevier Inc. All rights reserved.

Distinguishing rhinitis and nasal neoplasia by radiography.

PubMed

Russo, M; Lamb, C R; Jakovljevic, S

2000-01-01

To compare the incidence of radiographic signs in dogs with rhinitis and primary nasal neoplasia and to assess the performance of observers for distinguishing these conditions, the nasal radiographs of 72 dogs with either rhinitis (n = 42) or primary nasal neoplasia (n = 30) were examined by two independent observers using custom-designed forms to record their interpretations. Rhinitis was associated with a higher incidence of focal or multifocal lesions, localised soft tissue opacities, lucent foci, and a lack of frontal sinus involvement. Neoplasia was associated with soft tissue opacities and loss of turbinate detail that affected the entire ipsilateral nasal cavity, signs of invasion of the bones surrounding the nasal cavity, and soft tissue/fluid opacities within the ipsilateral frontal sinus. The signs with the highest positive predictive value (PPV) for rhinitis were absence of frontal sinus lesions and lucent foci in nasal cavity (PPV of each 82%), and invasion of surrounding bones for neoplasia (PPV 88%). There were no significant differences in the position of the lesion within the nasal cavity, incidence of unilateral versus bilateral lesions, calcified lesions, or absence of teeth. There was moderate agreement between observers about the diagnosis (kappa 0.59). Areas (SE) under ROC curves were 0.94 (0.03) and 0.96 (0.03) for observers A and B, respectively (not significantly different; P = 0.68). These results indicate a high accuracy for radiologists examining dogs with nasal diseases. Differentiation of rhinitis and nasal neoplasia should be based on finding combinations of radiologic signs that together have a high PPV. Differences in interpretation between experienced observers in this study suggest that certain signs are potential sources of error.

CT colonography of colorectal polyps: a metaanalysis.

PubMed

Sosna, Jacob; Morrin, Martina M; Kruskal, Jonathan B; Lavin, Philip T; Rosen, Max P; Raptopoulos, Vassilios

2003-12-01

For proper evaluation of the accuracy of CT colonography, prospective multiinstitutional trials would be ideal. Until these trials are available, data can be collectively analyzed. The purpose of this study is to use metaanalysis to assess the reported accuracy of CT colonography compared with conventional colonoscopy for detecting colorectal polyps. Articles comparing CT colonography and conventional colonoscopy were identified, and a standardized form was used to extract relevant study data. Fisher's exact test and the Mantel-Haenszel test were used for pooling of data. A 95% confidence interval (CI) was selected to determine sensitivity and specificity, and the Kruskal-Wallis exact test was used to identify trends relating to polyp size. Meta-analysis methods were used to test strength of results. Comparisons were made for the percentage of polyps detected grouped by size (> or = 10 mm, 6-9 mm, < or = 5 mm) and the percentage of patients identified who had polyps of the same size. Fourteen studies fulfilled all the study inclusion criteria and gave a total of 1,324 patients and 1,411 polyps. The pooled per-patient sensitivity for polyps 10 mm or larger was (sensitivity [95% CI]) 0.88 (0.84-0.93), for polyps 6-9 mm it was 0.84 (0.80-0.89), and for polyps 5 mm or smaller it was 0.65 (0.57-0.73). The pooled per-polyp sensitivity for polyps 10 mm or larger was 0.81 (0.76-0.85), for polyps 6-9 mm it was 0.62 (0.58-0.67), and for polyps 5 mm or smaller it was 0.43 (0.39-0.47). Sensitivity for detection of polyps increased as the polyp size increased (p < 0.00005). The pooled overall specificity for detection of polyps larger than 10 mm was 0.95 (0.94-0.97). The specificity and sensitivity of CT colonography are high for polyps larger than 10 mm.

Epithelial cell specific properties and genetic complementation in a delta F508 cystic fibrosis nasal polyp cell line.

PubMed

Kunzelmann, K; Lei, D C; Eng, K; Escobar, L C; Koslowsky, T; Gruenert, D C

1995-09-01

Analysis of vectorial ion transport and protein trafficking in transformed cystic fibrosis (CF) epithelial cells has been limited because the cells tend to lose their tight junctions with multiple subcultures. To elucidate ion transport and protein trafficking in CF epithelial cells, a polar cell line with apical and basolateral compartments will facilitate analysis of the efficacy of different gene therapy strategies in a "tight epithelium" in vitro. This study investigates the genotypic and phenotypic properties of a CF nasal polyp epithelial, delta F508 homozygote, cell line that has tight junctions pre-crisis. The cells (sigma CFNPE14o-) were transformed with an origin-of-replication defective SV40 plasmid. They develop transepithelial resistance in Ussing chambers and are defective in cAMP-dependent Cl- transport as measured by efflux of radioactive Cl-, short circuit current (Isc), or whole-cell patch clamp. Stimulation of the cells by bradykinin, histamine, or ATP seems to activate both K(+)- and Ca(+2)-dependent Cl- transport. Measurement of 36Cl- efflux following stimulation with A23187 and ionomycin indicate a Ca(+2)-dependent Cl- transport. Volume regulatory capacity of the cells is indicated by cell swelling conductance. Expression of the CF transmembrane conductance regulator mRNA was indicated by RT-PCR amplification. When cells are grown at 26 degrees C for 48 h there is no indication of cAMP-dependent Cl- as has been previously indicated in heterologous expression systems. Antibodies specific for secretory cell antigens indicate the presence of antigens found in goblet, serous, and mucous cells; in goblet and serous cells; or in goblet and mucous cells; but not antigens found exclusively in mucous or serous cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Nasal erosion as an uncommon sign of child abuse.

PubMed

Culotta, Paige A; Isaac, Reena; Sarpong, Kwabena; Chandy, Binoy; Cruz, Andrea; Donaruma-Kwoh, Marcella

2018-05-01

While various forms of facial trauma, bruising, burns, and fractures are frequently seen in cases of child abuse, purposeful nasal erosion has rarely been identified as a form of abusive injury. Progressive destruction of nasal tissue in children provokes a wide differential diagnosis crossing multiple subspecialties: infectious, primary immunodeficiencies, inflammatory conditions, malignancy, and genetic disorders. Progressive nasal erosion also can be a manifestation of child abuse. The proposed mechanism is repetitive mechanical denudation of the soft tissue and cartilage resulting in chronic inflammation, bleeding, and ultimately destruction of the insulted tissue. We report 6 cases of child abuse manifesting as overt nasal destruction. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of anatomy on human nasal air flow and odorant transport patterns: implications for olfaction.

PubMed

Zhao, Kai; Scherer, Peter W; Hajiloo, Shoreh A; Dalton, Pamela

2004-06-01

Recent studies that have compared CT or MRI images of an individual's nasal anatomy and measures of their olfactory sensitivity have found a correlation between specific anatomical areas and performance on olfactory assessments. Using computational fluid dynamics (CFD) techniques, we have developed a method to quickly (nasal CT scans from an individual patient into an anatomically accurate 3-D numerical nasal model that can be used to predict airflow and odorant transport, which may ultimately determine olfactory sensitivity. The 3-D model can be also be rapidly modified to depict various anatomical deviations, such as polyps and their removal, that may alter nasal airflow and impair olfactory ability. To evaluate the degree to which variations in critical nasal areas such as the olfactory slit and nasal valve can alter airflow and odorant transport, inspiratory and expiratory airflow with odorants were simulated using numerical finite volume methods. Results suggest that anatomical changes in the olfactory region (upper meatus below the cribriform plate) and the nasal valve region will strongly affect airflow patterns and odorant transport through the olfactory region, with subsequent effects on olfactory function. The ability to model odorant transport through individualized models of the nasal passages holds promise for relating anatomical deviations to generalized or selective disturbances in olfactory perception and may provide important guidance for treatments for nasal-sinus disease, occupational rhinitis and surgical interventions that seek to optimize airflow and improve deficient olfactory function.

TNF-alpha and endotoxin increase hypoxia-induced VEGF production by cultured human nasal fibroblasts in synergistic fashion.

PubMed

Sun, Dong; Matsune, Shoji; Ohori, Junichiro; Fukuiwa, Tatsuya; Ushikai, Masato; Kurono, Yuichi

2005-09-01

Vascular endothelial growth factor (VEGF) promotes angiogenesis and is associated with the invasion and metastasis of malignant tumors. It enhances vascular permeability and is expressed in inflammatory nasal as well as middle-ear mucosa. As the mechanism of VEGF induction during chronic inflammation, such as chronic paranasal sinusitis (CPS) remains to be clarified, we studied the factors regulating the production of VEGF in cultured human nasal fibroblasts and discussed the role of VEGF in the pathogenesis of CPS. We used ELISA to quantify VEGF levels in paranasal sinus effusions, nasal secretions, and serum from patients with CPS. In addition, we cultured human nasal fibroblasts isolated from nasal polyps of CPS patients and studied the effects of hypoxia, TNF-alpha, and endotoxin on their production of VEGF using ELISA and PCR. The VEGF concentration was significantly higher in paranasal sinus effusions than in nasal secretions and serum. Nasal fibroblasts produced high levels of VEGF, when cultured under hypoxic condition and this production was remarkably enhanced in the presence of TNF-alpha or endotoxin. VEGF is locally produced in paranasal sinuses as well as nasal mucosa and its production is increased in patients with CPS. Hypoxia is associated with the production of VEGF by nasal fibroblasts and TNF-alpha and endotoxin may act synergistically to enhance VEGF production in paranasal sinuses under hypoxic condition.

Flat colon polyps: what should radiologists know?

PubMed

Ignjatovic, A; Burling, D; Ilangovan, R; Clark, S K; Taylor, S A; East, J E; Saunders, B P

2010-12-01

With the recent publication of international computed tomography (CT) colonography standards, which aim to improve quality of examinations, this review informs radiologists about the significance of flat polyps (adenomas and hyperplastic polyps) in colorectal cancer pathways. We describe flat polyp classification systems and propose how flat polyps should be reported to ensure patient management strategies are based on polyp morphology as well as size. Indeed, consistency when describing flat polyps is of increasing importance given the strengthening links between CT colonography and endoscopy. Copyright © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Evaluation of patients with gastric polyps.

PubMed

Olmez, Sehmus; Sayar, Suleyman; Saritas, Bunyamin; Savas, Ayla Yildiz; Avcioglu, Ufuk; Tenlik, Ilyas; Ozaslan, Ersan; Koseoglu, Hasan Tankut; Altiparmak, Emin

2018-01-01

The incidence of gastric polyps (GPs) greatly differs according to study populations and was found to be 0.33%-6.7% in various studies. The majority of GPs are composed of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high risk of malignant potential, sporadic FGPs have no malignant potential. Conversely, HPs have a low risk of malignant potential. It is not sufficient to perform a biopsy to identify the polyp type and the presence of dysplasia; thus, some polyps may require multiple biopsies or total excision. This retrospective study included patients with GPs or polypoid lesions found on esophagogastroscopy with polyp or malignant histology on biopsy at Ankara Numune Training and Research Hospital Endoscopy Unit between 2005 and 2011. In a series of 56.300 upper endoscopies, 192 patients (0.34%) were found to have GPs. Among the patients, 51 (26.6%) were men and 151 (73.4%) were women. The average age of the patients was 61.9±13.3 (14-90) years. The frequency of HPs, APs, and FGPs were 88%, 2.6%, and 1.6%, respectively. The size of the polyps was ≤1 cm in 137 (70%) patients. One polyp was determined in 141 (73.4%) patients. The most common localizations of polyps were the antrum and corpus. Endoscopic snare polypectomy was performed in 64 patients. One bleeding episode was observed, which required endoscopic treatment after ESP. In our study, the GP frequency was low (0.34%), whereas the frequency of HP maybe high due to the high frequency of Helicobacter pylori (HPy) infection in our country. The frequency of FGP is probably low due to the high frequency of HPy infection and the short-term use of proton-pump inhibitors.

Automatic polyp detection in colonoscopy videos

NASA Astrophysics Data System (ADS)

Yuan, Zijie; IzadyYazdanabadi, Mohammadhassan; Mokkapati, Divya; Panvalkar, Rujuta; Shin, Jae Y.; Tajbakhsh, Nima; Gurudu, Suryakanth; Liang, Jianming

2017-02-01

Colon cancer is the second cancer killer in the US [1]. Colonoscopy is the primary method for screening and prevention of colon cancer, but during colonoscopy, a significant number (25% [2]) of polyps (precancerous abnormal growths inside of the colon) are missed; therefore, the goal of our research is to reduce the polyp miss-rate of colonoscopy. This paper presents a method to detect polyp automatically in a colonoscopy video. Our system has two stages: Candidate generation and candidate classification. In candidate generation (stage 1), we chose 3,463 frames (including 1,718 with-polyp frames) from real-time colonoscopy video database. We first applied processing procedures, namely intensity adjustment, edge detection and morphology operations, as pre-preparation. We extracted each connected component (edge contour) as one candidate patch from the pre-processed image. With the help of ground truth (GT) images, 2 constraints were implemented on each candidate patch, dividing and saving them into polyp group and non-polyp group. In candidate classification (stage 2), we trained and tested convolutional neural networks (CNNs) with AlexNet architecture [3] to classify each candidate into with-polyp or non-polyp class. Each with-polyp patch was processed by rotation, translation and scaling for invariant to get a much robust CNNs system. We applied leave-2-patients-out cross-validation on this model (4 of 6 cases were chosen as training set and the rest 2 were as testing set). The system accuracy and sensitivity are 91.47% and 91.76%, respectively.

Long-term treatment with aspirin desensitization: a prospective clinical trial comparing 100 and 300 mg aspirin daily.

PubMed

Rozsasi, A; Polzehl, D; Deutschle, T; Smith, E; Wiesmiller, K; Riechelmann, H; Keck, T

2008-09-01

The daily dose of aspirin in desensitization in aspirin-sensitive asthmatics with nasal polyps is still a matter of debate. To compare two doses of aspirin during the first year of desensitization and to evaluate long-term effects on nasal/pulmonary symptoms. Patients with positive aspirin provocation test were treated with either 100 or 300 mg aspirin daily. In all patients taking 100 mg aspirin (n = 7) recurrent nasal polyps were observed. No patient experienced reduction of asthma medication or improvement of pulmonary function. In the 300 mg group no recurrent nasal polyps were seen. Asthma medication could be reduced in three patients, pulmonary function was improved in five patients. Thirty-nine consecutively desensitized patients, taking 300 mg aspirin, showed significant improvement of olfaction and polyp-free nasal passages during the first year of therapy. After a median follow-up of 27 months no sinus revision surgery was necessary. Aspirin desensitization followed by 300 mg aspirin daily is efficacious and results in polyp-free nasal airways, improvement of sense of smell, and reduction of the need for sinus revision surgery for recurrent nasal polyps. Aspirin in a dose of 100 mg daily is not sufficient to effectively reduce nasal and bronchial or pulmonary symptoms and to prevent recurrent nasal polyps by at least the first 12 months of treatment.

Nasal packing and stenting

PubMed Central

Weber, Rainer K.

2011-01-01

Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue. PMID:22073095

Health risks associated with inhaled nasal toxicants.

PubMed

Feron, V J; Arts, J H; Kuper, C F; Slootweg, P J; Woutersen, R A

2001-05-01

Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and metabolism-based extrapolation of nasal data in animals to humans. Conspicuous findings in humans are the effects of outdoor air pollution on the nasal mucosa, and tobacco smoking as a risk factor for sinonasal squamous cell carcinoma. Objective methods in humans to discriminate between sensory irritation and olfactory stimulation and between adaptation and habituation have been introduced successfully, providing more relevant information than sensory irritation studies in animals. Against the background of chemoperception as a dominant window of the brain on the outside world, nasal neurotoxicology is rapidly developing, focusing on olfactory and trigeminal nerve toxicity. Better insight in the processes underlying neurogenic inflammation may increase our knowledge of the causes of the various chemical sensitivity syndromes. Nasal immunotoxicology is extremely complex, which is mainly due to the pivotal role of nasal lymphoid tissue in the defense of the middle ear, eye, and oral cavity against antigenic substances, and the important function of the nasal passages in brain drainage in rats. The crucial role of tissue damage and reactive epithelial hyperproliferation in nasal carcinogenesis has become overwhelmingly clear as demonstrated by the recently developed biologically based model for predicting formaldehyde nasal cancer risk in humans. The evidence of carcinogenicity of inhaled complex mixtures in experimental animals is very limited, while there is ample evidence that occupational exposure to mixtures such as wood, leather, or textile dust or chromium- and nickel-containing materials is associated with increased risk of nasal cancer. It is remarkable that these

Metastatic colonic and gastric polyps from breast cancer resembling hyperplastic polyps.

PubMed

Horimoto, Yoshiya; Hirashima, Tetsuro; Arakawa, Atsushi; Miura, Hiroyoshi; Saito, Mitsue

2018-03-23

Breast cancer metastasis to the gastrointestinal tract is relatively rare and is generally found when patients complain of symptoms such as gastrointestinal obstruction. Herein, we report a case with metastatic colonic and gastric lesions from breast cancer, with the formation of mucosal polyps which resembled typical hyperplastic polyps.A 47-year-old woman underwent curable surgery for breast cancer and received standard systemic treatments. Her primary tumor was composed of a mix of invasive lobular and ductal carcinomas. During adjuvant endocrine therapy, she developed multiple colonic metastases, identified by colonoscopy performed as part of a general health check-up. She had no symptoms. Small elevated sessile polyps in the transverse colon and rectum showed histological features of signet-ring cell type adenocarcinoma, similar to the invasive lobular component of the primary breast cancer. During treatments for recurrent disease, she also developed multiple gastric metastases, with the same endoscopic and pathological features as the colonic lesions. Her treatment regimen was switched to oral chemotherapy, and she has since maintained stable disease for nearly 3 years. Multiple bone metastases eventually developed, and she was again switched to another systemic treatment but, to date, has remained free of symptoms.We emphasize that the endoscopic findings of the metastatic lesions in the colon and stomach in this case highly resembled hyperplastic polyps. Since biopsy is not always performed for hyperplastic polyps in the gastrointestinal tract, we believe that this case report may encourage endoscopists to offer biopsies to the patient who has a history of breast cancer.

Reconstruction of Nasal Cleft Deformities Using Expanded Forehead Flaps: A Case Series.

PubMed

Ramanathan, Manikandhan; Sneha, Pendem; Parameswaran, Ananthnarayanan; Jayakumar, Naveen; Sailer, Hermann F

2014-12-01

Reconstruction of the nasal clefts is a challenging task considering the nasal anatomic complexity and their possible association with craniofacial defects. The reconstruction of these defects needs extensive amounts of soft tissue that warrant the use of forehead flaps. Often presence of cranial defects and low hairline compromise the amount of tissue available for reconstruction warrenting tissue expansion. To evaluate the efficacy of tissue expansion in reconstruction of congenital nasal clefts. 9 patients with congenital nasal clefts involving multiple sub units were taken up for nasal reconstruction with expanded forehead flaps. The average amount of expansion needed was 200 ml. The reconstruction was performed in 3 stages. Expanded forehead flaps proved to be best modality for reconstruction providing the skin cover needed for ala, columella and dorsum with minimal scarring at the donor site. Expansion of the forehead flap is a viable option for multiple sub unit reconstruction in congenital nasal cleft deformities.

CT biliary cystoscopy of gallbladder polyps

PubMed Central

Lou, Ming-Wu; Hu, Wei-Dong; Fan, Yi; Chen, Jin-Hua; E, Zhan-Sen; Yang, Guang-Fu

2004-01-01

AIM: CT virtual endoscopy has been used in the study of various organs of body including the biliary tract, however, CT virtual endoseopy in diagnosis of gallbladder polyps has not yet been reported. This study was to evaluate the diagnostic value of CT virtual endoscopy in polyps of the gallbladder. METHODS: Thirty-two cases of gallbladder polyps were examined by CT virtual endoscopy, ultrasound, CT scan with oral biliary contrast separately and confirmed by operation and pathology. CT biliary cystoscopic findings were analyzed and compared with those of ultrasound and CT scan with oral biliary contrast, and evaluated in comparison with operative and pathologic findings in all cases. RESULTS: The detection rate of gallbladder polyps was 93.8%(90/96), 96.9%(93/96) and 79.2%(76/96) for CT cystoscopy, ultrasound and CT scan with oral contrast, respectively. CT biliary cystoscopy corresponded well with ultrasound as well as pathology in demonstrating the location, size and configuration of polyps. CT endoscopy was superior to ultrasound in viewing the polyps in a more precise way, 3 dimensionally from any angle in space, and showing the surface in details. CT biliary cystoscopy was also superior to CT scan with oral biliary contrast in terms of observation of the base of polyps for the presence of a pedicle, detection rates as well as image quality. The smallest polyp detected by CT biliary cystoscopy was measured 1.5 mm×2.2 mm×2.5 mm. CONCLUSION: CT biliary cystoscopy is a non-invasive and accurate technique for diagnosis and management of gallbladder polyps. PMID:15069726

Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery.

PubMed

Jelavic, Boris; Grgić, Marko; Cupić, Hrvoje; Kordić, Mirko; Vasilj, Mirjana; Baudoin, Tomislav

2012-10-01

Compared with rhinologic patients without chronic rhinosinusitis (CRS), a higher prevalence of sinonasal Helicobacter pylori (HP) in patients with CRS was found. This study investigated if HP sinonasal colonization has a prognostic value for efficacy of functional endoscopic sinus surgery (FESS). Nasal polyps of 40 patients with CRS, undergoing FESS, were analyzed for presence of HP using immunohistochemistry (IHC). Patients were categorized as to whether the IHC was positive (HP+ group) or negative (HP- group). HP+ group and HP- group were compared according to the nasal polyp eosinophil density, and to the improvement (difference between pre- and post-operative scores) of the subjective symptom scores, and the nasal endoscopic scores. Nasal polyps in 28 (70%) patients were positive for HP. There were no significant differences between HP+ group and HP- group comparing the eosinophils, and the improvement of the single symptom and the total symptom scores. HP+ group had significantly greater improvement of the nasal endoscopic scores (F[1.38] = 6.212; P = 0.017). There is no influence of sinonasal HP on tissue eosinophilia and on CRS symptoms. There is a prognostic value for endonasal findings: CRS patients with HP have statistically significant greater improvement of the postoperative endoscopic scores.

The natural history of endometrial polyps.

PubMed

Wong, M; Crnobrnja, B; Liberale, V; Dharmarajah, K; Widschwendter, M; Jurkovic, D

2017-02-01

What is the natural history of endometrial polyps in women who are managed expectantly? The growth rates of expectantly managed polyps vary considerably and cannot be accurately predicted. The majority of polyps detected on ultrasound are treated surgically, and therefore little is known about their natural history. Some polyps have been reported to regress spontaneously without the need for treatment; however, the factors predictive of regression are unknown. This was a retrospective cohort study conducted at the Department of Gynaecology, University College London Hospitals. We searched our ultrasound clinic database between July 1997 and September 2015, to identify women aged 18 years or older with endometrial polyps that were managed expectantly for ≥6 months. All women attended for a minimum of two ultrasound scans. A single expert operator performed all ultrasound scans. Those with <6-month follow-up and those who were taking hormonal contraception, HRT or tamoxifen were excluded from the study. The mean diameter of each polyp was calculated from the measurements in three perpendicular planes. The polyp growth rate was expressed as annual percentage change in the mean diameter. Non-parametric tests and the Fisher's exact test were used to compare differences in polyp mean diameters and growth rates between women of different demographic characteristics. To correct for multiple significance testing, we used the Bonferroni method, giving the level of probability at which findings were considered significant as P < 0.0029 (as 17 tests were undertaken). We included 112 women with endometrial polyps, which were expectantly managed over a median period of 22.5 months (range, 6-136). The annual endometrial polyp growth rate varied with a median of 1.0% (interquartile range, -6.5 to 14.3). There was no association between women's demographic characteristics or polyps' morphology and their growth rates. Eleven out of 75 (15% (95% CI, 6.9%-23.1%)) women who initially

Histological and anatomical structure of the nasal cavity of Bama minipigs

PubMed Central

Yang, Jingjing; Dai, Lei; Yu, Qinghua; Yang, Qian

2017-01-01

Objective The nasal mucosa is equipped with abundant lymphatic tissues, serving as the first line of defense against invasion by microorganisms. In this study, we characterized the features of the nasal mucosa of Bama minipigs (Sus scrofa domestica) via histological analysis. Methods Five cross sections (I, II, III, IV, and V) were obtained from the distal end of the nasal cavity toward the pharynx (along the cavity axis) and examined. Specifically, CD3+ T cells, immunoglobulin A (IgA)+ cells, and M cells were detected by immunohistochemistry, while dendritic cells (DCs) were detected by immunofluorescence. The distribution of goblet cells was determined by periodic acid-Schiff (PAS) staining. Results The nasal cavity of Bama minipigs can be divided into three parts: the regio vestibularis (I, II), regio respiratoria (III, IV), and regio olfactoria (V). Lymphoid tissue was present at random locations in the nasal cavity. Abundant lymphoid tissue was located in the roof of the nasopharyngeal meatus and was continuous with the lymphoid tissue of the pharynx. The distribution of CD3+ T cells, IgA+ cells, M cells, and DCs increased distally in the nasal cavity. Conclusions The present work comprises a histological study of the nasal cavity of Bama minipigs, and will be beneficial for understanding the mechanisms of immunity in these animals after nasal vaccination. PMID:28339502

Inflammatory fibroid polyp of sigmoid colon.

PubMed

Lifschitz, O; Lew, S; Witz, M; Reiss, R; Griffel, B

1979-01-01

A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.

A study of oral contrast coating on the surface of polyps: an implication for computer-aided detection and classification of polyps

NASA Astrophysics Data System (ADS)

Singh, Harmanpreet; Li, Lihong C.; Pomeroy, Marc; Pickhardt, Perry J.; Barish, Matthew A.; Harrington, Donald P.; Liang, Zhengrong

2017-03-01

Accurate identification of polyps is the ultimate goal of Computed Tomography Colonography (CTC). While oral contrast agents were originally used to tag stool and fluid for the ultimate goal of CTC, recently their effect on coating the surface of polyps has been observed. This study aims to evaluate (1) the frequency at which the oral contrast adhered to polyp surfaces and (2) if there was a difference in contrast adherence with respect to diverse polyp types. To eliminate gravity as a factor in this study, the polyps in contact with tagged fluid pools, particularly on the bottom of the colon wall were excluded. A total of 150 polyps were selected under the above condition from a CTC database and screened for any adherent contrast on the luminal edge. Among the total, 53% of the screened polyps had adherent contrast. Serrated adenomas and hyperplastic polyps had a higher tagging percentage, 77.80% and 62.50% respectively, than tubular adenomas and tubulovillous adenomas, 44.40% and 43% respectively. Other factors that were analyzed for the effect on coating include size and location of the polyps. The higher tagging percentage of serrated adenomas and hyperplastic polyps may be due to their similar cellular features. The average size of the polyps was 8.9 mm. When the polyps were separated by size into small (5-9mm) and large (10-26mm) groups, the large group had a higher tagging percentage. The polyp types were also classified by location with the major findings being: 1) Tubular adenomas were present in all segments of the colon and 2) that serrated adenomas were present at a higher percentage in the proximal colon. These findings shall facilitate characterizing tagging agents and improve computer aided detection and classification of polyps via CTC.

Hyperspectral imaging of colonic polyps in vivo (Conference Presentation)

NASA Astrophysics Data System (ADS)

Clancy, Neil T.; Elson, Daniel S.; Teare, Julian

2017-02-01

Standard endoscopic tools restrict clinicians to making subjective visual assessments of lesions detected in the bowel, with classification results depending strongly on experience level and training. Histological examination of resected tissue remains the diagnostic gold standard, meaning that all detected lesions are routinely removed. This subjects the patient to risk of polypectomy-related injury, and places significant workload and economic burdens on the hospital. An objective endoscopic classification method would allow hyperplastic polyps, with no malignant potential, to be left in situ, or low grade adenomas to be resected and discarded without histology. A miniature multimodal flexible endoscope is proposed to obtain hyperspectral reflectance and dual excitation autofluorescence information from polyps in vivo. This is placed inside the working channel of a conventional colonoscope, with the external scanning and detection optics on a bedside trolley. A blue and violet laser diode pair excite endogenous fluorophores in the respiration chain, while the colonoscope's xenon light source provides broadband white light for diffuse reflectance measurements. A push-broom HSI scanner collects the hypercube. System characterisation experiments are presented, defining resolution limits as well as acquisition settings for optimal spectral, spatial and temporal performance. The first in vivo results in human subjects are presented, demonstrating the clinical utility of the device. The optical properties (reflectance and autofluorescence) of imaged polyps are quantified and compared to the histologically-confirmed tissue type as well as the clinician's visual assessment. Further clinical studies will allow construction of a full robust training dataset for development of classification schemes.

[Surgical indications in gallbladder polyps].

PubMed

Morera-Ocón, Francisco José; Ballestín-Vicente, Javier; Calatayud-Blas, Ana María; de Tursi-Rispoli, Leonardo Cataldo; Bernal-Sprekelsen, Juan Carlos

2013-05-01

The surgery of gallbladder polyps is not well defined due to the lack of evidence-based clinical guidelines. To analyse the management of polyps in Spain, and a review of the literature and treatment standards. The reports on cholecystectomy with gallbladder polyps (GBP) were extracted from the Pathology data base. Patients subjected to surgery with a diagnosis of GBP were identified in the Surgery data base. A single list was prepared and a review was made of the clinical histories, including, age, gender, clinical data, ultrasound report, and histopathology report. A total of 30 patients, with a median age of 51 years (range 22-83), 21 of whom were female, were included. The ultrasound diagnosis was GBP in 19 patients, GBP and calculi in 7 cases, and calculi with no polyps in 4 cases. Other diagnoses concurrent with GBP were multiple haemangiomas (3), large single simple cyst (1), and multiple simple cysts (1). Eleven patients had typical pain (biliary origin), 5 of which showed no calculi on ultrasound. Eight had non-specific pain, which persisted in 3 cases after the cholecystectomy. Pseudopolyps were found in 20 gallbladders, and true polyps in 4 cases. In 3 cases, polyps were not found in the pathology study. The ultrasound report must specify the size, shape, and number of polyps. Patients with biliary type pain would benefit from a cholecystectomy. The probability of malignancy is minimum if the GBP is less than 10mm and aged under 50 years, and a cholecystectomy is not required. A GBP greater than 10mm should be an indication of cholecystectomy. Copyright © 2011 AEC. Published by Elsevier España, S.L. All rights reserved.

Automatic Detection and Classification of Colorectal Polyps by Transferring Low-Level CNN Features From Nonmedical Domain.

PubMed

Zhang, Ruikai; Zheng, Yali; Mak, Tony Wing Chung; Yu, Ruoxi; Wong, Sunny H; Lau, James Y W; Poon, Carmen C Y

2017-01-01

Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide. Although polypectomy at early stage reduces CRC incidence, 90% of the polyps are small and diminutive, where removal of them poses risks to patients that may outweigh the benefits. Correctly detecting and predicting polyp type during colonoscopy allows endoscopists to resect and discard the tissue without submitting it for histology, saving time, and costs. Nevertheless, human visual observation of early stage polyps varies. Therefore, this paper aims at developing a fully automatic algorithm to detect and classify hyperplastic and adenomatous colorectal polyps. Adenomatous polyps should be removed, whereas distal diminutive hyperplastic polyps are considered clinically insignificant and may be left in situ . A novel transfer learning application is proposed utilizing features learned from big nonmedical datasets with 1.4-2.5 million images using deep convolutional neural network. The endoscopic images we collected for experiment were taken under random lighting conditions, zooming and optical magnification, including 1104 endoscopic nonpolyp images taken under both white-light and narrowband imaging (NBI) endoscopy and 826 NBI endoscopic polyp images, of which 263 images were hyperplasia and 563 were adenoma as confirmed by histology. The proposed method identified polyp images from nonpolyp images in the beginning followed by predicting the polyp histology. When compared with visual inspection by endoscopists, the results of this study show that the proposed method has similar precision (87.3% versus 86.4%) but a higher recall rate (87.6% versus 77.0%) and a higher accuracy (85.9% versus 74.3%). In conclusion, automatic algorithms can assist endoscopists in identifying polyps that are adenomatous but have been incorrectly judged as hyperplasia and, therefore, enable timely resection of these polyps at an early stage before they develop into invasive cancer.

[Gallbladder polyps: correlation between ultrasonographic and histopathological findings].

PubMed

Escalona, Alex; León, Francisca; Bellolio, Felipe; Pimentel, Fernando; Guajardo, Matías; Gennero, Rubén; Cruz, Juan Pablo; Viviani, Paola; Ibáñez, Luis

2006-10-01

Gallbladder polyps are becoming a common finding. The management of these polyps is complicated considering that they can bear malignant lesions. To analyze the ultrasonographic and histopathologic findings of patients operated due to gallbladder polyps. The records of patients with ultrasonographic diagnosis of gallbladder polyp and that underwent cholecystectomy in a thirteen years period were reviewed, collecting their demographic, ultrasonographic and histopathological data. One hundred and twenty three patients were operated. The mean age was 44+/-13 years, and 69% were women. The mean size of polyps in ultrasonography was 7.3+/-5 mm. Histopathology confirmed the presence of polyps in 79% of patients, with a mean size and number of lesions of 5.1+/-3.8 mm and 2.1+/-2, respectively. Nine percent of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p =0.003). Four cases of adenoma (3.2%) were diagnosed; one of them had in situ carcinoma. All were single and larger than 10 mm. We found a significant correlation between ultrasonographic and histopathological polyp size determination (r =0.47; p =0.002). Polyp size was also a predictor of the presence of adenoma (p =0.043; confidence intervals: 1.006-1.424). There is a good correlation between the size of the gallbladder polyp in ultrasonography and the size in the histopathology report. Gallbladder adenoma is uncommon and it correlates with the size of the polyp. In this series, size was the only predictor of the presence of adenoma.

[Gallbladder polyps: how should they be treated and when?].

PubMed

Matos, Ana Sofia Bento de; Baptista, Hamilton Neves; Pinheiro, Carlos; Martinho, Fernando

2010-01-01

The objective of this study was to determine the correct therapeutic management for patients with gallbladder polyps (GPs), what type of surveillance should be employed and how to differentiate between benign and malignant polyps in addition to also to providing reassurance in cases of "cancerophobia". This was a 5-years retrospective study. The study was conducted at a Surgery Department at the Hospitais da Universidade de Coimbra. We analyzed all patients operated on at the Surgery Service II from January 2003 to December 2007 who had had a preoperative diagnosis of GP. Clinicopathological correlations were traced for all patients. The following were analyzed: demographic data, clinical presentation, principal symptoms, associated pathologies, supplementary tests and diagnoses. We studied 93 patients, 91 of whom had benign polyps and two of whom had malignant polyps. Of the 91 benign polyps, 73 (78.5%) were cholesterol polyps, 14 (15%) were hyperplastic and two (2.2%) were adenomas. Two (2.2%) patients had malignant polyps, both adenogallbladder carcinomas. The mean diameter of benign polyps was 6 mm and 40 (43%) patients had multiple lesions. The mean diameter of malignant and premalignant polyps taken together was 18.8 mm, all were single polyps and the mean age of this patient subset was 57.7 years. It was concluded that the surgical option for GPs is cholecystectomy and that this should only be undertaken in cases where there are clinical signs of GP; polyps with diameters greater than 10 mm; fast-growing polyps; sessile polyps or wide-based polyps; polyps with long pedicles; patient aged over 50; concurrent gallstones; polyps of the gallbladder infundibulum or abnormal gallbladder wall ultrasound.

The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

PubMed Central

van de Meeberg, Maartje M.; Ouwendijk, Rob J. Th.; ter Borg, Pieter C. J.; van den Hazel, Sven J.; van de Meeberg, Paul C.

2016-01-01

Background and study aims: Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. Patients and methods: In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completeness of polyp descriptions was compared to a historical group with conventional reporting (CRH). Prospectively, we compared user-friendliness (VAS-scores) and time benefit of the endoscopist-operated PM to conventional reporting (CR) in one hospital. Duration of colonoscopy and time needed to report polyps and provide a pathology request were measured. Provided that using PM does not prolong colonoscopy, the sum of the latter two was considered as a potential time-benefit if the PM were fully integrated into a digital reporting system. Results: A total of 144 regular colonoscopies were included in the study. Both groups were comparable with regard to patient characteristics, duration of colonoscopy and number of polyps. Using the PM did reduce incomplete documentation of the following items in CRH-reports: location (96 % vs 82 %, P = 0.01), size (95 % vs 89 %, P = 0.03), aspect (71 % vs 36 %, P < 0.001) and completeness of removal (61 % vs 37 %, P < 0.001). In the prospective study 23 PM-colonoscopies where compared to 28 CR-colonoscopies. VAS-scores were significantly higher in the endoscopist-operated PM group. Time to report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. Conclusions: The PM is a user-friendly tool that seems to improve completeness of polyp reporting. Once integrated with digital reporting systems, it is probably time saving as

Sonographic diagnosis of juvenile polyps in children.

PubMed

Zhang, Yao; Li, Shi-Xing; Xie, Li-Mei; Shi, Bo; Ju, Hao; Bai, Yu-Zuo; Zhang, Shu-Cheng

2012-09-01

The aim of this study was to assess the diagnostic value of ultrasonography for juvenile polyps in children and their sonographic characteristics. A retrospective analysis was performed of the ultrasound findings in 27 children who were diagnosed preoperatively with juvenile polyp within the intestinal tract by ultrasonography and then confirmed by colonoscopy, laparotomy and histopathology. The ultrasonic finding common to all polyps was an isolated intraluminal nodular or massive protrusion, associated with multiple mesh-like fluid areas of different sizes. In 25 children, surrounding pedicle-like low echoes of varying lengths were seen connecting with the polyps to form "mushroom" sign. The color Doppler showed abundant blood flow signals within all polyps and pedicles in a shape of a branch or an umbrella. For seven children with an intussusception, the polyp shadow was detected in the cervical part or interior of the intussusception. Ultrasonography is, thus, considered to be a feasible method for diagnosing intestinal juvenile polyp. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

GSK-3β activation index is a potential indicator for recurrent inflammation of chronic rhinosinusitis without nasal polyps.

PubMed

Hong, Haiyu; Chen, Fenghong; Qiao, Yongkang; Yan, Yan; Zhang, Rongkai; Zhu, Zhe; Li, Huabin; Fan, Yunping; Xu, Geng

2017-12-01

Chronic rhinosinusitis without nasal polyps (CRSsNP) is one of the most common otorhinolaryngologic diseases worldwide. However, the underlying mechanism remains unclear. In this study, the expression of glycogen synthase kinase 3 (GSK-3) was quantitatively evaluated in patients with CRSsNP (n = 20) and healthy controls (n = 20). The mRNA levels of GSK-3α and GSK-3β were examined by qPCR, the immunoreactivities of GSK-3β and nuclear factor-κB (NF-κB) were examined by immunohistochemistry (IHC) staining, and the protein levels of GSK-3β, phospho-GSK-3β (p-GSK-3β, s9) and NF-κB were examined using Western blot analysis. We found that GSK-3 was highly expressed in both CRSsNP and control groups without significant difference in both GSK-3β mRNA and protein levels. However, when compared with healthy control group, the GSK-3β activation index, defined as the ratio of GSK-3β over p-GSK-3β, was significantly decreased, whereas the NF-κB protein abundance was significantly increased in CRSsNP group (P < 0.05). Strikingly, the GSK-3β activation index, was highly correlated with NF-κB protein level, as well as CT scores in CRSsNP group (P < 0.05). It was also highly correlated with the mRNA expressions of inflammation-related genes, including T-bet, IFN-γ and IL-4 in CRSsNP group (P < 0.05). Our findings suggest that GSK-3β activation index, reflecting the inhibitory levels of GSK-3β through phosphorylation, may be a potential indicator for recurrent inflammation of CRSsNP, and that the insufficient inhibitory phosphorylation of GSK-3β may play a pivotal role in the pathogenesis of CRSsNP. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Discrimination of premalignant lesions and cancer tissues from normal gastric tissues using Raman spectroscopy

NASA Astrophysics Data System (ADS)

Luo, Shuwen; Chen, Changshui; Mao, Hua; Jin, Shaoqin

2013-06-01

The feasibility of early detection of gastric cancer using near-infrared (NIR) Raman spectroscopy (RS) by distinguishing premalignant lesions (adenomatous polyp, n=27) and cancer tissues (adenocarcinoma, n=33) from normal gastric tissues (n=45) is evaluated. Significant differences in Raman spectra are observed among the normal, adenomatous polyp, and adenocarcinoma gastric tissues at 936, 1003, 1032, 1174, 1208, 1323, 1335, 1450, and 1655 cm-1. Diverse statistical methods are employed to develop effective diagnostic algorithms for classifying the Raman spectra of different types of ex vivo gastric tissues, including principal component analysis (PCA), linear discriminant analysis (LDA), and naive Bayesian classifier (NBC) techniques. Compared with PCA-LDA algorithms, PCA-NBC techniques together with leave-one-out, cross-validation method provide better discriminative results of normal, adenomatous polyp, and adenocarcinoma gastric tissues, resulting in superior sensitivities of 96.3%, 96.9%, and 96.9%, and specificities of 93%, 100%, and 95.2%, respectively. Therefore, NIR RS associated with multivariate statistical algorithms has the potential for early diagnosis of gastric premalignant lesions and cancer tissues in molecular level.

Treatment of nasal burns: analysis of 150 cases

PubMed Central

Prousskaia, E.; El-Muttardi, N.; Philp, B.; Dziewulski, P.; Shelley, O.P.

2015-01-01

Summary Nasal burns present a challenge for the plastic surgeon in terms of immediate management, choice of primary treatment and secondary reconstruction with the goals of good aesthetic and functional outcome. We present a retrospective analysis of the management of 150 patients with nasal burns treated in our center between July 2005 and July 2011. We rationalized our conservative and all surgical treatments of this subset of burns patients and organized them in a simple and structured way. The reconstructive options for most complex full thickness nasal injury is determined by the integrity of adjacent facial tissues which would always be preferred when available. Microsurgical free tissue transfer is dependent upon the fitness of the patient and the availability of unburned skin at the donor site. Secondary nasal reconstruction is based on an assessment of the residual functional and cosmetic problems. Airways narrowing from scar contracture or loss of support are managed using standard plastic surgical and rhinoplasty principles. Cosmetic refinements range from flap debulking to the importation of new tissue on to the nose. Our experience with this challenging group of patients has led us to develop a simple treatment algorithm for the management of nasal burns. PMID:27252610

Nasal polyposis in cystic fibrosis: follow-up of children and adolescents for a 3-year period.

PubMed

Weber, Silke Anna Theresa; Iyomasa, Renata Mizusaki; Corrêa, Camila de Castro; Florentino, Wellington Novais Mafra; Ferrari, Giesela Fleischer

Nasal polyposis is often found in patients with cystic fibrosis. To assess the incidence of nasal polyposis, the response to medical treatment, recurrence and the need for surgical intervention in children and adolescents with cystic fibrosis during a three-year follow-up. Clinical symptoms (pulmonary, pancreatic insufficiency, malnutrition, nasal obstruction), two positive sweat chloride tests, and genotype findings in 23 patients with cystic fibrosis were analyzed. All patients underwent nasal endoscopy every 12 months from January 2005 to December 2007, to assess the presence and grade of Nasal Polyps. Nasal polyposis, when present, were treated with topical corticosteroids for 6-12 months, with progress being evaluated within the 3 years of follow-up. In the first evaluation, nasal polyposis was diagnosed in 30.43% of patients (3 bilateral and 4 unilateral), recurrent pneumonia in 82.6%, pancreatic insufficiency in 87%, and malnutrition in 74%. The presence of nasal polyposis was not associated with chloride values in the sweat, genotype, clinical signs of severity of cystic fibrosis, or nasal symptoms. In the three-year period of follow up, 13 patients (56.52%) had at least one event of polyposis, with the youngest being diagnosed at 32 months of age. Only one patient underwent surgery (polypectomy), and there was one diagnosis of nasopharyngeal carcinoma. The study showed a high incidence of nasal polyposis. Monitoring through routine endoscopy in patients with cystic fibrosis, even in the absence of nasal symptoms, is highly recommended. The therapy with topical corticosteroids achieved good results. Thus, an interaction between pediatricians and otolaryngologists is necessary. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Nasal Chondromesenchymal Hamartoma in a Child

DOE Office of Scientific and Technical Information (OSTI.GOV)

Finitsis, Stefanos; Giavroglou, Constantinos; Potsi, Stamatia, E-mail: matinapotsi@hotmail.co

Nasal chondromesenchymal hamartoma (NCMH) is a benign tumor that was described in 1998. The occurrence of this lesion in the nasal cavity of infants and children is especially rare, with only 21 cases reported in the international literature. We report a 12-month-old boy with respiratory distress due to nasal obstruction. Computed tomographic scan and magnetic resonance imaging examination demonstrated a soft-tissue mass obstructing the left nasal cavity. Digital subtraction angiography and preoperative superselective embolization with microparticles were also performed. The tumor was completely resected surgically. Histopathology and immunohistochemical analyses of the tumor disclosed a NCMH. The imaging characteristics of themore » tumor are described and the radiology literature is reviewed.« less

The effect of smoking on CT score, bacterial colonization and distribution of inflammatory cells in the upper airways of patients with chronic rhinosinusitis.

PubMed

Uhliarova, Barbora; Adamkov, Marian; Svec, Martin; Calkovska, Andrea

2014-06-01

The study was designed to determine whether smoking affects CT score, bacterial colonization of the upper airways and distribution of inflammatory cells in nasal mucosa in patients with chronic rhinosinusitis. Sixty-four patients were enrolled in the prospective study. We characterized differences in CT score, rate of revision surgery, differences in bacterial colonization in the middle nasal meatus and distribution of inflammatory cells in nasal tissue in smoking and non-smoking patients with chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and control group. Direct tobacco use was associated with significantly more severe form of the disease according to the preoperative CT investigation of paranasal sinuses using Lund-Mackay scoring system in both CRSwNP (p = 0.035) and CRSsNP (p = 0.023) groups. More intense colonization of upper-respiratory tract by the pathogenic bacteria in smokers compared to non-smokers was found. Non-pathogenic bacterial flora was more often present in non-smokers compared to smokers. Plasma cells and lymphocytes were the most numerous cells in nasal tissue in all three groups. In smokers with presence of pathogenic bacteria in middle nasal meatus there was stronger neutrophil (p = 0.002) and macrophage infiltration (p = 0.044) in CRSsNP group. Tobacco smoke exposure is related to higher Lund-Mackay score, increased colonization by pathogenic bacteria and lower incidence of commensals in middle nasal meatus, but does not influence cell distribution in nasal mucosa in patients with chronic rhinosinusitis.

Molecular detection of microbes in nasal tissue of dogs with idiopathic lymphoplasmacytic rhinitis.

PubMed

Windsor, Rebecca C; Johnson, Lynelle R; Sykes, Jane E; Drazenovich, Tracy L; Leutenegger, Christian M; De Cock, Hilde E V

2006-01-01

Lymphoplasmacytic rhinitis (LPR) is a common histologic finding in dogs with chronic nasal disease; however, potential etiologies of this disorder have not been examined. We investigated the hypothesis that specific microbes contribute to clinical disease in dogs with LPR. Paraffin-embedded nasal biopsies were obtained from 19 dogs with LPR, 10 dogs with nasal neoplasia, and 10 dogs with nasal aspergillosis. Nucleic acids were extracted from paraffin blocks, and real-time quantitative polymerase chain reaction (PCR) was employed for detection of target genes for bacterial and fungal DNA, canine adenovirus 2 (CAV-2), parainfluenza virus 3 (PI-3), Chlamydial Chlamydophila spp., and Bartonella spp. Conventional PCR was used for detection of Mycoplasma spp. Statistical analysis was performed using the Mann-Whitney U-test for nonparametric data, and significance was set at P < 0.05. DNA or RNA for CAV-2, PI-3, Bartonella, Mycoplasma, and Chlamydophila was not detected in any nasal biopsy. DNA loads for bacterial DNA did not differ among disease groups. Detection of fungal DNA in nasal biopsies was highest in dogs with aspergillosis (P < 0.0001); however, nasal biopsies of LPR dogs also displayed higher fungal DNA levels than samples from dogs with nasal neoplasia (P = 0.016). Detection of high levels of fungal DNA in nasal biopsies of dogs with LPR suggests that fungal organisms may be causally associated with the inflammation observed, although the possibility of entrapment or accumulation of fungi in the nasal cavity due to chronic inflammation cannot be excluded. Further investigations are required to elucidate the underlying etiopathogenesis of LPR.

Calibrating amino acid δ13C and δ15N offsets between polyp and protein skeleton to develop proteinaceous deep-sea corals as paleoceanographic archives

NASA Astrophysics Data System (ADS)

McMahon, Kelton W.; Williams, Branwen; Guilderson, Thomas P.; Glynn, Danielle S.; McCarthy, Matthew D.

2018-01-01

Compound-specific stable isotopes of amino acids (CSI-AA) from proteinaceous deep-sea coral skeletons have the potential to improve paleoreconstructions of plankton community composition, and our understanding of the trophic dynamics and biogeochemical cycling of sinking organic matter in the Ocean. However, the assumption that the molecular isotopic values preserved in protein skeletal material reflect those of the living coral polyps has never been directly investigated in proteinaceous deep-sea corals. We examined CSI-AA from three genera of proteinaceous deep-sea corals from three oceanographically distinct regions of the North Pacific: Primnoa from the Gulf of Alaska, Isidella from the Central California Margin, and Kulamanamana from the North Pacific Subtropical Gyre. We found minimal offsets in the δ13C values of both essential and non-essential AAs, and in the δ15N values of source AAs, between paired samples of polyp tissue and protein skeleton. Using an essential AA δ13C fingerprinting approach, we show that estimates of the relative contribution of eukaryotic microalgae and prokaryotic cyanobacteria to the sinking organic matter supporting deep-sea corals are the same when calculated from polyp tissue or recently deposited skeletal tissue. The δ15N values of trophic AAs in skeletal tissue, on the other hand, were consistently 3-4‰ lower than polyp tissue for all three genera. We hypothesize that this offset reflects a partitioning of nitrogen flux through isotopic branch points in the synthesis of polyp (fast turnover tissue) and skeleton (slow, unidirectional incorporation). This offset indicates an underestimation, albeit correctable, of approximately half a trophic position from gorgonin protein-based deep-sea coral skeleton. Together, our observations open the door for applying many of the rapidly evolving CSI-AA based tools developed for metabolically active tissues in modern systems to archival coral tissues in a paleoceanographic context.

Anatomy of the nasal profile

PubMed Central

Anderson, K J; Henneberg, M; Norris, R M

2008-01-01

There is a lack in the understanding of the variation within the thickness of the soft tissue structures (muscle, skin and fat) overlying the cartilaginous skeleton of the nose and their relationship to the dorsum shape. We examined such relationships by dissecting noses of six adult female and six adult male cadavers, comparing the internal anatomical structures to the external nasal profile. We found that the soft tissue structures differ in thickness along the dorsum and that these differences are individualized. Specifically, continuous presence of subcutaneous fat from root to tip was found in half the sample, one nose had fat only on the tip, another one only on the root, the four others at both positions. The nasalis muscle was identifiable in nine of the 12 noses, transversing the nose in half the sample, and in the remaining three, only the lateral section of the muscle was identified. The superior border of the septal cartilage does not form a linear extension of the profile contour of the nasal bones but angles downwards. The actual profile contour of the dorsum does not follow the profile of the nasal bones or the septal cartilage. These results may influence the current use of nasal guidelines in forensic facial approximation. PMID:19172735

An aposymbiotic primary coral polyp counteracts acidification by active pH regulation

NASA Astrophysics Data System (ADS)

Ohno, Yoshikazu; Iguchi, Akira; Shinzato, Chuya; Inoue, Mayuri; Suzuki, Atsushi; Sakai, Kazuhiko; Nakamura, Takashi

2017-01-01

Corals build their skeletons using extracellular calcifying fluid located in the tissue-skeleton interface. However, the mechanism by which corals control the transport of calcium and other ions from seawater and the mechanism of constant alkalization of calcifying fluid are largely unknown. To address these questions, we performed direct pH imaging at calcification sites (subcalicoblastic medium, SCM) to visualize active pH upregulation in live aposymbiotic primary coral polyps treated with HCl-acidified seawater. Active alkalization was observed in all individuals using vital staining method while the movement of HPTS and Alexa Fluor to SCM suggests that certain ions such as H+ could diffuse via a paracellular pathway to SCM. Among them, we discovered acid-induced oscillations in the pH of SCM (pHSCM), observed in 24% of polyps examined. In addition, we discovered acid-induced pH up-regulation waves in 21% of polyps examined, which propagated among SCMs after exposure to acidified seawater. Our results showed that corals can regulate pHSCM more dynamically than was previously believed. These observations will have important implications for determining how corals regulate pHSCM during calcification. We propose that corals can sense ambient seawater pH via their innate pH-sensitive systems and regulate pHSCM using several unknown pH-regulating ion transporters that coordinate with multicellular signaling occurring in coral tissue.

Equine nasal and paranasal sinus tumours. Part 1: review of the literature and tumour classification.

PubMed

Head, K W; Dixon, P M

1999-05-01

The normal gross and histological anatomy of the equine nasal and paranasal sinuses are reviewed and the relationships between the local anatomy, the occurrence of different tumour types, and of tumour spread are examined. The histological classification of the more common equine sinonasal tumours and tumour-like lesions are discussed. Clinical and pathological descriptions of 50 more recently recorded such tumours are separately tabulated. The literature shows that equine sinonasal tumours, both endemic and sporadic, are relatively uncommon in horses, with non-neoplastic growths such as maxillary (sinus) cysts, progressive ethmoid haematoma and inflammatory nasal polyps more commonly recorded. The equine paranasal sinuses, especially the caudal maxillary sinus, are the most common sites for sinonasal tumours and, in contrast to other species, primary nasal tumours are uncommon. The more common tumour types include squamous cell carcinoma that, in some cases, arise in the oral cavity and spread to the maxillary sinuses; adenocarcinomas; bone and dental tumours; fibrosarcomas and haemangiosarcomas. Except for some benign bone tumours, there are few records of successful treatment of equine sinonasal tumours.

High-performance computer aided detection system for polyp detection in CT colonography with fluid and fecal tagging

NASA Astrophysics Data System (ADS)

Liu, Jiamin; Wang, Shijun; Kabadi, Suraj; Summers, Ronald M.

2009-02-01

CT colonography (CTC) is a feasible and minimally invasive method for the detection of colorectal polyps and cancer screening. Computer-aided detection (CAD) of polyps has improved consistency and sensitivity of virtual colonoscopy interpretation and reduced interpretation burden. A CAD system typically consists of four stages: (1) image preprocessing including colon segmentation; (2) initial detection generation; (3) feature selection; and (4) detection classification. In our experience, three existing problems limit the performance of our current CAD system. First, highdensity orally administered contrast agents in fecal-tagging CTC have scatter effects on neighboring tissues. The scattering manifests itself as an artificial elevation in the observed CT attenuation values of the neighboring tissues. This pseudo-enhancement phenomenon presents a problem for the application of computer-aided polyp detection, especially when polyps are submerged in the contrast agents. Second, general kernel approach for surface curvature computation in the second stage of our CAD system could yield erroneous results for thin structures such as small (6-9 mm) polyps and for touching structures such as polyps that lie on haustral folds. Those erroneous curvatures will reduce the sensitivity of polyp detection. The third problem is that more than 150 features are selected from each polyp candidate in the third stage of our CAD system. These high dimensional features make it difficult to learn a good decision boundary for detection classification and reduce the accuracy of predictions. Therefore, an improved CAD system for polyp detection in CTC data is proposed by introducing three new techniques. First, a scale-based scatter correction algorithm is applied to reduce pseudo-enhancement effects in the image pre-processing stage. Second, a cubic spline interpolation method is utilized to accurately estimate curvatures for initial detection generation. Third, a new dimensionality

CT differentiation of 1-2-cm gallbladder polyps: benign vs malignant.

PubMed

Song, E Rang; Chung, Woo-Suk; Jang, Hye Young; Yoon, Minjae; Cha, Eun Jung

2014-04-01

To evaluate MDCT findings of 1-2-cm sized gallbladder (GB) polyps for differentiation between benign and malignant polyps. Institutional review board approval was obtained, and informed consent was waived. Portal venous phase CT scans of 1-2-cm sized GB polyps caused by various pathologic conditions were retrospectively reviewed by two blinded observers. Among the 36 patients identified, 21 had benign polyps with the remaining 15 having malignant polyps. Size, margin, and shape of GB polyps were evaluated. Attenuation values of the polyps, including mean attenuation, maximum attenuation, and standard deviation, were recorded. As determined by visual inspection, the degree of polyp enhancement was evaluated. Using these CT findings, each of the two radiologists assessed and recorded individual diagnostic confidence for differentiating benign versus malignant polyps on a 5-point scale. The diagnostic performance of CT was evaluated using a receiver operating characteristic curve analysis. There was no significant difference in size between benign and malignant GB polyps. Ill-defined margin and sessile morphology were significantly associated with malignant polyp. There was a significant difference in mean and maximum attenuation values between benign and malignant GB polyps. Mean standard deviation value of malignant polyps was significantly higher than that of benign polyps. All malignant polyps showed either hyperenhancement or marked hyperenhancement. A z value for the diagnosis of malignant GB polyps was 0.905. Margin, shape, and enhancement degree are helpful in differentiating between benign and malignant polyps of 1-2-cm sizes.

Repair of bone defects in vivo using tissue engineered hypertrophic cartilage grafts produced from nasal chondrocytes.

PubMed

Bardsley, Katie; Kwarciak, Agnieska; Freeman, Christine; Brook, Ian; Hatton, Paul; Crawford, Aileen

2017-01-01

The regeneration of large bone defects remains clinically challenging. The aim of our study was to use a rat model to use nasal chondrocytes to engineer a hypertrophic cartilage tissue which could be remodelled into bone in vivo by endochondral ossification. Primary adult rat nasal chondrocytes were isolated from the nasal septum, the cell numbers expanded in monolayer culture and the cells cultured in vitro on polyglycolic acid scaffolds in chondrogenic medium for culture periods of 5-10 weeks. Hypertrophic differentiation was assessed by determining the temporal expression of key marker genes and proteins involved in hypertrophic cartilage formation. The temporal changes in the genes measured reflected the temporal changes observed in the growth plate. Collagen II gene expression increased 6 fold by day 7 and was then significantly downregulated from day 14 onwards. Conversely, collagen X gene expression was detectable by day 14 and increased 100-fold by day 35. The temporal increase in collagen X expression was mirrored by increases in alkaline phosphatase gene expression which also was detectable by day 14 with a 30-fold increase in gene expression by day 35. Histological and immunohistochemical analysis of the engineered constructs showed increased chondrocyte cell volume (31-45 μm), deposition of collagen X in the extracellular matrix and expression of alkaline phosphatase activity. However, no cartilage mineralisation was observed in in vitro culture of up to 10 weeks. On subcutaneous implantation of the hypertrophic engineered constructs, the grafts became vascularised, cartilage mineralisation occurred and loss of the proteoglycan in the matrix was observed. Implantation of the hypertrophic engineered constructs into a rat cranial defect resulted in angiogenesis, mineralisation and remodelling of the cartilage tissue into bone. Micro-CT analysis indicated that defects which received the engineered hypertrophic constructs showed 38.48% in bone volume

Interleukin-33 induces mucin gene expression and goblet cell hyperplasia in human nasal epithelial cells.

PubMed

Ishinaga, Hajime; Kitano, Masako; Toda, Masaaki; D'Alessandro-Gabazza, Corina N; Gabazza, Esteban C; Shah, Said Ahmad; Takeuchi, Kazuhiko

2017-02-01

We investigated whether IL-33 is involved in mucus overproduction and goblet cell hyperplasia in eosinophilic chronic rhinosinusitis (ECRS). IL-33 mRNA was significantly higher in the eosinophilic CRS group than in the non-eosinophilic CRS group from human nasal polyps. IL-33 induced MUC5AC mRNA and MUC5AC protein, and also goblet cell hyperplasia at air liquid interface culture in human nasal epithelial cells. In addition to that, IL-33 induced MUC5B and FOXA3, and reduces FOXJmRNA. In conclusion, our present study demonstrated that the direct evidence of IL-33 which lead to increase mucin gene and protein expression, as well as goblet cell hyperplasia. This study provides novel insights into the role of IL-33 on mucus overproduction in eosinophilic inflammation of human airways. Copyright © 2016 Elsevier Ltd. All rights reserved.

Uterine Polyps

MedlinePlus

... Signs and symptoms of uterine polyps include: Irregular menstrual bleeding — for example, having frequent, unpredictable periods of variable length and heaviness Bleeding between menstrual periods Excessively heavy menstrual periods Vaginal bleeding after ...

Inverted papillomas and benign nonneoplastic lesions of the nasal cavity

PubMed Central

Casiano, Roy R.

2012-01-01

Background: Benign lesions of the nasal cavity represent a diverse group of pathologies. Furthermore, each of these disorders may present differently in any given patient as pain and discomfort, epistaxis, headaches, vision changes, or nasal obstruction. Although these nasal masses are benign, many of them have a significant capacity for local tissue destruction and symptomatology secondary to this destruction. Advances in office-based endoscopic nasendoscopy have equipped the otolaryngologist with a safe, inexpensive, and rapid means of directly visualizing lesions within the nasal cavity and the initiation of appropriate treatment. Methods: The purpose of this study is to review the diagnosis, management, and controversies of many of the most common benign lesions of the nasal cavity encountered by the primary care physician or otolaryngologist. Results: This includes discussion of inverted papilloma (IP), juvenile angiofibroma, squamous papilloma, pyogenic granuloma, hereditary hemorrhagic telangiectasia, schwannoma, benign fibro-osseous lesions, and other benign lesions of the nasal cavity, with particular emphasis on IP and juvenile angiofibroma. Conclusion: A diverse array of benign lesions occur within the nasal cavity and paranasal cavities. Despite their inability to metastasize, many of these lesions have significant capability for local tissue destruction and recurrence. PMID:22487294

Colorectal polyps

MedlinePlus

... polyp, which protrudes out in the lumen (open space) of the colon Villous adenoma, which is sometimes ... DA, Levin TR; United States Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after ...

Crowd-assisted polyp annotation of virtual colonoscopy videos

NASA Astrophysics Data System (ADS)

Park, Ji Hwan; Nadeem, Saad; Marino, Joseph; Baker, Kevin; Barish, Matthew; Kaufman, Arie

2018-03-01

Virtual colonoscopy (VC) allows a radiologist to navigate through a 3D colon model reconstructed from a computed tomography scan of the abdomen, looking for polyps, the precursors of colon cancer. Polyps are seen as protrusions on the colon wall and haustral folds, visible in the VC y-through videos. A complete review of the colon surface requires full navigation from the rectum to the cecum in antegrade and retrograde directions, which is a tedious task that takes an average of 30 minutes. Crowdsourcing is a technique for non-expert users to perform certain tasks, such as image or video annotation. In this work, we use crowdsourcing for the examination of complete VC y-through videos for polyp annotation by non-experts. The motivation for this is to potentially help the radiologist reach a diagnosis in a shorter period of time, and provide a stronger confirmation of the eventual diagnosis. The crowdsourcing interface includes an interactive tool for the crowd to annotate suspected polyps in the video with an enclosing box. Using our work flow, we achieve an overall polyps-per-patient sensitivity of 87.88% (95.65% for polyps >=5mm and 70% for polyps <5mm). We also demonstrate the efficacy and effectiveness of a non-expert user in detecting and annotating polyps and discuss their possibility in aiding radiologists in VC examinations.

Higher Prevalence of Endometrial Polyps in Infertile Patients with Endometriosis.

PubMed

Zhang, Ya-Nan; Zhang, You-Sheng; Yu, Qian; Guo, Zi-Zhen; Ma, Jin-Long; Yan, Lei

2018-06-07

To study whether infertile patients with endometriosis have a higher prevalence of endometrial polyps, and to clarify the characteristics of the pathology of combined polyps. Infertile patients who had undergone both hysteroscopy and laparoscopy in Reproductive Hospital Affiliated with Shandong University from January 2014 to May 2017 were enrolled. Patients with and without endometriosis, diagnosed by laparoscopy, were staged and included in the study group and control group, respectively, and the prevalence of polyps was compared. The pathological types of endometrial polyps were analyzed. A total of 414 cases were enrolled in the study group and 3,048 cases in the control group; polyps were diagnosed, with endoscopy, in 1,107 patients. Endometrial polyps were detected by hysteroscopy in 47.83% of the endometriosis group and 29.82% of the control group. The prevalence of endometrial polyps was significantly higher in the endometriosis group than in the control group (p < 0.001) but not significantly different between stages of endometriosis (p = 0.580). The pathological diagnosis included 899 endometrial polyps and 208 polypoid hyperplasia; 66.5% of endometrial polyps were combined with simple hyperplasia. The infertile patients with endometriosis had a higher prevalence of endometrial polyps, and those polyps are often combined with simple hyperplasia. © 2018 S. Karger AG, Basel.

Airflow, gas deposition, and lesion distribution in the nasal passages.

PubMed Central

Morgan, K T; Monticello, T M

1990-01-01

The nasal passages of laboratory animals and man are complex, and lesions induced in the delicate nasal lining by inhaled air pollutants vary considerably in location and nature. The distribution of nasal lesions is generally a consequence of regional deposition of the inhaled material, local tissue susceptibility, or a combination of these factors. Nasal uptake and regional deposition are are influenced by numerous factors including the physical and chemical properties of the inhaled material, such as water solubility and reactivity; airborne concentration and length of exposure; the presence of other air contaminants such as particulate matter; nasal metabolism, and blood and mucus flow. For certain highly water-soluble or reactive gases, nasal airflow patterns play a major role in determining lesion distribution. Studies of nasal airflow in rats and monkeys, using casting and molding techniques combined with a water-dye model, indicate that nasal airflow patterns are responsible for characteristic differences in the distribution of nasal lesions induced by formaldehyde in these species. Local tissue susceptibility is also a complex issue that may be a consequence of many factors, including physiologic and metabolic characteristics of the diverse cell populations that comprise each of the major epithelial types lining the airways. Identification of the principal factors that influence the distribution and nature of nasal lesions is important when attempting the difficult process of determining potential human risks using data derived from laboratory animals. Toxicologic pathologists can contribute to this process by carefully identifying the site and nature of nasal lesions induced by inhaled materials. Images FIGURE 4. FIGURE 6. FIGURE 7. PMID:2200663

Carcinoma in gastric hyperplastic polyps: A phenotypic study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zea-Iriarte, W.L.; Sekine, Ichiro; Itsuno, Minoru

1996-02-01

One-hundred twelve hyperplastic polyps were analyzed. The aim was to study their malignant transformation. Among them, four hyperplastic polyps harbored adenocarcinoma; two were from our own institution (1.8%). The majority were pedunculated and located in the antrum with an average of 14.5 mm in diameter. The four polyps bore well-differentiated adenocarcinoma. Dysplasia and intestinal metaplasia were detected in two and three polyps, respectively. The cancer and dysplastic foci shared the same type of neutral and acid mucosubstances. p53 oncoprotein was positive in three cancer foci and in the dysplastic areas, and nucleolar organizer region counts were higher in the cancermore » foci. In conclusion, hyperplastic polyps have malignant potential. Such possibility increases in polyps larger than 14.5 mm. In our cases, the carcinoma foci may have arisen from dysplastic areas. Once the neoplastic changes occur, the cancer cells proliferate and behave as other adenocarcinomas of the stomach. 40 refs., 7 figs., 5 tabs.« less

Silicone nasal prosthesis retained by an intranasal stent: a clinical report.

PubMed

Goveas, Reiyal; Puttipisitchet, Ongart; Shrestha, Binit; Thaworanunta, Sita; Srithavaj, M L Theerathavaj

2012-08-01

Nasal defects after tumor excision can leave a patient functionally and esthetically impaired. Loss of nasal septal cartilage support causes the soft tissue to collapse or undergo stenosis, further compounding the problem. Intranasal stents can be used to maintain the patency of such nasal defects. This clinical report describes the use of an acrylic resin nasal stent bonded to a silicone nasal prosthesis to rehabilitate a patient with a nasal defect. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Endometrial polyp in an African wild dog (Lycaon pictus).

PubMed

Cho, H S; Park, N Y

2006-11-01

An 8-year-old female African wild dog (Lycaon pictus) from a zoo in Gyeonggi province, Republic of Korea presented with a 3.0 x 2.0 x 2.5 cm in size, smooth-surfaced, solitary pedunculated mass protruding into the uterine lumen. Microscopically, the mass was covered with epithelium, contained endometrial gland tissue, and was dilated in the vascularised stroma. Within the mass, there was extensive diffuse haemorrhage with several blood vessels apparently plugged with fibrin. At the base of the mass, the spaces lined with epithelium near the attachment of the stalk were interpreted to be glandular structures. There were segments of cuboidal epithelium found on the surface of the mass, which was similar to the lining the uterus. A diagnosis of an endometrial polyp was made based on the gross and histology findings. This is the first case report of a spontaneous endometrial polyp in an African wild dog.

[Application of metal hemoclip for endoscopic polypectomy in children with thick-pedunculated intestinal polyps].

PubMed

Deng, Zhao-hui; Xu, Chun-di; Zhong, Jie; Chen, Shun-nian; Yao, Wei-jiong

2004-03-01

With the development of endoscopic therapy in children, endoscopic electrocoagulation polypectomy had gradually replaced surgery and became an important method to resect gastrointestinal polyps in children. Simple electrocoagulation polypectomy could often bring some complications of gastrointestinal bleeding and perforation because of incomplete electrocoagulation or mechanical incision, especially in gastrointestinal thick-pedunculated polyps which always have thick nutrient blood vessel. Hemoclips can successfully interdict arteriovenous blood because it can clamp tissue firmly without causing necrosis around the target area. Based on its good mechanical hemostasis, hemoclips are not only widely used in treating bleeding like from ulcer, tumor and variceal ligation but also used in removal of thick-pedunculated gastrointestinal polyps in adults. This paper describes the application of endoscopic electrocoagulation with metal hemoclips to remove thick-pedunculated intestinal polpys in children for the first time, sums up the experience and evaluates its efficacy and safety. Between October, 2001 and December, 2002, 5 cases with thick-pedunculated intestinal polpys were presented. The age of the patients ranged from 3 to 5 years. The clinical features were gastrointestinal bleeding or abdominal pain. The longest course of disease was 2 years. Enough preparations for alimentary tract were necessary for polypectomy. The procedures were performed under general anesthesia in order to avoid the risk of bleeding aspiration. Endoscopy was performed in the standard fashion. The apparatus included electronic colonic endoscope (XQ 200, Fuji Corp, Tokyo, Japan), snare (XQ200, Fuji Corp, Tokyo, Japan), impeller of the clip (HX-5QR-1) and hemoclip (MD850) which could be passed through the biopsy channel of endoscope. The clip was completely covered with a hood avoiding any injury to the mucous membrane. The pedicel with diameter of more than 1.0 cm underwent endoscopic

Conjugated linoleic acids differentially alter polyp number and diameter in the Apc(min/+) mouse model of intestinal cancer.

PubMed

Mandir, N; Goodlad, R A

2008-04-01

Dietary conjugated linoleic acids (CLA) have had many health benefits claimed for them, including antineoplastic actions. The effects of the predominant forms of CLA, namely the c9t11 and t10c12 isomers, or a mixture of these on polyp development, were investigated in the Apc(Min/+) mouse. CLAs have also been linked to altered rates of cell renewal and cell proliferation so this was also studied, as was a further means of increasing tissue mass, namely crypt fission. The stomach and small intestine were significantly heavier in the t10c12, and in the mixture-treated groups (P < 0.001). Crypt fission was increased in the middle small intestine by the t10c12 diet while colonic weight was reduced by c9t11 provision and crypts were 20% shorter. The t10c12 and the mixture significantly reduced polyp number in the proximal small intestine but they increased polyp diameter in the middle and distal small intestine, to an extent that the polyp burden was significantly increased at these sites. All CLAs significantly reduced polyp number in the colon, but the mixture significantly increased polyp diameter in the colon. Increased polyp diameter associated with t10c12 diet and especially with the mixture is a cause of concern, as this is the commercially available form. The naturally occurring isomer, c9t11 decreased colonic polyp number and did not increase diameter, suggesting that this natural isomer is the most likely to be protective.

Impact assessment of repeated exposure of organotypic 3D bronchial and nasal tissue culture models to whole cigarette smoke.

PubMed

Kuehn, Diana; Majeed, Shoaib; Guedj, Emmanuel; Dulize, Remi; Baumer, Karine; Iskandar, Anita; Boue, Stephanie; Martin, Florian; Kostadinova, Radina; Mathis, Carole; Ivanov, Nikolai V; Frentzel, Stefan; Hoeng, Julia; Peitsch, Manuel C

2015-02-12

Cigarette smoke (CS) has a major impact on lung biology and may result in the development of lung diseases such as chronic obstructive pulmonary disease or lung cancer. To understand the underlying mechanisms of disease development, it would be important to examine the impact of CS exposure directly on lung tissues. However, this approach is difficult to implement in epidemiological studies because lung tissue sampling is complex and invasive. Alternatively, tissue culture models can facilitate the assessment of exposure impacts on the lung tissue. Submerged 2D cell cultures, such as normal human bronchial epithelial (NHBE) cell cultures, have traditionally been used for this purpose. However, they cannot be exposed directly to smoke in a similar manner to the in vivo exposure situation. Recently developed 3D tissue culture models better reflect the in vivo situation because they can be cultured at the air-liquid interface (ALI). Their basal sides are immersed in the culture medium; whereas, their apical sides are exposed to air. Moreover, organotypic tissue cultures that contain different type of cells, better represent the physiology of the tissue in vivo. In this work, the utilization of an in vitro exposure system to expose human organotypic bronchial and nasal tissue models to mainstream CS is demonstrated. Ciliary beating frequency and the activity of cytochrome P450s (CYP) 1A1/1B1 were measured to assess functional impacts of CS on the tissues. Furthermore, to examine CS-induced alterations at the molecular level, gene expression profiles were generated from the tissues following exposure. A slight increase in CYP1A1/1B1 activity was observed in CS-exposed tissues compared with air-exposed tissues. A network-and transcriptomics-based systems biology approach was sufficiently robust to demonstrate CS-induced alterations of xenobiotic metabolism that were similar to those observed in the bronchial and nasal epithelial cells obtained from smokers.

Identification of non-neoplastic and neoplastic gastric polyps using multiphoton microscopy

NASA Astrophysics Data System (ADS)

Jiang, Shanghai; Kang, Deyong; Xu, Meifang; Zhu, Xiaoqin; Zhuo, Shuangmu; Chen, Jianxin

2012-12-01

Gastric polyps can be broadly defined as luminal lesions projecting above the plane of the mucosal surface. They are generally divided into non-neoplastic and neoplastic polyps. Accurate diagnosis of neoplastic polyps is important because of their well-known relationship with gastric cancer. Multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) is one of the most important recent inventions in biological imaging. In this study, we used MPM to image the microstructure of gastric polyps, including fundic gland polyps, hyperplastic polyps, inflammatory fibroid polyps and adenomas, then compared with gold-standard hematoxylin- eosin(H-E)-stained histopathology. MPM images showed that different gastric polyps have different gland architecture and cell morphology. Dilated, elongated or branch-like hyperplastic polyps are arranged by columnar epithelial cells. Inflammatory fibroid polyps are composed of small, thin-walled blood vessels surrounded by short spindle cells. Fundic glands polyps are lined by parietal cells and chief cells, admixed with normal glands. Gastric adenomas are generally composed of tubules or villi of dysplastic epithelium, which usually show some degree of intestinal-type differentiation toward absorptive cells, goblet cells, endocrine cells. Our results demonstrated that MPM can be used to identify non- neoplastic and neoplastic gastric polyps without the need of any staining procedure.

Livestock-Associated, Antibiotic-Resistant Staphylococcus aureus Nasal Carriage and Recent Skin and Soft Tissue Infection among Industrial Hog Operation Workers

PubMed Central

Nadimpalli, Maya; Stewart, Jill R.; Pierce, Elizabeth; Pisanic, Nora; Love, David C.; Hall, Devon; Larsen, Jesper; Carroll, Karen C.; Tekle, Tsigereda; Perl, Trish M.

2016-01-01

Swine production work is a risk factor for nasal carriage of livestock-associated (LA-) Staphylococcus aureus and also for skin and soft tissue infection (SSTI). However, whether LA-S. aureus nasal carriage is associated with increased risk of SSTI remains unclear. We aimed to examine S. aureus nasal carriage and recent (≤3 months prior to enrollment) SSTI symptoms among industrial hog operation (IHO) workers and their household contacts. IHO workers and their household contacts provided a nasal swab and responded to a questionnaire assessing self-reported personal and occupational exposures and recent SSTI symptoms. Nasal swabs were analyzed for S. aureus, including methicillin-resistant S. aureus (MRSA), multidrug-resistant-S. aureus (MDRSA), absence of scn (livestock association), and spa type. S. aureus with at least one indicator of LA was observed among 19% of 103 IHO workers and 6% of 80 household members. Prevalence of recent SSTI was 6% among IHO workers and 11% among 54 minor household members (0/26 adult household members reported SSTI). Among IHO workers, nasal carriers of MDRSA and scn-negative S. aureus were 8.8 (95% CI: 1.8, 43.9) and 5.1 (95% CI: 1.2, 22.2) times as likely to report recent SSTI as non-carriers, respectively. In one household, both an IHO worker and child reported recent SSTI and carried the same S. aureus spa type (t4976) intranasally. Prevalence of scn-negative S. aureus (PR: 5.0, 95% CI: 1.2, 21.4) was elevated among IHO workers who reported never versus always wearing a face mask at work. Although few SSTI were reported, this study of IHO workers and their household contacts is the first to characterize a relation between nasal carriage of antibiotic-resistant LA-S. aureus and SSTI. The direction and temporality of this relation and IHO workers’ use of face masks to prevent nasal carriage of these bacteria warrant further investigation. PMID:27851746

Demonstration of carboxylesterase in cytology samples of human nasal respiratory epithelium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rodgers, D.A.; Nikula, K.J.; Avila, K.

1995-12-01

The epithelial lining of the nasal airways is a target for responses induced by a variety of toxicant exposures. The high metabolic capacity of this tissue has been suggested to play a role in both protection of the airways through detoxication of certain toxicants, as well as in activation of other compounds to more toxic metabolites. Specifically, nasal carboxylesterase (CE) has been shown to mediate the toxicity of inhaled esters and acrylates by converting them to more toxic acid and alcohol metabolites which can be cytotoxic and/or carcinogenic to the nasal mucosa. Due to difficulties in extrapolating rodent models tomore » human, new paradigms using human cells and tissues are essential to understanding and evaluating the metabolic processes in human nasal epithelium.« less

Wavelet method for CT colonography computer-aided polyp detection.

PubMed

Li, Jiang; Van Uitert, Robert; Yao, Jianhua; Petrick, Nicholas; Franaszek, Marek; Huang, Adam; Summers, Ronald M

2008-08-01

Computed tomographic colonography (CTC) computer aided detection (CAD) is a new method to detect colon polyps. Colonic polyps are abnormal growths that may become cancerous. Detection and removal of colonic polyps, particularly larger ones, has been shown to reduce the incidence of colorectal cancer. While high sensitivities and low false positive rates are consistently achieved for the detection of polyps sized 1 cm or larger, lower sensitivities and higher false positive rates occur when the goal of CAD is to identify "medium"-sized polyps, 6-9 mm in diameter. Such medium-sized polyps may be important for clinical patient management. We have developed a wavelet-based postprocessor to reduce false positives for this polyp size range. We applied the wavelet-based postprocessor to CTC CAD findings from 44 patients in whom 45 polyps with sizes of 6-9 mm were found at segmentally unblinded optical colonoscopy and visible on retrospective review of the CT colonography images. Prior to the application of the wavelet-based postprocessor, the CTC CAD system detected 33 of the polyps (sensitivity 73.33%) with 12.4 false positives per patient, a sensitivity comparable to that of expert radiologists. Fourfold cross validation with 5000 bootstraps showed that the wavelet-based postprocessor could reduce the false positives by 56.61% (p <0.001), to 5.38 per patient (95% confidence interval [4.41, 6.34]), without significant sensitivity degradation (32/45, 71.11%, 95% confidence interval [66.39%, 75.74%], p=0.1713). We conclude that this wavelet-based postprocessor can substantially reduce the false positive rate of our CTC CAD for this important polyp size range.

Menhaden oil administration to dogs treated with radiation for nasal tumors demonstrates lower levels of tissue eicosanoids.

PubMed

Hansen, Rodney A; Anderson, Christine; Fettman, Martin J; Larue, Susan M; Davenport, Deborah J; Gross, Kathleen L; Richardson, Kristine L; Ogilvie, Gregory K

2011-12-01

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or menhaden oil may reduce inflammatory eicosanoids (prostaglandin E₂, thromboxane B₂, leukotriene B₄, and 11-dehydro thromboxane B₂), matrix metalloproteinases (MMPs), and blood lactate in dogs with nasal carcinomas receiving radiation therapy. We hypothesized that menhaden oil would reduce inflammation from radiation damage and lower blood lactate levels in dogs with nasal carcinoma. In a randomized, double-blind, placebo-controlled clinical study, 12 dogs with malignant carcinomas of the nasal cavity were given dietary menhaden oil (DHA and EPA) or soybean oil (control) and then received radiation therapy. Megavoltage radiation was delivered in 18 fractions to a total dose of 56 Gy. Blood levels of DHA, EPA, insulin, glucose, lactic acid, and MMPs 2 and 9; resting energy expenditure; and inflammatory eicosanoids from nasal biopsies were measured throughout radiation therapy. Samples were obtained from each patient 1 week before the start of radiation therapy, at start of radiation, and 7, 18 (end of radiation therapy), and 42 days after radiation was initiated. Dogs that are fed with menhaden oil had significantly (P < .05) higher plasma concentration of DHA by 500% and EPA by 200% and had significantly lower tissue inflammatory eicosanoids and decreased resting energy expenditure by 20% when compared with controls. Increased plasma DHA was significantly associated (P < .05) with decreased plasma lactic acid and MMPs. These data may suggest that dietary fish oil could reduce some detrimental inflammatory eicosanoids and metabolic consequences of radiation therapy. Copyright © 2011 Elsevier Inc. All rights reserved.

A nasal dermoid sinus in an English bull terrier.

PubMed

Burrow, R D

2004-11-01

A five-year-old, entire female English bull terrier was presented with a six-week history of intermittent facial swelling and nasal pain, following an incident of nasal trauma. A small opening was present at the mucocutaneous junction on the dorsal nasal planum. Examination under general anaesthesia allowed catheterisation of this opening and confirmed the presence of a tract passing caudally. Plain radiographic examination of the region was unremarkable. Positive contrast sinography demonstrated contrast material filling a midline tract that passed caudally and subcutaneously towards the nasal bone. This tract was surgically excised. Histopathological examination of the excised tissue, together with the clinical findings, led to the diagnosis of nasal dermoid sinus.

Rapid promotion and progression of fibrovascular polyps by inflammation and/or hyperplasia in hamster check pouch: implications for carcinogenesis assay.

PubMed

McGaughey, C; Jensen, J L

1983-03-01

Tumor initiation by topical application of 7,12-dimethylbenz[a]anthracene (DMBA) in dimethyl sulfoxide (DMSO) followed by topical application of retinyl acetate (RA), ethylphenylpropiolate, or acetic acid in DMSO at inflammatory and hyperplasiogenic dose regimens caused the rapid promotion of fibrovascular polyps with dysplastic epithelium in hamster cheek pouch. Such lesions did not occur in control animals initiated with DMBA followed by application of DMSO only, where inflammation was also minimal. At the dose regimen employed, RA caused obvious cytotoxicity and tissue destruction. With EPP and AA, there was no histological evidence of tissue destruction. At dose regimens resulting in minimal inflammation and no apparent cytotoxicity, RA promoted almost no polyps, but a higher yield of other tumor types. Thus, inflammation and/or hyperplasia apparently exerted a strong polyp-promoting and progressive influence. This and other differences between the tumorigenic responses of hamster-pouch mucosa and mouse skin suggest that the former supplement the latter in carcinogenic risk assessment.

Molecular features of colorectal hyperplastic polyps and sessile serrated adenoma/polyps from Korea.

PubMed

Kim, Kyoung-Mee; Lee, Eui Jin; Ha, Sangyun; Kang, So Young; Jang, Kee-Taek; Park, Cheol Keun; Kim, Jin Yong; Kim, Young Ho; Chang, Dong Kyung; Odze, Robert Daniel

2011-09-01

Abundant recent data suggest that sessile serrated adenoma/polyp (SSA/P) is an early precursor lesion in the serrated pathway of carcinogenesis. It is believed that SSA/Ps develop cancer by an SSA/P-dysplasia-carcinoma sequence. Hyperplastic polyps (HPs) share some histologic and molecular characteristics with SSA/P, but it is unclear whether SSA/Ps are derived from HPs or whether they develop by a different pathogenetic pathway. Previous studies have shown that serrated polyps from Korean patients show different prevalence rates of certain molecular abnormalities compared with similar lesions from American patients, and this suggests that lifestyle and dietary factors may influence the serrated neoplasia pathway. The purpose of this study was to evaluate the molecular features of HPs and SSA/Ps, the latter both with and without dysplasia, from Korean patients and to compare the findings with similar lesions from American patients. One hundred and eleven serrated polyps, consisting of 45 HPs (30 microvesicular, 11 goblet cell, 4 mucin depleted) and 56 SSA/Ps (36 with dysplasia, 20 without dysplasia), were retrieved from the pathology files of a large medical center in Korea and 38 SSA/P from American patients were evaluated for BRAF and KRAS mutations, microsatellite instability, and hypermethylation of O6-methylguanine-DNA methyltransferase (MGMT), hMLH1, adenomatous polyposis coli (APC), p16, methylated in tumor-1 (MINT-1), MINT2, and MINT31. Methylation of hMLH1 was performed using 2 different sets of primers. Twenty-three conventional adenomas from Korean patients were included as controls. The data were compared between polyp subtypes and between polyps in the right versus the left colon. With regard to HP, KRAS mutations were present in 31.1% of polyps and BRAF mutations in 46.7% of polyps. KRAS mutations were significantly more common in goblet cell HP and BRAF in microvesicular HP (MVHP). Methylation of MGMT, hMLH1, APC, p16, MINT1, MINT2, and MINT31 were

Phenotype and function of nasal dendritic cells

PubMed Central

Lee, Haekyung; Ruane, Darren; Law, Kenneth; Ho, Yan; Garg, Aakash; Rahman, Adeeb; Esterházy, Daria; Cheong, Cheolho; Goljo, Erden; Sikora, Andrew G.; Mucida, Daniel; Chen, Benjamin; Govindraj, Satish; Breton, Gaëlle; Mehandru, Saurabh

2015-01-01

Intranasal vaccination generates immunity across local, regional and distant sites. However, nasal dendritic cells (DC), pivotal for the induction of intranasal vaccine- induced immune responses, have not been studied in detail. Here, using a variety of parameters, we define nasal DCs in mice and humans. Distinct subsets of “classical” DCs, dependent on the transcription factor zbtb46 were identified in the murine nose. The murine nasal DCs were FLT3 ligand-responsive and displayed unique phenotypic and functional characteristics including the ability to present antigen, induce an allogeneic T cell response and migrate in response to LPS or live bacterial pathogens. Importantly, in a cohort of human volunteers, BDCA-1+ DCs were observed to be the dominant nasal DC population at steady state. During chronic inflammation, the frequency of both BDCA-1+ and BDCA-3hi DCs was reduced in the nasal tissue, associating the loss of these immune sentinels with chronic nasal inflammation. The present study is the first detailed description of the phenotypic, ontogenetic and functional properties of nasal DCs and will inform the design of preventative immunization strategies as well as therapeutic modalities against chronic rhinosinusitis. PMID:25669151

Association of Endotoxins and Colon Polyp: A Case-Control Study

PubMed Central

Lee, Kang-Kon

2012-01-01

Endotoxins are known to be associated with the occurrence of various chronic diseases. This study was conducted to investigate the role of endotoxins in the pathogenesis of colon polyps through a case-control study. A total of 145 subjects (74 subjects in the polyp group and 71 subjects in the control group) had undergone a colonoscopy. Age, body mass index (BMI) and endotoxin levels were found to be significantly higher in the polyp group than in the control group. The endotoxin level was still significantly higher in the polyp group than in the control group, even after age and BMI had been adjusted (polyp group 0.108 ± 0.007 EU/mL, control group 0.049 ± 0.008 EU/mL, P < 0.001). In subgroup analysis, the endotoxin level significantly increased in accordance with the number of colon polyps (one-polyp group, 0.088 ± 0.059 EU/mL; two-polyp group, 0.097 ± 0.071 EU/mL; three-or-more-polyp group, 0.149 ± 0.223 EU/mL). The endotoxin levels also significantly increased in groups with tubular adenoma with high-grade dysplasia (hyperplastic polyp group, 0.109 ± 0.121 EU/mL; tubular adenoma with low grade dysplasia group, 0.103 ± 0.059 EU/mL; tubular adenoma with high grade dysplasia group, 2.915 ± 0.072 EU/mL). In conclusion, the serum level of endotoxins is quantitatively correlated with colon polyps. PMID:22969253

Association between colonic polyps and diverticular disease

PubMed Central

Hirata, Tetsuo; Kawakami, Yuko; Kinjo, Nagisa; Arakaki, Susumu; Arakaki, Tetsu; Hokama, Akira; Kinjo, Fukunori; Fujita, Jiro

2008-01-01

AIM: To evaluate the association between colonic polyps and diverticular disease in Japan. METHODS: We retrospectively reviewed the medical records of 672 consecutive patients who underwent total colonoscopy between August 2006 and April 2007 at Nishinjo Hospital, Okinawa, Japan. Patients with a history of any of the following were excluded from the study: previous polypectomy, colonic resection, and inflammatory bowel diseases. The association between colonic polyps and diverticular disease was analyzed by logistic regression analysis, adjusted for age and sex. RESULTS: Prevalence of colonic polyps in all patients with diverticular disease was significantly higher than that in those without diverticular disease (adjusted odds ratio 1.7). CONCLUSION: Our data showed that patients with diverticular disease have a higher risk of colonic polyps compared to those without. PMID:18416471

Evaluation of eicosanoids in nasal lavage as biomarkers of inflammation in patients with allergic rhinitis

PubMed Central

Górski, Paweł; Antczak, Adam

2014-01-01

Introduction Cysteinyl leukotrienes (cys-LTs), 8-isoprostane and prostaglandin E2 (PGE2) constitute fundamental mediators in allergic inflammation; therefore we wanted to determine the utility of PGE2, 8-isoprostane and cys-LT levels in nasal lavage as biomarkers of allergic inflammation. Material and methods Twenty-one patients with allergic rhinitis (AR) were included on the basis of a positive history of AR symptoms and positive results of skin prick tests to grass pollen allergens. The main exclusion criteria were: uncontrolled asthma, nasal polyps, respiratory infection, tuberculosis, neoplastic and autoimmune diseases, current smoking and immunotherapy. Both outside the pollen season and at the height of the pollen season, total nasal symptom score (TNS-4) was evaluated and the levels of cys-LTs, 8-isoprostane and PGE2 were measured in nasal lavage fluid (NALF). Results Natural allergen stimulation resulted in a significant increase of TNS-4 (p < 0.001) and nasal eosinophilia (p < 0.001). The concentration of PGE2 dominated in the NALF outside the pollen season and decreased significantly at the height of natural exposure (p < 0.01). In contrast, lower baseline concentrations of cys-LTs and 8-isoprostane increased significantly upon allergen stimulation (p < 0.05). There was a significant correlation between mean concentration of PGE2 and eosinophil number in NALF (r = 0.67, p = 0.0439). Conclusions The NALF concentrations of cys-LTs and 8-isoprostane change simultaneously with TNS-4 and nasal eosinophilia. However, due to the lack of any significant correlation, their utility as markers of allergic rhinitis should be warily considered. The decrease of PGE2 concentration in NALF which correlated with nasal eosinophilia may participate in escalation of allergic inflammation and needs further evaluation. PMID:25624848

Nonneoplastic polypectomy during screening colonoscopy: the impact on polyp detection rate, adenoma detection rate, and overall cost.

PubMed

Atia, Mary A; Patel, Neal C; Ratuapli, Shiva K; Boroff, Erika S; Crowell, Michael D; Gurudu, Suryakanth R; Faigel, Douglas O; Leighton, Jonathan A; Ramirez, Francisco C

2015-08-01

The frequency of nonneoplastic polypectomy (NNP) and its impact on the polyp detection rate (PDR) is unknown. The correlation between NNP and adenoma detection rate (ADR) and its impact on the cost of colonoscopy has not been investigated. To determine the rate of NNP in screening colonoscopy, the impact of NNP on the PDR, and the correlation of NNP with ADR. The increased cost of NNP during screening colonoscopy also was calculated. We reviewed all screening colonoscopies. PDR and ADR were calculated. We then calculated a nonneoplastic polyp detection rate (patients with ≥1 nonneoplastic polyp). Tertiary-care referral center. Patients who underwent screening colonoscopies from 2010 to 2011. Colonoscopy. ADR, PDR, NNP rate. A total of 1797 colonoscopies were reviewed. Mean (±standard deviation) PDR was 47.7%±12.0%, and mean ADR was 27.3%±6.9%. The overall NNP rate was 10.4%±7.1%, with a range of 2.4% to 28.4%. Among all polypectomies (n=2061), 276 were for nonneoplastic polyps (13.4%). Endoscopists with a higher rate of nonneoplastic polyp detection were more likely to detect an adenoma (odds ratio 1.58; 95% confidence interval, 1.1-1.2). With one outlier excluded, there was a strong correlation between ADR and NNP (r=0.825; P<.001). The increased cost of removal of nonneoplastic polyps was $32,963. Retrospective study. There is a strong correlation between adenoma detection and nonneoplastic polyp detection. The etiology is unclear, but nonneoplastic polyp detection rate may inflate the PDR for some endoscopists. NNP also adds an increased cost. Increasing the awareness of endoscopic appearances through advanced imaging techniques of normal versus neoplastic tissue may be an area to improve cost containment in screening colonoscopy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria.

PubMed

Oluyemi, Aderemi; Awolola, Nicholas; Oyedeji, Olufemi

2016-01-01

Colorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria. This is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 -July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria. A total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis. The study supports the present wisdom that polyps are clearly less

Predictive factors of neoplastic gallbladder polyps: Outcomes of 278 patients.

PubMed

Terzioğlu, Serdar Gökay; Kılıç, Murat Özgür; Sapmaz, Ali; Karaca, Ahmet Serdar

2017-05-01

Distinguishing between neoplastic and nonneoplastic gallbladder polyps (GBPs) in the preoperative workup is of great importance for appropriate treatment. The present study aimed to investigate the characteristics of GBPs and to determine potential predictive factors of neoplastic polyps. The data of 278 patients who were confirmed to have GBPs through laparoscopic cholecystectomy were retrospectively analyzed. Polyps were classified as nonneoplastic and neoplastic GBPs, according to histopathological diagnoses. All clinicopathological characteristics were compared between these two groups. There were 264 (95%) nonneoplastic GBPs and 14 (5%) neoplastic GBPs. In univariate analysis, there were significant differences in age with a cutoff value of 60 years (p=0.002), polyp size (p<0.001), number of polyps (p=0.014), and polyp morphology (p<0.001) between the groups. Multivariate analysis showed that solitary polyp (p<0.001) and sessile morphology (p<0.001) were the independent predictors of neoplastic GBPs. Receiver-operating characteristic curve analysis of three cut-off values of polyp sizes (6, 10, and 15 mm) indicated that a polyp size of 10 mm had the highest area under curve (0.942). Age above 60 years, solitary polyps larger than 1 cm, and sessile morphology are associated with an increased risk of neoplasia in GBP. Therefore, these characteristics should be considered in the management of GBPs to reduce the incidence of unnecessary surgeries and to prevent delays in the treatment of a possible cancer.

Promoter methylation, mRNA expression of goat tumor‑associated genes and mRNA expression of DNA methyltransferase in enzootic nasal tumors.

PubMed

Quan, Zifang; Ye, Ni; Hao, Zhongxiang; Wen, Caifang; Liao, Hong; Zhang, Manli; Luo, Lu; Cao, Sanjie; Wen, Xintian; Wu, Rui; Yan, Qigui

2015-10-01

The aim of the present study was to investigate the promoter methylation status and mRNA expression of goat tumor‑associated genes, in addition to the mRNA expression of DNA methyltransferase genes in enzootic nasal tumors (ENT). Methylation‑specific polymerase chain reaction and SYBR Green reverse transcription‑quantitative polymerase chain reaction were used to detect the methylation status and the mRNA expression levels of DNA methyltransferases (DNMTs), O6‑methylguanine‑DNA methyltransferase (MGMT), the tumor suppressor genes P73, P53, GADD45G, CHFR and THBS1, the transcription factor CEBPA, the proto‑oncogenes KRAS, NRAS and C‑myc and EGFR in 24 nasal tumor tissue samples and 20 normal nasal epithelia tissue samples. The associations between promoter methylation and DNMT, and promoter methylation and mRNA expression of the genes were analyzed. The results indicated that the expression levels of DNMT1 increased by 56% compared with those in normal nasal epithelial tissues, while MGMT, DNMT3a and DNMT3b had similar expression levels in the two tissue types. The expression levels of P53 decreased by 36.8% and those of THBS1 by 43%, while C‑myc increased by 2.9‑fold and CEBPA by 2‑fold compared with that in normal nasal epithelial tissues. GADD45G, P73, CHFR and NRAS were observed to have similar expression levels in the two tissue types. However, no expression was observed for EGFR and KRAS. CHFR, GADD45G and THBS1 were identified to be methylated in tumor suppressor genes. The methylation expression rate of the CHFR gene was ~60% in the two tissue types and for THBS1 it was 100% in the nasal tumor tissues as opposed to 20% in the normal nasal epithelial tissues. The exhaustive methylation expression rate of GADD45G was 62.5% and the partial methylation expression rate was 37.5% in nasal tumor tissue, while no methylation was observed in normal nasal epithelial tissues. C‑myc was the only gene identified to be methylated amongst proto�

Evaluating success of curettage in the surgical treatment of endometrial polyps.

PubMed

Hafizi, Leili; Mousavifar, Nezhat; Zirak, Nahid; Khadem, Nayereh; Davarpanah, Sousan; Akhondi, Mohsen

2015-02-01

To determine treatment efficacy of curettage on endometrial polyp. The quasi-experimental pre-and-post study was conducted in 2011-12 at the gynaecology department of Imam Reza Hospital, Mashhad, Iran, and comprised patients who underwent hysteroscopy for endometrial polyp. Location, size, number and base condition of the polyps were recorded before the patient underwent curettage. Hysteroscopy was then performed and the condition of the remaining polyps was compared with initial findings. Also, the remaining polyps were resected. SPSS 13 was used for statistical analysis. There were 51 patients in the study with a mean age of 33.14 ± 8.19 years (range: 23-59 years)Besides, there were 82 polyps; 38(46.3%) having a narrow base, and 44(53.7%) having a wide base. The mean polyp size was 2.39 ± 2.63cm.After performing curettage, 23 (28.0%) polyps were removed completely, 39(47.6%) had size reduction, and 20(24.4%) had no change in size. Curettage could not significantly remove polyps (p < 0.001). Polyps smaller than 2cm were more likely to have been removed compared to the bigger ones (p = 0.003).Polyps with wide base were more significantly removed than those with narrow base (p < 0.001).Further, those with wide base and also smaller than 2 cm were removed more significantly than others (p < 0.001).The location of polyps had no effect on removal probability by curettage (p = 0.114). Curettage was not found to be a reliable method for endometrial polyp removal. If hysteroscopy is not accessible, the size of the polyp should be determined by vaginal sonograghy to estimate the probability of its removal by curettage.

Endoscopy and polyps-diagnostic and therapeutic advances in management

PubMed Central

Steele, Scott R; Johnson, Eric K; Champagne, Bradley; Davis, Brad; Lee, Sang; Rivadeneira, David; Ross, Howard; Hayden, Dana A; Maykel, Justin A

2013-01-01

Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options. PMID:23885138

Fibroepithelial polyp in a child.

PubMed

Mydlo, J; Reda, E; Gill, B; Kogan, S J; Ziprkowski, M N; Weiss, R; Levitt, S B

1988-04-01

Only 15 cases of fibroepithelial polyp in children have been reported in the world medical literature. Clinical differentiation between this tumor and a malignant ureteral tumor is difficult and often results in unnecessary nephrectomy. We report the sixteenth case of a child with fibroepithelial polyp of the ureter. The lesion was resected, and the kidney was preserved. Optimum treatment of this lesion mandates renal preservation in children. The rationale for this recommendation is explored.

Epidemiology of goblet cell and microvesicular hyperplastic polyps.

PubMed

Qazi, Taha M; O'Brien, Michael J; Farraye, Francis A; Gould, Ryan W; Chen, Clara A; Schroy, Paul C

2014-12-01

Serrated polyps compromise both typical hyperplastic polyps as well as sessile serrated adenomas and dysplastic serrated polyps. Hyperplastic polyps exhibit two histological patterns: microvesicular hyperplastic polyps (MVHPs) and goblet cell hyperplastic polyps (GCHPs). MVHPs and GCHPs differ in their molecular signature. MVHPs have been frequently found to have the BRAF(V600E) mutation as well as aberrant methylation. In contrast, GCHPs have been associated with the KRAS mutation (KRAS-mut), which are infrequently seen in dysplastic serrated sessile adenomas. The particular risk factors that are associated with development of the types of hyperplastic polyps have not been previously studied. The purpose of this study is to characterize the associations between particular risk factors and the development of goblet cell or microvesicular hyperplastic polyps. We conducted a cross-sectional analysis of 3,543 asymptomatic, mostly average risk patients 50 and 79 years of age undergoing open-access screening colonoscopy between March 2005 and January 2012. Each patient was given a survey regarding 25 reputed risk factors for colorectal neoplasia and the responses were correlated with findings at colonoscopy. Associations between putative risk factors for colorectal neoplasia and MVHPs and GSHPs were examined using multiple logistic regression. MVHPS and GCHPs were identified in 5.3% and 8.7% of patients, respectively. The results of the statistical analysis indicate that a history of smoking greater than 20 years is associated with an increased risk of MVHPs (P<0.005) and GCHPs (P<0.005). An elevated BMI >30 kg/m(2) was also associated with the presence of MVHP at colonoscopy (P<0.005). Blacks and Asians appear to be protected from the development of MVHPs. In contrast, there was a positive association with the presence of GCHP at colonoscopy in blacks. The study suggests that the development of the distinct histological types of hyperplastic polyps are associated with

Computer assisted optical biopsy for colorectal polyps

NASA Astrophysics Data System (ADS)

Navarro-Avila, Fernando J.; Saint-Hill-Febles, Yadira; Renner, Janis; Klare, Peter; von Delius, Stefan; Navab, Nassir; Mateus, Diana

2017-03-01

We propose a method for computer-assisted optical biopsy for colorectal polyps, with the final goal of assisting the medical expert during the colonoscopy. In particular, we target the problem of automatic classification of polyp images in two classes: adenomatous vs non-adenoma. Our approach is based on recent advancements in convolutional neural networks (CNN) for image representation. In the paper, we describe and compare four different methodologies to address the binary classification task: a baseline with classical features and a Random Forest classifier, two methods based on features obtained from a pre-trained network, and finally, the end-to-end training of a CNN. With the pre-trained network, we show the feasibility of transferring a feature extraction mechanism trained on millions of natural images, to the task of classifying adenomatous polyps. We then demonstrate further performance improvements when training the CNN for our specific classification task. In our study, 776 polyp images were acquired and histologically analyzed after polyp resection. We report a performance increase of the CNN-based approaches with respect to both, the conventional engineered features and to a state-of-the-art method based on videos and 3D shape features.

Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging.

PubMed

Choi, Ji-Hoon; Yun, Jung-Won; Kim, Yong-Sung; Lee, Eun-A; Hwang, Sang-Tae; Cho, Yong-Kyun; Kim, Hong-Joo; Park, Jung-Ho; Park, Dong-Il; Sohn, Chong-Il; Jeon, Woo-Kyu; Kim, Byung-Ik; Kim, Hyoung-Ook; Shin, Jun-Ho

2008-11-28

To determine the clinical data that might be useful for differentiating benign from malignant gallbladder (GB) polyps by comparing radiological methods, including abdominal ultrasonography (US) and computed tomography (CT) scanning, with postoperative pathology findings. Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 mm. They were divided into two groups, one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender, age, symptoms, size and number of polyps, the presence of a GB stone, the radiologically measured maximum diameter of the polyp by US and CT scanning, and the measurements of diameter from postoperative pathology were recorded for comparative analysis. Fifteen of the 41 cases with cholesterol polyps (36.6%) were detected with US but not CT scanning, whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group, the maximum measured diameter of the polyp was smaller by CT scan than by US. Consequently, the discrepancy between those two scanning measurements was greater than for the non-cholesterol polyp group. The clinical signs indicative of a cholesterol polyp include: (1) a polyp observed by US but not observable by CT scanning, (2) a smaller diameter on the CT scan compared to US, and (3) a discrepancy in its maximum diameter between US and CT measurements. In addition, US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology.

Antral hyperplastic polyp: A rare cause of gastric outlet obstruction

PubMed Central

Aydin, Ibrahim; Ozer, Ender; Rakici, Halil; Sehitoglu, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

2014-01-01

INTRODUCTION Gastric polyps are usually found incidentally during upper gastrointestinal endoscopic examinations. These polyps are generally benign, with hyperplasia being the most common. While gastric polyps are often asymptomatic, they can cause gastric outlet obstruction. PRESENTATION OF CASE A 64 years-old female patient presented to our polyclinic with a history of approximately 2 months of weakness, occasional early nausea, vomiting after meals and epigastric pain. A polypoid lesion of approximately 25 mm in diameter was detected in the antral area of the stomach, which prolapsed through the pylorus into the duodenal bulbus, and subsequently caused gastric outlet obstruction, as revealed by upper gastrointestinal endoscopy of the patient. The polyp was retrieved from the pyloric canal into the stomach with the aid of a tripod, and snare polypectomy was performed. DISCUSSION Currently, widespread use of endoscopy has led to an increase in the frequency of detecting hyperplastic polyps. While most gastric polyps are asymptomatic, they can cause iron deficiency anemia, acute pancreatitis and more commonly, gastric outlet obstruction because of their antral location. Although there are no precise principles in the treatment of asymptomatic polyps, polyps >5 mm should be removed due to the possibility of malignant transformation. CONCLUSION According to the medical evidence, polypectomy is required for gastric hyperplastic polyps because of the risks of complication and malignancy. These cases can be successfully treated endoscopically. PMID:24747755

Can endoscopic ultrasonography differentiate nonneoplastic from neoplastic gallbladder polyps?

PubMed

Akatsu, Tomotaka; Aiura, Koichi; Shimazu, Motohide; Ueda, Masakazu; Wakabayashi, Go; Tanabe, Minoru; Kawachi, Shigeyuki; Kitajima, Masaki

2006-02-01

The present study aimed to clarify the endoscopic ultrasonography (EUS) features of nonneoplastic (cholesterol polyps and adenomyomatosis) and neoplastic (adenoma and adenocarcinoma) gallbladder polyps and to evaluate the effectiveness and limitation of EUS in the differential diagnosis of these lesions. We retrospectively compared EUS images with histologic findings in 29 surgical cases with gallbladder polyps with a diameter of 10 to 20 mm. Those cases were indicated for surgery based on the findings of a sessile appearance, a solitary lesion, low echogenicity, and/or a lobulated surface. Six of 10 cholesterol polyps were atypically seen as partially or completely hypoechoic due to predominant proliferation of glandular epithelia. Nine of 10 cholesterol polyps demonstrated an aggregation of hyperechoic spots, which represented multiple granules of cholesterosis. All adenomyomatoses (n = 10) showed multiple microcysts, which corresponded to proliferated Rokitansky-Aschoff sinuses. However, three of nine neoplastic lesions (three adenomas and six adenocarcinomas) showed one of these signs due to concomitant cholesterosis (n = 2) or proliferated Rokitansky-Aschoff sinuses (n = 1). In conclusion, 69% (20/29) of gallbladder polyps larger than 10 mm that were preoperatively suspected of malignancy were nonneoplastic. An aggregation of hyperechoic spots and multiple microcysts are considered to be important predictive factors for cholesterol polyps and adenomyomatosis, respectively. However, we should caution that these findings can also occur in neoplastic polyps when they contain a concomitant nonneoplastic component (cholesterosis or proliferated Rokitansky-Aschoff sinuses).

Diagnostic accuracy of transabdominal ultrasonography for gallbladder polyps: systematic review.

PubMed

Martin, Erin; Gill, Richdeep; Debru, Estifanos

2018-06-01

Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients. We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions. Polyps were defined as immobile features that on transabdominal ultrasonography appear to arise from the mucosa and that lack an acoustic shadow, and pseudopolyps were defined as features such as inflammation, hyperplasia, cholesterolosis and adenomyomatosis that convey no risk of malignant transformation. The search returned 1816 articles, which were narrowed down to 14 primary sources involving 15 497 (range 23-13 703) patients who had preoperative transabdominal ultrasonography, underwent cholecystectomy and had postoperative pathology results available. Among the 1259 patients in whom a gallbladder polyp was diagnosed on ultrasonography, 188 polyps were confirmed as true polyps on pathologic examination, and 81 of these were found to be malignant. Of the 14 238 patients for whom a polyp was not seen on ultrasonography, 38 had a true polyp on pathologic examination, none of which were malignant. For true gallbladder polyps, transabdominal ultrasonography had a sensitivity of 83.1%, specificity of 96.3%, positive predictive value of 14.9% (7.0% for malignant polyps) and negative predictive value of 99.7%. Transabdominal ultrasonography has a high false-positive rate (85.1%) for the diagnosis of gallbladder polyps. Further study of alternative imaging modalities and reevaluation of existing management guidelines are warranted.

Natural history of diminutive colorectal polyps: long-term prospective observation by colonoscopy.

PubMed

Mizuno, Ken-Ichi; Suzuki, Yutaka; Takeuchi, Manabu; Kobayashi, Masaaki; Aoyagi, Yutaka

2014-04-01

Endoscopic removal of colorectal adenomatous polyps effectively prevents cancer. However, the treatment strategy for diminutive polyps (diameter ≤ 5 mm) remains controversial. Understanding the natural history of diminutive polyps is a prerequisite to their effective management. We prospectively examined the natural history of diminutive polyps by long-term surveillance colonoscopy. A total of 207 polyps detected in 112 patients from December 1991 through March 2002 were studied. To avoid potential effects on size and morphological characteristics, all polyps were selected randomly and were followed without biopsy. Polyp size was estimated by comparing the lesion with the diameter of a biopsy forceps. Mean follow up was 7.8 years (SD, 4.8; range, 1.0-18.6; median, 7.5; interquartile range 3.4-11.2). Twenty-four polyps were resected endoscopically, and the histopathological diagnosis was mucosal high-grade neoplasia (Category 4) for one polyp, and mucosal low-grade neoplasia (Category 3) for 23 polyps. Mean linear size of the polyps was 3.2 mm (SD, 1.0; range, 1.3-5.0) at initial colonoscopy and 3.8 mm (SD 1.6; range 1.3-10.0) at final colonoscopy (P<0.01). Left-sided polyps showed a higher growth rate than right-sided polyps, and a type IIIL2 pit pattern was associated with a lower growth rate than a type IIIL1 pattern. We clarified the natural history of diminutive polyps by long-term follow-up colonoscopy. The benign course of diminutive polyps should be considered in the design of treatment strategies. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

Differential release and deposition of S100A8/A9 proteins in inflamed upper airway tissue.

PubMed

Van Crombruggen, Koen; Vogl, Thomas; Pérez-Novo, Claudina; Holtappels, Gabriele; Bachert, Claus

2016-01-01

Intracellular Ca(2+)-binding S100A8/A9 proteins gain novel functions when released during inflammation. The exact outcome of their extracellular function depends on the local tissue environment in which they are released; both anti-inflammatory and pro-inflammatory responses are described, modulating the immune system by binding Toll-like receptor (TLR)-4 or the receptor for advanced glycation end-products (RAGE). However, the contribution of the proteins in the pathophysiology of chronic rhinosinusitis (CRS) remains unclear.Homomeric S100A8 and S100A9, and heteromeric S100A8/A9 proteins were evaluated in CRS with/without nasal polyps (CRSw/sNP) and controls. Functional responses were assessed in polyp tissue stimulated with S100 proteins in the presence of TLR-4 and RAGE blocking antibodies.S100A8, S100A9 and S100A8/A9 protein levels were significantly higher in CRSwNP patients, showing increased deposition on extracellular matrix (ECM) structures of CRSwNP tissue in contrast to CRSsNP and controls. In the presence of Staphylococcus aureus, S100A8/A9 is released from neutrophils and from the ECM. Extracellular S100A8 and S100A9 proteins induced increased levels of diverse inflammatory mediators via TLR-4 engagement.The inflammatory/remodelling characteristics of CRSwNP specifically allow increased retention of S100A8, S100A9 and S100A8/A9 proteins in the ECM of CRSwNP tissue. Upon release, homodimeric proteins act as a local danger signal inducing inflammatory mediators, predominantly via TLR-4 activation. Copyright ©ERS 2016.

Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging

PubMed Central

Choi, Ji-Hoon; Yun, Jung-Won; Kim, Yong-Sung; Lee, Eun-A; Hwang, Sang-Tae; Cho, Yong-Kyun; Kim, Hong-Joo; Park, Jung-Ho; Park, Dong-Il; Sohn, Chong-Il; Jeon, Woo-Kyu; Kim, Byung-Ik; Kim, Hyoung-Ook; Shin, Jun-Ho

2008-01-01

AIM: To determine the clinical data that might be useful for differentiating benign from malignant gallbladder (GB) polyps by comparing radiological methods, including abdominal ultrasonography (US) and computed tomography (CT) scanning, with postoperative pathology findings. METHODS: Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 mm. They were divided into two groups, one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender, age, symptoms, size and number of polyps, the presence of a GB stone, the radiologically measured maximum diameter of the polyp by US and CT scanning, and the measurements of diameter from postoperative pathology were recorded for comparative analysis. RESULTS: Fifteen of the 41 cases with cholesterol polyps (36.6%) were detected with US but not CT scanning, whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group, the maximum measured diameter of the polyp was smaller by CT scan than by US. Consequently, the discrepancy between those two scanning measurements was greater than for the non-cholesterol polyp group. CONCLUSION: The clinical signs indicative of a cholesterol polyp include: (1) a polyp observed by US but not observable by CT scanning, (2) a smaller diameter on the CT scan compared to US, and (3) a discrepancy in its maximum diameter between US and CT measurements. In addition, US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology. PMID:19058309

Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

PubMed

Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

2015-06-01

Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction

PubMed Central

Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

2015-01-01

Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)–associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy. PMID:25578789

Antral hyperplastic polyp: A rare cause of gastric outlet obstruction.

PubMed

Aydin, Ibrahim; Ozer, Ender; Rakici, Halil; Sehitoglu, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

2014-01-01

Gastric polyps are usually found incidentally during upper gastrointestinal endoscopic examinations. These polyps are generally benign, with hyperplasia being the most common. While gastric polyps are often asymptomatic, they can cause gastric outlet obstruction. A 64 years-old female patient presented to our polyclinic with a history of approximately 2 months of weakness, occasional early nausea, vomiting after meals and epigastric pain. A polypoid lesion of approximately 25mm in diameter was detected in the antral area of the stomach, which prolapsed through the pylorus into the duodenal bulbus, and subsequently caused gastric outlet obstruction, as revealed by upper gastrointestinal endoscopy of the patient. The polyp was retrieved from the pyloric canal into the stomach with the aid of a tripod, and snare polypectomy was performed. Currently, widespread use of endoscopy has led to an increase in the frequency of detecting hyperplastic polyps. While most gastric polyps are asymptomatic, they can cause iron deficiency anemia, acute pancreatitis and more commonly, gastric outlet obstruction because of their antral location. Although there are no precise principles in the treatment of asymptomatic polyps, polyps >5mm should be removed due to the possibility of malignant transformation. According to the medical evidence, polypectomy is required for gastric hyperplastic polyps because of the risks of complication and malignancy. These cases can be successfully treated endoscopically. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Crowdsourcing for identification of polyp-free segments in virtual colonoscopy videos

NASA Astrophysics Data System (ADS)

Park, Ji Hwan; Mirhosseini, Seyedkoosha; Nadeem, Saad; Marino, Joseph; Kaufman, Arie; Baker, Kevin; Barish, Matthew

2017-03-01

Virtual colonoscopy (VC) allows a physician to virtually navigate within a reconstructed 3D colon model searching for colorectal polyps. Though VC is widely recognized as a highly sensitive and specific test for identifying polyps, one limitation is the reading time, which can take over 30 minutes per patient. Large amounts of the colon are often devoid of polyps, and a way of identifying these polyp-free segments could be of valuable use in reducing the required reading time for the interrogating radiologist. To this end, we have tested the ability of the collective crowd intelligence of non-expert workers to identify polyp candidates and polyp-free regions. We presented twenty short videos flying through a segment of a virtual colon to each worker, and the crowd was asked to determine whether or not a possible polyp was observed within that video segment. We evaluated our framework on Amazon Mechanical Turk and found that the crowd was able to achieve a sensitivity of 80.0% and specificity of 86.5% in identifying video segments which contained a clinically proven polyp. Since each polyp appeared in multiple consecutive segments, all polyps were in fact identified. Using the crowd results as a first pass, 80% of the video segments could in theory be skipped by the radiologist, equating to a significant time savings and enabling more VC examinations to be performed.

Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review

PubMed Central

Petrini, Allison C.; Lekovich, Jovana P.; Elias, Rony T.; Spandorfer, Steven D.

2015-01-01

Endometrial polyps are benign localized lesions of the endometrium, which are commonly seen in women of reproductive age. Observational studies have suggested a detrimental effect of endometrial polyps on fertility. The natural course of endometrial polyps remains unclear. Expectant management of small and asymptomatic polyps is reasonable in many cases. However, surgical resection of endometrial polyps is recommended in infertile patients prior to treatment in order to increase natural conception or assisted reproductive pregnancy rates. There is mixed evidence regarding the resection of newly diagnosed endometrial polyps during ovarian stimulation to improve the outcomes of fresh in vitro fertilization cycles. Hysteroscopy polypectomy remains the gold standard for surgical treatment. Evidence regarding the cost and efficacy of different methods for hysteroscopic resection of endometrial polyps in the office and outpatient surgical settings has begun to emerge. PMID:26301260

Histological observations in the Hawaiian reef coral, Porites compressa, affected by Porites bleaching with tissue loss

USGS Publications Warehouse

Sudek, M.; Work, Thierry M.; Aeby, G.S.; Davy, S.K.

2012-01-01

The scleractinian finger coral Porites compressa is affected by the coral disease Porites bleaching with tissue loss (PBTL). This disease initially manifests as bleaching of the coenenchyme (tissue between polyps) while the polyps remain brown with eventual tissue loss and subsequent algal overgrowth of the bare skeleton. Histopathological investigation showed a loss of symbiont and melanin-containing granular cells which was more pronounced in the coenenchyme than the polyps. Cell counts confirmed a 65% reduction in symbiont density. Tissue loss was due to tissue fragmentation and necrosis in affected areas. In addition, a reduction in putative bacterial aggregate densities was found in diseased samples but no potential pathogens were observed.

Nasal dermoid sinus cysts in the dog.

PubMed

Anderson, Davina M; White, Richard A S

2002-01-01

To describe the clinical and morphologic characteristics of nasal dermoid sinus cysts in the dog. Retrospective clinical study. Six client-owned dogs. Medical records (1995 to 1999) of 6 dogs that had a discharging sinus in the midline of the nose removed surgically were reviewed for signalment, physical examination, surgical and histopathologic findings, and outcome. Three golden retrievers, 1 springer spaniel, 1 cocker spaniel, and 1 Brittany spaniel with a history of intermittent discharge from a small opening in the midline on the bridge of the nose at the junction between the nasal planum and the skin were identified. The condition was unresponsive to antibiotic therapy, and previous surgical excision had been unsuccessful in 3 dogs. None of the dogs had any other congenital defects, and all dogs responded to complete surgical excision of the tract and cyst. On histopathologic examination of excised tissue, there were adnexal structures along a tract lined with stratified squamous epithelium, consistent with a developmental abnormality of ectodermal tissue. The lesions were diagnosed as nasal dermoid sinus cysts, similar to the congenital condition described in humans. Nasal dermoid sinus cysts are rare developmental defects related to abnormal development of the pre-nasal space and may extend into the cranial vault causing cerebral abscesses or recurrent meningitis. Complete surgical excision has a good prognosis. This is a new condition that should be added to the surgical differential diagnosis for a discharging sinus over the external nares in dogs. Copyright 2002 by The American College of Veterinary Surgeons

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

PubMed Central

Komeda, Yoriaki; Kashida, Hiroshi; Sakurai, Toshiharu; Tribonias, George; Okamoto, Kazuki; Kono, Masashi; Yamada, Mitsunari; Adachi, Teppei; Mine, Hiromasa; Nagai, Tomoyuki; Asakuma, Yutaka; Hagiwara, Satoru; Matsui, Shigenaga; Watanabe, Tomohiro; Kitano, Masayuki; Chikugo, Takaaki; Chiba, Yasutaka; Kudo, Masatoshi

2017-01-01

AIM To compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps. METHODS This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn’t routinely performed. RESULTS Two hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2). CONCLUSION CSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required. PMID:28127206

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy.

PubMed

Komeda, Yoriaki; Kashida, Hiroshi; Sakurai, Toshiharu; Tribonias, George; Okamoto, Kazuki; Kono, Masashi; Yamada, Mitsunari; Adachi, Teppei; Mine, Hiromasa; Nagai, Tomoyuki; Asakuma, Yutaka; Hagiwara, Satoru; Matsui, Shigenaga; Watanabe, Tomohiro; Kitano, Masayuki; Chikugo, Takaaki; Chiba, Yasutaka; Kudo, Masatoshi

2017-01-14

To compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps. This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn't routinely performed. Two hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2). CSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required.

Nasal cavity ossifying fibrosarcoma: an unusual fibro-osseous neoplasm.

PubMed

Alameda, Yadiel A; Perez-Mitchell, Carlos; Busquets, José M

2010-11-01

We describe the case of a 65-year-old woman who presented with left nasal obstruction. Clinical and radiographic examinations revealed the presence of a soft-tissue mass that had obliterated the left nasal cavity. The mass was completely excised via an endoscopic approach. Histopathologic examination identified the tumor as an ossifying fibrosarcoma. The patient recovered uneventfully and remained free of disease at the 2-year postoperative follow-up. To the best of our knowledge, no case of an ossifying fibrosarcoma of the nasal cavity has been previously reported in the English-language literature. We discuss the features of this case and the clinical presentation, diagnosis, and management of fibrosarcomas of the nasal cavity and paranasal sinuses.

Evaluation of risk factors for the recurrence of colorectal polyps and colorectal cancer

PubMed

Ateş, Öztürk; Sivri, Bülent; Kılıçkap, Saadettin

2017-11-13

Background/aim: Colorectal adenomatous polyps are precursors of colorectal cancer (CRC), which can be prevented with surveillance colonoscopy. This study aimed to assess risk factors for the recurrence of colorectal polyps and CRC following polypectomy. Materials and methods: In this single-center trial, a total of 510 patients who applied to the endoscopy unit of Hacettepe University Hospital for various reasons and who were diagnosed with at least one colorectal adenomatous polyp between 2000 and 2010 were retrospectively analyzed. Patients with colorectal adenomatous polyps or CRC recurrences were examined in terms of clinical and histological risk factors. Results: A total of 190 (37.1%) patients had surveillance colonoscopy. Among them, 127 (66.3%) were found to have polyp recurrence. Of the parameters defined for polyp recurrence, no association was found between the number of polyps (1-2, ≥3) (1-3, ≥4) in the first colonoscopy and diabetes mellitus, hypertension, hyperlipidemia, sex, family history of colon malignancy, smoking, alcohol usage, size of polyp (<10 mm, ≥10 mm), or advanced histologic type of polyp. The only significant difference was observed in patients who had left-sided colon polyps. In the basal colonoscopy, 130 patients had been diagnosed with CRC, and a significant correlation was found between the number of polyps (1, ≥2) and polyp size (≥10 mm), anemia, high sedimentation rate (>25), and CRC. In the first surveillance colonoscopy, CRC was detected in 12 patients. There was a significant correlation between the development of CRC and advanced histological type, anemia with high erythrocyte sedimentation rate, polyp size (<10 mm, ≥10 mm), and the number of polyps (<3, ≥3). Conclusion: Patients with left-sided colon polyps had a high risk of developing colorectal polyp recurrence. Moreover, the risk of developing CRC increased in patients who had advanced histology, a polyp larger than 10 mm, or more than three polyps.

Polyp bailout in  Pocillopora damicornis following thermal stress.

PubMed

Fordyce, Alexander J; Camp, Emma F; Ainsworth, Tracy D

2017-01-01

Polyp bailout is an established but understudied coral stress response that involves the detachment of individual polyps from the colonial form as a means of escaping unfavourable conditions. This may influence both the mortality and asexual recruitment of coral genotypes across a range of species. It has been observed in response to numerous stressors including high salinity and low pH. Polyp expulsion in association with thermal stress has once been described in a geographically restricted, temperate species. We therefore cannot reliably apply this observation to tropical coral reefs around the world, which are increasingly under threat from thermal stress events. We present the first qualitative observation of polyp bailout following acute temperature shock  in a near-natural mesocosm experiment. Detached polyps show similar characteristics to those described in previous studies, including the retention of endosymbiotic zooxanthellae and the ability to disperse across short distances. This finding strongly suggests that polyp bailout occurs in tropical coral reef environments and warrants further detailed research into the implication of this response in terms of individual survival, rapid migration into cooler micro-habitats and local recruitment within the reef environment and its coral community.

Polyp bailout in  Pocillopora damicornis following thermal stress

PubMed Central

Fordyce, Alexander J; Camp, Emma F; Ainsworth, Tracy D

2017-01-01

Polyp bailout is an established but understudied coral stress response that involves the detachment of individual polyps from the colonial form as a means of escaping unfavourable conditions. This may influence both the mortality and asexual recruitment of coral genotypes across a range of species. It has been observed in response to numerous stressors including high salinity and low pH. Polyp expulsion in association with thermal stress has once been described in a geographically restricted, temperate species. We therefore cannot reliably apply this observation to tropical coral reefs around the world, which are increasingly under threat from thermal stress events. We present the first qualitative observation of polyp bailout following acute temperature shock  in a near-natural mesocosm experiment. Detached polyps show similar characteristics to those described in previous studies, including the retention of endosymbiotic zooxanthellae and the ability to disperse across short distances. This finding strongly suggests that polyp bailout occurs in tropical coral reef environments and warrants further detailed research into the implication of this response in terms of individual survival, rapid migration into cooler micro-habitats and local recruitment within the reef environment and its coral community. PMID:28928944

US characteristics for the prediction of neoplasm in gallbladder polyps 10 mm or larger.

PubMed

Kim, Jin Sil; Lee, Jeong Kyong; Kim, Yookyung; Lee, Sang Min

2016-04-01

To evaluate the characteristics of gallbladder polyps 10 mm or larger to predict a neoplasm in US examinations. Fifty-three patients with gallbladder polyps ≥ 10 mm with follow-up images or pathologic diagnosis were included in the retrospective study. All images and reports were reviewed to determine the imaging characteristics of gallbladder polyps. Univariate and multivariate analyses were used to evaluate predictors for a neoplastic polyp. A neoplastic polyp was verified in 12 of 53 patients and the mean size was 13.9 mm. The univariate analysis revealed that adjacent gallbladder wall thickening, larger size (≥15 mm), older age (≥57 years), absence of hyperechoic foci in a polyp, CT visibility, sessile shape, a solitary polyp, and an irregular surface were significant predictors for a neoplastic polyp. In the multivariate analysis, larger size (≥15 mm) was a significant predictor for a neoplastic polyp. A polyp size ≥15 mm was the strongest predictor for a neoplastic polyp with US. The hyperechoic foci in a polyp and CT visibility would be useful indicators for the differentiation of a neoplastic polyp, in addition to the established predictors. • A polyp size ≥15 mm is the strongest predictor for a neoplastic polyp with US. • Hyperechoic foci in a polyp and CT visibility are new predictors. • The rate of malignancy is low in polyps even 10 mm or larger (15.1 %).

Endometrial polyps in 2 African pygmy hedgehogs

PubMed Central

2005-01-01

Abstract Reports of spontaneously occurring endometrial polyps in animals are rare and have only involved a few species. This report is intended to advise veterinarians that older African pygmy hedgehogs may develop endometrial polyps and that these lesions can be a cause of bloody vaginal discharge, sometimes interpreted as hematuria. PMID:16048013

Diagnostic and Therapeutic Management of Nasal Airway Obstruction: Advances in Diagnosis and Treatment.

PubMed

Mohan, Suresh; Fuller, Jennifer C; Ford, Stephanie Friree; Lindsay, Robin W

2018-05-10

Nasal airway obstruction (NAO) is a common complaint in the otolaryngologist's office and can have a negative influence on quality of life (QOL). Existing diagnostic methods have improved, but little consensus exists on optimal tools. Furthermore, although surgical techniques for nasal obstruction continue to be developed, effective outcome measurement is lacking. An update of recent advances in diagnostic and therapeutic management of NAO is warranted. To review advances in diagnosis and treatment of NAO from the last 5 years. PubMed, Embase, CINAHL, the Cochrane Library, LILACS, Web of Science, and Guideline.gov were searched with the terms nasal obstruction and nasal blockage and their permutations from July 26, 2012, through October 23, 2017. Studies were included if they evaluated NAO using a subjective and an objective technique, and in the case of intervention-based studies, the Nasal Obstruction Symptom Evaluation (NOSE) scale and an objective technique. Exclusion criteria consisted of animal studies; patients younger than 14 years; nasal foreign bodies; nasal masses including polyps; choanal atresia; sinus disease; obstructive sleep apnea or sleep-disordered breathing; allergic rhinitis; and studies not specific to nasal obstruction. The initial search resulted in 942 articles. After independent screening by 2 investigators, 46 unique articles remained, including 2 randomized clinical trials, 3 systematic reviews, 3 meta-analyses, and 39 nonrandomized cohort studies (including a combined systematic review and meta-analysis). An aggregate of approximately 32 000 patients were reviewed (including meta-analyses). Of the subjective measures available for NAO, the NOSE scale is outstanding with regard to disease-specific validation and correlation with symptoms. No currently available objective measure can be considered a criterion standard. Structural measures of flow, pressure, and volume appear to be necessary but insufficient to assess NAO. Therefore

Assessment of colon polyp morphology: Is education effective?

PubMed Central

Kim, Jae Hyun; Nam, Kyoung Sik; Kwon, Hye Jung; Choi, Youn Jung; Jung, Kyoungwon; Kim, Sung Eun; Moon, Won; Park, Moo In; Park, Seun Ja

2017-01-01

AIM To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers. METHODS For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants. RESULTS The overall Fleiss’ kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels. CONCLUSION The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy. PMID:28974894

Assessment of colon polyp morphology: Is education effective?

PubMed

Kim, Jae Hyun; Nam, Kyoung Sik; Kwon, Hye Jung; Choi, Youn Jung; Jung, Kyoungwon; Kim, Sung Eun; Moon, Won; Park, Moo In; Park, Seun Ja

2017-09-14

To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers. For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants. The overall Fleiss' kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels. The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy.

Histological observations in the Hawaiian reef coral, Porites compressa, affected by Porites bleaching with tissue loss.

PubMed

Sudek, M; Work, T M; Aeby, G S; Davy, S K

2012-10-01

The scleractinian finger coral Porites compressa is affected by the coral disease Porites bleaching with tissue loss (PBTL). This disease initially manifests as bleaching of the coenenchyme (tissue between polyps) while the polyps remain brown with eventual tissue loss and subsequent algal overgrowth of the bare skeleton. Histopathological investigation showed a loss of symbiont and melanin-containing granular cells which was more pronounced in the coenenchyme than the polyps. Cell counts confirmed a 65% reduction in symbiont density. Tissue loss was due to tissue fragmentation and necrosis in affected areas. In addition, a reduction in putative bacterial aggregate densities was found in diseased samples but no potential pathogens were observed. Copyright © 2012 Elsevier Inc. All rights reserved.

The golden ratio of nasal width to nasal bone length.

PubMed

Goynumer, G; Yayla, M; Durukan, B; Wetherilt, L

2011-01-01

To calculate the ratio of fetal nasal width over nasal bone length at 14-39 weeks' gestation in Caucasian women. Fetal nasal bone length and nasal width at 14-39 weeks' gestation were measured in 532 normal fetuses. The mean and standard deviations of fetal nasal bone length, nasal width and their ratio to one another were calculated in normal fetuses according to the gestational age to establish normal values. A positive and linear correlation was detected between the nasal bone length and the gestational week, as between the nasal width and the gestational week. No linear growth pattern was found between the gestational week and the ratio of nasal width to nasal bone length, nearly equal to phi, throughout gestation. The ratio of nasal width to nasal bone length, approximately equal to phi, can be calculated at 14-38 weeks' gestation. This might be useful in evaluating fetal abnormalities.

Relation between obesity and adenomatous polyps of the large bowel.

PubMed

Sato, Yumi; Nozaki, Ryoichi; Yamada, Kazutaka; Takano, Masahiro; Haruma, Ken

2009-07-01

We compared the prevalence of colorectal adenoma (polyps) in men and women and examined the role of body mass index (BMI) on polyp risk according to patient age and gender. The risk of developing colorectal polyps was studied in 15 380 subjects (7155 men and 8225 women) who underwent colonoscopy for the first time from April 1998 to March 2006 at our 'Human Dry Dock', which is the check-up service provided in Japan. Eligible subjects were 20-86 years old (mean age +/- SD, 47.3 +/- 8.5) and were free of invasive cancer, hyperplastic polyps and familial polyposis. Polyps were found in 1590 subjects (1062 men and 528 women). The odds ratio (OR) of detection of polyps in relation to obesity was determined in all cases by multivariate logistic regression analysis after making an adjustment for gender and age. The OR of polyp detection in obese subjects (BMI >or= 25) versus non-obese subjects (BMI < 25, OR = 1) was 1.34 (P < 0.001) in men and 1.13 (P = 0.26) in women. As the BMI increased in increments of one, the OR in men increased significantly to 1.01 (P < 0.001), whereas the OR in women was unchanged at 1.00 (P = 0.23), which was without significance. We conclude that obesity in men is a risk factor for the development of polyps. These results must be confirmed by additional epidemiological studies.

Oculosporidial polyp infected secondarily by Enterobius vermicularis.

PubMed

Anuradha, S; Bharathi, K; Khalique, Abdul

2014-01-01

Oculosporidiosis caused by Rhinosporidium seeberi is a common infectious disease of south India. Here we are reporting a rare case of oculosporidial polyp containing another parasite Enterobius vermicularis as a co infection. This is the first report of its kind in literature. A nine year old school going girl from a rural area presented with a reddish polypoidal lesion from conjunctiva along with complaints of severe itching over it. On examination, the polyp measured 5 mm × 5 mm in size, reddish, granular with a tendency to bleed on touch. Her vision was normal. All the basic investigations were within normal limits. A differential diagnosis of conjunctival papilloma, foreign body granuloma and oculosporidiosis were considered clinically. The polyp was removed completely using electro cautery with healthy margins around the lesion. To our surprise histopathological examination of the swelling revealed the presence of two different parasites in the conjunctival polyp. Sections showed sporangia of Rhinosporidium seeberi, fragments of Enterobius vermicularis and its eggs. She was then treated with anti helminthic drugs. Two months of follow up till now showed no recurrence of the lesion.

Nasal rhinosporidiosis in a mule.

PubMed

Berrocal, Alexis; López, Alfonso

2007-03-01

A mass was removed from the nostril of a mule that exhibited unilateral epistaxis and nasal discharge. Impression smears revealed oval structures consistent with spores of Rhinosporidium seeberi. Microscopically, the mass was composed of fibrovascular granulomatous tissue containing sporangia R. seeberi. Surgical excision and antifungal treatment proved curative.

Serum Cytokine Profile in Patients with Chronic Rhinosinusitis with Nasal Polyposis Infected by Aspergillus flavus.

PubMed

Rai, Gargi; Ansari, Mohammad Ahmad; Dar, Sajad Ahmad; Datt, Shyama; Gupta, Neelima; Sharma, Sonal; Haque, Shafiul; Ramachandran, Vishnampettai Ganapathysubramanian; Mazumdar, Arpeeta; Rudramurthy, Shivprakash; Chakrabarti, Arunaloke; Das, Shukla

2018-03-01

Fungi, especially Aspergillus flavus, can cause chronic rhinosinusitis with nasal polyposis and modulate host innate immune components. The objective of this study was to examine the serum levels of T helper (Th) cell subset Th1, Th2, and Th17 cytokines and total IgE in patients having chronic rhinosinusitis with nasal polyposis and Aspergillus flavus infection. A case-control study including 40 patients with chronic rhinosinusitis with nasal polyposis and 20 healthy controls was conducted. Aspergillus flavus infection was confirmed by standard potassium hydroxide (KOH) testing, culture, and PCR. Serum samples of all patients and controls were analyzed for various cytokines (interleukins [IL]-1β, IL-2, IL-4, IL-6, IL-17, IL-21, IL-27, TGF-β) and total IgE by ELISA. Data from patients with Aspergillus flavus infection and healthy volunteers were compared using the independent t-test and non-parametric Mann-Whitney U test. Aspergillus flavus infection was found in 31 (77.5%) patients with chronic rhinosinusitis with nasal polyposis. IL-1β, IL-17, IL-21, and TGF-β serum levels were significantly higher in these patients than in controls; however, IL-2, IL-4, IL-6, and IL-27 levels were lower. Compared with nine (22.5%) patients without Aspergillus flavus infection, IL-17 level was higher while IL-2 level was lower in patients with Aspergillus flavus infection. Total IgE was significantly higher in patients with Aspergillus flavus infection than in controls. High levels of IL-17 and its regulatory cytokines in patients with chronic rhinosinusitis with nasal polyposis infected by Aspergillus flavus raise a concern about effective disease management and therapeutic recovery. Surgical removal of the nasal polyp being the chief management option, the choice of post-operative drugs may differ in eosinophilic vs. non-eosinophilic nasal polyposis. The prognosis is likely poor, warranting extended care. © The Korean Society for Laboratory Medicine

Gallbladder stones and gallbladder polyps associated with increased risk of colorectal adenoma in men.

PubMed

Liu, Yen-Ling; Wu, Jin-Shang; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Chih-Ting; Lin, Wan-Ju; Chang, Chih-Jen

2018-04-01

Most cases of colorectal cancer develop via an adenoma to carcinoma sequence. Gallbladder polyps share some risk factors with colorectal polyps. Little is known about the relationship between gallbladder diseases and different status of colorectal polyps by gender. This study was to investigate the association of gallbladder stones and polyps with colorectal adenomas by gender in a Taiwanese population. A total of 7066 eligible subjects who underwent a total colonoscopy as a part of health check-up between January 2001 and August 2009 were recruited. Colonoscopic findings were classified into polyp-free, non-neoplastic polyps and colorectal adenomas. Gallbladder stones and gallbladder polyps were diagnosed based on ultrasonographic findings. There was a significant difference in the status of colon polyps between subjects with and without gallbladder polyps. However, the status of colon polyps was not significantly different between subjects with or without gallbladder stones. After adjusting obesity, fasting plasma glucose, and other variables, there was a positive relationship between gallbladder polyps and colorectal adenomas (odds ratio [OR]: 1.396, 95% confidence interval [CI]: 1.115-1.747) but not non-neoplastic polyps in all subjects. In men, gallbladder polyps (OR: 1.560, 95% CI: 1.204-2.019) and gallbladder stones (OR: 1.465, 95% CI 1.081-1.984) were positively associated with colorectal adenomas. In women, neither gallbladder polyps nor gallbladder stones were significantly related to colon polyps. Both gallbladder polyps and gallbladder stones were associated with an increased risk of colorectal adenomas in men but not in women. Gender difference was significant for the association between gallbladder lesions and colorectal polyps. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Clinicopathological features colon polyps from African-Americans

PubMed Central

Nouraie, Mehdi; Hosseinkhah, Fatemeh; Zamanifekri, Behrouz; Hamond, Issa W.; Ashktorab, Hassan

2013-01-01

Background & Aims Among the ethnic groups age standardized incidence rate of colorectal cancer (CRC) is highest among African-Americans. The majority of CRC arise from preexisting adenoma. It is shown that 30% of the US adult population has adenomas. The potential risk of malignant transformation in adenomas differs by specific pathologic and clinical characteristics that we aimed to study in AAs. Material and Methods All pathologic reports (150,000) in Howard University Hospital from 1959 to 2006 were reviewed manually. Those pathology reports compatible with the colorectal polyps were carefully reviewed and selected by a GI pathologist. All cases with cancer then excluded from the list. Data then were entered into excel and checked for missing data and duplications. Differences in right side and left side polyps for sex, histology, clinical symptoms were assessed by chi-2 test. Results A total number of 5013 colorectal polyps were diagnosed in this period that include 47% male, with mean age (SD) of 63 (12). Half of cases were diagnosed in 2001–2006. Tubular adenoma was the most frequent pathology (73%). The highest frequency of right sided polyps was observed in 1990’s (56%). Left sided polyps were younger (P<0.000), more hyperplasic (23% vs. 5%; P<0.000) and more frequent in female (56% vs. 52%; P=0.02) compared to right sided. The frequency of right sided adenoma significantly increases from 18% in 60’s to 51% in the period of 2001–2006 (P<0.000). The most frequent symptom in both sides was GI bleeding (21%). Conclusion There was a ratio of 9:1 for neoplastic to hyperplastic polyps in our study which is more than what has been reported in Caucasians (7:1). Our data shows a shift in polyps from the left side to the right side of the colon in recent years. This data is consistent with the lack of a reduction in the incidence of colon cancer in African Americans. Screening is thus very important in AA to reduce the incidence of colon cancer. PMID:20225129

Fabrication of custom PCL scaffold for nasal septal perforation repair

NASA Astrophysics Data System (ADS)

Gadaleta, Dominick; Lee, Daniel Z.; Peng, Matthew W.; Cruickshank, Nicholas; Shinde, Rohit; Hong, Abigail; Pennacchi, Sara; Dawit, Abel; Krein, Howard; Udupa, Jayaram K.; Rajapakse, Chamith S.

2018-03-01

Nasal septal perforations (NSPs) are relatively common. They can be problematic for both patients and head and neck reconstructive surgeons who attempt to repair them. Often, this repair is made using an interpositional graft sandwiched between bilateral mucoperichondrial advancement flaps. The ideal graft is nasal septal cartilage. However, many patients with NSP lack sufficient septal cartilage to harvest. Harvesting other sources of autologous cartilage grafts, such as auricular cartilage, adds morbidity to the surgical case and results in a graft that lacks the ideal qualities required to repair the nasal septum. Tissue engineering has allowed for new reconstructive protocols to be developed. Currently, the authors are unaware of any new literature that looks to improve repair of NSP using custom tissue-engineered cartilage grafts. The first step of this process involves developing a protocol to print the graft from a patient's pre-operative CT. In this study, CT scans were converted into STereoLithography (STL) file format. The subsequent STL files were transformed into 3D printable G-Code using the Slic3r software. This allowed us to customize the parameters of our print and we were able to choose a layer thickness of 0.1mm. A desktop 3D bioprinter (BioBot 1) was then used to construct the scaffold. This method resulted in the production of a PCL scaffold that precisely matched the patient's nasal septal defect, in both size and shape. This serves as the first step in our goal to create patient-specific tissue engineered nasal septal cartilage grafts for NSP repair.

Orbito-nasal cyst in a young European short-haired cat.

PubMed

Zemljič, Tadej; Matheis, Franziska L; Venzin, Claudio; Makara, Mariano; Grest, Paula; Spiess, Bernhard M; Pot, Simon A

2011-09-01

To describe a case of an orbito-nasal cyst in a cat. An 18-month-old male European short-haired cat was presented to the Ophthalmology service of the Vetsuisse Faculty, University of Zurich for a subcutaneous swelling in the medial canthal region of the right eye (OD). Ophthalmologic, ultrasound and CT examinations, and fine needle aspiration were performed. After lesion excision, the removed tissue was submitted for histopathology. CT examination was repeated 5 months after removal of the cyst. Ophthalmologic examination revealed a large fluctuant swelling inferonasal to OD. Despite patent lacrimal puncta, only the first few mm of the lacrimal canaliculi could be cannulated. A normal globe with moderate enophthalmos was present. Ultrasound examination showed a well-defined lobulated cyst-like structure in the right orbit, inferonasal and anterior to the eye. CT examination revealed extension of this lesion through the medial orbital wall into the right nasal cavity. Fine needle aspiration confirmed the cystic nature of the lesion. An orbito-nasal cyst was diagnosed. The orbital part of the cyst was dissected from the surrounding tissue and excised from the periosteum in the medial orbital wall defect. Part of the maxillary bone was removed to allow removal of the cyst from the nasal cavity. Histologically, the cyst wall consisted of a single to multilayered, mostly cuboidal epithelium and surrounding connective tissue. Follow-up revealed a good functional result and no recurrence 7 months after cyst removal. Similar orbito-nasal cystic structures were reported in dogs but not in cats. © 2011 American College of Veterinary Ophthalmologists.

Comparison of Nasal Acceleration and Nasalance across Vowels

ERIC Educational Resources Information Center

Thorp, Elias B.; Virnik, Boris T.; Stepp, Cara E.

2013-01-01

Purpose: The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Method: Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using…

Prevalence of endometrial polyps coexisting with uterine fibroids and associated factors

PubMed Central

Kınay, Tuğba; Öztürk Başarır, Zehra; Fırtına Tuncer, Serap; Akpınar, Funda; Kayıkçıoğlu, Fulya; Koç, Sevgi

2016-01-01

Objective: The aim of the study was to investigate the prevalence of endometrial polyps in patients with uterine fibroids and associated factors of coexistence of these two pathologies. Materials and Methods: The medical records of 772 patients who underwent hysterectomy because of uterine fibroids were retrospectively reviewed. Patients were divided into two groups according to the presence of endometrial polyps in the histopathologic examination. Demographic, clinical and histopathologic findings of the patients with and without endometrial polyps were compared. Student’s t-test, Mann-Whitney U test, Pearson’s Chi-square test, and logistic regression analysis were used for statistical analysis. Results: The prevalence of the endometrial polyps in uterine fibroid cases was found 20.1% (n=155). Age ≥45 years (odds ratio [OR] 1.61; 95% confidence interval [CI]: [1.06-2.44]; p=0.014), presence of hypertension (23.9% vs. 17.5%; p=0.047), endometrial hyperplasia (OR 4.00; 95% CI: [1.92-8.33]; p<0.001) and cervical polyps (OR 3.13; 95% CI: [1.69-5.88]; p<0.001) were significantly associated with the coexistence of endometrial polyps and uterine fibroids. Endometrial polyps were more common in patients with ≥2 fibroids (p=0.023) and largest fibroid <8 cm (p=0.009). A negative correlation was found between condom use and endometrial polyps (8.1% vs. 3.9%; p=0.044). Conclusions: The prevalence of the endometrial polyps coexisting with uterine fibroids was 20.1%. Age, hypertension, endometrial hyperplasia, cervical polyps, and number of fibroids were positively correlated; condom use and size of largest fibroid were negatively correlated with the coexistence of these two pathologies. PMID:28913086

Anatomy of nasal complex in the southern right whale, Eubalaena australis (Cetacea, Mysticeti).

PubMed

Buono, Mónica R; Fernández, Marta S; Fordyce, R Ewan; Reidenberg, Joy S

2015-01-01

The nasal region of the skull has undergone dramatic changes during the course of cetacean evolution. In particular, mysticetes (baleen whales) conserve the nasal mammalian pattern associated with the secondary function of olfaction, and lack the sound-producing specializations present in odontocetes (toothed whales, dolphins and porpoises). To improve our understanding of the morphology of the nasal region of mysticetes, we investigate the nasal anatomy, osteology and myology of the southern right whale, Eubalaena australis, and make comparisons with other mysticetes. In E. australis external deflection surfaces around the blowholes appear to divert water off the head, and differ in appearance from those observed in balaenopterids, eschrichtiids and cetotherids. In E. australis the blowholes are placed above hypertrophied nasal soft tissues formed by fat and nasal muscles, a pattern also observed in balaenopterids (rorqual mysticetes) and a cetotherid (pygmy right whale, Caperea marginata). Blowhole movements are due to the action of five nasofacial muscles: dilator naris superficialis, dilator naris profundus, depressor alae nasi, constrictor naris, and retractor alae nasi. The dilator naris profundus found in E. australis has not been previously reported in balaenopterids. The other nasofacial muscles have a similar arrangement in balaenopterids, with minor differences. A novel structure, not reported previously in any mysticete, is the presence of a vascular tissue (rete mirabile) covering the lower nasal passage. This vascular tissue could play a role in warming inspired air, or may engorge to accommodate loss of respiratory space volume due to gas compression from increased pressure during diving. © 2014 Anatomical Society.

Anatomy of nasal complex in the southern right whale, Eubalaena australis (Cetacea, Mysticeti)

PubMed Central

Buono, Mónica R; Fernández, Marta S; Fordyce, R Ewan; Reidenberg, Joy S

2015-01-01

The nasal region of the skull has undergone dramatic changes during the course of cetacean evolution. In particular, mysticetes (baleen whales) conserve the nasal mammalian pattern associated with the secondary function of olfaction, and lack the sound-producing specializations present in odontocetes (toothed whales, dolphins and porpoises). To improve our understanding of the morphology of the nasal region of mysticetes, we investigate the nasal anatomy, osteology and myology of the southern right whale, Eubalaena australis, and make comparisons with other mysticetes. In E. australis external deflection surfaces around the blowholes appear to divert water off the head, and differ in appearance from those observed in balaenopterids, eschrichtiids and cetotherids. In E. australis the blowholes are placed above hypertrophied nasal soft tissues formed by fat and nasal muscles, a pattern also observed in balaenopterids (rorqual mysticetes) and a cetotherid (pygmy right whale, Caperea marginata). Blowhole movements are due to the action of five nasofacial muscles: dilator naris superficialis, dilator naris profundus, depressor alae nasi, constrictor naris, and retractor alae nasi. The dilator naris profundus found in E. australis has not been previously reported in balaenopterids. The other nasofacial muscles have a similar arrangement in balaenopterids, with minor differences. A novel structure, not reported previously in any mysticete, is the presence of a vascular tissue (rete mirabile) covering the lower nasal passage. This vascular tissue could play a role in warming inspired air, or may engorge to accommodate loss of respiratory space volume due to gas compression from increased pressure during diving. PMID:25440939

Effect of hydration treatments on laryngeal nodules and polyps and related voice measures.

PubMed

Verdolini-Marston, K; Sandage, M; Titze, I R

1994-03-01

In this study, a double-blind, placebo-controlled approach was used in assessing the effectiveness of hydration treatments in the clinical management of selected voice disorders. Six adult female patients with laryngeal nodules or polyps each received 5 consecutive days of hydration treatment and 5 consecutive days of placebo/control treatment. The combined results indicated improvements in voice and in laryngeal appearance following both placebo/control and hydration treatments as compared with baseline. However, the greatest improvements were obtained following the hydration treatment. Although caution about generalization of the effects to the typical clinical situation is emphasized, the study provides preliminary evidence of a therapeutic benefit from hydration treatments in patients with nodules or polyps. Based on previous theoretical work, hydration effects may be related to reductions in the viscosity of vocal fold tissue, although other explanations are also possible.

Nasal deposition of ciclesonide nasal aerosol and mometasone aqueous nasal spray in allergic rhinitis patients.

PubMed

Emanuel, Ivor A; Blaiss, Michael S; Meltzer, Eli O; Evans, Philip; Connor, Alyson

2014-01-01

Sensory attributes of intranasal corticosteroids, such as rundown to the back of the throat, may influence patient treatment preferences. This study compares the nasal deposition and nasal retention of a radiolabeled solution of ciclesonide nasal aerosol (CIC-hydrofluoroalkane [HFA]) with a radiolabeled suspension of mometasone furoate monohydrate aqueous nasal spray (MFNS) in subjects with either perennial allergic rhinitis (AR) or seasonal AR. In this open-label, single-dose, randomized, crossover scintigraphy study, 14 subjects with symptomatic AR received a single dose of radiolabeled 74-μg CIC-HFA (37 μg/spray, 1 spray/each nostril) via a nasal metered-dose inhaler or a single dose of radiolabeled 200-μg MFNS (50 μg/spray, 2 sprays/each nostril), with a minimum 5-day washout period between treatments. Initial deposition (2 minutes postdose) of radiolabeled CIC-HFA and MFNS in the nasal cavity, nasopharynx, and on nasal wipes, and retention of radioactivity in the nasal cavity and nasal run-out on nasal wipes at 2, 4, 6, 8, and 10 minutes postdose were quantified with scintigraphy. At 2 and 10 minutes postdose, deposition of radiolabeled CIC-HFA was significantly higher in the nasal cavity versus radiolabeled MFNS (99.42% versus 86.50% at 2 minutes, p = 0.0046; and 81.10% versus 54.31% at 10 minutes, p < 0.0001, respectively; p values unadjusted for multiplicity). Deposition of radioactivity on nasal wipes was significantly higher with MFNS versus CIC-HFA at all five time points, and posterior losses of radiolabeled formulation were significantly higher with MFNS at 6, 8, and 10 minutes postdose. In this scintigraphic study, significantly higher nasal deposition and retention of radiolabeled aerosol CIC-HFA were observed versus radiolabeled aqueous MFNS in subjects with AR.

Accurate Classification of Diminutive Colorectal Polyps Using Computer-Aided Analysis.

PubMed

Chen, Peng-Jen; Lin, Meng-Chiung; Lai, Mei-Ju; Lin, Jung-Chun; Lu, Henry Horng-Shing; Tseng, Vincent S

2018-02-01

Narrow-band imaging is an image-enhanced form of endoscopy used to observed microstructures and capillaries of the mucosal epithelium which allows for real-time prediction of histologic features of colorectal polyps. However, narrow-band imaging expertise is required to differentiate hyperplastic from neoplastic polyps with high levels of accuracy. We developed and tested a system of computer-aided diagnosis with a deep neural network (DNN-CAD) to analyze narrow-band images of diminutive colorectal polyps. We collected 1476 images of neoplastic polyps and 681 images of hyperplastic polyps, obtained from the picture archiving and communications system database in a tertiary hospital in Taiwan. Histologic findings from the polyps were also collected and used as the reference standard. The images and data were used to train the DNN. A test set of images (96 hyperplastic and 188 neoplastic polyps, smaller than 5 mm), obtained from patients who underwent colonoscopies from March 2017 through August 2017, was then used to test the diagnostic ability of the DNN-CAD vs endoscopists (2 expert and 4 novice), who were asked to classify the images of the test set as neoplastic or hyperplastic. Their classifications were compared with findings from histologic analysis. The primary outcome measures were diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic time. The accuracy, sensitivity, specificity, PPV, NPV, and diagnostic time were compared among DNN-CAD, the novice endoscopists, and the expert endoscopists. The study was designed to detect a difference of 10% in accuracy by a 2-sided McNemar test. In the test set, the DNN-CAD identified neoplastic or hyperplastic polyps with 96.3% sensitivity, 78.1% specificity, a PPV of 89.6%, and a NPV of 91.5%. Fewer than half of the novice endoscopists classified polyps with a NPV of 90% (their NPVs ranged from 73.9% to 84.0%). DNN-CAD classified polyps as

Computed tomography as an aid in the diagnosis of chronic nasal disease in dogs.

PubMed

Lefebvre, J; Kuehn, N F; Wortinger, A

2005-06-01

To assess the use of computed tomography (CT) in the diagnosis of chronic nasal disease in dogs. A retrospective study of 85 dogs with chronic nasal discharge due to primary nasal disease, which had undergone nasal CT and biopsy, was carried out. Medical records were reviewed for signalment, clinical signs, CT findings, endoscopic findings and histopathology. The results obtained via CT were correlated with nasal histopathology and gross anatomical observations were recorded at the time of rhinoscopy. Neoplasia was diagnosed in 37 dogs for which CT typically revealed a soft tissue density associated with extensive turbinate destruction. Inflammatory rhinitis was diagnosed in 40 dogs. CT disclosed either normal turbinate structures or mild to moderate turbinate destruction, with or without the presence of soft tissue densities (mucopus) within the nasal passages. Fungal rhinitis was diagnosed in seven dogs for which CT disclosed extensive turbinate destruction with hyperlucency of the nasal passages. One dog had normal CT and histopathology findings. CT greatly enhanced the ability to diagnose chronic nasal disease in dogs, providing detailed Information regarding the extent of the disease, accurate discrimination of neoplastic versus non-neoplastic diseases, and identification of areas of the nose to examine rhinoscopically and suspicious regions to target for biopsy.

Serrated Colon Polyps as Precursors to Colorectal Cancer

PubMed Central

Sweetser, Seth; Smyrk, Thomas C.; Sinicrope, Frank A.

2013-01-01

Identification of the serrated neoplasia pathway has improved our understanding of the pathogenesis of colorectal cancer (CRC). Insights have included an increased recognition of the malignant potential of different types of serrated polyps, such as sessile and traditional serrated adenomas. Sessile serrated adenomas share molecular features with colon tumors, such as microsatellite instability and a methylator phenotype, indicating that these lesions are precursors that progress via the serrated neoplasia pathway. There is evidence that the serrated pathway contributes to interval or missed cancers. These data have important implications for clinical practice and CRC prevention, since hyperplastic polyps were previously regarded as having no malignant potential. Endoscopic detection of serrated polyps is a challenge because they are often inconspicuous with indistinct margins, and are frequently covered by adherent mucus. It is important for gastroenterologists to recognize the subtle endoscopic features of serrated polyps, which would facilitate their detection and removal, to ensure a high-quality colonoscopy examination. Recognition of the role of serrated polyps in colon carcinogenesis has led to the inclusion of these lesions in post-polypectomy surveillance guidelines. However, an enhanced effort is needed to identify and completely remove serrated adenomas, with the goal of increasing the effectiveness of colonoscopy to reduce CRC incidence. PMID:23267866

Linked color imaging improves the visibility of colorectal polyps: a video study

PubMed Central

Yoshida, Naohisa; Naito, Yuji; Murakami, Takaaki; Hirose, Ryohei; Ogiso, Kiyoshi; Inada, Yutaka; Dohi, Osamu; Kamada, Kazuhiro; Uchiyama, Kazuhiko; Handa, Osamu; Konishi, Hideyuki; Siah, Kewin Tien Ho; Yagi, Nobuaki; Fujita, Yasuko; Kishimoto, Mitsuo; Yanagisawa, Akio; Itoh, Yoshito

2017-01-01

Background/study aim  Linked color imaging (LCI) by a laser endoscope (Fujifilm Co, Tokyo, Japan) is a novel narrow band light observation. In this study, we aimed to investigate whether LCI could improve the visibility of colorectal polyps using endoscopic videos. Patients and methods  We prospectively recorded videos of consecutive polyps 2 – 20 mm in size diagnosed as neoplastic polyps. Three videos, white light (WL), blue laser imaging (BLI)-bright, and LCI, were recorded for each polyp by one expert. After excluding inappropriate videos, all videos were evaluated in random order by two experts and two non-experts according to a published polyp visibility score from four (excellent visibility) to one (poor visibility). Additionally, the relationship between polyp visibility scores in LCI and various clinical characteristics including location, size, histology, morphology, and preparation were analyzed compared to WL and BLI-bright. Results  We analyzed 101 colorectal polyps (94 neoplastic) in 66 patients (303 videos). The mean polyp size was 9.0 ± 8.1 mm and 54 polyps were non-polypoid. The mean polyp visibility scores for LCI (2.86 ± 1.08) were significantly higher than for WL and BLI-bright (2.53 ± 1.15, P  < 0.001; 2.73 ± 1.47, P  < 0.041). The ratio of poor visibility (score 1 and 2) was significantly lower in LCI for experts and non-experts (35.6 %, 33.6 %) compared with WL (49.6 %, P  = 0.015, 50.5 %, P  = 0.046). The polyp visibility scores for LCI were significantly higher than those for WL for all of the factors. With respect to the comparison between BLI-bright and WL, the polyp visibility scores for BLI-bright were not higher than WL for right-sided location, < 10 mm size, sessile serrated adenoma and polyp histology, and poor preparation. For those characteristics, LCI improved the lesions with right-sided location, SSA/P histology, and poor preparation significantly better than BLI

Surgical Approaches to the Nasal Cavity and Sinuses.

PubMed

Weeden, Alyssa Marie; Degner, Daniel Alvin

2016-07-01

The nasal cavity and sinuses may be exposed primarily via a dorsal or ventral surgical approach. Surgical planning involves the use of advanced imaging, such as computed tomography or MRI. Surgical treatment of lesions of the nasal cavity usually is limited to benign lesions or can also be used in combination with adjunctive therapy, such as radiation therapy. Extreme caution must be exercised with a dorsal approach to the nasal cavity to avoid complications of inadvertent penetration into the brain case. Gentle tissue handling and careful closure of the mucoperiosteum must be exercised following a ventral approach to minimize the risk of oronasal fistula formation. Copyright © 2016 Elsevier Inc. All rights reserved.

An analysis-by-synthesis approach to the estimation of vocal cord polyp features.

PubMed

Koizumi, T; Taniguchi, S; Itakura, F

1993-09-01

This paper deals with a new noninvasive method of estimating vocal cord polyp features through hoarse-voice analysis. A noteworthy feature of this method is that it enables us not only to discriminate hoarse voices caused by pathological vocal cords with a single golf-ball-like polyp from normal voices, but also to estimate polyp features such as the mass and dimension of polyp through the use of a novel model of pathological vocal cords which has been devised to simulate the subtle movement of the vocal cords. A synthetic hoarse voice produced with a hoarse-voice synthesizer is compared with a natural hoarse voice caused by the vocal cord polyp in terms of a distance measure and the polyp features are estimated by minimizing the distance measure. Some estimates of polyp dimension that have been obtained by applying this procedure to hoarse voices are found to compare favorably with actual polyp dimensions, demonstrating that the procedure is effective for estimating the features of golf-ball-like vocal cord polyps.

[Ultrastructural characteristics of mast cells and eosinophils in nasal inverted papilloma].

PubMed

Yokoshima, K; Ohnishi, M; Okuda, M; Okubo, K

1994-12-01

We previously found that an increased number of mast cells and eosinophils accumulated in nasal inverted papilloma and in the nasal mucosa of allergic subjects. Two subtypes of mast cells, i.e., mucosal mast cells and connective tissue mast cells are known to be present in the allergic nasal mucosa. Eosinophils in the allergic nasal mucosa are also heterogeneous. In addition, we demonstrated accumulation of formalin-sensitive mast cells at the tumor site of nasal inverted papilloma. The morphological characteristics and function of mast cells and eosinophils, however, have not yet been identified. The purpose of this study was to determine the ultrastructural characteristics of mast cells and eosinophils in relation to their function in tumor tissue. The results revealed two subtypes of mast cells in nasal inverted papilloma, one distributed mainly in the tumor site, the other mainly in the stromal site. These two subtypes of mast cells had different ultrastructural characteristics. In contrast to stromal mast cells, mast cells in the tumor site were characterized by a smaller cell diameter, fewer specific granules and a higher rate of degranulation. This suggested that they may have played some role in the pathogenesis of the tumor, however, their precise function is still unknown. In comparison with the mast cells in the allergic nasal mucosa, previously reported by Okuda et al, the mast cells in the tumor site were similar to those in the epithelial layer of the allergic nasal mucosa (MMCs), while mast cells in the stromal site resembled those in the lamina propria (CTMCs). There were no marked morphological differences between eosinophils in the tumor site and the stromal site.(ABSTRACT TRUNCATED AT 250 WORDS)

An umbilical polyp in an infant.

PubMed

Swanson, David L; Pakzad, Betty

2005-10-01

The persistence at birth of the omphalomesenteric (vitelline) duct may result in life-threatening consequences. Early identification of this congenital anomaly is essential for prompt surgical treatment to eliminate the risk of prolapse and herniation. A neonatal umbilical polyp may indicate the presence of an omphalomesenteric duct remnant. We describe the diagnosis and surgical treatment of an infant with an umbilical polyp. We also present an overview of the diagnosis and treatment of vitelline duct remnants and their associated anomalies.

Oculosporidial polyp infected secondarily by Enterobius vermicularis

PubMed Central

Anuradha, S.; Bharathi, K.; Khalique, Abdul

2014-01-01

Oculosporidiosis caused by Rhinosporidium seeberi is a common infectious disease of south India. Here we are reporting a rare case of oculosporidial polyp containing another parasite Enterobius vermicularis as a co infection. This is the first report of its kind in literature. A nine year old school going girl from a rural area presented with a reddish polypoidal lesion from conjunctiva along with complaints of severe itching over it. On examination, the polyp measured 5 mm × 5 mm in size, reddish, granular with a tendency to bleed on touch. Her vision was normal. All the basic investigations were within normal limits. A differential diagnosis of conjunctival papilloma, foreign body granuloma and oculosporidiosis were considered clinically. The polyp was removed completely using electro cautery with healthy margins around the lesion. To our surprise histopathological examination of the swelling revealed the presence of two different parasites in the conjunctival polyp. Sections showed sporangia of Rhinosporidium seeberi, fragments of Enterobius vermicularis and its eggs. She was then treated with anti helminthic drugs. Two months of follow up till now showed no recurrence of the lesion. PMID:25337525

[Nasal glial heterotopia: Clinical and morphological characteristics].

PubMed

Bykova, V P; Bakhtin, A A; Polyakov, D P; Yunusov, A S; Daikhes, N A

The paper describes a case of nasal glial heterotopia in a 10-month-old girl with a mixed (intranasal and subcutaneous) localization, which is accompanied by the divergence of the nasal bones. Histological examination supplemented by immunohistochemical reactions with antibodies to vimentin, S100 protein, neuron-specific enolase, as well as Ki-67 and smooth muscle actin confirmed the neural nature of the tumor. Fields of mature astrocytic glia including individual cells with neuronal differentiation were found among the fibrous and fibrovascular tissues. The paper provides a brief overview of the discussed pathology.

Automated matching of supine and prone colonic polyps based on PCA and SVMs

NASA Astrophysics Data System (ADS)

Wang, Shijun; Van Uitert, Robert L.; Summers, Ronald M.

2008-03-01

Computed tomographic colonography (CTC) is a feasible and minimally invasive method for the detection of colorectal polyps and cancer screening. In current practice, a patient will be scanned twice during the CTC examination - once supine and once prone. In order to assist the radiologists in evaluating colon polyp candidates in both scans, we expect the computer aided detection (CAD) system can provide not only the locations of suspicious polyps, but also the possible matched pairs of polyps in two scans. In this paper, we propose a new automated matching method based on the extracted features of polyps by using principal component analysis (PCA) and Support Vector Machines (SVMs). Our dataset comes from the 104 CT scans of 52 patients with supine and prone positions collected from three medical centers. From it we constructed two groups of matched polyp candidates according to the size of true polyps: group A contains 12 true polyp pairs (> 9 mm) and 454 false pairs; group B contains 24 true polyp pairs (6-9 mm) and 514 false pairs. By using PCA, we reduced the dimensions of original data (with 157 attributes) to 30 dimensions. We did leave-one-patient-out test on the two groups of data. ROC analysis shows that it is easier to match bigger polyps than that of smaller polyps. On group A data, when false alarm probability is 0.18, the sensitivity of SVM achieves 0.83 which shows that automated matching of polyp candidates is practicable for clinical applications.

Computer-assisted polyp matching between optical colonoscopy and CT colonography: a phantom study

NASA Astrophysics Data System (ADS)

Roth, Holger R.; Hampshire, Thomas E.; Helbren, Emma; Hu, Mingxing; Vega, Roser; Halligan, Steve; Hawkes, David J.

2014-03-01

Potentially precancerous polyps detected with CT colonography (CTC) need to be removed subsequently, using an optical colonoscope (OC). Due to large colonic deformations induced by the colonoscope, even very experienced colonoscopists find it difficult to pinpoint the exact location of the colonoscope tip in relation to polyps reported on CTC. This can cause unduly prolonged OC examinations that are stressful for the patient, colonoscopist and supporting staff. We developed a method, based on monocular 3D reconstruction from OC images, that automatically matches polyps observed in OC with polyps reported on prior CTC. A matching cost is computed, using rigid point-based registration between surface point clouds extracted from both modalities. A 3D printed and painted phantom of a 25 cm long transverse colon segment was used to validate the method on two medium sized polyps. Results indicate that the matching cost is smaller at the correct corresponding polyp between OC and CTC: the value is 3.9 times higher at the incorrect polyp, comparing the correct match between polyps to the incorrect match. Furthermore, we evaluate the matching of the reconstructed polyp from OC with other colonic endoluminal surface structures such as haustral folds and show that there is a minimum at the correct polyp from CTC. Automated matching between polyps observed at OC and prior CTC would facilitate the biopsy or removal of true-positive pathology or exclusion of false-positive CTC findings, and would reduce colonoscopy false-negative (missed) polyps. Ultimately, such a method might reduce healthcare costs, patient inconvenience and discomfort.

Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study.

PubMed

Feng, Shaoyan; Liang, Zibin; Zhang, Rongkai; Liao, Wei; Chen, Yuan; Fan, Yunping; Li, Huabin

2017-03-01

The objective of the study is to investigate the impact of receiving daily WeChat services on one's cell phone on adherence to corticosteroid nasal spray treatment in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS). This study was a two-arm, randomized, follow-up investigation. Patients with chronic rhinosinusitis with/without nasal polyps following bilateral FESS were randomised to receive, or to not receive, daily WeChat service on their cell phone to take corticosteroid nasal spray treatment. A prescription of budesonide aqueous nasal spray 128 µg bid was given to all the subjects. Then they returned to the clinic after 30, 60, 90 days. The primary study outcome was adherence to nasal spray treatment, whereas secondary outcomes were change in endoscopic findings and SinoNasal Outcome Test-20 (SNOT-20). On the whole, there was a significant inter-group difference in the change of adherence rate (F = 90.88, p = 0.000). The WeChat group had much higher adherence rate than the control group during the follow-up. In terms of postoperative endoscopic scores and SNOT-20, except granulation score, no significant differences were observed between the two randomization groups. WeChat services are already after a short period of observation associated with improved adherence to corticosteroid nasal spray treatment in CRS patients after FESS.

Spontaneous resolution of hemorrhagic polyps of the true vocal fold.

PubMed

Klein, Adam M; Lehmann, Marcus; Hapner, Edie R; Johns, Michael M

2009-01-01

Hemorrhagic polyps are the most common benign lesions surgically removed from the vocal folds. Although this modality does offer satisfactory results in most of the cases, there is a subset of polyps that seems to resolve with conservative therapy. This study was performed to examine this subset of polyps. Thirty-four consecutive subjects diagnosed with hemorrhagic polyps of the true vocal fold were retrospectively reviewed to determine the incidence of spontaneous resolution of the lesions with nonsurgical therapy. Sixteen subjects began conservative therapy, consisting of voice therapy and proper vocal hygiene, often while awaiting an optimal personal time for surgical intervention. Of these subjects, nine (56.3%) experienced a resolution of their lesion and symptoms without undergoing surgical therapy. Surgical removal of hemorrhagic polyps is often considered the standard of treatment for these benign lesions. However, these observations support a regimen of voice therapy and observation in select cases.

An evidence-based treatment algorithm for colorectal polyp cancers: results from the Scottish Screen-detected Polyp Cancer Study (SSPoCS).

PubMed

Richards, C H; Ventham, N T; Mansouri, D; Wilson, M; Ramsay, G; Mackay, C D; Parnaby, C N; Smith, D; On, J; Speake, D; McFarlane, G; Neo, Y N; Aitken, E; Forrest, C; Knight, K; McKay, A; Nair, H; Mulholland, C; Robertson, J H; Carey, F A; Steele, Rjc

2018-02-01

Colorectal polyp cancers present clinicians with a treatment dilemma. Decisions regarding whether to offer segmental resection or endoscopic surveillance are often taken without reference to good quality evidence. The aim of this study was to develop a treatment algorithm for patients with screen-detected polyp cancers. This national cohort study included all patients with a polyp cancer identified through the Scottish Bowel Screening Programme between 2000 and 2012. Multivariate regression analysis was used to assess the impact of clinical, endoscopic and pathological variables on the rate of adverse events (residual tumour in patients undergoing segmental resection or cancer-related death or disease recurrence in any patient). These data were used to develop a clinically relevant treatment algorithm. 485 patients with polyp cancers were included. 186/485 (38%) underwent segmental resection and residual tumour was identified in 41/186 (22%). The only factor associated with an increased risk of residual tumour in the bowel wall was incomplete excision of the original polyp (OR 5.61, p=0.001), while only lymphovascular invasion was associated with an increased risk of lymph node metastases (OR 5.95, p=0.002). When patients undergoing segmental resection or endoscopic surveillance were considered together, the risk of adverse events was significantly higher in patients with incomplete excision (OR 10.23, p<0.001) or lymphovascular invasion (OR 2.65, p=0.023). A policy of surveillance is adequate for the majority of patients with screen-detected colorectal polyp cancers. Consideration of segmental resection should be reserved for those with incomplete excision or evidence of lymphovascular invasion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Treatment for Vocal Polyps: Lips and Tongue Trill.

PubMed

de Vasconcelos, Daniela; Gomes, Adriana de Oliveira Camargo; de Araújo, Cláudia Marina Tavares

2017-03-01

Vocal polyps do not have a well-defined therapeutic indication. The recommended treatment is often laryngeal microsurgery, followed by postoperative speech therapy. Speech therapy as the initial treatment for polyps is a new concept and aims to modify inappropriate vocal behavior, adjust the voice quality, and encourage regression of the lesion. This study aimed to determine the effectiveness of the sonorous lips and tongue trill technique in the treatment of vocal polyps. The sample consisted of 10 adults diagnosed with a polyp who were divided into two subgroups: treatment and control. Ten speech therapy sessions were conducted, each lasting 30-45 minutes, based on the sonorous lips and tongue trill technique, accompanied by continuous guidance about vocal health. Speech therapy was effective in three of the five participants. The number of symptoms presented by the participants decreased significantly after voice therapy (P = 0.034) and vocal self-evaluation (P = 0.034). The acoustic evaluation showed improvements in parameters of noise values (P = 0.028) and jitter (P = 0.034). The size of the polyp and the degree of severity of dysphonia, hoarseness, and breathiness showed a significant reduction after treatment (P = 0.043). Among the remaining two participants, one opted out of laryngeal surgery, indicating that the improvement obtained was sufficient to avoid surgery. The sonorous lips and tongue trill technique was thus considered effective in 60% of the participants, and as laryngeal surgery was avoided in 80% of them, it should be considered a treatment option for vocal polyps. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Variation in polyp size estimation among endoscopists and impact on surveillance intervals.

PubMed

Chaptini, Louis; Chaaya, Adib; Depalma, Fedele; Hunter, Krystal; Peikin, Steven; Laine, Loren

2014-10-01

Accurate estimation of polyp size is important because it is used to determine the surveillance interval after polypectomy. To evaluate the variation and accuracy in polyp size estimation among endoscopists and the impact on surveillance intervals after polypectomy. Web-based survey. A total of 873 members of the American Society for Gastrointestinal Endoscopy. Participants watched video recordings of 4 polypectomies and were asked to estimate the polyp sizes. Proportion of participants with polyp size estimates within 20% of the correct measurement and the frequency of incorrect surveillance intervals based on inaccurate size estimates. Polyp size estimates were within 20% of the correct value for 1362 (48%) of 2812 estimates (range 39%-59% for the 4 polyps). Polyp size was overestimated by >20% in 889 estimates (32%, range 15%-49%) and underestimated by >20% in 561 (20%, range 4%-46%) estimates. Incorrect surveillance intervals because of overestimation or underestimation occurred in 272 (10%) of the 2812 estimates (range 5%-14%). Participants in a private practice setting overestimated the size of 3 or of all 4 polyps by >20% more often than participants in an academic setting (difference = 7%; 95% confidence interval, 1%-11%). Survey design with the use of video clips. Substantial overestimation and underestimation of polyp size occurs with visual estimation leading to incorrect surveillance intervals in 10% of cases. Our findings support routine use of measurement tools to improve polyp size estimates. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Objective Measure of Nasal Air Emission Using Nasal Accelerometry

ERIC Educational Resources Information Center

Cler, Meredith J.; Lien, Yu-An, S.; Braden, Maia N.; Mittleman, Talia; Downing, Kerri; Stepp, Cara, E.

2016-01-01

Purpose: This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Method: Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and…

Evaluation of polyvinylidene fluoride nasal sensor to assess deviated nasal septum in comparision with peak nasal inspiratory flow measurements.

PubMed

Manjunatha, Roopa G; Rajanna, K; Mahapatra, D Roy; Prakash, Surya

2014-01-01

Deviated nasal septum (DNS) is one of the major causes of nasal obstruction. Polyvinylidene fluoride (PVDF) nasal sensor is the new technique developed to assess the nasal obstruction caused by DNS. This study evaluates the PVDF nasal sensor measurements in comparison with PEAK nasal inspiratory flow (PNIF) measurements and visual analog scale (VAS) of nasal obstruction. Because of piezoelectric property, two PVDF nasal sensors provide output voltage signals corresponding to the right and left nostril when they are subjected to nasal airflow. The peak-to-peak amplitude of the voltage signal corresponding to nasal airflow was analyzed to assess the nasal obstruction. PVDF nasal sensor and PNIF were performed on 30 healthy subjects and 30 DNS patients. Receiver operating characteristic was used to analyze the DNS of these two methods. Measurements of PVDF nasal sensor strongly correlated with findings of PNIF (r = 0.67; p < 0.01) in DNS patients. A significant difference (p < 0.001) was observed between PVDF nasal sensor measurements and PNIF measurements of the DNS and the control group. A cutoff between normal and pathological of 0.51 Vp-p for PVDF nasal sensor and 120 L/min for PNIF was calculated. No significant difference in terms of sensitivity of PVDF nasal sensor and PNIF (89.7% versus 82.6%) and specificity (80.5% versus 78.8%) was calculated. The result shows that PVDF measurements closely agree with PNIF findings. Developed PVDF nasal sensor is an objective method that is simple, inexpensive, fast, and portable for determining DNS in clinical practice.

The diagnostic accuracy of transabdominal ultrasonography needs to be considered when managing gallbladder polyps.

PubMed

French, Daniel G; Allen, Philippe D; Ellsmere, James C

2013-11-01

Transabdominal ultrasonography (TAUS) is the most commonly used modality to diagnose gallbladder (GB) disease. GB polyps are reported in 1-5.6 % of TAUS studies. Histopathologic studies suggest that there is a relationship between GB polyps and GB cancer. Previous literature suggests GB polyps reported on TAUS do not correlate well with histological findings. There have been recent advances in TAUS technology. We hypothesize the recent advances in TAUS technology have improved the accuracy of TAUS for diagnosing GB polyps. Radiology and pathology databases at our tertiary care center were retrospectively searched between January 1, 2000, and December 31, 2010. Ultrasound reports that suggested a GB polyp was present on TAUS were correlated to histopathology in cases where a cholecystectomy was performed. The pathology reports where a GB polyp was found were correlated with preoperative TAUS reports. There were 102,740 TAUS reports referring to the GB, of which 6,612 (6.4 %) contained search terms suggesting a GB polyp was present. There were 13,278 cholecystectomy pathology reports, of which 159 (1.2 %) included a diagnosis of GB polyp. TAUS detected only 50 % of the polyps identified on histopathology. The sensitivity and specificity of TAUS for diagnosing GB polyps were 50.0 and 98.3 %, respectively. The positive and negative predictive values were 10.5 and 99.8 %. Despite improvement in TAUS technology, the accuracy for GB polyps remains poor. This needs to be considered when managing patients with TAUS-detected GB polyps. We recommend that the decision to operate on TAUS-detected GB polyps be largely based on symptoms, and following GB polyps with TAUS should be discouraged.

A new exploration for gallbladder polyps: gallbladder polypectomy by endolap technique.

PubMed

Wang, JingMin; Tan, YuYan; Zhao, Gang; Wang, Dong; Ji, ZhenLing

2014-12-01

Abstract Gallbladder polyps are most commonly treated with cholecystectomy, which is associated with various complications. For benign disease, preserving the gallbladder is preferable. Since 1994, we have been exploring percutaneous polypectomy and have recently developed an improved new technique. This study reports a new endoscopic-laparoscopic (Endolap) technique for the removal of polyps and the preservation of the gallbladder. Nine Chinese mini-pigs were used to observe mucosal regeneration. Microwaves of 50-70 mA for 9 seconds were safe, and the gallbladder mucosa of pigs recovered to nearly normal 2 weeks later. In the clinical cases, 60 patients with gallbladder polyps were studied. With the patient under general anesthesia, each polyp stem was coagulated, and then the polyp was removed. All procedures were successful at between 60 and 135 minutes. The success rate was 93.33% (56/60). A retrospective analysis was conducted to assess the recovery of gallbladder function. All patients were followed up and symptom-free, without recurrence of the polyps; 3 months after the operation, the volume and contraction of the gallbladder recovered to preoperative levels. Thus the Endolap technique is reliable for removing benign gallbladder polyps and is applicable to a wider range of clinical situations than percutaneous polypectomy.

Association between Metabolic Syndrome and Gallbladder Polyps in Healthy Korean Adults

PubMed Central

Park, Eun Jung; Lee, Hong Soo; Lee, Sang Hwa; Chun, Hye Jin; Kim, Sun Young; Choi, Yu Kyung; Ryu, Hee Jeong

2013-01-01

The goal of this study was to evaluate the association between gallbladder (GB) polyps and metabolic syndrome. A total of 5,685 healthy subjects were included, and 485 of these subjects had GB polyps and 744 had metabolic syndrome. In this study, metabolic syndrome was diagnosed according to standards suggested by the AHA/NHLBI ATP III 2005, and abdominal obesity (≥ 90 cm in men and ≥ 85 cm in women for Korean) was diagnosed according to standards set forth by the Korean Society for Study of Obesity. Biphasic logistic regression adjusted for age and gender was used to evaluate the association between metabolic syndrome and GB polyps. Subjects who were male (OR, 1.493; 95% CI, 1.11-2.00) and hepatitis B suface Ag (HBsAg) positive (OR, 1.591; 95% CI, 1.06-2.38) were significantly more likely to have GB polyps. The metabolic syndrome group had a higher risk of GB polyps (OR, 1.315; 95% CI, 1.01-1.69) than the group without metabolic syndrome. In conclusion, subjects who were HBsAg positive and male appear to be associated with the risk of GB polyps. The presence of metabolic syndrome also appears to be associated with the risk of GB polyps in Koreans. PMID:23772152

Association between metabolic syndrome and gallbladder polyps in healthy Korean adults.

PubMed

Park, Eun Jung; Lee, Hong Soo; Lee, Sang Hwa; Chun, Hye Jin; Kim, Sun Young; Choi, Yu Kyung; Ryu, Hee Jeong; Shim, Kyung Won

2013-06-01

The goal of this study was to evaluate the association between gallbladder (GB) polyps and metabolic syndrome. A total of 5,685 healthy subjects were included, and 485 of these subjects had GB polyps and 744 had metabolic syndrome. In this study, metabolic syndrome was diagnosed according to standards suggested by the AHA/NHLBI ATP III 2005, and abdominal obesity (≥ 90 cm in men and ≥ 85 cm in women for Korean) was diagnosed according to standards set forth by the Korean Society for Study of Obesity. Biphasic logistic regression adjusted for age and gender was used to evaluate the association between metabolic syndrome and GB polyps. Subjects who were male (OR, 1.493; 95% CI, 1.11-2.00) and hepatitis B suface Ag (HBsAg) positive (OR, 1.591; 95% CI, 1.06-2.38) were significantly more likely to have GB polyps. The metabolic syndrome group had a higher risk of GB polyps (OR, 1.315; 95% CI, 1.01-1.69) than the group without metabolic syndrome. In conclusion, subjects who were HBsAg positive and male appear to be associated with the risk of GB polyps. The presence of metabolic syndrome also appears to be associated with the risk of GB polyps in Koreans.

Pathogenesis and Management of Serrated Polyps: Current Status and Future Directions

PubMed Central

Anderson, Joseph C.

2014-01-01

Hyperplastic or serrated polyps were once believed to have little to no clinical significance. A subset of these polyps are now considered to be precursors to colorectal cancers (CRC) in the serrated pathway that may account for at least 15% of all tumors. The serrated pathway is distinct from the two other CRC pathways and involves an epigenetic hypermethylation mechanism of CpG islands within promoter regions of tumor suppressor genes. This process results in the formation of CpG island methylator phenotype tumors. Serrated polyps are divided into hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs). The SSA/P and the TSA have the potential for dysplasia and subsequent malignant transformation. The SSA/Ps are more common and are more likely to be flat than TSAs. Their flat morphology may make them difficult to detect and thus explain the variation in detection rates among endoscopists. Challenges for endoscopists also include the difficulty in pathological interpretation as well surveillance of these lesions. Furthermore, serrated polyps may be inadequately resected by endoscopists. Thus, it is not surprising that the serrated pathway has been linked with interval cancers. This review will provide the physician or clinician with the knowledge to manage patients with serrated polyps. PMID:25368744

Fully convolutional neural networks for polyp segmentation in colonoscopy

NASA Astrophysics Data System (ADS)

Brandao, Patrick; Mazomenos, Evangelos; Ciuti, Gastone; Caliò, Renato; Bianchi, Federico; Menciassi, Arianna; Dario, Paolo; Koulaouzidis, Anastasios; Arezzo, Alberto; Stoyanov, Danail

2017-03-01

Colorectal cancer (CRC) is one of the most common and deadliest forms of cancer, accounting for nearly 10% of all forms of cancer in the world. Even though colonoscopy is considered the most effective method for screening and diagnosis, the success of the procedure is highly dependent on the operator skills and level of hand-eye coordination. In this work, we propose to adapt fully convolution neural networks (FCN), to identify and segment polyps in colonoscopy images. We converted three established networks into a fully convolution architecture and fine-tuned their learned representations to the polyp segmentation task. We validate our framework on the 2015 MICCAI polyp detection challenge dataset, surpassing the state-of-the-art in automated polyp detection. Our method obtained high segmentation accuracy and a detection precision and recall of 73.61% and 86.31%, respectively.

Plasma RANTES and eotaxin levels are correlated with the severity of chronic rhinosinusitis.

PubMed

Chao, Pin-Zhir; Chou, Chi-Ming; Chen, Chen-Ho

2012-11-01

Eosinophilia occurs in up to 75-90% of nasal polyps in Caucasians. The chemokines eotaxin and RANTES increase eosinophil recruitment, activation, and survival, and these chemokines are significantly expressed in nasal polyps. We hypothesized that eotaxin and RANTES plasma levels might be correlated with disease severity. We compared the eotaxin and RANTES plasma levels in 20 Taiwanese patients with chronic rhinosinusitis and nasal polyps and 20 Taiwanese healthy controls. Eotaxin and RANTES plasma levels were measured by ELISA and disease severity was scored by CT scans. Compared to controls, patients with nasal polyps had significantly elevated plasma levels of eotaxin and RANTES and increased peripheral blood eosinophils (p < 0.001). Eotaxin plasma levels were significantly correlated with disease severity in patients with chronic rhinosinusitis to a greater extent than were RANTES levels. RANTES and eotaxin levels were also positively correlated with the percentages of peripheral blood eosinophils. Eotaxin plasma levels are significantly correlated with disease severity in Taiwanese patients with nasal polyposis to a greater degree than are RANTES levels. Additional studies are needed to assess whether eotaxin plasma levels can be used to monitor disease progression and attenuation.

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps.

PubMed

Cairns, Vaux; Neal, Christopher P; Dennison, Ashely R; Garcea, Giuseppe

2012-12-01

OBJECTIVE To ascertain the best management options for patients presenting with gallbladder polyps. DESIGN Retrospective case-note analysis. SETTING Tertiary referral teaching hospital practice. PATIENTS Patients with ultrasonography-detected gallbladder polyps. INTERVENTIONS Ultrasonography surveillance or surgery. MAIN OUTCOME MEASURES Demographic data and size and number of polyps were recorded as well as size increase and histological findings. Detection rates for potentially neoplastic and frankly neoplastic polyps were recorded and compared with complication rates from cholecystectomy. Cost-effectiveness of ultrasonography surveillance was examined. RESULTS Nine hundred eighty-six patients were identified and 467 patients underwent further follow-up. Only 6.6% of polyps exhibited an increase in size over the surveillance period. Polyps that subsequently progressed in size on surveillance had a significantly greater diameter at first presentation than those polyps that remained static (7 mm vs 5 mm, respectively) (P < .05). Only 3.7% of resected polyps had malignant or potentially malignant histology. Size greater than 10 mm and increase in size during surveillance predicted neoplastic potential. CONCLUSIONS A surveillance with or without selective surgery policy could potentially detect and prevent 5.4 gallbladder cancers per 1000 individuals per year with a cost saving of more than £130 000 (US $201 676) per year. Cancer prevention benefits would exceed the risk ratios from cholecystectomy complications. Polyps greater than 10 mm should be resected; those between 5 and 10 mm should be under ultrasonography surveillance.

Clinical significance of peripheral circulating tumor cell counts in colorectal polyps and non-metastatic colorectal cancer.

PubMed

Yang, Chengguang; Zhuang, Wenfang; Hu, Yuemei; Zhu, Leiming

2018-01-22

The presence of peripheral circulating tumor cells indicates the possible existence of a tumor in vivo; however, low numbers of circulating tumor cells (CTCs) can be detected in peripheral blood of healthy individuals as well as patients with benign tumors. It is not known whether peripheral CTC counts differ between patients with benign colorectal disease and those with colorectal cancer. Comparative analysis of preoperative peripheral circulating tumor cells counts was completed in patients with benign colorectal disease (colorectal polyps) and non-metastatic cancer of the colon and rectum. The results of this analysis showed that patients with colorectal cancer had higher CTC counts than patients with colorectal polyps (3.47 ± 0.32/3.2 ml vs 1.49 ± 0.2/3.2 ml, P < 0.001). Colorectal cancer patients with tumors of the sigmoid colon displayed the highest CTC counts (4.87 ± 0.95/3.2 ml), followed by those with tumors of the rectum (3.73 ± 0.54/3.2 ml), ascending colon (3.5 ± 0.63/3.2 ml), transverse colon (2.4 ± 0.68/3.2 ml), and descending colon (2.08 ± 0.46/3.2 ml). Colorectal polyp patients with polyps in the rectum showed the highest CTC counts (2.2 ± 0.77/3.2 ml), followed by those with polyps in the ascending colon (1.82 ± 0.54/3.2 ml), sigmoid colon (1.38 ± 0.25/3.2 ml), transverse colon (0.75 ± 0.25/3.2 ml), and descending colon (0.33 ± 0.21/3.2 ml). The differences in CTC counts suggest that anatomical location of colorectal tumors may affect blood vessel metastasis. Meanwhile, patients with moderately differentiated and poorly differentiated tumors displayed higher peripheral blood CTC counts compared to those with well-differentiated tumors (P < 0.001). This result suggests that the type of tissue differentiation of colorectal tumors may act as another factor that affects blood vessel metastasis. Circulating tumor cells can be detected in the peripheral blood of colorectal

Automated synthesis, insertion and detection of polyps for CT colonography

NASA Astrophysics Data System (ADS)

Sezille, Nicolas; Sadleir, Robert J. T.; Whelan, Paul F.

2003-03-01

CT Colonography (CTC) is a new non-invasive colon imaging technique which has the potential to replace conventional colonoscopy for colorectal cancer screening. A novel system which facilitates automated detection of colorectal polyps at CTC is introduced. As exhaustive testing of such a system using real patient data is not feasible, more complete testing is achieved through synthesis of artificial polyps and insertion into real datasets. The polyp insertion is semi-automatic: candidate points are manually selected using a custom GUI, suitable points are determined automatically from an analysis of the local neighborhood surrounding each of the candidate points. Local density and orientation information are used to generate polyps based on an elliptical model. Anomalies are identified from the modified dataset by analyzing the axial images. Detected anomalies are classified as potential polyps or natural features using 3D morphological techniques. The final results are flagged for review. The system was evaluated using 15 scenarios. The sensitivity of the system was found to be 65% with 34% false positive detections. Automated diagnosis at CTC is possible and thorough testing is facilitated by augmenting real patient data with computer generated polyps. Ultimately, automated diagnosis will enhance standard CTC and increase performance.

Histological variations in juvenile polyp phenotype correlate with genetic defect underlying juvenile polyposis

PubMed Central

van Hattem, W. Arnout; Langeveld, Danielle; de Leng, Wendy W. J.; Morsink, Folkert H.; van Diest, Paul J.; Iacobuzio-Donahue, Christine A.; Giardiello, Francis M.; Offerhaus, G. Johan A.; Brosens, Lodewijk A. A.

2011-01-01

Background Juvenile polyps are distinct hamartomatous malformations of the gastrointestinal tract that may occur in the heritable juvenile polyposis syndrome (JPS) or sporadically. Histologically, juvenile polyps are characterised by a marked increase of the stromal cell compartment but, an epithelial phenotype has also been reported. JPS has an increased risk of colorectal cancer but sporadic juvenile polyps do not. In 50–60% of JPS patients a germline mutation of the TGF-β/BMP pathway genes SMAD4 or BMPR1A is found. This study compares the histological phenotype of juvenile polyps with a SMAD4 or BMPR1A germline mutation and sporadic juvenile polyps. Methods H&E slides of 65 JPS polyps and 25 sporadic juvenile polyps were reviewed for histological features and dysplasia. Systematic random crypt and stroma counts were obtained by count stereology and a crypt-stroma ratio was determined. All polyps were subsequently categorised as type A (crypt-stroma ratio <1.00) or type B (crypt-stroma ratio ≥1.00), the latter referring to the epithelial phenotype. Cell cycle activity was assessed using immunohistochemistry of the proliferation marker Ki67, and mutation analysis was conducted for KRAS and APC to determine the involvement of the adenoma-carcinoma sequence. Results Juvenile polyps with a SMAD4 germline mutation were predominantly type B, whereas, type A was more common among juvenile polyps with a BMPR1A germline mutation, but this distinction could not be ascribed to differences in cell cycle activity. Dysplasia was equally common in JPS polyps with either a SMAD4 or BMPR1A germline mutation, where the involvement of the adenoma-carcinoma sequence does not seem to play a distinct role. Conclusion juvenile polyps in the setting of JPS exhibit distinct phenotypes correlating with the underlying genetic defect. PMID:21412070

Hypoechoic foci on EUS are simple and strong predictive factors for neoplastic gallbladder polyps.

PubMed

Cho, Jae Hee; Park, Jeong Youp; Kim, Yoon Jae; Kim, Hee Man; Kim, Hong Jeong; Hong, Sung Pil; Park, Seung Woo; Chung, Jae Bock; Song, Si Young; Bang, Seungmin

2009-06-01

EUS is an accurate imaging modality for delineating gallbladder (GB) structures; however, its clinical use in differentiating neoplastic GB polyps from nonneoplastic polyps is limited. Thus, we sought to characterize neoplastic GB polyps by analyzing unique EUS features. Our analysis revealed variably shaped, relatively hypoechoic portions in the core of polyps compared with general background echogenicity. Our purpose was to make a differential diagnosis between neoplastic and nonneoplastic GB polyps of less than 20 mm by use of EUS variables, including hypoechoic foci. Retrospective single-center study. University teaching hospital. Patients (n = 88) underwent preoperative EUS and cholecystectomy for GB polyps smaller than 20 mm. Hypoechoic foci were found in 30 of 33 patients (91%) with neoplastic polyps and 6 of 55 (11%) with nonneoplastic polyps. In a multivariate analysis, hypoechoic foci were the only significant predictive factor for neoplastic polyps (odds ratio [OR] 55.4, 95% CI, 8.26-371, P < .001); the sensitivity and specificity were 90% and 89%, respectively. In addition, polyps >15 mm had an increased risk of malignancy (OR 21.7, 95% CI, 2.35-201, P = .007), as did those with hypoechoic foci (OR 10.9; 95% CI, 1.01-117, P = .049). Retrospective review of selected patients from a tertiary medical center. The presence of hypoechoic foci on EUS is a strong predictive factor for neoplastic polyps. EUS may be useful in developing a treatment strategy for GB polyps.

Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea.

PubMed

Cui, Dan-Mo; Han, De-Min; Nicolas, Busaba; Hu, Chang-Long; Wu, Jun; Su, Min-Min

2016-03-20

Obstructive sleep apnea (OSA) is a common sleep disorder and is characterized by airway collapse at multiple levels of upper airway. The effectiveness of nasal surgery has been discussed in several studies and shows a promising growing interest. In this study, we intended to evaluate the effects of nasal surgery on the upper airway dimensions in patients with OSA using three-dimensional (3D) reconstruction of cone-beam computed tomography (CT). Twelve patients with moderate to severe OSA who underwent nasal surgery were included in this study. All patients were diagnosed with OSA using polysomnography (PSG) in multi sleep health centers associated with Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary and the Partners Health Care from May 31, 2011 to December 14, 2013. The effect of nasal surgery was evaluated by the examination of PSG, subjective complains, and 3D reconstructed CT scan. Cross-sectional area was measured in eleven coronal levels, and nasal cavity volume was evaluated from anterior nasal spine to posterior nasal spine. The thickness of soft tissue in oral pharynx region was also measured. Five out of the 12 patients were successfully treated by nasal surgery, with more than 50% drop of apnea-hypopnea index. All the 12 patients showed significant increase of cross-sectional area and volume postoperatively. The thickness of soft tissue in oral pharynx region revealed significant decrease postoperatively, which decreased from 19.14 ± 2.40 cm 2 and 6.11 ± 1.76 cm 2 to 17.13 ± 1.91 cm 2 and 5.22 ± 1.20 cm 2 . Nasal surgery improved OSA severity as measured by PSG, subjective complaints, and 3D reconstructed CT scan. 3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

In vivo effects of endotoxin on DNA synthesis in rat nasal epithelium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harkema, J.R.; Hotchkiss, J.A.

Airway inflammation in bacterial infections is characterized by the presence of neutrophils and often epithelial injury and repair. Release of endotoxin from bacteria may contribute to these processes. The purpose of this study was to determine the in vivo effects of repeated endotoxin exposure on DNA synthesis in rat nasal epithelium in the presence and absence of neutrophilic influx. Rats were intranasally instilled, once a day for 3 days, with endotoxin or saline (controls). Before the first and third instillations, half of the saline and endotoxin-instilled animals were depleted of circulating blood neutrophils by administering a rabbit anti-rat neutrophil antiserum.more » Rats were sacrificed 6 or 24 h after the last instillation. Two hours prior to sacrifice, rats were intraperitoneally injected with bromodeoxyuridine (BrdU), an analog of thymidine that is incorporated in the nucleus of cells in the S-phase of the cell cycle. Nasal tissues were processed for light microscopy and immunohistochemical detection of BrdU in nasal epithelial cells. The numbers of nasal epithelial cells, BrdU-labeled epithelial nuclei, and neutrophils per millimeter of basal lamina in the epithelium lining the nasal turbinates in the proximal nasal passages were determined by morphometric analysis. The authors did not observe a neutrophilic influx in the nasal tissues of neutrophil-depleted rats at 6 or 24 h after the last endotoxin instillation; however, the numbers of nasal epithelial cells and the BrdU-labeling index were significantly increased compared to saline-instilled controls. In contrast, non-neutrophil-depleted rats instilled with endotoxin had a marked neutrophilic influx, but no significant differences in the number of nasal epithelial cells at 6 or 24 h, compared to controls. In addition, the BrdU-labeling index in neutrophil-sufficient rats was increased only 6 h after the last instillation, compared to controls.« less

Case report and surgical solution for nasal spine agenesis in a woman with Binder syndrome.

PubMed

Kansu, Leyla; Akkuzu, Babur; Avci, Suat

2008-07-01

Binder syndrome is an uncommon disorder of unknown etiology. It is characterized by hypoplasia of the nose and maxilla and altered morphology of the associated soft tissue. We report a 19-year-old Binder syndrome patient with short-nose deformity and anterior nasal spine agenesis. We present a surgical technique for nasal spine agenesis treatment. We used a titanium screw without a graft, which supported the nasal tip and increased tip projection. As there is good soft-tissue coverage over the screw, infection or extrusion was not encountered, and the patient had no complaints 1 year after surgery.

Pneumolysin plays a key role at the initial step of establishing pneumococcal nasal colonization.

PubMed

Hotomi, Muneki; Yuasa, Jun; Briles, David E; Yamanaka, Noboru

2016-09-01

Nasopharyngeal colonization by Streptococcus pneumoniae is an important initial step for the subsequent development of pneumococcal infections. Pneumococci have many virulence factors that play a role in colonization. Pneumolysin (PLY), a pivotal pneumococcal virulence factor for invasive disease, causes severe tissue damage and inflammation with disruption of epithelial tight junctions. In this study, we evaluated the role of PLY in nasal colonization of S. pneumoniae using a mouse colonization model. A reduction of numbers of PLY-deficient pneumococci recovered from nasal tissue, as well as nasal wash, was observed at days 1 and 2 post-intranasal challenges, but not later. The findings strongly support an important role for PLY in the initial establishment nasal colonization. PLY-dependent invasion of local nasal mucosa may be required to establish nasal colonization with S. pneumoniae. The data help provide a rationale to explain why an organism that exists as an asymptomatic colonizer has evolved virulence factors that enable it to occasionally invade and kill its hosts. Thus, the same pneumococcal virulence factor, PLY that can contribute to killing the host, may also play a role early in the establishment of nasopharynx carriage.

Mometasone furoate nasal spray: a systematic review.

PubMed

Passali, Desiderio; Spinosi, Maria Carla; Crisanti, Anna; Bellussi, Luisa Maria

2016-01-01

The inflammatory diseases of the nose, rhino-pharynx and paranasal sinuses (allergic and non allergic rhinitis, NARES; rhinosinusitis with/without nasal polyposis, adenoidal hypertrophy with/without middle ear involvement) clinically manifest themselves with symptoms and complications severely affecting quality of life and health care expenditure. Intranasal administration of corticosteroids, being fast, simple, and not requiring cooperation, is the preferred way to treat the patients, to optimize their quality of life, at the same time minimizing the risk of exacerbations and complications. Among the different topical steroids available on the market, we performed a comparative analysis in terms of effectiveness and safety between mometasone furoate (MF) and its main competitors. Searching through Pub Med and Google Scholar and using as entries "mometasone furoate", "rhinitis", "sinusitis", "asthma", "polyposis", "otitis media with effusion", and "adenoid hypertrophy" we found 344 articles, 300 of which met the eligibility criteria. Taking into account relevance and date of publication, a sample of 40 articles was considered for the review. MF effectiveness for treatment and/or prophylaxis of nasal symptoms in seasonal and perennial allergic rhinitis has been fully established with a level of evidence Ia. Even though it has not been assessed for MF in particular, topical steroids are the most appropriate treatment in mixed rhinitis and NARES. In acute rhinosinusitis (ARS) evidences support their use as mono-therapy or as adjuvant to antibiotics for reducing the recurrence rate, and decrease the usage of related prescriptions and medical consultations. In chronic rhinosinusitis (CRS) with Nasal polyposis, MF reduces polyps size, nasal congestion, improves quality of life and sense of smell and it is also effective in the treatment of daytime cough. The topical use of MF has great efficacy in the management of adenoidal hypertrophy and otitis media of atopic

Ultrasound follow-up for gallbladder polyps less than 6 mm may not be necessary.

PubMed

Pedersen, Malene Roland V; Dam, Claus; Rafaelsen, Søren Rafael

2012-10-01

The management of ultrasound (US) detected gallbladder (GB) polyps remains a dilemma. The aim of this study was to assess the size distribution and the outcome of US follow-up of GB polyps. The study was approved by the Danish Data Protection Agency. US reports from patients examined with abdominal US in our department from January 2008 to the end of December 2009 were reviewed with a view to including all patients with GB polyps. Patients with GB polyps are routinely recommended a 2-year follow-up with US every six months. The GB polyp size was recorded at baseline and at subsequent US reports. Pathology reports were finally reviewed for all patients with GB polyps to check who underwent cholecystectomy and to register the histological diagnosis. A total of 203 patients (median age 54 years; range 19-95 years) with GB polyps were included; 89 (44%) men and 114 (56%) women. The mean polyp size was 5 mm (range 2-40 mm). In 143 patients (70%) the GB polyp diameter was less than 6 mm. The first US follow-up was performed in 120 patients (59%), and only 31 (15%) completed the full 2-year US follow-up programme. Polyp size was stable in 100 patients, decreased in five patients, increased in eight and resolved in 15 patients. A total of 13 patients (6%) underwent cholecystectomy. Of the 203 patients, none showed neoplastic or malignant GB polyps. We recommend that follow-up US of patients with GB polyps < 6 mm is avoided. Alternatively, the intervals between US follow-up of GB polyps < 6 mm may be extended. not relevant. not relevant.

High-resolution sonography for distinguishing neoplastic gallbladder polyps and staging gallbladder cancer.

PubMed

Kim, Jung Hoon; Lee, Jae Young; Baek, Jee Hyun; Eun, Hyo Won; Kim, Young Jae; Han, Joon Koo; Choi, Byung Ihn

2015-02-01

OBJECTIVE. The purposes of this study were to compare staging accuracy of high-resolution sonography (HRUS) with combined low- and high-MHz transducers with that of conventional sonography for gallbladder cancer and to investigate the differences in the imaging findings of neoplastic and nonneoplastic gallbladder polyps. MATERIALS AND METHODS. Our study included 37 surgically proven gallbladder cancer (T1a = 7, T1b = 2, T2 = 22, T3 = 6), including 15 malignant neoplastic polyps and 73 surgically proven polyps (neoplastic = 31, nonneoplastic = 42) that underwent HRUS and conventional transabdominal sonography. Two radiologists assessed T-category and predefined polyp findings on HRUS and conventional transabdominal sonography. Statistical analyses were performed using chi-square and McNemar tests. RESULTS. The diagnostic accuracy for the T category was T1a = 92-95%, T1b = 89-95%, T2 = 78-86%, and T3 = 84-89%, all with good agreement (κ = 0.642) using HRUS. The diagnostic accuracy for differentiating T1 from T2 or greater than T2 was 92% and 89% on HRUS and 65% and 70% with conventional transabdominal sonography. Statistically common findings for neoplastic polyps included size greater than 1 cm, single lobular surface, vascular core, hypoechoic polyp, and hypoechoic foci (p < 0.05). The value of HRUS in the differential diagnosis of a gallbladder polyp was more clearly depicted internal echo foci than conventional transabdominal sonography (39 vs 21). A polyp size greater than 1 cm was independently associated with a neoplastic polyp (odds ratio = 7.5, p = 0.02). The AUC of a polyp size greater than 1 cm was 0.877. The sensitivity and specificity were 66.67% and 89.13%, respectively. CONCLUSION. HRUS is a simple method that enables accurate T categorization of gallbladder carcinoma. It provides high-resolution images of gallbladder polyps and may have a role in stratifying the risk for malignancy.

Seeded amplification of chronic wasting disease prions in nasal brushings and recto-anal mucosal associated lymphoid tissues from elk by real time quaking-induced conversion

USGS Publications Warehouse

Haley, Nicholas J.; Siepker, Chris; Hoon-Hanks , Laura L.; Mitchell, Gordon; Walter, W. David; Manca, Matteo; Monello, Ryan J.; Powers, Jenny G.; Wild, Margaret A.; Hoover, Edward A.; Caughey, Byron; Richt, Jürgen a.; Fenwick, B.W.

2016-01-01

Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since been detected across North America and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction or prevalence studies of large or protected herds, where depopulation may be contraindicated. This study evaluated the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay of recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brushings collected antemortem. These findings were compared to results of immunohistochemistry (IHC) analysis of ante- and postmortem samples. RAMALT samples were collected from populations of farmed and free-ranging Rocky Mountain elk (Cervus elaphus nelsoni; n = 323), and nasal brush samples were collected from a subpopulation of these animals (n = 205). We hypothesized that the sensitivity of RT-QuIC would be comparable to that of IHC analysis of RAMALT and would correspond to that of IHC analysis of postmortem tissues. We found RAMALT sensitivity (77.3%) to be highly correlative between RT-QuIC and IHC analysis. Sensitivity was lower when testing nasal brushings (34%), though both RAMALT and nasal brush test sensitivities were dependent on both the PRNP genotype and disease progression determined by the obex score. These data suggest that RT-QuIC, like IHC analysis, is a relatively sensitive assay for detection of CWD prions in RAMALT biopsy specimens and, with further investigation, has potential for large-scale and rapid automated testing of antemortem samples for CWD.

Comparative study of the optical properties of colon mucosa and colon precancerous polyps between 400 and 1000 nm

NASA Astrophysics Data System (ADS)

Carvalho, Sónia; Gueiral, Nuno; Nogueira, Elisabete; Henrique, Rui; Oliveira, Luís.; Tuchin, Valery V.

2017-03-01

Optical properties of biological tissues are unique and may be used for tissue identification, tissue discrimination or even to identify pathologies. Early stage colorectal cancer evolves from adenomatous polyps that arise in the inner layer of the colorectal tube - the mucosa. The identification of different optical properties between healthy and pathological colorectal tissues might be used to identify different tissue components and to develop an early stage diagnosis method using optical technologies. Since most of the biomedical optics techniques use light within the visible and near infrared wavelength ranges, we used the inverse adding-doubling method to make a fast estimation of the optical properties of colorectal mucosa and early stage adenocarcinoma between 400 and 1000 nm. The estimated wavelength dependencies have provided information about higher lipid content in healthy mucosa and higher blood content in pathological tissue. Such data has also indicated that the wavelength dependence of the scattering coefficient for healthy mucosa is dominated by Rayleigh scattering and for pathological mucosa it is dominated by Mie scattering. Such difference indicates smaller scatterer size in healthy mucosa tissue. Such information can now be used to develop new diagnosis or treatment methods for early cancer detection or removal. One possibility is to use optical clearing technique to improve tissue transparency and create localized and temporary tissue dehydration for image contrast improvement during diagnosis or polyp laser removal. Such techniques can now be developed based on the different results that we have found for healthy and pathological colorectal mucosa.

Colonic polyps: application value of computer-aided detection in computed tomographic colonography.

PubMed

Zhang, Hui-Mao; Guo, Wei; Liu, Gui-Feng; An, Dong-Hong; Gao, Shuo-Hui; Sun, Li-Bo; Yang, Hai-Shan

2011-02-01

Colonic polyps are frequently encountered in clinics. Computed tomographic colonography (CTC), as a painless and quick detection, has high values in clinics. In this study, we evaluated the application value of computer-aided detection (CAD) in CTC detection of colonic polyps in the Chinese population. CTC was performed with a GE 64-row multidetector computed tomography (MDCT) scanner. Data of 50 CTC patients (39 patients positive for at least one polyp of ≥ 0.5 cm in size and the other 11 patients negative by endoscopic detection) were retrospectively reviewed first without computer-aided detection (CAD) and then with CAD by four radiologists (two were experienced and another two inexperienced) blinded to colonoscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of detected colonic polyps, as well as the areas under the ROC curves (Az value) with and without CAD were calculated. CAD increased the overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the colonic polyps detected by experienced and inexperienced readers. The sensitivity in detecting small polyps (5 - 9 mm) with CAD in experienced and inexperienced readers increased from 82% and 44% to 93% and 82%, respectively (P > 0.05 and P < 0.001). With the use of CAD, the overall false positive rate and false negative rate for the detection of polyps by experienced and inexperienced readers decreased in different degrees. Among 13 sessile polyps not detected by CAD, two were ≥ 1.0 cm, eleven were 5 - 9 mm in diameter, and nine were flat-shaped lesions. The application of CAD in combination with CTC can increase the ability to detect colonic polyps, particularly for inexperienced readers. However, CAD is of limited value for the detection of flat polyps.

High resolution microendoscopy for classification of colorectal polyps.

PubMed

Chang, S S; Shukla, R; Polydorides, A D; Vila, P M; Lee, M; Han, H; Kedia, P; Lewis, J; Gonzalez, S; Kim, M K; Harpaz, N; Godbold, J; Richards-Kortum, R; Anandasabapathy, S

2013-07-01

It can be difficult to distinguish adenomas from benign polyps during routine colonoscopy. High resolution microendoscopy (HRME) is a novel method for imaging colorectal mucosa with subcellular detail. HRME criteria for the classification of colorectal neoplasia have not been previously described. Study goals were to develop criteria to characterize HRME images of colorectal mucosa (normal, hyperplastic polyps, adenomas, cancer) and to determine the accuracy and interobserver variability for the discrimination of neoplastic from non-neoplastic polyps when these criteria were applied by novice and expert microendoscopists. Two expert pathologists created consensus HRME image criteria using images from 68 patients with polyps who had undergone colonoscopy plus HRME. Using these criteria, HRME expert and novice microendoscopists were shown a set of training images and then tested to determine accuracy and interobserver variability. Expert microendoscopists identified neoplasia with sensitivity, specificity, and accuracy of 67 % (95 % confidence interval [CI] 58 % - 75 %), 97 % (94 % - 100 %), and 87 %, respectively. Nonexperts achieved sensitivity, specificity, and accuracy of 73 % (66 % - 80 %), 91 % (80 % - 100 %), and 85 %, respectively. Overall, neoplasia were identified with sensitivity 70 % (65 % - 76 %), specificity 94 % (87 % - 100 %), and accuracy 85 %. Kappa values were: experts 0.86; nonexperts 0.72; and overall 0.78. Using the new criteria, observers achieved high specificity and substantial interobserver agreement for distinguishing benign polyps from neoplasia. Increased expertise in HRME imaging improves accuracy. This low-cost microendoscopic platform may be an alternative to confocal microendoscopy in lower-resource or community-based settings.

Similarity and Enhancement: Nasality from Moroccan Arabic Pharyngeals and Nasals

ERIC Educational Resources Information Center

Zellou, Georgia Eve

2012-01-01

Experimental studies of the articulation, acoustics, and perception of nasal and pharyngeal consonants and adjacent vowels were conducted to investigate nasality in Moroccan Arabic (MA). The status of nasality in MA is described as coarticulatorily complex, where two phoneme types (pharyngeal segments and nasal segments) yield similar…

[Psychopathological characteristics in patients with deviation of nasal septum: a preliminary analysis].

PubMed

Li, W T; Chen, X Z; Tu, W J; Huang, Z Z; Chang, L H; Wang, J; Zhang, G H

2016-09-07

Objective: To investigate the psychopathological characteristics in patients with deviation of nasal septum. Methods: Between May 2015 and December 2015, fourty-four patients with deviated nasal septum and 37 patients with vocal cord polyp as control were included in this study. Psychological characteristics were evaluated by a series of questionnaire instruments including symptom checklist-90 (SCL-90), self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Visual analogue scale (VAS) and rhinomanometry through front nostril were used to evaluate nasal symptom. The correlation between psychological characteristics and nasal symptom was evaluated. SPSS 20.0 software was used to analyze the data. Results: The SCL-90 score in nasal septal deviation group was 130.4±48.3. The total score and total average score of SCL-90 had no significant difference between nasal septal deviation group and the Chinese standard or control group( t value was 0.469, 0.112, 1.575, 1.564, respectively, all P >0.05). The scores of somatization, depression and anxiety factors in nasal septal deviation group were higher than control group ( t value was 2.380, 2.133, 1.969, respectively, all P <0.05). The proportion of positive patients in these three factors between nasal septal deviation group and control group had significant differences (χ 2 value was 11.585, 9.610, 5.429, respectively, all P <0.05). The scores of SDS and SAS in nasal septal deviation group were 46.0±10.6 and 43.0±10.2, which were higher than that in the Chinese standard and control group ( t value was 5.342, 6.236, 1.476, 3.013, respectively, all P <0.05). There were 9 patients companying with depression or anxiety (20.5%, 20.5%, respectively) and 5 patients companying with depression and anxiety in nasal septal deviation group (11.4%). There were positive correlation not only between the scores of SDS and the depression factor of SCL-90 but also between the scores of SAS and the anxiety factor of SCL

Saline nasal washes

MedlinePlus

... nasal wash helps flush pollen, dust, and other debris from your nasal passages. It also helps remove excess mucus (snot) and adds moisture. Your nasal passages are open spaces behind your nose. Air passes through your nasal ...

Treatment of hyperplastic inferior nasal turbinates by means of a Ho:YAG laser

NASA Astrophysics Data System (ADS)

Sroka, Ronald; Leunig, Andreas; Janda, P.; Rosler, P.; Grevers, G.; Baumgartner, Reinhold

1999-06-01

Although the successful use of the Ho:YAG laser in nasal turbinate surgery had been reported no clinical study had been performed to assess the clinical outcome in longterm. By means of a pulsed Ho:YAG laser emitting at λ=2080nm (1J/pulse, 3-8 Hz) 57 patients suffering from nasal obstruction due to allergic rhinitis and vasomotoric rhinitis were treated under local anesthesia. The study was conducted by standardized questionnaire, photo documentation, allergy test, mucocilliar test, rhinomanometry, radiology and histology. Within 2 weeks after laser treatment a significant improvement of nasal airflow correlating to the extent of the ablated turbinate tissue could be determined. This effect lasted up until 1 year post treatment resulting in an improved quality of life in more than 80 percent of the patients. Side effects like nasal dryness and pain were rare (<4%), no immediate complications were observed. The total treatment time takes 3-8 min and nasal packing was not necessary after the laser procedure. In conclusion Ho:YAG laser treatment can be performed as an outpatient procedure under local anesthesia with excellent ablation of soft tissue in a short treatment time with promising results.

Polyp Removal of a Bloom Forming Jellyfish, Aurelia coerulea, in Korean Waters and Its Value Evaluation

NASA Astrophysics Data System (ADS)

Yoon, Wonduk; Chae, Jinho; Koh, Byoung-Seol; Han, Changhoon

2018-04-01

Aurelia coerulea is a bloom forming jellyfish that first appeared before 1980 in the western and southern Korean seas and which has been blamed for huge economical losses in all fields of marine activities. As a preventive measure to reduce economical losses, polyp removal was undertaken at Lake Shihwa, Lake Saemangeum, and Masan Bay, Korea. In the course of efforts during 2 years to remove polyps, polyps were surveyed, quantified, and removed. In these areas, the initial total polyp abundance was 5.04 × 109 and 46.25% of them were removed; Lake Shihwa the highest rates of removal and Lake Saemangeum the lowest. These efforts to remove polyps prevented the appearance of 1.20 × 109 medusae, corresponding to 78.28 × 106 kg. The cost of polyp removal was evaluated and compared with that of medusae removal. The ratio between the cost of polyp removal and that of medusae removal ranged between 0.78-3.14%, indicating large cost savings for polyp removal undertakings. However, the effect of polyp removal varied from positive to none, and we assumed that the cleared surface for polyp removal, quantity of removed polyp, and existence of polyps' hotspots in neighboring areas were the causes of the non-effectiveness of polyp removal undertakings.

The Effects of Size and Type of Vocal Fold Polyp on Some Acoustic Voice Parameters.

PubMed

Akbari, Elaheh; Seifpanahi, Sadegh; Ghorbani, Ali; Izadi, Farzad; Torabinezhad, Farhad

2018-03-01

Vocal abuse and misuse would result in vocal fold polyp. Certain features define the extent of vocal folds polyp effects on voice acoustic parameters. The present study aimed to define the effects of polyp size on acoustic voice parameters, and compare these parameters in hemorrhagic and non-hemorrhagic polyps. In the present retrospective study, 28 individuals with hemorrhagic or non-hemorrhagic polyps of the true vocal folds were recruited to investigate acoustic voice parameters of vowel/ æ/ computed by the Praat software. The data were analyzed using the SPSS software, version 17.0. According to the type and size of polyps, mean acoustic differences and correlations were analyzed by the statistical t test and Pearson correlation test, respectively; with significance level below 0.05. The results indicated that jitter and the harmonics-to-noise ratio had a significant positive and negative correlation with the polyp size (P=0.01), respectively. In addition, both mentioned parameters were significantly different between the two types of the investigated polyps. Both the type and size of polyps have effects on acoustic voice characteristics. In the present study, a novel method to measure polyp size was introduced. Further confirmation of this method as a tool to compare polyp sizes requires additional investigations.

The Effects of Size and Type of Vocal Fold Polyp on Some Acoustic Voice Parameters

PubMed Central

Akbari, Elaheh; Seifpanahi, Sadegh; Ghorbani, Ali; Izadi, Farzad; Torabinezhad, Farhad

2018-01-01

Background Vocal abuse and misuse would result in vocal fold polyp. Certain features define the extent of vocal folds polyp effects on voice acoustic parameters. The present study aimed to define the effects of polyp size on acoustic voice parameters, and compare these parameters in hemorrhagic and non-hemorrhagic polyps. Methods In the present retrospective study, 28 individuals with hemorrhagic or non-hemorrhagic polyps of the true vocal folds were recruited to investigate acoustic voice parameters of vowel/ æ/ computed by the Praat software. The data were analyzed using the SPSS software, version 17.0. According to the type and size of polyps, mean acoustic differences and correlations were analyzed by the statistical t test and Pearson correlation test, respectively; with significance level below 0.05. Results The results indicated that jitter and the harmonics-to-noise ratio had a significant positive and negative correlation with the polyp size (P=0.01), respectively. In addition, both mentioned parameters were significantly different between the two types of the investigated polyps. Conclusion Both the type and size of polyps have effects on acoustic voice characteristics. In the present study, a novel method to measure polyp size was introduced. Further confirmation of this method as a tool to compare polyp sizes requires additional investigations. PMID:29749984

Effects of topical phenytoin on nasal wound healing after mechanical trauma: An experimental study.

PubMed

Şimşek, Gökçe; Ciftci, Osman; Karadag, Neşe; Karatas, Erkan; Kizilay, Ahmet

2014-12-01

Impaired postoperative wound healing is the second most common morbidity after synechia formation in endoscopic sinus surgery. The aim of this experimental study was to investigate the potential effects of topical phenytoin on wound healing after nasal mucosal trauma in rats. An experimental study at the Inonu University Faculty of Medicine. Twenty-four rats were randomized into three groups: 1) phenytoin group (n = 8), 2) control group (n = 8), and 3) vehicle group (n = 8). After damaging the right nasal cavity, in the phenytoin group, 1% topical phenytoin cream was applied for 7 days. The rats in the control group did not receive any treatment. The vehicle group was treated with daily topical cold cream for 1 week. The rats were sacrificed at the end, and the nasal cavities were excised. Tissue edema and inflammatory cell infiltration were compared among the groups. Additionally, proliferating cell nuclear antigen (PCNA) and cluster of differentiation 31 (CD31) immunoexpression levels were evaluated. Furthermore, in biochemical analysis, the tissue levels of vascular endothelial growth factor and (EGF) of the groups were investigated. In the phenytoin group, tissue edema and inflammatory cell infiltration were significantly decreased, and PCNA and CD31 immunoexpression levels were more prominent (P < .001) and the tissue EGF levels were significantly higher (P < .01). Topical phenytoin treatment may alter the nasal wound healing after mechanical trauma. The potential beneficial effects of topical phenytoin on nasal mucosa should be investigated by further experimental and human trials. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Natural history of small gallbladder polyps is benign: evidence from a clinical and pathogenetic study.

PubMed

Colecchia, Antonio; Larocca, Anna; Scaioli, Eleonora; Bacchi-Reggiani, Maria Letizia; Di Biase, Anna Rita; Azzaroli, Francesco; Gualandi, Roberta; Simoni, Patrizia; Vestito, Amanda; Festi, Davide

2009-03-01

Little is known about the natural history and pathogenesis of small gallbladder polyps (<10 mm, usually of the cholesterol type), particularly in Western populations. It is unclear if these polyps and gallstones represent different aspects of the same disease. The aim of this study was to characterize the natural history and pathogenesis of small gallbladder polyps. Fifty-six Caucasian patients with small gallbladder polyps, 30 matched gallstone patients, and 30 controls were enrolled in this 5-year prospective study. Patients underwent a symptomatic questionnaire, abdominal ultrasonography, and ultrasonographic evaluation of gallbladder motility at baseline and yearly intervals for 5 years. Cholesterol saturation index, cholesterol crystals in bile, and apolipoprotein E genotype were also determined. Most patients with polyps (mean size: 5.3 mm) were men (61%), asymptomatic, and had multiple polyps (57%). Polyps did not change in 91% of patients during follow-up. No subject experienced biliary pain or underwent cholecystectomy; four developed gallstones. Cholesterol saturation index was higher in patients with polyps or gallstones than in controls (P<0.05). Cholesterol crystals were more frequent in patients with polyps than in controls (P<0.0001) but less common than in gallstone patients (P<0.0001). Polyps and gallstones were associated with nonapolipoprotein E4 phenotypes. The natural history of small gallbladder polyps was benign, as no patient developed specific symptoms and/or morphological changes in polyps. Consequently, a "wait and see" policy is advisable in these patients. Polyps have some pathogenetic mechanisms in common with gallstones, but few patients developed gallstones.

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations.

PubMed

Teber, Mehmet Akif; Tan, Sinan; Dönmez, Uğur; İpek, Ali; Uçar, Ali Erkan; Yıldırım, Halil; Aslan, Ahmet; Arslan, Halil

2014-12-01

Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). The mean size for benign gallbladder polyps was 7.2 +/- 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

Spontaneous Nasal Septal Abscess Presenting as a Soft Tissue Mass in a Child.

PubMed

Cai, Yi; Saqi, Anjali; Haddad, Joseph

2017-04-01

Nasal septal abscess (NSA) is a rare condition most commonly seen as a complication of nasal trauma. The diagnosis of NSA requires emergent treatment, because delayed management can result in significant morbidity. Typically, NSA presents as a purulent collection that can be managed with drainage, either surgically or at bedside. We report an unusual presentation of a spontaneous NSA in a 7-year-old boy as a solid nasal mass eroding the nasal septum. The solid, tumor-like nature of the mass necessitated intervention beyond drainage and was ultimately excised. Imaging initiated in the emergency department revealed a partially cystic mass and erosion of the septum, which was key to the diagnosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Given the ease with which a diagnosis of NSA may be missed and the need for urgent management upon diagnosis of a NSA, we aim to highlight the clinical, radiologic, and histopathologic aspects that aid in diagnosis of NSA. Imaging, obtaining culture results, and initiation of antibiotics are paramount in management. In addition, NSAs may also necessitate bedside drainage given their emergent nature. Copyright © 2016 Elsevier Inc. All rights reserved.

Antrochoanal polyposis: a review of 33 cases.

PubMed

Cook, P R; Davis, W E; McDonald, R; McKinsey, J P

1993-06-01

We report on a series of 33 consecutive cases of antrochoanal polyp (ACP) treated by endoscopic sinus surgery over a five-year period. All but one patient was treated by endoscopic sinus surgery alone. This method of treatment was quite effective for ACPs. These 33 patients represent 22.3% of all nasal polyp patients on whom we operated during the same period. This incidence of ACP is greater than that generally reported in the literature. Some authors have attempted to distinguish ACPs from common nasal polyps primarily on the basis of morphology, histology, and the clinical behavior of the ACPs. In our series, a multivariate analysis, including histopathologic correlation, did not support the notion that ACPs are clearly distinct from common nasal polyps. Some interesting differences between the polyp groups did, however, become evident in our data analysis. Generally, ACPs are not thought to be associated with allergic disease; however, in our series we found the association of allergic disease with ACPs to be statistically significant (Chi-square = 4.575, p < .05).

Selective suppression of in situ proliferation of scyphozoan polyps by biofouling.

PubMed

Feng, Song; Wang, Shi-Wei; Zhang, Guang-Tao; Sun, Song; Zhang, Fang

2017-01-30

An increase in marine artificial constructions has been proposed as a major cause of jellyfish blooms, because these constructions provide additional substrates for organisms at the benthic stage (polyps), which proliferate asexually and release a large amount of free-swimming medusae. These hard surfaces are normally covered by fouling communities, the components of which have the potential to impede the proliferation of polyps. In this study, we report an in situ experiment of polyp survival of four large scyphozoan species found in East Asian marginal seas that were exposed to biofouling, a universal phenomenon occurring on marine artificial constructions. Our results showed that the polyps of three species (Nemopilema nomurai, Cyanea nozaki, and Rhopilema esculentum) attached to the artificial surfaces were completely eliminated by biofouling within 7-8months, and only those of moon jellyfish (Aurelia sp.1) in the upper layers could multiply on both artificial materials and other organisms (e.g., ascidians and bryozoans). Fouling-associated competition and predation and suppressed asexual reproduction of podocysts were observed to contribute to the loss of polyps. This study shows that the natural distribution of polyps is defined by the biofouling community that colonizes the surfaces of artificial constructions. Consequently, the contribution of marine constructions to jellyfish bloom is limited only to the ability of the jellyfish species to reproduce asexually through budding and inhabit solid surfaces of fouling organisms in addition to inhabiting original artificial materials. We anticipate that fragile polyps will colonize and proliferate in harsh environments that are deleterious to biofouling, and we propose special attention to polyps in antifouling practices for excluding the possibility that they occupy the available ecological space. Copyright © 2016 Elsevier Ltd. All rights reserved.

Retrospective review of 50 canine nasal tumours evaluated by low-field magnetic resonance imaging.

PubMed

Avner, A; Dobson, J M; Sales, J I; Herrtage, M E

2008-05-01

Low-field magnetic resonance imaging machines are being used more often in veterinary practice for the investigation of sinonasal disease. The aim of this retrospective study was to describe and characterise the low-field magnetic resonance imaging features of nasal tumours in dogs. The Queen's Veterinary School Hospital magnetic resonance imaging database (2001-2005) was searched for dogs with a magnetic resonance imaging diagnosis of a nasal tumour. Fifty cases with histological diagnosis of nasal tumour were found. The appearance and extent of the nasal tumour as well as the involvement of adjacent anatomic structures were examined against a checklist. The most common magnetic resonance imaging findings were as follows. (1) Soft tissue mass replacing the destroyed nasal conchae and/or ethmoturbinates (98 per cent of cases). (2) Nasal septum destruction (68 per cent of cases). (3) Retained secretions with or without mass caudally in frontal sinuses (62 per cent of cases). (4) Nasal/frontal bone destruction (52 per cent of cases). Low-field magnetic resonance imaging allowed differentiation of tumour tissue from retained secretions or necrotic tissue. Magnetic resonance imaging was invaluable in assessing the extension of the tumour into the maxillary recesses, caudal recesses, nasopharynx, adjacent bones and cranial cavity. The tumour often extended caudally into the frontal sinuses, nasopharynx and perhaps most importantly into the caudal recesses. Tumour extension into the cranial cavity was not common (16 per cent), and only three of these cases showed neurological signs. However, 54 per cent of cases showed focal meningeal (dural) hyperintensity, although the significance of this is unclear. A significant difference (P<0.05) in tumour signal intensity between the sarcomas and carcinomas was found. The use of a low-field magnetic resonance imaging technique is excellent for the diagnosis and determination of extent of sinonasal tumours.

Risk stratification of gallbladder polyps larger than 10 mm using high-resolution ultrasonography and texture analysis.

PubMed

Choi, Tae Won; Kim, Jung Hoon; Park, Sang Joon; Ahn, Su Joa; Joo, Ijin; Han, Joon Koo

2018-01-01

To assess important features for risk stratification of gallbladder (GB) polyps >10 mm using high-resolution ultrasonography (HRUS) and texture analysis. We included 136 patients with GB polyps (>10 mm) who underwent both HRUS and cholecystectomy (non-neoplastic, n = 58; adenomatous, n = 32; and carcinoma, n = 46). Two radiologists retrospectively assessed HRUS findings and texture analysis. Multivariate analysis was performed to identify significant predictors for neoplastic polyps and carcinomas. Single polyp (OR, 3.680-3.856) and larger size (OR, 1.450-1.477) were independently associated with neoplastic polyps (p < 0.05). In a single or polyp >14 mm, sensitivity for differentiating neoplastic from non-neoplastic polyps was 92.3%. To differentiate carcinoma from adenoma, sessile shape (OR, 9.485-41.257), larger size (OR, 1.267-1.303), higher skewness (OR, 6.382) and lower grey-level co-occurrence matrices (GLCM) contrast (OR, 0.963) were significant predictors (p < 0.05). In a polyp >22 mm or sessile, sensitivity for differentiating carcinomas from adenomas was 93.5-95.7%. If a polyp demonstrated at least one HRUS finding and at least one texture feature, the specificity for diagnosing carcinoma was increased to 90.6-93.8%. In a GB polyp >10 mm, single and diameter >14 mm were useful for predicting neoplastic polyps. In neoplastic polyps, sessile shape, diameter >22 mm, higher skewness and lower GLCM contrast were useful for predicting carcinoma. • Risk of neoplastic polyp is low in <14 mm and multiple polyps • A sessile polyp or >22 mm has increased risk for GB carcinomas • Higher skewness and lower GLCM contrast are predictors of GB carcinoma • HRUS is useful for risk stratification of GB polyps >1 cm.

MicroRNA signatures of colonic polyps on screening and histology

PubMed Central

Tsikitis, Vassiliki L.; Potter, Amiee; Mori, Motomi; Buckmeier, Julie A.; Preece, Christina R.; Harrington, Christina A.; Bartley, Angela N.; Bhattacharyya, Achyut K.; Hamilton, Stanley R.; Lance, M. Peter; Thompson, Patricia A.

2016-01-01

Colorectal cancer (CRC) and adenoma adjacent to cancer exhibit distinct microRNA (miR) alterations in an apparent mucosa-to-adenocarcinoma sequence. The pattern of microRNAs in screen-detected polyps in relation to histologic features and cancer risk has not been investigated. miR expression analysis was performed on normal mucosa (NM), hyperplastic polyps (HPs), tubular adenomas (TAs), tubulovillous adenomas or high-grade dysplasia (TVHGs), and serrated polyps (sessile serrated adenoma/polyps, SSA/Ps, and traditional serrated adenomas, TSAs) in biopsy specimens from 109 patients undergoing screening/surveillance colonoscopy. Generalized linear models were used to identify differentially expressed miRs by histologic type and logistic regression to identify miR predictors of histopathology. False discovery rate (FDR) was used to control for multiple comparisons. We identified 99 miRs differing in at least one of five histopathologic groups (FDR ≤ 0.05). In a comparison of HPNM vs. TVHG, the top most up- and down-regulated miRs in HPNM included miR-145, -143, -107, -194, and -26a (upregulated), and miR-663, -1268, -320b, -1275, and -320b (down-regulated) (FDR P-value < 0.05). miR-145 and -619 showed high accuracy to discriminate low- from high-risk polyps without serrated histology (TVHG vs. HPNM+TA) (CI= 95.6%), whereas miRs-124, -143, and -30a showed high accuracy of separating high-risk polyps (TVHG+TSA) from low-risk polyps (HPNM+TA+SSA/P) (CI=96.0%). For TSAs, miRs-125b and -199a were uniquely downregulated relative to HPNMs, and miR-335, -222 and -214 discriminated between non-serrated and serrated histology. Our data support the presence of CRC-associated miR alterations in screen-detected adenomas that may be useful for risk stratification for surveillance interval planning. PMID:27658891

Sino-Nasal Outcome Test-22: Translation, Cross-cultural Adaptation, and Validation in Hebrew-Speaking Patients.

PubMed

Shapira Galitz, Yael; Halperin, Doron; Bavnik, Yosef; Warman, Meir

2016-05-01

To perform the translation, cross-cultural adaptation, and validation of the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire to the Hebrew language. A single-center prospective cross-sectional study. Seventy-three chronic rhinosinusitis (CRS) patients and 73 patients without sinonasal disease filled the Hebrew version of the SNOT-22 questionnaire. Fifty-one CRS patients underwent endoscopic sinus surgery, out of which 28 filled a postoperative questionnaire. Seventy-three healthy volunteers without sinonasal disease also answered the questionnaire. Internal consistency, test-retest reproducibility, validity, and responsiveness of the questionnaire were evaluated. Questionnaire reliability was excellent, with a high internal consistency (Cronbach's alpha coefficient, 0.91-0.936) and test-retest reproducibility (Spearman's coefficient, 0.962). Mean scores for the preoperative, postoperative, and control groups were 50.44, 29.64, and 13.15, respectively (P < .0001 for CRS vs controls, P < .001 for preoperative vs postoperative), showing validity and responsiveness of the questionnaire. The Hebrew version of SNOT-22 questionnaire is a valid outcome measure for patients with CRS with or without nasal polyps. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Adaptive deformable model for colonic polyp segmentation and measurement on CT colonography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao Jianhua; Summers, Ronald M.

2007-05-15

Polyp size is one important biomarker for the malignancy risk of a polyp. This paper presents an improved approach for colonic polyp segmentation and measurement on CT colonography images. The method is based on a combination of knowledge-guided intensity adjustment, fuzzy clustering, and adaptive deformable model. Since polyps on haustral folds are the most difficult to be segmented, we propose a dual-distance algorithm to first identify voxels on the folds, and then introduce a counter-force to control the model evolution. We derive linear and volumetric measurements from the segmentation. The experiment was conducted on 395 patients with 83 polyps, ofmore » which 43 polyps were on haustral folds. The results were validated against manual measurement from the optical colonoscopy and the CT colonography. The paired t-test showed no significant difference, and the R{sup 2} correlation was 0.61 for the linear measurement and 0.98 for the volumetric measurement. The mean Dice coefficient for volume overlap between automatic and manual segmentation was 0.752 (standard deviation 0.154)« less

A randomized, prospective, double-blind study of the efficacy of dexpanthenol nasal spray on the postoperative treatment of patients with chronic rhinosinusitis after endoscopic sinus surgery.

PubMed

Tantilipikorn, Pongsakorn; Tunsuriyawong, Prayuth; Jareoncharsri, Perapun; Bedavanija, Anan; Assanasen, Paraya; Bunnag, Chaweewan; Metheetrairut, Choakchai

2012-01-01

To assess the efficacy of dexpanthenol nasal spray compared with normal saline spray in the postoperative treatment of patients with chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery (ESS). A prospective, randomized controlled study was conducted in CRS patients who underwent ESS. The enrolled patients had never been operated intranasally. These patients received either dexpanthenol or normal saline nasal spray intranasally four times a day for six weeks post-operatively. Fifty CRS patients were recruited in the present study. Age ranged from 23 to 63 years (means 43.4 +/- 11.2 years). Forty-four percent of patients were diagnosed as CRS without nasal polyps (NP) (CRSs NP) and 56% were CRS with NP (CRSw NP). Twenty-five cases were randomly assigned to use dexpanthenol nasal spray whereas the other 25 cases used normal saline nasal spray. The preoperative severity of CRS, determined by the computerized tomography (CT) scan scoring system of Lund-McKay was 13.9 +/- 6.2 in the dexpanthenol group and 13.6 +/- 6.9 in the normal saline group, which were not statistically different (p > 0.05). The endoscopic scoring was 10.2 +/- 2 in the dexpanthenol group and 10.7 +/- 3 in the normal saline group, which were not statistically different (p > 0.05). The mucociliary transit time improvement (time difference between pre- and post-treatment by nasal spray) was 8.4 +/- 3.3 minutes in the dexpanthenol group and 1.7 +/- 1.2 minutes in the normal saline group, which were statistically different (p < 0.05). The majority of the postoperative symptom scores and all of the endoscopic scores of the dexpanthenol group were not statistically different from those of the normal saline group. However, dexpanthenol nasal spray has superior efficacy compared with normal saline nasal spray on improvement of mucociliary clearance and nasal discharge in the postoperative care of CRS patients after ESS.

Deep ensemble learning of virtual endoluminal views for polyp detection in CT colonography

NASA Astrophysics Data System (ADS)

Umehara, Kensuke; Näppi, Janne J.; Hironaka, Toru; Regge, Daniele; Ishida, Takayuki; Yoshida, Hiroyuki

2017-03-01

Robust training of a deep convolutional neural network (DCNN) requires a very large number of annotated datasets that are currently not available in CT colonography (CTC). We previously demonstrated that deep transfer learning provides an effective approach for robust application of a DCNN in CTC. However, at high detection accuracy, the differentiation of small polyps from non-polyps was still challenging. In this study, we developed and evaluated a deep ensemble learning (DEL) scheme for reviewing of virtual endoluminal images to improve the performance of computer-aided detection (CADe) of polyps in CTC. Nine different types of image renderings were generated from virtual endoluminal images of polyp candidates detected by a conventional CADe system. Eleven DCNNs that represented three types of publically available pre-trained DCNN models were re-trained by transfer learning to identify polyps from the virtual endoluminal images. A DEL scheme that determines the final detected polyps by a review of the nine types of VE images was developed by combining the DCNNs using a random forest classifier as a meta-classifier. For evaluation, we sampled 154 CTC cases from a large CTC screening trial and divided the cases randomly into a training dataset and a test dataset. At 3.9 falsepositive (FP) detections per patient on average, the detection sensitivities of the conventional CADe system, the highestperforming single DCNN, and the DEL scheme were 81.3%, 90.7%, and 93.5%, respectively, for polyps ≥6 mm in size. For small polyps, the DEL scheme reduced the number of false positives by up to 83% over that of using a single DCNN alone. These preliminary results indicate that the DEL scheme provides an effective approach for improving the polyp detection performance of CADe in CTC, especially for small polyps.

Assessment of nasalance and nasality in patients with a repaired cleft palate.

PubMed

Sinko, Klaus; Gruber, Maike; Jagsch, Reinhold; Roesner, Imme; Baumann, Arnulf; Wutzl, Arno; Denk-Linnert, Doris-Maria

2017-07-01

In patients with a repaired cleft palate, nasality is typically diagnosed by speech language pathologists. In addition, there are various instruments to objectively diagnose nasalance. To explore the potential of nasalance measurements after cleft palate repair by NasalView ® , we correlated perceptual nasality and instrumentally measured nasalance of eight speech items and determined the relationship between sensitivity and specificity of the nasalance measures by receiver-operating characteristics (ROC) analyses and AUC (area under the curve) computation for each single test item and specific item groups. We recruited patients with a primarily repaired cleft palate receiving speech therapy during follow-up. During a single day visit, perceptive and instrumental assessments were obtained in 36 patients and analyzed. The individual perceptual nasality was assigned to one of four categories; the corresponding instrumental nasalance measures for the eight specific speech items were expressed on a metric scale (1-100). With reference to the perceptual diagnoses, we observed 3 nasal and one oral test item with high sensitivity. However, the specificity of the nasality indicating measures was rather low. The four best speech items with the highest sensitivity provided scores ranging from 96.43 to 100%, while the averaged sensitivity of all eight items was below 90%. We conclude that perceptive evaluation of nasality remains state of the art. For clinical follow-up, instrumental nasalance assessment can objectively document subtle changes by analysis of four speech items only. Further studies are warranted to determine the applicability of instrumental nasalance measures in the clinical routine, using discriminative items only.

Endotics system vs colonoscopy for the detection of polyps

PubMed Central

Tumino, Emanuele; Sacco, Rodolfo; Bertini, Marco; Bertoni, Michele; Parisi, Giuseppe; Capria, Alfonso

2010-01-01

AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age 51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation. PMID:21086563

Association of insulin-related serum factors with colorectal polyp number and type in adult males

PubMed Central

Comstock, Sarah S.; Xu, Diana; Hortos, Kari; Kovan, Bruce; McCaskey, Sarah; Pathak, Dorothy R.; Fenton, Jenifer I.

2014-01-01

Background Dysregulated insulin signaling is thought to contribute to cancer risk. Methods To determine if insulin-related serum factors are associated with colon polyps, 126 asymptomatic men (48–65yr) were recruited at colonoscopy. Blood was collected. Odds ratios were determined using polytomous logistic regression for polyp number and type. Results Males with serum C-peptide concentration >3.3 ng/ml were 3.8 times more likely to have an adenoma relative to no polyp than those with C-peptide ≤1.8 ng/ml. As C-peptide tertile increased, an individual was 2 times more likely to have an adenoma (p=0.01) than no polyp. There were no associations between insulin-like growth factor or its binding proteins with polyp number or type. Males with soluble receptor for advanced glycation end products (sRAGE) concentration >120.4 pg/ml were 0.25 times less likely to have ≥3 polyps relative to no polyps compared to males with sRAGE ≤94.5 pg/ml. For each increase in sRAGE tertile, a man was 0.5 times less likely to have ≥3 polyps than no polyps (p=0.03). Compared to males with a serum vascular endothelial growth factor (VEGF) concentration ≤104.7 pg/ml, males with a serum VEGF concentration >184.2 pg/ml were 3.4 times more likely to have ≥3 polyps relative to no polyps. As the VEGF tertile increased, a man was 1.9 times more likely to have ≥3 polyps than no polyps (p=0.049). Conclusions Serum concentrations of C-peptide, sRAGE, and VEGF may indicate which men could benefit most from colonoscopy. Impact Identification of biomarkers could reduce medical costs through the elimination of colonoscopies on low-risk individuals. PMID:24962837

Three-Dimensional Soft Tissue Nasal Changes After Nasoalveolar Molding and Primary Cheilorhinoplasty in Infants With Unilateral Cleft Lip and Palate.

PubMed

Mancini, Laura; Gibson, Travis L; Grayson, Barry H; Flores, Roberto L; Staffenberg, David; Shetye, Pradip R

2018-01-01

To quantify 3-dimensional (3D) nasal changes in infants with unilateral cleft lip with or without cleft palate (UCL±P) treated by nasoalveolar molding (NAM) and cheilorhinoplasty and compare to noncleft controls. Retrospective case series of infants treated with NAM and primary cheilorhinoplasty between September, 2012 and July, 2016. Infants were included if they had digital stereophotogrammetric records at initial presentation (T1), completion of NAM (T2), and following primary cheilorhinoplasty (T3). Images were oriented in 3dMD Vultus software, and 16 nasolabial points identified. Twenty consecutively treated infants with UCL±P. Nasoalveolar molding and primary cheilorhinoplasty. Anthropometric measures of nasal symmetry and morphology were compared in the treatment group between time points using paired Student t tests. Postsurgical nasal morphology was compared to noncleft controls. Nasal tip protrusion increased, and at T3 was 2.64 mm greater than noncleft controls. Nasal base width decreased on the cleft side by 4.01 mm after NAM and by 6.73 mm after cheilorhinoplasty. Columellar length of the noncleft to cleft side decreased from 2:1 to 1:1 following NAM. Significant improvements in subnasale, columella, and nasal tip deviations from midsagittal plane were observed. Treatment improved symmetry of the alar morphology angle and the nasal base-columella angle between cleft and noncleft sides. Three-dimensional analysis of UCL±P patients demonstrated significant improvements in nasal projection, columella length, nasal symmetry, and nasal width. Compared to noncleft controls, nasal form was generally corrected, with overcorrection of nasal tip projection, columella angle, and outer nasal widths.

Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography.

PubMed

Park, Chan Hyuk; Chung, Moon Jae; Oh, Tak Geun; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Kim, Hyunki; Hwang, Ho Kyoung; Lee, Woo Jung; Song, Si Young

2013-04-01

Differential diagnosis between gallbladder (GB) adenomas and cholesterol polyps based on ultrasonography or endoscopic ultrasonography (EUS) is challenging because they have similar echogenicity and morphology. We evaluated the usefulness of contrast-enhanced harmonic EUS (CEH-EUS) for differentiating between GB adenomas and cholesterol polyps. Between June 2010 and December 2011, a total of 87 patients with GB polyps who underwent a CEH-EUS were reviewed retrospectively. Of the 87 patients, 57 had a cholecystectomy. Of these, 34 patients were diagnosed with adenoma, cholesterol polyp, adenocarcinoma, or adenomyomatosis pathology. The remaining 23 patients were not diagnosed with GB polyps because their lesions separated from the GB mucosal layer during pathological sampling. On CEH-EUS, homogeneous and heterogeneous enhancement was shown in 6 and 2 patients with adenoma and in 4 and 8 patients with cholesterol polyps, respectively. Sensitivity and specificity of CEH-EUS for differential diagnosis of GB adenomas from cholesterol polyps based on the enhancement pattern were 75.0 and 66.6 %, respectively. CEH-EUS might be useful for distinguishing GB adenomas and cholesterol polyps based on enhancement patterns. However, an additional technique such as quantitative perfusion analysis is necessary because visual assessment of CEH-EUS images is subjective.

Oral polyp as the presenting feature of Beckwith-Wiedemann syndrome in a child

PubMed Central

Kujan, Omar; Raheel, Syed Ahmed; King, David; Iqbal, Fareed

2015-01-01

Beckwith-Wiedemann syndrome (BWS) is a congenital growth disorder characterised by abdominal wall defects, macroglossia and somatic gigantism. A number of associated features, including gastrointestinal and urinary tract polyps, have been described, but there are no previous reports of oral polyps occurring in this syndrome. We describe the first case of BWS presenting with an oral polyp. Clinicians should be alert to the possibility of BWS if other features of the syndrome are present, in children with oral polyps. PMID:26323977

Glycoprotein expression by adenomatous polyps of the colon

NASA Astrophysics Data System (ADS)

Roney, Celeste A.; Xie, Jianwu; Xu, Biying; Jabour, Paul; Griffiths, Gary; Summers, Ronald M.

2008-03-01

Colon cancer is the second leading cause of cancer related deaths in the United States. Specificity in diagnostic imaging for detecting colorectal adenomas, which have a propensity towards malignancy, is desired. Adenomatous polyp specimens of the colon were obtained from the mouse model of colorectal cancer called adenomatous polyposis coli-multiple intestinal neoplasia (APC Min). Histological evaluation, by the legume protein Ulex europaeus agglutinin I (UEA-1), determined expression of the glycoprotein α-L-fucose. FITC-labelled UEA-1 confirmed overexpression of the glycoprotein by the polyps on fluorescence microscopy in 17/17 cases, of which 13/17 included paraffin-fixed mouse polyp specimens. In addition, FITC-UEA-1 ex vivo multispectral optical imaging of 4/17 colonic specimens displayed over-expression of the glycoprotein by the polyps, as compared to non-neoplastic mucosa. Here, we report the surface expression of α-L-fucosyl terminal residues by neoplastic mucosal cells of APC specimens of the mouse. Glycoprotein expression was validated by the carbohydrate binding protein UEA-1. Future applications of this method are the development of agents used to diagnose cancers by biomedical imaging modalities, including computed tomographic colonography (CTC). UEA-1 targeting to colonic adenomas may provide a new avenue for the diagnosis of colorectal carcinoma by CT imaging.

Prospective randomized comparison of cold snare polypectomy and conventional polypectomy for small colorectal polyps.

PubMed

Ichise, Yasuyuki; Horiuchi, Akira; Nakayama, Yoshiko; Tanaka, Naoki

2011-01-01

The ideal method to remove small colorectal polyps is unknown. We compared removal by colon snare transection without electrocautery (cold snare polypectomy) with conventional electrocautery snare polypectomy (hot polypectomy) in terms of procedure duration, difficulty in retrieving polyps, bleeding, and post-polypectomy symptoms. Patients with colorectal polyps up to 8 mm in diameter were randomized to polypectomy by cold snare technique (cold group) or conventional polypectomy (conventional group). The principal outcome measures were abdominal symptoms within 2 weeks after polypectomy. Secondary outcome measures were the rates of retrieval of colorectal polyps and bleeding. Eighty patients were randomized: cold group, n = 40 (101 polyps) and conventional group, n = 40 (104 polyps). The patients' demographic characteristics and the number and size of polyps removed were similar between the two techniques. Procedure time was significantly shorter with cold polypectomy vs. conventional polypectomy (18 vs. 25 min, p < 0.0001). Complete polyp retrieval rates were identical [96% (97/101) vs. 96% (100/104)]. No bleeding requiring hemostasis occurred in either group. Abdominal symptoms shortly after polypectomy were more common with conventional polypectomy (i.e. 20%; 8/40) than with cold polypectomy (i.e. 2.5%; 1/40; p = 0.029). Cold polypectomy was superior to conventional polypectomy in terms of procedure time and post-polypectomy abdominal symptoms. The two methods were otherwise essentially identical in terms of bleeding risk and complete polyp retrieval. Cold polypectomy is therefore the preferred method for removal of small colorectal polyps. Copyright © 2011 S. Karger AG, Basel.

The possibility of clinical application of the solid state lasers: Nd:YAG, Ho:YAG, and Er:YAG in otolaryngology - head and neck surgery

NASA Astrophysics Data System (ADS)

Tomaszewska, M.; Kukwa, A.; Tulibacki, M.; Wójtowicz, P.; Olędzka, I.; Jeżewska, E.

2007-02-01

The purpose of this study was to summarize our experiences in clinical application of Nd:YAG, Ho:YAG and Er:YAG in otolaryngology- head and neck surgery. Choosing the laser type and parameters for the particular procedures was based on our previous research on tissue effects of those lasers. During the period of 1993-2006 we performed 3988 surgical procedures with the Nd:YAG laser. Over 87% of those were made for the nasal cavity pathologies as polyps, hyperplasia of inferior nasal turbinate, granulation tissue, postoperative adhesions, vascular malformations, under the local anesthesia conditions. In our experience Nd:YAG laser gives the possibility of good clinical control and low risk of side effects for disorders of high recurrence and frequent interventions necessity, as nasal polyps or respiratory papillomatosis. Nd:YAG assisted uvulopalatoplasty gives an interesting alternative for surgical procedures for snoring and slight/mild OSA-recognized patients. Due to its good hemostatic properties, it is a perfect tool for removal of the chemodectoma from meddle ear. During the period of 1995-2006 we performed 229 surgical procedures with the Ho:YAG laser, mostly for larynx pathologies (adhesion and scar tissue removal). In our experience Ho:YAG laser can serve as a precise laser knife for both soft and bony tissue. The ER:YAG laser still remain under clinical trial. Since 2001 year we performed 24 procedures of removing stone deposits from salivary glands. We believe it may become a promising method to cope with sialolithiasis which allows for glandule function preservation. All of the laser types mentioned above, can be easily coupled with endoscopes, what makes them available for all of the head and necklocalized disorders.

Improved computer-aided detection of small polyps in CT colonography using interpolation for curvature estimationa

PubMed Central

Liu, Jiamin; Kabadi, Suraj; Van Uitert, Robert; Petrick, Nicholas; Deriche, Rachid; Summers, Ronald M.

2011-01-01

Purpose: Surface curvatures are important geometric features for the computer-aided analysis and detection of polyps in CT colonography (CTC). However, the general kernel approach for curvature computation can yield erroneous results for small polyps and for polyps that lie on haustral folds. Those erroneous curvatures will reduce the performance of polyp detection. This paper presents an analysis of interpolation’s effect on curvature estimation for thin structures and its application on computer-aided detection of small polyps in CTC. Methods: The authors demonstrated that a simple technique, image interpolation, can improve the accuracy of curvature estimation for thin structures and thus significantly improve the sensitivity of small polyp detection in CTC. Results: Our experiments showed that the merits of interpolating included more accurate curvature values for simulated data, and isolation of polyps near folds for clinical data. After testing on a large clinical data set, it was observed that sensitivities with linear, quadratic B-spline and cubic B-spline interpolations significantly improved the sensitivity for small polyp detection. Conclusions: The image interpolation can improve the accuracy of curvature estimation for thin structures and thus improve the computer-aided detection of small polyps in CTC. PMID:21859029

Further refinements of the polyp snare for interuterine surgery--a new modality for treatment of myomas and polyps.

PubMed

McLucas, B

1995-01-01

Hysteroscopic treatment of 30 patients suffering from menorrhagia or post-partum complications was accomplished using an electrosurgical polyp snare. Using this method, 18 polyps and 12 myomas were successfully removed in less than twenty minutes without complications. Local anaesthesia was used in 12 patients. Three patients have presented with recurrence of menorrhagia, with a minimum of six months follow-up. Benefits of this technique compared to uterine resectoscopy include shorter operative time, decreased risk of fluid overload, and less risk of uterine perforation. The snare is difficult to use and a learning curve exists. Higher currents than that used for resection are required.

Measuring and Characterizing the Human Nasal Cycle

PubMed Central

Kahana-Zweig, Roni; Geva-Sagiv, Maya; Weissbrod, Aharon; Secundo, Lavi; Soroker, Nachum; Sobel, Noam

2016-01-01

Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state. PMID:27711189

Migration and Differentiation of GFP-transplanted Bone Marrow-derived Cells into Experimentally Induced Periodontal Polyp in Mice.

PubMed

Matsuda, Saeka; Shoumura, Masahito; Osuga, Naoto; Tsujigiwa, Hidetsugu; Nakano, Keisuke; Okafuji, Norimasa; Ochiai, Takanaga; Hasegawa, Hiromasa; Kawakami, Toshiyuki

2016-01-01

Perforation of floor of the dental pulp is often encountered during root canal treatment in routine clinical practice of dental caries. If perforation were large, granulation tissue would grow to form periodontal polyp. Granulation tissue consists of proliferating cells however their origin is not clear. It was shown that the cells in granulation tissue are mainly from migration of undifferentiated mesenchymal cells of the bone marrow. Hence, this study utilized GFP bone marrow transplantation mouse model. The floor of the pulp chamber in maxillary first molar was perforated using ½ dental round bur. Morphological assessment was carried out by micro CT and microscopy and GFP cell mechanism was further assessed by immunohistochemistry using double fluorescent staining with GFP-S100A4; GFP-Runx2 and GFP-CD31. Results of micro CT revealed alveolar bone resorption and widening of periodontal ligament. Histopathological examination showed proliferation of fibroblasts with some round cells and blood vessels in the granulation tissue. At 2 weeks, the outermost layer of the granulation tissue was lined by squamous cells with distinct intercellular bridges. At 4 weeks, the granulation tissue became larger than the perforation and the outermost layer was lined by relatively typical stratified squamous epithelium. Double immunofluorescent staining of GFP and Runx2 revealed that both proteins were expressed in spindle-shaped cells. Double immunofluorescent staining of GFP and CD31 revealed that both proteins were expressed in vascular endothelial cells in morphologically distinct vessels. The results suggest that fibroblasts, periodontal ligament fibroblasts and blood vessels in granulation tissue were derived from transplanted-bone marrow cells. Thus, essential growth of granulation tissue in periodontal polyp was caused by the migration of undifferentiated mesenchymal cells derived from bone marrow, which differentiated into fibroblasts and later on differentiated into

Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers.

PubMed

Tomassen, Peter; Vandeplas, Griet; Van Zele, Thibaut; Cardell, Lars-Olaf; Arebro, Julia; Olze, Heidi; Förster-Ruhrmann, Ulrike; Kowalski, Marek L; Olszewska-Ziąber, Agnieszka; Holtappels, Gabriele; De Ruyck, Natalie; Wang, Xiangdong; Van Drunen, Cornelis; Mullol, Joaquim; Hellings, Peter; Hox, Valerie; Toskala, Elina; Scadding, Glenis; Lund, Valerie; Zhang, Luo; Fokkens, Wytske; Bachert, Claus

2016-05-01

Current phenotyping of chronic rhinosinusitis (CRS) into chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP) might not adequately reflect the pathophysiologic diversity within patients with CRS. We sought to identify inflammatory endotypes of CRS. Therefore we aimed to cluster patients with CRS based solely on immune markers in a phenotype-free approach. Secondarily, we aimed to match clusters to phenotypes. In this multicenter case-control study patients with CRS and control subjects underwent surgery, and tissue was analyzed for IL-5, IFN-γ, IL-17A, TNF-α, IL-22, IL-1β, IL-6, IL-8, eosinophilic cationic protein, myeloperoxidase, TGF-β1, IgE, Staphylococcus aureus enterotoxin-specific IgE, and albumin. We used partition-based clustering. Clustering of 173 cases resulted in 10 clusters, of which 4 clusters with low or undetectable IL-5, eosinophilic cationic protein, IgE, and albumin concentrations, and 6 clusters with high concentrations of those markers. The group of IL-5-negative clusters, 3 clusters clinically resembled a predominant chronic rhinosinusitis without nasal polyps (CRSsNP) phenotype without increased asthma prevalence, and 1 cluster had a TH17 profile and had mixed CRSsNP/CRSwNP. The IL-5-positive clusters were divided into a group with moderate IL-5 concentrations, a mixed CRSsNP/CRSwNP and increased asthma phenotype, and a group with high IL-5 levels, an almost exclusive nasal polyp phenotype with strongly increased asthma prevalence. In the latter group, 2 clusters demonstrated the highest concentrations of IgE and asthma prevalence, with all samples expressing Staphylococcus aureus enterotoxin-specific IgE. Distinct CRS clusters with diverse inflammatory mechanisms largely correlated with phenotypes and further differentiated them and provided a more accurate description of the inflammatory mechanisms involved than phenotype information only. Copyright © 2016 American Academy of

Is it necessary to perform prophylactic cholecystectomy for asymptomatic subjects with gallbladder polyps and gallstones?

PubMed

Choi, Sung Youn; Kim, Tae Sun; Kim, Hong Joo; Park, Jung Ho; Park, Dong Il; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik

2010-06-01

The purpose of the present study was to determine the clinical characteristics of subjects with gallbladder polyps and cholelithiasis compared with those with gallbladder polyps only. Between August 1999 and December 2005, 176 subjects with gallbladder polyps and cholelithiasis (study group) by transabdominal ultrasonography performed during a medical check-up at our institution were recruited and compared with a control group of 185 subjects who had gallbladder polyps only. No significant difference in the mean interval change (delta) of polyp size during the follow-up period between the study and control groups (0.85 +/- 1.39 mm vs 0.84 +/- 1.58 mm, respectively, P = 0.927) was noted. A significantly higher proportion (9/176 [5.1%]) of examinees in the study group had attacks of acute cholecystitis compared with the control group (1/185 [0.5%], P < 0.01). By multivariate logistic regression analysis, gallbladder wall thickening on initial ultrasonography (odds ratio, 13.7; 95% confidence interval, 1.1-178.0; P = 0.046) and the interval increase in the size of the gallbladder polyps (odds ratio, 14.7; 95% confidence interval, 1.7-126.9; P = 0.014) were independent risk factors for cholecystectomy. No gallbladder cancer occurred during the follow-up period. There was no significant difference in delta polyp size between the examinees with gallbladder polyps and cholelithiasis and those with gallbladder polyps only. Hence, a small proportion of subjects with gallbladder polyps and cholelithiasis, such as those with thickened gallbladder walls and an interval increase in the size of the gallbladder polyps are candidates for prophylactic cholecytectomy.

Fluctuating olfactory sensitivity and distorted odor perception in allergic rhinitis.

PubMed

Apter, A J; Gent, J F; Frank, M E

1999-09-01

To characterize the relationship between allergic rhinitis, the severity and duration of nasal disease, olfactory function, and self-reported olfactory symptoms, including fluctuations or distortions in odor perception. Assessment of olfactory function and symptoms of 90 patients with allergic rhinitis. A clinic of a university teaching hospital and research facility. Sixty patients who presented to the Taste and Smell Clinic who had positive allergy test results and 30 patients who presented to the Allergy-Immunology Clinic. The Taste and Smell Clinic patients were grouped by nasal-sinus disease status (30 without chronic rhinosinusitis or nasal polyps, 14 with chronic rhinosinusitis but without polyps, and 16 with nasal polyps). Subjective olfactory symptom questionnaire and objective olfactory function tests. The Allergy-Immunology Clinic patients were diagnosed as being normosmic and the Taste and Smell Clinic patients as being hyposmic or anosmic with olfactory loss that increased significantly with nasal-sinus disease severity. Comparisons with normative data confirm that olfactory scores observed in all groups were significantly lower than expected because of the aging process alone. The self-reported duration of olfactory loss increased significantly with nasal-sinus disease severity. The Taste and Smell Clinic patients without chronic rhinosinusitis or nasal polyps reported the greatest incidence of olfactory distortions and olfactory loss associated with upper respiratory tract infections. There appears to be a continuum of duration and severity of olfactory loss in allergic rhinitis that parallels increasing severity of nasal-sinus disease. As a result of the increased frequency of respiratory infection associated with allergic rhinitis, these patients are at risk for damage to the olfactory epithelium.

High-definition endoscopy with digital chromoendoscopy for histologic prediction of distal colorectal polyps.

PubMed

Rath, Timo; Tontini, Gian E; Nägel, Andreas; Vieth, Michael; Zopf, Steffen; Günther, Claudia; Hoffman, Arthur; Neurath, Markus F; Neumann, Helmut

2015-10-22

Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital chromoendoscopy and the accuracy of predicting histology with digital chromoendoscopy was assessed. The overall accuracy of digital chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital chromoendoscopy were correctly predicted with >90 % accuracy. High-definition endoscopy in combination with digital chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps. ClinicalTrials NCT02217449.

Artificial substrates preference for proliferation and immigration in Aurelia aurita (s. l.) polyps

NASA Astrophysics Data System (ADS)

Feng, Song; Lin, Jianing; Sun, Song; Zhang, Fang

2017-01-01

The increasing amounts of artificial marine substrates, in many parts of the world have been proposed as a potential driver of Aurelia spp. blooms, on account of providing extra habitats for the settlement and the proliferation of the benthic stage (polyps). Previous experiments have mainly focused on the substrate choices of Aurelia spp. planulae. However, substrate preferences for the proliferation and immigration of polyps have not been reported. We monitored the propagation and immigration of Aurelia aurita (s. l.) polyps on two natural and nine artificial substrates at constant temperature (20±0.5°C) and salinity (30±0.5) in beakers and a glass aquarium in the laboratory, respectively. The results showed that, among artificial substrates, the highest number for polyp proliferation and immigration was found on nets, rigid polyvinyl chloride plates (RPVC), and wood. The lowest density of polyps was present on iron plates. Among natural substrates, the asexual reproduction rate of polyps on Patinopecten yessoensis (Jay, 1857) shells was significantly higher than Azumapecten farreri (Jones & Preston, 1904). On the account of the distinction in the roughness, chemical properties and biofilms of these material surfaces, bare artificial or natural substrates discriminatively affect the proliferation and the immigration of Aurelia spp. polyps at laboratory. These observations suggest that, even in the natural environment, different materials and texture may influence the composition and the abundance of the fouling communities and the assemblages of polyps and, indirectly, have effects on the amounts of released medusae.

Giant fibrovascular esophageal polyp misdiagnosed as achalasia.

PubMed

Cordoş, I; Istrate, A; Codreşi, M; Bolca, C

2012-01-01

A 59 years old woman was admitted in our unit accusing longtime dysphagia and regurgitation. On admission, the patient was wearing a 3 month old definitive feeding gastrostomy tube. The contrast swallow, endoscopy and esophageal manometry established the diagnostic--achalasia. We removed the gastrostomy tube and we performed an open Heller myotomy. The postoperative period was uneventful and the patient was discharged one week later with affirmatively unimpaired deglutition. One month later, the patient was admitted via emergency with a giant fibrous tumor arising from her mouth after an episode of strong coughing and vomiting. The repeated endoscopy showed a giant esophageal polyp that was missed by the previous investigations, originating from pharingoesophageal junction. The esophageal polyp was resected by cervical approach with good postoperative outcome. The polyp's particular extreme dimensions (27 cm) prevented the acute asphyxia by blockage at the laryngeal level, possibly provoked by smaller tumors. As postoperative one month barium swallow showed a normal esophageal aspect, a final question remains--was achalasia real or an erroneous diagnosis was established the second time too?

Clinical Significance of Colonoscopy in Patients with Upper Gastrointestinal Polyps and Neoplasms: A Meta-Analysis

PubMed Central

Wu, Zhen-Jie; Lin, Yuan; Xiao, Jun; Wu, Liu-Cheng; Liu, Jun-Gang

2014-01-01

Background Some authors have studied the relationship between the presence of polyps, adenomas and cancers of upper gastrointestinal tract (stomach and duodenum) and risk of colorectal polyps and neoplasms; however, the results are controversial, which may be due to study sample size, populations, design, clinical features, and so on. No meta-analysis, which can be generalized to a larger population and could provide a quantitative pooled risk estimate of the relationship, of this issue existed so far. Methods We performed a meta-analysis to evaluate risk of colorectal polyps or neoplasms in patients with polyps, adenomas or cancers in upper gastrointestinal tract comparing with controls. A search was conducted through PubMed, EMBASE, reference lists of potentially relevant papers, and practice guidelines up to 27 November 2013 without languages restriction. Odd ratios (ORs) were pooled using random-effects models. Results The search yielded 3 prospective and 21 retrospective case-control studies (n = 37152 participants). The principal findings included: (1) OR for colorectal polyps was 1.15 (95% CI, 1.04–1.26) in the gastric polyps group comparing with control groups; (2) Patients with gastric polyps and neoplasms have higher risk (OR, 1.31 [95% CI, 1.06–1.62], and 1.72 [95% CI, 1.42–2.09], respectively) of colorectal neoplasms comparing with their controls; and (3) Positive association was found between the presence of colorectal neoplasms and sporadic duodenal neoplasms (OR, 2.59; 95% CI, 1.64–4.11). Conclusions Findings from present meta-analysis of 24 case-control studies suggest that the prevalence of colorectal polyps was higher in patients with gastric polyps than in those without gastric polyps, and the risk of colorectal neoplasms increases significantly in patients with gastric polyps, neoplasms, and duodenal neoplasms. Therefore, screening colonoscopy should be considered for patients with upper gastrointestinal polyps and neoplasms. PMID

Associations between dietary fiber and colorectal polyp risk differ by polyp type and smoking status.

PubMed

Fu, Zhenming; Shrubsole, Martha J; Smalley, Walter E; Ness, Reid M; Zheng, Wei

2014-05-01

The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer.

Nasal Anatomy and Function.

PubMed

Patel, Ruchin G

2017-02-01

The nose is a complex structure important in facial aesthetics and in respiratory physiology. Nasal defects can pose a challenge to reconstructive surgeons who must re-create nasal symmetry while maintaining nasal function. A basic understanding of the underlying nasal anatomy is thus necessary for successful nasal reconstruction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction

PubMed Central

Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

2014-01-01

A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

Utility of Cartilage Grafts Wrapped With Amniotic Membrane in Dorsal Nasal Augmentation.

PubMed

Atespare, Altay; Kara, Hakan; Ilter, Erdin; Boyaci, Zerrin; Çelik, Öner; Midi, Ahmet

2016-06-01

The success of rhinoplasty may be compromised with postoperative problems like rough and rigid nasal dorsum. Biological grafts or alloplastic materials are required to hurdle and correct nasal dorsal deformities and also irregularities. The purpose of this experimental study was to compare pure cartilage graft, cartilage graft wrapped in amniotic membrane, and diced cartilage grafts wrapped in amniotic membrane for soft tissue augmentation. All grafts were transplanted through a subcutaneous tunnel created in the nasal dorsum of 18 rats, 6 in each group. After 3 months follow-up, the histopathological changes in all groups were evaluated by light microscopy and volumetric measurements. With regard to cartilage viability, cartilage wrapped in amniotic membrane had a higher success rate than pure cartilage graft. Also, a further increased success rate was found in the diced group. In the soft tissue augmentation after rhinoplasty surgery, especially diced cartilage wrapped in amniotic membrane keeps the graft viable and adjoined.

Island composite nasal flap for nasal dorsum skin defects.

PubMed

Skitarelić, Neven; Mladina, Ranko; Mraovic, Boris; Simurina, Tatjana; Skitarelić, Nataa; Vuković, Katarina

2009-08-01

Skin defects on the nasal dorsum remain a challenge for the plastic surgeon. There are few local nasal flap options for the repair of proximally positioned nasal skin defects. During a 3-year period, 22 patients were treated after excision of skin cancer in the proximal two-thirds of the nose. Nine patients (41%) were female and 13 (59%) were male, with an average age of 69 years. All patients were operated on under local anesthesia. The average follow-up was 25 months. In all patients, after tumor ablation, the skin defect was closed with an island composite nasal skin flap. Pathohistologic analysis confirmed that the margins of the removed tumor were free of malignant cells. Six patients (27.3%) had squamous cell and 16 (72.7%) had basal cell carcinoma. There was no total or partial flap loss. None of the patients has suffered from recurrence of the tumor. The island composite nasal flap is a reliable technique for the closure of proximal nasal skin defects. Complications in the elevation of the island composite flap were rare, and the final result was acceptable.

[Family study of patients with aspirin intolerance and rhinosinusitis].

PubMed

May, A; Wagner, D; Langenbeck, U; Weber, A

2000-09-01

The high prevalence of aspirin intolerance in asthmatics and patients with nasal polyps as well as reports of familial clustering suggest a genetic disposition of this disease. Our study aimed at obtaining further evidence of hereditary factors in this disease. We included 33 unselected patients from 28 families with aspirin intolerance and rhinosinusitis in this study. Controls were recruited from individuals treated in our ENT clinic for diseases other than aspirin intolerance (n = 52). A questionnaire focused on family histories as well as reports on diseases of the upper respiratory tract or allergies. ASS intolerance was verified either by bronchial or nasal provocation tests. We found cases of aspirin intolerance among parents, siblings, and children of ASS intolerant probands. The children of probands had nasal polyps and rhinosinusitis more often than the children of controls. We propose that ASS intolerance with nasal polyps and asthma represents a complex phenotype, with genetic and environmental factors contributing to its manifestation.

The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis?

PubMed

Cosway, Ben; Tomkinson, Alun; Owens, David

2013-03-01

Rhinosinusitis is a common condition with adults experiencing 2-5 episodes per year. The European Positional Paper on Rhinosinusitis and Nasal Polyps (EP3OS) published in 2005 and updated in 2007 provided evidence-based guidelines on the management of sinus disease promoting a conservative approach to treatment. This study examines the effect of EP3OS on sinus surgery uptake and acute admissions for sinusitis in England and Wales. A retrospective study using the national electronic health databases of England (Hospital Episodes Statistics, HES online) and Wales (Patient Episodes Database of Wales, PEDW) was undertaken from 2000 to 2010 using the OPCS-4 codes E12-E17 (sinus surgery) and ICD10 code J01 (acute admission for sinusitis). Data were analysed for effect following the introduction of the EP3OS in 2005 using linear regression and Chi squared analysis. 116,370 sinus procedures and 10,916 acute admissions for sinusitis were made during the study period. No significant decrease in sinus surgery procedures occurred following the introduction of the EP3OS as may have been expected (p > 0.05), although subgroup analysis suggested a significant increase in Wales (p < 0.05). In addition, significant increases in acute admissions for sinusitis were observed following the introduction of EP3OS (p < 0.05). However, subgroup analysis suggested this was not the case in Wales (p > 0.05). The EP3OS appears to have had little impact on the rates of sinus surgery but more conservative approaches to managing of sinus disease may have led to an increase in acute admissions. Further research is required to investigate whether changes in practice were adopted.

Simple colonoscopy reporting system checking the detection rate of colon polyps.

PubMed

Kim, Jae Hyun; Choi, Youn Jung; Kwon, Hye Jung; Park, Seun Ja; Park, Moo In; Moon, Won; Kim, Sung Eun

2015-08-21

To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps. A simple colonoscopy reporting system Kosin Gastroenterology (KG quality reporting system) was developed. The polyp detection rate (PDR), adenoma detection rate (ADR), serrated polyp detection rate (SDR), and advanced adenoma detection rate (AADR) are easily calculated to use this system. In our gastroenterology center, the PDR, ADR, SDR, and AADR test results from each gastroenterologist were updated, every month. Between June 2014, when the program was started, and December 2014, the overall PDR and ADR in our center were 62.5% and 41.4%, respectively. And the overall SDR and AADR were 7.5% and 12.1%, respectively. We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.

Correlation of Nasal Mucosal Temperature With Subjective Nasal Patency in Healthy Individuals

PubMed Central

Bailey, Ryan S.; Casey, Kevin P.; Pawar, Sachin S.; Garcia, Guilherme J. M.

2016-01-01

Importance Historically, otolaryngologists have focused on nasal resistance to airflow and minimum airspace cross-sectional area as objective measures of nasal obstruction using methods such as rhinomanometry and acoustic rhinometry. However, subjective sensation of nasal patency may be more associated with activation of cold receptors by inspired air than with respiratory effort. Objective To investigate whether subjective nasal patency correlates with nasal mucosal temperature in healthy subjects. Design, Setting, and Participants Twenty-two healthy adults were recruited for this study. Subjects first completed the Nasal Obstruction Symptom Evaluation (NOSE) and a unilateral visual analog scale (VAS) to quantify subjective nasal patency. A miniaturized thermocouple sensor was then used to record nasal mucosal temperature bilaterally in two locations along the nasal septum: at the vestibule and across from the inferior turbinate head. Results The range of temperature oscillations during the breathing cycle, defined as the difference between end-expiratory and end-inspiratory temperatures, was greater during deep breaths (ΔTexp-insp = 6.2 ± 2.6°C) than during resting breathing (ΔTexp-insp = 4.2 ± 2.3°C) in both locations (p < 10−13). Mucosal temperature measured at the right vestibule had a statistically significant correlation with both right-side VAS score (Pearson r = −0.55, p=0.0076) and NOSE score (Pearson r = −0.47, p=0.028). No other statistically significant correlations were found between mucosal temperature and subjective nasal patency scores. Nasal mucosal temperature was lower in the first cavity to be measured, which was the right cavity in all subjects. Conclusions and Relevance The greater mucosal temperature oscillations during deep breathing is consistent with the common experience that airflow sensation is enhanced during deep breaths, thus supporting the hypothesis that mucosal cooling plays a central role in nasal airflow sensation

Influence of cooling face masks on nasal air conditioning and nasal geometry.

PubMed

Lindemann, J; Hoffmann, T; Koehl, A; Walz, E M; Sommer, F

2017-06-01

Nasal geometries and temperature of the nasal mucosa are the primary factors affecting nasal air conditioning. Data on intranasal air conditioning after provoking the trigeminal nerve with a cold stimulus simulating the effects of an arctic condition is still missing. The objective was to investigate the influence of skin cooling face masks on nasal air conditioning, mucosal temperature and nasal geometry. Standardized in vivo measurements of intranasal air temperature, humidity and mucosal temperature were performed in 55 healthy subjects at defined detection sites before and after wearing a cooling face mask. Measurements of skin temperature, rhinomanometry and acoustic rhinometry were accomplished. After wearing the face mask the facial skin temperature was significantly reduced. Intranasal air temperature did not change. Absolute humidity and mucosal temperature increased significantly. The acoustic rhinometric results showed a significant increase of the volumes and the cross-sectional areas. There was no change in nasal airflow. Nasal mucosal temperature, humidity of inhaled air, and volume of the anterior nose increased after application of a cold face mask. The response is mediated by the trigeminal nerve. Increased mucosal temperatures as well as changes in nasal geometries seem to guarantee sufficient steady intranasal nasal air conditioning.

Reduced nasal growth after primary nasal repair combined with cleft lip surgery.

PubMed

Yoshimura, Y; Okumoto, T; Iijima, Y; Inoue, Y

2015-11-01

Nasal growth after cleft lip surgery with or without primary nasal repair was evaluated using lateral cephalograms. In 14 patients who underwent simultaneous nasal repair with primary cleft lip repair and 12 patients without simultaneous nasal repair, lateral cephalograms were obtained at 5 and 10 years of age. Lateral cephalograms of normal Japanese children were used as a control. At 5 years of age, there were significant differences in the nasal height and columellar angle among the three groups. Children without simultaneous nasal repair had shorter noses with more upward tilt of the columella compared with the controls, while children with simultaneous nasal repair had much shorter noses and more upward tilt than those without repair. At 10 years of age, the children without simultaneous nasal repair showed no differences from the control group, while those with simultaneous repair still had shorter noses and more upward tilt of the columella. These findings suggest that performing nasal repair at the same time as primary cleft lip surgery has an adverse influence on the subsequent growth of the nose. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Metamorphosis and acquisition of symbiotic algae in planula larvae and primary polyps of Acropora spp.

NASA Astrophysics Data System (ADS)

Hirose, M.; Yamamoto, H.; Nonaka, M.

2008-06-01

Coral planulae settle, then metamorphose and form polyps. This study examined the morphological process of metamorphosis from planulae into primary polyps in the scleractinian corals Acropora nobilis and Acropora microphthalma, using the cnidarian neuropeptide Hym-248 . These two species release eggs that do not contain Symbiodinium. The mode of acquisition of freshly isolated Symbiodinium (zooxanthellae) (FIZ) by the non-symbiotic polyp was also examined. Non-Hym-248 treated swimming Acropora planulae did not develop blastopore, mesenteries or coelenteron until the induction of metamorphosis 16 days after fertilization. The oral pore was formed by invagination of the epidermal layer after formation of the coelenteron in metamorphosing polyps. At 3 days after settlement and metamorphosis, primary polyps exposed to FIZ established symbioses with the Symbiodinium. Two-four days after exposure to FIZ, the distribution of Symbiodinium was limited to the gastrodermis of the pharynx and basal part of the polyps. Eight-ten days after exposure to FIZ, Symbiodinium were present in gastrodermal cells throughout the polyps.

Preoperative predictive factors for gallbladder cholesterol polyp diagnosed after laparoscopic cholecystectomy for polypoid lesions of gallbladder

PubMed Central

Lee, Hyojin; Park, Inseok; Cho, Hyunjin; Gwak, Geumhee; Yang, Keunho; Bae, Byung-Noe; Kim, Hong-Ju; Kim, Young Duk

2016-01-01

Backgrounds/Aims We investigated patients' clinical and radiological data to determine preoperative factors that predict cholesterol gallbladder (GB) polyps of large size, which can be helpful for decision on further diagnostic tools. Methods In this study, we retrospectively analyzed 126 patients who underwent laparoscopic cholecystectomy for GB polyps >10 mm diagnosed preoperatively by abdominal ultrasonography between February 2002 and February 2016 in Department of Surgery, Sanggye Paik Hospital. Patients were divided into non-cholesterol polyps group and cholesterol polyps group, based on the postoperative pathologic diagnosis. Clinical and radiological data, such as gender, age, body weight, height, body mass index (BMI), laboratory findings, size, number and shape of the polypoid lesions, and presence of the concurrent GB stone were compared between the two groups. Results Of the 126 cases, 73 had cholesterol polyps (57.9%) and 53 cases were non-cholesterol polyps (42.1%). The younger age (<48.5 years), size of polyp <13.25 mm and multiple polyps were independent predictive variables for cholesterol polyps, with odd ratios (OR) of 2.352 (p=0.045), 5.429 (p<0.001) and 0.472 (p<0.001), respectively. Conclusions Age, size and polyp number were used to predict cholesterol GB polyp among polypoid lesions of the gallbladder >10 mm. For cases in which these factors are not applicable, it is strongly recommended to evaluate further diagnostic tools, such as computed tomography, endoscopic ultrasonography and tumor markers. PMID:28261697

Surgical technique for reconstruction of the nasal septum: the pericranial flap.

PubMed

Paloma, V; Samper, A; Cervera-Paz, F J

2000-01-01

We describe a new technique for the surgical reconstruction of large-sized anterior septal perforations based on the pericranial flap. The technique requires a standard open rhinoplasty combined with a pericranial flap harvested after a bicoronal approach and tunnelled to the nasal cavity. We present the case of a man with complete destruction of the nasal septum as a result of chronic cocaine abuse. Surgery resulted in a permanent and complete closure of the perforation. The main advantage of this technique is the use of well-vascularized autogenous tissue and the minimal donor site morbidity. This technique provides a new method to close large nasal perforations. Copyright 2000 John Wiley & Sons, Inc. Head Neck 22: 90-94, 2000.

Effects of Endogenous Formaldehyde in Nasal Tissues on Inhaled Formmaldehyde Dosimetry Predictions in the Rat, Monkey, and Human Nasal Passages

EPA Science Inventory

ABSTRACT Formaldehyde, a nasal carcinogen, is also an endogenous compound that is present in all living cells. Due to its high solubility and reactivity, quantitative risk estimates for inhaled formaldehyde rely on internal dose calculations in the upper respiratory tract which ...

[Endoscopic treatment of small osteoma of nasal sinuses manifested as nasal and facial pain].

PubMed

Li, Yu; Zheng, Tianqi; Li, Zhong; Deng, Hongyuan; Guo, Chaoxian

2015-12-01

To discuss the clinical features, diagnosis and endoscopic surgical intervention for small steoma of nasal sinuses causing nasal and facial pain. A retrospective review was performed on 21 patients with nasal and facial pain caused by small osteoma of nasal sinuses, and nasal endoscopic surgery was included in the treatment of all cases. The nasal and facial pain of all the patients was relieved. Except for one ase exhibiting periorbital bruise after operation, the other patients showed no postoperative complications. Nasal and facial pain caused by small osteoma of nasal sinuses was clinically rare, mostly due to the neuropathic pain of nose and face caused by local compression resulting from the expansion of osteoma. Early diagnosis and operative treatment can significantly relieve nasal and facial pain.

Measurement of smaller colon polyp in CT colonography images using morphological image processing.

PubMed

Manjunath, K N; Siddalingaswamy, P C; Prabhu, G K

2017-11-01

Automated measurement of the size and shape of colon polyps is one of the challenges in Computed tomography colonography (CTC). The objective of this retrospective study was to improve the sensitivity and specificity of smaller polyp measurement in CTC using image processing techniques. A domain knowledge-based method has been implemented with hybrid method of colon segmentation, morphological image processing operators for detecting the colonic structures, and the decision-making system for delineating the smaller polyp-based on a priori knowledge. The method was applied on 45 CTC dataset. The key finding was that the smaller polyps were accurately measured. In addition to 6-9 mm range, polyps of even <5 mm were also detected. The results were validated qualitatively and quantitatively using both 2D MPR and 3D view. Implementation was done on a high-performance computer with parallel processing. It takes [Formula: see text] min for measuring the smaller polyp in a dataset of 500 CTC images. With this method, [Formula: see text] and [Formula: see text] were achieved. The domain-based approach with morphological image processing has given good results. The smaller polyps were measured accurately which helps in making right clinical decisions. Qualitatively and quantitatively the results were acceptable when compared to the ground truth at [Formula: see text].

Oxymetazoline Nasal Spray

MedlinePlus

... is recommended by a doctor. Children 6 to 12 years of age should use oxymetazoline nasal spray carefully and under adult supervision. Oxymetazoline is in a class of medications called nasal decongestants. It works by narrowing the blood vessels in the nasal passages.

Novel application for electrochemotherapy: Immersion of nasal cavity in dog.

PubMed

Suzuki, Daniela O H; Berkenbrock, José A; de Oliveira, Krishna D; Freytag, Jennifer O; Rangel, Marcelo M M

2017-08-01

Electrochemotherapy is a new modality of local cancer treatment that increases the delivery of chemotherapy drugs into tumor cells by applying intense electric fields. This novel electrochemotherapy application was applied as an adjuvant to surgery and eliminated intranasal tumors in dog. The treatment challenges are the surgery limitations due to anatomy and residual tumor in the bone cavity. Most of the tumoral mass on nasal cavity was surgically removed. The internal nasal cavity was immersed in liquid and bleomycin before applying electric field. The solution was necessary to increase the superficial contact between plate electrodes and residual tumor. The numerical study demonstrated electrochemotherapy efficiency in different clinical situations. The proximity between electrodes and bone (<3 mm) and bone irregularities affect the electric field distribution on tumoral tissue. The tumoral tissue around bone protuberances tends to be eliminated. Electrochemotherapy with plate electrodes inside the cavity might not be effective. Different values of electric conductivity solution were studied; the ideal value was 0.5 S/m. The numerical and experimental results confirm the successful application of electrochemotherapy on dog nasal cavity. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Validation of polyvinylidene fluoride nasal sensor to assess nasal obstruction in comparison with subjective technique.

PubMed

Roopa Manjunatha, G; Mahapatra, D Roy; Prakash, Surya; Rajanna, K

2015-01-01

The aim of this study is to validate the applicability of the PolyVinyliDene Fluoride (PVDF) nasal sensor to assess the nasal airflow, in healthy subjects and patients with nasal obstruction and to correlate the results with the score of Visual Analogue Scale (VAS). PVDF nasal sensor and VAS measurements were carried out in 50 subjects (25-healthy subjects and 25 patients). The VAS score of nasal obstruction and peak-to-peak amplitude (Vp-p) of nasal cycle measured by PVDF nasal sensors were analyzed for right nostril (RN) and left nostril (LN) in both the groups. Spearman's rho correlation was calculated. The relationship between PVDF nasal sensor measurements and severity of nasal obstruction (VAS score) were assessed by ANOVA. In healthy group, the measurement of nasal airflow by PVDF nasal sensor for RN and LN were found to be 51.14±5.87% and 48.85±5.87%, respectively. In patient group, PVDF nasal sensor indicated lesser nasal airflow in the blocked nostrils (RN: 23.33±10.54% and LN: 32.24±11.54%). Moderate correlation was observed in healthy group (r=-0.710, p<0.001 for RN and r=-0.651, p<0.001 for LN), and moderate to strong correlation in patient group (r=-0.751, p<0.01 for RN and r=-0.885, p<0.0001 for LN). PVDF nasal sensor method is a newly developed technique for measuring the nasal airflow. Moderate to strong correlation was observed between PVDF nasal sensor data and VAS scores for nasal obstruction. In our present study, PVDF nasal sensor technique successfully differentiated between healthy subjects and patients with nasal obstruction. Additionally, it can also assess severity of nasal obstruction in comparison with VAS. Thus, we propose that the PVDF nasal sensor technique could be used as a new diagnostic method to evaluate nasal obstruction in routine clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

A case of nasal chromoblastomycosis causing epistaxis.

PubMed

Penjor, D; Khizuan, A K; Chong, A W; Wong, K T

2014-12-01

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue that most commonly affects the feet and lower limbs. It is rare for this infection to occur on the face, and it is exceptionally rare for it to involve the nose and sinuses. This paper reports a rare case of nasal chromoblastomycosis in a 50-year-old Malaysian male. The patient, who was a rubber plantation worker in the southern state of Johor, presented to the ENT clinic with a history of epistaxis. He did not recall any history of injury to the nose. Nasal endoscopy showed a pale yellowish lesion at the inferior edge of the left middle turbinate. Histology revealed that this was a case of chromoblastomycosis. Chromoblastomycosis of the nasal cavity is very rare and can be mistaken for other granulomatous conditions in the nose. It progresses very slowly over many years. Our patient was managed conservatively, as he was not keen on undergoing surgical intervention. Lesion size remained the same at five months' follow up, with no recurrence of epistaxis.

Nasal Cavity Masses Resembling Chondro-osseous Respiratory Epithelial Adenomatoid Hamartomas in 3 Dogs.

PubMed

LaDouceur, E E B; Michel, A O; Lindl Bylicki, B J; Cifuentes, F F; Affolter, V K; Murphy, B G

2016-05-01

Chondro-osseous respiratory epithelial adenomatoid hamartomas (COREAHs) are rare tumors in the nasal cavity of people, which have not been described in other species. COREAHs in people are minimally invasive and rarely recur following excision. Histologically, these tumors are composed of disorganized, mature, nasal turbinate tissue that is organized into polypoid growths. These growths are lined by respiratory epithelium, contain glandular elements, and are organized around central cores of chondro-osseous matrix. This report describes 3 cases of dogs with nasal tumors that have histomorphology similar to that of COREAH in people. The tumors were all identified within the nasal cavity and were associated with regional bony lysis of the turbinates and surrounding skull bones, a feature that has not been reported in COREAH in people. There was no evidence of metastasis or extension beyond the nasal cavity in any of the 3 cases. © The Author(s) 2015.

Incidentally detected gallbladder polyps: is follow-up necessary?--Long-term clinical and US analysis of 346 patients.

PubMed

Corwin, Michael T; Siewert, Bettina; Sheiman, Robert G; Kane, Robert A

2011-01-01

To determine the natural history of gallbladder (GB) polyps incidentally detected at ultrasonography (US) and to propose management guidelines for these lesions based on polyp size. The HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. A database search for "polyp" in all US examinations of the GB between January 1, 1999, and December 31, 2001, at a single institution was performed. All subsequent US reports were reviewed to determine changes in GB polyp size. The electronic medical record was searched to obtain clinical and pathologic follow-up. Three hundred forty-six patients (mean age, 51.6 years; range, 20-93 years) with GB polyps were included. There were 156 men (45%) and 190 women (55%). US follow-up (mean, 5.4 years; range, 2-11.5 years) was performed in 149 patients (43%). Polyp size was stable in 90 (60%) polyps, decreased in eight (5%), increased in one (1%), and resolved in 50 (34%). Forty-two patients (12%) underwent cholecystectomy, revealing 13 (31%) GBs with polypoid lesions, 24 (57%) with stones and no polyps, and five (12%) with neither a stone nor a polypoid lesion. Clinical follow-up (mean, 8 years; range, 5-10.4 years) was performed in 155 patients (45%). No patient had clinical evidence of GB-related disease. Overall, no cases of GB malignancy were identified in 346 patients. Mean polyp size was 5.0 mm (range, 1-18 mm). No neoplastic polyps were found at 1-6 mm, one neoplastic polyp was seen at 7-9 mm, and two neoplastic polyps were found at 10 mm or larger. The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 6 mm or less may require no additional follow-up. Data are inconclusive regarding polyps 7 mm or greater, and further studies are warranted. © RSNA, 2010

Correlation of Nasal Mucosal Temperature With Subjective Nasal Patency in Healthy Individuals.

PubMed

Bailey, Ryan S; Casey, Kevin P; Pawar, Sachin S; Garcia, Guilherme J M

2017-01-01

Historically, otolaryngologists have focused on nasal resistance to airflow and minimum airspace cross-sectional area as objective measures of nasal obstruction using methods such as rhinomanometry and acoustic rhinometry. However, subjective sensation of nasal patency may be more associated with activation of cold receptors by inspired air than with respiratory effort. To investigate whether subjective nasal patency correlates with nasal mucosal temperature in healthy individuals. Healthy adult volunteers first completed the Nasal Obstruction Symptom Evaluation (NOSE) and a unilateral visual analog scale to quantify subjective nasal patency. A miniaturized thermocouple sensor was then used to record nasal mucosal temperature bilaterally in 2 locations along the nasal septum: at the vestibule and across from the inferior turbinate head. Nasal mucosal temperature and subjective patency scores in healthy individuals. The 22 healthy adult volunteers (12 [55%] male; mean [SD] age, 28.3 [7.0] years) had a mean (SD) NOSE score of 5.9 (8.4) (range, 0-30) and unilateral VAS score of 1.2 (1.4) (range, 0-5). The range of temperature oscillations during the breathing cycle, defined as the difference between end-expiratory and end-inspiratory temperatures, was greater during deep breaths (mean [SD] change in temperature, 6.2°C [2.6°C]) than during resting breathing (mean [SD] change in temperature, 4.2°C [2.3°C]) in both locations (P < .001). Mucosal temperature measured at the right vestibule had a statistically significant correlation with both right-side visual analog scale score (Pearson r = -0.55; 95% CI, -0.79 to -0.17; P = .008) and NOSE score (Pearson r = -0.47; 95% CI, -0.74 to -0.06; P = .03). No other statistically significant correlations were found between mucosal temperature and subjective nasal patency scores. Nasal mucosal temperature was lower (mean of 1.5°C lower) in the first cavity to be measured, which was the right cavity in all

Can gallbladder polyps predict colorectal adenoma or even neoplasia? A systematic review.

PubMed

Stergios, Konstantinos; Damaskos, Christos; Frountzas, Maximos; Nikiteas, Nikolaos; Lalude, Olutunde

2016-09-01

The purpose of the present systematic review is to identify whether an association between gallbladder polyps and colorectal adenoma or neoplasia exists. We conducted a systematic review searching the Medline (1966-2016), Scopus (2004-2016), ClinicalTrials.gov (2008-2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together with reference lists from included studies. All prospective and retrospective observational cohort studies were included. Four studies were finally included which included 17,437 patients. The association between gallbladder polyps and colorectal adenoma or even neoplasia is not unanimously supported. However, a possible association is clearly depicted. According to one study it seems that this correlation seems to become significant only when the gallbladder polyps exceed the size of 5 mm. However, the impact of size of gallbladder polyps was not investigated in the remaining studies. According to the results of our systematic review there is some evidence to support the hypothesis that gallbladder polyps might adequately predict future risk of colorectal neoplasia. At present, however, current knowledge is very limited and the available data scarce. In this context further studies are necessary to be carried out, before the presence of gallbladder polyps on ultrasound can be recommended as an indication to perform a screening colonoscopy on the same patient. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

A comparison of blood vessel features and local binary patterns for colorectal polyp classification

NASA Astrophysics Data System (ADS)

Gross, Sebastian; Stehle, Thomas; Behrens, Alexander; Auer, Roland; Aach, Til; Winograd, Ron; Trautwein, Christian; Tischendorf, Jens

2009-02-01

Colorectal cancer is the third leading cause of cancer deaths in the United States of America for both women and men. By means of early detection, the five year survival rate can be up to 90%. Polyps can to be grouped into three different classes: hyperplastic, adenomatous, and carcinomatous polyps. Hyperplastic polyps are benign and are not likely to develop into cancer. Adenomas, on the other hand, are known to grow into cancer (adenoma-carcinoma sequence). Carcinomas are fully developed cancers and can be easily distinguished from adenomas and hyperplastic polyps. A recent narrow band imaging (NBI) study by Tischendorf et al. has shown that hyperplastic polyps and adenomas can be discriminated by their blood vessel structure. We designed a computer-aided system for the differentiation between hyperplastic and adenomatous polyps. Our development aim is to provide the medical practitioner with an additional objective interpretation of the available image data as well as a confidence measure for the classification. We propose classification features calculated on the basis of the extracted blood vessel structure. We use the combined length of the detected blood vessels, the average perimeter of the vessels and their average gray level value. We achieve a successful classification rate of more than 90% on 102 polyps from our polyp data base. The classification results based on these features are compared to the results of Local Binary Patterns (LBP). The results indicate that the implemented features are superior to LBP.

Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

PubMed Central

Brigante, G.; Madeo, B.

2016-01-01

Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination. PMID:27022492

Anterior Ethmoidal Nerve Block in Prevention of Postoperative Agitation

ClinicalTrials.gov

2018-02-08

Postoperative Agitation: Impaired Awareness, Abnormal Cognitive Function, Confusion, and Verbal and Physical Agitation During Recovery From General Anesthesia; Deviated Nasal Septum; Chronic Rhinosinusitis (Diagnosis); Nasal Polyps

Growth rate and malignant potential of small gallbladder polyps--systematic review of evidence.

PubMed

Wiles, Rebecca; Varadpande, Mandar; Muly, Sudha; Webb, Jolanta

2014-08-01

The overall aim of this systematic review was to determine whether ultrasound (US) follow up for gallbladder polyps (GBPs) measuring less than 10 mms is necessary. A search was performed in MEDLINE and EMBASE between January 1976 and January 2012 using keywords: gallbladder, polyps, neoplasm, cancer, tumour, carcinoma, malignant, adenoma. Included were studies involving adult patients, examined with transabdominal US at least twice. The outcomes of included studies were gallbladder polyp growth as demonstrated on US over time, followed where available by histological examination of cholecystectomy specimens. Ten studies met the inclusion criteria for the review. Altogether 1958 subjects with mean age between 41.5 and 59 years were followed up with US. The percentage of GBPs which showed growth over the follow up period ranged from 1% to 23%. 43 neoplastic polyps were found in total irrespective of size, 20 of which were malignant and at least 7 of those were >10 mms. At least 7 malignancies were present in polyps <10 mms but it was unknown if they had undergone growth on follow up. Level II-2 and below evidence on rate of growth of small GBPs <10 mms exists in the literature. It indicates that growth does occur in a significant minority of small GBPs, but it is slow. Due to deficient reporting and small numbers of cases, the correlation between growth of GBP and development of malignancy cannot be established using currently available evidence. Malignancy can be present in polyps <10 mms although it is significantly more frequent in polyps >10 mms. Cholecystectomy for symptomatic GBPs irrespective of their size, alongside the current practice for removal of gall bladders containing asymptomatic polyps >10 mms, is proposed. No evidence based US follow up schedule can be recommended at present for asymptomatic polyps <10 mms, and in its absence an intuitive follow up with US is likely to continue. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish

Molecular response of nasal mucosa to therapeutic exposure to broad-band ultraviolet radiation

PubMed Central

Mitchell, David; Paniker, Lakshmi; Sanchez, Guillermo; Bella, Zsolt; Garaczi, Edina; Szell, Marta; Hamid, Qutayba; Kemeny, Lajos; Koreck, Andrea

2010-01-01

Abstract Ultraviolet radiation (UVR) phototherapy is a promising new treatment for inflammatory airway diseases. However, the potential carcinogenic risks associated with this treatment are not well understood. UV-specific DNA photoproducts were used as biomarkers to address this issue. Radioimmunoassay was used to quantify cyclobutane pyrimidine dimers (CPDs) and (6–4) photoproducts in DNA purified from two milieus: nasal mucosa samples from subjects exposed to intranasal phototherapy and human airway (EpiAirway™) and human skin (EpiDerm™) tissue models. Immunohistochemistry was used to detect CPD formation and persistence in human nasal biopsies and human tissue models. In subjects exposed to broadband ultraviolet radiation, DNA damage frequencies were determined prior to as well as immediately after treatment and at increasing times post-treatment. We observed significant levels of DNA damage immediately after treatment and efficient removal of the damage within a few days. No residual damage was observed in human subjects exposed to multiple UVB treatments several weeks after the last treatment. To better understand the molecular response of the nasal epithelium to DNA damage, parallel experiments were conducted in EpiAirway and EpiDerm model systems. Repair rates in these two tissues were very similar and comparable to that observed in human skin. The data suggest that the UV-induced DNA damage response of respiratory epithelia is very similar to that of the human epidermis and that nasal mucosa is able to efficiently repair UVB induced DNA damage. PMID:18671762

[Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance].

PubMed

Verse, T; Klöcker, N; Riedel, F; Pirsig, W; Scheithauer, M O

2004-07-01

Recent technical developments in metered pump systems allow the production and use of preservative-free nasal products. The aim of the current study is to compare the tolerability of a preservative-free dexpanthenol (5%) nasal spray with that of the established dexpanthenol (5%) nasal ointment, also without preservatives. The main outcome measure was in vivo mucociliary clearance. Mucociliary clearance was assessed by saccharin migration time in 20 volunteers. Wash-out phases were 7 days and the spray or ointment was always applied 20 min before the saccharin test. The study was designed to test for non-inferiority. Saccharin migration time was slightly longer after ointment administration, however, these were not significantly different to nasal spray. The saccharin migration time showed a significant correlation with the age of the volunteers. The upper confidence limit of dexpanthenol nasal spray was markedly less than that of the ointment. Therefore, dexpanthenol nasal spray is at least equal to if not better than dexpanthenol nasal ointment. Due to its ease of administration, preservative-free dexpanthenol nasal spray offers a valuable therapeutic alternative.

A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model.

PubMed

Hasan, Nazia; Gross, Seth A; Gralnek, Ian M; Pochapin, Mark; Kiesslich, Ralf; Halpern, Zamir

2014-12-01

Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures. To compare the diagnostic yield of balloon-assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model. Prospective, cohort study. International gastroenterology meeting. A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps"). Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-assisted colonoscopy. Detection of simulated polyps. The median polyp detection rate for all simulated polyps was significantly higher with balloon-assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P < .0001). The significantly higher simulated polyp detection rate with balloon-assisted versus standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P < .0001) and obscured polyps (88.0% vs 25.0%; P < .0001). Non-randomized design, use of a colon model, and simulated colon polyps. As compared with standard colonoscopy, balloon-assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

[Colonic polyps diagnosis by conventional video colonoscopes and chromoscopy with indigo carmine dye solution].

PubMed

Nakao, Frank Shigueo; Araújo, Isabella Saraiva; Ornellas, Laura Cotta; Cury, Marcelo de Sousa; Ferrari, Angelo Paulo

2002-01-01

Magnification colonoscopy and contrast chromoscopy with indigo carmine dye solution have been used to differentiate neoplastic polyps (adenomas and adenocarcinomas) from non-neoplastic (hyperplastic, inflammatory, juvenile) in an attempt to obviate endoscopic polypectomy. On the other hand, little published information exists concerning conventional video colonoscopes and chromoscopy for polyp histology prediction. Aim - To assess usefullness of conventional video colonoscopes and contrast chromoscopy with indigo carmine solution for differential diagnosis of colon polyps. In a routine colonoscopy series, we performed chromoscopy with conventional video colonoscopes before endoscopic excision of detected polyps. If a sulcus pattern was observed on the surface of the lesion, it was classified as neoplastic. Polyps were classified as non-neoplastic if no sulcus was detected on its surface. These observations were then compared with histology. In the study period (18 months), we detected 133 polyps in 53 patients. We were able to compare results of histology and chromoscopy in 126 lesions. The sensitivity, specificity, diagnostic accuracy, negative predictive value, and positive predictive value were 56,4%, 79,2%, 65,1%, 52,8%, and 81,5%, respectively. On the base of the presented data, we concluded that conventional video colonoscopes and contrast chromoscopy with indigo carmine solution is not a good technique for differential diagnosis of colon polyps.

Endoscopic mucosal resection for middle and large colorectal polyps with a double-loop snare.

PubMed

Yoshida, Naohisa; Saito, Yutaka; Hirose, Ryohei; Ogiso, Kiyoshi; Inada, Yutaka; Yagi, Nobuaki; Naito, Yuji; Otake, Yosuke; Nakajima, Takeshi; Matsuda, Takahisa; Yanagisawa, Akio; Itoh, Yoshito

2014-01-01

This study aimed to analyze the endoscopic mucosal resection (EMR) with a novel uniquely shaped, double-loop snare (Dualoop, Medico's Hirata Inc., Tokyo, Japan) for colorectal polyps. This was a clinical trial conducted in two referral centers, Kyoto Prefectural University of Medicine and National Cancer Center Hospital in Japan. First, the firmness of various snares including 'Dualoop' was experimentally analyzed with a pressure gauge. Five hundred and eighty nine consecutive polyps that underwent EMR with 'Dualoop' were compared to 339 polyps with the standard round snare. Lesion characteristics, en bloc resection, and complications were analyzed. 'Dualoop' had the most firmness among the various snares. The average tumor size was 9.3 mm (5-30), and en bloc resection was achieved in 95.4%. The rate of en bloc resection for middle polyps 15-19 mm in diameter was significantly higher with the 'Dualoop' than that with the round snare (97.9 vs. 80.0%, p < 0.05). The rate of en bloc resection was 64.7% for large polyps ≥20 mm in diameter using 'Dualoop'. Higher age, larger tumor size, and superficial polyps were associated with the failure of en bloc resection. EMR with 'Dualoop' was effective for resecting both middle and large polyps en-bloc. © 2014 S. Karger AG, Basel.

The frequency of early colorectal cancer derived from sessile serrated adenoma/polyps among 1858 serrated polyps from a single institution.

PubMed

Chino, A; Yamamoto, N; Kato, Y; Morishige, K; Ishikawa, H; Kishihara, T; Fujisaki, J; Ishikawa, Y; Tamegai, Y; Igarashi, M

2016-02-01

Sessile serrated adenoma/polyps (SSAPs) are suspected to have a high malignant potential, although few reports have evaluated the incidence of carcinomas derived from SSAPs using the new classification for serrated polyps (SPs). The aim of study was to compare the frequency of cancer coexisting with the various SP subtypes including mixed polyps (MIXs) and conventional adenomas (CADs). A total of 18,667 CADs were identified between April 2005 and December 2011, and 1858 SPs (re-classified as SSAP, hyperplastic polyp (HP), traditional serrated adenoma (TSA), or MIX) were removed via snare polypectomy, endoscopic mucosal resection, or endoscopic sub-mucosal dissection. Among 1160 HP lesions, 1 (0.1%) coexisting sub-mucosal invasive carcinoma (T1) was detected. Among 430 SSAP lesions, 3 (0.7%) high-grade dysplasia (HGD/Tis) and 1 (0.2%) T1 were detected. All of the lesions were detected in the proximal colon, with a mean tumor diameter of 18 mm (SD 9 mm). Among 212 TSA lesions, 3 (1%) HGD/Tis were detected but no T1 cancer. Among 56 MIX lesions, 9 (16%) HGD/Tis and 1 (2%) T1 cancers were detected, and among 18,677 CAD lesions, 964 (5%) HGD/Tis and 166 (1%) T1 cancers were identified. Among the resected lesions that were detected during endoscopic examination, a smaller proportion (1%) of SSAPs harbored HGD or coexisting cancer, compared to CAD or MIX lesions. Therefore, more attention should be paid to accurately identifying lesions endoscopically for intentional resection and the surveillance of each SP subtype.