Vylučování „fokusů“ v ORL oblasti, tedy vyloučení zánětlivého ložiska, patří k běžné ambulantní praxi každého ORL lékaře. Toto vyšetření je nejčastěji vyžadováno před ortopedickými endoprotetickými výkony a vybranými kardiochirurgickými výkony, nejčastěji před výměnami chlopenních náhrad. V České republice neexistují doporučené postupy provádění tohoto vyšetření a dále nejsou sjednoceny požadavky ortopedických a kardiochirurgických pracovišť. Výsledkem je nejednotný postup v obou případech, jak ve vyšetřování ORL lékařů, tak v požadavcích ohledně tohoto vyšetření. V práci jsme se dotazníkovou metodou zaměřili na zjištění rozdílů ve vyšetřovacích postupech a na rozdílné požadavky před plánovanými výkony. Výsledky jsme porovnali s dostupnou recentní literaturou.
Diagnosis of focal infection in ENT belongs to the normal outpatient practice of every ENT doctor. This examination is most often required before orthopedic endoprosthetic procedures and selected cardiac surgical procedures, most often before replacement of valve replacements. At that time, there were no recommended procedures for performing this examination in the Czech Republic, nor were there requirements for orthopedic and cardiac surgery departments. The result is a non-uniform procedure in both cases, both in the examination of ENT doctors and in the requirements regarding this examination. In this work, we focused on finding differences in investigation procedures, on different requirements before planned surgery using the questionnaire method, and compared the results with the available recent literature.
Two recent studies have highlighted the potential of nasal microbiota transplantation (NMT) to treat chronic rhinosinusitis (CRS). Here we evaluate these findings and propose that lessons from fecal microbiota transplantation (FMT) could guide NMT development, with possible implications for combating antimicrobial resistance in respiratory infections.
- MeSH
- Chronic Disease MeSH
- Feces microbiology MeSH
- Fecal Microbiota Transplantation * methods MeSH
- Humans MeSH
- Microbiota * MeSH
- Nose microbiology MeSH
- Rhinitis * microbiology therapy MeSH
- Sinusitis * microbiology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Olfactory sensitivity to odorant molecules is a complex biological function influenced by both endogenous factors, such as genetic background and physiological state, and exogenous factors, such as environmental conditions. In animals, this vital ability is mediated by olfactory sensory neurons (OSNs), which are distributed across several specialized olfactory subsystems depending on the species. Using the phosphorylation of the ribosomal protein S6 (rpS6) in OSNs following sensory stimulation, we developed an ex vivo assay allowing the simultaneous conditioning and odorant stimulation of different mouse olfactory subsystems, including the main olfactory epithelium, the vomeronasal organ, and the Grueneberg ganglion. This approach enabled us to observe odorant-induced neuronal activity within the different olfactory subsystems and to demonstrate the impact of environmental conditioning, such as temperature variations, on olfactory sensitivity, specifically in the Grueneberg ganglion. We further applied our rpS6-based assay to the human olfactory system and demonstrated its feasibility. Our findings show that analyzing rpS6 signal intensity is a robust and highly reproducible indicator of neuronal activity across various olfactory systems, while avoiding stress and some experimental limitations associated with in vivo exposure. The potential extension of this assay to other conditioning paradigms and olfactory systems, as well as its application to other animal species, including human olfactory diagnostics, is also discussed.
- MeSH
- Smell physiology MeSH
- Olfactory Mucosa metabolism MeSH
- Olfactory Receptor Neurons * metabolism physiology MeSH
- Phosphorylation MeSH
- Humans MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Odorants analysis MeSH
- Ribosomal Protein S6 * metabolism MeSH
- Vomeronasal Organ metabolism physiology MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Respiračný epiteliálny adenomatoidný hamartóm (REAH) je zriedkavá benígna lézia pochádzajúca z epitelu sliznice nazálnej dutiny a prínosových dutín. V práci opisujeme prípad 51-ročného muža s anamnézou pretrvávajúceho sťaženého dýchania a pocitu upchatého nosa. Diagnostikovanú mal veľkú polypovitú masu v pravom nosovom priechodne so stopkou vyrastajúcou z čuchovej štrbiny. Makroskopicky išlo kompaktný polyp rozmerov 40 × 32 × 10 mm s hladkým povrchom. Histologické vyšetrenie potvrdilo diagnózu REAH s ložiskovo výraznou prevahou žľazových štruktúr s prechodom do seromucinózneho hamartómu. Po operácii klinické ťažkosti ustúpili a pacient je v súčasnosti bez známok recidívy. Napriek zriedkavému výskytu by mal byť REAH zahrnutý v diferenciálnej diagnostike sinonazálnych polypovitých más, najmä ak pochádzajú zo zadnej časti nazálneho septa alebo olfaktoriálnej štrbiny. Včasné rozpoznanie a správna diagnóza predchádzajú zbytočným agresívnym chirurgickým intervenciám a ďalším zaťažujúcim vyšetreniam.
Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign lesion originating from the mucosal epithelium of the nasal cavity and paranasal sinuses. We describe a 51-year-old man with a history of persistent difficulty breathing and feeling of stuffy nose. He was diagnosed to have a large polypoid mass in the right nasal cavity with a stalk arising from the olfactory cleft. Grossly, it was a compact polyp measuring 40 × 32 × 10 mm with a smooth surface. The histology confirmed the diagnosis of REAH with predominance of glandular structures with a transition to seromucinous hamartoma. After the operation, the clinical problems had disappeared and the patient was free of recurrence. Despite rare occurrence, REAH should be included in the differential diagnosis of sinonasal polypoid masses, especially of those which originate from the posterior part of the nasal septum or olfactory cleft. Early recognition and correct diagnosis prevent unnecessary aggressive surgery and other burdensome examinations.
- Keywords
- respirační epitelový adenomatoidní hamartom,
- MeSH
- Adenoma surgery diagnostic imaging pathology MeSH
- Diagnosis, Differential MeSH
- Endoscopy MeSH
- Hamartoma * surgery diagnostic imaging pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Nasal Polyps surgery diagnostic imaging pathology MeSH
- Paranasal Sinuses * surgery diagnostic imaging pathology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
INTRODUCTION: Studies have correlated living close to major roads with Alzheimer's disease (AD) risk. However, the mechanisms responsible for this link remain unclear. METHODS: We exposed olfactory mucosa (OM) cells of healthy individuals and AD patients to diesel emissions (DE). Cytotoxicity of exposure was assessed, mRNA, miRNA expression, and DNA methylation analyses were performed. The discovered altered pathways were validated using data from the human population-based Rotterdam Study. RESULTS: DE exposure resulted in an almost four-fold higher response in AD OM cells, indicating increased susceptibility to DE effects. Methylation analysis detected different DNA methylation patterns, revealing new exposure targets. Findings were validated by analyzing data from the Rotterdam Study cohort and demonstrated a key role of nuclear factor erythroid 2-related factor 2 signaling in responses to air pollutants. DISCUSSION: This study identifies air pollution exposure biomarkers and pinpoints key pathways activated by exposure. The data suggest that AD individuals may face heightened risks due to impaired cellular defenses. HIGHLIGHTS: Healthy and AD olfactory cells respond differently to DE exposure. AD cells are highly susceptible to DE exposure. The NRF2 oxidative stress response is highly activated upon air pollution exposure. DE-exposed AD cells activate the unfolded protein response pathway. Key findings are also confirmed in a population-based study.
- MeSH
- Alzheimer Disease * genetics metabolism MeSH
- Olfactory Mucosa metabolism MeSH
- Epigenomics MeSH
- NF-E2-Related Factor 2 genetics metabolism MeSH
- Air Pollutants adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- DNA Methylation * MeSH
- MicroRNAs metabolism genetics MeSH
- Aged MeSH
- Gene Expression Profiling MeSH
- Transcriptome MeSH
- Vehicle Emissions * toxicity MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION AND OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the nasal cavity, penetrates the nasal epithelial cells through the interaction of its spike protein with the host cell receptor angiotensin-converting enzyme 2 (ACE2) and then triggers a cytokine storm. We aimed to assess the biocompatibility of fullerenol nanoparticles C60(OH)40 and ectoine, and to document their effect on the protection of primary human nasal epithelial cells (HNEpCs) against the effects of interaction with the fragment of virus - spike protein. This preliminary research is the first step towards the construction of a intranasal medical device with a protective, mechanical function against SARS-CoV-2 similar to that of personal protective equipment (eg masks). METHODS: We used HNEpCs and the full-length spike protein from SARS-CoV-2 to mimic the first stage of virus infection. We assessed cell viability with the XTT assay and a spectrophotometer. May-Grünwald Giemsa and periodic acid-Schiff staining served to evaluate HNEpC morphology. We assessed reactive oxygen species (ROS) production by using 2',7'-dichlorofluorescin diacetate and commercial kit. Finally, we employed reverse transcription polymerase chain reaction, Western blotting and confocal microscopy to determine the expression of angiotensin-converting enzyme 2 (ACE2) and inflammatory cytokines. RESULTS: There was normal morphology and unchanged viability of HNEpCs after incubation with 10 mg/L C60(OH)40, 0.2% ectoine or their composite for 24 h. The spike protein exerted cytotoxicity via ROS production. Preincubation with the composite protected HNEpCs against the interaction between the spike protein and the host membrane and prevented the production of key cytokines characteristic of severe coronavirus disease 2019, including interleukin 6 and 8, monocyte chemotactic protein 1 and 2, tissue inhibitor of metalloproteinases 2 and macrophage colony-stimulating factor. CONCLUSION: In the future, the combination of fullerenol and ectoine may be used to prevent viral infections as an intranasal medical device for people with reduced immunity and damaged mucous membrane.
- MeSH
- Amino Acids, Diamino MeSH
- Angiotensin-Converting Enzyme 2 metabolism MeSH
- COVID-19 * prevention & control MeSH
- Cytokines metabolism MeSH
- Epithelial Cells * drug effects virology MeSH
- Fullerenes * pharmacology chemistry MeSH
- Spike Glycoprotein, Coronavirus * metabolism MeSH
- Cells, Cultured MeSH
- Humans MeSH
- Nanoparticles * chemistry MeSH
- Nasal Mucosa drug effects cytology MeSH
- Reactive Oxygen Species metabolism MeSH
- SARS-CoV-2 * drug effects MeSH
- Cytokine Release Syndrome * prevention & control MeSH
- Cell Survival * drug effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
PURPOSE: The study analyses outcomes of the surgical treatment of odontogenic sinusitis that concurrently address sinusitis and its dental source. METHODS: A total of 364 adult patients were included, representing 13% of all patients we have operated on for any rhinosinusitis over the past 18 years. The diagnosis was based on both ENT and dental examinations including CT imaging. Patients were divided into three groups: (1) FESS with dental surgery without antrotomy, (2) FESS with intraoral antrotomy, and (3) intraoral surgery without FESS. The mean postoperative follow-up was 15 months. RESULTS: First group involved 64%, second group 31%, and third group 6% of the cases. The one-stage combined ENT and dental approach was used in 94% of cases (group 1 and 2) with a success rate of 97%. Concerning FESS, maxillary sinus surgery with middle meatal antrostomy only was performed in 54% of patients. Oroantral communication flap closure was performed in 56% of patients (success rate 98%). Healing was achieved within 3 months. The majority (87%) of patients were operated on unilaterally for unilateral findings. Over the past 18 years, a 6% increase of implant-related odontogenic sinusitis was observed. CONCLUSION: Odontogenic sinusitis is common, tending to be unilateral and chronic. Its dental source needs to be uncovered and treated and should not be underestimated. Close cooperation between ENT and dental specialists has a crucial role in achieving optimal outcomes. The one-stage combined surgical approach proves to be a reliable, safe, fast and effective treatment.
- MeSH
- Adult MeSH
- Endoscopy methods MeSH
- Humans MeSH
- Prospective Studies MeSH
- Maxillary Sinus surgery MeSH
- Sinusitis * complications surgery MeSH
- Maxillary Sinusitis * diagnostic imaging etiology surgery MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
Besides being responsible for olfaction and air intake, the nose contains abundant vasculature and autonomic nervous system innervations, and it is a cerebrospinal fluid clearance site. Therefore, the nose is an attractive target for functional MRI (fMRI). Yet, nose fMRI has not been possible so far due to signal losses originating from nasal air-tissue interfaces. Here, we demonstrated feasibility of nose fMRI by using novel ultrashort/zero echo time (TE) MRI. Results obtained in the resting-state from 13 healthy participants at 7T and in 5 awake mice at 9.4T revealed a highly reproducible resting-state nose functional network that likely reflects autonomic nervous system activity. Another network observed in humans involves the nose, major brain vessels and CSF spaces, presenting a temporal dynamic that correlates with heart rate and breathing rate. These resting-state nose functional signals should help elucidate peripheral and central nervous system integrations.
- MeSH
- Autonomic Nervous System physiology diagnostic imaging MeSH
- Adult MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Brain Mapping methods MeSH
- Young Adult MeSH
- Brain physiology diagnostic imaging MeSH
- Mice MeSH
- Nose * physiology diagnostic imaging MeSH
- Rest physiology MeSH
- Heart Rate physiology MeSH
- Animals MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Mice MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Chronická rinosinusitida (CRS) je komplexní heterogenní zánětlivé onemocnění dutiny nosní a vedlejších dutin nosních, které velmi často vede ke snížení kvality života s následným socioekonomickým zatížením zdravotnictví. Klinicky se rozděluje na chronickou rinosinusitidu s polypy (CRSwNP) a chronickou rinosinusitidu bez polypů (CRSsNP). V současné době se výzkum zaměřuje na složení mikroflóry v jednotlivých částech lidského těla, které již pomohlo objasnit roli mikrobiomu u zánětlivých respiračních onemocnění, jako je asthma bronchiale a chronická obstrukční plicní nemoc (CHOPN). V této návaznosti se výzkumy zaměřují i na roli nosního mikrobiomu v možné iniciaci a potenciaci CRS. Zdravé nosní mikrobiologické prostředí je z velké části tvořeno bakteriemi, plísněmi a viry. Bližší poznání interakcí mezi mikroby a jednotlivými složkami imunitního systému mohou pomoci ozřejmit patofyziologické mechanizmy probíhající během CRS. V tomto přehledovém článku se zaměříme na současné poznatky o změnách a možné roli komplexního mikrobiomu horních cest dýchacích u CRS v porovnání se zdravým nosním prostředím.
Chronic rhinosinusitis (CRS) is a complex heterogeneous inflammatory disease of the nasal cavity and paranasal sinuses, which very often leads to a decrease in the quality of life with subsequent socioeconomic burden on health services and medical care. CRS is clinically divided into chronic rhinosinusitis with polyps (CRSwNP) and chronic rhinosinusitis without polyps (CRSsNP). Currently, research focuses on the composition of microflora in individual parts of the human body, which has already helped clarify the role of the microbiome in inflammatory respiratory diseases such as bronchial asthma and chronic obstructive pulmonary disease (COPD). Furthemore, research also focuses on the role of the nasal microbiome in possible initiation and potentiation of CRS. A healthy nasal microbiological environment is composed of bacteria, fungi, and viruses. A closer understanding of interactions between microbes and individual components of the immune system may help clarify the pathophysiological mechanisms involved during CRS. In this review article, we will focus on the current knowledge of composition changes and the possible role of the complex microbiome of the upper respiratory tract in CRS compared to a healthy nasal environment.
- MeSH
- Chronic Disease classification MeSH
- Humans MeSH
- Microbiota * immunology MeSH
- Nasal Cavity microbiology physiopathology pathology MeSH
- Nasal Polyps diagnosis immunology classification MeSH
- Rhinosinusitis * diagnosis etiology microbiology physiopathology MeSH
- Immunity, Mucosal MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
OBJECTIVES: Mulberry-like changes of the posterior inferior nasal turbinate (MPINT) can lead to nasal obstruction. Extraesophageal reflux (EER) characterized by lower pH causes mucosal inflammation and therefore can contribute to sinonasal pathologies. No prior studies have objectively examined the possible association between acidic pH and MPINT formation. Therefore, this study is aimed to investigate the 24-h pharyngeal pH value in patients with MPINT. STUDY DESIGN: Prospective case-control multi-center study. METHODS: Fifty-five patients with chronic EER symptoms were included in the study. They filled in questionnaires aimed at reflux and sinonasal symptoms (RSI®, SNOT-22) and underwent video endoscopy evaluating the laryngeal findings (RFS®) and the presence or absence of the MPINT. And, 24-h oropharyngeal pH monitoring was used to detect the acidic pH environment in the pharynx. RESULTS: Out of the 55 analyzed patients, 38 had the MPINT (group 1), and in 17 patients, the MPINT was absent (group 2). Based on the pathological RYAN Score, in 29 (52.7%) patients, severe acidic pH drops were detected. In group 1, the acidic pH drops were diagnosed significantly more often (68.4%) compared with those in group 2 (p = 0.001). Moreover, in group 1, a significantly higher median total percentage of time spent below pH 5.5 (p = 0.005), as well as a higher median number of events lasting more than 5 min (p = 0.006), and higher median total number of events with pH drops (p = 0.017) were observed. CONCLUSION: In this study, the MPINT was significantly more often present in patients with acidic pH events detected by 24-h oropharyngeal pH monitoring. Acidic pH in the pharynx might lead to MPINT formation. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:62-68, 2024.
- MeSH
- Pharynx MeSH
- Gastroesophageal Reflux * diagnosis MeSH
- Hydrogen-Ion Concentration MeSH
- Humans MeSH
- Morus * MeSH
- Turbinates MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
