Association of nerve fibers and plasma cells in abnormal human nasal respiratory mucosa

Secretory IgA in saliva can be a useful stress marker

To evaluate secretory immunoglobulin A (slgA) in saliva as an immunological stress marker, we reviewed the literature on slgA and its variation caused by psychosocial factors. Among the studies on the effect of academic stress on slgA secretion, we could distinguish two kinds of stress effects: the immediate stress effect which increases slgA secretion immediately after stress, and the delayed stress effect which decreases slgA secretion several days after stress. On the basis of production and secretion mechanisms of slgA, we also speculated on possible mechanisms that underlie the variations of slgA caused by stress. Eventually, we concluded diat slgA in saliva can be a useful stress marker if we analyze the delayed stress effect on slgA separately from the immediate stress effect on slgA.

Rhinitis medicamentosa: therapeutic effect of diode laser inferior turbinate reduction on nasal obstruction and decongestant abuse

BACKGROUND

The purpose of this study was to evaluate long-term outcomes of an outpatient-based diode laser inferior turbinate reduction (ITR) in therapy-refractory rhinitis medicamentosa (RM).

METHODS

In a prospective clinical investigation, 42 consecutive RM patients underwent videoendoscopic ITR with a diode laser after topical anesthetic preparation. Intra- and perioperative details were recorded including the occurrence of bleeding, crusting, pain, or discomfort. Treatment efficiency was assessed by follow-ups 1 and 6 weeks as well as 6 and 12 months after surgery. Subjective pre- and posttherapeutic nasal airflow (NA) and patient satisfaction were rated on visual analog scales (VASs). Assessment of the long-term objective clinical effectiveness was based on rhinomanometry, IT photodocumentation, and the recurrent need for decongestants.

RESULTS

Preoperative addiction to decongestants lasted 5 +/- 2 years (mean +/- SD). There was no major bleeding requiring nasal packing, and there were no other perioperative complications. Postoperative edema disappeared within the 1st week and crusting within 6 weeks after surgery. VAS was characterized by very low values for intraoperative pain and discomfort and high postoperative patient satisfaction. After 6 months, NA data revealed a significant improvement of subjective VAS and objective rhinomanometry (250.4-413.9 cm3/s inspiration at 150 Pa). A total of 88% of patients managed to successfully stop decongestant abuse after 6 months (74% after 1 year).

CONCLUSION

In therapy-refractory RM, outpatient diode laser ITR of hyperplastic IT represents a highly effective, safe, and well-tolerated treatment option that provides long-lasting recovery by markedly improving NA and stopping addiction to nasal decongestants.

Use of nasal preparations and the incidence of sinonasal cancer

Data from a population based case control study in western Washington were analysed to determine whether the use of nasal sprays and drops was associated with an increased risk of sinonasal cancer. Telephone interviews were conducted with incident cases (n = 53) diagnosed between 1979 and 1983 or their next-of-kin, and with controls (n = 552) regarding their past use of nasal preparations, history of rhinologic problems, smoking history, alcohol consumption, and a number of other known or suspected risk factors. Both cigarette smoking and alcohol consumption were associated with an increased risk of sinonasal cancer; the strongest associations were found with squamous cell tumours. Subjects who reported a history of nasal preparation use were 3.5 times (95% confidence interval = 1.7-7.0) more likely than non-users to develop sinonasal cancer. The risk of sinonasal cancer increased with increasing duration of use of nasal preparations. These findings suggest the need for a more detailed investigation of the possible adverse consequences of long-term use of nasal preparations.

Histophysiology of the vegetative peripheral nervous system of skin

Preterminal nerve fibers of the peripheral vegetative nervous system make inmediate contact (neuro-effector-areas) to interstitial cells (I.C.). This connection is characterized through a common glycocalyx with the nerve fiber. The I.C. are specific innervated cells and differ morphologically from Schwann-cells, fibrocytes, and histiocytes. The I.C. are able to come into morphologically different contacts with neighbouring cells by microvilli-like cell protrusions. These neighbouring cells then are able to contact other cells by themselves. The results are interpreted in the sense of electro-mechanical feed-back system of information processing in the vegetative periphery.