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Objective Histopathology of the maxillary sinus mucosa with intractable odontogenic maxillary sinusitis (OMS) was investigated and the role endoscopic sinus surgery (ESS) plays in its pathophysiology was clarified. Study design Histopathological analysis of the OMS mucosa. Methods Surgical specimens were obtained from 20 patients who underwent ESS for intractable OMS. For rigid endoscopic observation of the mucosae, a 70° rigid endoscope 4 mm in diameter with an attached high definition surgical camera was used. Histopathological analyses of the maxillary sinus mucosa were conducted by light and scanning electron microscopy. Results All the maxillary sinuses were filled, not with viscous, but with purulent secretions. The high-definition camera showed that the maxillary sinus mucosa had gyrus-like appearance. Light microscopic histopathological studies revealed that the surface of the maxillary sinus mucosa was convoluted. Light and scanning electron microscopic histopathological studies revealed that the ciliated cells of the epithelium had not decreased and their goblet cells were not hypertrophic, indicating that the damage of the ciliated columnar epithelium was not severe and they were not injured irreversibly. Conclusion The ciliated columnar epithelium with intractable OMS was not severely damaged and not irreversibly injured. Hence, the pathophysiology of intractable OMS is one of the reasons why ESS is highly indicated for maxillary sinusitis requiring surgery and the treatment results are exceptionally good when the ventilation and drainage of the maxillary sinus is successfully restored after surgery. Level of evidence NA.

In this study, we aimed to investigate the effects of chronic sleep deprivation on mucociliary clearance, which is the primary defence mechanism of the upper airway tract and nasal mucosal histology. Forty-two Wistar Albino rats (250-300 g), 8 or 12 weeks old, were randomly assigned into three groups as follows. The first sleep-deprivation group consisted of 14 rats (A), another 14 of them were assigned to platform group (B), and the remaining 14 were included to the home cage control group (C). For the two deprivation groups (A and B), the modified multiple platform method (MMPM) was used to induce sleep deprivation for 21 days. Tc-99m MAA rhinoscintigraphy was performed to assess mucociliary clearance and the nasal histopathological changes of the sacrificed rats were also examined. Mucociliary clearance was significantly higher in sleep deprivation (A) and deprivation control (B) groups than the control group (C) (p = .037). The ratio of columnar ciliary was significantly higher in group A and B than in the control group (p = .003). The transitional epithelial ratio in groups A and B was also significantly increased compared with group C (p = .04). The control group's squamous epithelial ratio was increased compared to the sleep-deprived groups (p = .003). There was a significantly increased inflammatory response in the ciliated columnar epithelium in groups A and B compared to group C (p = .02). For the first time in the literature, we demonstrated that chronic sleep deprivation has caused a significant increase in mucociliary clearance speed and in the number of ciliary cells.

The present study examines anatomical and histological characteristics of tubular genital organs and its relationships with the reproductive state of 24 wild adult collared peccary (Tayassu tajacu) females. The tunica mucosa of the uterine tube presents a pseudostratified, intermittently ciliated columnar epithelium. The epithelial secretory cells of pregnant females and females in the luteal phase of the oestrous cycle became taller than the ciliated cells and showed abundant apical secretory blebs, whereas secretory cells of females in the follicular phase showed abundant mucous secretory activity (periodic acid-Schiff positive cells). The uterus is composed of two narrow and convoluted uterine horns, separated by the velum uteri, a small uterine body and a long and muscular cervix. The endometrial lining of both uterine horns and body is a monostratified, columnar ciliated epithelium. Pregnant females and females in luteal phase showed a more developed hyperplasia of the endometrial simple tubular glands than females in the follicular phase. The cervix presents interdigitated rows of mucosal prominences that project into the lumen, structures similar to pulvini cervicali, occluding the cervical canal. In pregnant females, the endocervical canal was filled by a viscous cervical secretion. Females in follicular phase presented a thicker vaginal epithelium than pregnant females and females in luteal phase. The present study suggests that the collared peccary female showed different histological features of the uterine tubes, uterus and vagina in accordance with the reproductive state of the females.

Total abdominal hysterectomy with bilateral salpingoophrectomy was carried out. Gross examination of the uterus revealed hyperplastic endometrium along with a small intramural leiomyoma. The isthmic end of both fallopian tubes showed a grey-white nodules measuring 1.5 cm in diameter [Figure 1] and the lumen was occluded with the distal portion of tubes appearing normal. Both the ovaries showed no significant pathology. Microscopic examination of bilateral nodules at the isthmus of fallopian tubes revealed cystically dilated glands surrounded by hypertrophic muscular layer with complete obliteration of tubal lumen [Figure 2].The glands were lined by ciliated columnar epithelium [Figure 3]. Few of the glands were seen infiltrating the muscular layer. Microscopic examination of uterine corpus showed endometrium displaying features of complex hyperplasia without atypia. Salpingitis isthmica nodosa involves women in the age group of 25- 60 years with average age at diagnosis being 30 years. The etiology Salpingitis isthmica nodosa is a condition of the fallopian tube characterized by nodular thickening of the tunica muscularis of the isthmic portion of the tube enclosing cystically dilated glands leading to complete obliteration of tubal lumen.

Background: Carinal reconstruction by direct suturing is associated with a high mortality because high tension at the anastomosis can lead to tracheobronchial fistula. A new tracheal prosthesis was therefore designed for reconstruction of the tracheal bifurcation and applied for experimental carinal replacement in dogs. Methods: The main frame of the new prosthesis consists of a Y-shaped Marlex mesh tube (C.R. Bard, Inc, Billerica, Mass) reinforced with polypropylene spirals, to which collagen extracted from porcine skin is chemically conjugated to provide biocompatibility and airtightness. This conjugated collagen is composed of amorphous and sponge collagen layers. The tracheobronchial bifurcation was replaced with the prosthesis in 10 beagle dogs. Results: Eight dogs survived the postoperative period, and 2 dogs died within 4 days after the operation. Bronchoscopic examination revealed that the tracheal prosthesis was covered with smooth whitish tissue and that no stenosis or dehiscence was present in the 8 dogs even 6 months after the operation. Slight mesh exposure was recognized in 1 dog. Histologic examination revealed that approximately one half of the luminal surface was covered with ciliated columnar epithelium or nonciliated squamous epithelium. In the remaining lumen, especially in the middle portion of the prosthesis, connective tissue without epithelium was observed. Conclusions: These long-term results indicate that our bifurcated tracheal prosthesis can be used for reconstruction of the tracheobronchial bifurcation with long-term safety. (J Thorac Cardiovasc Surg 2000;119:1162-8)

Objective Epidermal growth factor–loaded gelatin microspheres were tested for potential to accelerate tracheal allograft reepithelialization. Methods Epidermal growth factor–loaded gelatin microspheres were prepared by optimal double-phase emulsified condensation polymerization. One hundred age-matched allogeneic mice were randomly allocated to local administration of 1 mg epidermal growth factor–loaded gelatin microspheres (containing 1 μg epidermal growth factor), 1 mg gelatin microspheres, 1 μg epidermal growth factor, or nothing (control, all groups n=25) during orthotopic transplant of C57BL/6 donor tracheal segments into BALB/c recipients without immunosuppressors. On days 7, 14, 21, 35, and 52 after transplant, 5 mice per group were killed and evaluated by histologic assessment and scanning electronic microscopy for reepithelialization and fibrosis of tracheal grafts. Results Mean diameter of gelatin microspheres was 107 μm. Microspheres could not be fully degraded until 35 days after transplant in vivo. On days 7, 14, and 21, epithelium score and ratio of lamina propria to tracheal cartilage were not statistically different between mice with epidermal growth factor–loaded gelatin microspheres and other groups. On days 35 and 52, however, epithelium score was higher and ratio of lamina propria to tracheal cartilage was lower in epidermal growth factor–loaded gelatin microsphere recipients; these mice also had almost complete differentiation of regenerated epithelium into ciliated columnar epithelium on days 35 and 52, earlier than in other groups. Conclusions Gelatin microspheres act as a functional vector for epidermal growth factor. Sustained local application of epidermal growth factor could accelerate reepithelialization of tracheal allografts.