Epithelial Squamous Metaplasia Research Articles

Impact Of Underage Marriage On Reproductive Health In Cileles District

Married women under the age of 16 are usually 10-12 times more likely to develop cervical cancer than those who are married over the age of 20. At that age the uterus of a young woman is very sensitive. The juvenile cervix is ​​more susceptible to carcinogenic stimuli because of the active process of metaplasia, which occurs in the transformation zone during the developmental period. Squamous epithelial metaplasia is usually a physiological process. But under the influence of carcinogens, cell changes can occur resulting in a pathological transformation zone (Melva, 2017). These atypical changes initiate a process called cervical intraepithelial neoplasm (CIN) which is the preinvasive phase of cervical cancer. Under the age of 18, a woman's reproductive organs are still very weak. If she is pregnant, then As a result, it will be easy to miscarry because the uterus is not that strong, making it difficult for the fetus to attach to the uterine wall. This type of research is descriptive research with the method used is a quantitative approach. The sample in this study was taken from the entire population, because the method used was total sampling with a total of 46 people. This study uses a cross-sectional or cross-sectional design which can show the relationship between the independent and dependent variables but cannot show a causal relationship. The results of the study that based on the results of the Paired Samples t Test correlation test obtained a p-value of 0.00. Because the p value is 0.00 (p <0.05), there is a significant impact of early marriage on reproductive health.

Ozone exposure affects corneal epithelial fate by promoting mtDNA leakage and cGAS/STING activation

Ozone is a common air pollutant associated with various human diseases. The human ocular surface is frequently exposed to ozone in the troposphere, but the mechanisms by which ozone affects the ocular surface health remain unclear. This study aimed to establish a mouse model to investigate the effects of ozone exposure on the ocular surface and the corneal epithelium. The findings revealed that ozone exposure disrupted corneal epithelial homeostasis and differentiation, resulting in corneal squamous metaplasia. Further, ozone exposure induced oxidative damage and cytoplasmic leakage of mitochondrial DNA (mtDNA), thereby activating the cGAS/STING signaling pathway. The activation of the cGAS/STING signaling pathway triggered the activation of downstream NF-κB and TRAF6 signaling pathways, causing corneal inflammation, thereby promoting corneal inflammation and squamous metaplasia. Finally, C-176, a selective STING inhibitor, effectively prevented and treated corneal inflammation and squamous metaplasia caused by ozone exposure. This study revealed the role of mtDNA leakage-mediated cGAS/STING activation in corneal squamous epithelial metaplasia caused by ozone exposure. It also depicted the abnormal expression pattern of corneal epithelial keratin using three-dimensional images, providing new targets and strategies for preventing and treating corneal squamous metaplasia and other ocular surface diseases.

Airway Injury Caused by Aspiration of Iron Sulfate Pills: A Series of 11 Cases

It is not widely recognized that iron (ferrous sulfate) pill aspiration causes airway damage. Clinical diagnosis is challenging because patients are often unaware that they have aspirated a pill. The literature on this entity consists mainly of case reports. The aim of this study is to describe the clinical and pathologic features of iron pill aspiration in a series of 11 patients. A retrospective review of our pathology archives was performed to identify cases of iron pill aspiration (2013-2023). All available histologic and cytologic material was rereviewed. Clinical information was collected from the electronic medical record, and imaging studies were rereviewed. Eighteen endobronchial biopsies were identified from 11 patients (7 women and 4 men; mean age, 70 years; range, 44-82 years). Eight patients had corresponding cytology (20 specimens). Medication history was available in 9 of 11 patients, all of whom were taking iron sulfate pills. Two patients reported possible aspiration episodes; 4 had risk factors for aspiration. The diagnosis of iron pill aspiration was suspected prior to biopsy in only 1 case. Histologically, iron pill particles were yellow, golden brown, or gray, were elongated and crystal or fiber like, and stained strongly with an iron stain. Common histologic findings included mucosal ulceration, acute and/or chronic inflammation, fibrosis, and squamous metaplasia. Iron pill particles were also identified in 11 cytology specimens from 6 patients. On Papanicolaou staining, iron pill particles were yellow to golden, fiber like, refractile, and crystalline. Reactive epithelial cells, squamous metaplasia, and acute inflammation were common. The combination of iron pill intake and discolored mucosa on bronchoscopy is a potential clue to the diagnosis of iron pill aspiration. Pathologists should familiarize themselves with the appearance of iron pill particles in endobronchial biopsies and cytology specimens from the respiratory tract as this diagnosis is seldom suspected on clinical grounds, and most patients lack a history of aspiration.

Early pathological changes of peri-coronal tissue in the distal area of erupted or partially impacted lower third molars

AimThis study was performed to histologically evaluate peri-coronal tissues of partially impacted and erupted third molars that did not exhibit pathologic peri-coronal radiolucency.Materials and methodsHealthy patients with erupted or partially erupted (with part or all of the dental crown present in the oral cavity) mandibular third molars (classified as IA and IIA according to the Pell and Gregory classification) and vertically positioned (according to the Winter classification or erupted third molars) associated with peri coronal radiolucency of equal to or less than 2.5 mm. Associated with third molar surgery, tissue sampling from the distal area was performed, which was subjected to an anatomopathological examination to determine the histological nature.ResultsOne hundred teeth (100 patients) were selected, and 100 specimens were analyzed. 53% of the sample were included in the non-pathological group and 47% showed pathological changes (fibrotic tissue (n 15), periodontal cyst-like (n 9), squamous epithelial metaplasia (4 cases), islands of odontogenic epithelial residues organized micro-cyst with keratocystic/ameloblastic appearance (4 cases), granulation tissue (n 8), giant cell tumour (n 4) and lobular capillary hemangioma (n 4)). Pathological changes did not have differences in incidence between the gender (p value = 0.85) and did not show any correlation with age, (p value = 0,96).ConclusionsThese findings suggest that radiographic appearance may not be a reliable indicator of the absence of disease within a dental follicle. Therefore, clinicians should pay attention to or follow up on even peri-coronal radiolucency of less than 2.5 mm.

Barrett's Esophagus

Barrett’s esophagus (BE) is caused by metaplasia of squamous epithelium into columnar epithelium, mainly in the lower esophagus. Updates have been made in the etiology, diagnosis and treatment of BE since its first report as an ulcerative lesion in the lower esophagus. Columnar metaplasia of the lower esophagus has been reported as a result of gastroesophageal reflux, rather than genetic factors. When specialized intestinal metaplasia (SIM) is confirmed on biopsy, it is diagnosed as BE; otherwise, it is described as columnar line esophagus (CLE). Recent recommendations state that the following two conditions must be satisfied to diagnose BE: CLE with a length ≥1 cm proximal to the gastroesophageal junction, or SIM, with goblet cells confirmed on biopsy. BE is a key risk factor for esophageal adenocarcinoma. Early detection and treatment of BE, dysplasia, and early esophageal adenocarcinoma arising from BE has become a critical issue in the USA and Europe. The prevalence of BE in Korea is likely to increase because of the increasing prevalence of gastroesophageal reflux diseases. However, there are few reports on the diagnosis and treatment of BE in Korea. In this narrative review, important historical discoveries related to BE, the anatomical structures and endoscopic findings around the gastroesophageal junction required for diagnosing CLE and BE, and a brief review of the guidelines for the diagnosis and treatment of BE are summarized.

Malfunction of airway basal stem cells plays a crucial role in pathophysiology of tracheobronchopathia osteoplastica

Understanding disease-associated stem cell abnormality has major clinical implications for prevention and treatment of human disorders, as well as for regenerative medicine. Here we report a multifaceted study on airway epithelial stem cells in Tracheobronchopathia Osteochondroplastica (TO), an under-detected tracheobronchial disorder of unknown etiology and lack of specific treatment. Epithelial squamous metaplasia and heterotopic bone formation with abnormal cartilage proliferation and calcium deposits are key pathological hallmarks of this disorder, but it is unknown whether they are coincident or share certain pathogenic mechanisms in common. By functional evaluation and genome-wide profiling at both transcriptional and epigenetic levels, we reveal a role of airway basal cells in TO progression by acting as a repository of inflammatory and TGFβ-BMP signals, which contributes to both epithelial metaplasia and mesenchymal osteo-chondrogenesis via extracellular signaling and matrix remodeling. Restoration of microenvironment by cell correction or local pathway intervention may provide therapeutic benefits.

Exploring the Mechanism of Yiqi Qingre Ziyin Method in Regulating Neuropeptide Expression for the Treatment of Atrophic Rhinitis.

Atrophic rhinitis (AR) is a chronic disease that causes severe structural changes to the nasal mucosa leading to squamous epithelial metaplasia. However, treatment regarding AR remains a major challenge. We used network pharmacology and molecular docking methods to explore the potential mechanisms of the Yiqi Qingre Ziyin method to modulate neuropeptides in the treatment of AR. The active ingredients of the Yiqi Qingre Ziyin method and their targets of action were obtained from the Traditional Chinese Medicine Systematic Pharmacology Database Analysis Platform (TCMSP). Disease targets for AR were obtained from four databases: GeneCards, PharmGKB, DrugBank, and Online Mendelian Inheritance in Man (OMIM). A total of 59 active ingredients, 39 potential targets, and 76 relevant neuropeptides were obtained after deduplication. We constructed target interaction networks with the STRING database. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed on the 14 potential target proteins. We used Cytoscape software to construct the “drug-active ingredient-potential target” and “ingredient-target-pathway” networks of the Yiqi Qingre Ziyin method for treating AR. Molecular docking results suggest that dipeptidyl peptidase 4 (DPP4), opioid receptor gene d1 (OPRD1), and opioid receptor m1 (OPRM1) are key targets for the Yiqi Qingre Ziyin method. Therefore, this study proposed a potential mechanism for the treatment of AR by affecting the expression of neuropeptide-related genes (including DPP4, OPRD1, and OPRM1), which may potentially improve the immune microenvironment of the nasal mucosa.

Pathogenesis, clinical features of asthma COPD overlap, and therapeutic modalities.

Both asthma and COPD are heterogeneous diseases identified by characteristic symptoms and functional abnormalities, with airway obstruction common in both diseases. Asthma COPD overlap (ACO) does not define a single disease but is a descriptive term for clinical use that includes several overlapping clinical phenotypes of chronic airways disease with different underlying mechanisms. This literature review was initiated to describe published studies, identify gaps in knowledge, and propose future research goals regarding the disease pathology of ACO, especially the airway remodeling changes and inflammation aspects. Airway remodeling occurs in asthma and COPD, but there are differences in the structures affected and the prime anatomic site at which they occur. Reticular basement membrane thickening and cellular infiltration with eosinophils and T-helper (CD4+) lymphocytes are prominent features of asthma. Epithelial squamous metaplasia, airway wall fibrosis, emphysema, bronchoalveolar lavage (BAL) neutrophilia, and (CD8+) T-cytotoxic lymphocyte infiltrations in the airway wall are features of COPD. There is no universally accepted definition of ACO, nor are there clearly defined pathological characteristics to differentiate from asthma and COPD. Understanding etiological concepts within the purview of inflammation and airway remodeling changes in ACO would allow better management of these patients.

MP04-19 PROSTATIC METAPLASIA OF THE VAGINA IN TRANSGENDER MEN

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) I (MP04)1 Sep 2021MP04-19 PROSTATIC METAPLASIA OF THE VAGINA IN TRANSGENDER MEN David Diamond, Richard Yu, Joseph Borer, Rena Xu, William Anderson, and Sara Vargas David DiamondDavid Diamond More articles by this author , Richard YuRichard Yu More articles by this author , Joseph BorerJoseph Borer More articles by this author , Rena XuRena Xu More articles by this author , William AndersonWilliam Anderson More articles by this author , and Sara VargasSara Vargas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001971.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Gender-affirming surgery (GAS) of the reproductive tract in transgender males includes vaginectomy. In most centers, this is achieved by colpocleisis, with cautery ablation of the vaginal mucosa & suture ablation of the vaginal lumen. Having seen complications due to residual vaginal tissue following colpocleisis, we changed our technique to complete vaginectomy with full-thickness excision of vaginal tissue, allowing its histopathologic examination. Our institution recently reported prostatic metaplasia of vaginal epithelium in the first 6/7 patients treated in this manner. Having accrued 11 additional patients, we extend the analysis of this novel observation. METHODS: The study was IRB approved. Pathology archives were searched for vaginectomy specimens as part of GAS from 1/1/18-2/15/21. Gross features were reviewed. Hematoxylin-and-eosin-stained slides were examined in all cases. The majority were immunohistochemically stained for NKX3.1, prostate-specific antigen (PSA) and androgen receptor. 3 control cases of vaginal tissue from patients without clinical evidence of androgen supplementation were compared. RESULTS: 18 patients, ages 20-34, underwent vaginectomy or excision of vaginal remnants. Each had been assigned female gender at birth without history of endocrine or genetic abnormality. All had received long-term testosterone cypionate treatment (range, 26-60 mos). Grossly, there were no mucosal lesions identified at surgical or pathological examination. Microscopically, 17/18 cases demonstrated a patchy intraepithelial glandular proliferation along the basement membrane; the 18th had a nodular collection of prostate-type tissue within subepithelial stroma. Atrophy & transitional metaplasia of squamous epithelium was also seen. The glandular proliferation was positive for NKX3.1 (15/15; 100%), PSA (9/11; 82%), and androgen receptor (8/8; 100%). Control vaginal tissue showed no evidence of prostatic metaplasia or atrophy. CONCLUSIONS: This study further characterizes the occurrence of prostatic-type tissue in the vagina of transgender men. Prostatic tissue was present in 18/18 transgender men receiving androgen therapy and our findings are consistent with a form of androgen-associated prostatic metaplasia. This finding may have important clinical implications since some transgender men may elect to retain their vaginas, while those who do undergo GAS may have residual tissue left behind, particularly if colpocleisis is performed. Long-term follow-up of this population, with recognition of this entity, is in order. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e74-e74 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Diamond More articles by this author Richard Yu More articles by this author Joseph Borer More articles by this author Rena Xu More articles by this author William Anderson More articles by this author Sara Vargas More articles by this author Expand All Advertisement Loading ...

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

Clinicopathologic analysis of conjunctivochalasis and paste-pinch-cut conjunctivoplasty for management

ObjectiveTo correlate the histopathologic results of conjunctival specimens with clinical findings in patients with conjunctivochalasis and report the results of the paste-pinch-cut technique for management.Design: Retrospective chart review. SettingSingle tertiary ophthalmological centre (Ocular Surface Diseases and Dry Eye Clinic, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Md.). MethodsTwenty-five patients (32 eyes) with clinically significant conjunctivochalasis. All patients were referred for clinically significant dry eye without previous diagnosis of chalasis. Sixteen patients had an underlying inflammatory systemic condition. Intervention or Observation Procedure(s): Patients underwent surgery with paste-pinch-cut technique. Subjective dry eye symptoms and ocular surface staining scores (corneal and conjunctival staining using fluorescein and lissamine green respectively) were assessed at every visit. Main Outcome MeasuresChange in patient symptoms and ocular surface staining scores and histopathologic findings in conjunctival specimens. ResultsAfter surgery, significant improvement was achieved in dry-eye symptoms as well as both corneal and conjunctival staining scores in 29 eyes on reduced topical therapy. Only 3 eyes had persisting conjunctival lissamine staining. Light microscopic examination disclosed mild to moderate lymphoplasmocytic inflammation of the conjunctivae with areas of epithelial goblet cell loss, squamous metaplasia, stromal edema, and fibrosis. ConclusionConjunctivochalasis appears to be associated with significant inflammation in the setting of dry eye and underlying inflammatory systemic conditions. Although topical anti-inflammatory treatment could be attempted in the initial management, surgical excision should be considered in the absence of clinical response.

The Evolution of the Definition and Diagnosis of Barrett Esophagus: A Historical Perspective

Historical definitions of Barrett esophagus (BE) have depended on 2 beliefs: the esophagus is a squamous lined tube and the stomach is a columnar lined sac. Norman Barrett, in 1957, recognized that columnar lining in the tubular esophagus was reflux-induced metaplasia of squamous epithelium, leading to the present definition of BE. Recent evidence that gastric overdistension results in acid exposure of distal esophageal squamous epithelium, causing progressive columnar metaplasia, damage to the lower esophageal sphincter, and dilatation of the abdominal esophagus. This is presently mistaken at endoscopy for proximal stomach. The future definition of BE will likely include intra-sphincteric BE.

Ocular surface disorder among adult patients with type II diabetes mellitus and its correlation with tear film markers: A pilot study.

PURPOSE:The purpose is to study the ocular surface changes among patients with diabetes mellitus (DM) and to correlate them with tear film markers such as insulin-like growth factor (IGF)-1, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α levels.MATERIALS AND METHODS:The study was carried out on diabetic patients (>5 years' duration) and healthy age- and gender-matched controls with 21 individuals in each group. Schirmer's test for basal and reflex tear secretion, tear film breakup time (TBUT) for tear stability, ocular staining score (OSS) for dryness severity, ocular surface disease index (OSDI) for symptomatic assessment of dryness and conjunctival impression cytology (IC) for epithelial cell integrity, keratinization, squamous metaplasia, and goblet cell density was studied. Thirty microliters of tears were collected to test IGF-1, IL-1β, and TNF-α levels.RESULTS:Patients with DM showed significantly low Schirmer's, TBUT, and OSS values than controls. OSDI score showed moderate-severe dryness in patients with DM and only mild symptoms among controls. An abnormal IC score was seen among cases and controls. The level of TNF-α was significantly increased in patients with DM and positively correlated with Schirmer and TBUT values (P < 0.05).CONCLUSION:Dry eye is more prevalent in patients with DM compared to controls as evidenced by poor OSDI score, Schirmer, TBUT, and OSS. TNF-α in the tears of patients with DM is a useful marker that showed a good correlation with Schirmer, TBUT, and dry eye symptoms. IC could not conclusively differentiate the dry eye status in patients with DM from controls.

Progressive Immunologic Dysregulation with Exposure to Tobacco Smoke in a Model of Chronic Obstructive Pulmonary Disease (COPD)

Abstract Our research objective is to examine the role of dysregulated immune responses in disease progression and changes in lung physiology in a rat model of COPD. Spontaneously hypertensive rats were exposed to tobacco smoke (TS) (90 mg/m3) or filtered air (FA) for up to 12 weeks. Necropsy timepoints of 4, 6, 8, 10 and 12 weeks were chosen to define the immunological and pathophysiological changes in the lung. Rats exposed to TS showed significant increases in macrophage, neutrophil and lymphocyte number in bronchoalveolar lavage compared to FA at all weeks examined. Proinflammatory cytokines IL-1β, IL-6 and IFN-γ in whole lung homogenates were significantly increased following exposure to TS compared to FA controls. Physiological airway obstruction due to TS exposure was noted by significant elevations in central airway resistance and tissue damping. Central airway resistance was significantly increased at 4 weeks, decreased at 6 weeks, but returned to significantly elevated levels at 10 and 12 weeks following TS exposure. Tissue damping showed a peak at 4 weeks, then a decreasing trend, although remaining significantly elevated through 12 weeks of TS exposure. Strong positive correlations were noted between proinflammatory cytokines IL-1β, IL-6, IFN-γ, TNF-α and the degree of tissue damping. These changes were associated with increases in central airway squamous epithelial metaplasia and distal airway mucous metaplasia. These findings suggest progressive airway obstruction with an abnormal inflammatory response to TS exposure in this rodent model of COPD. We conclude a dysregulated immunologic response, along with airway inflammation are strongly associated with the impairment of physiological lung function in TS-exposed rats.

Epithelial Squamous Metaplasia and Dysplasia in Inflammatory Nasal Polyps: An Observational Study.

Nasal polyposis (NP) is characterized by polypoid outgrowths of chronically inflamed respiratory mucosa. The presence of squamous metaplasia and dysplasia on the mucosal surface of nasal polyps (NPs) represents different manifestations of epithelial atypia. The aim of this investigation was to evaluate the presence of epithelial squamous metaplasia and dysplasia in ethmoidal NPs. This retrospective analysis of prospectively collected data involved 212 patients with NP undergoing endoscopic ethmoidectomy. To evaluate possible etiological factors for epithelial atypia, the patients in whom we histopathologically detected the presence of epithelial atypia were compared with patients with "normal" NPs in accordance with the following characteristics as found in the patients' medical records: gender, age, main symptoms, preoperative extent of sinus disease on computed tomography, atopic status, aspirin sensitivity, cigarette smoking, and occupational exposure to different noxious factors. Epithelial atypia were detected histopathologically in 44 (20.7%) NP patients, whereas features of "true" dysplasia were found in only 1 (0.5%) patient. The presence of atypia was more frequent in males than in females (P = .008). The association with aspirin-exacerbated respiratory disease and with long-term occupational exposure to different noxious chemicals, especially in workers exposed to salts of heavy metals, was more frequent in NP patients with epithelial atypia than in patients without atypia (P = .023; P = .006, respectively). Our results suggest epithelial atypia in NPs are associated with aspirin sensitivity and occupational exposure to different noxious chemicals. Although extremely rare, epithelial dysplasia may occasionally be noted in NPs, a fact potentially useful for both rhinologists and pathologists.

Tracheobronchopathia osteochondroplastica: a clinicopathological analysis of 18 cases

Objective: To investigate the clinical symptoms, imaging features, pathologic manifestations and diagnosis of tracheobronchopathia osteochondroplastica (TO). Methods: The clinical data, imaging and pathologic features and outcome of 18 TO patients diagnosed at the First Affiliated Hospital of Zhengzhou University from August 2011 to August 2018 were collected and analyzed. Results: The 18 TO patients included 10 males and 8 females; patients' age range was 31 to 64 years (mean 52 years). Six patients (6/18) were smokers. The main presenting clinical symptoms included cough in 15 cases, expectoration in eight cases (8/18), hemoptysis in five cases (5/18), chest tightness in four cases, wheezing in three cases and chest pain in two cases. The time interval between the initial symptoms and diagnosis was 1.5 to 360.0 months, and the average time interval was 45.2 months. Blood calcium and phosphorus were normal in 18 patients (18/18). Chest X-ray showed no direct evidence of TO. Six patients (6/18) showed irregular changes in the trachea or bronchial wall by chest CT scan. Three patients (3/18) had mild ventilatory obstruction. TO was classified as: 10 cases (10/18) were scattered type, seven cases (7/18) were diffuse type and one case (1/18) was confluent type. Epithelial squamous metaplasia, submucosal cartilage, submucosal ossification and hematopoietic bone marrow within the ossified areas were the characteristic histopathologic findings of TO. Conclusions: TO is a rare benign disorder that shows atypical presentation. CT scan is insensitive, the histopathology shows submucosal cartilage or ossification. TO should be diagnosed by comprehensive consideration of clinical symptoms, imaging and pathology.

A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China.

The factors contributing to the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) remain elusive. This study was designed to investigate the inflammatory patterns and tissue remodeling of CRSwNP in patients from central China at two time points over 14 years apart and the influence of age. One hundred and eight CRSwNP patients enrolled in 2000 and 2001 (group A), and 134 CRSwNP patients enrolled in 2014 and 2015 (group B) were retrospectively studied. Hematoxylin-eosin stained tissue sections were used to study characteristics of inflammation and tissue remodeling. Immunohistochemistry was used to further evaluate the cells positive for eosinophil cationic protein (ECP), IL-5, IgE, tryptase or myeloperoxidase (MPO). Time- and age-related difference was analyzed. The number of eosinophils and proportion of eosinophilic CRSwNP were increased, whereas the numbers of total inflammatory cells and lymphocytes were decreased in group B as compared with group A. Group B had severer epithelial squamous metaplasia and basement membrane thickening, and a lower number of mucosal glands than group A. Higher numbers of ECP plus, IL-5 plus and IgE plus cells were detected in group B than those in group A. The elderly (60 yrs or older) and non-elderly (less than 60 yrs) had a comparable number of eosinophils and ratio of eosinophilic CRSwNP. Eosinophilic inflammation has been significantly augmented over time, which is associated with increased Th2 response and IgE production, and accompanied by exaggerated epithelium remodeling in CRSwNP patients from central China. Age has no significant influence on eosinophilic inflammation.

Tear Lactoferrin and Features of Ocular Allergy in Different Severities of Meibomian Gland Dysfunction.

Meibomian gland dysfunction, but not atrophy, was associated with lower tear lactoferrin concentration, greater dry eye, and allergic symptoms, indicating greater inflammation and discomfort in patients with lower meibomian gland expressibility. Meibomian gland dysfunction can potentially damage adjacent palpebral structures, which may induce inflammation in accessory lacrimal glands and affect lactoferrin secretion. This study aimed to examine the relationships between the severity of meibomian gland dysfunction with tear lactoferrin, conjunctival cell morphology, and clinical features of ocular allergy. Forty subjects were divided into two groups based on the severity of meibomian gland plugging and expressibility and secondarily based on its atrophy. Dry eye and allergy questionnaires; slit-lamp examination, including lid telangiectasia; and meibography were performed. Tear lactoferrin concentration was measured using TearScan 270 MicroAssay. Impression cytology was performed on the upper palpebral conjunctiva, and goblet cell density and epithelial squamous metaplasia were quantified. Twenty-two subjects with meibomian gland dysfunction were categorized into severely obstructed group (case), whereas 19 subjects had minimal/no obstruction (comparison). Lower lactoferrin (1.3 ± 0.4 vs. 1.7 ± 0.4 mg/mL, P = .007), greater dry eye (7 [1 to 10] vs. 2 [0 to 5], P = .03), and allergy symptoms (9 [4 to 23] vs. 6 [0 to 9], P = .05) were found in the cases compared with the comparisons. There were no differences in conjunctival cell morphology between groups. The plugging score was correlated with lactoferrin concentration (ρ = -0.43, P = .006), dry eye (ρ = 0.36, P = .02), and allergic symptoms (ρ = 0.33, P = .04). Greater lid margin telangiectasia was associated with meibomian gland obstruction, but not atrophy. Meibomian gland activity/dysfunction, but not atrophy, may be associated with increased inflammation on the ocular surface. The inflammation may be sufficient to reduce tear lactoferrin production from damage to accessory lacrimal glands and/or meibomian gland and result in increased symptoms.

Pathological changes of the nasolacrimal duct in rabbit models of chronic dacryocystitis: correlation with lacrimal endoscopic findings.

The aim of this study was to explore the pathological changes of the nasolacrimal duct in rabbits with experimentally induced obstructive dacryocystitis in correlation with lacrimal endoscopic findings. The rabbit model of obstructive dacryocystitis was created by injecting 0.15ml of self-curing resin into the lacrimal duct. The control group received 0.15ml of normal saline. Within 16weeks after the obstructive, lacrimal endoscopy and pathological examination of the nasolacrimal duct were conducted at different time points of 1, 2, 4, 8, and 16weeks. In the control group, lacrimal endoscopy revealed pink and smooth mucosa; and the pathological analysis revealed an epithelial layer that was composed of superficial columnar cells and a deep basal epithelial layer. The experimental rabbits showed clinical manifestations of obstructive dacryocystitis a week after the injection of self-curing resin. At weeks 1 and 2, the lacrimal endoscopy showed mucosal hyperemia and hemorrhagic spots on the nasolacrimal duct; and the pathological features included epithelial cell swelling and inflammatory cell infiltration. At weeks 4 and 8, the experimental group showed alternatively red and white mucosa under the lacrimal endoscopy, and the pathological features included proliferative epithelium accompanied by papillary hyperplasia. At week 16, the experimental group showed pale and coarse mucosa and white membrane-like layer covering the mucosal surface, and the pathological features included epithelial necrosis, squamous metaplasia, and sub-epithelial fibrosis. The mucosa of the nasolacrimal duct showed different pathological features at different time points after lacrimal duct obstruction, which was well correlated with the endoscopic findings. It is possible to predict the pathological stages by the endoscopic observation in NLOD patients.

Evaluation of β-carotene assimilation in leopard geckos (Eublepharis macularius).

Although leopard geckos (Eublepharis macularius) are commonly kept under human care, their vitamin requirements are largely unknown. Many invertebrate preys display a low vitamin A concentration; thus, gut-loading insects with vitamin A or carotenoids is a common practice. The objective of this prospective experimental study was to investigate whether dietary supplementation with β-carotene, including prey gut-loading, leads to sufficient vitamin A hepatic storage and prevents epithelial squamous metaplasia development in leopard geckos. Ten clinically healthy female leopard geckos were randomly divided in two groups with various supplementations: a group receiving vitamin A supplementation and a group receiving β-carotene. Insects were gut-loaded continuously with a supplement containing vitamin A or β-carotene, depending on the group. Oral supplementation with cod liver oil or carrot juice was administered weekly to each lizard from "vitamin A group" and "carotenoid group" respectively. After 10weeks of supplementation, surgical hepatic biopsies were obtained in three geckos of each group while the two remaining geckos were euthanized to undergo complete necropsy. Hepatic vitamin A concentration was determined for each lizard (n=10) by ultra-performance liquid chromatography. Histopathology revealed hepatocellular vacuolization and vitellogenic follicles in five females. Epithelial squamous metaplasia was not observed in any of the geckos. Hepatic vitamin A concentration was significantly higher in the carotenoid-supplemented group than in the vitamin A-supplemented group (p=0.03). Our results suggest that in leopard geckos, dietary supplementation with β-carotene allows sufficient vitamin A hepatic storage.