Ximena Fonseca

Epithelial Cell Culture from Human Adenoids: A Functional Study Model for Ciliated and Secretory Cells

Background. Mucociliary transport (MCT) is a defense mechanism of the airway. To study the underlying mechanisms of MCT, we have both developed an experimental model of cultures, from human adenoid tissue of ciliated and secretory cells, and characterized the response to local chemical signals that control ciliary activity and the secretion of respiratory mucins in vitro. Materials and Methods. In ciliated cell cultures, ciliary beat frequency (CBF) and intracellular Ca2+ levels were measured in response to ATP, UTP, and adenosine. In secretory cultures, mucin synthesis and secretion were identified by using immunodetection. Mucin content was taken from conditioned medium and analyzed in the presence or absence of UTP. Results. Enriched ciliated cell monolayers and secretory cells were obtained. Ciliated cells showed a basal CBF of 10.7 Hz that increased significantly after exposure to ATP, UTP, or adenosine. Mature secretory cells showed active secretion of granules containing different glycoproteins, including MUC5AC. Conclusion. Culture of ciliated and secretory cells grown from adenoid epithelium is a reproducible and feasible experimental model, in which it is possible to observe ciliary and secretory activities, with a potential use as a model to understand mucociliary transport control mechanisms.

Uso de desmopresina en niños con disfunción plaquetaria congénita sometidos a adeno y/o amigdalectomía

INTRODUCTION AND GOALS Adenotonsillar surgery represents a major haemostatic challenge in paediatric patients with mild inherited platelet dysfunction. While there are recommendations for perioperative haemostatic management, there are no reports of the outcomes with the different recommendations in these children when undergoing adenotonsillectomy. Our objective was to evaluate the management of perioperative bleeding with desmopressin in children with mild platelet dysfunctions who underwent adenotonsillar surgery in our hospital. METHODS We performed a retrospective study aimed at determining the perioperative bleeding and complication rate in children with mild inherited platelet dysfunction in whom desmopressin was used while undergoing adenotonsillar procedures. RESULTS Between 2004 and 2010, 27 children with mild inherited platelet dysfunction underwent adenotonsillar procedures in our hospital and were treated with desmopressin. One patient developed perioperative bleeding (3.7%) and there was 1 child (3.7%) who presented transitory hypotension as a side effect of desmopressin. CONCLUSIONS The use of desmopressin allowed adequate perioperative bleeding prophylaxis management in children with mild inherited platelet dysfunction who underwent adenotonsillar procedures without presenting severe complications.

Cultivo primario de células ciliadas de adenoides humanos: Un modelo experimental para evaluar la actividad ciliar in vitro

Introduccion: El clearance mucociliar normal es el mecanismo de defensa basico de las vias respiratorias. Sin embargo, los mecanismos de control ciliar aun se desconocen. Con el fin de entenderlo mejor, se han desarrollado diferentes tecnicas de cultivo de celulas ciliadas. Objetivos: Desarrollar un modelo experimental a partir de cultivos primarios de tejido adenoideo y cornete medio. Caracterizarla respuesta a adenosin trifosfato (ATP), agonista conocido de la frecuencia de batido ciliar (FBC). Material y metodo: Cultivos primarios a partir de explantes de epitelio adenoideo y cornete medio humano. Medicion de FBC, con tecnica de microfotodensitometria, en condicion basal y en respuesta a ATP a diferentes concentraciones. Resultados: La FBC basal (promedio (X) ±desv estandar (DE)) para los cultivos de cornete medio fue 11,9 ±1,5 Hz y para tejido adenoideo fue 10,9 ±1,9 (p >0,05). Se observo un aumento en la FBC en respuesta a ATP, dosis dependiente. No hubo diferencia significativa en la FBC basal ni en la respuesta a ATP entre cultivos de cornete medio y adenoides. Conclusion: El cultivo primario de celulas ciliadas nasales a partir de explantes de adenoides, es un modelo experimental reproducible, en el que es posible observar actividad ciliary una respuesta funcional concordante con lo descrito en la literatura

Otitis Media Complications

Otitis media (OM) complications are very infrequent in the post-antibiotic era. They can be secondary to acute otitis media or chronic otitis media, with or without cholesteatoma. OM complications are classified as extracranial (EOMC) and intracranial (IOMC). Acute mastoiditis is the most frequent EOMC. IOMC are less common than EOMC, but far more severe, with a mortality rate as high as 18 %. About half of IOMC patients have more than one complication simultaneously. Acute meningitis and cerebral abscess are the most common IOMC. Most of clinical reports indicate that OMC incidence has been stable during the past years. It is a matter of interest and study to know if the implementation of acute otitis media diagnosis and treatment guidelines, introduction of pneumococcal vaccines, and changes in bacterial susceptibility have modified the natural course of OM complications or will affect these in the years to come.

Encuesta de síntomas SNOT-20 para rinitis alérgica y rinosinusitis: validación en Chile

Background: Allergic rhinitis and sinusitis are common diseases that affect quality of life of pediatric and adult patients. Aim: To adapt and validate the Sino-Nasal Outcome Test 20 indicators (SNOT-20) survey in Chilean subjects. Material and Methods: In a psychometric validation study, an adapted version of the SNOT-20 adapted version was applied to 181 volunteers on two different occasions, three weeks apart. Feasibility (response time and perceived difficulty), reliability (internal consistency and test-retest) and validity (concurrent validity, correlating results with an independent instrument; predictive validity assessing its sensitivity to detect changes and discriminate validity, assessing receiver operating characteristic (ROC) curves), were assessed. An exploratory factor analysis was performed to confirm the presence of previously described underlying constructs. Results: Eighty percent of participants considered SNOT-20 easy to complete. This task was completed in less than 5 minutes. Cronbachs alpha was 0.946. Temporal stability on a healthy subgroup was strong with an intraclass correlation coefficient of0.92. SNOT-20 had a correlation coefficient of0.82 with an independent instrument and its score significantly decreased after 3 weeks of treatment (p = 0.003). The area under ROC curve was 0.895. Factor analysis identified four principal components which possessed identical structure as previously described. Conclusions: SNOT-20 survey was valid, reliable and easy to implement among Chilean subjects.

Viscosity Reduces ATP Response in Respiratory Cilated Cells

base defect in the endoscopic nasal neurosurgery. 2) Evaluate its efficacy. METHOD: In this study we present a novel technique to repair the skull base defect in the endoscopic nasal neurosurgery, in witch a new vegetable (Ricinus communis) derived polymer that was used in two different presentations: hard dural graft (plaque) and soft material (gum) that rapidly acquire a hard consistence. RESULTS: Nine cases of vegetable polymer utilization for skull base reconstruction are being reported. Four cases of meningiomas, two cases of large meningoceles and thee case of non-secreting pituitary adenoma. The dural graft was used alone in only two cases. The moldable gum was used alone in thee cases, and in the remaining four cases both presentations were used. Post-operative CSF leak occurred in the two cases that the dural graft was used alone. When the moldable gum was used, no CSF leak was observed. CONCLUSION: This new vegetable derived polymer has been useful for reconstruction of large skull base defects. It is another option for the skull base team armamentarium. Further studies are needed in order to determine its efficacy.