Disciplina Discipline MOF5753
Ultraestrutura da Mucosa Nasal e Seios Paranasais
Ultrastructure Of The Nasal Mucosa And Paranasal Sinuses

Área de Concentração: 5143

Concentration area: 5143

Criação: 11/08/2022

Creation: 11/08/2022

Ativação: 11/08/2022

Activation: 11/08/2022

Nr. de Créditos: 5

Credits: 5

Carga Horária:

Workload:

Docentes Responsáveis:

Professors:

Fabio de Rezende Pinna

Richard Louis Voegels

Objetivos:

Estudar aspectos da imunologia e ultraestrutura da mucosa nasal e dos seios paranasais. Pretendemos, para tanto, pesquisar as causas e os mecanismos que promovem alterações na fisiologia nasal normal levando a quadros de rinossinusites, rinites, poliposes, dentre outras doenças nasais.

Objectives:

GOALS: Study aspects of immunology and ultrastructure of the nasal mucosa and paranasal sinus. We intend to research the causes and mechanisms that promote changes in normal nasal physiology leading to rinosinusitis, rinitis, nasal polyposis, among other nasal diseases.

Justificativa:

O transporte mucociliar é um dos mais importantes meios de defesa do trato respiratório. Este mecanismo mantém as vias aéreas superiores limpas e saudáveis através da remoção contínua de partículas, poeira, bactérias, vírus, alérgenos e toxinas, que ficam aprisionadas na camada de muco, até a nasofaringe1. Quando ocorre falha neste mecanismo, como na Discinesia Ciliar Primária (DCP), em que há incoordenação do batimento ciliar, a estase e o acúmulo de muco e resíduos provocam infecções e inflamações recorrentes (otites e sinusites crônicas, bronquiectasias). Não existe um consenso sobre o melhor método de avaliação da função mucociliar. Eles vão desde a observação de transporte de substâncias in vivo (sacarina, radioisótopos, discos de Teflon, tinta, etc.)2,3,4, medidas de freqüência de batimento ciliar (fotometria computadorizada, ciliogênese)5,6,7 e exame da ultraestrutura ciliar (microscopia eletrônica), que é atualmente o método gold-standard para o diagnóstico de DCP. Estes exames possuem uma alta complexidade e custos elevados. Recentemente em nosso serviço estamos desenvolvendo a técnica de endoscopia de contato. Inicialmente utilizada para detecção de alterações epiteliais uterinas8, foi trazida à Otorrinolaringologia para o estudo da laringe9. Notou-se, porém, que quando usada na mucosa nasal, ela permitia uma visão detalhada do transporte mucociliar in vivo10, fornecendo uma observação da camada de muco deslizando por sobre a mucosa ciliada do nariz, muitas vezes carregando resíduos. Esta técnica é barata e não-invasiva, dispensando a necessidade de anestesia.

Rationale:

JUSTIFICATION: Mucociliary transport is one of the most importante means of defense of the respiratory tract. This mechanism keeps the upper airways clean and healthy by continuously removing particles, dust, bacteria, viruses, allergens and toxins, which are trapped in the mucus layer, up to the nasopharynx. When this mechanism fails, such as in Primary Ciliary Dyskinesia (PCD), in which there is incoordination of the ciliary beat, the accumulation of mucus and residues cause infections and recurrent inflammations (chronic otitis and sinusitis, bronchiectasis). There is no consensus on the best method for assessing mucociliary function. They range from the observation of transport of substances in vivo (saccharin, radioisotopes, Teflon discs, ink, etc.), ciliary beat frequency measurements (computerized photometry, ciliogenesis) and examination of the ciliary ultrastructure (electron microscopy), which is currently the gold-standard method for the diagnosis of PCD. These exams have a high complexity and high costs. Recently in our service we are developing the technique of contact endoscopy. Initially used to detect uterine epithelial alterations, it was brought to Otorhinolaryngology for the study of the larynx. It was noted, however, that when used in the nasal mucosa, it allowed a detailed view of mucociliary transport in vivo, providing an observation of the mucus layer sliding over the hairy mucosa of the nose, often carrying residues. This technique is inexpensive and non-invasive, without the need for anesthesia.

Conteúdo:

1-Anatomia da ultraestrutura da mucosa nasal; 2-Fisiologia nasal; 3-Imunologia básica da mucosa nasal; 4-Mecanismos de avaliação da ultraestrutura da mucosa nasal. – microscopia eletrônica; 5-Mecanismos de avaliação da ultraestrutura da mucosa nasal. – microscopia de contato; 6-Fatores genéticos envolvidos em alterações da ultraestrutura da mucosa nasal; 7-Fatores ambientais envolvidos em alterações da ultraestrutura da mucosa nasal; 8- Alterações Imunológicas da mucosa nasal; 9- Repercussões clínicas das alterações da ultraestrutura da mucosa nasal; 10- Repercussões clínicas das alterações da imunologia da mucosa nasal. Aulas práticas. 1-Endoscopia de Contato; 2-Microscopia Eletrônica; 3- Provas Imunológicas; 4- Conduta e tratamento; 5- Discussão de casos clínicos.

Content:

CONTENT (MENU): 1-Anatomy of the ultrastructure of the nasal mucosa; 2-Nasal physiology; 3-Basic immunology of the nasal mucosa; 4-Mechanisms for evaluation of the ultrastructure of the nasal mucosa. – electron microscopy; 5-Mechanisms for evaluation of the ultrastructure of the nasal mucosa. – contact microscopy; 6-Genetic factors involved in changes in the ultrastructure of the nasal mucosa; 7-Environmental factors involved in changes in the ultrastructure of the nasal mucosa; 8- Immunological changes of the nasal mucosa; 9- Clinical repercussions of changes in the ultrastructure of the nasal mucosa; 10- Clinical repercussions of immunology alterations of the nasal mucosa. Practical classes. 1-Contact Endoscopy; 2-Electron Microscopy; 3- Immunological Tests; 4- Conduct and treatment; 5- Discussion of clinical cases.

Forma de Avaliação:

Os alunos serão avaliados pela freqüência nas aulas (abaixo de 75% será reprovado); a participação e interesse nas aulas teóricas, empenho no preparo dos seminários. Prova no final do curso.

Type of Assessment:

RATING CRITERIA: Students will be evaluated by attendance in classes (below 75% will fail); participation and interest in theoretical classes, commitment to the preparation of seminars. Test at the end of the course.

Bibliografia:

Pinto Bezerra Soter AC, Bezerra TF, Pezato R, Teles Abdo TR, Pilan RM, Pinna FR, Gevaert P, van Zele T, Bachert C, Voegels RL, Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps, Rhinology. 2017 Apr 23. doi: 10.4193/Rhin15.291 Akyigit A, Keles E, Etem EO, Ozercan I, Akyol H, Sakallioglu O, Karlidag T, Polat C, Kaygusuz I, Yalcin S. Genetic polymorphism of antioxidant enzymes in eosinophilic and non-eosinophilic nasal polyposis. Eur Arch Otorhinolaryngol. 2017 Jan;274(1):267-273. Wormald PJ, Bassiouni A, Callejas CA, Kennedy DW, Citardi MJ, Smith TL, Orlandi RR, Kaschke O, Siow JK, Szczygielski K, Lund V, Fokkens W, Psaltis AJ., The International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus, Int Forum Allergy Rhinol. 2017 Apr;7(4):332-337. doi: 10.1002/alr.21893 Hellings PW, Fokkens WJ, Bachert C, Akdis CA, Bieber T, Agache I, Bernal-Sprekelsen M, Canonica GW, Gevaert P, Joos G, Lund V, Muraro A, Onerci M, Zuberbier T, Pugin B, Seys SF, Bousquet J; ARIA and EPOS working groups, Positioning the Principles of Precision Medicine in Care Pathways for Allergic Rhinitis and Chronic Rhinosinusitis - an EUFOREA-ARIA-EPOS-AIRWAYS ICP statement, Allergy. 2017 Mar 17. doi: 10.1111/all.13162 Oakley GM, Harvey RJ, Lund VJ, The Role of Macrolides in Chronic Rhinosinusitis (CRSsNP and CRSwNP), Curr Allergy Asthma Rep. 2017 May;17(5):30. doi: 10.1007/s11882-017-0696-z Tomassen P, Vandeplas G, Van Zele T, Cardell LO, Arebro J, Olze H, Förster-Ruhrmann U, Kowalski ML, Olszewska-Ziąber A, Holtappels G, De Ruyck N, Wang X, Van Drunen C, Mullol J, Hellings P, Hox V, Toskala E, Scadding G, Lund V, Zhang L, Fokkens W, Bachert C., Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers, J Allergy Clin Immunol. 2016 May; 137(5):1449-1456.e4. doi: 10.1016/j.jaci.2015.12.1324 Bachert C, Gevaert E, Advances in rhinitis and rhinosinusitis in 2015, J.Allergy Clin Immunol. 2016 Nov;138(5):1277-1283. doi: 10.1016/j.jaci.2016.09.008 Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol. 2016;6:S22-S209. Neri G, Cazzato F, Mastronardi V, Pugliese M, Centurione MA, Di Pietro R, Centurione L, Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery, J Transl Med. 2016 Jun 8;14(1):164 Andrews PJ, Poirrier AL, Lund VJ, Choi D., Outcomes in endoscopic sinus surgery: olfaction, nose scale and quality of life in a prospective cohort study, Clin Otolaryngol. 2016 Dec;41(6):798-803. doi: 10.1111/coa.12665 Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, Jirapongsananuruk O, Kern R, Meltzer EO, Mullol J, Naclerio R, Pilan R, Rhee CS, Suzaki H, Voegels R, Blaiss M, ICON: chronic rhinosinusitis, World Allergy Organ J. 2014 Oct 27;7(1):25. doi: 10.1186/1939-4551-7-25. eCollection 2014. Mulligan JK, Nagel W, O’Connell BP, et al. Cigarette smoke exposure is associated with vita- min D3 deficiencies in patients with chronic rhinos- inusitis. J Allergy Clin Immunol. 2014;134:342– 349 Richer SL, Truong-Tran AQ, Conley DB, et al. Epithelial genes in chronic rhinosinusitis with and without nasal polyps. Am J Rhinol. 2008;22:228–234. Nomura K, Obata K, Keira T, et al. Pseudomonas aeruginosa elastase causes transient disruption of tight junctions and downregulation of PAR-2 in hu- man nasal epithelial cells. Respir Res. 2014;15:21 Pezato R, de Almeida DC, Bezerra TF, Silva Fde S, Perez-Novo C, Gregório LC, Voegels RL, Câmara NO, Bachert C. Immunoregulatory effects of bone marrow-derived mesenchymal stem cells in the nasal polyp microenvironment. Mediators Inflamm. 2014;2014:583409. doi: 10.1155/2014/583409. Wood AJ, Fraser J, Amirapu S, Douglas RG. Bacterial microcolonies exist within the sphenoid bone in chronic rhinosinusitis and healthy controls. Int Forum Allergy Rhinol. 2012;2:116–121. Elwany S, Ibrahim AA, Mandour Z, Talaat I, Effect of passive smoking on the ultrastructure of the nasal mucosa in children, Laryngoscope. 2012 May;122(5):965-9 Arnaoutakis D, Collins WO. Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children. Int J Pediatr Otorhinolaryngol. Oct;75(10):1318-21, 2011. Alexander NS, Hatch N, Zhang S, Skinner D, Fortenberry J, Sorscher EJ, Woodworth BA. Resveratrol has salutary effects on mucociliary transport and inflammation in sinonasal epithelium Laryngoscope. Jun;121(6):1313-9, 2011. Zhang Z, Kofonow JM, Finkelman BS, et al. Clinical factors associated with bacterial biofilm for- mation in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2011;144:457–462. Bezerra TF, Padua FG, Gebrim EM, et al. Biofilms in chronic rhinosinusitis with nasal polyps. Oto- laryngol Head Neck Surg. 2011;144:612–616. Koblizek V, Tomsova M, Cermakova E, Papousek P, Pracharova S, Mandalia RA, Ceral J, Novosad J, Fila L, Sedlak V, Ruta J, Bartos V, Salajka F, Hrnciarik M, Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to the presence of a chronic bronchitis phenotype. Rhinology. Oct;49(4):397-406, 2011. Durmus R, Naiboglu B, Tek A, Sezikli M, Cetinkaya ZA, Toros SZ, Eriman TM, Egeli E. Does reflux have an effect on nasal mucociliary transport? Acta Otolaryngol. Sep;130(9):1053-7, 2010 Virgin FW, Azbell C, Schuster D, Sunde J, Zhang S, Sorscher EJ, Woodworth BA. Exposure to cigarette smoke condensate reduces calcium activated chloride channel transport in primary sinonasal epithelial cultures. Laryngoscope. Jul;120(7):1465-9, 2010. Van Crombruggen K, Van Bruaene N, Holtappels G, Bachert C. Chronic sinusitis and rhinitis: clinical terminology “chronic rhinosinusitis” further sup- ported. Rhinology. 2010;48:54–58. Melvin TA, Lane AP, Nguyen MT, Lin SY. Allergic rhinitis patients with recurrent acute sinusitis have increased sinonasal epithelial cell TLR9 expres- sion. Otolaryngol Head Neck Surg. 2010;142:659– 664 Kirtsreesakul V, Somjareonwattana P, Ruttanaphol S. Impact of IgE-mediated hypersensitivity on nasal mucociliary clearance. Arch Otolaryngol Head Neck Surg. Aug;136(8):801-6, 2010 Kowalski ML, Lewandowska-Polak A, Wozniak J, et al. Association of stem cell factor expression in nasal polyp epithelial cells with aspirin sensitivity and asthma. Allergy. 2005;60:631–637 Shin SH, Ponikau JU, Sherris DA, et al. Chronic rhinosinusitis: an enhanced immune response to ubiquitous airborne fungi. J Allergy Clin Immunol. 2004;114:1369–1375. Merigo F, Benati D, Piacentini G, Boner A, Sbarbati A, The ultrastructure of nasal mucosa in children with asthma Ultrastruct Pathol. 2002 Sep-Oct;26(5):293-8 Giacchi RJ, Lebowitz RA, Yee HT, et al. Histopathologic evaluation of the ethmoid bone in chronic sinusitis. Am J Rhinol. 2001;15:193–197. Jorissen M, Willems T, De Boeck K. Diagnostic evaluation of mucociliary transport : From symptons to coordinated ciliary activity after ciliogenesis in culture. Am J Rhinol 14: 345-52, 2000. Bush A, Cole P, Hariri M, et al. Primary ciliary diskinesia: diagnosis and standards of care. Eur Respir J 12: 820-24, 1998. Jorissen M. Correlations among mucociliary transport, ciliary function and ciliary structure. Am J Rhinol 12: 53-58, 1998. Kennedy DW, Senior BA, Gannon FH, et al. Histology and histomorphometry of ethmoid bone in chronic rhinosinusitis. Laryngoscope. 1998;108:502–507. Andrea M, Dias O, Macor C, Santos A, Varandas J. Contact Endoscopy of the Nasal Mucosa. Acta Otolaryngol (Stockh) 117: 307-311, 1997. Lindberg S, Runer T, Cervin A, Thomasson L. Recordings of mucociliary activity in vivo: Benefit of fast fourier transformation of the photoelectric signal. Ann Otol Rhinol Laryngol 105: 734-45, 1996. Cervin A, Lindberg S, Mercke U. Effects of halothane om mucociliary activity in vivo. Otolaryngol Head Neck Surg 112: 714-22, 1995. Andrea M, Dias O, Santos, A. Contact endoscopy during microlaryngeal surgery: A new technique for endoscopic examination of the larynx. Ann Otol Rhinol Laryngol 104: 333-9, 1995. Lindberg S, Runner T. Method for in vivo measurement of mucociliary activity in the human nose. Ann Otol Rhinol Laryngol 103: 558-66, 1994 Lund VJ, Holmstron M, Scadding GK. Functional endoscopic sinus surgery in the management of chronic rhinosinusitis: An objective assesment. J Laryngol Otol 105: 832-35, 1991. Jorissen M, Van der Schueren B, Van den Berghe H, Cassiman JJ. The preservation and regeneration of cilia on human nasal epithelial cells cultured in vitro. Arch Otorhinolaryngol 246: 308-14, 1989. Hamou JE. Hysteroscopy and microcolpohysteroscopy. Text and Atlas. Norwalk, Conn: Appleton and Lange, 1991. Lindberg S, Dolata J, Mercke U. Nasal exposure to airway irritants triggers a mucociliary defence reflex in the rabbit maxillary sinus. Acta Otolaryngol Stockh 104: 552-60, 1987. Van der Baan S, Veerman AJP, Wulffraat N, et al. Primary ciliary diskinesia: Ciliary activity. Acta Otolaryngol Stockh 102: 274-281, 1986. Van der Baan S, Veerman AJP, Weltevreden EF, Feenstra L. Kartagener’s syndrome: clinical symptons and laboratory studies. Eur J Respir Dis 64 ( suppl. 127): 91-95, 1983. Jafek BW. Ultrastructure of human nasal mucosa. Laryngoscope 93: 1576-99, 1983 Reissig M, Bang BG, Bang FB, Ultrastructure of the mucociliary interface in the nasal mucosa of the chicken, Am Rev Respir Dis. 1978 Feb;117(2):327-41 Busuttil A, More IA, McSeveney D, A reappraisal of the ultrastructure of the human respiratory nasal mucosa, J Anat. 1977 Nov;124(Pt 2):445-58 Kartagener M. Zur Pathogenese der bronchiactasien. Beitr Klin Tuberkulose 33: 489-501, 1933.

Bibliography:

BIBLIOGRAFIA: Pinto Bezerra Soter AC, Bezerra TF, Pezato R, Teles Abdo TR, Pilan RM, Pinna FR, Gevaert P, van Zele T, Bachert C, Voegels RL, Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps, Rhinology. 2017 Apr 23. doi: 10.4193/Rhin15.291 Akyigit A, Keles E, Etem EO, Ozercan I, Akyol H, Sakallioglu O, Karlidag T, Polat C, Kaygusuz I, Yalcin S. Genetic polymorphism of antioxidant enzymes in eosinophilic and non-eosinophilic nasal polyposis. Eur Arch Otorhinolaryngol. 2017 Jan;274(1):267-273. Wormald PJ, Bassiouni A, Callejas CA, Kennedy DW, Citardi MJ, Smith TL, Orlandi RR, Kaschke O, Siow JK, Szczygielski K, Lund V, Fokkens W, Psaltis AJ., The International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus, Int Forum Allergy Rhinol. 2017 Apr;7(4):332-337. doi: 10.1002/alr.21893 Hellings PW, Fokkens WJ, Bachert C, Akdis CA, Bieber T, Agache I, Bernal-Sprekelsen M, Canonica GW, Gevaert P, Joos G, Lund V, Muraro A, Onerci M, Zuberbier T, Pugin B, Seys SF, Bousquet J; ARIA and EPOS working groups, Positioning the Principles of Precision Medicine in Care Pathways for Allergic Rhinitis and Chronic Rhinosinusitis - an EUFOREA-ARIA-EPOS-AIRWAYS ICP statement, Allergy. 2017 Mar 17. doi: 10.1111/all.13162 Oakley GM, Harvey RJ, Lund VJ, The Role of Macrolides in Chronic Rhinosinusitis (CRSsNP and CRSwNP), Curr Allergy Asthma Rep. 2017 May;17(5):30. doi: 10.1007/s11882-017-0696-z Tomassen P, Vandeplas G, Van Zele T, Cardell LO, Arebro J, Olze H, Förster-Ruhrmann U, Kowalski ML, Olszewska-Ziąber A, Holtappels G, De Ruyck N, Wang X, Van Drunen C, Mullol J, Hellings P, Hox V, Toskala E, Scadding G, Lund V, Zhang L, Fokkens W, Bachert C., Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers, J Allergy Clin Immunol. 2016 May; 137(5):1449-1456.e4. doi: 10.1016/j.jaci.2015.12.1324 Bachert C, Gevaert E, Advances in rhinitis and rhinosinusitis in 2015, J.Allergy Clin Immunol. 2016 Nov;138(5):1277-1283. doi: 10.1016/j.jaci.2016.09.008 Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol. 2016;6:S22-S209. Neri G, Cazzato F, Mastronardi V, Pugliese M, Centurione MA, Di Pietro R, Centurione L, Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery, J Transl Med. 2016 Jun 8;14(1):164 Andrews PJ, Poirrier AL, Lund VJ, Choi D., Outcomes in endoscopic sinus surgery: olfaction, nose scale and quality of life in a prospective cohort study, Clin Otolaryngol. 2016 Dec;41(6):798-803. doi: 10.1111/coa.12665 Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, Jirapongsananuruk O, Kern R, Meltzer EO, Mullol J, Naclerio R, Pilan R, Rhee CS, Suzaki H, Voegels R, Blaiss M, ICON: chronic rhinosinusitis, World Allergy Organ J. 2014 Oct 27;7(1):25. doi: 10.1186/1939-4551-7-25. eCollection 2014. Mulligan JK, Nagel W, O’Connell BP, et al. Cigarette smoke exposure is associated with vita- min D3 deficiencies in patients with chronic rhinos- inusitis. J Allergy Clin Immunol. 2014;134:342– 349 Richer SL, Truong-Tran AQ, Conley DB, et al. Epithelial genes in chronic rhinosinusitis with and without nasal polyps. Am J Rhinol. 2008;22:228–234. Nomura K, Obata K, Keira T, et al. Pseudomonas aeruginosa elastase causes transient disruption of tight junctions and downregulation of PAR-2 in hu- man nasal epithelial cells. Respir Res. 2014;15:21 Pezato R, de Almeida DC, Bezerra TF, Silva Fde S, Perez-Novo C, Gregório LC, Voegels RL, Câmara NO, Bachert C. Immunoregulatory effects of bone marrow-derived mesenchymal stem cells in the nasal polyp microenvironment. Mediators Inflamm. 2014;2014:583409. doi: 10.1155/2014/583409. Wood AJ, Fraser J, Amirapu S, Douglas RG. Bacterial microcolonies exist within the sphenoid bone in chronic rhinosinusitis and healthy controls. Int Forum Allergy Rhinol. 2012;2:116–121. Elwany S, Ibrahim AA, Mandour Z, Talaat I, Effect of passive smoking on the ultrastructure of the nasal mucosa in children, Laryngoscope. 2012 May;122(5):965-9 Arnaoutakis D, Collins WO. Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children. Int J Pediatr Otorhinolaryngol. Oct;75(10):1318-21, 2011. Alexander NS, Hatch N, Zhang S, Skinner D, Fortenberry J, Sorscher EJ, Woodworth BA. Resveratrol has salutary effects on mucociliary transport and inflammation in sinonasal epithelium Laryngoscope. Jun;121(6):1313-9, 2011. Zhang Z, Kofonow JM, Finkelman BS, et al. Clinical factors associated with bacterial biofilm for- mation in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2011;144:457–462. Bezerra TF, Padua FG, Gebrim EM, et al. Biofilms in chronic rhinosinusitis with nasal polyps. Oto- laryngol Head Neck Surg. 2011;144:612–616. Koblizek V, Tomsova M, Cermakova E, Papousek P, Pracharova S, Mandalia RA, Ceral J, Novosad J, Fila L, Sedlak V, Ruta J, Bartos V, Salajka F, Hrnciarik M, Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to the presence of a chronic bronchitis phenotype. Rhinology. Oct;49(4):397-406, 2011. Durmus R, Naiboglu B, Tek A, Sezikli M, Cetinkaya ZA, Toros SZ, Eriman TM, Egeli E. Does reflux have an effect on nasal mucociliary transport? Acta Otolaryngol. Sep;130(9):1053-7, 2010 Virgin FW, Azbell C, Schuster D, Sunde J, Zhang S, Sorscher EJ, Woodworth BA. Exposure to cigarette smoke condensate reduces calcium activated chloride channel transport in primary sinonasal epithelial cultures. Laryngoscope. Jul;120(7):1465-9, 2010. Van Crombruggen K, Van Bruaene N, Holtappels G, Bachert C. Chronic sinusitis and rhinitis: clinical terminology “chronic rhinosinusitis” further sup- ported. Rhinology. 2010;48:54–58. Melvin TA, Lane AP, Nguyen MT, Lin SY. Allergic rhinitis patients with recurrent acute sinusitis have increased sinonasal epithelial cell TLR9 expres- sion. Otolaryngol Head Neck Surg. 2010;142:659– 664 Kirtsreesakul V, Somjareonwattana P, Ruttanaphol S. Impact of IgE-mediated hypersensitivity on nasal mucociliary clearance. Arch Otolaryngol Head Neck Surg. Aug;136(8):801-6, 2010 Kowalski ML, Lewandowska-Polak A, Wozniak J, et al. Association of stem cell factor expression in nasal polyp epithelial cells with aspirin sensitivity and asthma. Allergy. 2005;60:631–637 Shin SH, Ponikau JU, Sherris DA, et al. Chronic rhinosinusitis: an enhanced immune response to ubiquitous airborne fungi. J Allergy Clin Immunol. 2004;114:1369–1375. Merigo F, Benati D, Piacentini G, Boner A, Sbarbati A, The ultrastructure of nasal mucosa in children with asthma Ultrastruct Pathol. 2002 Sep-Oct;26(5):293-8 Giacchi RJ, Lebowitz RA, Yee HT, et al. Histopathologic evaluation of the ethmoid bone in chronic sinusitis. Am J Rhinol. 2001;15:193–197. Jorissen M, Willems T, De Boeck K. Diagnostic evaluation of mucociliary transport : From symptons to coordinated ciliary activity after ciliogenesis in culture. Am J Rhinol 14: 345-52, 2000. Bush A, Cole P, Hariri M, et al. Primary ciliary diskinesia: diagnosis and standards of care. Eur Respir J 12: 820-24, 1998. Jorissen M. Correlations among mucociliary transport, ciliary function and ciliary structure. Am J Rhinol 12: 53-58, 1998. Kennedy DW, Senior BA, Gannon FH, et al. Histology and histomorphometry of ethmoid bone in chronic rhinosinusitis. Laryngoscope. 1998;108:502–507. Andrea M, Dias O, Macor C, Santos A, Varandas J. Contact Endoscopy of the Nasal Mucosa. Acta Otolaryngol (Stockh) 117: 307-311, 1997. Lindberg S, Runer T, Cervin A, Thomasson L. Recordings of mucociliary activity in vivo: Benefit of fast fourier transformation of the photoelectric signal. Ann Otol Rhinol Laryngol 105: 734-45, 1996. Cervin A, Lindberg S, Mercke U. Effects of halothane om mucociliary activity in vivo. Otolaryngol Head Neck Surg 112: 714-22, 1995. Andrea M, Dias O, Santos, A. Contact endoscopy during microlaryngeal surgery: A new technique for endoscopic examination of the larynx. Ann Otol Rhinol Laryngol 104: 333-9, 1995. Lindberg S, Runner T. Method for in vivo measurement of mucociliary activity in the human nose. Ann Otol Rhinol Laryngol 103: 558-66, 1994 Lund VJ, Holmstron M, Scadding GK. Functional endoscopic sinus surgery in the management of chronic rhinosinusitis: An objective assesment. J Laryngol Otol 105: 832-35, 1991. Jorissen M, Van der Schueren B, Van den Berghe H, Cassiman JJ. The preservation and regeneration of cilia on human nasal epithelial cells cultured in vitro. Arch Otorhinolaryngol 246: 308-14, 1989. Hamou JE. Hysteroscopy and microcolpohysteroscopy. Text and Atlas. Norwalk, Conn: Appleton and Lange, 1991. Lindberg S, Dolata J, Mercke U. Nasal exposure to airway irritants triggers a mucociliary defence reflex in the rabbit maxillary sinus. Acta Otolaryngol Stockh 104: 552-60, 1987. Van der Baan S, Veerman AJP, Wulffraat N, et al. Primary ciliary diskinesia: Ciliary activity. Acta Otolaryngol Stockh 102: 274-281, 1986. Van der Baan S, Veerman AJP, Weltevreden EF, Feenstra L. Kartagener’s syndrome: clinical symptons and laboratory studies. Eur J Respir Dis 64 ( suppl. 127): 91-95, 1983. Jafek BW. Ultrastructure of human nasal mucosa. Laryngoscope 93: 1576-99, 1983 Reissig M, Bang BG, Bang FB, Ultrastructure of the mucociliary interface in the nasal mucosa of the chicken, Am Rev Respir Dis. 1978 Feb;117(2):327-41 Busuttil A, More IA, McSeveney D, A reappraisal of the ultrastructure of the human respiratory nasal mucosa, J Anat. 1977 Nov;124(Pt 2):445-58 Kartagener M. Zur Pathogenese der bronchiactasien. Beitr Klin Tuberkulose 33: 489-501, 1933.

Tipo de oferecimento da disciplina:

Presencial

Class type:

Presencial