Nasopharyngeal bursitis: from embryology to clinical presentation

Nasopharyngeal bursitis is a relatively rare syndrome characterized by a collection of symptoms that multidisciplinary specialists should be aware of. Here we present an audit of cases presenting to a rhinology clinic over a two-year period, as well as an overview of the relevant embryology and different clinical presentations of nasopharyngeal bursitis. For 2008–2009, six patients were diagnosed to have nasopharyngeal bursitis, including four males and two females, of mean age 54 years. Two distinct pathologic types were observed, comprising three patients with classical Tornwaldt’s cyst and three with crust-type bursitis. This audit highlights the importance of recognition of the crust-type of nasopharyngeal bursitis and its anatomic and clinical features. A combined endonasal and transoral endoscopic approach is a minimally invasive procedure and an effective method of treating both types of the disease. Our findings are discussed in relation to the embryology of the disorder, with a clinical emphasis on crust- type nasopharyngeal bursitis

Chemoattractant Receptor Homologous to the T Helper 2 Cell (CRTH2) Is Not Expressed in Human Amniocytes and Myocytes

BACKGROUND: 15-deoxy-Δ 12,14- Prostaglandin J2 (15dPGJ2) inhibits Nuclear factor kappa B (NF-κB) in human myocytes and amniocytes and delays inflammation induced preterm labour in the mouse. 15dPGJ2 is a ligand for the Chemoattractant Receptor Homologous to the T helper 2 cell (CRTH2), a G protein-coupled receptor, present on a subset of T helper 2 (Th2) cells, eosinophils and basophils. It is the second receptor for Prostaglandin D2, whose activation leads to chemotaxis and the production of Th2-type interleukins. The cellular distribution of CRTH2 in non-immune cells has not been extensively researched, and its identification at the protein level has been limited by the lack of specific antibodies. In this study we explored the possibility that CRTH2 plays a role in 15dPGJ2-mediated inhibition of NF-κB and would therefore represent a novel small molecule therapeutic target for the prevention of inflammation induced preterm labour. METHODS: The effect of a small molecule CRTH2 agonist on NF-κB activity in human cultured amniocytes and myocytes was assessed by detection of p65 and phospho-p65 by immunoblot. Endogenous CRTH2 expression in amniocytes, myocytes and peripheral blood mononuclear cells (PBMCs) was examined by PCR, western analysis and flow cytometry, with amniocytes and myocytes transfected with CRTH2 acting as a positive control in flow cytometry studies. RESULTS: The CRTH2 agonist had no effect on NF-κB activity in amniocytes and myocytes. Although CRTH2 mRNA was detected in amniocytes and myocytes, CRTH2 was not detectable at the protein level, as demonstrated by western analysis and flow cytometry. 15dPGJ2 inhibited phospho-65 in PBMC'S, however the CRTH2 antagonist was not able to attenuate this effect. In conclusion, CRTH2 is not expressed on human amniocytes or myocytes and plays no role in the mechanism of 15dPGJ2-mediated inhibition of NF-κB

ICAR: endoscopic skull‐base surgery

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Interpreting high-pressure phengite ⁴⁰Ar/³⁹Ar laserprobe ages: an example from Saih Hatat, NE Oman

New single grain fusion and core-rim 40Ar/39Ar laserprobe phengite data from the Saih Hatat high-pressure terrane in NE Oman show that individual samples yield a range of apparent ages which is similar to that previously reported from across the entire terrane. The majority of the determined ages are older than the previously reported U-Pb zircon peak metamorphic age. Core to rim age variations within individual grains range from no discernible difference across the grain to grains with older cores, or, rarely, older rims; some samples manifest all three patterns. Numerical diffusion modelling shows that due to the peak temperature of ca. 550°C, the measured apparent ages cannot be explained by simple cooling or by partial retention of crystallisation or detrital ages in an open system. The age variability is better explained by spatially and temporally variable open or closed system behaviour at the mm-cm scale coupled with pervasive and heterogeneously distributed excess argon. Anomalously old eclogite phengite 40Ar/39Ar ages are due either to internally derived 40Ar inherited from a K-bearing precursor, or externally derived 40Ar distributed by grain boundary fluids. Mica-rich schists within the eclogite boudins yield younger phengite ages, suggesting excess argon was absent or diluted. Pelites hosting the eclogite appear to have been affected by later fluid ingress during deformation and greenschist-facies overprint and yield very variable ages commonly with apparently older rims on younger cores. The grain- and sample-scale age variations measured in Saih Hatat indicate that the grain boundary network in eclogite pods was not an efficient transfer pathway for argon transport, whereas the grain boundary network in the surrounding pelites acted as a more efficient pathway on the timescale of the metamorphic cycle