Fatty tissue within the maxillary sinus: a rare finding.

BACKGROUND: We report a rare case of fatty tissue within the maxillary sinus in a 21-years-old woman, with a history of several previous punctures of the maxillary sinus. CASE PRESENTATION: Clinical data of the patient was analysed retrospectively. The patient presented with symptoms of left-sided chronic maxillary sinusitis and had undergone several punctures of the left maxillary sinus 18 months earlier. Subsequent to one of the procedures an acute pain in the left orbit lasting a couple of days was noted. Left endoscopic transnasal antrotomy was performed. The maxillary sinus was filled with polypous, chronically inflamed mucous membrane. Upon its removal, the maxillary roof was identified as drawn downwards and covered with normal mucous membrane. Upon dissection of the membrane, adipose tissue filling the zygomatic recess of the sinus was identified and subsequently removed. The maxillary roof was unchanged. Histopatologic examination confirmed the material to be adipose tissue. No short or long term sequelae occurred. CONCLUSION: Adipose tissue can be found in the maxillary sinus most commonly when penetrating from surrounding locations. It is our hypothesis that in the reported patient it penetrated from the orbit to the maxillary sinus following puncture. It seems that a hole in the maxillary sinus roof, about 1 mm in diameter, caused by the needle, may have been a portal of entry for the adipose tissue into the maxillary sinus. The discussed case suggests particular care be taken in performing puncture of the maxillary sinus

Activity and Interactions of Liposomal Antibiotics in Presence of Polyanions and Sputum of Patients with Cystic Fibrosis

BACKGROUND:To compare the effectiveness of liposomal tobramycin or polymyxin B against Pseudomonas aeruginosa in the Cystic Fibrosis (CF) sputum and its inhibition by common polyanionic components such as DNA, F-actin, lipopolysaccharides (LPS), and lipoteichoic acid (LTA). METHODOLOGY:Liposomal formulations were prepared from a mixture of 1,2-Dimyristoyl-sn-Glycero-3-Phosphocholine (DMPC) or 1,2-Dipalmitoyl-sn-Glycero-3-Phosphocholine (DPPC) and Cholesterol (Chol), respectively. Stability of the formulations in different biological milieus and antibacterial activities compared to conventional forms in the presence of the aforementioned inhibitory factors or CF sputum were evaluated. RESULTS:The formulations were stable in all conditions tested with no significant differences compared to the controls. Inhibition of antibiotic formulations by DNA/F-actin and LPS/LTA was concentration dependent. DNA/F-actin (125 to 1000 mg/L) and LPS/LTA (1 to 1000 mg/L) inhibited conventional tobramycin bioactivity, whereas, liposome-entrapped tobramycin was inhibited at higher concentrations--DNA/F-actin (500 to 1000 mg/L) and LPS/LTA (100 to 1000 mg/L). Neither polymyxin B formulation was inactivated by DNA/F-actin, but LPS/LTA (1 to 1000 mg/L) inhibited the drug in conventional form completely and higher concentrations of the inhibitors (100 to 1000 mg/L) was required to inhibit the liposome-entrapped polymyxin B. Co-incubation with inhibitory factors (1000 mg/L) increased conventional (16-fold) and liposomal (4-fold) tobramycin minimum bactericidal concentrations (MBCs), while both polymyxin B formulations were inhibited 64-fold. CONCLUSIONS:Liposome-entrapment reduced antibiotic inhibition up to 100-fold and the CFU of endogenous P. aeruginosa in sputum by 4-fold compared to the conventional antibiotic, suggesting their potential applications in CF lung infections