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Ultrastructure of nasal cilia in children with recurrent or persistent respiratory diseases

Korean Journal of Pediatrics 2006;49(4):410-416.
Published online April 15, 2006.
Ultrastructure of nasal cilia in children with recurrent or persistent respiratory diseases
Su-A Shin1, Seung Yang1, Jae-Won Oh1, Ha-Baik Lee1, Cheol-Eon Park2, Jung-Kyun Kwan3
1Department of Pediatrics, College of Medicine, Hanyang University
2Department of Otolaryngology, Electron Microscopy Laboratory, College of Medicine, Hanyang Universit
3Electron Microscopy Laboratory, College of Medicine, Hanyang University
반복 지속성 호흡기 질환 소아에서 비강 섬모의 미세구조 검사의 의의
신수아1, 양승1, 오재원1, 이하백1, 박철원2, 권중균3
1한양대학교 의과대학 소아과학교실
2한양대학교 의과대학 이비인후과학교실
3한림대학교 전자현미경 연구실
Correspondence: 
Ha-Baik Lee, Email: hablee@hanyang.ac.kr
Abstract
Purpose
: Ciliary abnormalities of the respiratory system usually accompany recurrent or persistent respiratory diseases such as paranasal sinusitis, bronchiectasis, rhinitis, and/or otitis media, since they cause certain derangements in ciliary cleaning activities. This disease is usually inherited by autosomal recessive trait, but may also be found to be acquired or transient in rare cases after heavy exposure to pollutants, cigarette smoking or severe infection. We performed this study in children with frequently recurrent or persistent respiratory diseases to clarify if the ciliary abnormalities are preceding factors.
Methods
: We enrolled 17 children with suspected respiratory ciliary abnormalities. The indications for evaluation of ciliary ultrastructure were recurrent or persistent respiratory infections. Children with immunologic abnormalities were excluded. From August 2000 to July 2003, we performed a biopsy on nasal mucosa and examined the structure of ciliary status by using an electron microscope.
Results
: Of the subjects, there were seven males and 10 females, aged 2 to 10 years. Out of the 17 subjects, 12 cases of chronic paranasal sinusitis, nine chronic coughs, nine frequent upper respiratory infections, seven cases of recurrent otitis media, four cases of recurrent pneumonia, and four cases of bronchial asthma were found. Out of the 17 cases on which histologic examinations were conducted, four cases showed pathologic findings, including one case of inner dynein arm defect, one of microtubular transposition, one of supernumerous tubules, and one singlet, respectively.
Conclusion
: It is essential for differential diagnosis and effective treatment to identify the abnormalities of ultrastructure of nasal cilia in children with symptoms of frequently recurrent or persistent respiratory diseases, if immunodeficiency or respiratory allergy could be excluded.
Key Words: Cilia , Nasal mucosa , Biopsy , Ultrastructure , Respiratory disease


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