PubMed · 498818
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K M Unger. 1979. Sputum or spit?. https://doi.org/10.1378/chest.76.5.498
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OBJECTIVE: To determine whether the expression of L-selectin is reduced in patients with systemic inflammatory response syndrome (SIRS) compared with control subjects, to test the effect of exudation of neutrophil L-selectin expression, and to measure soluble serum concentrations of shed L-selectin in the two groups. DESIGN: Prospective study. SETTING: Intensive care unit in a tertiary care hospital (Royal Victoria Hospital, Montreal). PATIENTS: Twenty-five patients with SIRS and 20 healthy, age-matched controls. INTERVENTIONS: Collection of exudate neutrophils from skin window and circulating neutrophils from venous blood. OUTCOME MEASURES: Neutrophil L-selectin levels, measured with the use of fluorocytometry, and soluble L-selectin levels, measured with the use of enzymelinked immunosorbent assay. RESULTS: There is a significant reduction in L-selectin expression on circulating neutrophils in patients with SIRS, compared with control subjects. Exudation of neutrophils to an extravascular site resulted in a dramatic down-regulation of L-selectin in both groups. Serum levels of soluble L-selectin were higher in patients with SIRS than in control subjects. CONCLUSIONS: The loss of L-selectin may be partly responsible for reduced neutrophil exudation to extravascular sites in patients with SIRS.
Few anatomopathological criteria for distinguishing vocal nodules, polyps or REINKE's edema have been established in previously published studies. In order to study this issue, 163 samples (from 119 patients) were examined by an experienced anatomopathologist, without her prior knowledge of the macroscopic or microscopic diagnosis. In all the cases, the presence of exudative phenomena in REINKE's space proved to be the determining factors, with four outstanding stages of evolution: edema, fibrosis, deposits of fibrin and development of vascular ectasia. Although each of the three entities were seen to have their specific characteristics, a large number of lesions showed histological features which were not very specific, and were dominated by edema. Furthermore, the coexistence of different anatomopathological features makes each group heterogeneous. We propose a model which groups all the exudative lesions of REINKE's space by insisting, on the one hand, on the evolution of the anomalies and, on the other hand, the etiological factors (vocal misuse, tobacco, alcohol acute, vocal trauma ...) which determine the onset of either one or other lesion.