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At least 757 records · Page 42Linked to original sources

Complications following total inferior turbinectomy: facts or myths?

Various surgical procedures have been described for the relief of chronic nasal obstruction due to inferior turbinate hypertrophy, but none has been consistently satisfactory. We have performed total inferior turbinectomy for this condition for 5 years. Of the 39 patients followed for at least 2 years, 90% were relieved permanently of nasal obstruction. However, only 36% and 61% of patients with rhinorrhoea and anosmia respectively were relieved of these symptoms. Complications were minimal. It is concluded that even in a dry, dusty tropical climate, inferior turbinectomy does not appear to disturb the function of the nasal cavity appreciably.

Airway Obstruction↗

Association of isolated hypogonadotropic hypogonadism, pronounced hypodontia and the Wolff-Parkinson-White syndrome.

Diagnosis of idiopathic isolated hypogonadotropic hypogonadism was made in a 22-year-old female patient referred for primary amenorrhoea. It was considered a separate entity from Kallmann's syndrome, because it was not accompanied by anosmia or other specific pleiotropic features. On the other hand, the patient showed severe hypodontia and an intermittent Wolff-Parkinson-White syndrome. To our knowledge, this association has never been reported before. This unusual phenotype points to a nonrandom association. However, no information in the literature is available to consider a new single gene defect or a contiguous gene syndrome.

Adult↗

Intranasal schwannoma in a young woman.

A rare case of a schwannoma arising from the middle meatus in a 24-year-old woman is reported. The patient presented with a 12-month history of right-sided nasal obstruction, rhinorrhoea, anosmia, headache and recurrent minor nosebleeds. Examination of the right nasal cavity revealed a polypoidal mass. Computerised tomography showed the mass completely occluding the nasal passage with evidence of a secondary maxillary sinusitis. She underwent a complete intranasal excision of the polypoidal mass which was arising from the right middle meatus. The histological features of the lesion were consistent with a schwannoma including diffuse immunoreactivity for S-100 protein. This case illustrates the need to consider schwannoma, amongst many other lesions, in the differential diagnosis of a unilateral nasal mass and reinforces the established principle of sending all material removed from the nose for histological examination.

Adult↗

Prevalence of nasal polyposis in France: a cross-sectional, case-control study.

BACKGROUND: The prevalence of nasal polyposis (NP) has never been established in France due to the lack of diagnostic tools for population-based studies. METHODS: Using a recently validated questionnaire/algorithm (90% specificity and sensitivity) in a population-based random sample, the present cross-sectional, case-control study allowed to determine NP prevalence and describe the principal aspects of NP epidemiology. A total of 10 033 subjects (>/=18 years) were screened. After identification of subjects with NP and those without, another questionnaire was submitted to NP patients only for further data collection. Controls were individuals without NP, matched by gender and age to NP patients. RESULTS: Nasal polyposis prevalence was 2.11% (95% CI 1.83-2.39). NP patients (n = 212, 45% males) were aged 49.4 +/- 17.6 years. No gender preponderance was observed, but NP tended to increase with age. Mean duration of nasal symptoms was 22.4 +/- 15.7 years. Among the 145 patients having already seen a doctor for their symptoms, 77.2% have been referred to a specialist, and 18.6% had a diagnosis of NP. Rhinorrhoea was reported by 39.9% of NP patients, blocked nose by 30.8%, and anosmia by 28.9%. Only 6.9% reported facial discomfort while 24.6% complained about general discomfort. Most NP patients (61.3%) had a pharmacological treatment, a nasal spray for the major part (76.9%). CONCLUSION: The present study provides valuable and reliable information on NP epidemiology in France; the collected information are in accordance with most published international data.

Administration, Intranasal↗

Autosomal recessive blepharophimosis, ptosis, V-esotropia, syndactyly and short stature.

A recessively inherited syndrome of blepharophimosis and ptosis with weakness of extraocular and frontal muscles is reported in six members of three related kindreds. Prognathism, synophrys and thick eyebrows added to a typical facial appearance. Additional findings included short stature, borderline head circumference and toe syndactyly. Borderline mental retardation and anosmia were found in one patient. The clinical features and the mode of inheritance distinguish this syndrome from other blepharophimosis and ptosis syndromes.

Adolescent↗

Olfactory evoked potentials in Parkinson's disease, Alzheimer's disease and anosmic patients.

Olfactory evoked potential (OEP) recordings were undertaken using amyl acetate stimulation in 20 patients with Parkinson's disease, nine patients with Alzheimer's disease, seven patients with olfactory dysfunction with no other neurological disorder, and 17 control subjects. In order to eliminate the somatosensory factor from the combined somatosensory and olfactory components produced by amyl acetate stimulation, we substracted the potentials using odorless air from those using amyl acetate. In normal subjects, three components were observed, the mean latencies of which were 309 +/- 46, 484 +/- 61 and 710 +/- 55 ms. In all subjects with anosmia (n = 7), no responses were observed. In the patients with Alzheimer's disease, the components were fewer despite having no olfactory dysfunction. In the 20 patients with Parkinson's disease, eight [corrected] patients showed no components, seven patients showed one component and four [corrected] patients showed two components. The components rarely were detected in spite of whether the patients had olfactory dysfunction or not. Olfactory evoked potentials are useful in detecting olfactory dysfunction and the early stages of Alzheimer's disease and Parkinson's disease.

Aged↗

Kartagener's syndrome: a re-visit with Chinese perspectives.

The objective of this study was to evaluate the clinical, radiological investigation profiles, and ciliary function and ultrastructure in Chinese patients with Kartagener's syndrome (presence of dextrocardia, sinusitis and bronchiectasis). All patients with dextrocardia were assessed for the presence of sinusitis and bronchiectasis in our hospital network. Patients identified with Kartagener's were assessed when they were at steady state for their bronchiectasis. Seven cases (4 males; mean age 34.9 years) were identified and systematically reviewed. The mean 24 h sputum volume was 26.6 +/- 32.77 mL/day and the patients suffered from a mean of 2.9 exacerbations/year. Nasal symptoms (anosmia in one, obstruction in six and persistent discharge in three patients) were common. Only two cases (1 M) were married and both had normal fertility. Lung function assessment showed a mean FEV1/FVC of 83.3 +/- 38.78/86.5 +/- 36.72 (% predicted) with little reversibility. High resolution computerized tomography (HRCT) revealed bronchiectactic involvement of the lower lobes in seven and middle lobe/lingula in four cases. Assessment of alpha-1-anti-trypsin, aspergillus precipitins, auto-antibodies and serology for Pseudomonas pseudomallei was normal. Sputum culture yielded Pseudomonas aeruginosa in three, Haemophilus influenzae in three and commensals in one case. Phase contrast microscopy assessment of respiratory cilia, obtained by brushing the inferior turbinate, revealed that most of the mucosa was unciliated. The mean ciliary beat frequency was 5.2 +/- 6.76 Hz (range 0-13.7; normal range 12-18 Hz). Four patients had immotile cilia whilst the rest had normal ciliary movement. Transmission electron microscopy showed the absence of dynein arms in four patients. The results of this study show that patients with Kartagener's syndrome may have normal ciliary ultrastructure and the absence of dynein arms is not necessarily associated with ciliary immotility. The presence of ciliary immotility might have prognostic value as these patients appear to have more active bronchiectasis. Our experience on this series should help clinicians in the investigation and management of these patients.

Adolescent↗

Differential activation of glomeruli in the ferret's main olfactory bulb by anal scent gland odours from males and females: an early step in mate identification.

Peripheral anosmia was previously found to disrupt sex discrimination and partner preference in male and female ferrets. Here we show directly that volatile anal scent gland odourants from male and female ferrets activated overlapping but distinguishable clusters of glomeruli located in the ventral-caudal portion of the main olfactory bulb (MOB) of breeding ferrets of both sexes. No glomerular activation was seen in the accessory olfactory bulb (AOB). The profile of MOB glomerular activation induced in oestrous females by male anal scents was very similar to that induced by direct contact with a male during mating, and oestrogen treatment failed to alter the profile of glomerular activation induced in ovo-hysterectomized females by male anal scents. In rodents, 'atypical' MOB glomeruli, which have dense acetylcholinesterase (AChE) activity in the neuropil, may be activated by body odours from conspecifics. No such AChE-staining 'atypical' glomeruli were found in the ferret's MOB, suggesting that in this carnivore they do not constitute a subset of MOB glomeruli that respond to body odourants. In ferrets of both sexes, volatile body odourants that are detected by the main as opposed to the vomeronasal-AOB accessory olfactory system may play a critical role in mate identification.

Anal Sacs↗

Old syndromes and new cytogenetics.

This annotation has been confined to well-established clinical syndromes with recently discovered chromosomal etiologies. It deliberately omits retinoblastoma, the oft-cited paradigm of a contiguous gene syndrome, since it is usually inherited as a Mendelian single gene disorder. However, it was recognition of both the deletion of band q14 of chromosome 13 in mentally retarded children with retinoblastoma, and the linkage of retinoblastoma with the genetic marker esterase D, which resulted in the eventual cloning of the gene. Also omitted are microdeletions of the X chromosome. These disorders are seen primarily in males, who manifest the phenotypic effects of the deletion of the loci of various combinations of adjacent genes: Duchenne muscular dystrophy, glycerol kinase deficiency, adrenal hypoplasia, optic albinism, hypogonadotropic hypogonadism and anosmia (Kallman syndrome), chondrodysplasia punctata and ichthyosis. Many are also mentally retarded. The third group omitted are Mendelian disorders occurring with atypical mental retardation (not usually part of the disorder), the presumption being that they include small deletions. It is expected that other contiguous gene syndromes will be recognized eventually; Rubinstein-Taybi and Cornelia de Lange syndromes are prime candidates. Why do deletions have such dramatic consequences when a normal homologue of the region is present? If their effects were due to the uncovering of recessive genes, we would expect to see greater variations in phenotype among carriers, including normal individuals whose deletions were masked by the protective effects of dominant alleles in the homologous regions. Imprinting--the 'stamping' of a gene as it passes through the germ line--provides a more satisfactory explanation.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Multiple↗

Psychomotor seizures, arterio-venous malformation and the olfactory reference syndrome. A case report.

A case history is reported of a 44-year-old man with a 6-year history of psychomotor seizures. For the past year he had described persistent olfactory hallucinations of an unpleasant nature which he referred to himself. In many respects these symptoms conform to the pattern observed in the olfactory reference syndrome, a recently described but apparently quite discrete psychiatric disorder; there were, however, certain atypical features. At a later stage unilateral anosmia was noted. Radiological examination then demonstrated an arterio-venous malformation in the right frontal lobe. The relationship between the malformation and the psychomotor seizures, and the implications that each has for the development of an olfactory reference syndrome are fully discussed.

Adult↗

Characterization of a pineal-mediated inhibition of pubertal prolactin cell development in blind-anosmic female rats.

The purpose of this study was to define the peripubertal changes in prolactin (PRL) synthesis in blind-anosmic female rats. To do this prepubertal female rats were either rendered blind-anosmic (BA) or blind-anosmic-pinealectomized (BAP) or left intact (INT). Half the animals were killed after 1 wk (before puberty) while the remaining animals were terminated after 4 wk (after puberty). Pituitary PRL synthesis was measured by the in vitro incorporation of 3H-leucine into PRL. Anterior pituitary weight and DNA content did not differ between BA, BAP, and INT animals 1 wk after treatment. There was a 65% increase in weight and a 55% increase in DNA content in INT pituitaries between 1 and 4 wk. While these increases were also present in BAP rats, they were almost entirely prevented in BA animals. PRL synthesis followed a similar pattern with a 78% increase in synthesis in INT groups between 1 and 4 wk which was, once again, almost entirely absent in BA rats. Pinealectomy prevented this effect. Blinding and anosmia in postpubertal animals produced only a minor decrease in PRL synthesis and pituitary weight and no decrease in pituitary cell number. From these data we conclude that the pineal can inhibit the normal proliferation of PRL cells that occurs during puberty in blind-anosmic female rats.

Animals↗

Inhibitory effects of superior cervical ganglionectomy on dimethylbenz(a)anthracene-induced mammary tumors in the rat.

The role of the pineal in regulating the oncogenic processes was explored in Sprague-Dawley female rats by comparing incidence and growth of mammary tumors in animals subjected to superior cervical ganglionectomy (SCGx) or blinding and anosmia (BAs) with that of intact rats treated with 7-12-dimethylbenz(a)anthracene (DMBA). The surgery was performed at the age of 56 days, 1 day following the administration of the carcinogen. Growth of mammary tumors was studied, and 15 weeks later the rats were sacrificed by decapitation and the activity of the pineal hydroxyindole-O-methyltransferase (HIOMT) was determined. Carcinostatic effects of similar magnitude were present in both SCGx and BAs groups as evident from tendency toward reduced tumor incidence and decreased total tumor mass. Ganglionectomized rats developed significantly smaller numbers of tumors than intact control animals. A trend toward reduced tumor number and increased tumor regression was evident in the BAs group. Although there was no significant difference in tumor volumes among the groups, BAs animals showed a distinct trend toward smaller tumor volumes at the termination of the experiment. Despite similar carcinostatic tendencies, SCGx rats had significantly lower HIOMT activity than BAs animals. The possible existence of multiple carcinostatic mechanisms in BAs and SCGx rats is discussed.

9,10-Dimethyl-1,2-benzanthracene↗

Gonadotropin-releasing hormone (LH-RH) and human chorionic gonadotropin in the treatment of two boys with hypogonadotrophic hypogonadism.

Two brothers, 16 and 14 years of age, with hypogonadotrophic hypogonadism and anosmia were treated with subcutaneous injections of 200 microng gonadotropin-releasing hormone at 8-hour intervals for 4 weeks. Serum FSH increased to the range of normal adult men, but serum LH and serum testosterone showed little change and no clinical signs of pubertal development occurred. Thereafter the 2 patients were given HCG for 11 months and a combination of HCG and HMG for a further 3 months. In response to this treatment, the serum testosterone levels increased to the range of normal adult men and marked development of the secondary sex characteristics was seen.

Adolescent↗

Genome dynamics, evolution, and protein modeling in the olfactory receptor gene superfamily.

The human olfactory subgenome represents several hundred olfactory receptor (OR) genes in a dozen or more clusters on several chromosomes. One OR gene cluster on human chromosome 17 has been characterized by us in detail. Based on a large-scale DNA sequence analysis, we have identified events of gene duplication and fusion as well as the generation of pseudogenes. The latter instances of 'gene death' could underlie the widespread phenomenon of human specific anosmias. Sixteen OR coding regions were found on this cluster, and six of them are pseudogenes. One of these pseudogenes, OR17-23, was found to be an intact open reading frame in an old world monkey. This may be a reflection of an OR repertoire diminution in man. A homology model of the OR protein was constructed by utilizing the rich information available on approximately 200 OR sequences. The putative odorant complementarity determining regions (CDR) was found to consist of 20 hypervariable residues facing an interior caving defined by transmembrane helices 3, 4 and 5. Such a model could be useful in analyzing additional OR gene sequences in the human genome in terms of odorant binding.

Base Sequence↗

Olfaction in Korsakoffs, alcoholics and normals.

Samples of 12 hospitalized Korsakoffs, 12 hospitalized non-Korsakoff alcoholics, and 12 controls, all groups being of comparable age range, were tested using a set of seven visual and olfactory measures which involved memory. By stepwise multiple discriminant analysis it was shown that strong separation could be effected between the three groups, solely on the basis of the olfactory recognition and recall tests, which included the Campbell-Gregson (1972) procedure. The use of of anosmia as a diagnostic indicator for Korsakoff's syndrome is discussed.

Adult↗

Vomeronasal organ: critical role in mediating sexual behavior of the male hamster.

Sexual behavior in male hamsters is totally abolished by bilateral removal of the olfactory bulbs. This operation eliminates sensory input from both the olfactory and the vomeronasal systems. We previously demonstrated that peripheral destruction of the olfactory receptors caused anosmia but did not impair male hamster mating behavior. Here we demonstrate that peripheral deafferentation of the vomeronasal system produces severe sexual behavior deficits in approximately one-third of the treated animals. Combined deafferentation of both the vomeronasal and the olfactory systems eliminates copulation in 100 percent of the animals. This is the first experimental demonstration of a functional role for the vomeronasal organ in a mammalian species.

Animals↗

Kallmann syndrome in a boy with a t(1;10) translocation detected by reverse chromosome painting.

Prometaphase chromosomes from a 16 year old boy with hypogonadotrophic hypogonadism and anosmia (Kallmann syndrome) showed a tiny chromosome fragment attached to the long arm of one chromosome 1 without a visible reciprocal translocation chromosome. Chromosome painting with libraries from chromosomes 1 and X excluded a t(X;1) translocation, but failed to detect a second translocation chromosome. Through reverse chromosome painting, an unbalanced der(1), t(1;10) (q44;q26) translocation could be detected. This is the third case of Kallmann syndrome with a de novo rearrangement between two autosomes. The distal long arm of chromosome 1 may contain a candidate locus for a gene, mutations of which may cause the Kallmann phenotype; a 10q location seems less likely.

Adolescent↗