Clinical validation of a new olfactory test

A new approach to clinical olfactometry is presented using nasal sprays. A special dosage valve was used to standardize an aerosol size to 40 μm. For evaluation a 6 × 6 matrix (substance/olfactory quality) with verbal associative clues was used according to test psychological findings. Validation took place in three steps after determining smell-associated thresholds in preliminary examinations. Recognition of different aromas administered either by spraying into the open mouth from a distance of 5 cm using nasal sprays or sniffing opened bottles was compared in 50 subjectively normosmic subjects. Findings showed that the correspondence between the two procedures was relatively high, with global identification of odorous substances as high as 98.4% in the spray test. The number of substances used was next reduced to those six substances providing the most reproducible results in an investigation with 56 normosmic and 55 hyposmic subjects. Verbal associative clues were also tested. In a last step 50 patients with hyposmia of various origin and 110 normosmic subjects were tested, allowing previous results to be reproduced regardless of the cause of hyposmia. The spray test was shown to be easily performed and was suitable as a screening test, with a sensitivity of 88% and a specificity of 100%. Received: 29 September 1997 / Accepted: 11 February 1998     

鼻腔嗅神经母细胞瘤11例临床分析

目的 回顾分析鼻腔嗅神经母细胞瘤的放疗疗效.方法 1974～1994年鼻腔嗅神经母细胞瘤11例,其中B期6例,C期5例.单纯放疗6例,术后放疗5例.3例术后无肿瘤肉眼残留者照射剂量D_T45Gy～55Gy/23～28次共4.5～5.5周.其余8例照射剂量D_T均在60Gy/30次共6周以上.3例颈淋巴结转移者照射剂量D_T60Gy～65Gy/30～33次共6～7周.结果 本组病例三、五年生存率分别为55%、36%,单纯放疗组分别为33%、17%,术后放疗组分别为80%、60%.P值0.2727,二组在统计学上无显著差异.全组病例中3例局部复发,2例血行转移.结论 B、C期患者根治性手术加术后放疗为局部控制的较好治疗方案.     

Regional differences in brain monoamine oxidase subtypes in an animal model of geriatric depression: effects of olfactory bulbectomy in young versus aged rats

Geriatric depression is often associated dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis, and with poor responsiveness to antidepressants that work through inhibition of monoamine reuptake; accordingly, it has been suggested that MAO inhibitors may represent a therapeutic alternative in this group. In the current study, we evaluated expression of MAO subtypes in brain regions of young and aged rats subjected to olfactory bulbectomy (OBX), a procedure that reproduces many of the biochemical and functional changes associated with human depression. Activities of both MAO A and B were elevated in aged rats as compared to young rats in most regions, but not in the midbrain, and the OBX lesion failed to produce any change in this pattern. These results stand in contrast to the differential effects of glucocorticoids, which reduce brain MAO in young animals but induce activity in aged rats. Our results support the view that the aged brain possesses biochemical characteristics that distinguish its monoamine biochemistry from that of young brain, and that these distinctions may work in conjunction with HPA axis dysregulation to influence the etiology and therapy of geriatric depression. The use of appropriate animal models for depression and for disruption of HPA axis function can allow for the testing of potential human biomarkers (such as platelet MAO) that may serve to predict treatment outcome.     

嗅球成鞘细胞移植对成年大鼠皮质脊髓束损伤的修复

目的 研究嗅球成鞘细胞(OECs)对成年大鼠皮质脊髓束损伤(CSI)的作用.方法 采用电解损毁大鼠C1-C2脊髓节段的皮质脊髓束(CST)的方法 制备脊髓损伤(SCI)模型.原代培养OECs后移植到SCI大鼠.分别进行斜板实验和皮层运动诱发电位(MEP-C)的记录,测定斜板角度以及潜伏时、阈刺激强度、波幅等电生理指标的改变.结果 与对照组比较,损伤组的斜板角度下降,MEP-C潜伏期延长,阈刺激强度增加,所记录三个峰值均减小,且各项指标均与对照组有显著性差异.这反映出大鼠CST的受损.与损伤组比较,损伤 移植组动物显示出斜板角度增大,MEP-C各项指标中,潜伏期缩短,阈刺激强度减小,所记录三个峰值均增大,且各项指标与损伤组比较有显著性差异.这提示CST的功能恢复.结论 OECs可能有促进CST修复的作用.     

原发性帕金森病患者嗅觉功能临床分析

目的 分析原发性帕金森病患者嗅球体积、嗅沟深度与嗅觉功能的相关性.方法 选取2011年1月至2013年12月天津市环湖医院原发性帕金森病患者(测试组)及无运动障碍的健康受试者(对照组)各100例,应用T&T嗅觉测试法检查所有受试者的嗅觉功能,并行嗅球体积、嗅沟深度的MRI检查及测量.对测试组进行H-Y分期、统一帕金森病评分量表(UPDRS)、左右肢体功能评分、简易精神状态检查表(MMSE)及蒙特利尔认知评估表(MoCA)检查.以SPSS 13.0软件进行统计学分析.结果 测试组T&T嗅觉识别阈分数为(3.0±0.3)分,明显高于对照组的(1.3±0.2)分,差异有统计学意义(t=2.537,P＜0.01),测试组、对照组男女嗅觉识别阈差异无统计学意义(t值分别为0.893、1.184,P值均＞0.05).测试组左右两侧嗅球体积[分别为(34.25 ±5.14)、(35.79±5.28)mm3]及平均嗅球体积[(35.28±5.21) mm3]均明显小于对照组[分别为(47.38±6.47)、(47.75 ±6.51)、(47.53±6.49)mm3],差异有统计学意义(t值分别为2.876、2.747、2.798,P值均＜0.01).测试组与对照组左右两侧嗅沟深度及平均嗅沟深度差异无统计学意义(t值分别为0.914、0.987、0.951,P值均＞0.05).测试组及对照组嗅觉识别阈与平均嗅球体积呈负相关趋势(r值分别为-0.537、-0.526,P值均＜0.05),与平均嗅沟深度无关(r值分别为-0.142,-0.157,P值均＞0.05).测试组平均嗅球体积与UPDRSⅢ、UPDRS总评分及H-Y分期具有相关趋势(r值分别为0.312、-0.419、-0.358,P值均＜0.05),与病程无相关性(r=-0.089,P＞0.05).结论 原发性帕金森病患者嗅球体积减小,嗅沟深度不变;其嗅觉功能与嗅球体积具有相关性,与嗅沟深度无关;其嗅觉减退的程度与疾病的严重程度具有一致性,与疾病的病程无关.     

小鼠不同发育阶段肾小体细胞凋亡的实验研究

目的　研究小鼠不同发育阶段肾小体细胞凋亡的规律并探讨其作用。方法　选择不同胚龄和出生后小鼠肾脏做常规光镜标本 ,采用末端脱氧核苷酸转移酶介导的dUTP切口末端标记法进行末端标记。结果　TUNEL阳性细胞主要在Ⅲ、Ⅳ期肾小体内表达 ,而Ⅰ、Ⅱ、Ⅴ期肾小体TUNEL阳性细胞少见。结论　细胞凋亡在小鼠不同发育阶段肾小体内均有不同程度的表达。细胞凋亡在肾小体发育、形成中有着重要的作用。     

鼻腔嗅神经母细胞瘤6例报告

目的 :探讨鼻腔嗅神经母细胞瘤的临床表现、病理、诊断、鉴别诊断及治疗。方法 :诊治鼻腔嗅神经母细胞瘤 6例 ,B期 4例 ,C期 2例 ,均行手术加放射治疗。结果 :B期患者 2年生存率 5 0 % ,3年生存率2 5 %。C期患者 2年生存率 5 0 % ,5年生存率 5 0 %。结论 :鼻腔嗅神经母细胞瘤B、C期患者手术加放疗是最佳的治疗方案     

Evaluation of olfactory dysfunction to estimate the presence of eosinophilic chronic rhinosinusitis in patients with asthma

BackgroundEosinophilic chronic rhinosinusitis (ECRS) is often complicated by asthma and can be difficult to diagnose. This study aimed to clarify the usefulness of the self-administered odor questionnaire (SAOQ) and visual analog scale (VAS) to identify olfactory disorders in patients with asthma.MethodsThis retrospective study was conducted on patients with asthma who were referred to the Otolaryngology clinic between May and September 2018. The treatment step of asthma, asthma control test (ACT), pulmonary function test, peripheral blood eosinophils, and fractional exhaled nitric oxide (FeNO) were analyzed. ECRS was diagnosed based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study score. Olfactory dysfunction was evaluated using the SAOQ and VAS for olfactory disorders.ResultsThe study included 56 patients (18 males and 38 females), who were divided into two groups; those with ECRS (n = 18) and those without ECRS (n = 38). Age, sex, treatment step, ACT score, and pulmonary function were not significantly different between the groups. The ECRS group had a significantly higher FeNO value (89.1 ppb vs. 39.1 ppb) and a significantly lower SAOQ score (40.1% vs. 96.1%). The area under the receiver operating characteristic curve for the efficacy of ECRS diagnosis was 0.88, 0.889, 0.799, and 0.757 for SAOQ, VAS, blood eosinophil count, and FeNO, respectively.ConclusionThe SAOQ and VAS scores were useful tools that presented similar results to the blood eosinophil count and FeNO, and may help to improve the diagnosis of ECRS in patients with asthma.     

Hepatocellular Carcinoma: An Update

Hepatocellular carcinoma (HCC) is the most common malignant tumor of males in the world, with an incidence of 1,000,000 new cases a year. It is endemic in Southeast Asia and Sub-Saharan Africa. Risk factors include chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV), Aflatoxin B1 uptake, hemochromatosis, and &#102 1-antitripsin deficiency. Epidemiological studies provide evidence for the association of HCC with HBV infection. The incidence of HCC is high in regions hyperendemic for HBV. Chronic carrier state and maternal-infant transmission are important factors in the development of HCC. Evidence of direct oncogenic effect of HBV is well established, HCCs contain viral DNA sequences integrated into hepatocyte DNA that act as random insertional mutagens, and these sites are near genes involved in the control of proliferation and differentiation. The mechanism of hepatitis C virus in hepatocarcinogenesis is still imprecise but a high percentage of cases are related to this virus. Chronic alcohol consumption and cirrhosis are cofactors that increase the development of HCC in patients with chronic viral infection. In experimental carcinogenesis a multipotential element called oval cell proliferates in the early stages. The cellular events are accompanied by increased expression of several growth factors that enhance the survival of carcinogen-activated cells by suppressing apoptosis and increasing elements entering the cell cycle. Hepatic carcinogenesis is a complex process associated with accumulation of genetic and epigenetic changes that run through steps of initiation, promotion and progression. Activation of oncogenes of the "ras" family and others has been detected during chemically-induced HCC in rodents, but there is little evidence of such activation in human tumors. The role of tumor supressor genes such as retinoblastoma (RB) and P53 genes has been documented. Aflatoxin B1 that contaminates foods in endemic areas has a clear role in hepatocarcinogenesis. Metabolites of this toxin promote apurinic sites and G to T mutations in chromosomal DNA, the third base of codon 249 of the P53 gene is preferentially targeted to form aducts with aflatoxin B1, and this mutation has been specifically identified in HBV infection. Histological and cytological criteria for the diagnosis of HCC are well established and are based in architectural and cytological changes. An important issue is the diagnosis of liver "nodules" detected by image, from which small biopsies or aspiration material is obtained. Special studies such as reticulin, CD34, cytokeratin profile, and MOC-31 can be very useful for the differential diagnosis of primary and metastatic tumors. Telomerase activity has been found in HCC and negative in pericancerous tissue. It is more pronounced in poorly differentiated tumors and correlates with factors of clinical importance, such as prognosis and recurrences. Cells of well-differentiated HCC have an ultrastructural appearance similar to normal hepatocytes. During the process of dedifferentiation, there is progressive loss of organization of intracellular organelles. The cell cohesion is lost, intercellular gaps with microvilli appear, the sinusoids become capillarized, and reparative changes are seen in the spaces of Disse. A variety of inclusions, such as Mallory bodies, granular material, secondary lysosomes, and Dubin-Johnson pigment, have been described. Fibrolamellar carcinoma has a characteristic histological picture and ultrastructurally oncocytic features. Neuroendocrine granules and combination of HCC with bile duct carcinoma are seen by electron microscopy.