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Biomedical subjects

B Arellano

Publications and source records attributed to B Arellano.

At least 19 recordsLinked to original sources

Point mutation of an EYA1-gene splice site in a patient with oto-facio-cervical syndrome.

Mutations of the EYA1 gene (8q13.3) are the most common known cause of the branchio-oto-renal dysplasia (BOR), an autosomal dominant disease that includes developmental defects of branchial arch structures, middle and/or inner ear and kidney. The distinction between BOR and other dysplasias, such as oto-facio-cervical syndrome (OFC), is challenged by frequent association of the former to other diverse malformations, and by variable expressivity even within the same family. OFC is characterized by trophic alterations of the facies and shoulder girdle in addition to the malformations seen in BOR. Recent characterization of one OFC patient shed some light on the controversy over whether OFC and BOR are the same disease, and led to the hypothesis that OFC is caused by contiguous deletions of EYA1 and adjacent genes. By contrast, we show here that an OFC patient bears a single-nucleotide substitution in a splice site of EYA1. Our results indicate that not only major rearrangements, but also point mutations altering the EYA1 reading frame, can be found in patients with OFC syndrome.

Abnormalities, Multiple↗

[Prevalence of the A1555G mutation in the mitochondrial DNA in patients with cochlear or vestibular damage due to aminoglycoside-induced ototoxicity].

OBJECTIVE: To determine the frequency of the A1555G mutation in the mitochondrial genome among Spanish patients with aminoglycoside-induced ototoxicity. PATIENTS AND METHODS: We screened 25 unrelated cases, totalling 39 individuals with cochlear or vestibular damage due to aminoglycoside-induced ototoxicity. This group was made up of 18 subjects from 4 unrelated families with a history of aminoglycoside ototoxicity in more than one relative, 8 subjects from 8 families that also had other relatives with hearing loss in absence of aminoglycoside exposure, and 13 sporadic cases. Among the 13 sporadic cases, there were 3 patients with vestibular involvement. Detection of the A1555G mutation was seen by mean of techniques for molecular diagnosis. RESULTS: The A1555G mutation was identified in all of the individuals from 4 families with aminoglycoside-induced cochlear damage and in 6 of 8 individuals with familial hearing loss. None of the sporadic cases carried the mutation. CONCLUSIONS: A high proportion of patients with cochlear damage due to aminoglycoside ototoxicity and having a familial history of hearing loss, related or not to aminoglycoside exposure, harbor the A1555G mutation.

Adolescent↗

Management of N0 neck in laryngeal carcinoma. Impact on patient's survival.

Management of patients with carcinoma of the larynx should systematically include an appropriate treatment of lymph nodes according to the TNM stage. One of the most controversial points of the treatment in these patients is the management of the clinically negative neck (N(0)). A retrospective study of 295 patients with laryngeal carcinoma and N(0) neck undergoing treatment in our centre between 1983 and 1993 is presented. We observed a significant decrease in the survival of clinically N(0) patients with histologically affected lymph nodes. Lymphadenopathy was more frequently detected in patients with supraglottic tumours (38 per cent) when compared to glottic tumours (16 per cent). In our experience, routine bilateral and unilateral dissection of N(0) necks in all supraglottic tumours and in T3-T4 glottic tumours, respectively, is the most beneficial approach for patients in terms of survival.

Adult↗

Sensorineural hearing loss and Mondini dysplasia caused by a deletion at locus DFN3.

OBJECTIVE: To study a family with inner ear malformations and sensorineural hearing loss. DESIGN: Clinical, radiological, and genetic study of the members of a family with different degrees of sensorineural hearing loss. RESULTS: The males in the family manifested profound congenital hearing loss with severe inner ear malformations, while the only affected female had progressive hearing loss that had begun during puberty. Computed tomography showed inner ear malformations in both males, with enlarged internal auditory meatus and Mondini dysplasia. Genetic analysis disclosed a microdeletion at the locus DFN3 on chromosome X. CONCLUSION: A familial Mondini dysplasia is associated to a microdeletion at the deafness locus DFN3.

Adolescent↗

[Perilymphatic gushers: myths and reality].

The term perilymphatic gusher refers to the escape of inner ear fluid under pressure through the oval window, generally during surgery for otosclerosis. It also appears during cochlear implantation. We reviewed the morphological aspects of the temporal bone of patients with perilymphatic gusher. The cases of three patients with the features of cerebrospinal fluid leaks under pressure cited in the literature are described. Anatomic and pathologic features are discussed in the light of knowledge of molecular genetics.

Adult↗

[Early cellular immune response in experimental labyrinthitis: immunohistochemical study].

Labyrinthitis ossificans is a recently recognized entity with the extending cochlear implant surgery. Up to date there are not so many studies of the cellular response leading the organization of the inflammatory reaction within the cochlea. Immunemediated labyrinthitis is a valid experimental model that allow the knowledge of the cellular infiltration mechanisms within the cochlea. The inner ear communicates with systemic immunity via the circulation by the passage of cells through the spiral modiolar vein (SMV) and its collecting venules in the scala tympani. Inflammatory reaction within the cochlea lead to the formation of fibrotic tissue and bone (osteoneogenesis) inside it and injuring the neurosensory organs of hearing and balance. To test which cells are proliferating early in an inflammatory response, an animal model of Keyhole limpet haemocyanin (KLH) induced labyrinthitis was utilized, showing a granulomatous lesions not previously reported in this experimental model.

Animals↗

[Inflammatory pseudotumor of the larynx].

Inflammatory pseudotumors are rare and usually located in lung, although they can develop in any organ. They are unusual in head and neck and very rare in the larynx. A case of laryngeal pseudotumor in a patient with odinophagia and neck pain is reported. After diagnosis, the patient was treated with steroids, which produced complete resolution. These lesions can simulate malignant neoplasms and must be considered in the differential diagnosis.

Aged↗

[Cervical teratoma in an adult].

Teratomas are germ-cell tumors that usually originate in the gonads. Extragonadal teratomas are rarely found in the neck, particularly in adults. A case of cervical teratoma that presented as a rapidly growing mass in a young man is described. The diagnostic problems are commented.

Adult↗

[Protocol for the endoscopic sinus surgery: comparative analysis of 200 cases].

A preliminary analysis was published in 1993 of 100 cases of endoscopic sinus surgery (ESS) carried out in our service following a protocol that included sinusitis, nasal polyps, and other endoscopic nasal procedures. Another 100 cases of ESS were analyzed for the present study and compared with the 1993 group. Comparative analysis showed improved results in the second series, with fewer minor complications and no major complications. These findings confirm the general opinion that endoscopic sinus surgery requires an adequate training period before optimal results are obtained.

Adolescent↗

[Use of the Internet in otorhinolaryngology].

The Internet is considered by some as one of the most important advances of the late 20th century. The Internet is the functional linking of personal computers via telephone lines to a worldwide network of millions of other computers, which enables them to exchange information freely. Although the Internet crops up in daily conversation, many persons are not aware of its usefulness and relevance for ear, nose and throat specialists. The Internet is accessed by special software that maximizes the potential of this vast computer network. The most important tools are e-mail and the World Wide Web. These tools make it possible to consult multimedia medical publications, access Medline, and carry out information searches, etc. The Internet and its most important uses in otolaryngology are summarized and a list of useful addresses is given. Although its advantages still are not widely appreciated, widespread Internet use is imminent and we think that it is a useful technology to know and use. Moreover, access is becoming easier and cheaper.

Computer Communication Networks↗

[Treatment protocol for sudden deafness].

There are two types of rapidly progressive sensorineural hearing loss: sudden hearing loss, which is generally unilateral and develops in less than 72 hours, and rapidly progressive sensorineural hearing loss, which develops over days or months. The origin of sudden deafness is difficult to establish. Several etiopathogenic factors have been postulated, such as viral infection, autoimmune origin, vascular and metabolic disease, rupture of the labyrinthine membrane, and, recently, immune-mediated inner ear disease. We made a retrospective study of 40 patients seen in our department. Patients were given a combined treatment with steroids, nimodipine, heparin, and oxygen. Patients were divided into two groups by intravenous or oral treatment.

Adolescent↗

[Immune-mediated inner ear disease: report of clinical cases].

Many clinical and experimental studies have obtained evidence of immune-mediated inner ear disease. Discrepancies between theories of the mechanisms of injury to the inner ear and the laboratory tests that identify it mean that the diagnosis is based on clinical symptoms and a positive response to treatment. We report four cases of immune-mediated inner ear disease characterized by endolymphatic hydrops, fluctuating hearing loss, sudden deafness (first symptom of primary Sjögren's syndrome), and rapidly progressive sensorineural hearing loss.

Adult↗

Inner ear malformations: Mondini's dysplasia.

Advances in imaging techniques are enabling the detection of increasing numbers of inner ear malformations. Mondini's dysplasia, whether alone or in association with other malformations, is one of those most frequently encountered. We report 4 cases of Mondini's dysplasia treated by us, discussing recent embryological and genetic findings.

Adolescent↗

[Retrospective study of complications of surgery for laryngeal cancer].

Surgery, alone or in combination with other therapeutic measures, is one of the main approaches to curing laryngeal cancer. The risk of complications is implicit in any surgical procedure. We describe our experience with general and local complications in surgery for laryngeal cancer and examine their relation to tumor extension and surgical technique. A review was made of a series of 431 patients who underwent surgery for laryngeal cancer over a 10-year period (1982-1991). Twenty-two patients (5.1%) had systemic complications, including upper gastrointestinal hemorrhage (n = 5), massive cervical hemorrhage (n = 5), and four renal failure. Minor complications were recorded in 77 cases (17.8%), predominantly pharyngocutaneous salivary fistula, which developed in 55 patients (13.8%). The incidence of local complications was significantly greater in patients with extensive local spread (T4). There were no differences among patients with regional spread. The surgical technique and type of pharyngoesophageal reconstruction played no role in the development of complications. Preoperative radiotherapy did not influence on the development of salivary fistulas.

Adult↗

[Study of spontaneous cytotoxic activity in laryngeal carcinoma: prognostic value].

The status of natural killer (NK) cell activity in peripheral blood, based on number and functional state, was studied in relation to the clinical and histopathologic stage of 52 patients with laryngeal carcinoma and in 23 healthy controls. The number of NK cells, estimated using CD16 and CD56 monoclonal antibodies, was similar in patients and controls and showed no relation to tumor size and nodal involvement. NK cell function did not show significant differences in spontaneous cytotoxic activity either overall or in relation to tumor size and the presence of palpable lymph nodes. However, cytotoxic activity was significantly lower in patients who had histologically confirmed nodal involvement. NK activity under 36% (the percentage of specific lysis at an effector:target dilution of 50:1) was suggested the probable presence of nodal metastases and was a highly sensitive and specific test. In patients with laryngeal carcinoma, NK-cell cytotoxic activity may be an independent prognostic parameter for evaluating cervical lymph node involvement.

Adult↗