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Biomedical subjects

D Ophir

Publications and source records attributed to D Ophir.

At least 19 recordsLinked to original sources
PubMed1992

Evidence for genetic determination in human twins of olfactory thresholds for a standard odorant.

Olfactory thresholds for four odorants were determined in groups of monozygotic and dizygotic human twins. Odorants were presented in an ascending dilution series in odorless solvent, using a three-way forced choice method. For two of the tested odorants, 5 alpha-androst-16-en-3-one and isoamyl acetate, the thresholds showed a strong genetic component. This was demonstrated by respective values of 0.78 and 0.73 for the intraclass correlation difference, and of z = 3.69 and z = 2.71 in a within-pair difference analysis. The results for isoamyl acetate are novel, and suggest that genetic polymorphism in the affinity of odorant receptor proteins contributes to the (nearly normal) threshold distribution for this odorant.

Humans↗
PubMed1992

[Septic cavernous sinus thrombosis].

Septic cavernous sinus thrombosis is a rare complication of facial infections, particularly of the dangerous triangle (nose and upper lip) and less often of the orbit, middle ear, pharynx or teeth. Staphylococcus aureus is the most frequent causative agent. Prompt diagnosis and early aggressive antibiotic therapy, with or without anticoagulants, is required. A 49-year-old woman developed this complication following multiple nasal abscesses. Despite intensive antibiotic and anticoagulant therapy she became permanently blind. We present this case to stress the fact that this disease is still fraught with high morbidity, and even mortality.

Abscess↗
PubMed1992

Oral ciprofloxacin in the management of chronic suppurative otitis media without cholesteatoma in children: preliminary experience in 21 children.

The current medical management of children with chronic suppurative otitis media without cholesteatoma unresponsive to local treatment and oral antibiotics is intravenous antibiotic therapy in the hospital setting. We studied the efficacy and toxicity of oral ciprofloxacin in chronic suppurative otitis media. Twenty-one children received oral ciprofloxacin, 30 mg/kg/day. Ear discharge was positive for bacteria resistant to other oral medications and susceptible to the quinolones. The mean duration of treatment was 16.7 days. In 18 children suppuration ceased and 3 failed their first course. During a mean follow-up of 15.4 months, 6 children remained free of ear, nose and throat problems. Otorrhea recurred in 12 children. Ear cultures were positive for organisms susceptible to amoxicillin in 5 of them. In 7 cases Pseudomonas aeruginosa was again isolated from otorrhea. Repeated antibiotic therapy was advocated only in 3 (2 responded to ciprofloxacin; 1 failed ciprofloxacin and was cured by ceftazidime). Adverse clinical effects were not observed. Transient neutropenia was observed in 1 child. There was no change in the height percentile. The results of this study show that children with chronic suppurative otitis media without cholesteatoma can be effectively treated with oral ciprofloxacin. This novel approach may prevent hospitalization.

Administration, Oral↗
PubMed1992

Long-term follow-up of the effectiveness and safety of inferior turbinectomy.

The long-term effectiveness and safety of inferior turbinectomy were assessed in 186 patients who were interviewed and examined 10 to 15 years after surgery (mean 12.3 years). Relief of nasal obstruction was reported by 82 percent of the patients; rhinoscopy showed wide, clean nasal airways in 88 percent. Rhinorrhea was still a problem for 34 percent of patients, and 19 percent were receiving medical treatment for this symptom. Smell acuity had improved in 52 percent of the patients. Before turbinectomy, 32 patients had suffered from bronchial asthma; postoperatively, there was an improvement in 16, and no change in 13; 3 patients reported exacerbation of asthmatic attacks. Atrophic changes of the nasal mucosa and chronic purulent infection were not observed in any of the patients.

Adolescent↗
PubMed1991

Familial multicentric paragangliomas in a child.

A 12-year-old girl presented with bilateral carotid-body paragangliomas and a unilateral jugular paraganglioma. The tumours were surgically removed. This is a rare combination of tumours in any patient and previously unreported in a child of this age. Her father died of a cerebellar astrocytoma and her mother underwent surgical removal of a large mediastinal paraganglioma. The association of astrocytoma with familial paragangliomas has never been documented. The literature on the epidemiology and inheritance pattern of familial paragangliomas is reviewed. The need for thorough pre-operative evaluation of the patient and close follow-up of family members is stressed.

Carotid Body Tumor↗
PubMed1991

Needle aspiration and pressure sutures for auricular pseudocyst.

Auricular pseudocyst is an asymptomatic cystic swelling of the upper portion of the auricle. Various therapeutic approaches have been employed with variable success. We report our results with nine patients treated by needle aspiration and bolstered pressure sutures applied over both aspects of the cyst for 1 week. Treatment resulted in complete resolution with no recurrence of the lesion in any of the patients. This procedure is simple, does not require an operating room setting, and is more comfortable and more acceptable aesthetically by the patient.

Cysts↗
PubMed1991

[Pulmonary edema complicating upper airway obstruction].

A 40-year-old man who developed acute pulmonary edema following relief of upper airway obstruction is presented. The mechanism of pulmonary edema associated with upper airway obstruction is complex and not fully understood. It is therefore difficult to predict which patients will develop pulmonary edema during or after the relief of obstruction.

Acute Disease↗
PubMed1990

Functional upper airway obstruction in adolescents.

Functional upper airway obstruction is an uncommon manifestation of a conversive reaction characterized by recurrent stridor attacks caused by adduction of the vocal cords during inspiration. The oxygen saturation never drops to pathologic levels. The stridor is not accompanied by an appropriate degree of anxiety and is not associated with other symptoms. Patients benefit from verbal reassurance and speech therapy, but stridor attacks tend to recur and psychiatric consultation seems necessary in most cases. We present the case histories of three adolescent patients with nonorganic upper airway obstruction and describe the features that may facilitate the diagnosis of this condition. Early diagnosis and intervention may prevent unnecessary and potentially harmful investigations and therapy.

Adolescent↗
PubMed1990

Resection of obstructing inferior turbinates following rhinoplasty.

Total inferior turbinectomy was carried out in 38 patients who complained of nasal obstruction following rhinoplasty or rhinoseptoplasty and in whom hypertrophied inferior turbinates were found to be the cause of obstruction. Postoperatively, relief of nasal obstruction was reported by 84 percent of patients, while rhinoscopy showed wide, clean nasal airways in 92 percent. Nasal airflow measurements in 32 tested patients showed increased patency in all of them, including 3 who still complained of nasal obstruction postoperatively. The follow-up period ranged from 1 to 7 years (mean 2.8 years). Atrophic changes of the nasal mucosa or chronic purulent infection was not observed in any of the patients. Because the results of partial procedures on the inferior turbinates are often unsatisfactory, I suggest performing total inferior turbinectomy in patients with obstructing inferior turbinates following rhinoplasty.

Adolescent↗
PubMed1990

Minicricothyrotomy for tracheobronchial toilet.

Thirty-six patients underwent percutaneous cannulation of the cricothyroid membrane, using a small endotracheal tube, for the purpose of repeated suction of secretions from the tracheobronchial tree. The duration of cannulation ranged from 4 to 62 days (average, 12 days). Twenty-eight patients were followed up for a maximum of 3.5 years (mean, 20 months). There were no immediate or delayed postoperative complications. Subglottic stenosis did not occur in any of the patients. Minicricothyrotomy is a relatively safe and simple and efficient technique for tracheobronchial toilet in patients with chronic lung disease and in the postoperative period.

Adolescent↗
PubMed1990

Experience with the Wilkie procedure for sialorrhea.

Sialorrhea (drooling) is most commonly seen in children with cerebral palsy or mental retardation. Surgical procedures for the control of sialorrhea include salivary gland excision, parasympathetic nerve section, and salivary duct ligation and/or rerouting. Eighteen children between the ages of 5 and 17 years underwent bilateral submandibular gland excision and rerouting of Stensen's duct (Wilkie procedure). All children had severe drooling associated with cerebral palsy or mental retardation. Follow-up at 7 years showed satisfactory control of sialorrhea in 16 of 18 patients (89%). There was one major complication: xerostomia. Our results indicate that submandibular gland excision together with parotid duct retropositioning provides effective control of sialorrhea in most cases. Unfavorable head and mandibular posturing seemed to cause persistent sialorrhea in one case.

Adolescent↗
PubMed1989

[Thyroglossal duct cyst].

Thyroglossal duct cysts are embryologic anomalies arising from epithelial remnants of the duct left after the descent of the developing thyroid. Clinical, operative and pathological findings in 124 patients operated on in the past 14 years were analyzed. There were 60 males and 64 females. 69 (56%) were under 10 years of age and the youngest was 6 months old. 26 (21%) were over the age of 30, and the oldest was 72 years old. All excisions were performed in accordance with the Sistrunk procedure, which includes removal of the body of the hyoid bone. Overall recurrence was 6.4%, but in infected cysts or cysts with a fistula to the skin, it was 3.5 times greater. In 20% the cyst was located off the midline. The lining of the cysts was cuboidal, columnar, pseudostratified or stratified squamous epithelium, and varied according to the location of the cyst. There were no malignant changes.

Adolescent↗
PubMed1989

Olfactory function following late repair of choanal atresia.

Results of olfactory function tests (threshold determination and odor identification) in three cases of bilateral and one case of unilateral choanal atresia are reported. All four patients underwent successful repair of choanal atresia at relatively advanced ages (8 to 31 years). Test results showed that patients who had suffered from bilateral atresia had permanent olfactory deficits, while the patient who had suffered from unilateral atresia appeared to have normal olfactory acuity. Although these results should be interpreted with caution due to the small number of cases examined, they suggest the possibility that early sensory exposure might be needed for the normal development of central olfactory functions in analogy to the visual system.

Adolescent↗
PubMed1989

Oncocytic cystic lesions of the upper respiratory tract.

Oncocytic cystic lesions in the larynx comprise an uncommon but pathologically well-defined group, whereas only one case has been reported in the nasopharynx. The laryngeal cysts generally originate from the ventricle and occur in an older age group. Hoarseness is the most common clinical manifestation, with lesions appearing as polypoid masses. Their pathogenesis is considered to be the result of oncocytic metaplasia, apparently related to aging of cells in the seromucinous gland and ducts. The cystic dilatation is probably due to an obstructive phenomenon. Complete endoscopic removal is the treatment of choice. Examples of these lesions in the larynx and in the nasopharyngeal mucosa are described.

Aged↗
PubMed1988

Allergen-induced leukotriene production by nasal mucosa and peripheral blood leukocytes.

The relationship between release of leukotriene C4 (LTC4) from nasal mucosa in vivo and from peripheral blood leukocytes (PBLs) in vitro was examined in 18 patients with untreated rhinitis allergic to the house dust mite, Dermatophagoides pteronyssinus, and in 20 nonallergic control subjects following challenge with the specific allergen. Allergic patients were subjected to intranasal and PBL challenge with D pteronyssinus and a nonrelevant allergen, Artemisia vulgaris. In all allergic patients, intranasal challenge by D pteronyssinus, but not by A vulgaris, resulted in a release of substances from the nasal mucosa that reacted in a radioimmunoassay with antiserum to LTC4. Dermatophagoides pteronyssinus challenge in vitro of PBLs from the same patients, but not A vulgaris challenge, induced release of the same immunoreactive material into the supernatant. By comparison, the nonallergic subjects challenged with D pteronyssinus showed significantly lower LTC4 levels in their nasal secretions and PBL supernatants. The results show that, following specific allergen challenge, the release of LTC4 by the allergic nasal mucosa is similar in extent and nature to that of PBLs, indicating that these procedures can be used as tools to measure the efficacy of topically and systemically administered antiallergic drugs.

Allergens↗
PubMed1988

Peritonsillar abscess. A prospective evaluation of outpatient management by needle aspiration.

Outpatient management of peritonsillar abscess by needle aspiration and oral antibiotic therapy was evaluated for its effectiveness in providing rapid symptom relief and cure and in preventing recurrence. Between 1984 and 1987, 124 patients with peritonsillar infection were treated in our department, and 115 were included in this prospective study. Needle aspiration was not carried out in 11 patients because of young age, noncooperation, or severe trismus. The other 104 patients underwent permucosal aspiration and were followed up for periods of four months to three years. Of these, findings of aspiration were positive in 75 (72%). Only nine (12%) of the 75 patients with positive aspirates had to be hospitalized. In 64 (85%) of the 75 patients, the abscess resolved without further therapy. Aspiration of pus, along with oral administration of antibiotics, thus appears to be a reasonable alternative to incision and drainage or "hot" tonsillectomy in patients with peritonsillar abscess. This conservative approach obviates the need for hospital admission in most patients, thus enabling a significant cost reduction.

Adolescent↗