Unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy: benign exophthalmos syndrome (BES). A description of a new clinical condition

PURPOSE

To report the clinical and radiologic characteristics of a group of patients who experienced unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy. The clinical features of these patients are presented and a hypothesis proposed to explain this condition for which the authors introduce the term benign exophthalmos syndrome (BES).

METHODS

Retrospective, noncomparative case series.

PARTICIPANTS

Four patients experienced slow progressive unilateral exophthalmos associated with ipsilateral mucosal turbinate hypertrophy, with no evidence of orbital mass or extraocular muscles involvement.

INTERVENTION

Main Outcome Measures. Symptomatic outcome and measurement of the degree of relative exophthalmos.

RESULTS

The onset of exophthalmos was associated with clinical and radiologic features that resemble BES. In all patients, radiologic examination demonstrated an ipsilateral mucosal turbinate hypertrophy and not the presence of orbital disease or expanding lesions of paranasal sinus. After daily intranasal spray of steroid, in three of the four cases the globe returned to within 1 mm of exophthalmometry of the contralateral eye.

CONCLUSIONS

The relationship between the feature of paranasal sinus disease and the development of ipsilateral exophthalmos has been described in the literature. The four cases described herein appear peculiar for the slow progressive onset of the exophthalmos, without inflammatory and mass effect signs. This condition associated in all cases with ipsilateral hypertrophy of the nasal mucosa provides a guide to a hypothetical mechanism for BES. According to these hypothesis, the therapy should be devoted to the nasal disease more than the orbital.

Solid-state NMR characterization of diastereoisomeric chiral stationary phases and their soluble models

Two diastereoisomeric chiral stationary phases (CSPs), devised for enantioselective HPLC, showing unexplained differences in their chromatographic performances, have been characterized, together with their soluble models, by means of 13C-cross polarization/magic angle spinning (CP/MAS), 1H-MAS and 1H-free induction decay (FID) analysis. The NMR investigation of the soluble models has not highlighted significant structural/conformational differences between the two diastereoisomers, but has constituted a useful support for the analysis of the more complex NMR data of the CSPs. The organic chiral selectors of the stationary phases show a poor internal mobility and no conformational differences between the two diastereoisomers have been observed. On the contrary, interesting differences between the two CSPs have been found involving the silanols on the silica surface and the dynamics of the linking chains between the organic selectors and the silica surface itself. An explanation of the chromatographic behaviour has been proposed in terms of different proximity of the organic moieties with respect to the inorganic surface in the two CSPs.

Association between polycystic ovary and fibrocystic breast disease

OBJECTIVE

The aim of this study was to assess whether or not there was an association between a polycystic ovary (PCO) and fibrocystic breast disease based on ultrasound findings, both pelvic and mammographic.

DESIGN

Prospective case-control study.

POPULATION

Women aged between 18 and 30 years not using oral contraceptives attending the outpatient ultrasound clinic from January 1996 to December 1998.

MAIN OUTCOME

Confirm the association between PCO and fibrocystic breast disease.

RESULTS

According to the ultrasound findings, women were allocated to three groups: 351 out of 456 showed normal-appearing ovaries (group A), 93 had polycystic-appearing ovaries/PCO (group B) and 12 had PCO syndrome (group C). In group A, 24 (6.83%) women showed breast pathology. In group B, there was an association between PCO and breast pathology in 53 (56.98%) women, while in group C it was noted in 11 out of 12 (91%).

CONCLUSION

This study showed a significant association between PCO and benign pathology. This should encourage the performance of a screening breast sonography on women with PCO.

[Incidence of fibrocystic disease of the breast in women with polycystic ovary. Clinico-instrumental study]

BACKGROUND

The aim of this study was to assess whether or not there was an association between polycystic ovaries (PCO) and fibrocystic breast disease. It is known that hyperestrogenism and anovulation are involved in the etiology of the fibrocystic breast disease; we evaluated the incidence of this disorder in women with PCO or Polycystic Ovary Sindrome (PCOS) based on ultrasound findings both pelvic and mammographic.

METHODS

From January 1995 to December 1997 we performed in our outpatient ultrasound service (I Divisione I Istituto di Clinica Ostetrica e Ginecologica, Università di Roma "La Sapienza") pelvic standard scan on 980 women. Patients between 18 and 30 years of age, not using oral contraceptives, both with Normal Appearing Ovariest (NAO) or with PCO Polycystic Appearing Ovaries (PAO) enrolled in the study, informed and agreed to undergo ultrasound mammography. All the subject were examined using an Aloka SSD ZOOO and Esaote AU3 ultrasound equipment with 3.5 MHz and 10 MHz probes for pelvic and mammographic scan respectively. The relationship between pelvic and mammographic scan findings were studied and the chi 2 analysis was used to examine them.

RESULTS

Women by the US findings were allocated into three groups: 203 over 264 showed NAO (group A); 54 had PAO/PCO (group B) and 7 had PCOS (group C). In group A (6.83%) women showed breast pathology. In group B there was association between PCO and breast pathology in 30 (56.98%) women, while in group C on 6 over 7 (91.66%).

CONCLUSIONS

This study showed a significant association between PCO and benign pathology. This should encourage the performance of a screening breast sonography in women with PCO.

Identification and determination of 3,4-dihydroxyphenylacetaldehyde, the dopamine metabolite in in vivo dialysate from rat striatum

3,4-Dihydroxyphenylacetic acid (DOPAC) is commonly considered to be the main dopamine (DA) metabolite produced by monoamine oxidase (MAO); however, the initial product of DA oxidation is 3,4-dihydroxyphenylacetaldehyde (DOPALD). Owing to technical difficulties in detecting DOPALD from a biological matrix, no studies have so far been performed to measure brain levels of this aldehyde in vivo. In this work, using transstriatal microdialysis in freely moving rats, we identified DOPALD by HPLC coupled to a coulometric detector. In chromatograms obtained from microdialysis samples, DOPALD appeared as a peak with a retention time coincident with that of the standards obtained via enzymatic and chemical synthesis. On the other hand, DOPALD was undetectable ex vivo from rat striatal homogenates. This discrepancy is probably due to the preferential extraneuronal localization together with the high reactivity of the aldehyde, which is rapidly removed by the dialysis probe, whereas the ex vivo procedure allows its condensation and enzymatic conversion. Measurement of DOPALD levels as a routine procedure might represent a reliable tool to evaluate DA oxidative metabolism directly, in vivo. Moreover, parallel detection of DOPALD and DOPAC levels in brain dialysate may make it possible to distinguish between the activity of MAO and aldehyde dehydrogenase. DOPALD, like many endogenous aldehydes, has been shown to be toxic to the cell in which it is formed. Therefore, in vivo measurement of DOPALD levels could highlight new aspects in the molecular mechanisms underlying both acute neurological insults and neurodegenerative diseases.

Pharmacokinetic study of intravenous rifampicin

The time course of the serum and urine concentrations of rifampicin were evaluated during and after administration of an intravenous preparation of the antibiotic. 300, 450 and 600 mg dose levels of the antibiotic were evaluated, all being given as intravenous infusion after solution in 500 ml of glucose, the infusion lasting 3 h. The results have shown that the serum level curves and the kinetic parameters calculated on them do not differ to any major extent from those corresponding to the same doses given orally. No changes of relevance in the half-life values were observed between doses. Changes in serum bilirubin levels were observed with a pattern similar to that commonly seen with oral administration of rifampicin.