Is there any association between jugular venous reflux and nonpulsatile subjective tinnitus? A preliminary study of four-dimensional magnetic resonance angiography.

OBJECTIVE: To demonstrate whether there is an association between jugular venous reflux and nonpulsatile subjective tinnitus (NST) using real-time four-dimensional magnetic resonance imaging (MRI) angiography. MATERIALS AND METHODS: Patients with unilateral NST who underwent contrast-enhanced MRI with a special protocol were included in the study. Thick slab dynamic maximum intensity projection images were obtained including interleaved stochastic trajectories (TWIST)-MRI examination. All patients were requested to perform Valsalva maneuver during the sequence. Jugular venous reflux grading was performed as follows: absence of reflux or if reflux does not reach the base of the skull: grade 0; if reflux reaches the jugular bulb, but no intracranial contrast is observed: grade 1; and if reflux extends into the intracranial cortical veins and/or the cavernous sinus above the jugular bulb: Grade 2. RESULTS: A total number of 30 patients, 23 male and 7 female, were included in the study. Jugular venous reflux was not identified (Grade 0) in 20 patients. Grade 1 reflux was determined in 7 cases and Grade 2 reflux was observed in 3 cases. Notably, only patients with Grade 2 reflux described worsening of their tinnitus symptoms during the examination and their daily activities as well. CONCLUSIONS: NST might also be associated with hemodynamic problems of the venous system and the MRI protocol starting with TWIST accompanied with Valsalva maneuver is not well-known, yet seems to be a feasible and beneficial method to detect potential jugular venous reflux in NST patients.

[Changes in the invasive process and the immune response of the host during the mebendazole and voltaren treatment of experimental trichinelliasis in guinea pigs]. / Izmenenie invazionnogo protsessa i immunnogo otveta khoziaina pri lechenii mebendazolom i vol'tarenom éksperimental'nogo trikhinelleza morskikh svinok.

Guinea pigs infested with Trichinella (5-10 larvae per 1 g body weight) at the intestinal (at days 2-4 of infection), migration al (at days 6-11), and muscular (at days 22-27) stages of invasion, were given voltaren, 2.14 mg/kg daily, and mebendazole, 75 mg/kg daily. The amount of adult Trichinella in small intestine and larvae in the diaphragm, T- and B-lymphocyte count (T-REC and B-RFC), functional leukocyte activity in RTML for FGA and Trichinella larvae antigens, content of circulating immune complexes and complement were determined. Voltaren did not cause delay in adult Trichinella elimination from the intestine of experimental animals, it also did not increase invasion rate at the muscular stage. As compared to the control, T- and B-lymphocyte content and RTML for FGA remained unaltered. Experimental animals show elevated blood complement activity and RTML inhibition of trichinella antigens. The combination of mebendasole and voltaren did not reduce parasitogenic effect. Despite the terms of drug injection, T- and B-lymphocytes count and complement levels in blood were found to increase, as well as the RTML index on FGA and its inhibition of specific antigens as compared with the infected untreated animals.