Oral therapy with flurithromycin in ear, nose and throat infections.

In this study efficacy and tolerability of flurithromycin ethylsuccinate (FE) were evaluated in ear, nose and throat infections. One hundred and three patients were treated with FE tablets 375 mg 12-hourly for a mean duration of treatment of 8.2 days and they were divided into groups according to the pathology: pharyngitis/tonsillitis (chronic 7, acute 38), rhinosinusitis (chronic 7, acute 12), otitis (chronic 6, acute 32) and sialadenitis (acute 1). Patients evaluable for clinical efficacy were 101, among them a complete recovery was registered in 88.2%, an improvement in 9.9% and a treatment failure in 1.9%. Bacteriological evaluation was possible in 95 patients, showing the eradication of the pathogen in 94.7%. Tolerability was judged to be excellent in 81.6%, good in 15.5% and discrete in 2.9%. These results demonstrate that FE is safe and effective in the treatment of infections established on acute or chronic inflammatory states.

Angioneurosis in Menière's disease.

The main aim of this paper was to analyse whether labyrinthic angioneurosis, Menière's disease, can be provoked by immunity reaction at labyrinth level. The Menière's disease immunologic thesis dates back to the 1920's when Duke supposed an allergic origin for Menière's disease. Actually, this allergy could show local autonomic nervous system disturbances. This would be cholinergic and as a consequence, it would involve vascular elements of the inner ear. In any case, one should not forget that it has been found out that some patients suffering from Menière's disease have showed hypersensitivity to inhalants and food. A new theory has recently drawn scientists' attention. It states that atopic hypersensitivity cannot be mediated just from an immunologic point of view. Therefore, labyrinthic angioneurosis is not to be considered as immunomediated allergy but as a sort of altered reactivity of autonomic activities, to chemical mediators. These mediators can be released thanks to various stimulations: mental, physical, chemical and infective. We think that in some cases labyrinthic angioneurosis is not to be ascribed to labyrinth immune reaction which is immunomediated but this disease must be analysed from a chemical neuromediation point of view.

[Presence of the regulatory peptide endothelin in the vascular endothelium of the human nasal mucosa]. / Presenza del peptide regolatore endotelina nell'endotelio vascolare della mucosa nasale umana.

Endothelin is a 21-amino acid peptide originally isolated from cultured endothelial cells. Besides being the most potent vasoconstrictor peptide. Endothelin is known to produce a wide range of biological effects: contraction of smooth airway muscle, stimulation of cell growth and modulation of hormone and neurotransmitter release. The aim of the present study was to use immunocytochemical techniques in investigating the possible occurrence of endothelin in normal human nasal mucosa. Endothelial cells of both capacitance and resistance blood vessels of the mucosa displayed endothelin-like immunoreactivity. It is reasonable to presume that endothelin, produced and released locally by endothelial cells, may play a role in controlling blood flow, in neuromodulation and in wound healing via a paracrine mechanism.

[Cytodiagnosis by fine needle aspiration biopsy in laryngeal diseases]. / Cytodiagnostic par ponction a l'aiguille fine dans la pathologie laryngienne.

Aspiration cytodiagnosis is widely employed in head and neck tumors since it is atraumatic, it avoids neoplastic seeding and is highly reliable from a diagnostic standpoint. We used such method to support diagnosis in deep intramural laryngeal tumors, and in the post-radiotherapy evaluation of laryngeal areas coated with hard oedema and fibrosis. Needle aspiration was performed during direct laryngoscopy according to Kleinsasser. The method proved to be highly reliable for a diagnostic standpoint, with an agreement of 93% with the final histologic examination, higher than the one provided by traditional bioptic techniques.

Concentrations of flurithromycin in serum and tonsils.

The concentrations of flurithromycin in serum and palatine tonsils of eleven adult male patients undergoing tonsillectomy were determined. Each patient received 500 mg t.i.d., in all ten doses, before tonsillectomy. Flurithromycin concentrations were measured by a microbiological method. Mean serum levels (+/- SE) were 0.72 microgram/ml (+/- 0.19) after 8 h from the 9th dose and 0.67 microgram/ml (+/- 0.13) after 4 h from the 10th dose. Average concentrations (+/- SE) in tonsils were: 1.43 +/- 0.20 microgram/g (right) and 1.32 +/- 0.21 (left) 4 h after the last administration. Therefore, the mean tissue/serum ratio was about 2:1. These results indicate a good diffusion of flurithromycin from serum to tonsillar tissue.

[A study using laser-Doppler velocimetry of modifications of the labyrinthine microcirculation induced by chemical and physical stimuli]. / Etude par vélocimétrie au laser-Doppler des modifications de la microcirculation labyrinthique induites par des stimuli chimiques et physiques.

Vasomotor activity induced by physical and chemical stimuli in the cochlear microcirculation was evaluated by laser-doppler flowmetry. Cochlear flow changes were studied after pharmacological administration and noise exposure. The reaction of cochlear microcirculation after drug administration is similar to that observed in the brain. After phenylephrine injection the authors observed an increase of cochlear blood flow, contrary to that observed in the peripheral vessels. The authors studied the difference in time-activity and quantitative effect of several drugs commonly used in cochlear vascular diseases. Cochlear flow decrease after exposure to noise is proportional to the stimulus intensity and the exposure time.

Roxithromycin disposition in tonsils after single and repeated administrations.

Levels of roxithromycin in serum and tissue were investigated in 29 subjects undergoing tonsillectomy. A total of 13 subjects received a single oral dose of 300 mg, and 16 received four oral doses 12 h apart as follows: a 300-mg loading dose followed by three 150-mg doses. Measurable levels of roxithromycin were present in tonsil samples of 11 of 13 subjects in the first group. The mean levels in tonsils and serum were 0.8 microgram/g and 6.7 micrograms/ml, resulting in a mean tissue/serum ratio of 0.16. In the multiple-dose group, roxithromycin was found in 14 of 16 subjects at mean levels in tonsils and serum of 1.6 micrograms/g and 8.7 micrograms/ml, and the tissue/serum ratio was 0.23.

Bacterial adherence and upper respiratory tract disease: a correlation between S. pyogenes attachment and recurrent throat infections.

The attachment of bacteria to mucosal surfaces is the initial event in the pathogenesis of infectious diseases. The authors present a study about the adherence of strain of S. pyogenes isolated in subjects with recurrent tonsillitis. A correlation was found between the adherence ability of the bacterium and the number of episodes per year. The study about the SIgA, the infection development and the bacterium adherence showed a direct correlation between SIgA levels and the number of phlogistic episodes. The importance of the role assumed by bacterial adherence in the genesis of the phlogistic process is to be emphasized yet again.

Prognostic parameters in metastatic spread of laryngeal cancer: clinico-histopathological correlations.

The authors present a series of 130 patients with laryngeal tumours submitted to total or horizontal laryngectomy and to neck dissection. The possible correlations between the staging and histology of the primary lesion, tumour marker (LASA) and the incidence of lymph node metastases are examined. The information provided by clinical and histopathological parameters is no doubt useful, but the margin of clinical error is high. On the contrary, the tumour marker concentration (LASA) was significantly higher in the patients whose lymph nodes were found to be histologically invaded, than in those without metastatic spread. Consequently, the LASA test may assume clinical importance before surgical therapy and in the follow-up of treated patients.

[Determination of sialic acid in cancer of the upper aero-digestive tract]. / Le dosage de l'acide sialique (LSA) dans les cancers des voies aéro-digestives supérieures.

The determination of serum lipid sialic acid (LSA) in subjects with laryngeal and oral cavity carcinomas demonstrated an important correlation between the presence of carcinoma and tumor marker elevation. 90% of positivity has been found in 60 cases of laryngeal carcinoma; 100%, on the contrary in 19 cases of oral cavity. The authors affirm the importance of LSA as a tumor marker, in particularly in monitoring patients submitted to surgical excision.