[Effects of one cycle of inhalation crenotherapy with radioactive fluoridated oligomineral]. / Studio oggettivo degli effetti di un ciclo di crenoterapia inalatoria con acque oligominerali radioattive fluorurate delle Terme di Merano.

The objective of the study was to test the effects of inhalation crenotherapy using the radioactive, fluoridated oligomineral waters from the Merano Spa on both subjects with specific upper respiratory tract phlogosis and normal subjects. The double-blind study was performed on a population of 27 adults of both sexes treated with radioactive-fluoridated water (group A) and 20 subjects, suffering from the same chronic catarrh pathology, selected with the same criteria but treated with inhalation of steam and an aerosol using drinking water from the municipal water supply (group C). In addition, a group of 13 subjects--which in terms of age and sex were statistically comparable to groups A and C but who did not show any signs of acute or chronic upper respiratory tract pathologies (group B) were also treated with the radioactive-fluoridated waters. All subjects included in the study underwent the following tests before and after the cycle of crenotherapy: Objective E.N.T. examination. Computerized Active Anterior Rhinomanometry. Detection of the ciliary mucous transport (CMT) time. Nasal cytology. Physical and immunochemical examination of the nasal mucous. The results of this study--seen in the trend in some parameters monitored both before and after the cycle of crenotherapy using Merano Spa water--clearly show that that the crenotherapy studied had an effect on aspecific chronic phlogosis of the upper respiratory tract. In fact, among other things, group A showed decreased nasal resistance, increased nasal respiratory flow, normalized mucociliary transport, decreased bacterial flora and an increased number of plasma cells in the rhinocytogram. In addition there was an increase in the following values in the nasal mucous: Albumin, non-secretory Immunoglobulin and the secretory portion of secretory Immunoglobulin A. None of these variations are seen in the results from the control group treated with municipal drinking water. After treatment with Merano spa water, the pathology-free subjects showed variations in the parameters in line with those found for group A. This biological reality can most likely be attributed to the favorable response of the respiratory mucosa, promoting anti-infection defenses.

[Effects of sulphur-arsenic-ferrous water treatment on specific chronic phloglosis of the upper respiratory tract]. / Studio sperimentale degli effetti di un ciclo di trattamento con acque solfato-arsenicali-ferruginose su flogosi croniche aspecifiche delle vie aeree superiori.

The aim of the present study was to demonstrate the therapeutic effect sulphurous-arsenical-ferruginous waters from had on aspecific phlogosis of the upper respiratory tract (URT). This double-blind study involved treating 37 adults of both sexes with sulphurous-arsenical-ferrignous water (group A) and another 14 subjects, again suffering from the same aspecific, chronic catarrhal disorder and selected with the same criteria, with the aerosol vapor inhalation of drinking water from the city mains (group B). All subjects included in the study underwent the following tests both before and after the cycle of crenotherapy: Objective E.N.T. examination Anterior Active Computerized Rhinomanometry (AACR) Mucociliary transport time (MTT) Nasal cytology Physical and immunochemical examination of the nasal mucous. The post crenotherapy variations achieved indicate that the sulphurous-ferruginous waters have a beneficial therapeutic effect: indeed, the mucosa was able to perform its complex functions, particularly specific and aspecific defense of the organism. In fact, among other things, group A showed decreased resistance and increased nasal respiratory flow, normalized of mucociliary transport, decreased bacterial layer and increased plasma cells in the rhinocytogram, and an increase in albumin, non secretory immunoglobulin and the secretory portion of secretory immunoglobulin A in the nasal mucosa. None of these variations--many of which were statistically significant--were seen in the controls group treated with drinking water from the public mains.

[Positional impedance tests with acetazolamide: a clinical test for evaluating endolymphatic hydrops]. / La valutazione clinica dell'idrope endolinfatica mediante test all'acetazolamide in impedenzometria posizionale.

The authors report on the possible advantages acetazolamide, in conjunction with Positional Impedenzometry, can provide in the detection of minor labyrinthine hydrops and major labyrinthine fluid tension disorders. This study was carried out using the case/control method. The subjects were selected on the basis of symptoms and clinical examination revealing signs of endolymphatic hydrops. Tonal audiometry and positional impedenzometry according to Marullo were performed both before (pre-test) and after i.v. administration of 500 mg sodium acetazolamide (post-ACZ1 and post-ACZ2). Audiometry showed that in 77.2% of the cases there was a significant variation in threshold. In positional impedenzometry the average post-ACZ1 (delta PISC went from 22.06% (pre-test) to 13.16% and the post-ACZ2 (delta PISC went to 23.15%). On the other hand no significant changes were seen in the controls. Some hypotheses are offered on the mechanisms giving rise to these effects and particular attention is focused on the effect acetazolamide has on the carbon dioxide in the endolymphatic sac. In conclusion the authors consider the advantages this method offers over the "classical" tests used in diagnosing Ménière's Disease and minor hydrops.

Occult metastases in cancer of the larynx and their relationship to clinical and histological aspects of the primary tumor: a four-year multicentric research.

The authors have tried to verify whether some clinical or pathological features of laryngeal cancer may favor the occurrence of occult metastases in the lymph nodes of the neck in N0 cases. The purpose of the investigation was to define the possible existence of tumors, where elective neck dissection, in the absence of palpable nodes, could be done without, thus contributing to settlement of a long debated problem. Different parameters, both clinical and pathological, have been considered. The result of a cross comparison of such parameters in 237 cases of cancer of the larynx without palpable nodes, submitted to surgery on the primary and elective neck dissection, indicates that, although the frequency of occult metastases is significantly related to the site and size of the tumor, its grading, and the degree and type of stromal reaction, the favorable concurrence of all said parameters occurs in 2% of cases only. However, if only clinical parameters, viz. site and size of tumor, are taken into account, a favorable concurrence occurs in 18% of cases with an incidence of occult metastases lower than 2%. These cases are almost exclusively represented by T1N0 supraglottic and T2N0 glottic tumors. We can conclude by saying that clinical and pathological preoperative findings may offer a useful clue in evaluating the risk of occult metastases, and hence advising, or not, an elective neck dissection in N0 cases. Nevertheless, in the vast majority of cases, an elective functional neck dissection still offers the best guarantee of oncologic safety while avoiding unnecessary mutilation.

Wave VII recognizability in brainstem auditory-evoked potentials.

Brainstem auditory-evoked potentials (BAEP) recorded with a far-field from the scalp technique are generally described as 7 positive waves in the initial post-stimulatory 10 ms period. Also at high stimulus intensities, the Jewett wave VII appears to be undetectable in the majority of normal subjects. We present an original recording method to reproducibly detect this late BAEP wave. 48 normal ears were examined and wave VII was detectable in all the recordings with clicks delivered at an intensity of 75 dBHL.