[The therapy of tinnitus resulting from blast injury (author's transl)]

In a prospective study aimed at the cure of tinnitus due to blast injury, oral treatment of 172 patients with the mono-substances Betahistine, Pentoxifyllin and Xantinol-nicotinate were compared with those of control patients who received no medications. Patients treated with Pentoxifyllin and Xantinol-nicotinate improved better than the comparative group without therapy although the differences were not considerable. Betahistine as compared with the other groups produced significantly better therapeutic results.

[The treatment of acute acoustic trauma (blast injury) with dextran 40 (author's transl)]

In a prospective study the results of treatment of 72 patients with deafness due to blast injury were assessed. All patients received infusions of Dextran 40. When treatment started within 3 days of the injury 74% showed complete recovery of hearing and the remaining 26% showed some improvement. When treatment started within 3 weeks of the injury 26.5% showed complete recovery, 61.8% had some improvement and 11.8% had no improvement. In 87.5% of those patients who attended after a longer interval no change in the audiograms occurred and only 12.5% had any significant improvement. The disappearance of tinnitus was effectively more common with early treatment. On account of these results the use of Dextran 40 is strongly advised.

[Clinical comparison of dextran 40 and xantinol nicotinate in the treatment of sudden deafness caused by shock waves (author's transl)]

The therapeutic success of inner ear lesions by acute acoustic trauma was examined by two statistically comparable groups of patients. 80 patients were attended by dextran 40 and 59 by xantinol nicotinate. The amelioration of hearing and tinnitus was statistically better after treatment with dextran 40.

Effects of chronic ethanol consumption on the catabolism of chylomicron triacylglycerol and cholesteryl ester in the rat

Rats were fed for 24 days a liquid diet with ethanol as 36% of calories to produce hyperlipemia and hepatic steatosis. The catabolism of chylomicrons doubly-labeled in the triacylglycerol and cholesteryl ester moieties was studied in conscious rats after ingestion of their usual liquid diets with or without ethanol. A constant intravenous infusion of chylomicrons revealed a defect in chylomicron catabolism after chronic treatment with ethanol. The plasma clearance of chylomicron cholesteryl ester was impaired to a greater extent than clearance of chylomicron triacylglycerol. These findings are consistent with defective catabolism of chylomicron remnants, and suggest that the accumulation of chylomicron remnants in the plasma contributes to the development of increased post-prandial hyperlipemia and chronic hyperlipemia in association with excessive ethanol consumption.

Cervical spondylotic myelopathy in wide canals

The anteroposterior diameters of the cervical spinal canal in 21 patients with cervical spondylotic myelopathy were measured. In more than one-third (eight) of these it was found that this diameter of the canal was more than 14 mm, despite a widely held belief that this myelopathy is unlikely if the cervical spinal canal is wider than 14 mm in the AP diameter.

The palm tree cervical spine--a normal anatomical variant

A case of "palm tree" cervical spine with cervical spondylitic myelopathy is described. It is shown that this upward course of the nerve roots over the pedicle is a variant of normal anatomy, not described in standard textbooks and that this variation may be seen on myelograms. The futility of attempting to correct the variation is described.

Comparative metabolism of fenclorac in rat, dog, monkey, and man

Fenclorac (alpha,m-dichloro-p-cyclohexylphenylacetic acid, diethylammonium salt), a new nonsteroidal anti-inflammatory agent, was rapidly and quantitatively absorbed from the gastrointestinal tract of rat, dog, monkey, and man following oral administration of a solution of 14C-labeled compound. Radiochromatography and mass spectrometry indicated that fenclorac was the principal component in plasma during both the absorption and elimination phases in all species. Small quantities of m-chloro-p-cyclohexylphenylglycolic acid metabolite were also present. Fenclorac and metabolite were confined primarily to the plasma phase of whole blood and were extensively bound to serum albumin. The plasma elimination half-time was species-dependent and varied from 1.6 hr in the rat to 6.5 hr in the dog. The principal tissues of distribution were liver, kidney, and small intestine. There was no significant accumulation or retention of drug or metabolites in any tissue compartment. Fenclorac was completely biotransformed prior to elimination in urine and bile. The major route of elimination was renal in man and monkey, and biliary in the dog. Enterohepatic recirculation of fenclorac metabolites was shown to occur in the rat. The major urinary metabolites were hydroxycyclohexyl analogs of fenclorac and m-chloro-p-cyclohexylphenylglycolic acid. There was no difference in metabolism and biological disposition of fenclorac in normal rats and rats with adjuvant-induced polyarthritis.

[A case report of an unusually long uvula (author's transl)]

An unusually long uvula as a cause of chronic throat irritation with the sensation of a foreign body in a 35-year old patient is reported, with symptoms relieved by partial resection of the uvula.

[Neurotic disorders in monkeys during increased stress on analytic-synthetic processes]

It has been shown in experiments on three rhesus monkeys that an enhanced stress of analytical-synthetic processes consisting in learning to differentiate a sequence of tones, leads to neurotic disorders of monkeys higher nervous activity. They are manifested individually and consist in disturbances of general behaviour, in forced movements, breakdowns of differentiations, the missing of positive responses in the previously elaborated conditioned stereotype and in typical dynamics of the formation of positive and negative conditioned reflexes to a chain of tones (2000 + + 4000 c/s; 2000 + 2000 c/s; 4000 + 2000 c/s; 4000 + 4000 c/s).

Role of gamma-carboxyglutamic acid. Cation specificity of prothrombin and factor X-phospholipid binding

Divalent cations are required for two roles in prothrombin-phospholipid interaction. The first role, catalysis of a prothrombin protein transition has a reaction half-life of 100 min at 0 degrees and is a prerequisite to phospholipid binding. The binding sites required for the transition have a very low cation specificity. All di- and trivalent cations tested were effective in this role with the exception of beryllium. Barium catalyzed the transition but only at high concentrations (6.6 mM was required for half-reaction). Blood-clotting Factor X, another gamma-carboxyglutamic acid-containing protein, also undergoes a cation-catalyzed protein transition which is a prerequisite to Factor X-phospholipid binding. In both proteins, the transition can be monitored by a decrease in the protein's intrinsic fluorescence. Compared to prothrombin, the Factor X transition occurs much more rapidly, has a somewhat greater specificity for cations, and requires higher concentrations of cations. This indicates that the cation binding sites provided by gamma-carboxyglutamic acid are not completely uniform in all proteins. The second role of divalent cations in prothrombin-phospholipid interaction is in the actual protein-phospholipid binding. This interaction was studied by protein fluorescence quenching resulting from excitation energy transfer to a chromophore attached to the phospholipid membrane. Only strontium and barium satisfactorily replaced calcium in this role. A number of other cations form protein-phospholipid complexes but of the wrong structure. These cations inhibit the prothrombinase complex (Factor Xa, calcium, phospholipid, Factor V). The cation specificity for Factor X-phospholipid binding is the same as for prothrombin except that higher concentrations of cations are required. Factor Xa (generated by action of Russell's viper venom on Factor X) displayed the same calcium requirements for the protein transition and phospholipid interaction as Factor X. The cation requirements of the prothrombinase complex correlate with the cation requirements of prothrombin and Factor X-phospholipid binding. Strontium is the only cation that will singly replace calcium. Barium is ineffective alone because the concentrations required to catalyze the protein transitions cause precipitation of the phospholipid. Combination of certain other cations with barium will, however, substitute for calcium. The other cations (specifically magnesium or manganous ion) catalyze the protein transitions and barium forms the correct protein-phospholipid complexes.

[Results of otoplasty (author's transl)]

77 patients with uni- or bilateral otoplasty have been reviewed between 6 months and 5 years postoperatively. Surgery had been performed using a modified Converse technique. A comparison was made between the objective results and the patient's satisfaction. Using our own classification, we listed 64.9% as good results and 3.9% as failures, suggesting a reoperation. 31.2% of the cases demonstrated only some improvement. Evaluating our results listed as "good", the average distance helix: planum mastoideum, measured between the upper and middle third of the ear, was 18.8 mm and between the middle and lower third 18.0 mm.