The incidence of subclinical central diabetic neuropathy is unclear due to difficulty in detecting latent alterations of central neural transmission process. The aim of this study was to evaluate a central neuroconductive mechanism in diabetics by brainstem auditory evoked responses (BAER). We found increased latencies of peaks I, III, V in diabetics as compared to control subjects. These BAER abnormalities were demonstrated in 62 per cent of insulin-controlled diabetics and in 33 per cent o patients treated by diet, or peroral drugs. No alterations in brainstem responses were observed in patients with latent diabetes. We did not find any correlation between the BAER abnormalities and the duration of the disease, the blood glucose level or the level of control of the diabetes.

The response of ACTH, beta-endorphin and cortisol to calcitonin administration was investigated in 8 subjects with recent fractures of the vertebrae due to postmenopausal or senile osteoporosis (Ost) and in seven normal healthy controls (NC). A significant increase of the three hormones was observed in 13 subjects. The maximum increase was observed between 15 and 60 min.: the cortisol level (microgram/100 ml) rose from 14.3 +/- 1.9 to 24.8 +/- 3.2 (P less than 0.05) in Ost and from 7.7 +/- 0.6 to 21.7 +/- 1.7 (P less than 0.001) in NC, the beta-endorphin (pmol/l) from 5.8 +/- 0.6 and to 21.2 +/- 1.3 in OST (P less than 0.001) and from 5.9 +/- 0.4 to 21.9 +/- 4.5 (P less than 0.01) in NC and the ACTH levels (pg/ml) from 21.3 +/- 5.7 to 61.7 +/- 3.6 (P less than 0.001) in OST and from 30.0 +/- 6.2 to 58.8 +/- 7.5 (P less than 0.05) in NC. The results indicate a possible role of calcitonin in modulating the anterior pituitary function. It also suggests that the analgesic effect of calcitonin might be mediated by the increase of beta-endorphin. The possibility that this analgesic effect of calcitonin is due to its direct binding to the opiate receptors was excluded in the present study by in vitro binding assay.

A retrospective 10-year review of thyroid function in 144 patients treated for cancer of the head and neck by radiation therapy, surgery, and combined surgery and radiation therapy was done. In five patients, hypothyroidism had been found in the posttreatment period. Two of them had developed a pharyngeal fistula resistant to intensive local care and surgical procedures, and a third patient had edema and necrosis of the skin flap. The five hypothyroid patients reported here have all been treated for laryngeal malignancy. In any other group of patients treated for head and neck malignancies studied within this article, we did not find clinical or chemical signs of thyroid hypofunction. Our report stresses the importance of periodic evaluation of thyroid function in patients who underwent irradiation of the neck or combined therapy for malignancy in the neck, even if they were clinically euthyroid. Hypofunction may be more frequent than generally recognized after multimodality treatment, and hormonal replacement therapy may be the keystone in curing rebellious pharyngeal fistula and shortening the disabled state of the patient.

The brainstem auditory evoked responses (BAER) were utilized for the evaluation of central neural transmission in alloxan-induced diabetes in rats. The mean latencies of waves I, III, V and the interpeak latencies III-V and I-V were prolonged in diabetic rats as compared to the same rats before alloxan administration. The incidence of abnormal BAER was more frequent in the group of rats with severe diabetes (82 per cent) than in mildly diabetic animals (42 per cent). Our results may suggest the presence of a central neuropathy in experimental diabetes, which can be detected by the method of BAER.