The click-evoked electrical responses of the human cochlear nerve were recorded from the external ear canal concurrently with the cortical evoked potentials from the scalp. Paying attention to the clicks during a discrimination task resulted in a highly significant enhancement of the cortical response but no change in the cochlear nerve response. Hence no evidence was obtained for the operation of a peripheral gating mechanism during attention in man.
The presence of an angiogenic protein basic fibroblast growth factor (FGF) was established in juvenile nasopharyngeal angiofibroma (JNF). Extracts of these tumors have the capacity to stimulate endothelial cell proliferation. This activity is indistinguishable from basic FGF. The biological activity contained in the extracts binds to heparin-Sepharose columns and is eluted with a characteristic 2 mol sodium chloride. The exact fraction of the biological activity corresponds to the location where an immunoreactive basic FGF can be detected by radioimmunoassay. These same fractions contain an 18,000-d molecule which is identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting with an antibody to basic FGF. Indeed, immunohistochemical studies localize the growth factor to the endothelium of JNF. Although these findings do not establish that basic FGF mediates the development of this angiofibroma, they do support the possibility that the pathogenesis of JNF is associated with the presence of angiogenic factors like basic FGF. If this is the case, a comprehensive study of the etiology of JNF may lead to a better understanding of how locally produced growth factors mediate proliferative disease and how its modification might lead to better treatment on a biological basis.
A case of juvenile nasopliaryngeal angiofibronia trcatcd preoperatively first w i t h antlrogcii and then writ11 estrogen is rcported. I;nder androgeii therapy tlic tumor appe:n-cd to enlarge sonicwliat. T h i s w a s followed h y ;I conrse o f estrogen tlicrapy wliicli rcsultctl in a prompt and d r n i~i a t i c involution antl decrease i n size o f the tumor. It became w r y firni antl permitted cv~rlsioii with a iiiiniiiial ((i00 c c ) blood loss for this type of tunlor. Thc response of this tnnior to cstrogcn w a s similar to tliat found by one of the authors in four previously unreported cases. Pul i c r o sc 01) i c 11 i c t ur e s sh owe (1 a d r a i i i at ic fibrosis wit I i 111 at lira t ion of t h c vascttlar and connective tissue elciiients. Prroperativc estrogen therapy is recoiiimendcd :IS :I supplciiicnt but not :I snbstitute for surgery. 'I'lic Mood loss is definitely clecreascd. Acta Otolaryngol Downloaded from informahealthcare.com by Monash University on 08/25/15 For personal use only. A c f a oto-larung. GI Acta Otolaryngol Downloaded from informahealthcare.com by Monash University on 08/25/15 For personal use only. Acfci oto-Iargng. 61 Acta Otolaryngol Downloaded from informahealthcare.com by Monash University on 08/25/15 For personal use only. S l ecn Joli n sen, ,II .I) ., ENT I k p r i ni e n t , G f o s f r n p Hospiftrl, Copenliciyen I)enmcrrf Heceiried Jnne 16, 1!)65 Acfa ofo-lnryng. 61 Acta Otolaryngol Downloaded from informahealthcare.com by Monash University on 08/25/15 For personal use only.
Tympanosclerosis is a preventable disease. Its elimination is more the responsibility of the pediatrician and general practitioner than the otolaryngologist's. The education of our colleagues is the most effective way of possibly eliminating this disease process. Cholesteatoma and tympanosclerosis may have similar causative factors, but certainly have different pathogenic developmental patterns; their occurrence together in otologic disease is coincidental. The mechanism of this disease process shows that the subepidermal and submucosal connective tissue layers of the eardrum are the ones involved. The cure for tympanosclerosis may be achieved more easily than its amelioration. This may seem like a strange paradox, but cure is intimately bound up with prevention which is the key for the clinical significance of this theory of pathogenesis. The pediatrician and the general practitioner, or family physician--the first to see the children with their ear problems--are urged to refer patients to an otologist when fluid is turbid. Development of tympanosclerosis must be prevented in the early but treatable stages. Prevention is less costly than repair.
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