[TREATMENT OF PERIPHERAL VERTIGO SYNDROMES WITH A SOLUBLE DERIVATIVE OF PYRIMIDO-PYRIMIDINE. PATHOGENIC CONSIDERATIONS].
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A diagnosis of perilymph fistulas (PLFs) can be made only by identification of repeated accumulation of crystal-clear fluid from an otic capsule defect or labyrinthine window at tympanotomy. It would be highly desirable to base a decision to operate for the diagnosis and management of PLFs on a database that includes quantitative test data, which confirms, with a high probability, a clinical suspicion of PLF. This article reviews progress in the development of a test of the vestibular response to external auditory canal pressure changes as recorded by dynamic posturography. Based on results to date, it appears that a fistula test with dynamic posturography is more sensitive than those based on VOR responses. This may be due to the ability of dynamic posturography to isolate vestibular from both visual and somatosensory influences on motor responses during external canal pressure changes.
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Blood osmolality was altered in guinea pigs by intravenous administration of glycerin (glycerol). After glycerin administration, serum osmolality increased rapidly, reaching a plateau within 15 minutes. Perilymph osmolality lagged significantly behind the increase of serum osmolality and equalled serum osmolality only after one hour. While perilymph osmolality responded to changes of serum osmolality, there was some time lag noted in the response of perilymph, suggesting the existence of a blood-labyrinth barrier. It was observed that this barrier is permeably to glycerin and water, suggesting the possibility of transient reduction of hydrostatic pressure in the labyrinth by the injection of an osmotic agent into the systemic circulation.
Contamination of perilymph with other fluids (cerebrospinal fluid, tissue fluid, blood, endolymph) together with sampling, anaesthesia, surgical intervention or food intake of the animals may considerably affect the analytical result. The numerous possible artefacts seem to be the main reason why varying values are given in the literature for the same chemical component of perilymph. This is also partly true of cerebrospinal fluid and blood. The effect of some sources of error on selected chemical components of perilymph, cerebrospinal fluid and blood is briefly summarized.
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White rabbits were immunized with pooled and concentrated cerebro-spinal fluid (CSF) and with tumour homogenate concentrate from specimens taken from five patients with acoustic neurinoma. The absorbed anti-CSF-antitumour antiserum was tested with the micro-immunodiffusion test against normal human serum (NHS), CSF, perilymph and CSF from tumour patients and tumour homogenate. NHS showed no precipitates in any of the tests. One protein band was observed in all the other four reactants. Tumour tissue and perilymph had two proteins in common. Diffusion from the CSF space into the perilymph can thus occur via both the cochlear aqueduct and the internal acoustic meatus.
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