Saliva contains a complex mixture of proteins and peptides as well as fragments derived from these molecules. By RP 1 -HPLC-ESI-MS analysis of the acidic soluble fraction of human whole saliva we have identified in the chromatographic pattern more than 120 different proteins and naturally occurring peptides (1-6). Their characterization was performed by a variety of mass spectrometric techniques coupled with different enzymatic treatments and amino acid sequencing. The proteins and naturally occurring peptides belong to families of well characterized salivary proteins including Histatins, Statherin, acidic and basic proline-rich proteins (aPRP and bPRP), Cystatins, and Defensins (1-6). Two-dimensional gel electrophoresis has also been used by other researchers for analysis of salivary proteins and peptides, but this technique is not well suited for identification of small peptides as illustrated by the difficulty in identifying Histatins and the majority of bPRPs and bPRP fragments (7-9). However, knowledge of salivary proteins and peptides as well as their naturally occurFrom the ‡Dipartimento di Scienze Applicate ai Biosistemi, Università di Cagliari,

In agreement with literature reports, results obtained in group A confirmed that gastroesophageal reflux is often present in patients with neoplastic lesions of the pharynx and larynx. Furthermore, gastric resection is indicated for the first time as an additional risk factor or cofactor of precancerosis and squamous cell carcinoma of the pharynx or larynx. Further studies are necessary to establish the cause and effect relationship between biliary reflux and pharyngo-laryngeal tumors.

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Objective: To investigate the role of magnetic resonance imaging (MRI) in the diagnosis of sudden sensorineural hearing toss (SSNHL).Methods: Fifty-four consecutive patients affected by SSNHL were investigated using brain MRI. MRI was performed with an eightchannel phased-array head coil to study the entire audiovestibular pathway and the whole brain. The protocol study consisted of a highresolution study of the temporal bone, internal auditory canal (lACI, cerebellopontine angle (CPA). and brainstem combining 2 mm thinslice axial T2-weighted two-dimensional fast spin echo (FSE) and fluid-attenuated inversion recovery (FLAIR) sequences, pre-and postcontrast (gadolinium-diethylenetriamine pentaacetic acid) administration fat-suppressed axial Ti-weighted two-dimensional FSE sequences, and a Tj*-weighted three-dimensional Fourier transformation-constructive interference in steady state sequence (FT-CISS), with 0.4 mm ultrathin partitions. The rest of the brain was studied with a 4 mm axial T2-weighted FLAIR sequence.Results: Thirty-one of 54 (57%) cases of SSNHL presented with MRI abnormalities. In 6 of 54 cases, the detected abnormality was directly correlated to the clinical picture (2 labyrinthine hemorrhage, 1 cochlear inflammation, 1 acoustic neuroma, 1 arachnoid cyst of the CPA, and 1 case of white matter lesions in the pons, compatible with demyelinating plaques along the central audiovestibular nervous pathway, as the first expression of multiple sclerosis).Conclusions: An extensive MRI study of the audiovestibular nervous pathway and of the whole brain, pre-and postparamagnetic contrast administration, is recommended to rule out the wide spectrum of abnormalities that can cause SSNHL. SOMMAIRE Objectif: Investiguer le role de I'imagerie par resonance magnetique dans le diagnostic de la surdite de perception subite. Methode: Cinquante-quatre patients consecutifs avec un diagnostic de surdite subite ont ete investigues par IRM pour etudier tout le cerveau et les voies audiovestibulaires. Le protocole incluait une etude a haute resolution de I'os temporal, du conduit auditif interne, de Tangle ponto-cerebelleux et du tronc cerebral combinant des coupes axiales de 2 mm en T2, en sequence FLAIR, en T1 avant et apres contraste (gadolinium) et en T2 FT-CISS avec des coupes ultra-minces de 0.4 mm. Le reste du cerveau a ete etudie avec T2 en sequence FLAIR.Resultats: Trente-et-un des 54 cas (57%) de surdite subite avaient une anomalie a I'lRM. Dans 6 de ces cas, I'anomalie etait directement lie a I'episode clinique (2 hemorragies labyrinthiques, une inflammation cochleaire, un neurinome acoustique, un kyste arachoidien de Tangle ponto-cerebelleux et un cas probable de sclerose en plaque).Conclusion : Nous recommandons dans investigation de la surdite subite neuro-sensorielle, I'utilisation de I'lRM du cerveau et en particulier des voies vestibulo-cochleaires dans le but d'eliminer les nombreuses pathologies qui peuvent se cacher derriere cette entite cliniqua.

Further studies are needed to elucidate whether low folate levels can be considered a risk factor for SSHL.