The aim of the present study is to investigate more piecisely the distribution of the sensory cells, the over-all cytoarchitecture and sensory cell populations of the cristae.The inner ears from 35 individuals whose age ranged from newborn to 90 years old were obtained within 10 hours post-mortem.Their medical records showed no evidence of auditory or vestibular disorders or therapy with ototoxic drugs. Using a silver staining method, surface preparations of the vestibular sense organs were studied by light-microscopy.Graphic reconstructions were made for the whole area of the crista and the macula.The sensory cells with large free surface predominantly occupied the central region of the crista and the striola of the macula.The sensory cells in the peripheral region of the crista and in the extra-striolar region of the macula showed smaller free surfaces and they varied less in size.The free surfaces of the supporting cells, however, no size differences.The sensory cells were more in number in the peripheral regions of the cristae and in the extra-stri-olar regions of the maculae.In the cristae, almost 6800 sensory cells were observed in a 0.9 square mm area.In the saccular macula, about 16, 000 sensory cells were discovered in a 2.2 square mm area and almost 30, 000 sensory cells were found in a 3.5 square mm area in the utricular macula.
Case 1.A 5-year-old boy was given a heavy blow in his nasal root by one of his friends.In the evening of that day, swelling of the nasal root and bleeding from the left nasal cavity were developed, accompanied by headache, nausea and vomit.About one month after this accident, he was admitted to our clinic.At that time, coagula which filled his left nasal cavity, right deviation of septum and diffuse swelling of the nasal root were observed.A specimen was removed from the tumor surgically through his left fossa canina, and histologically it was revealed Ewing's sarcoma.60Co teletherapy(150 rads daily and the total dose of 6000 rads) combined simultaneously with cobalt-protophyrin(10mg daily and the total dose of 210 mg) and bleomycin(5mg weekly and the total dose of 75mg) was administered.Subsequent to these therapies, FT-270(400mg daily) was continuously administered orally for about 10 months. These anti-neoplastic therapies resulted in marked diminution of swelling in the nasal root and significant improvement of general condition.One and a half years after the onset of his illness, he is doing well without evidence of recurrence and metastasis. In this case, glycogen particles in the cytoplasm of the tumor cell, which is one of the characteristics of Ewing's sarcoma, were assessed by PAS reaction histologically as well as on the electron microscopic pictures. Case 2.A 20-year-old female complained of slight swelling of the right inner canthus and was treated under the diagnosis of conjunctivitis uneffectively.This swelling was considered to be caused by paranasal sinusitis, a radical antrostomy was performed.Following the surgery, however, exophthalmus was developed and she was admitted to our clinic 3 months after the onset of her illness.At that time, tumorous tissue associated with fibrosis filled the right maxillary sinus and reoperation was performed.The histological examination of the surgical specimens could not disclose definite diagnosis.Metastases were observed in the subclavicular, abdominal and sternal region.Her condition deteriorated so rapidly that no radiation therapy and anti-neoplastic chemotherapy could be administered.Postmortal examination revealed Ewing's sarcoma originated from the right maxilla with distant metastases.
Impedence audiometry is gaining rapid popularity as a clinical differential diagnostic technique for conductive auditory lesions.However, it is not clearly shown whether the diagnostic standard reported so far is appropriate for Japanese ears or not. Therefore, impedance audiometry using Madsen ZO-72 was performed on 109 normal ears of 66 individuals in order to determine the normal ranges of the peakpoint value of tympanogram and of the static compliance.The difference between right and left ears were also studied. In type A tympanogram, following data were obtained as normal ranges with 95% reliability. i.The peakpoint value on tympanogram:1.5-7.4 2.The difference of the peakpoint values between both ears:less than 2.0 3.Static compliance:0.23-1.22c.c. 4.The difference between both ears:less than 0.25c.c. After the survey on normal and pathological ears, it is our conclusion that pathological patterns should be defined when peakpoint value is larger than 7.4 or less than 1.5 in type A tympanogram, and Japanese seems to have-less static compliance of the ear than Caucasians. In our study on 87 patients with conductive auditory lesions with intact tympanic membrane, more than 90%(38/40) of ears of exsudative otitis media was correctly diagnosed by impedance audiometry.However, the impedance audiometry did not always lead to correct diagnosis of ossicular discontinuity or fixation.For instance, five ears out of six ears with ossicular discontinuity did not show type AD tympanogram, which had peakpoint value of less than 1.5, and they had static compliance within normal limits.No cases of 7 patients with ossicular fixation showed type As tympanogram of peakpoint values more than 7.5 and four out of the seven cases have normal static compliance
Middle ear mucosae of 56 fetal and 90 young rats were investigated with SEM, TEM andserial sections for light microscope for the purpose of obtaining a better understanding of the fine structure of middle ear mucosa. The results of this study showed that secretory cells interspersed with ciliated cells were predominantly distributed around the tympanic orifice and transitionl zone.In general, the cellular distribution pattern between suckling rats and adult rats was similar, even though the distribution of ciliated and secretory cells varied to a certain extent from one adult to another. It was also evidenced that(1) light and dark secretory granules appeared in the Golgi area of some epithelial cells in 17 to 20 fetal day and that(2) primary cilla and immature cilia were seen from 16 to 17 fetal day in the transitional zone near the tympanic orifice.The number of ciliated and secretory cells increased rapidly after birth. It was failed to find glands in the osseous tube, tympanic orifice and other portion of the middle ear cavity in fetal, newborn and suckling rats, while there existed abundant glands in the cartilaginous portion of the tube. Secretory modes of Kurosumi's extrusion type II, 111, IV and V could be observed.The most common secretory cells were mucous cells with light secretory granules, showing eccrine secretion(type IV).The less common cells were the mixed granulated cells with apocrine secretion(type II and III).The liest was the dark granulated cells with eccrine secretion(type V).The distinction between light granulated and dark granulated cells was able to establish at 20 fetal day.Findings of this study indicate that both secretory and ciliated cells are normal components of middle ear mucosa although these cells are restricted within the tympanic orifice and transitional zone, and that the mucociliary defense system starts to develop at the fetal stage
It is already known that some single vestibular nuclei unit of the rabbit and cat respond both to the rotational and tilt stimuli.In this experiment the convergence of ampullar and macular impulses on the vestibular nuclei unit was examined by the horizontal rotation and the head tilt in the rat.Experimental animals, surgical preparations and recording procedures were identical with those in the previous report.Rotational stimulus method and unitary response to the rotation were also described there in detail.For the tilt stimulation, the head of animals was manually inclined 10-20 in the roll and pitch planes together with a stereotaxic frame. Seventy-four units out of 167 neurons responded to the tilt stimulation.Neural response patterns to the head tilt in the rat were similar with those observed in the cat.Firing frequency decreased with side-up(i.e.recording side was raised) and increased with side-down in 36 units (Type a).Thirty-one units had opposite trend(Type j).The other 7 units exhibited only the increase or decrease of discharge rate in the inclination to one or both sides.Ninety-seven percent of el-neuron responded to the rotation as well as the head tilt, but in cc-neuron only 64% responded to the rotation.Different rates of the convergent input from the canal in each neuron were statistically significant and possible physiological meaning of this difference was discussed.Out of 153 neurons, which responded to the rotation, 60 units(39.2%) responded to the tilt stimulation and considered to receive the convergent impulses from macular receptors.High degree of the canalotolith convergence observed in the rat was in good parallel with the result in the cat.The convergence in vestibular nucleus is supposed to have the important roles not only in ocular movemet but also in efferent influences upon ampullar receptors, which probably occur in each other.Anatomical locations of the recording sites revealed that most neurons(75.6%) were located in the medial vestibular nucleus, and others in the superitar, lateral and inferior nuclei.Few units existed in the reticular formation and cerebellum.These findings were compared with the morphological studies concerning the termination of the primary vestibular fibers in the cat and monkey
A preliminary investigation was made for establishing an automatic method of scoring of brain stem response.(BSR).Averaged BSR to click stimuli was recorded in 7 normal young children and 4 normal adults.They were scored visually and by 3 different methods of amplitude measurement. The stimuli were given to the subject through a loudspeaker at intensity levels of 10, 20, 30 and 40 dB above mean subjective thresholds of normal adults(HL) for young children and of 0, 10, 20 and 30 dB(HL) for adul subjects.Ten averaged responses were recorded with each stimulus intensity and additional 10 traces were made without stimulation.Thus 50 traces were obtained per subject. The amplitudes of the responses of all traces were measured using 3 different methods shown in Fig.i(A, B.C).Then 5 percent rejection limits were calculated of the amplitudes of 10 control traces measured by the 3 methods.These values were used as amplitude criteria for judging the presence or absence of a response.Responses whose amplitude exceeded the above-mentioned criteria were scored positive, and the rate of positive responses in the 3 methods were compared with that in the visual scoring. Results obtaiaed were as follows: 1) In young child group, Method B and C achieved almost similar detectability of the response as did visual scoring, whereas the rate of positive responses in Method A was significantly lower than those in B and C. 2) In adult groug, on the contrary, no such a significant difference was found in the response detectability-among the 3 methods, though all of the methods showed 15 to 40 percent lower delectability than that of visual scoring. 3) We thus concluded that Method B was regarded as the most useful procedure for measuring response amplitude automatically
Three cases of bilateral Sudden deafness in infants which we had experienced for these 5 years were reported and their specificity and origin were discussed. 1.Despite of the adequate treatment from the onset of the disease, hearing disturbances recurred in two of them and another one became almost deaf after a progressive involvement.Therefore, their prognosis was considered poor. 2.Considering that the cases of the Meniere disease due to the autonomic nervous and circulatory disturbance were very few in the infant, it was assumed that the origin of the sudden deafness of the infant was ascribed not to the autonomic nervous disturbance but to some infection such as virus one. 3.We also considered that the individual disposition would be an important factor for this disease