For the purpose of the improvement of circulatory metabolism in inner ears, the microwave irradiation was induced to vertebral artery to increase blood flow volume of this artery. Microwave irradiated from 5 cros above parietal area of guinea pigs and rabbits toward the inner ears. The followings were examined in inner ears; changes of temperature, blood flow volume and diameter of blood vessels, and potential existence of tissue injuries. At 20 to 30 watts output, the temperature in rabbits rose gradually soon after irradiation, and after 15 minutes it reached about 1 to 1.7-C higher in living bodies, and elevated 4 to 5.5-C in dead animals proportionally to irradiating duration. After ceasing irradiation the temperature decreased gradually and returned to the original degree within 10 to 15 minutes in living bodies, but it took more than 40 minutes in dead bodies. From the difference between living and dead bodies, it was considered that blood flow in living body worked as to keep homeostasis by the way of activating circulatory metabolism. Light and electron microscopic examinations were performed with inner ears of guinea pigs after 10 days' irradiation at 30 watts/15 min./day without any abnormal change. Seven to ten percent increase of the diameter of arteriolas in bony cochlear was observed by irradiation in guinea pigs. From the measurement of erythrocyte flow speed, I could also admit the increase of blood flow speed due to the improvement of disturbances such as sludging. Consequently it was suspected that blood flow volume increased more than 14 to 21 through the irradiation. Output antenna was set a few cros away from human auricle toward the inner ear including a part of vertebra. From the glass model experiments it would be considered that blood flow volume of arterioles in irradiated inner ear was increased as well as that of vertebral artery at the same side. This supposition was confirmed by the ultrasonic blood rheography. After 3 minutes' irradiation I could recognize the increase of blood flow in 22 cases out of 41 cases, and the mean increase rate was 21% which was equivalent to the experimental data in guinea pigs. Therefore microwave irradiation was considered to improve blood flow of arteries such as vertebral, basilar, anterior inferior cerebellar, labyrinthine and those related arteriolas and veins. In the treatment of sudden deafness, combined microwave and drug therapy, showed more effect than drug therapy alone. The above mentioned experimental data support the usefulness of microwave treatment. Many merits are counted with microwave treatment and this therapy may be tried effectively for various diseases
Histopathological findings of chronically inflamed maxillary sinus mucous membrane were treated using grading codes for computer processing. The criteria prepared for this purpose were as follows: 1) thickness of mucous membrane, 2) infiltration of inflammatory cells, 3) infiltration of eosinophils, 4) edema, 5) polypoid change, 6) fibrosis, 7) vascularization, 8) numerical presence of proper mucosal glands, 9) increase in goblet cells, 10) formation of pseudoglands, 11) sloughing of epithelium, 12) stratification of epithelial cells, 13) thickening of basement membrane, 14) squamous metaplasia, and 15) dysplasia of epithelium. In each criterion, the grade of pathological change was coded in the range of 1 to 4. The mucous membranes studied in this investigation were taken from 923 maxillary sinuses of 582 patients. Correlation coefficients for all possible pairs of the 14 histopathological criteria were calculated and factor analysis was applied. From these results, a new system of classification was proposed in relation to the histopathological findings. It consisted of four main types, i.e., infectious type, edematous type, fibrous type, and mild type. Two subtypes of secretory type and non-secretory type were also suggested. Furthermore, allergic reaction was found by factor analysis as an independent factor. The correlations of the histopathological type with the age of the patient, clinical findings, macroscopic findings obtained at the time of operation and in the postoperative course were also investigated.
With a view to clarifying the disease state of exudative inflammation of the middle ear, the pressent study was conducted to look for underlying problems by way of clinical statistics and to make observation of changes of the middle ear mucosa in experimental animals. The condition has generally been ragarded as a clinical entity classified among the diseases of the eustachian tube and attributed to tubal obstruction. A retrospective study of patients with exudative otitis media, however, showed that the ear canal on the affected side was frequently not impeded in chronic cases of unilateral involvement where, therefore, the condition could be hardly ascribed to tubal obstruction but rather due to disorders of the middle ear. In view of this, an attempt was made to investigate mucosal changes of the middle ear in guinea pigs with experimentally induced exudative inflammation of the middle ear without direct obstruction of the ear canal. Injection of viscous fluids into the tympanic cavity or reduction of pressure in the middle ear was found to result in retention of fluid in the middle ear cavity. The mucosa was observed to undergo dysplastic changes into mucosal epithelium with secretory cells as a result of inflammation or in response to stimulation of the middle ear. It would follow that exudative otitis media is caused (1) by obstruction of the eustachian tube or (2) from pathologic changes in the middle ear, and the data suggest that the condition which has arisen from tubal obstruction may turn in its progress into that form attributable to pathologic changes of the middle ear.
In order to clarify the properties of optokinetic nystagmus (OKN), optokinetic response was recorded by DC-ENG in 14 healthy young adults, to whom constant speed stimulations (20-120-/sec) were administered using an Ohm's rotatory drum. The OKN obtained was analysed quantitatively and qualitatively. Among the factors considered to influence nystagmus response, the condition of stare and focus, the direction of vision, the number of stripes on the drum, age, and abnormality of visual field were studied. The following results were obtained. (1) In normal OKN response, the frequency of the nystagmus coincided with the number of stripes which passed before the eyes up to * drum speed of 120-/sec. The speed of the slow phase of nystagmus was in direct proportion to drum speeds up to 75-/sec, but tended to increase in lesser proportion at higher drum speeds of up to 120°/sec. The amplitude of nystagmus was 39±7° at a drum speed of 20°/sec and decreased with an increase of drum speed. The initial phase of the optokinetic response was a slow eye movement corresponding to thedirection of drum rotation. Although the field of nystagmus often deviated from the median to the direction of the rapid phase, it was reversible to the direction of the slow phase by strengthening the degree of fixation. (2) The nystagmus responses by a stare and a look test were compared. It was found that the co-existence of stare and look should be avoided, if an accurate quantitative analysis was to be obtained, and that the look test should he regarded as the standard. (3) There was no difference in frequency and amplitude between 20- lateral gaze and straight gaze. The speed of the slow phase was, to some extent, lower in the lateral gaze than in the straight gaze. (4) There was no difference between 8 and 12 black stripes in the quantitative relationship between stimulations and responses. (5) Normal values of OKN obtained from young adults could he adopted for individuals in their fifties. (6) When there was concentric narrowing up to 15°or central scotoma up to 5° in the visual field, the speed of the slow phase of OKN decreased, but there was no abnormal wave pattern. However, in a case with the narrowed visual field up to 5°, the fixation by the rapid eye movement to a stripe appeared in the visual field became inadequate and the eyes tended to return to the median position. During the slow phase the eye movement delayed from the moving object, which was supplemented by saccade. These results showed that the perifoveal region (5-15 degrees) of the retina played an essential role in the development of OKN.
By means of agar immunoelectrophoresis and antigen antibody crossed electrophoresis (Laurell), protein components in endolymph and periymph of guinea pig inner ear were analized. 1) Agar immunoelectrophoresis: Three to four components in endolymph and 4 to 5 components in perilymph were observed with Amido Black 10B staining. In these precipitates of both fluids, each component of Al- and *-Gl fraction was stained with periodic acid Schiff reagent. According to the mobility of serum protein components and glycoprotein staining, Albumin, Haptoglobin, Transferrin, and *-Globulin were determined. 2) Ag Ab crossed electrophoresis: Three to five components in endolymph and 5 to 7 components in perilymph were observed with Amido Black 10 B staining. Albumin showed the largest arc in all of them. *-Globulin found appeared skew and showed weak arc at the negative pole. Several unknown arcs were found on *- and *-Gl fraction. A/*-G was 1.50 in endolymph and 1.52 in perilymph. From these results obteined, it is probable that protein components in serum and those in inner ear fluids were different, and high molecular protein components were poorer in inner ear fluids compared with serum.
IgE content and specific IgE antibodies to mites (dermatophagoides farinae) and alternaria were determined in sera and nasal secretions from 166 patients with nasal allergy, 40 patients with bronchial asthma and 50 control subjects, using radioimmunosorbents test (RIST) and radioallergosorbent test (RAST). Out of 166 patients with nasal allergy, 109 (66%) were allergic to house dust (HD) or mites, 29 (17%) to pollen of Japanese ceder and 9 (5%) to Alternaria. Other causative allergens were pollen of ragweed and cock's foot and Candida. Mean concentrations of IgE in both serum and nasal secretion were significantly greater in groups of nasal allergy and bronchial asthma than in the control group. However, in 24% of the patients with nasal allergy the IgE content was below the mean value of the control group. The mean IgE concentration of serum and nasal secretion was significantly greater in patients with marked eosinophilia in nasal secretion and peripheral blood than those with no eosinophilia. In HD allergy the RAST scores were significantly correlated with the reactivity to HD skin tests, the amount of eosinophiles in nasal secretion and peripheral blood and the IgE contents in serum and nasal secretion. The results of the present study showed the usefulness of the determination of IgE and specific IgE antibodies in the diagnosis of nasal allergy. RAST for estimation of specific reaginic antibodies was more clinically useful than the measurement of IgE concentration. IgE in nasal secretion was much more closely related to pathogenesis of respiratory allergies than was IgE in serum.
For the purpose of investigating the function of tonsils, seventeen kinds of free amino acids (Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Valine, Alanine, Glycine, Proline, Glutamic acid, Serine, Tyrosine, Aspartic acid, Cystine, Histidine, and Arginine) were analysed by an automatic amino acid analyser (JLC-6AH) for the tonsillar tissues taken from 70 cases. The plasma specimens which were taken at the pre- and post-operative periods were also analysed in 50 of the above cases. The free amino acids were divided into 3 groups as glucogenic, ketogenic and others according to their metabolic pathways. The results of the present study are summarized as follows: 1) The amount of free glucogenic amino acids is much larger than that of ketogenic amino acids in the tonsillar tissues. 2) It is found that the level of glucogenic amino acids fluctuates significantly in the tonsillar tissues. Namely, the level increases in hypertrophied tonsils, in the non-inflammatory stage, and also according to the degree of hypertrophy. The level decreases in acute tonsillitis and in the group having high serum ASO titers. There is no significant fluctuation in the level of ketogenic amino acids. 3) As for the amino acid level in the postoperative plasma, the level of glucogenic amino acids increases in aged subjects, in the first degree of hypertrophy and in the group showing high serum ASO titers, while it decreases in acute tonsillitis. The level of ketogenic amino acids increases in accordance with aging and decreases in acute tonsillitis. The other amino acids increase with aging and also in the first degree hypertrophy, while decrease during the intermediate period of tonsillitis. 4) Here is -- tendency to decrease in the level of the plasma free amino acids during the period of 4 weeks after tonsillectomy. Particularly, the level of all types decreases with aging, in focal tonsillitis, in inflammatory stage, in the first degree hypertrophy and in the group showing high serum ASO titers. On the other hand, the tendency is found only for the levelsof glucogenic and ketogenic types in acute tonsillitis and for that of the other amino acids in hypertrophied tonsils. In the third degree hypertrophy, the levels of ketogenic and other amino acid types show decreasing tendency. No elevation is found for the level of the plasma amino acids during the post-operative period.