Permeability and ototoxicity across the round window membrane was studied in guinea pigs by applying neomycin directly to the round window membrane, and the following results were obtained. 1) Neomycin passed the round window membrane freely, and caused damage to the cochlea. 2) Damage of the cochlea was confined to the organ of Corti. In general, the damage was severest in the basal turn, and was observed more frequently in the outer hair cells. 3) In some cases, the severest damage was observed in the second turn. 4) When neomycin was applied to the round window membrane on both sides, the damage was often quite severe. 5) Damage was observed as early as 4 hours after application of neomycin, and it increased in frequency as the time of application became longer. 6)Damage was compared in normal ears and in ears with experimental otitis media with effusion, and no significant difference was observed. The result appeared to indicate that neomycin passed the round window membrane quite freely regardless of condition of the middle ear mucosa. 7) Analysis of the concentration of neomycin in the perilymph disclosed that neomycin on the round window membrane penetrated into the perilymph quickly, and that its concentration in the perilymph became extremely high, reaching a peak after 2 hours, and then decreased gradually. 8) No consistent relationship was observed between the concentration of neomycin in the perilymph and the presence or absence of the damage at each time interval of neomycin application. 9) Results of this study suggested probable existence of individual variations among guinea pigs.
In order to elucidate the characteristic of two different kinds of nasal mast cells, i.e., mucosal mast cells (MMC) and connective tissue mast cells (CTMC), we examined the inhibitory effect of disodium cromoglycate (DSCG) on the allergen induced histamine release from nasal mast cells in 75 patients with the house dust nasal allergy. Pharyngeal mast cells were also examined as a control. After incubation of nasal scrapings, pieces of chopped nasal mucosae without epithelial layer or chopped pharyngeal mucosae with house dust extract alone or mixture of house dust and DSCG solution (30uM, 150uM, 750uM), we measured the percentage of histamine release and the percentage inhibition of histamine release of DSCG. As results, nasal scrapings were less sensitive to DSCG, and both the chopped nasal mucosas without epithelial layer and chopped pharyngeal mucosas were very sensitive to DSCG. These results clearly indicate that DSCG is non-effective on nasal surface basophilic cells (NSBC), whereas effective on the lamina propria mast cells of the nasal as well as the pharyngeal mucosa. These indicate that there are two distinct types of mast cells in the allergic nasal mucosa. NSBC is similar to MMC and lamina propria mast cells of nasal mucosa are similar to CTMC in response to DSCG.
The branching patterns of axons of lateral vestibulo-spinal tract neurons (LVSTNs) were investigated in the cervical cord of the cats. After electrophysiological identification of axons of LVSTNs, HRP was injected iontophoretically into single axons. The branching patterns of 47 single axons were reconstructed in three dimensions from 100μm thick serial sections stained by the Heavy Metal Method. Many LVSTNS had multiple axon collaterals at different cervical segments (maximum 7 collaterals). Each axon collateral had a narrow rostro-caudal extension, usually less than 1.0mm in length. In the upper cervical cord (C1-C4), axon terminals were observed in the gray matter of laminae VIII and IX of Rexed, and they made direct contact with the proximal dendrites and cell bodies of motoneurons. In the lower cervical cord (C5-C8), axons of LVSTNs were divided into two types; medial and lateral types. Medial type: This was the most popular type (65%). Most of the axon branches projected to laminae VII and VIII. Some of them projected directly into the contralateral gray matter through the anterior commissure. Lateral type: The axon branches of this type projected to lamina IX and made direct contact with the proximal dendrites and cell bodies of motoneurons in this lamina.
In order to understand the actual state of Japanese cedar pollinosis in all cities, towns and villages in Wakayama Prefecture, 30 serum samples were randomly collected from each of 50 municipalities of Wakayama Prefecture for investigating the frequency of sera giving positive RASTs to Japanese cedar. The results were as follows. 1. Unlike juniper or mite, the frequency of positive RASTs to Japanese cedar reached a peak in their twenties. The frequency of RAST positive subjects decreased with increasing age. 2. The frequency of subjects who showed Japanese cedar-specific IgE by RAST varied in different municipalities. As a whole, the frequency was high in the mountainous regions and low in the coastal regions. It was high in the southern part of the prefecture, so-called Kinan District. 3. The frequency of subjects with positive RASTs to Japanese cedar was positively correlated with the area of Japanese cedar grove and with the total area of Japanese cedar and Japanese cypress groves in cities, towns or villages. 4. The relation between positive RAST reactions and weather conditions was investigated. In coastal regions where there were many RAST positive subjects, the wind blew most frequently from the mountain side in February through April. There was no relation between the sunshine duration or mean atmospheric temperature and the frequency of positive RAST reactions to Japanese cedar. Subjects giving positive RAST reactions were frequently seen in places where the mean wind velocity was high (January, April, May, June, August, September, October) and where the quantity of precipitation was large (February, March, April, July, December).
Among non specific granulomas of the larynx, those, whose main cause seems to be vocal abuse, are usually called "Contact Granuloma". Our report deals with a) 14 cases we experienced and their clinical analysis, b) statistics of hitherto reported cases, c) one rare case, in which we find squamous cell carcinoma subsequently to contact granuloma. Among 14 cases, 11 cases are male, and 3 female. Male predominantly suffer this desease. Patient age ranges from 32 to 62, and there are no cases in younger generation. These inclination is almost the same as were reported before. As for the clinical symptoms, it is characteristic that the degree of hoarseness is remarkably low compared with the size of the tumor. We guess that the reason for this is the location of the tumor. The tumor is not just at the level of the glottis, but a little upper or lower the glottis. Therefore, it is not until the mass grows relatively large, that it comes to the glottis and interferes the vibration of the vocal cord. Another characteristic symptom is that many patients complain of sudden interruption of their phonation. We believe that this symptom can also be accounted for by their location.
Sixteen cases of Ramsay Hunt syndrome were investigated concerning the prognosis of facial nerve palsy, hearing impairment, and vestibular disorder. The satisfactory prognosis of facial nerve palsy was achieved in those cases which a good response was evoked by the maximal stimulation test as well as in cases of Bell's palsy. And also, the satisfactory prognosis of hearing impairment was achieved in those cases which showed a well-developed auditory whole nerve action potential and a well-developed cochlear microphonics the electrocochleography as well as in cases of sudden deafness. On the contrary, both facial nerve palsy and hearing impairment showed unsatisfactory prognosis in those cases which there was a low amplitude or even no response. Thus, satisfactory prognosis was achieved in those cases which showed well-developed responses induced by an intensive stimulation. This phenomenon is suggestive of the pathophysiology of reversible impairment of sensorineural elements. However, no correlation among the prognosis of facial nerve palsy, hearing impairment, or vestibular disorder was observed.
Bone reconstruction with ceramics after the removal of carcinoma in the head and neck was performed and the results were discussed. Among the cases we treated, 8 patients received jawbone excision due to cancer of the tongue and the oral cavity, and 2 received removal of the orbital floor due to cancer of the maxilla. Ceramics we used were hydroxy apatite for 3 cases with jawbone reconstruction and alumina ceramics for the other cases. Approximately half of the patients showed better result in jawbone reconstruction. The major cause of poor result was necrosis of skin or mucosa that covers ceramica. Therefore, it seems probable to apply myocutaneous flap which may allow better blood circulation. Furthermore, considerations should be given to the dose of irradiation and ischemia from operation and postoperative infections. The affinity between ceramics and bones was found satisfactory and operative invasion accompanying self bone collection did not exist in this method. Thus, this method appears effective and allows bone reconstruction with arbitrary size and shape.
In order to clarify the, pattern of spread in the cavity and neck metastasis of hypopharyngeal cancer, submucosal lymph flow and its drainage from the cavity were experimentally studied using dye injection method. Pick up of RI into each group of cervical lymph node from the hypopharyngeal cavity was quantitatively investigated in patients with a variety of head and neck cancers but intact hypopharynx when the nodes were extirpated by prophylactic neck dissection. Results obtained are as follows: 1. There are two kinds of lymph channel in the submucosal layer of the hypopharynx : superficial capillary and deeper channel that has a larger diameter. 2. Lymph flow in the capillary channel disseminates in every direction, while that in the deeper channel shows a directional preponderance to the specific way. 3. In the pyriform sinus and the posterior hypopharyngeal wall, it flows upward to the oropharynx, while in the postcricoid, it flows to the same way and also downward to the cervical esophagus. 4. Lymph of the hypopharynx drains mainly through minute lymph vessels that accompany with the internal branch of the superior laryngeal nerve and also through those along the recurrent laryngeal nerve. It seems most likely that there are additional routes of drainage through oropharyngeal cavity and the thyroid gland. 5. Lymph of the hypopharynx flows primarily into deep cervical and paratracheal nodes, and also into submandibular, submental, prelaryngeal and pretracheal nodes probably through the orophar ynx, thyroid gland and cervical esophagus. 6. Metastasis from hypopharyngeal cancer may occur in any group of cervical node. 7. Histopathologically positive nodes in ipsilateral and contralateral necks of the patients with hypopharyngeal cancer were found in 70% and 31% respectively. 8. It seems reasonable that bilateral neck dissection must be applied in all cases of hypopharyngeal cancer but well differentiated T2.