The purpose of this study was to determine the effects of vascular occlusion on the cochlear blood flow and auditory brainstem response (ABR) in the cat basilar artery system. Any occlusion in the basilar, anterior inferior cerebellar, or internal auditory arteries had chances of decreasing the cochlear blood flow, in which case the extent of the depression of the waves I and II of ABR was proportional to the blood flow decrease. This results suggests attention should be payed to the ischemic cochlear involvement in evaluation of the brainstem pathology using ABR.
Twenty-one cases of isolated medial orbital wall fractures were reported and CT findings by coronal planes were evaluated as to the effects of fractures upon the ethmoidal cells and nasal meati. Three coronal planes, which respectively contain such structures as Agger nasi, Pars membranacea and superior meatus, were selected for the study. The extent of fracture was evaluated by dividing the medial wall into three equal portions, i.e., superior, middle and inferior. The prolapsed volume was evaluated in three classes of occupying 1/3, 2/3 and 3/3 of the ethmoid. The presence of soft tissue density was recorded at the three surfaces, upper, medial and lower, around the prolapsed orbital content. The extent of the fracture was most often seen in such cases as involving all the three divisions in 41. 3%. The prolapsed volume occupying 1/3 was seen in 28. 6%, and 2/3 in 23. 8%. The presence of soft tissue density was seen in 38. 1% of upper surface, in 36. 5% of medial, and 11. 1% of lower. Summarizing the total effects of the fractures, the coronal plane containing Pars membranacea was most severely damaged followed by the plane of the superior meatus. Two rare cases of fronto-ethmoidal mucoceles, caused by the traumas of 23 and 14 years before respectively, were also included and reported. The ophthalmological prognosis was favorable in 90. 5% of cases by observations extending more than 6 months. Five cases were surgically treated including two cases of mucoceles. It follows from the present study that the main stay in the treatment for the medial orbital wall fracture is conservative and selective indications for the surgery is the persistent and annoying diplopia in spite of about two weeks' observations.
Glycoconjugates are essential for normal functioning of the mucociliary defence system of the tubotympanum. Recently, terminal glycosylation sequences of glycoconjugates have been recog- nized for their role in mediating biological recognition, such as serving as a receptor for bacterial adherence. In this study, neuraminidase and 6 different lectins: Wheat germ agglutinin (WGA), Limaz flavus agglutinin (LFA), Sambucus nigra agglutinin (SNA), Peanut agglutinin (PNA), Ricinus communis agglutinin-I (RCA-I), and Concanavalin A (Con A), were used to characterize histochemically the carbohydrate structures of glycoconjugates of the chinchilla tubotympanum. WGA, LFA, SNA, and RCA-I strongly labeled epithelial goblet cells, glandular mucous cells, cell surfaces, and mucous blanket. PNA weakly labeled only a small number of epithelial goblet cells and glandular mucous cells, and did not label cell surfaces. After neuraminidase treatment, PNA labeled large number of these secretory cells and cell surfaces. Con A predominantly labeled glandular serous cells, epithelial dark granulated cells, and cell surfaces, and also labeled dark cores of mucinous granules. These results revealed that : sialomucin are produced from glandular mucous cells and epith- elial goblet cells and are present on cell surfaces and within the mucous blanket ; their terminal trisaccharide linkage appears to be the sequence Neu5Ac (a2-6) Gal (B61-3) GaINAc and serum type glycoproteins are produced from glandular serous cells and dark cores of mucinous granules.
Auditory brainstem response (ABR) and auditory middle latency response (MLR) in 128 patients were recorded during the surgical operation which was performed under the various anesthetic methods and conditions. The relation between the anesthetic methods and the charac- teristics of the auditory evoked responses was investigated. From the results, the anesthesia could be classified into following three types : type A such as enflurane-nitrous oxide-oxygen and halothane-nitrous oxide-oxygen anesthesia by which both ABR and MLR were affected, type B such as thiamylal and diazepam anesthesia by which only MLR was affected, and type C such as neuroleptanesthesia (NLA), high dose fentanyl, ketamine, althesin, spinal and epidural anesthesia, by which both ABR and MLR were not affected. Therefore, when ABR and MLR are recorded as a monitor of the eighth nerve surgery, NLA would be the most adequate and available method. On the other hand, it was proved that ABR and MLR were markedly affected by the decrease of body temperature. Therefore, the decrease of body temperature should be taken into considera- tion when the auditory evoked response of comatous patients was monitored.
Previously the author reported the immediate development of endolymphatic hydrops (e. hydrops) following direct challenge of secondary antigen to the endolymphatic sac (ES) in guinea pigs, during the early phases of postchallenge, ranging from 1 to 5 weeks. The present study reports the results of specimens taken up to 10 weeks postchallenge, and correlation of e.hydrops to perilymph in antigenspecific antibody levels. From the present results, mechanisms of e.hydrops induced ES immune reaction are suggested as follows. 1) In the early stage of e.hydrops, an acute inflammatory reaction in the ES may produce endolymph by an increased vascular permeability of the inner ear and may impaire endolymph absorption from the ES. 2) In the latter stage of e.hydrops, the moderate cellular infiltration in the ES may cause chronic impairment of endolymph absorption in the ES.
Mucosal bridge of the vocal fold is a newly recognized laryngeal disease need to be differentiated from the functional voice disorder. A 16-year-old woman with deteriorating hoarseness presented for indirect laryngoscopy and laryngofiberoscopy of just slight swelling of the bilateral vocal folds. Since the laryngeal stroboscopy revealed the decrease of wave formation at the swelling portion, we performed an endolaryngeal microsurgery and discovered a sulcus in a side of the vocal fold and a mucosal bridge in the other side. Resection of the bridge followed by the voice therapy increased the voice range and decreased the hoarseness. This case suggests that the laryngeal stroboscopy and microscopic examination with direct laryngoscopy are the most impor-tant for diagnosing the mucosal bridge of the vocal fold.
Pyogenic granuloma is one of the diseases sometimes seen in otorhinolaryngology clinics. The clinical features of this disease are understood to be that the lesion is located in the oral cavity in the majority of cases that its causative agent is usually discovered and that it most likely grows as a malignant tumor. However, the entity of pathological diagnosis has not been established. Thirty-one cases of oral pyogenic granuloma, including 16 males and 15 females, are reported in this paper. The granuloma was located most frequently at the tongue, followed, in order, by the gingiva, buccal mucosa, hard palate, lip and oral floor. The period between the patient's first visit to our clinic and the onset of his/her complaint was variable. It was relatively shorter in those cases with the lesion at the gingiva or tongue as compared to other locations. The size of the lesion was smaller than 10 × 10 mm. We classified the pathological features into three patterns ; granuloma type, hemangioma type, and intermediate type. Many cases of lesions located at the back of the tongue, buccal mucosa, or hard palate were of the hemangioma type, while many cases of lesions located at the top of the tongue, gingiva, or oral floor were of the granuloma type. We have the impression that pyogenic granuloma could be one of the purulent changes associated with benign oral tumors.
One-stage reconstruction of head and neck defects following radical surgery was performed for two patients with the peroneal flaps which had the peroneal artery, vein and their branches as a pedicle. These flaps were viable without any post-operative complications. The advantages of these flaps are described as follows. (1) The subcutaneous fat is thin, and thus the flap is flexible and not bulky. (2) The diameters of the peroneal artery and vein are relatively large and the pedicle is long. (3) A pretty large size of the flap can be utilized. (4) A relatively long bone can be obtained together with skin at the same time, and the angle of the fibula can be easily changed. (5) Bleeding is little when the flap is taken out. (6) The resection of the tumor and the harvest of the flap can be done at the same time, due to different surgical areas. (7)The skin graft to the donor defect is not necessary, and the defect can be closed at one-stage. (8) The donor site does not stand out. Thus, this method is cosmetically excellent. This procedure has many advantages. Reconstruction with the peroneal flap offers a safe, reliable, and versatile method.
Vascular architectur of tumors in experimental animals has been studied in detail. However, the reports on architecture of the capillaries in human carcinoma in the head and neck regions are few nowadays. In this paper architecture of the blood vessels reproduced by using methacrylate casting medium in human carcinoma of the tongue was studied by scanning electron microscopy. Tortous capillaries and loop-like vessels were observed at the proliferative area of the tumor on the surface of the tongue. There were avascular zones around the vessels of the tumor characterizing irregular proliferation. The vessels of sinusoidal, tapering, distorted and disrupted characters were seen in the muscle layer of the tongue. Ruptured vessels and viable tumor-cells were observed at the areas surrounding necrotic lesions. These findings elucidated combination of verious kinds of architectures of vessels in various stages of tumor-growing. Existence of the avacular area suggests that proliferation of tumor-cells proceeds before proliferation of the capillaries. Both avascular and necrotic changes in the structure might reduce the effects of anti-cancer agents.
The location and vector moment of the equivalent current dipoles of ABR (wave V) evoked by unilateral acoustic stimuli were estimated in normal adults with the Dipole Tracing (DT) Method. The ABR's were recorded through 21 electrodes arranged according to the international 10-20 standard. The DT method is based on a realistic head shape with uniform volume conductor and individual differences of the skull were corrected for afterwards. The 3-D dipole locations were plotted on the cross-sectional MRI data of the subject. As a result the dipole of the wave V of auditory brainstem responses was found near the contralateral midbrain.
Afferent fibers from the larynx traverse through the superior layngeal nerve (SLN) and the inferior layngeal nerve (ILN), and the parent cell bodies of these fibers are located in the nodose ganglion (NG). However, the exact location and form of these neurons in the NG have not been clarified. The aim of this study is to determine the exact location and form of the sensory neurons in the canine NG which send fibers to the laryngeal nerves, using the retrograde tracer technique with wheat germ agglutinin-horseradish peroxidase (WGA-HRP). The cell bodies sending sensory fibers to the internal and external branches of the SLN (SLNI & SLNE) were localized on the rostro-lateral side of the NG, but the cell bodies sending fibers to the ILN were widely distributed. These findings suggest that the location of cells does not reflect differences in the roles of the cells, but is due to the courses of nerve fibers. The cell bodies sending sensory fibers to the SLNI accounted for about 11% of all cells in the NG ; about 0. 1% of cells sending fibers to the SLNE ; and about 0. 2% in the ILN. The cell bodies sending sensory fibers to each laryngeal nerve varied in size, from 15 to 60, um, suggesting differences in the roles of these cells.
The mechanism of induction of antitumor activity by local administration of recombinant interleukin-2 (rIL-2) combined with cisplatin (CDDP) was investigated in order to establish a method of immunochemotherapy against head and neck cancer. Local administration of r1L-2 had significantly greater inhibitory effects on tumor growth in both Meth A and C26 tumor bearing mice than did systemic administration. The cytotoxic activity of tumor infiltrating lymphocytes (TILs) obtained from C26 tumor bearing mice was studied. Local injection of rIL-2 around the tumor site for 4 days induced augmentation of the cytotoxicity of TILs not only in NK sensitive tumors but also in NK resistant C26 tumors. This phenomenon was not observed in spleen cells. Both negative selection assay and cold target inhibition assay revealed that the effector cells were tumor nonspecific asialoGMl positive activated NK cells. Additional experiments were performed to determine the effectivenss of combined immuno-chemotherapy using CDDP and rIL-2 in C26 tumor bearing mice. The intraperitoneal administra-tion of CDDP following the local administration of rIL-2 was more effective in suppressing tumor growth and in promoting well-survival than the use of CDDP or rIL-2 alone. To investigate the mechanism of antitumor activity, the effects of CDDP on the tumor cells and immunological changes were observed in tumor bearing mice. The susceptibility of tumor cells to effector cells was enhanced after in vitro culture with CDDP. In vivo administration of CDDP augmented the cytotoxic activity of effector cells and responsivenss to IL-2 of TIL. These results suggest that local immunochemotherapy using locally administered rIL-2 com-bined with CDDP may be available as a therapy for head and neck cancers.