Inner ear decompression sickness (IEDCS) is one form of Type II decompression sickness.
Most cases of IEDCS have been associated with saturation dives, so there are very few reports of occurrence following shallow scuba dives.
We present here the case of a diver who sufferred from IEDCS following a shallow scuba dive (30m), and was successfully treated by the protocol outlined in U.S. Navy treatment table 6.
This case suggests that there is the possibility of occurrence of IEDCS, even following a shallow scuba dive, if proper decompression procedures are not adhered to. In addition, detailed analysis of diving profiles should be used to distinguish the inner ear dysfunction seen in some divers from inner ear barotrauma which may be attributable to IEDCS.

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A 50-year-old woman with adenoid cystic carcinoma of the nasal septum is presented. Her chief complaint was recurrent epistaxis. Surgery was originally performed to remove a nasal polyp, but during resection, the surgeon discovered that the mass had arisen from the nasal septum, so only a biopsy was done. The pathological report was adenoid cystic carcinoma, so she was referred and admitted to our hospital.
A flat 1.5×1.5cm tumor was recognized on the left side of the nasal septum. Nasal septectomy was performed. The tumor was dissected with nasal septal cartilage, and the defect was covered with a free skin flap from the thigh.
The incidence of malignant tumors from the nasal septum is very low, composing from 2.7% to 8.4% of nasal and paranasal malignant tumors. Therefore the incidence of adenoid cystic carcinoma in particular is very low.

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Three-component analysis of caloric nystagmus, focusing on horizontal, vertical, and torsional directions, using a newly developed computerized eye movement analysis system was carried out in ten normal human subjects. The caloric response was induced by cold stimulation to the right ear while the subjects were in supine and prone positions. The directions of the three components of nystagmus, were left in ten subjects (10), upward (8) or downward (2), and clockwise (10) in the supine position. In the prone position, on the other hand, the three components were directed toward the right (10), downward (5), upward (3), and counterclockwise (10) or were not present (2). These findings indicate that caloric stimulation activates the three semicircular canals simultaneously. In addition the changes in the direction of nystagmus in the supine and prone positions could not be explained in detail by the convection theory of caloric response alone.

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The relationship between the rate of speech flow and speech intelligibility was investigated in normal and hearing-impaired subjects. It is usually observed that a slowly and clearly delivered speech is easier for hearing-impaired patients to understand. The purpose of this paper is to analyze this phenomenon clinically and to present useful data for developing new hearing aids.
Four or 5 syllabic words lists were prepared for this experiment and speech stimuli were chosen from these lists. The subjects consisted of 15 normal subjects and 79 hearing-impaired patients (57 with inner ear hearing loss and 22 with retrocochlear hearing loss). Hearing tests were performed using a tape recorder with various speech control systems in a soundproof room. Speech samples were presented at three speaking rates, that is, a conversational speech rate, a rate one and a half times as fast as the conversational speech rate and a rate twice as fast as that rate.
The results obtained in the normal subjects confirmed that the faster the speaking rate was, the more the word intelligibility was reduced. According to the results in the hearing-impaired subjects, both the correlation coefficient and regression parameter between the word intelligibility in this experiment and speech discrimination scores measured by 57S-monosyllabic lists were low at the conversational speaking rate, but the higher the speaking rate was, the closer the relation between the both factors was. It was estimated by analizing the data of inner ear hearing loss and retrocochler hearing loss separately that the subjects with retrocochler hearing loss had more difficulty in speech-mediated communication than the subjects with inner ear hearing loss.

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In order to develop a more objective method of evaluating the origin of adenolymphoma, we immunohistochemically investigated the expression of cytokeratins, vimentin, S-100 protein, and α-smooth-muscle actin using the avidin-biotin-peroxidase (ABC) method in ethanol-fixed paraffin-embedded specimens from 8 adenolymphomas. Several kinds of monoclonal antibodies which react monospecifically with each subclass of cytokeratins were used. Results were compared with specimens of 8 normal parotid glands by radical neck dissection in patients with other diseases who had not undergone radiotherapy.
In the adenolymphoma specimens, basal cells were strongly positive for CK-6, but reactivity of columnar cells was apparently reduced. In contrast, columnar cells were strongly positive for CK-7, but reactivity of basal cells was reduced. In normal parotid gland specimens, CK-7 was also detected in all columnar cells in the ductal system, although some duct cells around the columnar cells, which showed strong CK-6 expression, showed poor CK-7 expression. α-smooth-muscle actin was present in myoepithelial cells in normal parotid gland specimens, but not in basal cells of adenolymphoma or of the normal ductal system, which were CK-6-positive. As these characteristic findings were consistently observed in all specimens, the demonstration of CK-6, CK-7, and α-smooth-muscle actin may be useful in the recognition and classification of columnar and basal cells. CK-8 was present in both columnar and basal cells of adenolymphoma and of the normal duct, but in the normal parotid gland, acinus cells were also strongly positive for CK-8. On the other hand, acinus cells in normal parotid glands were negative for CK-19, although both columnar and basal cells of adenolymphoma and of the normal duct were strongly positive for CK-19. The expression patterns of CK-3, -13, and -18 were similar to that of CK-19. All cells in adenolymphoma and normal parotid gland were uniformly negative for CK-1, -4, -10, -11, and -14, vimentin, and S-100 protein.
In adenolymphoma, staining patterns of all cytokeratins and other proteins investigated generally resembled their distribution in the corresponding portion of the normal parotid gland ductal system. Since our results revealed no differences which would support a bi-cellular theory regarding the origin of adenolymphoma, we suggest that basal cells, which can be recognized by CK-6 expression in the ductal systems of normal parotid glands, should be investigated further to determine the origin of adenolymphoma.

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Recently, ceramic prostheses for ossicular replacement have become very popular in middle ear surgery. These prostheses have a good affinity with the surrounding tissue. But, it is difficult to identify the position of these prostheses postoperatively. We used magnified tomography in order to identify the implanted ceramic prostheses, and to determine whether these prostheses were in the appropriate position. In the case of patients without stapes, we usually use Apaceram type T, which restores ossicular continuity to the inner ear. When the shaft of the ceramic prosthesis is placed on the oval window niche, the overhanging Fallopian canal obstructs the tip of the prosthetic shaft to obtain the appropriate place in the oval window. The angle of the shaft should be slightly tilted inferiorly against the medial wall of the middle ear cavity.

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Pollinosis is known as a hereditary disease. Recently, association of HLA antigens and pollinosis caused by several pollen allergens has been reported. Furthermore, HLA antigens are considered to have a very important role in the development of pollinosis.
We performed an HLA population study and tested the lymphocyte proliferative response (LPR) to birch pollen allergens with birch pollen allergic patients and healthy control subjects.
The results of the HLA population study indicated that HLA-DR9 and HLA-DQw3 correlated with the development of birch pollinosis (relative risk [R. R]=6.37 for DR9 and R. R=7.92 for DQw3).
DNA typing revealed that serotype DQw3 in patients were DQw9 specific.
Two sources of birch pollen allergens, betula pendula and betula platyla var. japonica, were used in LPR. Lymphocytes from the patients, but not from the healthy control subjects, proliferated in response to these two allergens.
Anti-HLA-DR antibody, but not anti-HLA-DQ antibodies, inhibited the patients' LPR. These results suggest that the HLA-DR molecules are responsible to present the pollen specific antigen to T lymphocytes inducing LPR in the patients. Furthermore, in some of the healthy control subjects, anti HLA-DQ antibodies enhanced this LPR almost to the same level as that of the patients'. This result indicates that HLA-DQ molecules might be associated with the suppression of T cell proliferation.

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Recently, "Biopty-Gun" technique has been introduced as a new biopsy technique specially in urological field. We applied it to obtain histopathological specimens of head and neck lesions. 25 specimens were taken with 18-gauge needle, using ultrasonic guidance in cases where the targets were very close to arteries or very small or cystic lesions. All these 25 specimens could be obtained without any complication such as crushing of tissue and they were all sufficiently clear and high-quality specimens. In 23 of these 25 specimens, exact histopathological diagnosis could be made. "Biopty-Gun" minimizing possible movement of tissue which may often occur with the conventional biopsy technique, permitted obtaining tissue specimens without crushing or damaging cells of tissue to be sampled, and it was concluded to be a highly safe and useful biopsy procedure.

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Albino and pigmented guinea pigs were compared in terms of susceptibility to acoustic trauma. The animals were exposed to a 4kHz pure tone of 120dB for 60min. Nl thresholds of CAP were measured before and after the acoustic exposure. Changes in the outer hair cell and stria vascularis were studied using SEM and TEM. After acoustic trauma, Nl thresholds were more elevated in the albino than in the pigmented guinea pigs. Also, pathological changes in the outer hair cell and stria vascularis were more severe in the albino animals. A noteworthy finding in the stria vascularis was that the melanin in intermediate cells had moved into marginal cells. This melanin migration may be possibly involved in mechanisms underlying prevention of acoustic trauma.

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Pigs are frequently used in basic studies of the middle ear because they have a middle ear air cell system which resembles the human mastoid air cell system. However, the morphology of epithelial cells of the middle ear of pigs has not been thoroughly studied. In this study, the morphological features of the mucosal epithelium of the normal porcine middle ear from juveniles to adults were investigated by scanning and transmission electron microscopy. The features were compared with the mucosal epithelium of the human middle ear. Macroscopic observation of the resected middle ears showed all normal.
The mucoepithelial cells of the normal porcine middle ear consisted of ciliated cells, nonciliated cells, secretory cells and basal cells.
Ciliated cells were distributed most densely in the Eustachian tube and tube orifice of the middle ear cleft, decreasing in number towards the air cell system, where no ciliated cells were found. The distribution of secretory cells was similar to that of ciliated cells, while non-ciliated cells distributed conversely.
Ciliated cells of juvenile pigs had 40 to 100 cilia 5 to 6μ in length and 0.2 to 0.3μ in thickness and microvilli on the cell surface. On the other hand, pigs 4 weeks old or older, had ciliated cells with 80 to 100 cilia 5 to 8μ in length and 0.3 to 0.4μ in thickness. Younger pigs had a smaller range of ciliated cell distribution. The range increased with growth, and rapidly expanded by 2 weeks after birth; then the expansion slowed down to 4 weeks, when the distribution was similar that in maturity.
Comparsion of the results with mucoepithelial cells of the human middle ear revealed that the mucoepithelial cells of the middle ear in pigs are similar to those of human on the basis of the basic sturucture of mucoepithelial cells, morphology of individual cells and cell distribution of humans. These features make them suitable experimental animals for basic studies of the middle ear. The findings that ciliated cells of juvenile pigs have smaller, shorter and fewer cilia with a narrower range of distribution then those of adult pigs show the morphological immaturity of these cells in juvenile pigs. Because mucoepithelial cells of the porcine middle ear are morphologically similar to those in humans, morphological immaturity of ciliated cells should be considered one of the factors contributing to increased susceptibility otitis media in children.

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In previous studies, the morphology of the mucoepithelial cells of the middle ear of normal pigs has been found to be similar to that of humans. In this study, otitis media was induced in 18 ears by transcanal injection of glycerin into the middle ear cleft and morphological changes were investigated by scanning and transmission electron microscopy.
The mucoepithelial cells of the inflamed porcine middle ear consisted of ciliated cells, nonciliated cells, secretory cells and basal cells, and the distribution of these cells was similar to that of normal cases.
In the inflamed Eustachian tube and middle ear cleft, the epithelial cells were detached, the intracellular junctions ruptured and there was subepithelial thickening in some places. In addition, the cilia were detached or deformed irregularly. On the other hand, ciliated cells, bulging non-ciliated cells, secretory cells and columnar cells were increased in numbers. These features suggested that the muco-ciliary system of the inflamed ears had been stimulated.
In the air cell system, however, there were signs of mucoepithelial cell injury, but no evidence suggesting that the muco-ciliary system had been stimulated as in the Eustachian tube or middle ear cleft.
The inflammatory changes in the mucoepithelial cells in the Eustachian tube and middle ear cleft gradually returned to normal but in the air cell system, the changes were persistent. Morever, the signs of mucoepithelial cell injury remained longer when inflammation occured at a younger age.
These results suggest that inflammation involving the air cell sytem, where there is no muco-ciliary system, is prolonged more readily than in the Eustachian tube or middle ear cleft, which have a muco-ciliary system. These findings correlated well with the clinical findings that we commonly see during middle ear surgery, that is the existence of granulation tissue and subepithelial thickening in the mastoid air cell system in spite of slight inflammatory changes in the middle ear cleft and ear drum. This results from the disparity in muco-ciliary function due to differences in cell distribution between the Eustachian tube, middle ear cleft and air cell system.
Because of the morphological similarity between pigs and humans, the morphological immaturity of ciliated cells demonstrated in previous studies is considered to be one of the factors contributing to the comparative prolongation of otitis media in children.

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In spite of a large number of electrophysiological studies into the vestibulospinal (VS) effects on the spinal cord, there are far fewer anatomical studies on the VS projections.
The present study was undertaken to determine the origins and descending pathways of VS neurons in the cat, using a retrograde labelling technique of horseradish peroxidase (HRP) combined with a lesion in the lower brainstem. HRP was applied unilaterally into the cervical or lumbar spinal cord and either the medial longitudinal fasciculus (MLF) or the lower medulla oblongata, sparing the MLF, was dissected.
In all cases, HRP-labelled neurons were located in two distinct areas of the vestibular nuclear complex, the rostral and caudal areas. In the rostral area, HRP-labelled neurons after dissection of the MLF appeared in the ipsilateral lateral (LN), medial (MN) and descending nuclei (DN), on the same side as HRP insertion into the spinal cord, but somatotopical arrangement was not seen in the present study. Labelled neurons in the rostral part after impairment of a wide area of the lower medulla, though sparing the MLF, were seen bilaterally in the areas bordering the LN, MN, DN and superior nuclei. In the caudal area, HRP-labelled neurons were seen bilaterally in the caudal thirds of the MN and DN, and these projected to the lumbar spinal cord.
Therefore the origins and descending pathways of the VS tracts were considered to be different from those shown in previous anatomical studies.

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