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Volume 98, Issue 6
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YUKO HATA, TAKASHI FUKAYA1995 Volume 98 Issue 6 Pages 931-936,1073
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSBoth the furosemide test, and the glycerol test have been reported as being effective for detection of endolymphatic hydrops. In the furosemide test, the caloric test is performed first, and then repeated 40 minutes after i.v. injection of furosemide, 20mg. The maximum velocities of each caloric nystagmus are compared, so the caloric stimulus conditions must be constant. In the original method, the caloric test is performed by irrigation with 50ml of water at 30°C or 44°C for 20 seconds. Since it is difficult to accurately maintain the water temperature at a constant level, however, we use the air caloric stimulator NCA-105 (ICS) for the furosemide test. By using this stimulator, we can always perform the caloric test under the same conditions.
The conditions of air irrigation in 28 normal subjects were set at 37±11°C, 61/min., and 60 seconds. These conditions were confirmed in other normal subjects to fairly well correspond to water irrigation (30°C or 44°C, 50ml, 20 seconds).
Next we reassessed the furosemide test by using the air caloric stimulator in normal subjects. As a result. positive effects were observed in 7.4% of the normal subjects. This finding was similar to that reported in the literature (Futaki et al., 1971).
The air caloric test is considered to be a more useful examination than the water caloric test because it is less unpleasant for the subject and easily provides the same conditions before and after furosemide administration.View full abstractDownload PDF (599K) -
TAKAYUKI NAKANO, TAKESHI KUSUNOKI, KUNIHIKO FUNASAKA, KIYOTAKA MURATA, ...1995 Volume 98 Issue 6 Pages 937-941,1073
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe activity of type I and IV collagenase was measured in thyroid tissue obtained from 6 non-diseased thyroids, 4 patients with Graves' diseases, 5 with follicular adenoma, 6 with papillary carcinoma and 4 with follicular carcinomas. The relationship between these enzyme activities and invasion or metastasis of the original tumors was studied. The activity of type I collagenase in papillary carcinomas and follicular carcinomas was higher than in non-diseased thyroids, Graves' disease and follicular adenoma. Carcinoma tissue with invasion beyond the capsule in particular had higher type I collagenase activity. Type IV collagenase activity in carcinoma with lymph node metastasis was higher than in non-diseased thyroids, Graves' disease and follicular adenoma, and especially higher than carcinoma without lymph node metastasis. These findings suggest that increased type I collagenase activity plays an important role in local invasion in thyroid carcinoma, and that increased type IV collagenase activity plays an important role in lymph node metastasis.View full abstractDownload PDF (573K) -
AKIMITSU KAWAI1995 Volume 98 Issue 6 Pages 942-950,1073
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSIt is commonly accepted that the endocochlear DC potential (EP) of the cochlea is generated by electrogenic transport of potassium ion into the scala media from the marginal cells of the stria vascularis. In recent years, many models of the marginal cell have been developed in which the EP is generated by an electrogenic ion transport system localized in either the basal or apical membranes of the marginal cell. On the other hand, Salt et al. reported that EP cannot be generated by the marginal cells alone but, rather, may involve passive potassium movement across the apical membranes of basal cells. In this study, the effect of Nicorandil, a potassium channel opener, on EP and cochlear microphonics (CM) were investigated by perfusion through the perilymphatic space of the guinea pig from the scala tympani to the scala vestibuli with an artificial perilymph. The results of several concentrations were examined. Characteristic of Nicorandil, a vasodilatory agent, is an increase in membrane potassium conductance due to the opening of plasmalemma ATP-regulated K+ channels in cardiac muscle and vascular smooth muscle. This effect results from the membrane hyperpolarization and consequent reduced opening probability of voltage-dependent Ca2+ channels.
When the perilymphatic space was perfused with a solution containing 1×10-4M Nicorandil, the EP level decreased from 74.8±2.4mV to+50.0±12.8mV and the CM amplitude fell to 78.6% of the control. At a concentration of 5×10-4M, EP decreased from 77.8±4.1mV to 47.0±7.6mV and CM amplitude fell to 16.7%. At 1×10-3M, EP decreased from 78.3±1.7mV to 8.8±5.4mV and CM fell to 28%. At all concentrations tested, CM gradually declined in parallel with the EP. In one out of four preparations, a decrease in EP produced by 1×10-4M Nicorandil was reversed to the initial level after washout of Nicorandil by the control artificial endolymph perfusion. When the concentration of Nicorandil was 1×10-3M or higher, interruption of perfusion did not bring about a recovery of EP but did stop any further decrease in the EP.
These results suggest that a reactive channel for Nicorandil, functioning as an ATP-regulated K+ channel opener, exists in the stria vascularis or the organ of Corti.View full abstractDownload PDF (1203K) -
CLINICAL IMPLICATIONS FOR SUDDEN VERTIGONORIAKI TAKEDA, IZUMI KOIZUKA, MIKIKO KOHNO, SUETAKA NISHIIKE, TAKESHI ...1995 Volume 98 Issue 6 Pages 951-958,1073
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWe defined sudden vertigo as a sudden, unilateral peripheral vestibular dysfunction. The criterion for its diagnosis is a single episode of vertigo without cochlear and central symptoms. Among 20 patients with sudden vertigo there was no difference in clinical aspects between those with CP (canal paresis) (CP%≥25%) and those without CP (CP%<25%). This suggests that sudden vertigo with CP is due to sudden vestibular dysfunction with predominant involvement of the lateral semicircular canal. Basically, vestibular neuronitis is considered to be due to acute unilateral neuropathy of the vestibular nerve. However, since we have no routine examination for evaluating vestibular nerve function, sudden vertigo with CP should be diagnosed as vestibular neuronitis. We then assessed the prognosis of sudden vertigo with CP (vestibular neuronitis). About two years after the onset of CP 4 of 10 patients had recovered. However, patients with persistent CP had a handicap in their everyday life because of the dizziness induced by head movements. The possibility of recovery of vestibular function in response to steroid therapy may improve the prognosis in vestibular neuronitis.View full abstractDownload PDF (1007K) -
FUYUKI ENOMOTO, GINICHIROU ICHIKAWA, ISAO NAGAOKA, TATSU-HISA YAMASHIT ...1995 Volume 98 Issue 6 Pages 959-967,1075
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSLeukotrienes B4, C4 (LTB4, LTC4) and prostaglandin E2 (PGE2) are arachidonic acid metabolites which are released from various types of cells, and are considered to be the mediators of inflammation because of their potent vascular permeability increasing activity (LTC4 and PGE2) and chemotactic activity (LTB4).
In this study, to evaluate the involvement of arachidonic acid metabolites in otitis media with effusion, we measured the LTB4, LTC4 and PGE2 in rat middle ear effusion (MEE) by radioimmunoassay (RIA).
SD rats weighing about 200g were used. The animals were divided into two groups, and lipopolysaccaride (LPS) or concanavalin A (ConA) was injected into the right middle ear cavity through the tympanic membrane. The left middle ear cavities were injected with 200μl of phosphate balanced buffered saline (PBS) and used as controls.
After stimulation, middle ear effusion and accumulation of inflammatory cells such as neutrophils, macrophages, and lymphocytes was observed in the middle ear cavity. In contrast, no inflammatory cells were observed in the control ears. Proteins exudated into the middle ear cavity after LPS or ConA injection. The protein content increased up to 3 days, and then decreased. Substantial amounts of LTs and PG were detected in experimental rat OME, although hardly and LTs or PG was detected in the control ears or serum. LTs levels increased up to 7 days, and then decreased. PGE2 levels increased up to 3 days, and decreased thereafter. Dexamethasone effectively suppressed protein exudation, cell accumulation and production of arachidonic acid metabolites in thce middle ear.
Thus. LTs and PGE2 are synthesized in the local milieu of the middle ear in otitis media, and probably play an important role in the pathogenesis of OME by virtue of their potent vascular permeability increasing activity and chemotactic activity.View full abstractDownload PDF (2295K) -
HITOSHI HENTONA, JIN OKUBO, HIDEKAZU TANAKA, YUZURU NAKAMURA, ATSUSHI ...1995 Volume 98 Issue 6 Pages 968-973,1075
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe area and volume of the air cell system of fifty normal temporal bones were investigated. The area on a plain X-ray, Sonnenkalb projection, was measured by a planimetric method and a rectangular dimensional method by Imai in 1978. The volumes of the temporal bone air cells on high-resolution CT were calculated separately as partial volumes divided in all CT planes. The sum of the partial volumes was calculated as the total volume of the air cells. The relationship between the area and the total volume of the air cell system was analyzed statistically. The ratio of the partial spatial volume, e.g. the tympanic cavity and the apical air space, to the total volume of the temporal bone air cells was also calculated.
The results were as follows: 1) The relationship between the two measurements were as follows: planimetric method, Y=0.901X-2.26 (r=0.885), and rectangular dimensional method, Y=0.542X-2.57 (r=0.876). 2) The ratio of the volume of the tympanic cavity to the total volume of the air cell system was 6.74±4.07%. The larger the total volume, the smaller the ratio. 3) The ratio of the apical space was 7.09±4.98%, and the larger the total volume, the larger the ratio.View full abstractDownload PDF (922K) -
SHIROH MAGUCHI, MASAHIKO TAKIZAWA, YUKIKO MIYATAKE, YUUJI NAKAMARU, SA ...1995 Volume 98 Issue 6 Pages 974-983,1075
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWe assessed the clinical significance of cANCA in relation to the diagnosis and follow-up of Wegener's granulomatosis patients using NephroScholor C-ANC, the ELISA kit for the detection of cANCA.
The NephroScholor C-ANC test for cANCA was revealed to be useful for the diagnosis of Wegener's granulomatosis, but slightly less sensitive than the indirect immunofluorescence assay using human neutrophils, which has been in widespread use for the detection of ANCAs.
With NephroScholor C-ANC, the cANCA titer can be estimated conveniently and expressed quantitatively. When conventional immunosuppressive therapy with prednisolone and cyclophosphamide was applied, the patients' symptoms subsided as the cANCA titer decreased, and thus it also seemed useful for the follow-up of Wegener's granulomatosis patients. However, a rising ANCA titer during the course of the disease was not always correlated with the occurrence of a relapse as previously reported. Based on these findings, it is not recommended that treatment be changed immediately because of elevation of the ANCA titer alone, and it never seemed too late to increase immunosuppressive therapy, even after a clinical exacerbation was observed.
Several treatments other than the conventional immunosuppressive therapy have often been applied for our patients, especially in the limited type of this disease, and these treatments, including sulfamethoxazole-trimethoprim alone, low-dose prednisolone alone, and cyclophosphamide alone, have often been useful. We conclude that the choice of therapy must depend on the severity or the condition of the individual patient, and this therapeutic policy should reduce unnecessary side effects of potentially toxic drugs.View full abstractDownload PDF (1163K) -
KOSHIRO NAKAMURA, SHINJI KITANI, HIDEMITSU SATO, EIJI YUMOTO, SEIJI KA ...1995 Volume 98 Issue 6 Pages 984-988,1075
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSEndoscopic endonasal surgery was performed on 64 patients (69 sides) with postoperative maxillary cyst. We marsupialized the cyst in the inferior and/or middle meatus to enlarge it as much as possible. To facilitate an easier approach to the cyst wall in the inferior nasal meatus, some patients underwent submucous resection of the inferior nasal concha or inferior turbinectomy. Thirty eight patients (44 sides) were followed for more than six months after surgery and a wide opening was confirmed in 36 (81.8%) of the 44 sides.
Whether we should utilize an endonasal approach or a Caldwell-Luc approach depends mainly on the location of the medial wall of the cyst. We classified the cysts into medial, anterolateral and posterolateral types. Drawing a line between the anterior end of the inferior turbinate and the base of the lateral pterygoid process, on the axial plane of CT at the mid level of the inferior meatus, is the first stop. A medial cyst extends toward the midline across this imaginary line. A lateral cyst is subdivided into anterolateral and posterolateral based on the position of the center of cyst. The endoscopic endonasal approach resulted in excellent outcomes in medial and posterolateral cysts, while this approach was not found to be suitable for anterolateral cysts.View full abstractDownload PDF (2462K) -
HISTOPATHOLOGICAL STUDYYASUHIRO KUDO, KIMITAKA KAGA, HISAO SAKURAI, YASUYUKI OHIRA1995 Volume 98 Issue 6 Pages 989-999,1077
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSNineteen cases of secondary tumor of the temporal bone with involvement of the internal auditory meatus (IAM) were studied. The cases were classified into 4 invasion modes; direct extension from head and neck tumors (12 cases), hematological dissemination (3 cases), diffuse leptomeningeal carcinomatosis (3 cases), and direct extension of tumors from the intracranium (1 case).
There were some differences in the manner in which the tumor had spread among these 4 modes. In most cases involving “direct extension from head and neck tumors”, the tumor had invaded the pyramis, and then the Eustachian tube and the middle ear. When the inner ear or the IAM was involved, it was directly invaded by massive tumor. In all cases of “hematological dissemination”, metastatic tumor was found bilaterally, but there were some differences in the manner of invasion between the two sides. In “leptomeningeal carcinomatosis” and “intracranial tumor”, the tumor had invaded the temporal bone bilaterally via the IAM.
In the IAM, cochlear and inferior vestibular nerves were more vulnerable to tumor invasion than facial and superior vestibular nerves. It was suggested that there are some differences in vulnerability to tumor invasion between the superior and inferior vestibular nerves.
The bottom of the IAM presented a barrier-like effect against the spread of tumor from the IAM to the labyrinth. In some cases, however, there was massive tumor invasion of the internal ear directly from the IAM.
Whether denervation of the ganglionic neurons (spiral or vestibular) causes secondary degeneration of peripheral sensory endorgans remains controversial. In some cases in our series, degeneration of the auditory or vestibular peripheral organs might be attributed to denervation of neurons in the spiral or vestibular ganglia. In other cases, however, auditory and vestibular peripheral organs remained intact despite severe degeneration of ganglionic neurons.View full abstractDownload PDF (5594K) -
NORMAL EARHIDEKAZU EBIHARA1995 Volume 98 Issue 6 Pages 1000-1005,1077
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe middle ear is a cavity surrounded by solid bones, lined with mucosa, which has a gas-filled lumen. Cavernous organs sush as the ear should have their own ventilation system under atmospheric pressure. The mechanism of ventilation in the middle ear has not been sufficiently clarified.
Ventilation performed in the middle ear may be classified into two types: 1) passive ventilation via the Eustachian tube, required in cases of abnormal pressure and 2) unique physiological active ventilation of the middle ear performed under atmospheric pressure and not involving the Eustachian tube. The purpose of the present study is to prove the existence of this active ventilation under atmospheric pressure.
The subjects were 50 normal ears and elevation of middle ear pressure in the lateral position (determined by positional tympanometry) was studied. The change in the peak level, on tympanometry, was used as an index. The results were continuously recorded every 12 seconds.
The following results were obtained.
1. Middle ear pressure was elevated by changing from the sitting to the lateral position. Venous pressure was regarded as a causative factor in this pressure elevation.
2. The elevated middle ear pressure in the lateral position suggested gas production from mastoid cells of the middle ear. The observation that the middle ear pressure was stabilized with the increase in pressure, up to a level of 85-90mm H2O, indicated the existence of gas leakage from the Eustachian tube and a mechanism for controlling gas production from the mastoid cells of the middle ear.View full abstractDownload PDF (520K) -
THE POSSIBILITY OF A PARTICIPATION OF VELOCITY STORAGE AND OTHER NON-CONVECTION FACTORSYOSHIKO TSUCHIYA1995 Volume 98 Issue 6 Pages 1006-1020,1077
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSTo clarify the role of central velocity storage in caloric nystagmus, 20 normal subjects in the lateral recumbent position underwent recording and analysis using ENG and an infra-red video camera in darkness. The caloric stimulus was applied by pouring 10 ml of water at 20°C for 20 seconds into the ear canal. After irrigation, each subject then turned to an ear-up or an ear-down lateral position. Ninety-nine percent of the rapid phases of the horizontal components were directed to the up-side ear with no relation to the irrigated ear. Sixty-six percent of the vertical components showed vertical nystagmus toward the lower eyelid, and the remaining 34% of the vertical components showed no vertical nystagmus. The direction of the torsional components was from the up-side ear to the leg with no relation to the irrigated ear. After the first phase, the nystagmus was more significantly reversed in the ear-up lateral position than in the ear-down lateral position (p<0.01). The maximum slow-phase velocity of the first phase horizontal component and the nystagmus frequency of the first phase horizontal and vertical components were significantly smaller in the irrigated ear up lateral position than in the ear-down lateral position (p<0.01). The maximum slow-phase velocity of the first phase vertical component was also smaller in the ear up lateral position (p<0.05). However, the duration of the first phase vertical component revealed no difference between the two positions.
These findings indicate that factors other than endolymph convection are involved in the first phase horizontal and vertical components. A role for central velocity storage in the vertical components was suggested. When caloric nystagmus was analyzed as one respose, including not only the horizontal component but also the vertical and torsional components, the possibility of otolithic involvement was suggested as one of the non-convection factors.View full abstractDownload PDF (1684K) -
1995 Volume 98 Issue 6 Pages 1021-1031
Published: June 20, 1995
Released on J-STAGE: December 22, 2010
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1995 Volume 98 Issue 6 Pages 1031-1038
Published: June 20, 1995
Released on J-STAGE: December 22, 2010
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1995 Volume 98 Issue 6 Pages 1039-1048
Published: June 20, 1995
Released on J-STAGE: December 22, 2010
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1995 Volume 98 Issue 6 Pages 1048-1059
Published: June 20, 1995
Released on J-STAGE: December 22, 2010
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[in Japanese]1995 Volume 98 Issue 6 Pages 1060-1063
Published: June 20, 1995
Released on J-STAGE: October 22, 2010
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