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Yoshihiro Dake, Hiromu Kakiuchi, Takashi Jinnin, Yutaka Katoh, Toshihi ...
1989 Volume 1989 Issue Supplement33 Pages
1-11
Published: October 20, 1989
Released on J-STAGE: November 27, 2012
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S. pneumoniae has been identified as one of the major pathogens on acute otitis media. It has been shown that the specific antibody against the pathogen protects the middle ear infection and the prolongation of inflammation in animal models. We will review the mechanism of the pathogenesis of otitis media with effusion from viewpoint of the immune defense to bacteria. Childeren with recurrent otitis media have low levels or a deficency of IgG2 subclass and low pneumococcal antibody titer. In chronic otitis media with effusion, pneumococcal anti-IgG antibody levels were low in infants and rose with increasing age. There were no abnormal IgG subclass value. This suggests that an antibody production system against bacterial invasion may not be fully developed in infants and a delayed immune response may associate with otitis media.
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Hiromu Kakiuchi, Yoshihiro Dake, Yutaka Katoh, Takashi Jinnin, Toshihi ...
1989 Volume 1989 Issue Supplement33 Pages
12-22
Published: October 20, 1989
Released on J-STAGE: November 27, 2012
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In middle ear effusion of otitis media with effusion, immunocytes and various soluble substances (immunoglobulin, immune complex, complement, interferon, tumor necrosis factor, immunosuppressive substance, immunosuppressive acidic protein) related to immune response are detected. We reviewed the literature on these immune soluble factors with respect to their effects on otitis media with effusion.
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Takashi Jinnin, Yutaka Katoh, Yoshihiro Dake, Hiromu Kakiuchi, Toshihi ...
1989 Volume 1989 Issue Supplement33 Pages
23-30
Published: October 20, 1989
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We reviewed the literature with respect to local immunoresponses in middle and inner ear. The middle ear is known to be an immunoreactive organ once it has been exposed to the antigenic stimuli and it has been considered to be protected by both the local and systemic immune system. Recently the inner ear especially endolymphatic sac has been reported to be an immunoreactive organ. In both middle and inner ears, antibody-producing cells (IgG-, IgM-, IgA-committed B cells) which contributed for humoral immunity were immunohistochemically demonstrated. In addition, T cells suggesting the involvement of the cellular immune system were also observed in both middle and inner ears.
A concept of mucosal immunity on gut associated lymphoid tissue and br o nchus associated lymphoid tissue is generally accepted. In these mucosal sites IgA immunocytes are mainly observed. IgA immunocytes in the middle ear mucosa and endolymphatic sac have been demonstrated. However the sources of these cells are still not clear. The regional lymph nodes of middle ear may play an important role for the supply of these immunocytes.
The inner ear immunoreaction is also thought to be related to both the local and systemic immunoreactions.
The importance of systmic contributions to middle and inner ear diseases is stressed.
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Yutaka Katoh, Sayoko Kuki, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
31-42
Published: October 20, 1989
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The historical aspect of the progress of screening test for detection of hearing impairment during the fetal stage, neonatal stage, infantile stage and early childhood (2-4 years of age) is reviewed.
The method using intra-uterine sound introduced here is quite useful for detection of hearing loss in the neonate stage. In addition, the role of auditory brainstem response in early detection of hearing-impaired children was described in detail.
Conclusively, an infant hearing screening program was proposed for the public health centers, that is an intra-uterine sound method, auditory eye opening response at falling into sleep using a tongue-clicking sound, a developmental test of auditory function and identification of risk factors associated with hearing loss.
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Tadao Enomoto, Hiroshi Nakanishi, Michiaki Yokoyama, Takao Samukawa, D ...
1989 Volume 1989 Issue Supplement33 Pages
43-57
Published: October 20, 1989
Released on J-STAGE: November 27, 2012
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Japanese cedar pollinosis has been increasing in its incidence year by year and is now one of the most common pollinoses in Japan. Cases of Japanese cedar pollinoses are also many in Wakayama Prefecture.
With intention to elucidate the nature of Japanese cedar pollinosis in Wakayama area, we have been doing the following studies in recent years: 1) Epidemiological study using Japanese cedar RAST (Radioallergosorbent test),2) Measurement of the number of Japanese cedar pollens in the air, and 3) Immunological study of Japanese cedar specific IgG and its subclass antibodies on many clinical cases.
The results show the incidence of RAST positivity is 16.6% in the general public of Wakayama Prefecture, and it is higer in mountainous areas than in littoral areas, and also higer in the southern parts of the prefecture where plantation areas of Japanese cedar tress are wider.
The pollens tend to appear in the air first in the south, and are greater in number in Shingu City and Hashimoto City while they are not so many in Wakayama City. The number changes in a two-year cycle and there is a good correlation between the number of the pollens and the yearly incidence of the pollinosis. The statistical analysis of the measured number of pollens in the air and meteorological data was done to forecast the number of pollens in the future. But no good method of forecast has been developed probably due to insufficiency of data we have obtained.
In the study of incidence of positivity of Japanese cedar RAST and measurement of specific IgG and subclass antibodies, it is shown that the incidence of RAST positve subjects is highest in the age bracket of 20 to 30 years and is lower with increasing age. However, the amount of specific IgG and total IgG increases with aging. This result is of interest in view of the presence of a highest incidence of the pollinosis in a particular age bracket and the phenomenon of natural subsidence of the disease in individuals.
Based on our studies on this disease in Wakayama Prefecture with the comparison of studies of other Japanese researchers, our opinion on the coutermeasures is also stated.
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Mitsuo Mukudai, Kazuya Kinoshita, Kyoko Tamaki, Takeo Kusumoto
1989 Volume 1989 Issue Supplement33 Pages
58-62
Published: October 20, 1989
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Facial bone fracture is one of the most commonly treated type of case ENTclinicians treat.
We encountered 52 patients with facial bone fractures since 1984. These patients were analyzed according to sex, age, cause and location of the fractures. Males were significantly predominant,86.5 on average. The majority of patients were teenagers. Sports and fights were the most common cause. Nasal bone fractures accounted for 85% of the fractures. The majority of patients caught treatment for the injury within a week.
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Kiyonori Kuki, Yasuhiro Hayashi, Takaaki Kimura, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
63-74
Published: October 20, 1989
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We reviewed reports about immunohistological studies and blastoid formations of lymphocytes of human palatine tonsils.
First, we studied the immunohistological distributions of lymphocyte subsets in the human tonsil. Second, we produced the monoclonal antibody against tonsillar epithelium of palmoplantar pustulosis (PPP) and studied the blastoid formation of tonsillar lymphocytes in vitro by epithelial proteins extracted from tonsils with PPP.
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Keiji Fujihara, Masaya Yokota, Takaaki Kimura, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
75-81
Published: October 20, 1989
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The three-dimensional structure of capillary vessels in the human palatine tonsil using corrosion casting technique was investigated. The postcapillary venules and arterioles were distinguishable from the nuclear impressions on their walls. The configuration of vessels around cryptal micropores is similar to images obtained by a recently developed cryptscope.
The palatine tonsil has no efferent lymphatic duct. Lymphocytes enter the tonsil via capillary vessels. The capillary vessel is considered to be closely associated with tonsillar immunity.
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Masaya Yokota, Keiji Fujihara, Shinji Tamura, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
82-92
Published: October 20, 1989
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The palatine tonsil is a lympho-epithelial organ, and has the characteristic structure of crypts and lymphoepithelial symbiosis. Since the crypts and the lympho-epithelial symbiosis in tonsil are considered to be the sites of reaction with exogenous antigens, they are an important structure in immunological functions of the tonsil.
Ultrastructure of the crypt epithelium has been made clear by electron microscopic studies. Many papers reported the relationship with the micropore (microcrypt) on epithelial surface of crypt, the lympho-epithelial symbiosis, and the micropore of basement membrane. We summarized these problems in this review.
However, it is still unknown what mechanisms contribute to cell infiltrations and in uptake of exogenous substances. It is not explicated what relations exist between these problems and recurrent inflammation of recurrent tonsillitis or focal infection of affected tonsil. Both immunohistological studies and immunoelectron microscopic studies are necessary to determine the real mechanism on immunological bases.
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Pustulosis Palmaris et Plantaris
Yasuhiro Hayashi, Kiyonori Kuki, Masaru Kunimoto, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
93-102
Published: October 20, 1989
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Pustulosis palmaris et plantaris (PPP) is a skin disease caused by focal infection of the tonsil and tonsillectomy is the best treatment. However, the actual mechanism of the development of PPP and the role of the tonsil as the focal site are still unclear.
Recently various researches with immunological approaches suggest that the disease may develop when tonsillar lymphocytes are sensitized with epithelial antigen of the ton- sillar crypt, which has features common to that of skin tissue, in the course of chronic inflammation.
In order to clarify the relationship between the tonsils and PPP, immunological investigations were performed focusing on keratin and anti-keratin antibody. As materials, the tonsils, plantar skins and peripheral blood from the patients with PPP undergoing tonsillectomy were used. The results were summarized as follows:
1. Common keratin polypeptides reacting with monoclonal anti-keratin antibody were found both in the tonsillar epithelium and in the plantar skin.
2. High molecular weight keratin polypeptides were predominant in the tonsillar epithelium of the patients with PPP as in the plantar skin.
3. The antikeratin antibody titers in the sera of the patients with PPP were high level, and tended to decrease after tonsillectomy.
4. The antibody in the sera of the patients with PPP reacted with 67,63 and 56 kd bands of keratin polypeptides.
5. The antikeratin antibody titers in the culture medium of the patients with PPP, especially in the tonsillar lymphocyte cultures, were high level.
These results suggest the possibility that the keratin of the tonsillar epithelium and the anti-keratin antibody in the serum may play an important role for the pustule formation.
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Takaaki Kimura, Masaru Kunimoto, Kiyonori Kuki, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
103-111
Published: October 20, 1989
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The tonsil is a lymphoid tissue located at the entrance of aeroalimentary tract. The antigen invades into the tonsil through the epithelium. We investigated the route of antigen penetration and the reaction of lymphocytes.
When the tonsillar epithelium was penetrated by lymphocytes, it forms a reticular structure. Some functional cells belonging to the mononuclear phagocytic system were found in the tonsillar epithelium. These cells possessed the HLA-DR antigen on their surface and were associated with the antigen presentation system.
Lymphoid follicles, which are responsible for external antigenic stimulation, consisted of a germinal center and the mantle zone. Several types of immunoglobulins (IgG, IgA, IgM, IgD and IgE) were present in both compartments (the existence of IgE in tonsillar tissue is still contraversial). Differences in localization were observed among the cells containing different immunoglobulin.
At the last symposium of the Japan Society for Tonsil Problems, we compared the expression of HLA-DR antigen in tonsillar hypertrophy, recurrent tonsillitis and tonsil with focal infection. The tonsillar epithelium from the tonsil with focal infection exhibited a marked reaction to anti-HLA-DR antibody. The CD3 positive cells are restricted by major histocompatibility antigen class II. If antigen stimulations are presented to CD3 positive cells, it is necessaty that MHC class II antigen is also presented with it. Then we assumed that tonsillar epithelial cells, which express HLA-DR antigen, can present certain epitopes to CD3 positive cells without macrophage. This hypothesis has been discussed in thyroid disease.
Though focal infection has been argued from the point of humoral immunity, we tried to consider it from cellular immunity.
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Shinji Tamura, Keiji Fujihara, Masaya Yokota, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
112-118
Published: October 20, 1989
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It has been well accepted that the tonsil may often induce secondary diseases such as skin diseases, nephritis, rhumatoid arthritis and so on. Therefore, various types of techniques have been developed for accurate diagnosis of the tonsil with focal infection. A longterm clinical study has showed that tonsillectomy in this case is quite valuable. The tonsillar provocation test has been widely carried out, though specificity is not yet sufficient.
Recently, we devised a new instrument, cryptoscope, for observation of t h e inside crypts of the tonsil, which is a more convincing technique for exact diagnosis. In addition, cryptomassage newly devised in our clinic is also quite available.
This paper deals with a review of the diagnosis of the tonsil with focal infection based on our new techniques.
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Masaru Kunimoto, Shinji Tamura, Yasuhiro Hayashi, Toshihide Tabata
1989 Volume 1989 Issue Supplement33 Pages
119-126
Published: October 20, 1989
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We reviewed the reports on the mechanisms of focal infection of tonsil and our recent research.
Recent reports suggested that the focal infection of tonsil may relate to the viral or bacterial products.
In the case of viral infection, Epstein-Barr (EB) virus transformes not only B lymphocyte to produce immuno-globulins, but also infects the epithelium.
The serological data of EB virus were related to the various types of tonsillar disease with focal infection.
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Junichi Yoda, Tadahito Saito, Takaaki Kawaguchi, Hiroki Arai, Toshihid ...
1989 Volume 1989 Issue Supplement33 Pages
127-135
Published: October 20, 1989
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Since 1980, a new approach of adoptive immunotherapy has developed. It has become more necessary to evaluate the immunological conditions in tumor-bearing hosts for treat- ment. Recent studies of cytokines and effector cells have clarified the tumor-host immune reaction.
The present paper reviews the immunological parameters to understand the immunological conditions and prognosis of the patients with malignant tumors of head and neck.
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Focusing on the Study of Local Administration of rIL-2
Tadahito Saito, Takaaki Kawaguchi, Junichi Yoda, Hiroki Arai, Toshihid ...
1989 Volume 1989 Issue Supplement33 Pages
136-147
Published: October 20, 1989
Released on J-STAGE: November 27, 2012
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Immunological surveillance has been elucidated and many cytokines, which participate in the immunological response between cancer and host, has been detected with recent progress of biotechnology. Furthermore, recent genetic engineering enables clinical application of these cytokines in cancer treatment.
In this article, the role of immunotherapy in multimodal treatment for head and neck cancer is reviewed, and clinical evaluation and prospect of local administration of recombinant interleukin-2 (rIL-2) is discussed.
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Kazuya Kinoshita, Takeo Kusumoto, Takaaki Kawaguchi, Takaaki Kimura, K ...
1989 Volume 1989 Issue Supplement33 Pages
148-153
Published: October 20, 1989
Released on J-STAGE: November 27, 2012
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Microvascular reconstruction has become a reliable procedure after the ablation of oral or pharyngeal cancer.
Seven pat i e nts underwent reconstruction of the hypopharyngeal and cervical esophageal cancer by use of free jejunal graft techniques in our clinic. All patients could begin to drink and eat in 2 weeks after operation. With this method, wide resection of hypopharynx and cervical esophagus was possible. In one case, radical wide resection with mediastinal dissection was accomplished using free jujunum transfer.
Radial forearm flap was preferable as a patch for reconstru c tion of defects of oral cavity and mesopharynx.
We performed reconstruction of oral cavity or mesopharynx with 7 radial forearm flaps and one free rectus abdominis musculocutaneous flap in eight patients. All forearm flaps were successful, but the rectus abdominis flap became ischemic on the next day. The immediate reoperation revealed that the cause of ischemia was venous thrombosis, and reanastomosis of the vein with vein interposition could make the flap survive without oral fistula or necrosis.
In conclusion, microvascular reconstruction is clearly beneficial for head and neck cancer.
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