Middle ear barotrauma is the most common otologic problem associated with alternobaric exposure. Many previous publications have described this entity in detail. Middle ear barotrauma results from inadequate pressure between the middle ear and the external environment. To evaluate early diagnosis of middle ear barotrauma, tympanometry was supposed to be one of the most useful examinations. The authors developed an impedance audiometer that can be used in the hyperbaric environment, and examined tympanometry with 2 artificial ear models in various pressure environment. The results obtained were as follows; 1 Tympanometry can be examined in hyperbaric environment. 2 The external auditory canal pressure which makes the peak of tympanogram can reveal the relative pressure of middle ear. 3 Tympanometric volume on+200mm H2O of external auditory canal does not indicate the external auditory canal volume in hyperbaric environment. 4 Tympanometric volume of middle ear increase with environmental pressure, and positivecorrelation between both is determined.
A few autoradiographical studies have shown that the lifespan of lingual epithelium in mice is about 4-8 days, and that of taste buds is about 10 days. However, the autoradiographic method requires a special isotope institute and a long time for the final specimen to be observed. Recently, alternative rapid non-radioactive techniques have been developed, where in a thymidine analogue, 5-bromo-2'-deoxyuridine (BrdU), is incorporated into replicating DNA and subsequently localized using a specific monoclonal antibody. In this study, cell dynamics of taste buds and lingual epithelium in mice were investigated by means of this immunohistological technique. Results were as follows: 1, The labelled elements were concentrated at the basal layer of the epithelium and in the basal cells of the taste buds, which were observed 5hrs after the first injection. 2, At five days after administration of BrdU, the labelled elements were located in the taste buds and epithelium. 3, At eight days after injection, the labelled elements were still located in the epithelium, on the other hands, obvious incorporation was not observed in the taste buds. After ten days, the labelled elements disappered from the epithelium. It indicates that the lifespan of lingual epithelium in mice is within ten days, and that of taste buds is within 8 days.
In mammals, the nasal mucosa is divided into the respiratory and olfactory regions. It is considered that the respiratory region had a function of adjusting the temperature and humidity of inspired air. The vascular morphology and structure of the respiratory region have been described. However there have been few reports on the vascular arrangement of the olfactory region. The purpose of the presest study is to clarify the vascular arrangement of the nasal septum, especially the olfactory region in rabbits and rats. Continuous sections of the nasal septum were observed by light microscopy, and comparisons were made of the vascular morphology between the two regions. Microvascular corrosion casts were made using methyl-methacrylate (Mercox ®), and observed by stereomicroscopy and scanning electron microscopy. In the respiratory region, numerous vessels were observed in the entire width of the lamina propria, displaying various profiles. On the other hand, fewer vessels were observed in the olfactory region. The vessels were located in the deeper layers of the lamina propria, running posterio-anteriorly. The rich vascular network was mainly composed of several arteries running bach and forth, and spiral vessels, which are branches of the thick vessels, radially extending anterio-superiorly. While the former had few connections with other vessels, the latter had numerous connections and branches. In the superficial layers in particular, small vessels constituted the cubic network. The morphology of the medial (septal) side differed from that of the lateral (cavum) side. The medial side showed straight running arteries, and around these a network of small vessels was seen both in the respiratory and olfactory regions. The lateral side of the submucosal vascular cast showed an enormous network only in the respiratory region, which therefore could be distinguished from the olfactory region not so rich vessels. In the olfactory region, vessels mainly ran posterio-anteriorly and had scanty connection with each other. It is considered that the microvascular arrangement of the respiratory region favors the adjustment of temperature and humidity of inspired air more than that of the olfactory region. In rabbits, no change was observed in the microvascular arrangement after repeated nasal irrigation with aqueous solution of zinc sulfate.
During the period from January 1981 to April 1988 we experienced 8 cases of epistaxis which required ligation of the ethmoid artery. Histopathological findings of these cases are reported with some discussion. With the recent rapid progression in the tendency of the high-aged society, cases of epistaxis in elderly persons have been encountered increasingly. Naturally in these cases complications such as hypertension and arteriosclerosis are often seen and much difficulties are experienced in obtaining hemostasis. In particular in cases of bleeding from the branches of the internal carotid artery, even ligation of the ethmoid artery is required not infrequently. In cases we could follow up histological findings of arteries the internal elastic membrane of the ethmoid artery was injured. Moreover, it is needless to say that the ethmoid artery shows arteriosclerosis as high age associated changes. Therefore, it is considered that cases which require ligation will increase in number in the future.
The patient is a 14-year-old boy. The onset of the episode was marked by fever, headache and gait disturbance. The initial examination revealed spontaneous downbeat nystagmus, bilateral gaze nystagmus with rebound nystagmus, truncal ataxia, and an increased cerebular count and protein volume in the cerebrospinal fluid. About one month later, there was no clear downbeat nystagmus, but so-called nystagmus alternans was observed. In this case, the downbeat nystagmus and rebound nystagmus observed early during the course of the disease, as well as cerebellar symptoms, suggested that the main lesion was located in the cerebellum. As inflammation was suspected from fever observed at the onset and the abnormal CSF findings, he was diagnosed as having had acute cerebellitis. The nystagmus alternans in this case disappeared seven months after the onset.
Plasmacytoma is a disease which causes malignant proliferation of plasmacytes. In general, multiple myeloma developing in the bone marrow is well-known as a plasmacytoma, while extramedullary plasmacytoma developing in the soft tissue is a relatively rare disease and is not well-known. We encountered a patient with extramedullary plasmacytoma which was thought to be a primary tumor developing in the orbital wall of the maxillary sinus. The details of this case are reported together with a brief discussion. The case was a 72-year-old male. CT, which was performed to examine a cerebral infarction, revealed a shadow in the right maxillary sinus, and he was thus transferred to our department for detailed examination. The shadow region was biopsied by the transmaxillary approach, and the disease was diagnosed to be IgA-λ type extramedullary plasmacytoma. In this case, there were no abnormal findings in relation to serum protein, urinary protein or bones of the whole body, and the tumor disappeared as a result of surgical treatment and subsequent rj.diotherapy. The patient is being followed up on an outpatient basis, and no tumor recurrence has been noted to date.
Most of malignant tumors of the larynx are squamous cell carcinomas, and there are only a very few cases of other malignant tumors in this organ. We encountered a very rare malignant pleomorphic adenoma occurring in the larynx. It is histologically understood that this tumor is formed as a result of atypical neoplastic growth of both epithelial and mesenchymal cells. An immunohistological study was also made on this case, in which immunohistological reactions to keratin (an intermediate filament of epithelial cell), the epithelial membrane antigen (EMA) and vimentin (an intermediate filament of mesenchymal cell) were examined. As a result, positive reactions were obtained for both keratin and EMA along with tumor cells showing alveolar growth or canalicular structure, while vimentine-positive findings were congruous with roundish and spindle cells indicating cartilagenous formation. Our immunohistological findings clearly revealed the distribution of tumor components showing the differentiation into epithelial cells as well as into mesenchymal cells. Since the tumor was relatively localized in the epiglottis with apparent expansion into the vallecula, horizontal partial laryngectomy in combination with preand postoperative irradiation was performed with a successful result.
Transmeatal atticotomy is a good means for treatment of early cholesteatoma developing in the pars flaccida of the eardum. In the technique, the epitympanic space is exposed by removing posterosuperior wall of the external auditory canal. The ossicles, mucosa on the medical wall and the pars tensa of the eardrum are not disturbed. After removal of disease lateral wall of the attic and the defect of the eardrum are reconstructed. The advantages of this method include a better ventilation and reepithelization of the attic space, decrease in retraction of the lateral wall, better hearling and better hearing.