Archives of oto-rhino-laryngology最新文献

A study was performed to determine whether the predominant direction of body sway is influenced by changes of head-to-trunk position. A group of ten patients suffering from acute unilateral vestibular loss was compared with a group of ten healthy subjects. Body sway was assessed by measurement on a posture platform. Center-of-force stabilograms were recorded with the subjects' eyes closed. After a baseline interval in the normal head-to trunk orientation, the head was torsioflexed with respect to the trunk and the locus of the center-of-force further assessed over a defined interval. It was observed that the patient group manifested a systematic translation of the direction of body sway that was associated in a consistent manner with the unilateral deficit. This translation occurred synchronously with head torsioflexion and could also be reproduced when turning the trunk with the head fixed, so that a semicircular canal influence could be excluded. It appears that cervical proprioceptive input to the central vestibular system is responsible for the effect observed.

The distribution and origin of peptide-containing and sympathetic nerve fibers were studied in the tympanic membrane of rats with intact innervation, and in rats following sympathectomy, vagotomy, or capsaicin treatment. Nerve fibers showing substance-P-like immunoreactivity (SP-LI), calcitonin gene-related peptide (CGRP)-LI, vasoactive intestinal polypeptide (VIP)-LI, enkephalin-LI, neuropeptide Y (NPY)-LI and tyrosine hydroxylase (TH)-LI were detected along blood vessels in the pars flaccida, the external auditory canal and in the fibrocartilaginous ring of the pars tensa. In the pars flaccida there were numerous fibers demonstrating SP-LI and CGRP-LI, while there were few such fibers in the pars tensa. In both portions of the tympanic membrane these fibers were present within and beneath the keratinized stratified squamous epithelium. In the pars flaccida, nerve fibers showing SP-LI and CGRP-LI were also seen near mast cells. Sympathectomy led to a loss of nerve fibers showing TH-LI and NPY-LI, whereas the other peptide-containing nerve fibers remained unaffected. Vagotomy did not reduce the immunoreactivity for any of the neuropeptides studied. Capsaicin treatment caused a reduction in nerve fibers displaying SP-LI and CGRP-LI. The abundance of nerve fibers showing SP-LI and CGRP-LI in the keratinized squamous epithelium indicates that the tympanic membrane is richly supplied with sensory nerves. The localization of nerve fibers exhibiting these latter substances in the vicinity of mast cells in the pars flaccida suggests that this part of the tympanic membrane is a site where neurogenic inflammation occurs.

We have studied the fine structure of the cerebral cortex, the cerebellar cortex, the thalamus, the caudate nucleus, the amygdala, the putamen, the vestibular nuclei, the substantia nigra, the hippocampus and the centrum semiovale in a canine model following 20 min controlled hypotension by the administration of sodium nitroprusside. The neurons and the astrocytes of all structures were intact morphologically. The synapses in the cerebral and cerebellar cortex were all unremarkable. Sensitive areas such as the molecular layer of the cerebellum did not demonstrate any ultrastructural alterations. We believe that carefully controlled sodium-nitroprusside-induced hypotension might be applied in middle ear microsurgery in otherwise healthy patients as an effective and innocuous method without causing any anoxic insult to sensitive areas of the central nervous system.

Elevated nasal resistance, as a result of nasal mucosal swelling and/or adenoidal hyperplasia, has been associated with an increased incidence of mouth breathing, which may lead to alterations in facial morphology. The classical approach to studying this problem clinically has been through the adoption of percentiles and various other norms. However, these techniques are only crude estimates and are subject to error. We have developed a novel approach to the assessment of nasal resistance measurements that provides the means for its differential diagnosis. Two- and three-parameter discriminant (or classification) functions were found to replicate an experienced orthodontist's clinical diagnosis very accurately. We also propose the adoption of "sensitivity" and "specificity" when discussing the evaluation and/or success of such models.

Rat submandibular glands were exposed to fractionated irradiation of 50 Gy, as given comparably in clinical practice. The induced changes were compared by giving only irradiation or radiation in conjunction with stimulating the salivary glands with cyclocytidine prior to treatment. Cyclocytidine is an alpha-adrenergic agonist that effectively depletes the serous cells of their granules and their heavy metal content. Findings in the present study show that the administration of the drug prior to each irradiation reduces the radiation-induced destruction in the epithelial cells in the submandibular gland.

An indirect immunofluorescent method with monoclonal anti-cytokeratin antibodies was used to localize various cytokeratins in human middle ear cholesteatoma. The 50 K/58 K and 56.5 K/65-67 K paired cytokeratins are markers of skin type and were found in the specimens of human middle ear cholesteatomas studied. In contrast, the 40 K and 45 K cytokeratins (markers of simple epithelia), the 48 K cytokeratin (marker of hyperproliferative epidermal disease) and the 51 K cytokeratin (marker of internal organ epithelia) were absent in human middle ear cholesteatoma. These findings indicate that the pattern of cytokeratins in human middle ear cholesteatoma is similar to that of skin but is different from those of simple epithelium, internal organ epithelia, and hyperproliferative epidermal disease. These findings also support the skin type epithelial origin of cholesteatoma and strongly favor the migration theory in the genesis of cholesteatomas.

Titers of anti-keratin antibodies (AKA) involving IgG and IgM fractions were determined by a solid-phase enzyme-linked immunsorbent assay (ELISA) and were found to be significantly higher on average in patients with pustulosis palmaris et plantaris (PPP) than in normal controls. Positive rates of IgG-AKA and IgM-AKA in sera of PPP patients were 50% and 66%, respectively. Following tonsillectomies, patients with high IgM-AKA titers that decreased after surgery were found to benefit by a marked improvement in their skin lesions. There was a close relationship between the degree of this improvement in the skin lesions and the changes in IgM-AKA titers after the operation. These results suggest that PPP may be a tonsil-related immunological skin disease.

For three-dimensional computer graphic reconstruction of histological sections, it is important to determine reference points. We have developed a machine that makes reference points in a celloidin block for this purpose by drilling holes straight into the block. A sliding microtome is placed under the machine, which consists of a worktable, a stand, and a motor-driven unit. The celloidin block is sectioned on a microtome to determine a plane for serial sectioning. Several holes are then drilled in the block vertical to the plane selected. Serially sectioned specimens are next stained with hematoxylin and eosin and are mounted in the usual manner. Three-dimensional reconstructions of the specimens were next done using a PC-9801 computer and CosmoZone-S software. As an example, the reconstruction of a guinea pig stapes is described.

Representative tumor samples and mucosal samples were taken from three different groups of patients and were stained immunohistochemically for their expressions of epidermal growth factor receptors (EGFR). Patients in group 1 had oral squamous carcinoma, with specimens taken from the tumor as well as from the mucosa without tumor invasion. Patients in group 2 had no evidence of tumor but had heavy drinking and smoking habits. Tumor-free patients who do not drink or smoke served as the control group. The findings in the present study showed that the tumor and mucosal samples from groups 1 and 2 had increased EGFR expression while the control group showed significantly less EGFR. These results suggest that EGFR may play a role in the development of premalignant tissue changes, which are probably influenced by chronic toxic irritation.

Following several studies on the effects of kanamycin toxicity on the inner ears of guinea pigs, we have studied the importance of melanin in this phenomenon. Transmission electron microscopy showed that, under the influence of kanamycin, the intermediate strial cells developed a secretory aspect similar to that seen in skin melanocytes. This aspect as yet has never been described for the inner ear cells. A planimetric, morphometric method was also used to determine the strial cell melanin status in control animals. Additional findings in the study confirmed an increase in the number of melanosomes during kanamycin poisoning. Statistical data are discussed.