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The objective of this study is to develop a special self-training program for students of occupational therapy forthe National Examination and to explore changes in their scholastic ability and in their consciousness as well as the relationbetween their scholastic ability and their consciousness. The new study method was developed by referring to the KJ Method.The subjects were 28 students in their junior and senior years who were enrolled in the Department of Occupational Therapyof Teikyo University of Science. The examination of the scholastic ability of the students and a questionnaire to makeevaluation of consciousness was administrated to the juniors at the start and completion of the program, and to the seniors atthe completion of the program. As a result, it was found that improvement of scholastic ability was not significant. This mayhave been due to the inability of students with poor abilities to maintain their motivations since only a single, advanced methodof study was indicated to them. Next, it was found that there is a relationship between the consciousness and the scholasticability of the students. Further, the ability to obtain a high score was related to possession of basic information about theNational Examination. In addition, whereas the consciousness of students with good ability to obtain high scores was foundto converge to a single trend, that of students with poor ability to do so was found to be widely dispersed. These findingssuggest that it is necessary to make modifications to the program in accordance with the scholastic ability of the students.

We examined the cathepsin L activity and expression of cystatin A (an inhibitor of cathepsin L) in 7 cases of cholesteatoma epithelia, 3 cases of cholesteatoma subepithelial granulation, 3 cases of non-cholesteatoma granulation and 3 cases with an intact mucous membrane in the middle ear. The mean cathepsin L activity was higher in the diseased tissues than in the intact mucous membrane of the middle ear. Those granulation tissues with high cathepsin L activity resulted in extensive bony destruction in both cholesteatomas and non choleateatomas of the middle ear. Cystatin A expression was assessed by Western blotting. All of the cases with an intact mucous membrane in the middle ear exhibited no expression of cystatin A. 7 of the 10 cases with diseased tissues expressed cystatin A in their cholesteatoma epithelia, cholesteatoma subepitheial granulation or non cholesteatoma granulation tissues. No relationship between cystatin A expression and the level of cathepsin L activity could be observed.

Objectifs: Nous avons examine l'activite de la cathepsine L, l'expression de la cystatine A, et deux dismutases du superoxide (contenant du cuivre ou du zinc) dans l'otite moyenne chronique humaine. Nous avons aussi etudie la relation entre ces resultats et le degre de destruction osseuse clinique. Devis: Etude de laboratoire et clinique retrospective. Localisation: Departement d'oto-rhino-laryngologie et premier departement de biochimie, Kinki University School of Medicine, Osaka, Japan. Methode: Nous avons analyse les tissus provenant de l'oreille moyenne de sept patients operes pour cholesteatome, trois patients avec tissu de granulation associe a un cholesteatome, trois patients avec tissu de granulation sans cholesteatome, et, finalement, trois patients avec une muqueuse de l'oreille moyenne normale. Variables: L'activite de la cathepsine L dans le cholesteatome, dans le tissu de granulation avec ou sans cholesteatome a ete mesuree a l'aide de la methode Barrett. L'expression de la cystatine A, quant a elle, a ete observee par analyse Western blot. Les dismutases ont ete mesurees dans le cholesteatome par une technique immuno-histochimique. Resultats: L'activite moyenne de la cathepsine L est plus elevee dans les tissus malades que dans la muqueuse de l'oreille moyenne normale. Les tissus de granulation avec une haute activite de la cathepsine L ont ete associes a une destruction osseuse extensive autant dans les cholesteatomes que dans les processus non-cholesteatomateux. Aucun des cas de muqueuse normale n'a exprime la cystatine A. Sept des 10 cas de muqueuse anormale ont par contre exprime la cystatine A. Nous n'avons pas trouve de relation entre l'expression de la cystatine A et le niveau d'activite de la cathepsine L. L'expression des dismutases du superoxide etait plus positive dans l'epithelium cholesteatomateux que dans les regions de tissu de granulation. Conclusion: Ces resultats suggerent que la dismutase du superoxide autant celle contenant du cuivre que du zinc dans les epitheliums cholesteatomateux previent les complications en supprimant l'activite de la cathepsine L.