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Objective/Hypothesis: This study was undertaken to determine the efficacy of a new treatment system with a high power diode laser and rigid nasal endoscopic device on patients with perennial allergic rhinitis at an outpatient clinic. Study Design: A pilot study involving 30 patients with perennial allergic rhinitis refractory to conventional treatment was performed. Method: A high power diode laser and rigid nasal endoscopic device were used. The high power diode laser with an 805 nm-wavelength has been applied for laser surgery. The entire surface of the inferior turbinate until the posterior part was treated by a high power diode laser beam. To assist the laser surgery of the inferior turbinate, a specially designed nasal endoscope (Baerenbach nasalendoscope, Nisco), xenon light sources, and television monitors were used. The 4-mm 0° telescope which measured with 7 cm length was equipped with an infused cannula and hand grip in order to remove any smoke while performing the procedure. Results: 11 patients (36.7%) and 6 patients (20%) out of 30 patients obtained either excellent or good results at 1 month after laser surgery, respectively. Thereafter, the improvement rate increased to 43.3 with excellent and 23.3% with good results at 3 months, respectively. Conclusion: These findings suggest that a high power diode laser with a nasal rigid endoscopic device can be successfully utilized for the surgical treatment of perennial allergic rhinitis on an outpatient clinic.

Recent investigations on the pathophysiology of otitis media with effusion (OME) were summarized from several points of view.(1) Experimental study of OME: The long-standing mucoid type of OME was induced for the first time by the impairment of eustachian tube active function and the administration of immunosuppressant drugs.(2) Bacterial adherence to nasopharynx: In vitro experiments on adherence of nontypable Haemophilus influenzae and Streptcoccus pneumoniae to nasopharyngeal epithelial cells clarified the significance of bacterial adherence to the nasopharynx in the pathogenesis of OME in children: a secretory immunoglobulin (IgA) in nasopharyngeal secretions is related to a decrease of bacterial adherence.(3) Lipid A in the middle ear: The instillation of lipid A component of endotoxin into the middle ear cavity can induce inflammatory changes with middle ear effusion. The lipid A interacts with glycoconjugates on the epithelial surface and with secretion from goblet cells. Excess secretion from the goblet cells to exclude endotoxin from the middle ear cavity seems to play an important role in the pathogenesis of OME.(4) Pressure regulation in the middle ear: Middle ear pressure is thought to be regulated not only by active opening of the Eustachian tube but also by transmucosal gas exchange in the middle ear cavity. In addition to poor dynamic tubal function, impaired transmucosal pressure regulation due to mucosal inflammation is thought to be related to the pathoetiology of OME.(5) Size of the mastoid pneumatization: The suppression of mastoid pneumatization is closely related to a persistent state of middle ear inflammation. Patients with OME can be treated by conservative therapy or by tube insertion based on the degree of mastoid pneumatization seen on x-ray films. Patients with a well-pneumatized mastoid air system can be managed with conservative treatment alone.

The YAMIK sinus catheter, which was developed in Russia, is less difficult to use and causes fewer complications than the Proetz displacement method, the standard physical therapy procedure for chronic sinusitis. This method was used once a week for 3 consecutive weeks to treat 132 patients with chronic sinusitis. The only complication was slight nasal bleeding found during receiving negative pressure. An evaluation of subjective symptoms and objective findings showed that headache and nasal secretion were significantly diminished during and after treatment. Its remarkable effectiveness in reducing sinus pressure supports the “hydrops ex vacuo” theory as the mechanism of frontal sinusitis.

In order to clarify whether autoimmune mechanisms form part of the etiopathogenesis of Meniere's disease, sera and endolymphatic sac tissues from 30 patients with Meniere's disease were analyzed according to the clinical criteria for autoimmune diseases stated by Mackay & Burnet. Several cases showed hyper gamma-globulinemia, antibody elevation to Type II collagen in the serum and endolymph, positive staining to immunoglobulins and C3 or infiltration of immuno-competent cells in the endolymphatic sac, good response to prednisolone and combination with systemic immune disorders. Other examinations showed a significant elevation of OKT 4/8 ratio and a decrease of OKT8-positive cells, and elevated levels of circulating immune complex and antiviral antibody titers. It is suggested that certain cases of Meniere's disease may have an altered immunological background, which may be attributed to an autoimmune mechanism dependent on humoral and/or cellular responses.

A survey was conducted of 201 patients with abnormal sensation in the throat who stopped treatment for various reasons. The respose to therapy and the psychological background were the main focuses. Anxieties about cancer at the first medical examination and desire for treatment for non-cancerous conditions were recorded. The reasons for discontinuing treatment and expectations for help from the staff, etc were considered.1. When treatment was discontinued the intensity of the abnormal sensation was 63% of that recorded at the first examination. The period of ambulatory therapy averaged 3 months.2. The response to therapy was not related to anxiety about cancer. However, the prognosis was better in patients who could ignore symptoms if cancer was ruled out than in those who wanted treatment even though cancer was not present.3. The reasons for discontinuing treatment were closely related to the degree of symptomatic improvement. Remission of symptoms was the reasons for discontinuing treatment in 27.5%; no change in symptoms was the reasons in 10.8%; in a third group some other reasons for discontinuing treatment were noted although the abnormal sensation was 74% as severe as at the first examination.The above results suggest that abnormal sensation in the throat is due to some unknown local and general factors other than psychological.

Surgical anatomy for infralabyrinthine approach to the internal auditory canal was evaluated using human temporal bone in order to understand advantages and disadvantages of this approach. The procedure is extracranial without any damage of labyrinth. Lateral exposure of the internal auditory canal allows for easy separation of the cochlear and vestibular nerves. There are some potential problems of little importance stemming from anatomical variations, such as high jugular bulb, forward positioned sigmoid sinus and poor pneumatization of the infralabyrinthine space. This approach offers access to the eighth cranial nerve with minimal risk and morbidity.

Combined cranial and facial procedures for resection of malignancies of the paranasal sinuses and nasal cavity have been increasing in recent years.For patients undergoing combined craniofacial procedures for these tumors are reported. In three of these cases, the defect caused by a resection of the skull base was reconstructed with a free rectus abdominis flap.The patients in this series showed no major complications and all have remained free of disease during the short follow-up period.

Cisplatin (CDDP) is one of the most potent and useful anticancer agents for head & neck cancers. The cytotoxicity of this drug is known to include inhibition of DNA synthesis. However, the development of resistance by tumor cells to this drug is an important problem. In order to elucidate the mechanism of CDDP resistance, we established CDDPresistant KB cell lines (KBrc cells) from oral epidermal carcinoma cell lines (KB cells). In this study, we investigated the mobilization of intracellular free calcium ion concentration ([Ca2+]i) to elucidate the mechanism of CDDP resistance in case of contact with a high dose of CDDP (500μg/ml) using these cell lines. Incubation with CDDP markedly increased [Ca2+]i in both cell lines. In contrast, a low dose of CDDP resulted in the reduction of [Ca2+]i toward the resting level. Furthermore, the peak and plateau of [Ca2+]i were higher in KB cells than in KBrc cells, and the speed toward the plateau phase was later in KB cells in comparison with that in KBrc cells. This increase in [Ca2+]i was thought to be due mainly to an influx of extracellular calcium ions. Moreover, the viability of KB cells was lower than that of KBrc cells. It was speculated that KBrc cells possesed the ability to protect CDDP compared with KB cells and the change of [Ca2+]i in KBrc cells was less than that in KB cells. It appears that CDDP can injure cell membranes as well as inhibit DNA synthesis.

This retrospective study concerns benign parotid gland tumors in 306 Japanese patients who were treated by partial parotidectomy with preservation of the facial nerve. There were no recurrences in 112 with a pleomorphic adenoma in over a 5-year follow-up. Facial weakness and temporal paresis occurred in 18% of 232 patients and Frey's syndrome in 18% of 93 with longer than a 3-year follow-up. In comparison with reported results of lateral or superficial parotidectomy, partial parotidectomy with preservation of the facial nerve seems preferable for treatment of patients with a benign parotid gland tumor.

Induction of Fos, a proto-oncogene c-fos protein product, was immunohistochemically examined in the rat brainstem by using pure tone stimuli (0.25 kHz, 4kHz and 8 kHz) at 60 and 80 dB sound pressure levels for 30 min. In comparison with non-stimulated control rats, the brainstem of sound-stimulated rats exhibited distinct Fos-labeled neuronal cell nuclei in i) the ascending auditory nuclei, ii) the brainstem sites which receive afferents from the auditory nuclei, i.e. the pretectum and rostroventrolateral reticular nucleus, iii) the parvocellular part of the ventral lateral geniculate nucleus, lateral reticular nucleus, ventral border region of the spinal trigeminal nucleus, and the medial vestibular and spinal vestibular nuclei, all of which lack established auditory projections, and iv) the brainstem sites where some Fos-labeled neurons were present in controls. Sound stimulation at 80 dB led to widespread Fos-labeling in all these sites. Sound stimulation at 60 dB caused a decrease in number of positive cells in the brainstem sites and yielded a tone-dependent subregional distribution pattern in the dorsal cochlear nucleus and central nucleus of the inferior colliculus.

An arteriovenous malformation is defined as a congenital lesion of dysplastic vascular origin with large feeding arteries. Previously, attempts at treatment by complete excision of the vascular mass were complicated by severe hemorrhage. With the advantages of angiography, the arteriovenous anomaly can be defined more clearly, and preoperative embolization effectively reduces intraoperative blood loss.This paper describes an extensive arteriovenous malformation supplied by the ipsilateral external carotid artery, internal carotid artery, and vertebral artery and the contralateral external carotid artery. This patient was treated successfully with radiologic microembolization followed by surgical extirpation with little blood loss.

To control the recurrence of nasal allergic symptoms, we performed revaporization with CO2 Laser beam in 27 patients with perennial nasal allergy whose nasal symptoms had been alleviated after the initial laser surgery. Revaporization was effective in 85% of the patients one month after surgery in 78% 2 years after surgery and in 64% 3 years after the revaporization. Patients with relapse within one year after surgery had little improvement in subjective symptoms, while patients with relapse later than one year after surgery responded well, and long-term results were good. No differences were found in the severity of the preoperative symptoms, RAST score, or IgE values between patients with early and with late recurrence.

A rare case of mucus-producing adenopapillary carcinoma of the parotid gland in a 12-year-old man has been reported. The clinical and pathological characteristics of mucus producing adenopapillary carcinoma of the parotid gland and its management have been discussed.

We performed chemosensitivity tests with MTT assay using KB cells derived from epidermal carcinoma of the mouth. Optical density (OD) for the MTT assay was measured with dual wave lengths: measurement wave (540nm) and reference wave (620nm). Five platinum (Pt) drugs and three anthracycline drugs were tested. The chemosensitivity to drugs was evaluated by the 50% OD of each drug concentration in the control group. CDDP was the most effective Pt drug, followed by 254S, NK121, CBDCA and DWA2114R. No significant difference among the three anthracycline drugs. We observed a linear increase of OD, corresponding to the increase in the number of cells. When we added 0.1M sodium succinate (SS) to 0.4% MTT {3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide}, the sensitivity of this assay was increased five fold.MTT assay is a precise, rapid, easy and inexpensive experimental system, which should be an useful method of evaluating the effect of antitumor drugs on tumor cell lines.

The effects of putative efferent neurotransmitters on intracellular Ca2+ concentration ([Ca2+]i) in isolated vestibular hair cells (VHCs) of the guinea pig were determined using the Ca2+ sensitive dye Fura-2 and digital imaging microscopy. In the presence of 1 mM acetylcholine (ACh) there was a gradual increase in [Ca2+]i. In the presence of 10 microM ATP there was a rapid rise in [Ca2+]i. Thus, both ACh and ATP seem to be efferent neurotransmitters in VHCs of the guinea pig. When 100 microM Gamma-aminobutyric acid (GABA) was added there was a rapid increase in [Ca2+]i; thus GABA also seems to be an efferent neurotransmitter in VHCs. With the independent addition of 10 microM calcitonin gene-related peptide and 10 microM M- and L-enkephalin there were no significant increase in [Ca2+]i. We presume that these neuropeptides were functioning as efferent neuromodulators rather than as neurotransmitters.

Caloric responses to intracellular calcium homeostasis of vestibular hair cells isolated from the guinea pig were examined. An increase in intracellular free calcium ion concentration ([Ca2+]i) in the isolated cells was observed by direct heat stimulation. The cells, dissociated enzymatically or mechanically, were stimulated by perfusion of solution, in the temperature range of 2.2-5.2 degrees C. The [Ca2+]i was analysed using a digital imaging microscope and the Ca2+ sensitive dye, Fura-2. There was an increase in [Ca2+]i in both Types I and II vestibular hair cells with this heat stimulation. The direct thermal influence on vestibular sensory cells is discussed in relation to mechanisms involved in caloric nystagmus.

To elucidate efferent inhibitory mechanisms of the cochlear inner hair cells (IHCs), the effects of candidate efferent neurotransmitters on intracellular Ca2+ concentrations ([CA2+]i) in the isolated IHCs of guinea pig were determined using the Ca2+ sensitive dye fura-2 and digital imaging microscopy. In the presence of 1 mM acetylcholine (ACh), there was a gradual and reversible increase in [Ca2+]i. In the presence of 10µM ATP, there was a rapid and marked rise in [Ca2+]i. Thus, both ACh and ATP seem to be efferent neurotransmitters in IHCs of guinea pig. The ATP-induced elevation of [Ca2+]i in IHCs was suppressed when ACh was concomitantly applied; therefore, ACh may act as an antagonist of ATP-induced Ca2+ entry. With the independent addition of 10 µM calcitonin generelated peptide and 10 µM enkephalin, there were no significant increases in [Ca2+]i. These neuropeptides are putative candidates for the efferent neuromodulators in IHCs of the guinea pig

The chemosensitivity of KB cells derived from oral epidermal carcinoma to various antitumor agents was analyzed using the MTT[3-(4,5-dimethyl-2-thiazoyl)-2,5-diphenyl-2H tetrazolium bromide] assay. Optical density (OD) for MTT assay was measured with dual wavelengths. The chemosensitivity of the drugs was evaluated by the 50% OD (OD50) of each drug concentration in the control group. Five platinum (Pt) drugs and 3 anthracycline (AC) drugs were used in this study. The chemosensitivity differed among the 5 Pt drugs. No significant difference was observed among the 3 AC drugs. A linear increase in OD corresponding to an increase in number of cells was observed. When 0.1 M sodium succinate (S.S.) was added to 0.4% MTT, the sensitivity increased five-fold compared to the control group without S.S. The MTT assay is a precise, rapid, easy and inexpensive experimental system useful for evaluation of antitumor drug sensitivity on tumor cell lines.

We discuss several techniques of culturing middle ear epithelium from several species, which was formerly difficult but is now possible because of recent advances in culture methods. The three main methods of initiating a culture are organ culture, primary explant culture, and cell culture. Although each method has both advantages and disadvantages, investigators can choose the method most suitable to their purpose. A few researchers, including ourselves, have succeeded in obtaining serial culture of middle ear epithelium. Using 3T3 feeder layer technique or conditioned medium enabled us to develop a fibroblast-free cultured middle ear epithelium. The availability of cultured middle ear epithelium provides a potential tool in future middle ear research.

Branchial cysts in the parotid gland are rare. Among 392 parotid masses which we examined and operated on during the past 15 years and 7 months in our hospital nine were branchial cysts. All were identified as second branchial cysts. Ultrasonography showed a septum structure in two of the cysts. Although ultrasonography and magnetic resonance imaging (MRI) provide useful information in the diagnosis of cysts, those which contain non-serous materials are sometimes misdiagnosed as solid tumor.

Sera obtained from patients with perennial mite nasal allergy and Japanese cedar pollinosis were examined to identify "beta receptor inhibitory factor". This was done by evaluating the inhibition of 3H-dihydroalprenolol binding to guinea pig cerebral membrane. beta receptor binding was inhibited by preincubation with sera from 8 of 44 (18.1%) perennial allergy patients, whereas sera from 2 of 41 (4.9%) controls showed this inhibition. Sera from 6 of 41 pollenosis patients (14.6%) showed this inhibitory effect in the pollen season but not in other seasons. Serum from one such patient (2.4%) demonstrated this effect both in and out of the pollen season. Sera from 2 pollenosis patients inhibited the beta receptor function not in the pollen season, but in the off season. This inhibitory effect was eliminated by immunodepletion from the positive-inhibition serum. These findings identified circulating beta receptor inhibitory factor in a limited population of patients with nasal allergy indicating the possible pathogenetic role of this factor in the disturbance of the sympathetic nerve function. This beta receptor inhibitory effect may correspond to the anti beta receptor autoantibody which Venter postulated in 1980.

Electron microscopic observations were used to study the relation between the adrenergic nerve terminal and the effector cell in the nasal mucosa of toluene diisocyanate-sensitized and non-sensitized guinea pigs. Adrenergic nerve terminals were abundantly distributed in the adventitia of arterioles, however, no synapse formation was observed in smooth muscle cells of the mesothelium, i.e., effector cells. Adrenergic nerve terminals were observed separated from smooth muscle cells of the mesothelium of the arteriole by distances of 1000 A-3000 A. Neurotransmission by the sympathetic nerve in the nasal mucosa is assumed to be by diffusion of norepinephrine (NE) or by diffusive synaptic conduction. The mechanism of sympathetic hypofunction in the nasal mucosa in nasal hypersensitivity is assumed to be as follows: Released histamine directly stimulates H-1 receptors at the sympathetic nerve terminal, leading to the release of NE. Once released, NE is not readily reabsorbed, and is gradually depleted in the sympathetic nerve terminal, leading to hypofunction of the sympathetic nerve.

A rat model of otitis media with effusion (OME) was developed by intratympanic injection of E. coli endotoxin and section of the third branch of the trigeminal nerve (V3). The period of fluid retention induced by the endotoxin was prolonged for 5 days or longer, in cases when tubal function was impaired by cutting of V3. Three Eustachian tube function tests (patency test of inflation-deflation tests, forced response test and negative pressure test) were carried out before and after the endotoxin inoculation and V3 sectioning. At 4 days after these procedures, passive opening pressure (Po), closing pressure (Pc) and tubal resistance (R2) were significantly lowered. The negative pressure test showed impaired capacity of active opening. This model of Eustachian tube dysfunction is considered to reveal functional obstruction, a condition similar to that of clinical cases of OME. The study shows that both inflammation in the middle ear and tubal dysfunction, such as functional obstruction, are factors in the development and prolongation of OME.

During the 1980s, our view of airway hypersensitivity was altered significantly. Advances in biochemical techniques revealed involvement of several nonspecific events in nasal hyperreactivity: Autonomic dysfunction involving primary and/or secondary receptor disorders, epithelial damage by cytotoxic proteins in eosinophil, which is stimulated by inflammatory mediators, and an axonal reflex of sensory C fibers. Since 1983, we have neurobiochemically investigated the autonomic nerve dysfunction in the nasal mucosa of patients with nasal allergy and guinea pigs with experimentally-induced nasal hypersensitivity. We propose the following mechanisms as potential contributors to the disturbance of the beta receptor function in airway hyperreactivity: i) Down-regulation caused by excess endogenous norepinephrine stimulation, ii) down-regulation and uncoupling to adenylate cyclase, produced by the inflammatory mediator-induced activation of protein kinase C, iii) the action of beta receptor inhibitory factor, presumably anti beta receptor autoantibodies, and iv) dysfunction of beta receptor kinase, which is known to cause short-term desensitization of beta receptors after exposure to beta agonists. This review provides the anatomical and neurobiochemical background for the autonomic regulation and dysfunction in the nose. We also introduce our series of experiments and the above updated hypotheses of how functional disturbances of the autonomic nerve in the nasal mucosa may occur.

A clinical and statistical study of methicillin-resistant Staphylococcus aureus (MRSA) was conducted on 27 patients with malignany tumor who had been on the ward for over 2 months and 27 medical personnel on the otolaryngological ward. Seven of the 27 patients (25.9%) had MRSA in the oralcavity and 2 of the medical personnel (7.4%) in the nasal cavity. Two background factors seem to be correlated to the colonization of MRSA. The reduced local host defense in the oral cavity after surgical or radiation therapy and the application of third generation cephalosporins. These patients with MRSA in the oral cavity were treated with iodine mouth wash 6 times a day for 14 days, but no reduction of MRSA was observed.

Single cochlear spiral ganglion cells (SGCs) were isolated using enzymatic and mechanical techniques. Intracellular free calcium ion concentrations ([Ca2+]i) in the SGCs were measured using a digital imaging microscope and the Ca(2+)-sensitive fluorescence dye fura-2. In the presence of the Ca2+ ionophore ionomycin (1 microM), there was an irreversible increase in [Ca2+]i. Depolarization by high K+ (150 mM) led to an increase in [Ca2+]i in SGCs, and this effect was reversible. The SGCs apparently possess voltage-gated calcium channels.

Effects of capsaicin on autonomic nerves in the nasal mucosa and olfactory bulb of toluene diisocyanate sensitized guinea pigs were studied using immunocytochemistry. In the nasal mucosa, substance P (SP)- and tyrosine hydroxylase (TH)-like immunoreactive (SPI and THI) fibers seemed to decrease after capsaicin application. Calcitonin gene-related peptide (CGRP)-like immunoreactive (CGRPI) fibers did not show obvious alterations. In the olfactory bulb, SPI and CGRPI fibers were few and the effects of capsaicin on those fibers were difficult to evaluate. THI fibers seemed not to be affected by capsaicin. It is suggested that capsaicin affects not only sensory nerves but that it also impacts on THI sympathetic nerves in the nasal mucosa.

Enhanced MRI was performed in 14 patients with Ramsay-Hunt's syndrome to investigate the pathogenesis of this syndrome. All MRI studies were performed on a 0.5T superconductivity MRI system using a head coil with Gd-DTPA. Enhancement was observed in the areas of the distal internal auditory canal and labyrinthine segment in many patients, and was especially prominent in patients suffering from vertigo, tinnitus, and hearing loss. In some patients it involved not only the facial nerve of the internal auditory canal but also the cochlear nerve and vestibular nerves. Since histological changes of the facial nerve in patients with Ramsay-Hunt's syndrome are assumed to occur in the distal internal auditory canal and labyrinthine segment, which is more proximal than the geniculate ganglion, and the possibility is suggested that inflammation may spread to the vestibular and cochlear nerve via the internal auditory canal.

The long-term results of CO2 laser surgery in 45 patients with perennial allergic rhinitis were reviewed, and compared with the short-term results in 365 patients. Improvement was noted in 78% of the patients one month after laser surgery, and in 76% two years later. Symptoms of nasal blockage, sneezing and nasal discharge did not seem to be different between the short-term and long-term treatment groups. Laser surgery was more effective in younger than in older patients. The results were supported by the histological appearance of the nasal mucosa: a layer of abundant fibrous tissue was evident even 5 years after CO2 laser surgery.

A KB cell line resistant to cisplatin (KB-rc cell) was successfully established by exposing KB cells to a gradually increasing dose of cisplatin in vitro. The concentration of cisplatin required for 50% inhibition of KB-rc cell proliferation was 1.0 micrograms/ml, while that of KB cells was 0.5 micrograms/ml. Studies of KB-rc cell kinetics after treatment with cisplatin, using flow cytometry, showed that the G2M phase block was inhibited on day 3, and that G0G1 phase cells started to increase on day 5. Therefore, cisplatin-resistance is related to inhibition of the G2M phase block. The decrease of KB-rc cell viability with cisplatin was accelerated by the addition of a Ca antagonist (verapamil) and S phase cells increased on day 3. Verapamil may therefore be useful for enhancement of the effect generated by cisplatin on cisplatin-resistant tumor cells.

Slow shortening of cochlear outer hair cells has been speculated to modify cochlear sensitivity. Tetanic electrical field stimulation of isolated outer hair cells from guinea pigs shortened the cells for 2-3 min. Electrical stimulation reduced cell length and volume (-13.5 +/- 1.5 and -37.3 +/- 3.0% of initial values, respectively, n = 16) and decreased the intracellular Cl- concentration. Cytochalasin B (100 microM) inhibited electrical stimulation-induced shortening but not volume reduction. The following chemicals or manipulations inhibited the responses: 10 microM furosemide, 0.1 mM 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), 1 mM anthracene-9-carboxylic acid (AC9), 25 mM tetraethylammonium, 2.3 microM charybdotoxin (ChTX), 250 nM omega-conotoxin, and Ca(2+)-free medium. These findings suggest that both electrical stimulation-induced shortening and shrinkage of outer hair cells result not only from an actin-mediated contractile force, but also from Cl- efflux through furosemide-, DIDS-, and AC9-sensitive Cl- channels, and K+ efflux through ChTX-sensitive K+ channels.

We investigated electron microscopically the changes of anionic sites of a charge barrier in the capillary basement membrane of the stria vascularis and endolymphatic sac following inner ear immune reactions. Hartley guinea pigs were immunized with bovine type II collagen, keyhole limpet hemocyanin, or horseradish peroxidase, with boosted and challenged antigens through the stylomastoid foramen. Animals were killed painlessly from several days up to 56 days after the antigen challenge. Polyethylenimine was used as a cationic tracer in order to observe the localization of anionic sites of the charge. In the animals immunized with bovine type II collagen or horseradish peroxidase, a significant decrease of anionic charge in the stria and the sac was found in the early stage of immunization. However, the keyhole limpet hemocyanin immunization group did not show any remarkable changes in the charge because of its lesser transfer into the inner ear due to of its high molecular weight and negative surface charge. A decrease of the charge under immunologic conditions may induce a hyperpermeability of vessels and a malabsorption of endolymph, and thus may cause endolymphatic hydrops.

To explore the mode of appearance of Fos, a gene product of proto-oncogene c-fos, in the cochlear nucleus, a pure tone was given to rats and Fos was detected by immunohistochemistry. Following low-tone stimuli applied with moderate ranges of sound intensity, neurons with Fos-label occurred band-like in the ventral subregions of the dorsal cochlear nucleus. Organization of low-to-high tones in the ventral-to-dorsal orientation became visible at the caudal level. Several other subnuclei consistently exhibited Fos with no topographic pattern. Neurons interspersed in the adjoining vestibulocochlear nerve were also found to elicit Fos. Low-tone stimuli with very high sound intensity led to a rather widespread distribution of Fos, making the tone-specific distribution less visible.

Na, K-ATPase was quantitatively localized in the epithelial cells of rat vestibular apparatus such as macula utriculi, macula sacculi and crista ampullaris. Immunogold localization method was carried out at the saturation level of antibody using an affinity purified antibody against the α-subunit of rat kidney Na, K-ATPase. Numerous gold particles were found on the basolateral membrane of the dark cells, a small number of gold particles were found on the basolateral membrane of the transitional epithelium cells and hair cells, but the luminal surface membranes of the hair cells, transitional epithelium cells, planum semilunatum cells and dark cells were rarely labeled by gold particles. Significance of the abundant localization of Na, K-ATPase on the basolateral surface of the dark cells in the production of endolymph was discussed.

Cisplatin resistance was examined with the use of KB cells and KB-rc cells (cisplatinresistant KB cells). Their viability under the influence of cisplatin and verapamil was determined with trypan blue staining. Verapamil reinforced the effect of cisplatin on both KB cells and KB-rc cells. In a study of cell kinetics with flow cytometry S phase accumulation was observed when verapamil was added to cisplatin. The Ca channel blocker, verapamil increases the effect of cisplatin.

We investigated the effect of inner ear immune responses on the anionicsites of the charge barrier. Guinea pigs were immunized with type II collagen (BIIn), keyhole limpet hemocyanine (KLH) o horse radish peroxidase (HRP) through the stylomastoid foramen to induce a second immune response.Polyethyleneimine (PEI) was used as a cation tracer. A decrease of the charge in the stria vascularis and endolymphatic sac was found in animals immunized with type II collagen and HRP. The KLH group did not show any of changes because the immune reaction was less due to its high molecular weight and strong negative surface charge.A decrease of the charge under immunological conditions may induce hyperpermeability of the vessels and disturb endolymph absorption, thus causing endolymphatic hydrops.

We investigated the effect of various anticancer drugs on CDDP-sensitive KB cells and CDDP-resistant KB cells (KBrc cells). The effect of CDDP and CDDP analogues on the two tumor cell lines were evaluated by in vitro cell growth curves. KBrc cells were resistant to both CDDP and CDDP analogues, which were effective against KB cells. No significant difference between KB cells and KBrc cells was observed in terms of the effect of 5FU and peplomycin.Futhermore, to investigate the mechanism of resistance of KBrc cells to CDDP and CDDP analogues, we compared the intracellular platinum concentration of two tumor cell lines after the addition of CDDP and CDDP analogues to the cell culture. The platinum concentration in KBrc cells was much lower than in KB cells, when CDDP was added to the cell culture in concentrations of 10μg/ml and 100μg/ml. These results indicate that a difference in the intracellular platinum accumulation may be involved in the mechanism of resistance of CDDP-resistant tumor cells.

Magnetic resonance imaging (MRI) provides high tissue contrast resolution. The structure of soft tissues is clearly demonstrated, so MRI is now one of the most advanced topographical imaging methods. In this study, we used the short TI inversion recovery sequence (STIR method), which is called “fat suppression imaging”, to examine 26 patients (19 males and 7 females) 29 to 80 years of age. The resolution of the soft tissue structures was investigated by analyzing only the contrasts of the lesions, which were divided into 4 Grades according to Robert's classification.Excellent contrast was obtained by the STIR method in almost all the patients. Of the 26 patients, 22 has good contrast, i.e. Grade 2 or more. The contrast of thyroid tumor by STIR was almost the same as that by the short SE sequence, but the contrast of parotid and tongue tumors by STIR was better than that by the short SE sequence. The contrast of parotid tumor by STIR was better than that by the long SE sequence, but the contrasts of thyroid, tongue and neck tumors by STIR was almost the same as that by the long SE sequence.The S/N ratio of the imaging quality by STIR sequence was inferior to that of conventional MRI.However, the imaging quality has improved with advances in the equipment in recent years. The STIR method is expected to be a useful pulse sequence in MRI because it provides high resolution of tissue contrasts

We present nine cases of parathyroid tumor, and a review of the literature on surgical treatment. In seven patients, the histologic diagnosis was parathyroid hyperplasia, which were observed in patients with secondary hyperplasia due to chronic renal failure. The other two patients had adenomas. The preoperative examination with computed tomography (CT) and echogram indicated the number and location of the parathyroid glands. However, more precise preoperative examination was necessary to avoid a false negative diagnosis. In our experience, total parathyroidectomy and retransplantation of autologous parathyroid tissue is one of the best surgical approaches.

The pH values of endolymph in the inner ear of guinea pigs were studied with the use of H+ selective double-barreled microelectrodes. The pH in the endolymph was similar in the cochlea (7.54±0.06, n=12), in the saccule (7.54±0.04, n=7) and in the utricle (7.53±0.06, n=7) under different DC potentials in each endolymphatic space. The intravenous injection of ethacrynic acid resulted in a significant increase of pH value in the cochlea but not in the saccule and the utricle. The possibility that different mechanisms producing the endolymph pH may exist in different parts of the inner ear is discussed.

Pharmacologic effects of cisplatin (CDDP) and peplomycin (PEP) on tumor cell kinetics were studied both in vitro and in vivo with the aid of flow cytometry (FCM). Double staining with propidium iodide (PI) and fluorescein isothiocyanate (FITC)-labeled bromodeoxyuridine (BrdU) was used to analyze the cell cycle, and the number of viable cells was determined with fluorescein diacetate (FDA). Effects of combining the 2 agents were also studied to establish the most effective method of combination therapy. Furthermore, these agents were tried clinically on the basis of experimental results. Results showed that CDDP exerted its action at the S and G2M phases in the cell cycle and PEP at the G2M phase. Among the combination regimens in the experiments with CDDP, PEP, and CDDP + PEP as analyzed by FCM, the strongest block on the G2M phase was shown in the one at a 2-day interval, resulting in the most effective killing of the tumor cells. Clinical trial of the combination therapy showed the same results as the in vitro experiment; the therapy proved useful for improving the patient's clinical condition and the results obtained with CT imaging and pathology.

A 39-year-old man with dull pain in both eyes visited our clinic. Magnetic resonance imaging (MRI) revealed a midline cyst in the posterior wall of the nasopharynx which had high intensity signal characteristics in both T1-and T2-weighted pulse sequences. After removal of the anterior wall of the cyst, his pain disappered, and he has been well since. Histological sections revealed epitheliallined cyst with no evidence of lymphoid tissue, consistent with Tornwaldt's cyst.Tornwaldt's cyst results from the embryological relationship of the notochord and the pharyngeal endoderm.MRI is well suited to distiguish this cyst because of its greater soft-tissue contrast resolution and of the anatomic advantage obtained by multiplanar views.

頭頸部腫瘍細胞株 (HEp-2) に対するTNFとIFN-γの抗腫瘍効果を in vitro で検討し, さらにフローサイトメトリー (FCM) を用い, HEp-2細胞の細胞動態に及ぼす影響を検討した。HEp-2細胞にINF-γ, TNFを各単独及び併用し, 一定時間培養後の細胞増殖曲線を求めた。その結果, IFN-γとTNFの抗腫瘍効果の増強が二剤併用により示唆された。細胞周期の解析で, 両者とも低濃度単独投与では, 軽度S期増加を認め, 濃度上昇に伴い, IFN-γ単独投与では late S期増加を, TNF単独投与ではG2M期増加の傾向を認めた。両者併用群では著明なS期増加を観察し, S期ブロックの発現が示唆された。