Hiromitsu Tamaki

Ultrastructural Study of the Effect of Acute Hypertension on the Stria Vascularis and Spiral Ligament

The effect of acute hypertension, induced in rats by intravenous injection of methoxamine chloride (Mexan), on the stria vascularis and spiral ligament was studied electronmicroscopically with the tracer method of horseradish peroxidase (HRP). Considerable extravasation of HRP occurred in the stria vascularis, due to the increased vesicular transport. The leaked HRP spread into intercellular spaces, but was prevented from spreading towards the endolymph by zonulae occludentes between marginal cells and towards the perilymph by zonulae occludentes between basal cells. The reaction product was occasionally found between basal cells. No leakage of HRP from capillaries was observed in the spiral ligament, although some labelled micropinocytotic vesicles were present in the endothelium. It is suggested that, under acute hypertensive conditions, areas of zonulae occludentes bordering the stria vascularis play an important role as a barrier to HRP, whereas capillaries in the spiral ligament themselves act as a barrier to it.

Increased Capillary Permeability of the Stria Vascularis to HRP, Induced by Experimental Acute Hypotension in Rats

Acute hypotension was produced in rats by using two experimental techniques: intravenous infusion of a ganglion-blocking agent (Arfonad), and venesection of a femoral vein. Horseradish peroxidase (HRP) was injected intravenously after each procedure, and subsequently observed in the inner ear by light and electron microscopy. In both experimental models, a large amount of tracer spread into the intercellular spaces, but it was halted by tight junctions bordering the stria vascularis. The endothelium exhibited a high distribution density of labelled vesicles, which suggested increased vesicular transport. There was no extravasation of HRP from capillaries in the spiral ligament in spite of the presence of some labelled pinocytotic vesicles. The present study was concerned with the discovery of enhanced capillary permeability of the stria vascularis under acute hypotension, as in the case of acute hypertension (Sakagami et al., 1984).

Changes in Gastric EMG Resulting from Differences in Direction of Linear Acceleration in Rabbits

The role of direction of linear acceleration in stimulation of the otolith organ, which leads to alteration of autonomic activities in the form of inhibition of gastric motility, has not been fully studied. With a view to elucidating this problem, we placed healthy adult rabbits unanesthetized and unrestrained in individual cages, and subjected them to the three different linear acclerations to study changes in gastric EMG. As a result, the forward-and-backward movement was found to inhibit the EMG activity most potently, and was followed in decreasing order by side-to-side movement and up-and-down movement. These findings, when viewed from the standpoint of the accepted concept that optimum stimulation to the otolith organ constitutes the shearing force, account well for the supposition that forward-and-backward movement stimulates both the sacculi and utriculi, while up-and-down movement stimulates the sacculi alone.

Blood and tissue concentrations of Latamoxef.

The concentration of Latamoxef (LMOX) was determined by bioassay in surgical patients with sinusitis and chronic tonsillitis. One or two grams of LMOX was injected intravenously prior to tonsillectomy under general anesthesia and the Caldwell-Luc operation under local anesthesia.Concentrations of LMOX in the tonsil and maxillary bone were 12.7μg/g and 16.8μg/g respectively one hour after administration;and 9.4μg/g and 2.3μg/g respectively two hours after administration.The transfer ratio, the concentration in the tonsil to that in the serum, was about 20 percent. The tissue concentrations exceeded the antibacterial level of LMOX except for Pseudomonas aeruginosa.

A clinical study of MS-antigen 40 (MS-A) nebulizer therapy for nasal hypersensitivity.

The clinical effects of MS-A nebulizer therapy were evaluated in 23 patients with nasal hypersensitivity: 13 with nasal allergy (NA) and 10 with vasomotor rhinitis (VMR). The patients received 2 ampules once or twice a week for a total of 8 times.The efficacy rate was 61.5% for NA and 60.0% for VMR. The rate of improvement in nasal congestion was 46.2% for NA and 60.0% for VMR. Rhinorrhea decreased in 61.5% of these with NA and 70.0% of those with VMR. Percentages of patients showing a decrease in the number of sneezing attacks was 61.5% for NA and 57.1% for VMR. In half of the patients, the effects of MS-A nebulizer therapy were noted by the 5th application. There was no side effect observed in any subject.MS-A nebulizer therapy was considered to be effective for the treatment of nasal hypersensitivity.

Relationship of Postoperative Maxillary Cyst and Radicular Cyst

We reported 3 cases of the postoperative maxillary cyst and the radicular cyst which occured after the radical operation.Case 1. A 36 year old male was received the radical operation of maxillary sinuses 22 years ago. The patient complained of swelling and pain of the right cheek. Postoperative maxillary cyst and atypical radicular cyst were found at the reoperation of maxillary sinus.Case 2. A 23 year old male was operated for chronic maxillary sinusitis 11 years ago. The patient complained of the swelling and pain of the right cheek. The Reoperation revealed the radicular cyst. He was operated by Neumanns method. The teeth from 4 to 7 was extracted with extirpation of the cyst. The cyst wall was squamous cell with granulation pathologically. In granulation, cholesteatoma and macrophage were observed.Case 3. A 29 year old male was operated for the diagnosis of maxillary blood boil 13 years ago. During the treatment of the caries of the teeth, the swelling of the left cheek occurred. X-ray finding (pantomography) showed the destruction of the left lateral portion of the maxillary sinus and the periodontitis from 5 to 8. and the fistula between the 6th tooth and the maxillary sinus was found. This case was the 2nd operation showed the postoperative maxillary cyst with odontogenic inflammation.The following results were obtained from these 3 cases;1) The cyst which should be differentiated as the postoperative radicular cyst could occur after the radical operation of maxillary sinus.2) The postoperative radicular cyst may be caused by the disturbance of the dental roots which have been exposed into the sinus at 1st operation.3) Pantomography of the teeth is useful for the differential diagnosis between the postoperative maxillary cyst and the radicular cyst.

Peripheral Facial Palsy Accompanied with the Systemic Disease

In the entity of the peripheral facial palsies, there are idiopathic, otitic, traumatic palsy, Ramsay Hunts syndrome, and others. The causes of the facial palsies were due to the disturbance of microcirculation and the bleeding in Fallopian canal, infection of bacteria and virus, the direct damage of the facial nerve and etc..Some of them occur accompanying with the systemic disease. We reported 8 cases of the facial palsies which were accompanied with the systemic disease. These systemic disease were diabetes mellitus, sarcoidosis, aseptic and carcinomatous meningitis, systemic lupus erythematosus, aplastic anemia, and pregnancy. The facial palsies accompanied with diabetes mellitus and pregnancy are due to the disturbance of microcirculation (anoxia, ischemia, microembolism). As sarcoidosis sometimes involves in degeneration of myelin, and aseptic meningitis and infectious mononucleosis are viral infection of seventh nerve, these cause probably a neuritis or a ganglionitis. The palsy of carcinomatous meningitis is rare, but if initial symptom is only facial palsy, this palsy should be differentiated from idiopathic facial palsy (Bells palsy).As aplastic anemia causes the tendency of bleeding, this palsy occurs from the bleeding in Fallopian canal. One case of the facial palsy accompanying the aplasic anemia revealed the bleeding in Fallopian canal by autopsy. The importance of systemic disease as a possible cause of idiopathic facial palsy was emphasized.

A Foreign Body in the Parotid Gland and Facial Palsy

2歳小児の耳下腺内異物による晩発性顔面神経麻痺症例を報告した. 診断は非常に困難であり, 試験切除術時にたまたま異物がみつかり, はじめて診断がえられた.どの疾患でもそうであるが, 既往歴, 現症歴の重要性を痛感させられた. とくに小児では充分な情報が得られないので, 家族および関係者から事情を充分に聴取することが大切である.疾患が極めて珍しい種類のものであったため, 耳下腺内に異物を113日もの間, 長期滞在させ, 診断上種々反省させられた症例であった.

Motion Sickness and Nasal Allergy among Preschool and School-age Children

A survey of 7, 200 preschool and children between ages 6 and 15, for motion sickness and nasal allergy showed that 2, 600 (35.7%) habitually experienced motion sickness, with the incidence being higher among females, and that 1, 000 (13.7%) had symptoms of nasal allergy with its predilection for males.Comparison of these data with the data in 1963 showed that the incidence of motion sickness has increased tenfold during this 14 year period probably due to increased utilization of cars and buses.