Isuzu Kawabata

Scheibe Dysgenesis of the inner ear

A Scheibe-type dysgenesis of the inner ear was found in the temporal bones of an 85-year-old deaf-mute woman. Both temporal bones showed similar histopathological findings, which were confined mainly to the cochlea and saccule. The stria vascularis was atrophic and contained cysts with eosinophilic content throughout the cochlea. The scala media had disappeared owing to marked collapse of Reissners membrane. The saccule showed collapse. Many eosinophilic spherical masses were observed in the area of the macula sacculi and attached to the saccular wall.

Primary Tuberculosis of the Nasopharynx with Erythema induratum of Bazin

A 44-year-old Japanese woman with primary tuberculosis of the nasopharynx associated with erythema induratum of Bazin (EI) is reported. The patient presented with erythematous nodules of the lower legs diagnosed as EI. Since EI is a tuberculosis-related skin disease, the presence of latent tuberculous lesions was investigated, and a tuberculous lesion was found in the nasopharynx. Primary tuberculosis of the nasopharynx is very rare. Furthermore, our review of the literature revealed no case in which nasopharyngeal tuberculosis acted as the latent focus of EI.

A Case Report of Proliferative Myositis of Bilateral Sternocleidomastoid Muscles.

A case of prolif erative myositis of the bilateral sternocleidomastoid muscle in a 64-year old woman is reported. The patient visited our clinic, complaining of a sore throat and cervical pain, with strong limitation of neck movement, especially backward movement. Physical examination revealed hardness along the bilateral sternocleidomastoid muscles. CT, MRI and Echo imaging studies suggested the presence of pathological lesions in the muscles. Immunochemical examination showed a high level of muscle emzymes, suggesting myositis. The histopathological diagnosis of the excised tissue was proliferative myositis. This disease is a very rare condition, and no case of bilateral myositis has been previously reported in the Japanese literature. We discussed this disease from a clinicopathological viewpoint.

Chondrosarcoma of the Larynx.

A 72-year-old female visited our clinic with mild dyspnea and hoarseness. Laryngoscopic examination revealed a mass in the subglottic space and partial paralysis of both vocal cords. A CT scan showed a mass arising from the cricoid cartilage: half of the mass could be visualized. Biopsy under direct laryngoscopy was done, and the pathohistological examination revealed chondrosarcoma of low grade malignancy according to the classification of Lichtenstein and Jaffe. Because the tumor was large, total laryngectomy was performed. Chondrosarcoma of the larynx is an uncommon cartilaginous tumor. Only 13 cases have been reported in Japan since Shibuis description in 1973. The clinical features, pathohistological findings and management of this tumor are discussed, and the literature is reviewed.

An Apoptosis in the Germinal Center of Human Palatine Tonsil.

Apoptosis in the human tonsillar germinal center was studied by immunocytochemical methods. It is generally accepted that the germinal center of the lymphoid tissues plays an important role both in cell proliferation and cell death. Although many studies of cell proliferation have been reported, the mechanism of cell death is not yet well understood. According to recent studies, apoptosis indicates programmed cell death, not pathological death, and plays an important role in maintenance, immunity and development of life.In 1885, Flemming reported hematoxin-stained dense bodies within the cell in the germinal center and named them tingible bodies.Subsequent studies showed that the tingible body was a mass of nuclear chromatin from dead cells, and the cell containing tingible bodies was the macrophage, then called the tingible body macrophage.This study investigated the relationship between tingible body macrophages and apoptosis. Tingible body macrophage and adjacent structures were examined by immunostaining. The results were as follows:1. H. E. stained section: tingible body macrophage and tingible bodies were clearly shown. Tingible body was a hematoxin-stained granule.2. Observation of apoptosis: immunostained apoptotic body was shown to be same as tingible body by comparing observations on H. E. stained sections.3. Observation of macrophage : Tingible body macrophage was clearly observed by the CD68 immunostaining method.4. Observation of 5-100 protein positive cell: S-100 protein positive cells consist of large cytoplasma and long cytoplasmic processes. The latter are intermingled with each other to form a network around the tingible body macrophage.5. Observation of B-cells: The immunostained B-cell is found near the tingible body macrophage.6. Observation of T-cells: Immunostained T-cells were found in the germinal center, but did not contact the tingible body macrophage.We discussed apoptosis of the tonsillar germinal center based on the findings cited above.

Pleomorphic Adenoma of Submandibular Gland.

Five patients were treated for pleomorphic adenoma of the submandibular gland: 2 males and 3 females, aged 24 to 53 years. The tumors were on the right side in 3 cases, on the left in 2. All 5 patients complained of a painless mass in the submandibular lesion. Ultrasound sonography and CT scan were useful in the diagnosis In 3 patients Ga scintigraphy showed abnormal accumulation although the histopathological diagnosis was benign tumor. It was presumed that the proliferating activity is higher in pleomorphic adenomas of the submandibular gland than in those of the parotid gland. All patients were treated surgically.

Unilateral profound deafness following chickenpox infection; A case report.

This paper reports on a case of unilateral profound deafness which occurred following chickenpox infection. A 5-year-old boys hearing had been found to be normal by pure tone audiometry before he contracted chickenpox. After the infection, which was confirmed by an antibody titer rise in the serum, the patient was found to be profoundly deaf in his left ear. The similarity of the clinical features of this case to those of deafness following mumps allows us to suppose that a similar pathology underlies these two types of deafness. A review of the literature revealed only two detailed reports of such cases, while several other reports indicated a low incidence of deafness following chickenpox. Accumulation of more such cases is necessary to elucidate the clinical picture of this type of deafness.

耳鳴の局在に関する研究 方向感自動記録装置による測定:―方向感自動記録装置による測定―

The lateralization of tinnitus on the cranium was measured by a directional hearing device, which can generate binaural time or intensity differences for various sound sources. Tracings of sound locomotion are recorded as sawteeth-like waves by repetition of the dial operation in the right and left directions.First, the central and lateral sound images on the cranium were measured by method of adjustment for subjects with normal hearing. The range of the values was determined after three measurements per day for three days. The regions of these locations of sound impression were in close agreement, and 67% of 20 normal control subjects showed stable results.Next, 30 subjects with normal hearing ability and monaural tinnitus were tested. The location of tinnitus on the cranium was determined after localization of the sound impression in the central and lateral positions by the method described above. The results were as follows: in 53% of the subjects the results were stable; 46% showed agreement between the positions of tinnitus and the lateral side, and 27% showed a more medial impression of tinnitus than the lateral position.This method has no restrictions as a clinical test. The fact that the position of tinnitus may disagree with the lateral impression on the cranium was clarified by these experiments.