Tadami Kumazawa

Experimental Study of the Eustachian Tube Function with Regard to its Related Muscles

Utilizing electromyography and electrical muscle stimulation, the muscle responsible for opening the Eustachian tube was examined im 12 dogs. Different time values for tubal opening and levator activity indicate little contribution of the levator in the functioning of the tube. By relatively low stimulation of the tensor, the tube opened consistently, while the levator failed to produce any dilation of the tube, regardless of the amount of stimulation, in 6 dogs. Thus, it is concluded that the sole muscle responsible for tubal opening is the tensor, while the levator does not participate in the functioning of the tube.

The Usefulness of Partial Parotidectomy for Benign Parotid Gland Tumors A retrospective study of 306 cases

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 Freys 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.

Quantitative immunocytochemical localization of Na+,K+-ATPase alpha-subunit in the lateral wall of rat cochlear duct.

Ultrastructural localization of the alpha-subunit of Na+,K+-ATPase on the lateral wall of rat cochlear duct was investigated quantitatively by the protein A-gold method, using affinity-purified antibody against the alpha-subunit of rat kidney Na+,K+-ATPase. In the stria vascularis, gold particles were sparse over the endolymphatic luminal surface of the marginal cells but were numerous over the basolateral membrane. The labeling density of the basolateral membrane was almost equal to that of the same domain of the distal tubule cells of kidney. The intermediate cells were studded with a large number of gold particles on the plasma membrane domain facing the basolateral domain of the marginal cells. On the luminal surfaces of the other epithelial cells, including those of Reissners membrane, no significant amount of gold particles was found. Many gold particles were localized on all the plasma membranes of the spiral prominence stromal cells and on the intracellular membrane domain of the external sulcus cells.

Kinetics of Epidermal Growth Factor in Saliva

Human epidermal growth factor (hEGF) stimulates the growth and differentiation of various tissues. We measured EGF levels in saliva (n = 128), urine (n = 94), and serum (n = 99) with radioimmunoassay in order to study the kinetics of hEGF in saliva of normal subjects and patients with oral disease. Salivary EGF levels showed an apparent diurnal rhythm related to the taking of meals. Urinary and serum EGF levels showed no obvious diurnal rhythm. There was no significant correlation between salivary and urinary EGF levels, nor between salivary and serum EGF levels. Salivary EGF levels were significantly lower in the younger group (0-9 years old, 3.06 +/- 0.32 ng/ml, p < 0.05) than in the elder group (10-79 years old, 4.78 +/- 3.5 ng/ml), but did not correlate with age in the elder group. There was no significant difference between males and females between EGF levels in saliva, urine or serum. The relative proportion of EGF levels in submandibular gland saliva, parotid saliva, and whole saliva was 1:6:4. The positive rate of immunohistochemical EGF showed no significant differences between submandibular gland, parotid gland, sublingual gland or minor salivary gland. Salivary EGF levels were markedly low in patients with oral inflammations (stomatitis aphthosa, or peritonsillar abscess) or head and neck tumors (squamous cell carcinoma of the tongue, oral cavity, hypopharynx or larynx). These findings may be significant pathophysiologically. Low salivary EGF levels may reduce the capacity of oral mucosal defense mechanisms to fight against injury by physiochemical agents.

Adrenergic and cholinergic receptors in human nasal mucosa in cases of nasal allergy

ZusammenfassungVerfasser konnten zum ersten Mal α-1 adrenergische, β-adrenergische und muskarin-cholinergische Rezeptoren in der menschlichen Nasenschleimhaut bei Patienten mit nasaler Allergie oder Sinusitis nachweisen. Muskarin-Rezeptoren fanden sich bei nasaler Allergie vermehrt, α-1 und β-Rezeptoren waren dagegen vermindert. Bei Sinusitis war dies nicht der Fall. Nach Ansicht der Verfasser spielen Störungen der autonomen Nervenrezeptoren eine wichtige Rolle bei der Pathologie der nasalen Allergie.SummaryWe have demonstrated for the first time α-1 adrenergic, β-adrenergic, and muscarinic cholinergic receptors in human nasal mucosa obtained from patients with nasal allergy or sinusitis. Using the radioligand 3H-prazosin, 3H-dihydroalprenolol (3H-DHA) and 3H-quinaclidinyl benzilate (3H-QNB), we determined the receptor densities (Bmax) and affinities (KD) of α-1, β, and muscarinic receptors. There was an increased number of muscarinic receptors and a decreased number of α-1, β receptors in patients with nasal allergy but not in those with sinusitis. Binding affinites (KD) of α-1, β, and muscarinic receptors were unchanged in all patients with nasal allergy and sinusitis. Disorders of the autonomic nerve receptors appear to play a definite role in pathology of nasal allergy.

Identification of Rat Brainstem Sites with Neuronal Fos Protein Induced by Acoustic Stimulation with Pure Tones

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.

Subjective Results of Laser Surgery for Allergic Rhinitis

Inferior turbinates of 389 patients with perennial allergic rhinitis were vaporized by a defocused carbon dioxide (CO2) laser beam, using specially designed handpieces. This laser surgery can be done under local anesthesia as an outpatient procedure, with no pain or bleeding. One month after laser surgery, 78% of 389 patients had excellent or good results, while 21 had no improvement, subjectively. Seventy-two of 389 patients were followed for over 2 years, and 61 of the 72 had excellent or good results. Twenty-seven of the 72 cases need revaporization because of recurrence. Patients with relapse less than one year after surgery had little improvement in subjective symptoms, even after revaporization; while patients with relapse more than one year after surgery responded well, and long-term results were favorable. All things considered, laser surgery is an effective treatment for perennial allergic rhinitis.

Mapping of the cochlear nucleus subregions in the rat with neuronal Fos protein induced by acoustic stimulation with low tones

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.

Aerodynamic evaluation of eustachian tube function. Preliminary report on normal subjects.

SummaryA clinical test for evaluating Eustachian tube function and normal range of recordings obtained by this test were reported. Simultaneous registration of ear canal and pharyngeal pressures were made during Valsalvas maneuver and deglutition. One hundred recordings of normal subjects were classified into 3 types; normal 77%, obstructive 11% and patent 10%. Thus with the provision of information regarding the normal ear, evaluation of many different functional disorders of the tube is quite feasible.

Meniere's disease and autoimmunity. Clinical study and survey

In order to clarify whether autoimmune mechanisms form part of the etiopathogenesis of Menieres disease, sera and endolymphatic sac tissues from 30 patients with Menieres 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 Menieres disease may have an altered immunological background, which may be attributed to an autoimmune mechanism dependent on humoral and/or cellular responses.