Yasuro Miyoshi

Nasal Mucociliary Clearance Under Various Conditions

We applied the tagged-particle method or the saccharin method or both to the nasal mucociliary clearance. There was no effect of ageing on the transport time of saccharin in control subjects of ages under 60, and 70% of control subjects of ages more than 60 had the same transport time as that obtained in younger control subjects. The significant inverse correlation between the mucociliary transport rates with the particle method and the transport time with the saccharin method were established in control subjects, but not, however, in patients with chronic sinusitis. The mucociliary transport rates were measured under non-physiologic conditions of the nose: laryngectomy, chronic sinusitis, Sjögrens syndrome, and Kartageners syndrome.

Mucociliary clearance in chronic sinusitis: related human nasal clearance and in vitro bullfrog palate clearance.

Nasal mucociliary clearance was measured in both healthy subjects and patients with chronic sinusitis using saccharin granule technique. Nasal mucociliary transit time (ST) was significantly slower in the patients with chronic sinusitis compared with that in controls (p less than 0.005). Nasal mucus collected from each nasal cavity was used for in vitro bullfrog palate clearance studies and compared to the in vivo nasal ST. Mucociliary clearance rate (MTR) on frog palate was 12.5 +/- 2.5 mm/min in the mucus from control subjects, 6.1 +/- 1.5 mm/min in the mucus from the patients. The difference was statistically significant (p less than 0.005). The MTR on frog palate in the patients whose nasal ST was within normal range was significantly slower than that in controls (p less than 0.005), but not significantly different from that in the patients whose nasal ST was over the normal range. These results suggest that the nasal mucous properties which decreased the mucociliary clearance on frog palate did not contribute to the mucociliary clearance of the patients who had a normal one. No significant correlation existed between MTR on frog palate and nasal ST in both control and chronic sinusitis. In chronic sinusitis patients, decelerated nasal ST was recovered significantly by normal saline nebulization compared with the value before the nebulization (p less than 0.01). None of the significant change of ST was observed in control before and after the nebulization.

Circadian Variation of Secretory IgA in Nasal Secretions from Normal Subjects

In normal subjects the concentration ratio of secretory IgA (sIgA) to total IgA in nasal secretion was measured by means of enzyme-linked immunosorbent assays (ELISA). No marked circadian variation was disclosed in the sIgA/IgA ratio in nasal secretion.

Antifibrinolytic activity in middle ear effusion

No activity of the plasmin and plasminogen activators could be detected in middle ear effusion (MEE). A streptokinase proactivator, which was not plasminogen and markedly enhanced the activation of plasminogen by streptokinase, could be detected. MEE had an apparent inhibitory activity against both thiol protease (papain) and serine proteases (plasmin and trypsin). All these findings indicate that MEE contains unsaturated protease inhibitors and is in a state of predominance of inhibitors over fibrinolytic activity.

Lysosomal thiol proteases (cathepsin B-like proteases) in serous middle ear effusions from adult patients.

Hydrolytic activity of cathepsins B, H and trypsin-like proteases was measured in 38 serous middle ear effusion (MEE) samples. The concentrations of (alpha 1-AT) and alpha 2-macroglobulin (alpha 2-M) were also quantitated. The mean value of cathepsin B activity was 25.0 +/- 20.7 RFU and that of cathepsin H was 14.3 +/- 3.0--both significantly higher than those in plasma (1.8 +/- 0.4 RFU, 1.2 +/- 0.3 RFU, p less than 0.005). Very low trypsin-like protease activity could be observed. The mean concentrations of alpha 1-AT and alpha 2-M were 368 +/- 94.8 mg/dl and 57.5 +/- 57.3 mg/dl. The bulk of alpha 1-AT in MEEs was occupied by free alpha 1-AT, which can saturate exogenous trypsin. Due to the very low molar concentration of alpha 2-M in MEEs, thiol proteases (mainly cathepsin B) could be a possible major factor inflicting proteolytic injury on the middle ear mucosa and reflecting the severity of the inflammatory process.

Absorption of various drugs through the rabbit's respiratory mucosa in vitro

ZusammenfassungDie Aufnahme von DOTC, AKM, CEZ, PC-G, Predonisolon und menschlichem IgG durch die Trachealmucosa des Kaninchens wurde mit der Doppelkammermethode geprüft. Als Resultat zeigte sich, daß die Trachealmucosa sowohl kleine Moleküle als auch Makromoleküle resorbieren konnte. Durch die Interzeüularspalten wurde DOTC, ein kleines Molekül von dem Trachealepithelium durch Diffusion resorbiert. Das menschliche IgG, ein Makromolekül, wurde durch den Mechanismus des Energie verbrauchenden Transportprozesses resorbiert. Die vorliegende Studie läßt neue Wege für die Verwendung einer intrarespiratorischen Verabreichung von Arzneien erkennen und kann wichtigen Erkenntnissen über den Mechanismus der respiratorischen Allergie führen.SummaryThe absorption of doxycycline (DOTC), bekanamycin (AKM), cefazolin (CEZ), penicillin G (PC-G), predonisolone, and human IgG through the rabbits tracheal mucosa was examined using the double-chamber method. The results indicate that the tracheal mucosa can absorb both small molecules and macromolecules. Passing through the intercellular space, DOTC, a small molecule, was absorbed through the tracheal epithelium by diffusion. Human IgG, a macromolecule, was absorbed by the mechanism of an energy-consuming transport process. This study of the absorption of drugs through the respiratory mucosa could open up new areas in the utilization of intrarespiratory administration of drugs and lead to a better understanding of the mechanisms involved in respiratory allergies.

Plasma Component of Middle Ear Effusion Evaluated by Prekallikrein Level

Plasma leakage into middle ear was evaluated by the level of prekallikrein in middle ear effusions (MEE), measured by the fluorometric assay. Plasma leakage into middle ear is a major source of MEE, especially serous effusions. The degree of plasma leakage at the time of sampling is very low in mucoid effusions and varied in serous effusions. Active plasma leakage into middle ear would occur at the early restricted inflammatory phase in the middle ear.

Nasal Secretion from Normal Subjects

A new method of collection of nasal secretion, by dilution with condensed mositure of the exhaled air, is described. This method may be defined as a sefl-administered nasal lavage. The method permits quantitative determination of pH, relative viscosity, and electrolyte and protein composition. Concentrations of sodium, potassium, calcium, total protein, IgA, IgG, IgM, secretory compoenent and polysaccharide are reported for normal subjects. Significant correlations were noted between the relative viscosity and variables: dry weight, total protein and calcium.

The Significance of Protease Inhibitors in the Pathogenesis of Otitis Media with Effusion

Concentration of alpha 1-antitrypsin (alpha 1-AT), alpha 1-antichymotrypsin (alpha 1-AChyT), inter-alpha-trypsin inhibitor (I-alpha-I), and alpha 2-macroglobulin (alpha 2-M) was measured in 27 serous middle ear effusions (MEEs) from 24 adult patients. The presence of protease-inhibitor complex was analyzed by crossed immunoelectrophoresis (CIEP). Mean concentration of alpha 1-AT was 361 +/- 90.0 mg/dl and was higher than that of other inhibitors: alpha 1-AChyT, 80.6 +/- 40.7; I-alpha-I, 21.3 +/- 21.5; alpha 2-M, 59.5 +/- 57.1. Molar concentration of alpha 2-M was the lowest. Most of alpha 1-AT and alpha 1-AChyT in MEEs were unsaturated; free inhibitors. Alpha-1-AT could be saturated by trypsin and elastase immediately, and only alpha 2-M could be saturated by papain (classical thiol protease). Serous MEEs have high anti-trypsin activity attributed to mainly free alpha 1-AT. Since level of alpha 2-M was very low, lysosomal thiol proteases could be one of the major proteases inducing proteolytic damage to middle ear mucosa.

Serum bactericidal effect on capsulated and non-capsulated Haemophilus influenzae in chronic sinusitis

SummaryStudy on the incidence of bactericidal (BC) antibodies to a Haemophilus influenzae type b and a non-capsulated H. influenzae was carried out on sera from 50 healthy subjects, and from 30 patients with chronic sinusitis. Of the 50 sera from normal subjects, only one (2.0%) lacked BC antibodies to the H. influenzae type b, whereas 13 (26.0%) lacked BC antibodies to the non-capsulated H. influenzae. All of the 30 sera from patients with chronic sinusitis were bactericidal for the H. influenzae type b, whereas only three (10.0%) lacked BC antibodies to the non-capsulated H. influenzae. Specific IgG, IgM and IgA antibodies to the non-capsulated H. influenzae in serum were determined by the indirect fluorescent antibody assay. Of the 22 sera tested in this study, 15 (68.0%) had antibodies of at least the IgG, IgM, or IgA classes; with IgG occurring most often. These data suggest that a lack of circulating BC antibodies to both H. influenzae isolates is not associated with the chronic carriage of these organisms by patients with chronic sinusitis.