Yasushi Kukuminato

Role of serum antibodies to streptococci in patients with IgA nephropathy

Serum antibodies to whole cells of streptococci and serum immune complexes were investigated in patients with IgA nephropathy accompanied by tonsillitis and in healthy adult controls by enzyme-linked immunosorbent assay (ELISA). Serum IgA levels to Streptococcus salivarius, S. sanguis I and S. pneumoniae were higher in patients with IgA nephropathy than in healthy controls. The levels of IgG to S. pyogenes T12, S. gordonii and S. sanguis II in patients with IgA nephropathy were also higher than in healthy controls. Serum immune complexes of IgG and IgA were higher in patients with IgA nephropathy than in healthy controls. Serum levels of IgA to some strains of streptococci tended to correlate with the level of IgA immune complex in both patients and healthy controls. These results suggest that antibodies to some strains of streptococci play a role in the pathogenesis of IgA nephropathy.

Effect of radiotherapy on the levels of secretory immunoglobulin A against indigenous and virulent streptococci

It is well known that the frequency of upper respiratory infection is clinically increased after radiotherapy of the head and neck region. This study found higher antibacterial secretory immunoglobulin A (S-IgA) activity against three indigenous streptococci (Streptococcus mitis, S. salivarius, and S. sanguis I) and S. pneumoniae in patients who had undergone radiation therapy of the head and neck region than in control subjects. This showed no relation to the extent of the radiation field. Compared with before radiotherapy, the S-IgA titer against S. pneumoniae and its ratio to the activities against the indigenous streptococci were significantly higher in patients with fully irradiated major salivary glands. These results indicated that the radiotherapy promoted the antigen-specific S-IgA production of virulent streptococci in most patients with head and neck cancer, even more than 6 months after radiotherapy. The resulting altered balance in the S-IgA system of normal indigenous streptococci may also impair the ability to maintain the stable bacterial interference between normal indigenous and virulent streptococci in the oropharyngeal cavity.

Peripheral Facial Nerve Palsy; A Statistical Study.

A statistical analysis of the prognostic factors of peripheral facial nerve palsy was performed on 110 patients with Bells palsy and 24 patients with Hunts syndrome admitted to the Department of Neurotology at Nakamura Memorial Hospital from 1981 to 1989. The patients treated within 13 days after the onset got to be recovered significantly better than those treated after 14 days. The final recovery rate was significantly higher in patients with Bells palsy than those with Hunts syndrome. High evoked electro nerve potential and low nerve excitability differences were good prognostic signs in both disease. Steroid and acyclovir were significantly effective in the patients with Hunts syndrome.

Pediatric otolaryngological diseases found on screening tests in Hokkaido rural district.

Otolaryngological examinations were carried out on 1017 children (1-13, mean 4.9 years old) in 5 rural towns in Hokkaido. In addition to the usual ENT examinations, tympanometric examination and cytological study of nasal secretions were performed in all children.The incidence of abnormal nasal findings and nasal eosinophilia increased, whereas that of abnormal ear findings and abnormal tympanograms decreased with age. There was no correlation between the occurence of nasal eosinophilia and abnormal tympanograms. A history of allergy, included asthma, also showed no correlation with the incidence of abnormal ear findings. The incidence of upper respiratory tract infection was lower in the older children.These findings suggest that allergy is not related to otological abnormalities, including otitis media with effusion.

Acute sensorineural hearing disturbance with vertigo caused by circulatory insufficiency of anterior and posterior inferior cerebellar arteries; A case report.

A 77-year-old male complained of acute left hearing disturbance with vertigo. A diagnosis of circulatory insufficiency of the left anterior inferior cerebellar artery (AICA) and the posterior inferior cerebellar artery (PICA) was made from the results of examinations and the clinical course.Otoneurological examination showed profound sensorineural hearing disturbance and spontaneous horizontal and rotatory nystagmus toward the right in both eyes indicating left peripheral vestibular dysfunction.Vertebral angiography showed occlusion of the basilar artery leading to circulatory insufficiency of the left AICA and PICA.After conservative treatment, the hearing disturbance and vertigo were reduced as the blood flow increased in the left AICA and PICA.Although sensorineural hearing disturbance with vertigo of sudden onset is usually diagnosed as sudden deafness in clinical practice, RICA and PICA circulation should be assessed for a precise diagnosis.