Yoshio Umeda

Surfer's ear in Japan

Fifty‐one Japanese professional surfers were examined in order to analyze surfers ear. Forty‐one cases (80%), 71 ears, were diagnosed as surfers ear. In 19 cases (37%), 30 ears, the external auditory canals had stenosed by more than 50%. In general, surfers ear begins to appear after 5 years and is further aggravated by continued surfing. The age at which surfing is taken up has no influence on the appearance of surfers ear. Surfers who surf on northern (colder) coasts have severer surfers ear than those who frequent the southern (warmer) coasts.

Alcohol and the oculomotor system

— The influence of alcohol on the oculomotor system was observed by means of the caloric eye tracking pattern (CETP) test, the visual suppression test on caloric nystagmus, and the positional nystagmus, eye tracking and gaze nystagmus tests. In Group A (nine cases whose CETP before the intake of alcohol was normal), the influence of alcohol consumption appeared regularly and consistently in the following order: abnormality of CETP ≥ positional alcohol nystagmus ≥ abnormality of the eye tracking pattern ≥ alcohol gaze nystagmus. On the contrary, in Group B (eight cases whose CETP before the consumption of alcohol was already abnormal), with one exception, the regularity noted in Group A was not observed. This phenomenon may be attributable to the presence of latent disorders of the oculomotor system. In both groups, the duration of the caloric nystagmus itself was slightly shortened and its amplitude somewhat suppressed after the consumption of alcohol. The results were confirmed by experiments in which the subjects kept their eyes open in darkness. On the other hand, when the eyes were kept open in light surroundings, the duration and amplitude of the caloric nystagmus were exaggerated in appearance because the mechanism of visual suppression was disturbed by alcohol.

Equilibrium Disorder in Carbamazepine Toxicity

Three cases of acute carbamazepine intoxication were evaluated neurotologically and neurologically. Findings included symptoms of equilibrium, gait and speech disorders, drowsiness, gaze nystagmus, depressed optokinetic nystagmus and disturbances of smooth pursuit eye movement. These findings, suggestive of a space-occupying lesion, disappeared after the cessation of the medication. On the basis of the clinical findings it is felt that carbamazepine affects structures within the brain stem and the cerebellum. It is well known that equilibrium disorders caused by anticonvulsant intoxication are due to cerebellar disorders but from our present study it should be noted that they originate not only from cerebellar lesions but also from brain stem lesions.

Treatment Of Tinnitus By Transtympanic Infusion

Transtympanic infusion of local anesthetics has been used to alleviate inner ear vertigo for many years. However, it is shown that one drawback persists in that although vertigo is often abolished following Lidocaine infusion the functional depression of the labyrinth is reversible. It is also indicated that although tinnitus is selectively abolished, or considerably reduced, following Lidocaine anesthesia of the inner ear, functional depression of the inner ear is reversible. Anesthetizing the inner ear with Lidocaine, proved to be an effective method of treatmenting cochlear tinnitus. Of 58 ears thus treated, long-term persistent tinnitus was abolished in 20 and considerably reduced in 22.

Clinical Usefulness of Nasal Mucus Specimen for Rapid Influenza Antigen Test

During the 2004-2005 influenza season, a clinical study was conducted to evaluate the utility of nasal mucus collected by nose blowing as a specimen for the rapid influenza antigen test. In this study, nasal swab specimens and nasal mucus specimens were respectively collected from 136 patients who were suspected of having influenza infection. The nasal specimens were collected by existing standard methods and nasal mucus specimens were collected by the method that patients themselves blew their own noses. Then, both specimens were tested with a rapid influenza antigen detection kit (QuickVue rapid SP influ) and the results were compared. These results were also compared with the results of a culture test, which was performed as a gold standard.Out of 40 influenza patients (type A: 9; and type B: 31) who were diagnosed by the culture test, 7 nasal swab specimens were A positive (sensitivity: 77.8%) and 13 were B positive (sensitivity: 41.9%) and 7 nasal mucus specimens were A positive (sensitivity: 77.8%) and 18 were B positive (sensitivity: 58.1%) with the rapid test. On the other hand, out of 96 influenza negative patients, all specimens of both types showed negative results (specificity: 100%) with the rapid test.These results indicate that nasal mucus specimens collected by patients blowing their own nose have an equal or superior performance (sensitivity and specificity) to existing nasal swab specimens for the influenza antigen rapid test. Considering the easier and safer sampling practice of the nasal mucus specimen, we concluded that nasal mucus specimens collected by nose blowing have a clinical usefulness in the rapid influenza antigen test.

ALCOHOL AND THE OCULOMOTOR SYSTEM

It is known that alcohol affects the oculomoto system and elicits positionalacoholnystagmus Recently it has been shown that disturbance in smooth pursuit eye movements occurs depend-ing on the quantity of ingested alcohol.However, it is also known that test is normal at the early stage of alcohol-induced breakdown of smooth pursuit movements.This indicates that alcohol affects the cerebellum prior to affecting the midbrain and pons(WILKINSON et al., 1974).In order to further investigate the effect of alcohol on th cerebellum, subjects ingested alcohol(whisky)and their oculomotor function was tested.The followings are general findings obtained.1)Low blood-alcohol concentration causes slight disturbance in the caloric eye-tracking pattern and slight positional nystagmus is occasionally evident.2)As the blood-alcohol level increases, positional nystagmus becomes more apparent and the eye-tracking pattern begins to break down.The caloric eye-trackingpa ttern be-comes severely disturbed.3)Gaze nystagmus does not appear until the blood-alcohol level becomesmuch higher.hese findings indicate that alcohol affects the caloric eye-tracking patterns prior to the conventional eye-tracking patterns.Alcohol must therefore initially affect the areas of the cerebellum related tovisual suppression, namely the flocculo-nodular system.