bluuebunny/crossref_metadata_2025 huggingface dataset:
The Results of Trabeculectomy with and without Mitomycin C in Young Patients
Authors: Yalvac Ilgaz Sagdic , Nurözler Ayse , Kahraman Canan , Kasim Remzi , Duman Sunay
Published: April 2003

The results of primary trabeculectomy with and without mitomycin C (MMC) were evaluated in young glaucoma patients. The patients, 15–40 years of age, were divided into two main groups and two subgroups. In group IA, primary Cairns type trabeculectomy was performed in 24 eyes of 24 patients with juvenile glaucoma; in group IB, trabeculectomy + MMC 0.4 mg/ml in 3 min was done in 20 eyes of 20 patients with juvenile glaucoma; in group IIA, primary trabeculectomy was performed in 20 eyes of 20 patients with developmental glaucoma, and in group IIB, trabeculectomy + MMC 0.4 mg/ml in 3 min was performed in 16 eyes of 16 patients with developmental glaucoma. The success rate of the surgery was 75% in group IA, 90% in group IB, 50% in group IIA, and 75% in group IIB. There was no statistically significant difference among the groups in terms of success rates of trabeculectomies (p > 0.05).
Effect of Intraocular Acetylcholine and Carbachol on the Corneal Endothelium
Authors: Roszkowska Anna M. , Ferreri Giuseppe , Squeri Carlo A. , D’Angelo Paolo , Ferreri Felicia M.  B.
Published: April 2003

The purpose of this study is to evaluate differences in corneal endothelial cell loss after intraocular use of two different miotics in subjects who have undergone extracapsular cataract extraction with posterior chamber intraocular lens implantation. The patients were divided into two groups: the first received 1 ml of 1% acetylcholine chloride and the scond 0.5 ml of 0.01% carbachol as intraocular miotics. The endothelial count was done preoperatively and then 1 month after cataract extraction. There were no statistically significant differences in the mean cell loss between both groups. The authors believe that both miotics could be used in cataract surgery.
Restrictive Limitation of Sursumduction Caused by an Anomalous Muscular Structure
Authors: Savino Gustavo , D’Ambrosio Anna , Tamburrelli Ciro , Colosimo Cesare , Dickmann Anna
Published: April 2003

We report a peculiar case of congenitally restricted sursumduction caused by an anomalous band-like structure within the right orbit which was completely distinct from the extraocular muscles. Imaging (static and dynamic ultrasound studies of the orbit and globe, CT and MRI) revealed the origin of the anomalous structure in Zinn’s ring, its intraconal course and bulbar insertion. The ultrasound characteristics were similar to those of the extraocular muscles and optic nerve, and contractile activity appeared to occur during eye movements. The seemingly muscular nature of this structure and its total autonomy with respect to the normal extraocular muscles distinguish this case from previously reported cases of congenital restrictive strabismus.
Ultrastructure of the Lens Epithelium in Alport’s Syndrome
Authors: Sargon Mustafa F. , Çelik H. Hamdi , Şener Cumhur
Published: April 2003

The ultrastructure of the lens epithelium in Alport’s syndrome was studied. In a transmission electron-microscopic examination, a large number of tonofilaments, swollen mitochondria, a dilated Golgi complex, a dilated rough endoplasmic reticulum with electron-dense (osmiophilic) material in some of these irregular structures and myelin figures were observed. Most of the cells had regularly shaped and only a few of them irregularly shaped nuclei. Additionally, polymorphism and marked degeneration in the transitional zone were observed in the scanning electron-microscopic examination of the lens epithelium. After the transitional zone, there were no epithelial cells present under the lens capsule, an observation that has never been reported in the literature.
Role of Nocturnal Arterial Hypotension in Optic Nerve Head Ischemic Disorders
Authors: Hayreh SohanSingh , Podhajsky Patricia , Zimmerman M.Bridget
Published: April 2003

Objective: To investigate the role of nocturnal arterial hypotension, intraocular pressure (IOP) and heart rate in optic nerve head (ONH) ischemic disorders, and the effects of systemic factors and topical β-blocker eye-drops on nocturnal arterial hypotension and heart rate. Methods: We investigated prospectively, by 24-hour ambulatory blood pressure (BP) monitoring and diurnal curve of the IOP, 275 white patients with anterior ischemic optic neuropathy (AION – 114), normal tension glaucoma (NTG – 131) and primary open angle glaucoma (POAG – 30). Results: Hourly average BP data analyses showed a significantly greater drop in mean diastolic BP (p < 0.009) at night in NTG than AION. Cases with visual field deterioration had significantly (p = 0.05) lower minimum nighttime diastolic BP. Arterial hypertensives on oral hypotensive therapy showed a significantly lower mean nighttime systolic BP (p = 0.006) and larger mean percentage drop in systolic (p < 0.0001), diastolic (p = 0.0009) and mean (p < 0.0001) BPs. Normotensives and hypertensives without therapy had no such difference. IOP showed no significant correlation with visual field deterioration in any of these conditions. Patients using β-blocker eyedrops, compared with those not using them, had greater percentage drop in diastolic BP (p = 0.028), lower minimum nighttime diastolic BP (p = 0.072) and lower minimum nighttime heart rate (p = 0.002). Conclusions: Findings of our study suggest that nocturnal hypotension, by reducing the ONH blood flow below a crucial level during sleep in a vulnerable ONH, may play a role in the pathogenesis of AION and glaucomatous optic neuropathy (GON) and progression of visual loss in them. Thus, nocturnal hypotension may be the final insult in a multifactorial situation.
Peripheral Choriovitreal Neovascularization in Proliferative Diabetic Retinopathy: Histopathologic and Ultrastructural Study
Authors: Ishibashi Tatsuro , Murata Toshinori , Kohno Toshihiko , Ohnishi Yoshitaka , Inomata Hajime
Published: April 2003

We describe the histopathologic and ultrastructural evidence of choriovitreal neovascularization in the peripheral fundus of a non-vitrectomized eye with proliferative diabetic retinopathy (PDR). One eye with PDR was surgically enucleated because of neovascular glaucoma and studied with light and electron microscopy. The eye had neovascular membranes at the ora serrata of the peripheral fundus. The newly formed vessels originated from the choroid, passed through Bruch’s membrane and the retina, and extended into the vitreous. These vessels had either developing or mature characteristics. The endothelial cells of the developing vessels contained a bulky cytoplasm with many intracytoplasmic filaments, ribosomes and rough endoplasmic reticulum. Budding endothelial cells were frequently found in the developing vessels. The endothelial cells of the mature vessels had attenuated cytoplasm and fenestrations with diaphragms. These observations suggest that choriovitreal neovascularization in the peripheral fundus is one of the features of PDR.
Comparison of Halothane/Thiopental and Propofol Anesthesia for Strabismus Surgery
Authors: Serin Simay , Elibol Orhan , Sungurtekin Hulya , Gonullu Mustafa
Published: April 2003

Day case surgery has become a widely accepted practice for many ophthalmological procedures including strabismus surgery. Prompt recovery from anesthesia and minimal postoperative morbidity are especially requested to the anesthesiologists to deal with the high day case surgery burden. The purpose of this study was to compare two anesthesia techniques, halothane/thiopental anesthesia and propofol anesthesia, for patients undergoing monocular strabismus surgery. We studied the level of postoperative consciousness, nausea and vomiting, ocular pain, starting oral intake and activity in 43 patients, ranging from 7 to 41 years of age. A scoring system was used to assess these parameters in the first postoperative 48 h. Although there was not a significant difference in the level of ocular pain, the propofol group had less morbidity in terms of having a better level of consciousness and appetite, less nausea and vomiting and enhanced activity than the halothane/thiopental group. We conclude that propofol anesthesia has significant advantages over halothane/thiopental anesthesia on an outpatient basis for strabismus surgery.
A Major Review of Antimetabolites in Glaucoma Therapy
Authors: Loon Seng Chee , Chew Paul T.K.
Published: April 2003

Antimetabolites have been used in combination with filtering surgery to improve surgical results for more than 10 years. Based on research published since the introduction of antimetabolites right up to date, we discuss the various forms of antimetabolites that have been used, including drugs and irradiation. Among the drugs used, mitomycin C and 5-fluorouracil are the most prominent. We discuss the background of these agents, the progress in the use of antimetabolites and the research done on these drugs. These agents have been used both intra-operatively and perioperatively. We discuss the indications for their use, their mode of action, the techniques of usage, their variations as well as the complications and the treatment of complications.
Benign Pleomorphic Adenoma Arising from the Palpebral Lobe of the Lacrimal Gland Associated with Elevated Intraocular Pressure
Authors: Yamada Tetsuya , Kato Tsuyoshi , Hayasaka Seiji , Hayasaka Yoriko , Kadoi Chiharu
Published: April 2003

A 46-year-old man complained of a painless mass in the left upper eyelid. At age 51 years, the patient complained of dull pain in the left eye and diplopia. His left intraocular pressure had increased to 33 mm Hg. No proptosis was noted. The nontender mass in the eyelid was palpable. Computed tomography showed a mass anterior to the orbital rim compressing the globe. The lesion was removed en bloc by a transconjunctival approach. Histopathologic examination of the excised mass showed myxomatous stroma and highly cellular epithelial areas. Postoperatively, the left intraocular pressure normalized. To our knowledge, benign pleomorphic adenomas arising from the palpebral lobe of the lacrimal gland associated with elevated intraocular pressure, as demonstrated in our patient, may be rare.
Color Doppler Imaging of Ocular Blood Flow after Topical Ketanserin
Authors: Cellini Mauro , Caramazza Roberto
Published: April 2003

The authors investigated the effect of ketanserin 0.5% eye drops on intraocular pressure and orbital blood flow in some healthy volunteers. Ketanserin is a selective antagonist of serotonin S2 receptors; moreover, it produces an α1-blocking effect. It causes a systemic reduction of blood pressure and capillary vasodilatation. Three hours after topical administration of ketanserin 0.5%, the intraocular pressure was decreased by about 14% from the baseline. At the same time, we observed by color Doppler imaging that the mean percent increase in the peak systolic velocity in the ophthalmic artery (OA) was 5.18% (p < 0.161) and 23.18% (p < 0.001) in the posterior ciliary arteries (PCAs). The mean resistance index of the OA was in contrast reduced by 1.16% (p < 0.669) and by 32.14% (p < 0.003) in the PCAs. These data show that ketanserin 0.5% eye drops may be useful not only to decrease intraocular pressure but also to improve blood flow in the PCAs that supply the optic nerve head.
Inflammatory Response in Experimental Staphylococcus andPseudomonas Endophthalmitis
Authors: Kim In Taek , Park Sung Kyu , Lim Jung Hoon
Published: April 2003

Staphylococcus epidermidis [2.0 × 104 colony-forming units (CFU)/0.1 ml] and Pseudomonas aeruginosa (2.0 × 103 CFU/ml) were inoculated in the vitreous humor of rabbits. In S. epidermidis endophthalmitis, the numbers of microorganisms reached a maximum (4.1 × 107 CFU/ml) at day 2 after inoculation and then declined spontaneously. However, clinical scores were observed to be worst at day 5. In P. aeruginosa endophthalmitis, the numbers of microorganisms reached a maximum (9.3 × 106 CFU/ml) 36 h after inoculation. However, culture results were persistently positive until day 15. Electroretinogram (ERG) b-wave amplitudes in S. epidermidis endophthalmitis continued to decrease from day 3 (>24%) until day 5, and then recovered to the preinoculative level of amplitudes at day 7. ERG b-wave amplitudes in P. aeruginosa endophthalmitis continued to decrease after 24 h (>24%). ERG b-wave amplitudes from day 7 to day 15 were flat. The inflammatory response continued under the absence of microorganisms in S. epidermidis endophthalmitis. The time in which a maximum in the number of microorganisms was reached was earlier than that in the clinical examination scores in both S. epidermidis and P. aeruginosa endophthalmitis.
Presumed Congenital Ocular Toxoplasmosis in Two Successive Siblings
Authors: Ladas Ioannis D. , Rallatos Charalampos Livir , Kanaki Christina S. , Damanakis Alexandros G. , Zafirakis Panayotis K. , Rallatos Gerasimos Livir
Published: April 2003

We present the cases of 2 consecutive siblings with bilateral macular lesions, for which there is strong clinical and laboratory evidence supporting the diagnosis of congenital ocular toxoplasmosis. These cases raise the possibility of maternal parasitemia during Toxoplasma gondii reinfection, leading to transmission to the fetus and congenital ocular toxoplasmosis despite prior immunity and lack of an immune disturbance in the mother.
Bilateral Granulomatous Panuveitis as Initial Presentation of Diffuse Systemic T Cell Lymphoma
Authors: Goeminne J.C. , Brouillard A. , Jaumain P. , Ferrant A. , Snyers B. , De Potter P.
Published: April 2003

A high-grade diffuse T cell lymphoma, initially simulating bilateral panuveitis, was diagnosed by analysis of a vitreous biopsy specimen and a breast tumor in a 57-year-old woman. It responded favorably to aggressive chemotherapy before it relapsed in leukemic transformation. This case emphasizes the misleading initial symptoms of primary intraocular lymphoma and the role of immunophenotyping in the diagnosis and classification of lymphoproliferative ocular disorders. The presentation and management of uveal lymphoid neoplasia are discussed.
Risk Factors in Retinopathy of Prematurity
Authors: Seiberth Volker , Linderkamp Otwin
Published: April 2003

Objective: To analyze risk factors in retinopathy of prematurity (ROP). Patients and Methods: Four hundred forty-seven surviving very-low-birth-weight infants (birth weight ≤1,500 g) were enrolled in a retrospective study. Clinical data underwent multivariate analysis using stepwise logistic forward regression. Results: For 402 of the babies a complete dataset of 38 possible risk factors was available. Multivariate analysis showed 10 factors to be independently significant variables. Low birth weight, low gestational age, artificial ventilation for more than 7 days, high volume of blood transfusion and surfactant therapy were risk factors associated with higher rates of ROP. Necrotizing enterocolitis, maternal pre-eclampsia, lung maturation by antepartum betamethasone application, vitamin E and phototherapy were accompanied by a lower incidence of ROP. Conclusions: This study confirms several risk factors recognized by previous statistical analysis. In addition, this study reveals maternal pre-eclampsia, which is associated with chronic intrauterine stress, as a statistically independent factor and as having an influence on the incidence of ROP.
Oxygen-Induced Retinopathy in the Newborn Rat: Morphological and Immunohistological Findings in Animals Treated with Topical Timolol Maleate
Authors: Ricci Benedetto , Ricci Francesco , Maggiano Nicola
Published: April 2003

Oxygen-induced retinopathy (OIR) similar to that seen in premature infants can be produced in newborn rats by exposure to 80% oxygen for the first 5 days of life, with subsequent recovery for 7 days in a room air environment. Previous studies have shown that the latter phase is associated with degeneration of retinal astrocytes. In the absence of astrocytes, the vascular endothelial growth factor (VEGF) is produced by the neurons of the inner retina. In this study, immunohistochemical methods were used to assess retinal expression of VEGF protein in ratlings exposed to the above protocol, with and without simultaneous treatment with topical timolol maleate. Intraocular pressure (IOP) and arterial pressure were measured. The severity of OIR was also evaluated in retinal flat mounts after India ink perfusion. The mean IOP was 8.25 ± 0.32 mm Hg in untreated ratlings and 5.15 ± 0.24 mm Hg in timolol-treated animals. OIR in retinas from the timolol group was less severe than that seen in untreated ratlings. VEGF protein expression was almost completely absent in the latter group. Retinas from timolol-treated animals expressed VEGF protein, though the level was inferior to that found in controls raised under room air conditions. In conclusion, these data seem to indicate that experimental OIR can be attenuated by a reduction of the IOP during and after oxygen supplementation. It is possible that these effects are due to improved ocular perfusion pressure, which would mitigate the hypoxic insult to the retina during the room air recovery period.
Indocyanine Green Angiographic Findings in Choroidal Hemangiomas: A Study of 75 Cases
Authors: Schalenbourg Ann , Piguet Bertrand , Zografos Leonidas
Published: April 2003

Indocyanine green (ICG) angiography is a new diagnostic modality that was suggested, in small series, to provide a typical angiographic pattern in cases of choroidal hemangioma. Our study, through an exceptionally large series of 75 patients, assessed in a prospective way whether a typical ICG pattern of choroidal hemangioma exists and what would be its possible variations. The most constant feature is the sequence of the different ICG angiographic phases. The arterial phase demonstrates the filling of intratumoral vessels on a hypofluorescent tumoral background. During the venous phase, the hemangioma reaches a stage of maximal ICG-A fluorescence, with superimposed hyper- and hypofluorescent spots. Sturge-Weber cases have also extratumoral hyperfluorescent spots. The late phase shows a hypofluorescent lesion with residual hyperfluorescent caverns and a well-delineated, but complex border structure.
Melanoma-Associated Retinopathy versus Abnormal Retinal Function due to Interferon-α/Isotretinoin Therapy in Cutaneous Malignant Melanoma
Authors: Feigl Beatrix , Faschinger Christoph , Soyer Peter
Published: April 2003

Purpose: To analyze whether an abnormal retinal function in patients with a cutaneous malignant melanoma was due to paraneoplastic retinopathy or due to isotretinoin or interferon-α. Methods: We studied 15 patients with malignant melanoma in stage IIa and IIb who are all participants in a randomized, multicentered, double-blind placebo-controlled clinical trial comparing interferon-α/isotretinoin versus interferon-α/placebo performed by the Department of Dermatology, University of Graz. Our assessment included a full ophthalmic history and examination, electrophysiological testing (ERG, EOG), dark adaption, color vision and visual field testing. Results: The most prevalent ocular symptom patients complained about was ocular dryness (8 patients). Electrophysiological as well as psychophysical testings showed no abnormalities in 12 patients. In 1 patient the therapy was stopped because of electrophysiological and psychophysiological pathology. This patient suffered from severe reduction of night vision and visual disturbances. Another patient had had night blindness since childhood which remained stable. Conclusions: We postulate that in 1 of 15 patients, visual complaints are caused with a high probability by melanoma-associated retinopathy although, in the literature, isotretinoin is described to show similar effects on retinal function.
Occlusions of Branch Retinal Arterioles following Amniotic Fluid Embolism
Authors: Kim In Taek , Choi Jeong Beom
Published: April 2003

Amniotic fluid embolism is a serious complication of pregnancy with a high mortality. We present a 28-year-old healthy woman who underwent dilatation and curettage for an elective abortion, followed by the sudden loss of vision in her left eye. Occlusion of one branch retinal arteriole was the initial finding of her left fundus, and two occlusions developed consecutively on the color fundus photographs. Fluorescein angiography demonstrated occlusions in three retinal arterioles among seven retinal arterioles originating from the optic disc. These findings suggest that possible mechanisms of amniotic fluid embolism are the unusual cause in retinal arteriolar occlusions. Here clinical course and ophthalmic findings are reviewed, and the relationship between amniotic fluid embolism and retinal arteriolar occlusions is discussed.
Anterior Uveal and Episcleral Metastases from Carcinoma of the Breast
Authors: Reddy S.C. , Madhavan M. , Mutum S.S.
Published: April 2003

Breast carcinoma is the most common primary tumor producing intraocular metastasis. Metastases to the iris and ciliary body are relatively rare. The authors report a case of a 61-year-old lady, operated for carcinoma of the left breast 3 years back, who presented with symptoms and signs of acute narrow-angle glaucoma in the right eye. A diffuse whitish plaque-like mass in the upper nasal quadrant of the iris with an episcleral nodule on the limbus in the corresponding area and all the signs of acute narrow-angle glaucoma were present in the right eye. Intraocular pressure was controlled medically. Fine-needle aspiration cytology from the episcleral nodule showed malignant cells. Histopathology of the excised nodule showed metastatic poorly differentiated carcinoma, and the cellular pattern was similar to the carcinoma of the breast. There was no other metastasis anywhere in the body. Fine-needle aspiration cytology from an external lesion of the eye is a less invasive and easier procedure than paracentesis to diagnose the metastatic nature of the lesions. The rare features in our case are the clinical presentation as acute glaucoma and the ocular structures being the first and only site of metastasis.
Effective Treatment with Topical Cyclosporin A of a Patient with Cogan Syndrome
Authors: Shimura Masahiko , Yasuda Kanako , Fuse Nobuo , Nakazawa Mitsuru , Tamai Makoto
Published: April 2003

The purpose of this report is to describe the effective treatment of severe anterior segment inflammation due to Cogan syndrome through the use of topical administration of cyclosporin A. A 47-year-old female patient had been experiencing headaches and difficulties with her vision. Subsequent examination revealed the sudden onset of bilateral conjunctival injection and swelling of bilateral auricles. Despite the multiple treatment (systemic and topical corticosteroid and antibiotic therapy), necrotizing scleritis had appeared bilaterally and the scleral wall was thinning. Topical administration of 1% cyclosporin A was applied to both eyes 4 times a day. After 2 months of this therapy, the epithelial tissue covered the necrotizing tissue and her symptom of ocular pain was relieved and her corrected visual acuity was improved. This is the first case exhibiting that topical cyclosporin A is an effective treatment for severe anterior segment inflammation associated with Cogan syndrome.
Memantine Suppresses the Glutamatergic Neurotransmission of Mammalian Inner Hair Cells
Authors: Oestreicher Elmar , Arnold Wolfgang , Ehrenberger Klaus , Felix Dominik
Published: April 2003

The glutamatergic synapses between inner hair cells and afferent neurons seem to be involved in pathophysiological conditions of the cochlea. The excessive release of glutamate from inner hair cells during noise trauma and ischemia affects the afferent neurons. It is possible that in tinnitus outer hair cell or inner hair cell dysfunction or damage leads to an altered spontaneous release of glutamate from inner hair cells. Thus, the pharmacological modulation of glutamatergic neurotransmission could be of great value in the therapy of certain inner ear diseases. Recently, it has been discovered that the spasmolytic drug memantine has antiglutamatergic properties. As a possible drug for inner ear diseases, we were interested in the action of memantine on the neurotransmission of inner hair cells. With the aid of microiontophoretic techniques we were able to show a strong depressing effect on spontaneous activity as well as on glutamate-induced activity. This effect seems to be mediated by a blockade of N-methyl-D-aspartate (NMDA) receptors as memantine showed a strong inhibiting effect on NMDA-induced activity but not on AMPA-induced activity. These results recommend memantine for the treatment of inner ear diseases, e.g. especially tinnitus.
The Presence of Platelet-Activating Factor-Acetylhydrolase in Human Middle Ear Effusions
Authors: Tsuji Hiroyuki , Furukawa Masayuki , Ikeda Hiroki , Asako Mikiya , Yamashita Toshio
Published: April 2003

Factors related to inflammation, including platelet-activating factor (PAF), apparently have a role in chronic otitis media with effusion. PAF is metabolized to the biologically inactive lyso-PAF by the enzyme PAF-acetylhydrolase (PAF-AH). We have obtained evidence that PAF-AH activity is present in human middle ear effusions in patients with chronic otitis media with effusion. The present study revealed the enzyme in human middle ear effusions to be the plasma type PAF-AH. We suggest that PAF-AH may be involved in regulating inflammation in the middle ear by inactivating PAF, the potent proinflammatory autacoid.
Kaposi’s Sarcoma of the Tonsil
Authors: Chetty Runjan , Batitang Sixto
Published: April 2003

Two cases of Kaposi’s sarcoma presenting as tonsilar masses in HIV-positive patients are described. At the time of examination neither patient had other manifestations of AIDS. Both patients also had concomitant cervical lymphadenopathy at the time of presentation, but the tonsillar masses were the dominant clinical findings. Biopsy of both tonsils revealed typical features of Kaposi’s sarcoma. Both patients subsequently defaulted treatment and have been lost to follow-up.
Treatment of an Esophagorespiratory Fistula by Insertion of an Esophageal Montgomery and Tracheal Dynamic Stent after Failure of Conventional Endoprosthesis
Authors: Alexiou Ch. , Neuhaus H. , Kau R.J. , Hauck R. , Classen M.
Published: April 2003

Esophagorespiratory fistulae at the adult age can develop through malignant tumor growth, endoscopy, bougienage, laser therapy, or through a radiochemotherapy. We report a female patient with inoperable bronchial cancer, who developed a symptomatic esophagorespiratory fistula during radiochemotherapy with cisplatin. At first, conventional plastic tubes and then novel selfexpanding silicone-coated Gianturco-Song stents were used in an unsuccessful attempt to close the fistula. After the extraction of two Gianturco-Song stents, the insertion of a Montgomery-Salivary bypass stent in the esophagus and a dynamic stent in the trachea resulted in a permanent occlusion of the fistula. This case demonstrates that Montgomery-Salivary bypass stents do not tend to migrate due to their characteristic shape and self-fixation, and that the novel self-expanding, silicone coated Gianturco-Song stents can be extracted with rigid endoscopy if necessary.
{FC12}aB-Crystallin in the Mammalian Inner Ear
Authors: May Ch. Albrecht , Arnold Barbara , Welge-Lüssen Ulrich , Arnold Wolfgang , Bloemendal Hans , Lütjen-Drecoll Elke
Published: April 2003

To study the distribution of αB-crystallin, formalin-fixed preparations of the inner ear of the rat, cynomolgus monkey, rhesus monkey and human were stained immunohistochemically for αB-crystallin. In all cochleae investigated, intense staining for αB-crystallin was found in the inner and outer pillars as well as in the cells of Hensen and Claudius. In the primate inner ear, αB-crystallin was also present in the polygonal epithelial cells of Reissner’s membrane, the interdental cells and some fibrocytes of the spiral limbus, epithelial cells of the outer spiral sulcus and the Schwann cells of the 8th nerve. In the primate stria vascularis, αB-crystallin was mainly seen in the basal cell layer and the adjacent cells of the connective tissue layer. αB-crystallin was found to be present in a large variety of cells in the inner ear surrounding the scala media.
High-Speed Digital Videoimaging of Fast Eardrum Motions During Valsalva Maneuver
Authors: Vorwerk Ulrich , Hey Matthias , Steinicke Gunnar , Begall Klaus
Published: April 2003

Digital high-speed camera systems are used to record high-frequency videoclips. After adapting this technology to the analysis of eardrum motions, fast motions of the eardrum can be recorded using an endoscope. Under specific static pressure conditions during the Valsalva maneuver, recordings of eardrum motions were made. The use of a Kodak Image Ektapro 1000 Motion Analyzer allowed only conventional videosignal processing and storage. A new type of data interface made it possible to save and process the complete videoclip digitally. Using an image-processing workstation and special mathematical algorithms, three-dimensional computer animations of fast eardrum motions under static pressure can be generated. In the present study, several animations of fast eardrum movements are described. High-speed digital videoimaging is an adequate method to describe fast eardrum displacements under static pressure (Valsalva maneuver). It is possible to create visible time-shift images of separate eardrum parts during the fast Valsalva maneuver.
A CT Study of the Course of Growth of the Maxillary Sinus: Normal Subjects and Subjects with Chronic Sinusitis
Authors: Ikeda Atsuko , Ikeda Motohisa , Komatsuzaki Atsushi
Published: April 2003

We measured the maxillary sinus volume of normal children and those with bilateral chronic sinusitis by coronal CT scan of the paranasal sinus, and compared the results with findings previously obtained from adult patients. The distribution of mean maxillary sinus volume by age group from 4–9 to 70–79 years exhibited a monomodal pattern with a peak in the 20s in both the normal group and the surgical therapy group. The maxillary sinus volumes of children aged 10–15 years and adults tended to be smaller in the surgical therapy group than in the normal group; this tendency was more prominent in the adult group. These findings appear to support the hypothesis that the ethmoid infundibulum and middle meatus are narrowed by inflammation of the ostiomeatal complex and by various bony anatomic variations in the nasal cavity, leading to impaired pneumatization of the maxillary sinus.
Adult Rhabdomyoma Located Near the Thyroid Gland
Authors: Harbo Grethe , Jensen Steen
Published: April 2003

A case of adult rhabdomyoma, a rare muscle-derived tumor, is described in a 40-year-old man. The tumor was located in close proximity to the thyroid gland and was initially misinterpreted as an adenoma of the gland. The most important differential diagnoses are discussed including methods available for differentiating those from rhabdomyoma.
Stereocilia-Like Structures in the Endolymphatic Sac in Ménière’s Disease and Acoustic Neuroma
Authors: Danckwardt-Lillieström Niklas , Friberg Ulla , Kinnefors Anders , Rask-Andersen Helge
Published: April 2003

The vestibular aqueduct was surgically removed in 3 patients undergoing labyrinthectomy due to severe Ménière’s disease (MD). Stereocilia-like structures were found in the luminal contents of the endolymphatic sac (ES) in all of these patients. The ES from 18 patients with acoustic neuroma were used as controls. In 1 of these, numerous stereocilia-like structures were found in the ES and in 3 additional patients, a few isolated cilia-like structures were disclosed. The findings may suggest an ongoing hair cell degeneration in the inner ear that is more advanced in patients with MD. The data also suggest that the endolymphatic duct is patent and that a longitudinal flow of endolymph also occurs in patients with MD.
Correlation between Objective and Subjective Assessments of Nasal Patency
Authors: Hirschberg Andor , Rezek Ödön
Published: April 2003

The correlation between the subjective sensation of nasal patency and nasal resistance (NR) to airflow was examined in a large population. The subjective estimation was assessed by a visual analogue scale and the NR by active anterior rhinomanometry in 158 subjects. Evaluation and statistical analysis – including correlation and regression analysis – were computerized. A statistically significant correlation was found between the subjective and objective values (r = –0.301, p < 0.001). There was no correlation between the parameters if the groups with or without nasal obstruction were evaluated apart. In 84% of the cases, the narrower side of the nose was identified with both the objective and the subjective methods. Statistically significant correlations were exhibited between the subjective and the objective measures if unilateral NR and the ipsilateral subjective values were related to each other (n = 316, r = –0.476, p < 0.001), in both cases, on the side of the higher and the lower NR. The best correlation was found on the side of the higher NR, that is when nasal breathing is more impeded. Subjective estimation seems to be sufficient only to indicate the more obstructed side of the nose independently from the dimensions of the NR values.
Platysma Myocutaneous Flap Including the External Jugular Vein with Special Reference to Neck Dissection
Authors: Saito Hitoshi , Tsuda Gota , Ohtsubo Toshio , Noda Ichiro , Fujieda Shigeharu , Saito Takehisa
Published: April 2003

Although platysma myocutaneous flap (PTMCF) is suitable for a small intraoral defect, combination with neck dissection (ND) decreases the viability. Therefore, a version of PTMCF was devised to increase the viability. This version consists of three points: preservation of the external jugular vein (EJV), preservation of the facial artery after skeletonization from the submandibular gland, and a new incision around the flap. This procedure was applied to 21 patients with intraoral cancer. All 21 patients underwent some kind of ND. The average viable area of transferred skin was 80%. This rate was significantly better than that for 46 previous cases using Farr’s modification with ND, in which the facial artery was divided. Viability of the flaps was analyzed by the vessels preserved, especially by EJV. ND is not a contraindication with this version.
Successful Treatment of Angioimmunoblastic Lymphadenopathy with Dysproteinemia by Local Irradiation
Authors: Okamura Hiro-oki , Misawa Takanori
Published: April 2003

We report an 85-year-old man presenting with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) of the palatine tonsil with cervical and axillary lymph node enlargement, pleural effusion and hypergammaglobulinemia. The patient was treated in Internal Medicine with combined chemotherapy with steroids which resulted in a complete remission. However, he returned almost 1 year later with an ulcerative lesion in the left palatine tonsil, with no lymph node involvement. Considering that the patient was an elderly person, chemotherapy had been administered during the initial admission, tumor cells appeared to originate from T cells and relapse occurred only in the local lesion, the lesion was treated by local irradiation using 60Co at a dose of 40 Gy, which produced a complete resolution. Radiotherapy appeared to be effective for the treatment of localized lesions of AILD.
Lipopolysaccharide-Induced Expression of Reactive Oxygen Species and Peroxynitrite in the Guinea Pig Vestibular Organ
Authors: Takumida Masaya , Popa Raul , Anniko Matti
Published: April 2003

The purpose of this study was to investigate the occurrence of reactive oxygen species and peroxynitrite in the vestibular organ of the guinea pig following inoculation with bacterial lipopolysaccharide (LPS). The animals were injected transtympanically with 1 mg of LPS 24 h after the intraperitoneal injection of 0.1 mg LPS. Forty-eight hours after the inoculation, varying degrees of degeneration of the vestibular end organs were observed. Immunohistochemical study revealed immunoreactivity to xanthine oxidase (which generates O–2) in the vestibular organ after inoculation with LPS. Immunohistochemical investigation with a specific antinitrotyrosine antibody also showed intense staining of sensory epithelium, fluid transporting cells and the endolymphatic sac, suggesting formation of peroxynitrite in the vestibular organ through the reaction of NO with O–2. On the basis of these data, it can be concluded that NO together with O–2, which form more reactive peroxynitrite, may be the most important pathogenic agents in LPS-induced labyrinthitis in the guinea pig.
Intracellular Calcium Suppresses Mechano-Electrical Transduction Current in Chick CochlearHair Cells
Authors: Kimitsuki T. , Taira T. , Komune S. , Komiyama S.
Published: April 2003

Intracellular calcium concentration ([Ca2+]i) was elevated by photolysis of the caged calcium compound, Nitr-5, and by use of the intrapipette perfusion technique in hair cells dissociated from the chick cochlea. An increase in [Ca2+]i induced an outward-going current at a membrane potential of –40 mV, as recorded with an intracellular medium of 160 mM KCl. This current was carried by the Ca2+-activated K+ current. In contrast, an increase of [Ca2+]i induced an inward-going current at –50 mV with a 160 mM CsCl-based intracellular medium. This inward-going current was carried by the Ca2+-activated non-selective cation current. The amplitude of the mechano-electrical transduction current was suppressed by the increase of [Ca2+]i, achieved both by photolysis and by use of the intrapipette perfusion method.
Programmed Cell Death in the Mouse Cochleovestibular Ganglion during Development
Authors: Nishizaki Kazunori , Anniko Matti , Orita Yorihisa , Masuda Yu , Yoshino Tadashi
Published: April 2003

Programmed cell death (PCD) is as essential to development as is cell proliferation. Our objective was to elucidate the spatiotemporal occurrence of PCD during the development of the cochleovestibular ganglion. We performed a time-sequence study on the distribution of in situ PCD, apoptosis, during the development of the mouse cochleovestibular ganglion by using the TUNEL method to detect apoptosis histochemically. Apoptosis in the cochleovestibular ganglion was observed from the 11.5th gestational day (GD) to the 18.5th GD. Apoptosis was seen most extensively in the vestibular ganglion cells at the 13.5th GD, while in the spiral ganglion cells apoptosis was maximal between the 15.5th and 16.5th GD. Because these times of peak apoptotic activity almost exactly corresponded to the events of innervation and terminal mitosis of the cochleovestibular ganglion cells, we infer that PCD is involved in the innervation and modulates the number of cochleovestibular ganglion cells overproduced by terminal mitosis.
Interleukin-2 Affects Cochlear Function Gradually but Reversibly
Authors: Kubo Takeshi , Anniko Matti , Stenqvist Monika , Hsu Wey-Jim
Published: April 2003

Interleukin-2 (IL-2), one of the chemical mediators produced by helper T cells, activates its target cells via its receptor and induces inflammatory reactions indirectly. In this study, IL-2 was instilled into the round window niche of rats and the electrophysiological effects of inflammation on the inner ear were evaluated by a frequency-specific auditory brainstem response (ABR) technique. ABR threshold curves and intensity-latency (I-L) curves were investigated. In most cases, moderate sensorineural hearing loss (SNHL) was observed in the high-frequency areas (16–31.5 kHz). In the time course investigation of I-L curves, the responses of SNHL type appeared only 1 day after instillation (day 1) gradually becoming more prominent, to become most pronounced on days 5–7. The electrophysiological impairment was reversible within 2 weeks. Differing degrees of responsiveness of effusion production were observed following the instillation of IL-2, varying from pronounced middle ear effusion causing rather severe mixed hearing loss, to complete lack of effusion. Inflammation induced by IL-2 affects cochlear function gradually but reversibly.
Vagal Paraganglioma
Authors: Furukawa M. , Furukawa M.K. , Matsuda H. , Tsukuda M. , Kamijo S. , Nakatani Y. , Taguchi T.
Published: April 2003

Vagal paragangliomas are rare tumors and difficult to differentiate from carotid body tumors or schwannomas of the vagus nerve. We present a patient who could be preoperatively diagnosed as having a vagal paraganglioma by ultrasonography and color Doppler sonography.
Diagnosis of Cochlear Ménière’s Disease with Electrocochleography
Authors: Dornhoffer John L.
Published: April 2003

The existence of cochlear Ménière’s disease, once considered a variant of classic Ménière’s disease but without vertigo, has been questioned due to lack of objective evidence that endolymphatic hydrops is involved with the disease process. Transtympanic electrocochleography (TT ECoG) has emerged as a useful tool for electrophysiologic monitoring of the inner ear, and is especially valuable in assessing endolymphatic hydrops. A retrospective chart review was performed to identify those patients with a diagnosis consistent with cochlear Ménière’s disease in order to determine the presence or absence of endolymphatic hydrops using TT ECoG. A total of 7 patients were identified with at least a 2-year follow-up. Using established norms for the summating potential to action potential ratio with click stimulus, 67% of the ears examined demonstrated values consistent with endolymphatic hydrops. Fluctuating aural pressure and tinnitus were present in all patients and medical therapy of diuretics and salt restriction seemed to stabilize or improve the condition in about 80% of the patients. Theoretical considerations are discussed, and a case history of 1 of the study patients is presented to illustrate a typical example of this variant of Ménière’s disease.
Effect of Acoustic Trauma on Cytochrome Oxidase Activity in Stria vascularis
Authors: Hsu Chuan-Jen , Liu Tien-Chen , Lin Kai-Nan
Published: April 2003

The present study was undertaken to determine the role of metabolic disturbance in noise-induced hearing loss by histochemical studies of cytochrome oxidase activity. Adult normal albino guinea pigs were used. The experimental animals were exposed to broad-band noise at 105 dB SPL for 24 h. The control animals were not exposed to the noise. The thresholds of the auditory brainstem response (ABR) of all guinea pigs were measured 3 times: before noise exposure, 1 day and 1 month later. The difference between the ABR thresholds before and after noise exposure was statistically significant. Vibratome sections of decalcified cochleae of the noise-exposed (n = 8) and control groups (n = 4) were incubated with Spector’s medium and embedded with Epon. Thin sections (2 µm) and ultrathin sections (100 nm) were cut to observe cytochrome oxidase activity in the stria vascularis under light and electron microscopes, respectively. A decreased activity of cytochrome oxidase was consistently shown in the normal-appearing stria vascularis of most noise-exposed ears. Acoustic trauma has an adverse effect on cytochrome oxidase activity in the stria vascularis as well as on hearing. A decrease in the activity of cytochrome oxidase implicates that metabolic damage may play a role in noise-induced hearing loss.
Bilateral Cholesterol Granulomas of the Temporal Bone
Authors: Eby Thomas L. , Guthrie Barton L.
Published: April 2003

Cholesterol granulomas of the temporal bone without clinical symptoms of chronic otitis media may result from an indolent inflammatory process caused by a congenitally blocked group of air cells. A unique case of giant bilateral cholesterol granulomas of the temporal bone is presented to support this theory. Management allowed bilateral surgical removal with hearing preservation. The differentiation between cholesterol granuloma, giant cholesterol cyst and other lesions of the temporal bone is discussed. The presumed pathogenesis of this condition is reviewed.
Free Radicals in the Guinea Pig Inner Ear following Gentamicin Exposure
Authors: Takumida Masaya , Popa Raul , Anniko Matti
Published: April 2003

The purpose of this study was to investigate the occurrence of free radicals, nitric oxide (NO), superoxide (O–2) and peroxynitrite, in the inner ear of the guinea pig following intratympanic injection with 5 mg of gentamicin (GM). Forty-eight hours after GM injection, varying degrees of degeneration of the inner ear were observed. Immunohistochemical study revealed immunoreactivity to NO synthase II (which generates NO) and to xanthine oxidase (which generates O–2) in both the vestibular organ and the organ of Corti. Immunohistochemical investigation, using a specific antinitrotyrosine antibody, also showed intense staining, suggesting formation of peroxynitrite in the inner ear through the reaction of NO with O–2. Scanning electron-microscopic study showed that the ototoxic effects could be blocked with N-nitro-L-arginine methylester, a competitive inhibitor of NO synthase, with superoxide dismutase, an O–2 scavenger, and with ebselen, a scavenger of peroxynitrite. On the basis of these findings, it can be concluded that NO together with O–2, which form more reactive peroxynitrite, play an important role in GM ototoxicity in the guinea pig.
Perilymphatic and Endolymphatic Pressure in the Normal Guinea Pig
Authors: Warmerdam T.J. , Schröder F.H.H.J. , Wit H.P. , Albers F.W.J.
Published: April 2003

Perilymphatic and endolymphatic pressures were measured consecutively in the normal guinea pig using a WPI 900A micropressure system. The mean (n = 10) perilymphatic and endolymphatic pressures were 2.26 and 2.31 cm H2O, respectively. There was no statistically significant difference between the pressures of the endolymphatic and perilymphatic compartments. The measured values were within the range of pressures found in the literature.
Long-Term Prognosis of Profound Facial Nerve Paralysis Secondary to Acoustic Neuroma Resection
Authors: Kunihiro Takanobu , Kanzaki Jin , Shiobara Ryuzo , Inoue Yasuhiro , Kurashima Kazuhiro
Published: April 2003

The long-term prognosis of profound facial nerve paralysis was reviewed in 107 patients who, despite preserved nerve continuity, showed no facial movement after acoustic neuroma resection. Spontaneous recovery occurred in 77 patients. However, there was no apparent recovery in 30 patients. Twenty-two of these patients underwent hypoglossal-facial nerve anastomosis 7–33 months after tumor resection. When spontaneous recovery occurred, the first sign of remission was observed between 3 and 4 months after surgery in nearly half of the patients. Such a sign did not appear after 12 months. The recovery of facial movement deteriorated depending on how long remission onset was delayed. However, the quality of facial movement in patients with such delayed remission was still identical or better than that in those after hypoglossal-facial nerve anastomosis. These results showed that hypoglossal-facial nerve anastomosis should be performed approximately 1 year after tumor resection if no sign of remission has been observed by then.
Cytokine Expression of Human Oral Keratinocytes
Authors: Formanek Michael , Knerer Birgit , Kornfehl Johannes
Published: April 2003

The present study aimed to examine the cytokine expression pattern of human oral mucosa-derived keratinocytes at the protein and RNA level. The mRNA expression was measured by a RT-PCR method and the protein production was determined by an ELISA technique. In freshly isolated oral keratinocytes, IL-1α (interleukin 1α), IL-6, IL-8, transforming growth factor β, tumor necrosis factor α and basic fibroblast growth factor were detectable at the protein and mRNA level, whereas platelet-derived growth factor, acidic fibroblast growth factor and transforming growth factor α were found only at the mRNA level. There were no detectable signals of IL-2 and IL-4. The cytokine production at the protein level was independent of prior stimulation with phorbol myristate acetate. Our results show that human oral keratinocytes – under nonpathological conditions – produce a cytokine pattern quite similar to that of epidermal keratinocytes, which may have implications for further functional studies.