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Biomedical subjects

K Mizukoshi

Publications and source records attributed to K Mizukoshi.

At least 73 records · Page 4Linked to original sources

Otoneurological findings in inner ear syphilis.

Eighty-one ears in 48 patients who had had ear syphilis for the past ten years were studied and otoneurological examinations reviewed. Twenty-five of 48 cases complained of vertigo, 13 of giddiness and/or unsteadiness, and 10 cases denied dizziness. Approximately one half of the patients had abnormal findings on primary equilibrium examinations, such as Mann's test and stepping test. Spontaneous nystagmus and positional nystagmus were frequently seen on electronystagmographic examinations. Many patients showed abnormal responses to the bithermal caloric test and pendular rotation (VOR) test. Moreover, 5 of 8 patients had positive furosemide VOR tests. On transtympanic electrocochleography, 13 of 22 ears demonstrated a dominant -SP response. Eleven of 26 ears had positive findings on an intravenously administered glycerol test. In conclusion, some cases of inner ear syphilis show the characteristic findings of endolymphatic hydrops.

Adult↗

A clinical study of electrocochleography in Menière's disease.

Electrocochleography (ECochG) of 168 ears with definite Meniere's disease was studied. The results were compared with recordings from 29 normal ears and 444 ears with other types of sensorineural hearing loss. It is shown that the SP/AP ratio is much more useful than SP amplitude for detecting endolymphatic hydrops. There was little difference in the mean values of SP/AP from those proposed by many other investigators; the mean values all being near 0.25. From 0.30 to 0.40 of SP/AP was considered adequate as the upper limit. Following intravenous administration of glycerol, a significant decrease in SP/AP was found in 21 Meniere's ears. However, there was no change of SP/AP after oral administration of glycerol and isosorbide. This difference may be due to the fact that a larger oral than intravenous administration is necessary to affect SP/AP. Although a postoperative decrease of 10% or more in SP/AP was observed in 5 patients, 10 patients followed up for 2 years or more after surgery did not show a statistically significant change of SP/AP and pure tone threshold. ECochG should be repeatedly recorded to be useful as a monitor for the presence of hydrops. It is discussed whether biochemical or mechanical changes in endolymph may cause a decrease in SP/AP after the use of dehydrating agents and endolymphatic sac surgery.

Audiometry, Evoked Response↗

Difference between visual feedback and visual suppression upon the stabilization of body sway in normal subjects.

We developed a system to feedback the center of foot pressure by vision using a microcomputer. The subjects were instructed to adjust the center of foot pressure (displayed on the computer display at real time) to the point of intersection of the two stable (horizontal and vertical) lines on the computer display. The peak of the power spectra of body sway shifted significantly to the higher frequency range in the Y component (the lateral direction) in the visual feedback condition. Thus, we conclude that the visual feedback of body sway depends mainly on the error signals between the fovea and the image in the lateral direction to stabilize body sway.

Adult↗

Blood pressure abnormalities as background roles for vertigo, dizziness and disequilibrium.

In 3 years, a total of 1,291 patients have undergone equilibrium examinations because of vertigo, dizziness and disequilibrium in the Otoneurological Division of Toyama Medical and Pharmaceutical University. Abnormal blood pressures (hypertension, hypotension and orthostatic hypotension) were found in 18.67% (241 patients). Hypotension was found significantly more often in peripheral vestibular disorders and hypertension in central nervous system disorders. Furthermore, the incidence of orthostatic hypotension was statistically higher in hypertensive patients than in hypotensive patients. Therefore, we conclude that blood pressure measurement by the Schellong test method in patients with vertigo, dizziness and disequilibrium is very important.

Adolescent↗

Retro-labyrinthine disorders detected by galvanic body sway responses in routine equilibrium examinations.

Galvanic stimulation applied to the head provides important information for differential diagnosis between inner ear and retro-labyrinthine disorders of the vestibular system. So far, galvanic stimulation has been difficult to introduce in routine practice because of side effects such as severe pain around the electrode area. We have developed a new method to record fine body sway elicited by low current stimulation of less than 0.4 mA and to quantitatively evaluate the responses by Fourier transform. During the past 5 years, 502 patients, showing uni- or bilateral canal paresis in the caloric test or findings of central disequilibrium, were tested by this method without producing any side effects. In 122 patients (24.8%), such as sudden deafness, acoustic tumour, vascular disorders of the CNS system and so on, findings of retro-labyrinthine disorders were detected. It has been concluded that this method was easy to perform and very useful for differential diagnosis of diseases of the vestibular system.

Aged↗

Neurotological follow-up studies upon Minamata disease.

During 1986-87, 35 patients with organic mercury intoxication, who had been recognized as having Minamata disease by the Arbitration Committee in Niigata during 1968-78, were followed up neurotologically in Kido Hospital, Niigata, Japan. Characteristic follow-up features were served, as follows. 1. In 6 cases, spontaneous nystagmus had disappeared, but had newly appeared in 9 cases. However, positional nystagmus was markedly improved in 15 cases. 2. In OKN tests, especially in the vertical OKN test, relatively significant deterioration was observed at the follow-up examinations. 3. There was little significant change in the caloric nystagmus test and body-equilibrium tests. 4. In pure-tone audiometry, 16 out of 58 ears showed deterioration of hearing (28%), while 4 ears showed improvement (7%). In the neurotological findings there was much variation among the patients themselves. Therefore, these variable findings should be considered as being caused not by duration of the intoxication alone, but also by ageing factors in the patients.

Adult↗

The furosemide VOR test for Menière's disease. A preliminary report.

In order to easily detect endolymphatic hydrops and to avoid the side effects, we applied a furosemide VOR test in 24 patients with unilateral Meniere's disease, 6 patients with delayed endolymphatic hydrops, and 2 patients with labyrinthine syphilis. Immediately preceding an i.v. injection of 20 mg furosemide, and then 30, 60, 90 min after the administration, the VOR test was repeatedly performed. The slow-phase velocity in the VOR test was measured during harmonic sinusoidal rotation with eyes closed. Increased or decreased VOR-DP% beyond the normal range (10%) was referred to as positive. In 13 out of 24 cases (54%) with Menieres's disease, positive results were observed. Moreover, 4 out of 6 (67%) with delayed endolymphatic hydrops, one case out of 2 with labyrinthine syphilis were also positive in the furosemide VOR test. From these clinical investigations, we have concluded that the furosemide VOR test appeared to be another type of clinical test for the detection of vestibular endolymphatic hydrops.

Adult↗

[A case of primary pulmonary cryptococcosis showing spontaneous recovery].

A 37-year-old woman was admitted with fever and cough. The chest roentgenogram revealed a solitary large round mass in the right lower lung field. Diagnosis was made by transbronchial lung biopsy. There was no evidence of abnormal cell-mediated immunity. The patient made an uneventful recovery and the chest X-ray showed progressive clearing without specific therapy. After 6 months, the mass lesion disappeared. This case suggests that specific therapy may not be necessary for all cases of primary pulmonary cryptococcosis.

Adult↗

Prognostic value of blink test in patients with facial paralysis.

In order to gain an early estimate of a prognosis for facial paralysis, the vertical eye movements associated with eyeblinks (Bell's phenomenon) in 39 patients with acute unilateral Bell's paralysis and Hunt's syndrome and of 21 normal subjects were recorded by electronystagmography. These data were then analysed with a small digital computer (PDP 11/34). The results were compared with electroneurography (ENoG) and nerve excitability test (NET) results and can be summarized as follows: 1. Difference in velocity and amplitude between left and right eye movement during eyeblink (called blink index), diminished in inverse proportion to any improvement of lagophthalmos. 2. All the 5 patients showing more than 80% in maximum blink index (MBI) proved to have a poor prognosis, whereas 18 of 19 patients having a MBI of 40% or less proved to have a good prognosis. The blink test was deemed to be of equal clinical significance to ENoG and NET for predicting facial paralysis. 3. The blink test does not require needle electrodes for electrical stimulus, nor any special equipment other than electronystagmography, and yet this test can provide a quantitative analysis of a degeneration profile in facial paralysis.

Blinking↗

Epidemiological studies on benign paroxysmal positional vertigo in Japan.

In 1980, the Research Committee of Peripheral Vestibular Disorders in Japan, which is supported by the Ministry of Health and Welfare, was founded by 24 members, from several districts in Japan. The Committee's first task was to draft the diagnostic criteria for several peripheral vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), and vestibular neuronitis. For the national epidemiological survey, they then collected the data on 101 cases of BPPV out of some 783 vestibular disorder patients. In addition, data on 103 patients of BPPV out of 559 vestibular disorder patients were also collected from the Neuro-otological Clinic of the Toyama Medical and Pharmaceutical University Hospital. From these epidemiological surveys, the incidence of BPPV in Japan was estimated at 10.7 per 100,000 population, while that of BPPV in Toyama was estimated at 17.3 per 100,000 population. The ratio of BPPV was higher in female than male patients in both surveys. The age at the onset of BPPV peaked in the fourth decade in both males and females. Compared with the other epidemiological features of Meniere's disease and sudden deafness with vertigo in the same surveys, it appeared that the characteristic features of BPPV are epidemiologically similar to those of Meniere's disease, but different from those of sudden deafness.

Female↗

Quantitative study on phagocytosis of human tonsillar adherent cells by the flow cytometric and immunocytochemical methods.

An in vitro phagocytosis assay of adherent cells of 12 palatine tonsils (7 children's and 5 adults' cases with persistent angina) was performed by use of flow cytometry (FCM), using fluorescent latex particles (FLP). The mean value of the percentages of phagocytic cells in the children's group (81.4%) was higher than that in the adults' group (64.0%). In addition, separate immunocytochemical stainings with each antibody--Anti-Leu-M5, OKDR, OKT6, S-100, and lysozyme--were made on smear preparations of a child's and an adult's tonsillar adherent cells after incubation with FLP. By use of the light microscope, the percentages of phagocytic cells in relation to positive cells for each antibody were calculated. The lysozyme positive cell proved to have the highest percentage of phagocytic cells. Then, the average number of phagocytized FLP in one positive cell for each antibody were calculated. With regard to the lysozyme positive cell, this cell proved to have the highest average number of FLP.

Adolescent↗

Clinical evaluation of medical treatment for Menière's disease, using a double-blind controlled study.

There are great variations in the clinical evaluations of the effectiveness of antivertiginous drugs for Meniere's disease. In our clinical evaluation, subjective and objective signs and symptoms of 128 patients with Meniere's disease and of 98 with other peripheral vestibular disorders were analyzed in a double-blind controlled study comparing adenosine triphosphate (ATP) (300 mg) and betahistine (36 mg) each given daily for 4 weeks. The method of administration was the matched-pair-group-method for this double-blind controlled trial. The attending physicians concluded that ATP was significantly more effective than betahistine in the treatment of Meniere's disease and other peripheral vestibular disorders.

Adenosine Triphosphate↗