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Biomedical subjects

N Yanagihara

Publications and source records attributed to N Yanagihara.

248 records · Page 14Linked to original sources
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Association of diabetes mellitus and hypertension with Bell's palsy and Ramsay Hunt syndrome.

This study included 625 patients with Bell's palsy and 124 patients with Ramsay Hunt syndrome. Seven percent of the cases of Bell's palsy and 1.6% of the cases of Ramsay Hunt syndrome were associated with diabetes mellitus, while 14.1% of the cases of Bell's palsy and 10.4% of the cases of Ramsay Hunt syndrome were associated with hypertension. In the patients over 40 years of age, rates of association with diabetes and hypertension were 11.2% and 23.0% in Bell's palsy and 1.3% and 10.4% in Ramsay Hunt syndrome, respectively. The rates of diabetes and hypertension in association with Bell's palsy were significantly high compared with those of the general population.

Adult↗
PubMedDate not supplied

Familial Bell's palsy: analysis of 25 families.

Of 625 patients with Bell's palsy, 26 from 25 families (4.0%) had a positive family history of Bell's palsy. Genealogic analysis of the families indicated the mode of inheritance of familial Bell's palsy possibly to be autosomal dominant inheritance with low penetration. The prognosis of familial Bell's palsy was generally favorable. Age, sex, recurrence, and inherited factors are discussed.

Age Factors↗
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Human leukocyte antigens in Bell's palsy.

Ninety-three patients with Bell's palsy including 12 members of two families with familial Bell's palsy were typed for human leukocyte antigens (HLAs). Significant association between HLAs and Bell's palsy was found. The association of certain HLAs with the palsy may predict the specific clinical course and prognosis.

Facial Paralysis↗
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Topodiagnosis of lesions in Bell's palsy.

Combined measurements of reflexive lacrimation, stapedial reflex, and electrically induced taste give an indication of the site and extent of intratemporal lesions of the facial nerve. Using refined test batteries, we established the presence of intratemporal lesions in Bell's palsy in 80 patients with facial paralysis. In the acute stage of Bell's palsy, suprastapedial lesions predominated and the occurrence of a suprageniculate lesion was not rare. In the subacute stage, the lesions proximal to the stapedial nerve tended to subside and infrastapedial lesions increased. In 60% of 53 patients with denervation verified by electrodiagnostic examinations, the suprastapedial lesion was responsible for degeneration of the nerve. In the other 40%, degeneration involved the infrastapedial segment.

Electromyography↗
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Neutralization antibody to herpes simplex virus type 1 in Bell's palsy.

In 45 patients with Bell's palsy of recent onset, the neutralization antibody titers to herpes simplex virus type 1 (HSV-1) were assayed by a microtiter technique. As a control, the neutralization antibody titers of 50 normal subject were assayed. Complement fixation tests also were performed. The geometric means of the neutralization antibody titers of the patients appeared higher at all times than those of the normal subjects. Significant change in the neutralization antibody titer suggesting a recent infection of HSV-1 was seen in seven patients (15.6%), while the complement fixation test demonstrated significant change in only one patient (2.2%). The higher geometric means of the neutralization antibody titers in the patients was thought to indicate that reactivation of the HSV-1 infection was responsible for the onset of Bell's palsy.

Adolescent↗
PubMedDate not supplied

Facial nerve biopsy for etiologic clarification of Bell's palsy.

Electron microscopic findings of biopsy specimens of the intratemporal facial nerve from four selected patients with Bell's palsy are described, and the results of clinical examinations and surgical findings are presented. In all specimens, wallerian degeneration of various degrees was demonstrated. In one specimen, extravascular erythrocytes, and in another, lymphatic infiltrations were noted. On the basis of the present investigation and reported temporal bone histopathologic evidence, the causes of Bell's palsy are concluded to be multiple and to be vascular, inflammatory, or degenerative.

Adolescent↗
PubMedDate not supplied

Transmastoid decompression of the facial nerve in temporal bone fracture.

Among 41 cases of facial palsy caused by closed heart injury, temporal bone fractures were surgically confirmed in 36 cases, of which there were two mixed fractures and 34 longitudinal fractures. The fracture involved the geniculate ganglion area in 20 cases (55%). In 15 cases, decompression of the facial nerve was carried out using the transmastoid supralabyrinthine approach with disarticulation of the incus; in only five cases was the middle fossa approach used. The technique avoids the craniotomy for the middle fossa approach and is a reliable method of treatment in the majority of patients with facial palsy caused by temporal bone fracture involving the geniculate ganglion area.

Facial Nerve↗
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Evaluation of middle-ear implant: a six-month observation in cats.

The efficacy of a middle-ear implant was evaluated by measuring auditory brain stem responses. Middle-ear implants, including an input-transducer, an amplifier, a battery and an output-transducer, were implanted in cats. Most of the implants were kept functioning for a six-month period. Observation on the characteristics of these implants during this time showed allowable changes in an implant, now being prepared, for use in human subjects.

Animals↗
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Middle ear implant for humans.

In humans, a partially implantable middle ear implant (MEI) will first be applied, followed by a wholly implantable MEI, since with the former only an induction coil and a vibrator (to the stapes' head) are used. One of the various advantages of the partially implantable MEI vis-à-vis air conduction hearing aids is that the tone quality is of much higher fidelity, with less noise.

Cochlear Implants↗
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Electron microscopic study of muscle spindle in human interarytenoid muscle.

Using transmission electron microscopy, the fine structure of the muscle spindle in the interarytenoid muscle was studied. The specimen was made from a fresh adult male larynx which had been surgically removed. The muscle spindle showed the following characteristic features: (1) the capsule was thin, with only a small number of layers of capsular sheet cells; (2) the periaxial space was narrow and there were abundant collagenous fibrils; (3) the sensory endings consisted of irregularly coiled terminal axons with varicose swellings, and some endings penetrated the sarcoplasm; (4) one nuclear chain fiber terminated on the capsule, while the other branched into two bundles; and (5) special sarcoplasmic inclusions, possibly related to the sensory endings, were also observed. These findings suggest that the muscle spindle in the interarytenoid muscle is not only a very sensitive stretch receptor, but also a pressure receptor.

Aged↗
PubMedDate not supplied

Implantable hearing aid using a piezoelectric ossicular vibrator: a speech audiometric study.

The speech discrimination provided by a piezoelectric implantable hearing aid (IHA) was compared to that by a conventional hearing aid (CHA) using speech audiometric studies in seven patients. Recognition of monosyllabic and bisyllabic words was measured using word lists recorded on a compact disc with and without background noise. the intensity of speech sound was 65 dB SPL, while that of background noises varied from 65 to 75 dB SPL. The ear canal opposite the test ear was closed with a clay mold to avoid perception of the test sound through the contralateral ear. On monosyllabic test without noise, speech discrimination scores by the IHA and the CHA showed no significant difference. However, with noise of 65 dB SPL, the IHA outperformed the CHA. When the intensity of the noise increased to 70 or 75 dB SPL, the scores by both devices decreased, but a significant difference was noted between the two. On the bisyllabic test, the results were almost identical with those on the monosyllabic test. These findings indicate that speech recognition by the IHA was superior to that by CHA under noisy circumstances.

Aged↗
PubMedDate not supplied

Incising the thick retrolental fibrovascular tissue with a hooked sclerotome in persistent hyperplastic primary vitreous.

A technique for incising thick retrolental fibrovascular tissue and extensive cyclitic membrane is reported in a case of anterior persistent hyperplastic primary vitreous. A membranectomy was performed in a 1-month-old post-lensectomy baby via a limbal approach. A sclerotome tip was hooked to cut through an extremely thick fibrovascular tissue by rotating the sclerotome by its grip. Sutherland microscissors (Grieshaber, Switzerland) and a vitrectomy cutter were used for further membranectomy. The baby was followed-up until age 18 months. A total of 3 membranectomy sessions were required because of rapid cyclitic membrane formation, severe centripetal retraction of the membrane on the ciliary processes, and posterior synechia. Thorough membranectomy and cutting the iris edge maintained a clear pupillary area during the 13-month postoperative period. Extremely thick retrolental fibrovascular tissue is a challenging condition that can be dealt with by delicate instrumentation.

Anterior Eye Segment↗
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A modified Schirmer test: the fine-thread method for measuring lacrimation.

Fine cotton thread is used instead of the filter paper of the Schirmer test. One end stained with fluorescein is inserted into the lateral upper conjunctival sac for 5-30 seconds. The length of the soaked portion is measured in millimeters and the two eyes are compared with each other. One test consists of several consecutive measurements. This new method has many advantages over the conventional Schirmer test: (1) It takes less time (5-30 seconds, compared to Schirmer's method which takes five minutes); (2) It is less injurious to the eye than the stiff and rather large absorbing paper; (3) A diagnosis of lacrimal deficiency must be based on several consecutive measurements and the comparison between two eyes in each measurement (the lacrimation normally is very irregular in the same person). It is difficult to measure consecutively with filter paper; (4) The fine thread itself acts as a potent mechanical trigeminal stimulator and as absorbing agent; (5) The thread maintains a stable position in the eye, while the filter paper which hangs on the lower lid sometimes shifts out of place; (6) The fluorescein dye disappearance and dilution tests can be performed simultaneously; (7) This method can be applied to children.

Adolescent↗