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Biomedical subjects

S Komune

Publications and source records attributed to S Komune.

At least 19 recordsLinked to original sources

Expression of pituitary adenylate cyclase-activating polypeptide mRNA in the cochlea of rats.

Expression of mRNA for pituitary adenylate cyclase-activating polypeptide (PACAP) was detected in the cochlea of rats using a reverse transcription-polymerase chain reaction and in situ hybridization. Examination of in situ hybridization demonstrated that cells in the spiral ganglion, and marginal cells in the stria vascularis expressed mRNA for PACAP. These findings suggest that PACAP may play an important role in regulating cochlear functions.

Animals↗

Membrane current possessing the properties of a mechano-electric transducer current in inner hair cells of guinea-pig cochlea.

We measured the membrane current possessing the properties of a mechano-electric transducer current in isolated inner hair cells of guinea-pig cochlea. In a free-standing hair bundle, depolarization to +80 mV evoked a stable outward current attributable to the opening of transducer channels, and repolarization to -80 mV evoked a transient inward current indicating adaptation. The time constant of adaptation increased as the membrane potential depolarized. Dihydrostreptomycin diminished both the outward and inward currents.

Animals↗

Selective expression of aquaporin 1, 4 and 5 in the rat middle ear.

The middle ear cavity is an air-filled space that must be maintained for effective sound transmission to the inner ear. To examine the mechanisms of water homeostasis in the middle ear, we investigated whether aquaporins (AQPs), a family of water-permeable channels, were expressed in the middle ear. Reverse transcription-polymerase chain reaction and immunoblot analyses revealed that mRNAs encoding AQP1, 4 and 5 (but not 2 or 3) subtypes were expressed in rat middle ear epithelium; AQP1, 4 and 5 were detected as 28-, 30- and 30-kDa proteins, respectively. Immunohistochemical analysis showed that AQP1 was localized at capillary endothelial cells and fibroblasts in lamina propria mucosae; AQP4 was present solely at the basolateral membrane of ciliated cells, whereas AQP5 was on the apical surface of ciliated cells as well as of flat and columnar epithelial cells. The characteristic different localizations of AQP1, 4 and 5 subtypes in the middle ear suggest that middle ear water homeostasis requires the coordinated operation of these AQPs.

Animals↗

[Bilateral primary carcinoma of the external auditory meatus].

We report an extremely rare case of bilateral primary carcinoma of the external auditory meatus. A 50-year-old man suffered 1 month from left-ear discharge and otalgia. Examination revealed a tumor of the left ear canal and a biopsy showed well-differentiated squamous cell carcinoma. The patient underwent 60 Gy radiotherapy and left subtotal temporal bone resection. A tumor with irregular swelling of the right external canal was found 8 months after the first diagnosis. Biopsy of the right external canal confirmed the same squamous cell carcinoma. Genetic examination that the carcinoma of the right ear was probably not a metastatic from the carcinoma of the left ear.

Carcinoma, Squamous Cell↗

Idiopathic hypereosinophilic syndrome involving the middle ear: clinical case report and discussion.

Multiple organ system involvement is seen in the idiopathic hypereosinophilic syndrome (HES). Cardiovascular, lung and upper airway, liver, spleen, skin and nervous systems are frequently involved. In this article, we describe two cases of HES involving the middle ear and lung. In both cases, the histological pictures showed an increase of eosinophils in the tissue of the tympanic cavity.

Adult↗

A role of glutamate in drug-induced ototoxicity: in vivo microdialysis study combined with on-line enzyme fluorometric detection of glutamate in the guinea pig cochlea.

The time course of the changes in perilymphatic glutamate was determined during the application of kanamycin and ethacrynic acid, which are known to damage the hair cells in the inner ear. For the continuous recording of glutamate, the microdialysis technique combined with an enzyme-linked fluorometric assay was used. In guinea pigs receiving a loading dose of 800 mg/kg of kanamycin subcutaneously followed 3 h later by an i.v. injection of 40 mg/kg of ethacrynic acid, a marked glutamate release was clearly found about 2 h after the injection of ethacrynic acid. Injection of kanamycin or ethacrynic acid alone did not produce any change in the perilymphatic glutamate. The morphological changes induced by the administration of both drugs indicated that the collapsing hair cells might release glutamate into the perilymphatic space. The present findings provide additional evidence that glutamate acts as an aggravating factor in aminoglycoside-induced ototoxicity.

Animals↗

Prevalence of mitochondrial gene mutations among hearing impaired patients.

The frequency of three mitochondrial point mutations, 1555A-->G, 3243A-->G, and 7445A-->G, known to be associated with hearing impairment, was examined using restriction fragment length polymorphism (RFLP) analysis in two Japanese groups: (1) 319 unrelated SNHL outpatients (including 21 with aminoglycoside antibiotic injection history), and (2) 140 cochlear implantation patients (including 22 with aminoglycoside induced hearing loss). Approximately 3% of the outpatients and 10% of the cochlear implantation patients had the 1555A-->G mutation. The frequency was higher in the patients with a history of aminoglycoside injection (outpatient group 33%, cochlear implantation group 59%). One outpatient (0.314%) had the 3243A-->G mutation, but no outpatients had the 7445A-->G mutation and neither were found in the cochlear implantation group. The significance of the 1555A-->G mutation, the most prevalent mitochondrial mutation found in this study of a hearing impaired population in Japan, among subjects with specific backgrounds, such as aminoglycoside induced hearing loss, is evident.

Aminoglycosides↗

Congenital malformation of the inner ear associated with recurrent meningitis.

Congenital deformities of the labyrinth of the inner ear can be associated with meningitis and varying degrees of hearing loss or deafness. A recurrence of meningitis is due to the development of a fistulous communication between the subarachnoid space and the middle ear cavity, and can prove lethal. An illustrative case of a 4-year-old Japanese girl with bilateral severe hearing loss, recurrent meningitis and malformations of the inner ear and stapes footplate is presented. Removal of the stapes during tympanotomy provoked a gush of cerebrospinal fluid. The defect was repaired successfully, and there has been no further episodes of meningitis to date.

Anti-Infective Agents↗

Cholesteatoma extending into the internal auditory meatus.

We report our experiences in managing a patient with cholesteatoma complicated by meningitis, labyrinthitis and facial nerve palsy. The antero-inferior half of the tympanum was aerated but the postero-superior portion of the tympanic membrane was tightly adherent to the promontry mucosa. An attic perforation was present at the back of the malleolar head. High-resolution computed tomography also uncovered a fistula in the lateral semicircular canal. Surgical exploration of the middle ear cavity demonstrated that both the vestibule and cochlea were filled with cholesteatoma, and the cholesteatoma extended into the internal auditory meatus through the lateral semi-circular canal fistula. The cholesteatoma was removed by opening the vestibule and cochlea with a preservation of the facial nerve. Post-operatively, an incomplete facial palsy remained, but has improved slowly. There is no sign of recurrence to date after a 3-year period of observation.

Adult↗

Treatment of sudden sensorineural hearing loss with a continuous epidural block.

The efficacy of a continuous epidural block was evaluated in the treatment of 20 patients with sudden sensorineural hearing loss (SNHL). Ten patients were treated with continuous cervicothoracic epidural block (group A) and the other 10 were treated with stellate ganglion block (group B). No significant difference in factors affecting prognosis was noted between the groups. In the epidural block group 70% achieved substantial hearing improvement, while this occurred in only 30% of patients undergoing stellate ganglion block. These findings suggest that continuous epidural block can be effective in the treatment of sudden SNHL.

Adult↗

Regulation of inner ear fluid in the guinea pig cochlea after the application of saturated NaCl solution to the round window membrane.

The regulation of K+ and Na+ in the inner ear fluid of the guinea pig was studied after the application of saturated NaCl solution to the round window membrane. K+ and Na+ activities in the scala tympani increased rapidly and then decreased. K+ activity in the scala media increased immediately, but Na+ activity continued to increase during the period of observation. K+ activity in the scala vestibuli continued to increase in the observation period. Na+ activity in the scala vestibuli increased and then decreased. The endocochlear potential decreased immediately to approximately 20% of its initial level. Total activities of K+ and Na+ increased immediately and then decreased in both the scala tympani and scala media. The total activity of K+ and Na+ increased slowly and showed no regulatory decrease in the scala vestibuli. Thus, changing patterns in the total activity of K+ and Na+ were similar for the scala tympani and scala media, but not for the scala media and the scala vestibuli. Different patterns of K+ and Na+ activities among the three scalae indicate that their mechanisms for regulating inner ear fluid differ.

Animals↗

Treatment of cholesteatoma in children.

We studied retrospectively 28 cases of cholesteatoma in children whose ages were 3 to 13 years old. All had undergone surgery between 1989 and 1995. The intact canal wall technique was the predominant method used in the initial operation, with long term goals of an anatomically normal and infection-free ear. Cholesteatoma was found postoperatively in 15 cases and was considered to be residual in 6 cases and recurrent in 9. The residual cholesteatoma was relatively uncommon and usually removable in an exploratory second operation. Our findings showed that the intact canal wall technique was the best initial operation if two-stage surgery was planned. Avoidance of a retraction pocket, which tends to progress to a recurrent cholesteatoma, is important to successful treatment.

Adolescent↗

Increase in glutamate-aspartate transporter (GLAST) mRNA during kanamycin-induced cochlear insult in rats.

Kanamycin (KM)-induced changes in expression of the gene for glutamate-aspartate transporter (GLAST) in the rat cochlea were analyzed by Northern blotting. With the administration of KM (600 mg/kg/day) once daily for 20 days, the expression of GLAST mRNA gradually increased and reached a peak on day 20. Although the expression of GLAST mRNA remained at a high level until 12 days after the completion of the KM treatment, it then fell to the normal level within 2 months. Such KM treatment resulted in loss of both inner and outer hair cells and a concomitant profound permanent threshold shift. The present findings suggest that during KM administration, high concentrations of extracellular glutamate released by collapsing hair cells induced GLAST mRNA expression. Increased GLAST mRNA might play an important role in the prevention of the secondary death of spiral ganglion neurons from glutamate neurotoxicity.

ATP-Binding Cassette Transporters↗

Recording of mechano-electrical transduction currents by a nystatin perforated-patch method.

Mechano-electrical transduction (MET) currents in isolated cochlear hair cells of chicks were recorded by use of a nystatin perforated-patch method. The membrane of a cell-attached patch was permeabilized by nystatin in the patch pipette, thus providing electrical continuity between the pipette and the cytoplasm of the cell without loss of cytoplasmic compounds. The current-voltage relationship was linear for the inward-going MET current at negative membrane potentials, but outward currents were reduced at positive membrane potentials, evidence of inward-going rectification. Elevation of the intracellular concentration of calcium at positive membrane potential, mediated via a voltage-dependent Ca2+ channel, may suppress the outward-going MET current by acting from within the cell.

Animals↗

[Clinical experiences and postoperative results with partially implantable middle ear implant].

A partially implantable middle ear implant using an ossicular vibrator of a piezoelectric ceramic bimorph has recently been developed in Japan as a new rehabilitative method for hearing. Four patients at the Miyazaki Medical College Hospital were implanted with this device between September 1994 and October 1996. Implantation of the internal component was performed under local anesthesia after confirmation of sufficient sensitivity to the ossicular vibrator in an intraoperative vibratory hearing test. All patients regained socially useful hearing with the middle ear implant without any foreign body reactions or recurrence of otitis media. None of the cases showed any elevations of bone conduction thresholds 2 to 4 years postoperatively. Natural and clear sounds without interference noise and howling due to acoustic feedback were highly satisfactory in all patients. However, the first case, who had an implant in an ear following cholesteatoma surgery using the intact canal wall technique, experienced about a 10dB deterioration of the average hearing level with the implant 2 years after implantation. Gradual deterioration appeared to be caused by the retracted tympanic membrane interfering with the mobility of the ossicular vibrator. The following three cases were implanted in ears previously operated on by radical mastoidectomy, showing stable or improving hearing results with the implant. Closure of the external canal skin at the cartilaginous portion at the time of implantation seemed appropriate to maintain a sufficient middle ear space for the ossicular vibrator to work properly. Our case study confirms that the partially implantable middle ear implant is a safe and useful tool for patients with mixed deafness which cannot be satisfactorily rehabilitated by tympanoplasty and/or a conventional hearing aid.

Deafness↗