Biomedical subjects
Publications and source records attributed to T Inouye.
Four cases of laryngeal dysfunction are presented. The substantial advantages derived from the use of flexible fiberoptic instruments in children is described, together with a description of 3 scopes developed by the author.
The distribution pattern of ciliated cells and goblet cells in the mucosa of the normal adult human eustachian tube has been determined by means of SEM. In general, the density of the ciliated cells decreased from the pharyngeal to the tympanic orifice, and from the tubal floor to its roof. Most ciliated cells possessed about 100-200 cilia, and the average length of the cilia was approximately 8 mu. It is interesting to note that their number and length had a tendency to diminish towards the tympanic orifice of the tube. The ciliated epithelial cells at the tubal floor and lower parts of the walls undoubtedly play an important part in providing an active mucociliary mechanism, as in other parts of the upper respiratory system.
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The authors have induced experimentally middle-ear effusions and cholesterol granulomas one month and later after tubal obstruction in squirrel monkeys. Cholesterol crystallization has occurred frequently in the middle-ear fluids of three-and six-month-animals, and, typical cholesterol granulomas were noted in four of the eight middle ears of six-month-monkeys. The shape and size of the cholesterol crystals were variable, depending upon the surrounding cells of fluid. In middle-ear effusion, the crystals formed rather large rectangular structures, which tended to become smaller and thinner, as the granulomas developed. The granuloma containing cholesterol crystals was rich in various oxidative and hydrolytic enzymes. The large cells surrounding the crystals show intense-to-strong enzyme activity and probably play a phagocytic role in the developing and healing processes of the granuloma.
Pneumatosis coli was diagnosed in a 66-year-old atopic woman with a 6-month history of chronic cough and intermittent wheeze. A sequence of chest x-rays demonstrated the appearance of gas-filled cysts in the splenic flexure of the colon approximately 2 months before the development of bowel symptoms. The pneumatosis coli and symptoms disappeared in 6 days with the administration of oxygen at a flow rate of 6 liters/min by nasal prongs. The case demonstrates the slow progression of the condition from x-ray recognition to development of symptoms and the simple, effective treatment of the condition with nasal oxygen.
Hemispheric specialization for the linguistic process was studied by the 'entropy analysis' method which distinguishes the direction of information flow for mutually coupled time series. Meaningful and non-meaningful stimuli were presented to 14 subjects. EEGs were recorded from homologous Wernicke's and occipital areas in the two hemispheres. The amount of information flow both from the left to right hemisphere and from the right to left hemisphere was obtained under the 3 conditions (i.e., meaningful, non-meaningful and resting baseline conditions) in each area. The information flow from the left to right hemisphere was significantly larger under the meaningful condition than from the right to left hemisphere in Wernicke's area, but no significant differences in the information flow could be found between the two directions under the non-meaningful condition in Wernicke's or the occipital area. Therefore, the dominant direction of the left to right hemisphere was observed under the meaningful condition in Wernicke's area but not in the occipital (non-speech) area, while no dominant direction was observed under the two control (i.e., non-meaningful and baseline) conditions in either area. These results may suggest that the dominant direction of information flow with the meaningful stimuli is related to linguistic meaningfulness in Wernicke's area.
The efferent nervous system of the guinea pig inner ear is histochemically investigated. Remarkable activity of alkaline phosphatase and acetylcholinesterase is demonstrated by Burstone's (1958) azo dye method and Koelle's (1949) method as modified by Gomori (1952) respectively. The distribution pattern of both enzymes in the efferent nervous system is entirely similar. The intraganglionic spiral bundles, fascicles of the osseous spiral lamina and efferent plexus of the organ of Corti reacted intensely for both enzymes. Afferent nerve fibers give no histochemical reaction for both alkaline phosphatase and acetylcholinesterase. However, spiral and vestibular ganglion cells are rich in both enzymes, though they belong to the afferent nervous system. The significance of both enzymes in the nervous system of the guinea pig inner ear is briefly discussed.
Remarkable morphological changes of the fiber arrangement was observed in the middle lamina propria of the pathological human tympanic membranes. These changes were present mainly in the middle zone of the pars tensa. There were several fibers running in entirely different directions among the regularly arranged radial and circular fibers. These abnormal fibers had a tendency of forming fiber bundles of varying sizes and lengths. It is stressed that the normal fiber arrangement was undoubtedly disordered in the healing process of the inflamed middle lamina propria of the human tympanic membrane.
Unusual blood vessels in the cochlea of the squirrel monkey are reported. The blood vessels in Reissner's membrane and basilar membrane are occasionally found in the course of the experimental middle ear study. The blood vessel of Reissner's membrane derives from a radiating arteriole in the upper spiral ligament and takes a straight course down to the inner surface of the spiral limbus, running on the scala vestibuli side of Reissner's membrane, and finally joins the venous vessel of the spiral limbus. Two blood vessels are noted in the basilar membrane of basal turn, running fairly parallel to each other from the tympanic lip to the basilar crest of the spiral ligament in the same cochlea. It is confirmed that these unusual blood vessels derive from the radiating arterioles in the osseous spiral lamina and connect with the venules of the basilar crest in the spiral ligament. Although unusual blood vessels in both Reissner's membrane and basilar membrane are thought to be vestigial structures, they contain a remarkable amount of alkaline phosphatase in their walls. This suggests that these unusual vessels have actually functioned until their death. Multiple occurrence of unusual blood vessels in both Reissner's membrane and basilar membrane of the cochlea of various animals, including man, has not yet been reported in the literature as far as we have been able to ascertain. Incomplete devascularization in the developing process of the cochlea may possibly be the cause of such unusual conditions after birth.
A new method, named the 'alpha wave modulated light' (AML) stimulation, has been used for controlling the frequency of sine wave modulated light by the subject's on-going alpha rhythm. The EEG was recorded from O1 and O2. With the AML stimulation using either the left occipital alpha rhythm or the right, two phase differences of O degrees and 180 degrees were created between AML and the alpha rhythmn. The peak frequency and power of occipital alpha in both hemispheres and the coherence and phase between the left and right occipital EEG were obtaned for 7 subjects. The alpha power was larger at a 180 degrees phase shift than at a 0 degrees phase shift with ipsilateral AML stimulation. The ipsilateral increase in the alpha power was greater than the contralateral at a 180 degrees phase shift. Larger coherence value and right phase lead were observed at 180 degrees phase shift by use of the right alpha rhythm. The possible mechanisms of influences of AML stimulation on the alpha activity were discussed.
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A low-birth-weight infant with malformed upper extremities and congenital heart disease was observed. Cytogenetic analysis revealed a 46,XY,r(9)(p24q34) complement.
The distribution pattern of alkaline phosphatase was studied in the ganglion cells in and near the temporal bone of some mammals. No or extremely weak activity of alkaline phosphatase was observed in or near the spiral and vestibular ganglion cells of the bat, rat, cat, and monkey. However, intense to moderate enzyme activity was noted exclusively in the peripheral areas of the spiral and vestibular ganglion cells of the guinea pig. The enzyme activity was also demonstrated in the nerve fibers at some distance from both axonal and dendritic processes of the spiral and vestibular ganglion cells of the guinea pig. Trigeminal and geniculate ganglion cells of all mammals examined showed intense to moderate enzyme activity in their capsular cells. There is a marked difference in the phosphate metabolism in the capsular tissues of the ganglion cells in or near the temporal bone of various mammals.
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A comparison is made of lung function tests and radiographic findings in 20 asthmatic patients with allergic bronchopulmonary aspergillosis paired in terms of sex, age, and duration of asthma with 20 other asthmatics in whom the diagnosis of aspergillosis was excluded in order to see if the aspergillosis causes more lung damage. One hundred per cent of the patients with aspergillosis and 75% of the patients with asthma alone showed a significantly reduced forced expiratory volume in one second (FEV1) before bronchodilator. All the patients in the two groups had a significantly reduced maximal expiratory flow at 50% vital capacity breathing air (V50air) but the severity of the reduction was statistically greater in the aspergillosis group. Reversibility in FEV1 of 15% and more was found in 50% of patients with asthma alone as against 31% of patients with aspergillosis. The degree of reversibility of FEV1 was also statistically greater in patients with asthma alone. Improvement of less than 20% of V50 after helium-oxygen breathing was found in 33% of the patients with asthma alone and in 75% of the patients with aspergillosis. Patients with aspergillosis also showed significantly (0-001 less than P less than 0-01) more reduced gas transfer factor. Radiological features of overinflation were as common in the two groups. Tubular and ring shadows were found in 95% and 60% respectively of patients with aspergillosis as against 45% and 15% of patients with asthma alone.
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