Artifactually low serum urea caused by antibodies to bacteria urease.
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Biomedical subjects
Publications and source records attributed to T Morizono.
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To investigate the role of cervical proprioceptive inputs in the process of vestibular compensation, we performed static posturography in patients with acute and compensated unilateral vestibular dysfunction, by applying vibratory stimulation to the dorsal neck muscles. Neck vibration induced disequilibrium in both groups of patients, but was more pronounced in the compensated patients. These results indicate that manipulation of the neck afferents causes discompensation in subjects whose vestibular dysfunction has already been compensated by multisensory inputs including neck afferents.
The supratubal recess (STR), located superior to the bony eustachian tube and anterior to the attic and often the site of disease, is clearly separated from the attic by the presence of a bony partition. Its anatomic development in childhood, however, remains nuclear. We reviewed serial horizontal sections of fetal and children's temporal bones from the collection of the Otopathology Laboratory, University of Minnesota. Apparently, upward expansion of the bony eustachian tube begins at a late fetal stage and continues throughout childhood, thus forming the STR. Our finding that the STR had already developed in temporal bones without pneumatization of petrous bone suggests that its formation is independent of the air-cell system. Absorption of mesenchymal tissue in the STR tends to be slower than elsewhere in the temporal bone. Surrounded solely by petrous bone, the STR seems, both developmentally and anatomically, a distinctive compartment of the middle ear.
The scalp topography of binaural interaction (BI) in the auditory brainstem response (ABR) was studied in fourteen normal individuals. BI was observed from all recording sites of the scalp, and the peak amplitude was noted mostly in the bilateral parietal and occipital regions. There was a significant difference in amplitude shown by significance probability mapping (SPM) when the waveform obtained by binaural stimulation was compared with the sum of the waves obtained by monaural stimulation. The topography of BI was different from that of the wave III and the wave IV/V complex. In contrast to previous reports by other workers, we found that BI mainly corresponded to the first half of the wave IV/V complex.
The auditory brainstem responses (ABRs) obtained from 28 normal healthy adults were studied using the ipsilateral and contralateral recordings from the positions of vertex and each mastoid to monaural stimulation. Each wave of ABRs recorded by ipsilateral and contralateral derivations to stimulation site showed slightly significantly differences. Comparing the ipsilateral and contralateral data, the latencies of waves II and V showed a slightly small reduction in the ipsilateral recording, while these of waves III and IV showed a small increase. Next, the distributions of potentials and latencies of waves II to V were investigated from ABRs situating different electrodes in mid-coronal array of the scalp and non-cephalic reference electrode on the seventh cervical vertebra (CVII). The results of latencies showed the reverse relation to the data obtained from the ipsilateral and contralateral recordings using the reference electrodes on each mastoid. These facts suggest that the comparable differences of latencies in the bilaterally recorded ABRs are explained by the pseudo-phenomena of differential recordings, which the phase delayed or advanced potential propagated to each mastoid being reference electrode position.
We developed a device for odorous stimuli control to record olfactory evoked responses from the human scalp. The characteristics of the apparatus are as follows. Translating the subject's respiration into electric signals with a sensor attached to the nose. The period and timing of odorous stimuli could be adjusted, so that stimuli could be synchronous with respiration. The interstimulus interval could be arbitrarily selected once every 1 to 9 respiration(s) so that adaptation could be prevented. We obtained evoked responses to odorous stimuli using this apparatus from the human scalp, whose positive peak latencies were approximately 350 and 700 msec. Such responses were not recorded if oxygen stimuli were used instead of odorous stimuli or with click sounds produced by the switching electromagnetic valve. Three types of odorant evoked scalp potentials were obtained in normal human subjects. The first type consisted mainly of two positive peaks with a peak latency of about 350 msec (P350) and about 700 msec (P700). The second type and the third type consisted of only one positive peak with a peak latency of about 350 msec and 700 msec, respectively. Such a P350 or P700 peak as that observed in the normal subjects was not detected in anosmic patients.
Three-component analysis of Benign Paroxysmal Positional Nystagmus (BPPN), focusing on the horizontal, vertical, and torsional, using a computerized eye movement analysis system, was carried out in 10 patients. Using a pendular rotation stimulus, we also measured three components of eye movement elicited from the vertical semicircular canals in normal subjects. We compared two components (vertical and torsional) of BPPN with that of eye movements elicited from the vertical semicircular canals. In BPPN, the torsional component of eye movements was larger than that of the vertical component. Conversely, the vertical component from the vertical semicircular canals was larger than that of the torsional component. From these results, by analysing the vestibulo-ocular reflex of the vertical semicircular canals, it is difficult to support the idea that the pathology of the BPPV is localized in the posterior semi-circular canal alone.
Multiple myeloma is a malignant disease of the skeleton. Anatomically, any bone may ultimately come to be involved in a given case. In a literature review, no published series of temporal bone findings have been reported. In this study, oto-histopathologic changes associated with multiple myeloma are analyzed and reported in 15 temporal bones from 8 patients. The bone marrow of 13 temporal bones was involved by the tumor. Osteolysis was evident in 11 temporal bones. Serous otitis media (SOM) or purulent otitis media (POM) was seen in 13 ears with 12 showing mastoid effusions. Eight ears exhibited pathological changes in inner ears, including degeneration of the organ of Corti, atrophy of stria vascularis, decreased ganglion cells, and labyrinthine hydrops. The inner ear changes were most severe in 2 patients who had otologic symptoms. Infiltration of myeloma cells was not apparent in the middle ear mucosa or the inner ears.
In spite of the wealth of information on the clinical, histologic, and pathologic aspects of tympanosclerosis, the pathogenesis of tympanosclerosis is still unclear. In an attempt to understand the pathogenesis, 319 human temporal bones from 196 individuals with otitis media were studied. The extent and nature of tympanosclerosis and the characteristics of the otitis media associated with it were studied. Forty-five temporal bones from 35 individuals with otitis media were found to have tympanosclerosis, giving an incidence of 14.1%. It was seen most commonly in individuals over 40 years of age (86.7%). The male-to-female ratio was 1.6:1. The most common site of occurrence was the tympanic membrane (88.9%). Tympanosclerosis was seen more often in the anterior and posterior inferior quadrants of the tympanic membrane and that, too, in a central position. Tympanosclerosis was seen more commonly in temporal bones with irreversible inflammatory changes, and in this group, late plaques were more commonly seen than early or intermediate plaques. Audiometric charts failed to show any direct relationship between extent of tympanosclerosis and the severity of hearing loss. The only audiometric finding of any consequence was a mixed hearing loss in the presence of middle ear tympanosclerosis.
Histopathological findings in seven temporal bones from four infants diagnosed as Potter's syndrome are described. The infants were labelled as Potter's syndrome after autopsy confirmed bilateral renal agenesis. Extrarenal manifestations included pulmonary hypoplasia and facial anomalies. The middle ear volume in infants with Potter's syndrome remained unchanged with age resulting in a significantly higher percentage of residual middle ear mesenchyme in these infants as compared to normal infants. Dehiscence of the facial nerve was seen in all the temporal bones studied. One ear showed the presence of eosinophilic effusion in the endolymphatic sac, an underdeveloped malleus and a wide facial nerve canal. The inner ear structures showed no significant anomalies except for the absence of the organ of Corti in the basal turn of the cochlea in one of the ears.
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Three-component analysis of caloric nystagmus, focusing on the horizontal, vertical, and torsional, using a computerized eye movement analysis system, was carried out in 10 normal human subjects. The caloric response was induced by cold stimulation to the right ear of the subjects in the supine and prone positions. In the supine position, the three components of nystagmus were toward the left (10 subjects), upward (eight subjects) or downward (two subjects), and clockwise (10 subjects). In the prone position, on the other hand, the three components were directed toward the right (10 subjects), downward (five subjects), upward (three subjects), and counterclockwise (10 subjects); there was no vertical direction in two subjects. These findings indicate that caloric stimulation activates the three semicircular canals simultaneously. Also the changes in the nystagmus direction in the supine and prone positions could be explained, at least partially, by the nonconvective component of caloric stimulation.
We have tested the hypothesis that the cause of cochlear dysfunction associated with perilymphatic fistula (PLF) is closely related to endolymphatic hydrops (ELH). Using guinea pigs, we studied the tone-burst elicited compound action potential (CAP) and its modulation as caused by a 50 Hz biasing tone in experimental PLF. We compared these results with those of experimental ELH. Following perilymph aspiration through the perforated round window membrane, mild but significant elevations of CAP thresholds at tested frequencies were found. A reduction in the amplitude of cochlear microphonics (CM) for a 50 Hz sine wave appeared to correlate with these CAP threshold changes. However, there were no significant changes in the modulation effect of the 50 Hz biasing tone on the CAP elicited by an 8 kHz tone burst. This finding differed from that in ears with experimental ELH, in which significant reductions of both 50 Hz CM and the degree of CAP modulation were consistently observed. We concluded that it is unlikely that the underlying mechanisms of a modification to the low frequency response of the base of the cochlea following perilymph aspiration is linked to that of experimental ELH.
By the use of computer-assisted morphometric analysis of the organ of Corti and/or measurements of action potential threshold changes, inner ear changes in chinchillas were evaluated 4 weeks after application on the round window membrane of a Pseudomonas aeruginosa exotoxin A solution. Severe inner ear damage was detected after application of 50 ng (5 microL at a concentration of 10 micrograms/mL) exotoxin A, whereas application of 5 ng exotoxin did not cause measurable inner ear damage. Perilymph concentrations of exotoxin A were measured with an enzyme-linked immunosorbent assay 1.5 to 19 hours after 50 ng, 0.5 micrograms, or 5 micrograms of exotoxin A was applied on the round window membrane. Only the highest concentration produced measurable levels of exotoxin in the inner ear fluids. It is concluded that exotoxin A present on the round window membrane of the chinchilla has the ability to penetrate into the inner ear and cause irreversible inner ear changes.
Pseudomonas aeruginosa exotoxin A was applied to the round window membrane of the chinchilla in concentrations ranging from 1 microgram/ml to 1 mg/ml. Haemophilus influenzae type b endotoxin (45,000 endotoxin units/ml) was applied in the same way. Five animals were also subjected to blocking of the Eustachian tube, 3 to 8 months earlier, resulting in serous otitis media and exotoxin A (1 mg/ml) was applied into the round window niche of these animals. Effects on the inner ear was recorded with quantitative morphology (hair cell counting) and electrophysiologically (action potential threshold measurements) 4 weeks after application of exotoxin A. Concentrations of exotoxin A in perilymph was measured with ELISA and concentration of endotoxin in perilymph was measured with Limulus Amoebocyte Lysate and Quantitative Chromogenic Limulus Amebocyte Lysate. Four weeks after application of exotoxin A at a concentration of 10 micrograms/ml severe inner ear damage could be demonstrated. No inner ear damage was demonstrated when lower concentrations were used. Passage into the inner ear could only be demonstrated after exposure of the round window membrane to an exotoxin A concentration of 1 mg/ml. Round window membranes affected by chronic inflammation were shown to be less permeable to exotoxin A, thus indicating that thickening of the round window membrane may have a protective effect on the inner ear. A low passage rate into the inner ear was demonstrated after endotoxin exposure. It may be concluded that small amounts of exotoxin A passing through the round window membrane may cause inner ear damage. The passage rates, however, for both exotoxin A and endotoxins are low.
Consecutive CAP threshold shifts were studied in chinchillas following round window application of Cortisporin Otic Suspension for 10 minutes. A marked deterioration in CAP threshold was observed at 24 hours following otic application but these threshold shifts were reversible at lower frequencies. The shifts were progressive at higher frequencies at the 4 week measurement. The progressive high frequency loss with recruitment and with normal EP levels implies some hair cell dysfunction due directly to Cortisporin Otic Suspension ototoxicity and/or secondarily to middle ear inflammatory reactions to the otic. Short-term studies of ototopical drugs may result in misleading assessments as to the pattern and degree of ototoxicity. Long-term (i.e., one month or longer) studies are recommended for accurate ototoxicity assessment.
Ionic activities (K+, Na+, and Cl-) of the perilymph and endolymph of the basal turn were measured using ion-selective microelectrodes in experimentally induced endolymphatic hydrops of the guinea pig. Three months following the obstruction of the endolymphatic duct and sac, the endocochlear potential (EP) of hydroptic ears was measured at 59.7 +/- 9.6 mV (N = 12) which was significantly lower than the EP of the contralateral control ears (84.4 +/- 2.8 mV, N = 12). A paired t-test (P greater than 0.05) showed no significant differences of ion concentrations of the inner ear fluid between the hydroptic and contralateral ears. Ion permeabilities of the cochlear duct following anoxia were calculated according to the Nernst-Planck equation. Comparing hydroptic and normal ears following anoxia, a statistically significant decrease was observed in the permeability coefficients for K+. Similarly, K+ conductance was significantly lower in the hydroptic ears than in the normal ears. Total conductance of the cochlear duct, defined as the sum of each ion conductance, was 0.560 siemens in the normal ears and 0.217 siemens in the hydroptic ears. On the basis of the Goldman-Hodgkin-Katz equation, preexisting negative EP in the normal state was calculated to be -24.5 mV in normal ears and -21.4 mV in hydroptic ears. Therefore, the positive component of the EP was 108.9 mV in normal ears and 81.1 mV in hydroptic ears. These findings suggest that the pathophysiology of hydrops involves changes in K+ permeability and the inhibition of the electrogenic transport processes.
The ionic composition of the endolymph in the endolymphatic sac (ES) of the chinchilla was measured using double-barreled ion-selective micro-electrodes. The DC potential of the ES was 9.3 +/- 1.8 mV (N = 18). The K+, Na+, and Cl- concentrations of the ES were 13.3 +/- 4.7 mM (N = 6), 129.0 +/- 8.8 mM (N = 6), and 124.3 +/- 16.6 mM (N = 6), respectively. In light of the chemical potentials of the cochlear endolymph previously reported [Ikeda and Morizono (1989), Hear. Res., 39, 279-286] the pressure gradient of the endolymph between the cochlea and ES was calculated to be 71.5 mmHg at 38 degrees C. The contribution of the osmotic and hydrostatic pressure gradients of the endolymph to the longitudinal flow is discussed.