ABSTRACT
We experienced four cases of vertical gaze palsy induced by midbrain lesions. Lesions commonly covered the rostral midbrain, including the rostral interstitial nucleus, dorsomedial to the red nucleus. Two of the four cases resulted from vascular insult, in which a single, unpaired perforator is supposed to innervate the rostral midbrain and medial thalamus bilaterally. One case showed vertical gaze palsy accompanied by bilateral ptosis. The findings agree with recent experimental evidence that a neural substrate in eyelid control lies in the supraoculomotor area immediately dorsal to the oculomotor nucleus. The remaining two cases, a brain hemorrhage and an inflammatory tumor, showed unilateral lesions of the rostral midbrain. In these cases, vertical gazes were not abolished, but were limited in an incomplete way. This may be explained by partial damages of the descending fibers, some of which decussate through the posterior commissure before it reaches the oculomotor nucleus. Thus, clinical signs and symptoms were clarified based on anatomical and physiological points of view.
Subject(s)
Blepharoptosis/diagnosis , Blepharoptosis/etiology , Brain Neoplasms/complications , Cerebral Hemorrhage/complications , Mesencephalon , Oculomotor Nerve Diseases/diagnosis , Oculomotor Nerve Diseases/etiology , Adult , Aged , Aged, 80 and over , Electrooculography , Eye Movements , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Oculomotor Nerve Diseases/physiopathologyABSTRACT
Four cases with acute sensorineural hearing loss on one side and one case with bilateral ear fullness associated with Mycoplasma pneumoniae (MP) were described. These cases were characterized by highly elevated MP complement fixation titer, and cold hemagglutinin titer. All patients experienced cochlear symptoms in an early stage following common cold. In all cases, clarythromycin (CAM) had been administered for 10 days, and adenosine triphosphate (ATP), vitamin B1, B12, and prednisolone were concurrently administered for 14 days. Two cases with acute hearing loss and one case with ear fullness returned to normal hearing after treatment. The other cases were remarkably improved in hearing level. MP is a common causative agent for protein respiratory disease. The true incidence of hearing loss in this disease may be higher than has been reported so far. Prompt diagnosis possibly facilitates the administration of specific treatment and leads to good prognosis.
Subject(s)
Hearing Loss, Sensorineural/etiology , Mycoplasma Infections/complications , Mycoplasma Infections/microbiology , Mycoplasma pneumoniae/isolation & purification , Adult , Aged , Audiometry, Pure-Tone , Child , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/physiopathology , Humans , Middle Aged , Tympanic Membrane/physiopathologyABSTRACT
Epstein-Barr virus DNA was detected in 3 cases of lymph node metastasis with nasopharyngeal carcinoma, using in situ hybridization. EBV-DNA was demonstrated on the nuclei of the neoplastic cells, and was absent on those of lymphocytes. Localization of EBV-DNA in neoplastic cells was confirmed by the double-labeling method combining in situ hybridization and immunocytochemistry. Direct evidence of the presence of EBV-DNA in malignant epithelial cells from lymph node metastasis with nasopharyngeal carcinoma was clearly demonstrated in this study.
Subject(s)
Carcinoma/virology , Herpesvirus 4, Human/isolation & purification , Lymph Nodes/virology , Nasopharyngeal Neoplasms/virology , Nasopharynx/virology , Neoplasm Metastasis , Carcinoma/pathology , Carcinoma/ultrastructure , Culture Techniques , Herpesvirus 4, Human/ultrastructure , Humans , In Situ Hybridization , Lymph Nodes/ultrastructure , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/ultrastructure , Nasopharynx/pathology , Nasopharynx/ultrastructureABSTRACT
A case of acquired choanal atresia of unknown origin is reported. A 68-year-old woman had been complaining of nasal obstruction for 28 years. Bilaterally her nasal choanae were found to be completely closed at the depth of the orifice of the eustachian tube. Surgical intervention into the margin of the soft and hard palate removed the adhesive connective tissue from the choanae, which had involved no osseous component. Because part of the intranasal basal epithelium was missing due to surgery, buccal mucosa was removed and implanted to prevent proliferation of granulation. A silicone tube was placed in each choanae for a week postoperatively. An adequate nasal passage has been maintained for 10 months postoperatively, and the patient was followed up closely.
Subject(s)
Choanal Atresia/surgery , Aged , Choanal Atresia/diagnosis , Female , Humans , Magnetic Resonance Imaging , Surgical Flaps , Tomography, X-Ray ComputedABSTRACT
Epstein-Barr virus DNA was detected in a case of lymphoepithelioma-like thymic carcinoma. A homogeneous terminal structure of the viral DNA was demonstrated in this case, indicating the presence of the viral genome in clonally expanded tumor cells. Since all of 26 other thymic epithelial tumors (eight non-invasive, 13 invasive thymomas and four non-lymphoepithelioma-like thymic carcinomas) in Japanese were negative by polymerase chain reaction, it is suggested that lymphoepithelioma-like thymic carcinoma may represent a unique pathological entity distinct from Epstein-Barr virus-negative thymic epithelial tumors, which are in the majority in Japan.
Subject(s)
Carcinoma, Squamous Cell/genetics , DNA, Neoplasm/analysis , DNA, Viral/analysis , Herpesvirus 4, Human/genetics , Thymoma/genetics , Thymus Neoplasms/genetics , Child , Humans , Japan , Male , Polymerase Chain ReactionABSTRACT
The polymerase chain reaction method for amplification of DNA in formalin-fixed, paraffin-embedded tissue sections was used to detect Epstein-Barr virus DNA in nasopharyngeal carcinomas from Japanese patients. Thirty-one cases of nasopharyngeal carcinoma and 8 cases of lymph node metastasis of nasopharyngeal carcinoma were studied. Detection rates of Epstein-Barr virus in various types of nasopharyngeal carcinoma according to the World Health Organization classification were as follows: 10 of 10 undifferentiated carcinomas, 8 of 13 nonkeratinizing carcinomas, and 5 of 7 keratinizing carcinomas. Eight lymph node metastases, for which the primary was positive for Epstein-Barr virus, also contained Epstein-Barr virus DNA. By in situ hybridization using a biotinylated Epstein-Barr virus probe, it was clearly demonstrated that Epstein-Barr virus DNA was localized in the nuclei of the neoplastic cells. The clinical features of nasopharyngeal carcinoma with or without Epstein-Barr virus were not different. These results demonstrate that nasopharyngeal carcinoma in Japanese patients is closely associated with Epstein-Barr virus infection, similar to nasopharyngeal carcinoma of other endemic and nonendemic areas.
Subject(s)
Carcinoma/microbiology , DNA, Viral/analysis , Herpesvirus 4, Human/genetics , Nasopharyngeal Neoplasms/microbiology , Carcinoma/pathology , Female , Histological Techniques , Humans , Male , Middle Aged , Nasopharyngeal Neoplasms/pathology , Nucleic Acid Hybridization , Polymerase Chain ReactionABSTRACT
Thirty-one cases of Hodgkin's disease were examined for the occurrence of Epstein-Barr virus (EBV) genome by using the polymerase chain reaction (PCR) of DNA in formalin-fixed paraffin-embedded tissues and in situ hybridization technique. The cases were subdivided into 17 cases of nodular sclerosis (NS), nine cases of mixed cellularity (MC), four cases of lymphocyte predominance (LP), and one case of lymphocyte depletion (LD). EBV DNA was detected in eight cases including four cases of NS, three cases of MC and one case of LP. The sensitivity of PCR was higher than that of Southern blot hybridization of DNA from fresh frozen tissue, because Southern blot hybridization using the BamHI-W fragment of EBV detected virus DNA only in two of three cases which were positive by PCR. The results of in situ hybridization studies confirmed that EBV genome was localized within the nuclei of Reed-Sternberg (RS) cells and their mononuclear variants. Furthermore, double-labeling studies combining in situ hybridization and immunocytochemistry using CD30 (BerH2) and CD15 (LeuM1) as markers of RS cells, as well as pan B-marker (L26) and pan T-marker, CD45RO (UCHL1), were performed to demonstrate the phenotype of EBV DNA-positive cells, confirming that EBV DNA was present in RS cells but not in lymphocytes. The results of this study indicate a significant association between EBV and some cases of Hodgkin's disease.
