[Facial bone fracture--statistical analysis and clinical aspects].

We experienced 102 cases of facial bone fracture during 16 months of 1986 to 1987. These cases were analyzed statistically concerning causes, age and locations of the fracture. These fractures have increased rapidly in number. The causes were classified into three types; occurrence during sport, traffic accident and fighting, which were equal in number. There were 85% males and 15% females in the patient cohort, which were concentrated at the ages of 10-20 years. A large part of the fractures was mostly consisted of maxillo-facial components (95%). These trends were similar to the previous report of our clinic (1972-1979). On the other hand, not only severe dysfunctioning cases but also complicated cases increased in number, so that the several clinical aspects were reported. Case 1: 17-year-old male presented with retraction of left cheek caused by Rugby foot ball, whose malar bone was dislocated backward and anticlockwise, was treated with oroantral reduction and with the intermaxillary packing of silicon blocks. Case 2: 10-year-old boy with complaint of double vision occurred by head blow to right eye. Pure type blowout fracture of the orbital floor was presented, which was reconstructed by silicon plate from the incision of the lower eyelid. Case 3: 59-year-old male presented with 6 month history of diplopia and retraction of left eye ball, had been under the conservative care by an eye doctor. X-ray examination showed the intraorbital soft tissue was blown out into the ethmoidal sinus. However the transethmoidal reduction was performed, the result was not satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Prostaglandin content in human middle ear effusions.

The concentrations of prostaglandins (PGs) were measured by a radioimmunoassay in human middle ear effusions (MEEs) obtained from patients with otitis media with effusions. Each sample of MEE was divided into two groups: serous effusions and mucoid ones. The main PG in both the serous and mucoid effusions was TXB2 (375 and 857 pg/ml, respectively), followed by PGE2 (173 and 459 pg/ml, respectively). Smaller quantities of PGD2 (35 and 64 pg/ml, respectively), PGF2 alpha (139 and 183 pg/ml, respectively), and 6ketoPGF1 alpha (129 and 201 pg/ml, respectively) were also found in the MEEs. The amounts of each PG in the mucoid effusions were 2 or 3 times higher than those found in the serous effusions, while protein concentrations and the profile of these PGs in the MEEs were almost the same in the mucoid and serous groups. These results suggest that PGs may play an important role as a mediator of the inflammatory responses in the pathogenesis of MEEs.

Prostaglandin synthesis by the cochlea.

The exogenous and endogenous syntheses of prostaglandins (PG's) by the cochlea of adult mongolian gerbils were studied in vitro. After incubation of the whole membraneous cochlea with [3H]-arachidonic acid (AA), syntheses of PGF2 alpha, 6-keto PGF1 alpha, PGE2, thromboxane (TX) P2 and PGD2 were evidenced in this order. The synthesis of radioactive PG's was almost completely inhibited by incubation with 10(-5) M indomethacin. No significant amounts of those PG's were detected by radioimmunoassay (RIA) in the cochlea obtained from animals killed by microwave irradiation at 5.0 kw for 0.8 sec. However, when the homogenate of the whole membraneous cochlea obtained from animals without microwave irradiation was incubated at 37 degrees C for 0-15 min, PGD2, PGE2, PGF2 alpha and 6-keto PGF1 alpha were found to be formed from endogenous AA in the cochlea by RIA. PG's were formed already at 0 time to considerable level (PGD2, PGF2 alpha and 6-keto PGF1 alpha, 90-120 pg/cochlea; PGE2, 370 pg/cochlea), reached to the maximum level (PGD2, PGF2 alpha and 6-keto PGF1 alpha, 170-200 pg/cochlea; PGE2, 500 pg/cochlea) at a 5-min incubation, and then gradually decreased. On the other hand, the amount of TXB2 was lower than the detection limit by RIA (less than 50 pg/cochlea) even after the incubation. The cochlea was dissected into three parts: organ of Corti + modiolus (OC + M), lateral wall (LW), and cochlear nerve (CN), and then PG's formed by these tissues were determined after a 5-min incubation of the homogenates. In the CN and OC + M, PGE2 was the major PG (100 and 160 pg/tissue, respectively), and the amounts of PGD2, PGF2 alpha and 6-keto PGF1 alpha were about 1/3 of those of PGE2. In the LW, the amounts of PGD2, PGE2, PGF2 alpha and 6-keto PGF1 alpha were about the same level (70-100 pg/LW).

Ciliated mucous cells found in the nasal mucosa of a patient with Kartagener's syndrome.

Transmission electron microscopy revealed the presence of ciliated cells containing many mucous secretory granules in the nasal surface epithelium of a 13-year-old patient suffering from Kartagener's syndrome. In these cells, mucous secretory granules were accumulated in the apical cytoplasm, and the Golgi apparatus was well developed in the supranuclear region. Mucous secretory granules were discharged infrequently through the apical cell membranes by single or compound exocytosis. The cells were considered to be ciliated mucous cells, which have already been reported to be present in the lower respiratory tract but not in the upper respiratory tract.

In vitro synthesis of IgE antibody by human tonsil mononuclear cells. Preliminary report.

Using anti-human IgE monoclonal antibody E235I63, an IgE antibody to mite extract response by peripheral blood lymphocytes (PBL) and tonsillar lymphoid cells from 3 atopic patients suffering nasal allergy and 2 normal individuals was detected by a sensitive radioimmunoassay of culture supernatants. Although the spontaneous IgE antibody response was characteristic of atopic PBL, PBL of normal controls did not produce anti-mite IgE antibody spontaneously. IgE antibody to mite extracts were detected in supernatants of all tonsillar cells cultured with mite antigen or PWM, but PBL from only atopic donors could produce IgE antibody in the same conditions.

Cytochemical localization of specific carbohydrates in the cochlea using wheat germ agglutinin-gold.

Localization of specific carbohydrates in the cochlea was examined by postembedding labelling by wheat germ agglutinin (WGA)-gold at the electron microscopic level. Gold labelling was observed in the tectorial membrane, basilar membrane, basal membrane of the capillary and other connective tissues. In these areas, the labelling was observed over either fibrous structures or the ground substance. WGA is known to bind specifically with N-acetylneuraminic acid, N-acetyl-D-galactosamine, N-acetyl-D-glucosamine and its beta-(1-4)-linked oligosaccharides. The labelled sites, therefore, are considered to indicate the presence of glycoconjugates that contain these carbohydrates as their constituent.

Experimental otitis media with effusion induced by intratympanic lipid A instillation.

Otitis media with effusion was induced in guinea pigs by intratympanic instillation of lipid A, the lipid moiety of gram-negative bacterial lipopolysaccharide from Salmonella minnesota Re595. Lipid A was chosen as an inducer because of its similar composition among various bacterial species. Animals were killed from the first to 14th day after instillation of various concentrations (0.2, 2, 20, 200 micrograms/ml) of lipid A in 0.5% triethylamine. By 3 days after instillation, all experimental animals developed serous middle ear effusion. The histologic findings included hemorrhage, mucosal edema, capillary engorgement, and migration of infiltrative cells including macrophages, polymorphonuclear neutrophils, and lymphocytes. These findings were most prominent 3 days after instillation, and the recovery of the middle ear epithelium was observed within 14 days. Repeated instillation of lipid A (2 micrograms/ml) at an interval of 14 days reinforced the local response accompanied by serous middle ear effusion. These findings indicate that lipid A can induce the inflammatory changes with middle ear effusion and that lipid A plays an important role in the pathogenesis of otitis media with effusion.

Wheat germ agglutinin binding sites in the organ of Corti as revealed by lectin-gold labeling.

The distribution of wheat germ agglutinin(WGA)-binding sites in the organ of Corti of the guinea pig and mongolian gerbil was studied. WGA was conjugated with gold particles and applied on thin sections of the cochlea embedded in Spurr's resin and in Lowicryl K4M. WGA-binding sites were found on the plasma membrane, lysosomes and cytoskeletons of hair and supporting cells as well as on the tectorial and basilar membranes. No distinct difference was discovered between hair cells and supporting cells in terms of WGA-binding activities.

Serial section method for cytofluorometric determinations of the DNA content of component cells of the human cochlea.

We describe a method for measuring the DNA content of the component cells of the organ of Corti using serial sections of human cochleae obtained at autopsy. Cochleae were fixed in Carnoy's solution and embedded in Acrytron E, a water-miscible methacrylate resin. A procedure was developed to reduce the background fluorescence in methacrylate-embedded sections; the resin was pretreated with ion-exchange resin (Amberlite IRA-410). Experiments showed that pretreatment reduce the background fluorescence practically to zero. Seventy 3 microns-thick serial sections were prepared on fluorescence free glass slides and stained with azocarmin G and acriflavine-Feulgen. After postirradiation using blue excitation light, the amount of Feulgen-DNA present in the target nucleus in each section was determined using a microfluorometer. The amount of DNA in the entire nucleus was determined by adding together the DNA content of the segments of the nucleus. The characteristic appearance of the organ of Corti made it easy to detect these cells; under green excitation light the cells of this organ exhibited red cytoplasmic azocarmin-G fluorescence. Due to the relatively wide internuclear spaces, cytofluorometry fo individual nuclei could be performed without interference from the neighboring cells. Our technique using serial sections allowed us to measure the DNA content of individual cells and obtain histological information about particular cells and their neighboring cells. Several polyploid cells were found among the Hensen's cells in the cochlea, while all other component cells of the organ of Corti were diploid.

Cupulogenesis and glycoconjugates in the labyrinthine ampulla as revealed by WGA-gold labeling.

We studied the distribution of wheat germ agglutinin (WGA)-bindable glycoconjugates in the vestibular ampulla of mongolian gerbils. WGA was conjugated with gold particles and applied to Lowicryl K4M sections of the ampulla. WGA-binding sites were found on the cupula and some of the secretory granules and Golgi apparatuses in the supporting cells of the sensory epithelia. The granules were seen to secrete into the endolymphatic space through reticular membrane. It is likely, therefore, that glycoconjugates are glycosylated at the Golgi apparatus in the supporting cells, stored in the granules, and secreted through the reticular membrane into the endolymphatic space to be used as a component of the cupula. The cell membranes of various cells, connective tissue filaments in the perilymphatic space and the cytoplasm of melanocytes were also labeled with WGA-gold.

UFT for head and neck cancers: its tissue concentrations and effects on lymphocyte subpopulations.

UFT, a combination of the masked compound of 5-fluorouracil (FT-207) and uracil, was given to head and neck cancer patients for 1 week preoperatively and for 8 weeks postoperatively. Drug concentrations were examined in the surgically removed tissues. The concentrations of FT-207, 5-fluorouracil, and uracil were higher in tumor tissues than in normal tissues. The lymphocyte subpopulations were assessed by cytofluorometry with monoclonal antibodies. There was no evidence that adjuvant chemotherapy with UFT specifically suppresses immunocompetent cells. We therefore conclude that further clinical evaluation of adjuvant chemotherapy with UFT would be worthwhile.

An electron microscopic study of the muscle spindle in the arytenoid muscle of the human larynx.

We used transmission electron microscopy to examine a muscle spindle found in serial sections of the arytenoid muscle of the human larynx. Eight intrafusal fibers were observed at the equatorial region and contained two types of muscle fibers, nuclear bag fibers and nuclear chain fibers. The sensory nerve endings found on the nuclear bag fibers were annular or varicose in shape and contained numerous mitochondria. Another small sensory ending was composed of many vesicles and some dense granules. The fusimotor nerve endings found on the nuclear chain fibers had three types of endings with different sizes and complexities.

Amylase secretion by nasal glands. An immunocytochemical study.

Amylase, an enzyme that hydrolyzes starch, has been localized in the nasal mucosa for the first time by the protein A-gold technique. The amylase appeared to be produced by serous cells of the nasal glands. This enzyme has the potential for use as a tumor marker for cancer of the nasal cavity. The function of amylase in the physiology of nasal secretions is discussed.

Lysozyme producers in nasal mucosa. An immunocytochemical study.

The question of whether or not goblet cells in the nasal mucosa are lysozyme producers has yet to be examined. In the present study, lysozyme was localized by the protein A-gold technique in human nasal mucosa with special attention to goblet cells. Both light and electron microscopic immunostaining revealed lysozyme in the secretory granules of the goblet cells, although far less than the amount present in the serous cells of the nasal glands. We concluded that the nasal glands were the main producer and goblet cells the subsidiary producer of lysozyme in nasal mucosa.

Teratoma of the soft palate with multifocal cyst formation in the tongue and the brain.

We report a case of a solid and cystic teratoma appearing in the soft palate that was associated with a cyst in the tongue and a huge cystic formation in the arachnoid of the brain. Histologically, the tumor of the soft palate contained elements of all three germ layers, with a predominance of mature glial tissues. This typical teratoma and the two other concurrent lesions were all located on the same side of the head, and were thought to have a common embryonic origin. These multifocal tumors may represent an incomplete manifestation of a "teratoma complex".

Bacteriolytic activity of lysozyme in the nasal mucosa.

During an experiment to study the localization of the lysozyme in the nasal mucosa of humans by the protein A-gold technique, we observed the accumulation of lysozymes around bacteria possibly causing bacteriolysis. The lysozyme, therefore, seems to play a preventive role against some kind of bacterial infection in the nasal mucosa in situ.

Polymyxin-B-binding sites in the cochlea as demonstrated by polymyxin-B/gold labeling.

A polymyxin-B/bovine-serum-albumin/gold complex was used as a probe to detect the binding sites of polymyxin B on thin sections of cochlea embedded in Spurr's resin. The binding sites were found to be mainly located on the stereocilia, the cuticular plate of hair cells, the head plate of Deiters' cells, the tonofilaments in pillar cells and Deiters' cells, fibrous structures in the spiral limbus, the tectorial membrane and the basilar membrane and neural elements such as nerve endings, fibers, and the myelin sheath. The mitochondria, plasma membrane, and chromatin of the nuclei of the cells observed also exhibited binding. Our results suggest that phospholipids, glycoconjugates, cytoskeletal proteins and nucleic acids are responsible for this binding activity.

Aminoglycoside binding sites in the cochlea as revealed by neomycin-gold labelling.

Neomycin/bovine serum albumin/gold was used as a probe to detect the binding sites of aminoglycosides on the thin sections of the cochlea embedded in Spurr. The binding sites were mainly located on the stereocilia, the cuticular plate of hair cells, the head plates of Deiters' cells, fibrous structures in pillar cells, in the spiral limbus and tectorial membrane and basilar membrane, plasma membranes, mitochondria and the chromatin of various kinds of cells. Triphosphoinositide, acidic glycosaminoglycans, and RNA were considered to be responsible for the binding activity.

Substance P nerve fibres in the canine larynx by PAP immunohistochemistry.

The distribution of the Substance P (SP) immunoreactive nerve fibres in the canine larynx and laryngeal nerves was studied by PAP immunohistochemistry. Many individual SP immunoreactive nerve fibres with varicosities were observed within the epithelial layer and in the connective tissue below the epithelium of the laryngeal mucosa. Small numbers of SP immunoreactive nerve fibres were also found in the submucosal gland region and some of them appeared to terminate in glandular cells. These findings are consistent with the view that SP might be involved in the laryngeal sensory innervation system and the laryngeal glandular secretion. No SP immunoreactive nerve fibres were found in any intrinsic laryngeal muscles. The recurrent laryngeal nerve and the superior laryngeal nerve contained SP immunoreactive nerve fibres and were considered to lie in the pathway of the SP nerve fibres to the larynx.

Immunocytochemical detection of triphosphoinositide in vestibular hair cells.

Triphosphoinositide (TPI), an aminoglycoside receptor and a possible regulator of cationic permeation through its ability to bind with Ca++, was localized by the protein-A gold technique in vestibular sensory epithelia using an antibody highly specific to TPI. TPI was detected on the stereocilia, kinocilia, and cuticular plate of hair cells, and in the reticular membrane of supporting cells. The cilia of hair cells are damaged by aminoglycosides at a relatively early stage of toxicity. Ca++-regulated bioactivity in this area is probably involved.