Clinical utilities of the measurement of the subsets of the lymphocyte in peripheral blood of the 47 head and neck cancer patients were investigated.Lesion of the subjects were larynx (21), paranasal sinus (8), epipharynx (4), mesopharynx (4), tongue (4), parotis (3), cervical esophagus (2) and ear (1). Histologies of them were squamous cell carcinoma (38), adenocarcinoma (5), malignant melanoma (3) and malignant lymphoma (1). Lymphocytes of the patients were incubated with monoclonal antibody marked with fluorecent substances, then were counted by fiuorocytometer EPICS V(C). Most useful parameter was the numbers of OKT4+ lymphocytes, because they were well correlated with clinical course and prognosis. Although percentage of OKT8+ lymphocytes was elevated in the condition with cancer, the numbers of OKT8+ lymphocytes did not changed. So the elevation of percentage of OKT8+lymphocytes was caused by the decrease of the numbers of OKT4+ lymphocytes. Then for units of the subsets of lymphocytes as parameter, absolute numbers were better than percentage. According to the examination of the change of the subsets in radiation therapy, it was supposed that the best preoperative dose was 2000 rads.
The maculo-ocular reflex related to horizontal sinusoidal linear accelerations was studied in 7 patients with labyrinthine disorders, 4 with unilateral and 3 with bilateral disturbances.1. The responses of the patients with unilateral labyrinthine disorders were the same as those of normal human subjects.2. Reduced responses and increased phase differences were observed in the patients with bilateral labyrinthine disorders.3. Differences in functional vulnerability between the semicircular canals and the otolith organs were demonstrated in patients with ototoxic disorders by comparing the results of the pendural rotation test with those of the sinusoidal linear acceleration test.
The tissues consisted of adenocarcinoma of the prostate were examined by immunohistochemical study with monoclonal antibody (43-21-1-1) against γ-seminoprotein (γSm). The degree of staining regarding any correlation with the histological grade was evaluated. The prostatic tissues were obtained by transurethral resection or by fine needle biopsy from untreated 38 patients. The avidinbiotin peroxidase complex technique was used to stain on 3μm-sections of 10% formalin fixed, paraffin embedded tissue. In addition, immunohistochemical staining with the commercialized antibodies to prostate-specific antigen (PSA; polyclonal, DAKO) and to prostatic acid phosphatase (PAP; polyclonal, DAKO) was done simultaneously for a comparative study. The degree of immunoperoxidase stain was classified into two categories, namely location and pattern, and was graded from 0 to 3, respectively. The product of the degree of location and the degree of pattern was noted as the total score. The mean of score was calculated in each histological grade. Then the means of total scores were compared and evaluated as having any statistical difference by Student's t test among 3 histological grades as well as among 3 primary antibodies used in this study.When the monoclonal antibody to γ-Sm was used for immunoperoxidase staining, the means of total scores and the rates of negative reactions (% Negative) in 3 histological grades were 6.8±1.8 (M±SD) and 0% in well (N=9), 4.4±2.4 and 14% in moderately (N=22), and 1.8±2.3 and 54% in poorly differentiated lesions (N=11), respectively. There were statistically significant differences (P<0.05) among 3 histological grades. The means of total scores and % Negative by PAP staining were 7.1±1.5 and 0% in well (N=8), 6.1±2.5 and 9% in moderately (N=22), and 4.3±3.2 and 30% in poorly differentiated lesions (N=10) respectively. However, no statistical differences were noted among 3 histological grades. The PSA staining demonstrated almost the same findings as did PAP staining. The means of total scores and % Negative by PSA staining were 7.1±1.5 and 0% in well (N=8), 5.9±2.5 and 9% in moderately (N=21), and 3.8±2.5 and 10% in poorly differentiated lesions (N=10), respectively. There was no statistical difference between the moderate and the poor, but between well and moderately differentiated lesions (p<0.05).In conclusion, the degree of immunoperoxidase staining with the monoclonal antibody to γ-Sm correlated well with histological grade. The monoclonal antibody to γ-Sm may have an important role to distinguish between moderately and poorly differentiated adenocarcinoma of the prostate.
From August 1971 to July 1978, 110 patients with benign paroxysmal positional vertigo visited the Neuro-otological Clinic of Kitasato University Hospital.The incidence and prevalence of benign paroxysmal positional vertigo in Sagamihara city, the population of which is about 400, 000 were estimated by the extended medical care fasility of Kitasato University Hospital.The mean incidence of benign paroxysmal positional vertigo for one year in Sagamihara city was 1.7per 100, 000 population and the prevalence for seven years was 10.2per 100, 000 population.A predominance in female and rising ratio of cases with benign paroxysmal positional vertigo to cases of Ménière's disease were observed.
Vestibular neuronitis is a peripheral vestibular disease of unknown etiology, in which severe vertigo attacks associated with disequilibrium usually start without any cochlear signs such as tinnitus or deafness after acute upper respiratory inflammation. It is generally accepted that the disease has a good prognosis beacause both subjective sensation and objective disequilibrium gradually improve and no recurrence of attacks is noticed.However, some patients complain of a transient dizzy sensation induced by quick body motion and disequilibrium during standing or walking, especially in darkness, a long time after the onset.Follow-up studies were carried out in six patients with vestibular neuronitis for 1 to 2 years after the beginning of the disease. Canal paresis was revealed by caloric tests in all six, it was bilateral in one. Five had transient diz-ziness and or unsteadiness during quick body movements 1 to 2 years after the onset of the disease. ENG studies revealed spontaneous nys-tagmus with eyes closed in two patients more than 2 years after the onset. The residual symptoms of dizziness and disequilibrium during body motion in vestibular neuronitis were assumed to be caused by prolonged failure in the acquisition of central vestibular compensation. Physical exercises were ordered in 2 patients, but complete recovery was not achieved.Disturvance of activities of daily living (ADL) are also discussed.
Aortitis syndrome is known to be an autoimmune disease, which has many symptoms of occulusive thromboaortopathy. It has recently been reported that the patients with systemic autoimmune diseases may have sensorineural hearing loss and that steroid therapy should be effective not only for the original disorder but also for the associated hearing disturbance.Eleven patients (3 males and 8 females) with aortitis syndrome and sensorineural hearing loss have been treated in Kitasato University Hospital during the 16 years since the opening of the hospital.The onset of hearing impairment was at 32 to 48 years of age, 10 years older than the mean age of onset of the aortitis syndrome reported in the literatures.Various types of hearing impairment were noted : slight hearing loss, total deafness of sudden onset and fluctuating type. Tinnitus was associated with hearing loss in many cases.Several patients also had vertigo and dysequilibrium, and in some of them the diagnosis was peripheral vestibular hearing loss, although in the cases of aortitis syndrome with hearing loss reported in the literature neither vertigo nor dizziness was mentioned.The usual treatment for acute stage sudden deafness was not effective in most of our patients. However, one female patient treated with long-term steroid therapy for systemic arteritis showed marked improvement of both her hearing and her general condition.We cannot conclude that the origin of sensorineural hearing loss is arteritis in the inner ear in all cases of aortitis syndrome with hearing loss. However, our cases of aortitis syndrome with steroid-dependant hearing loss indicate that the possibility remains of hearing loss due to arteritis of the labyrinthine artery in aortitis syndrome.
In order to evaluate the effectiveness of various therapies for vertigo at-tacks associated with tinnitus and hearing loss in Ménière's disease, the standard of both AAOO in 1972 and AAO-HNS in 1985 for the evaluation have been used in the United States and in Japan. The efficacy of treatment to prevent or decrease vertigo attacks and the duration of observation to evaluate it are the two main points discussed because the recurrence of attacks causes great suffering and it may make a hearing loss irreversible.There is often need to evaluate conservative treatment even soon after the start of therapy in order to judge whether the treatment is suitable for the patient. The modified evaluation method of AAO-HNS, which compares the mean numbers of attacks during the same intervals before and after the start of treatment is proposed in this study. This method can be useful both for short observation times less than 2.5 years and for long times of 3 or 5 years or more.
