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IgA nephropathy (IgAN) is the most common form of chronic glomerulonephritis with IgA deposits present mainly in the mesangial areas. We performed a 10-year retrospective case-control study of 71 patients with IgAN to evaluate the long-term effects and prognostic factors associated with tonsillectomy. Forty-one patients (19 males and 22 females) underwent tonsillectomy (Group A) and 30 patients (13 males and 17 females) did not (Group B). These patients were followed for more than 10 years after renal biopsy. The average age at initial renal biopsy was 29.78 years in Group A and 33.0 years in Group B. The average follow-up period was 13 years and 3 months in Group A, and 12 years and 7 months in Group B. Glomerular damage demonstrated on renal biopsy was more extensive in Group A than in Group B. Prognosis after 10 years of follow-up was compared between the two groups. The clinical remission rate was 24.4% in Group A and 13.3% in Group B, the stable renal function rate was 82.9% in Group A and 70.0% in Group B, and the renal survival rate was 95.1% in Group A and 73.3% in Group B. The renal survival rate in Group A was significantly higher than that in Group B ( p <0.05). Although evaluation of renal pathology based on renal biopsy was useful in predicting the long-term effects of tonsillectomy in IgAN patients, the results of tonsillar provocation tests were not. [ABSTRACT FROM AUTHOR]

Allergic rhinitis is a common condition among schoolchildren. However, little is known about the prevalence of nasal eosinophilia. We investigated the prevalence of rhinitis via questionnaire and nasal smears for eosinophils. The questionnaire was administered in 1992 and 1995. Complete responses were obtained from 1044 and 431 schoolchildren, respectively, of whom 26.5% and 22.5% claimed to have nasal symptoms. Nasal smears were taken in 1992, 1993 and 1994, and 415, 285 and 384 samples were collected, respectively. Positive eosinophilia were seen in 39.8%, 35.1% and 35.9% children in 1992, 1993 and 1994, respectively. In 1992, we utilized both questionnaire and nasal smears simultaneously to evaluate 415 schoolchildren. Of 415 schoolchildren, 72 (17.3%) had both nasal symptoms and nasal eosinophilia. Interestingly, those who showed positive eosinophilia in 1992, especially those who had eosinophilia with nasal symptoms, had significantly higher incidence of nasal symptoms three years later in 1995 than those who showed negative eosinophilia in 1992. These results suggest that nasal eosinophilia in schoolchildren are associated with subsequent nasal symptoms, and that nasal smear examination may be a potentially valuable test to predict prolonged or recurrent allergic rhinitis. [ABSTRACT FROM AUTHOR]

Auditory Brainstem Response (ABR) is the most reliable and most frequently used procedure to evaluate audiological conditions in early infancy. However, several reports have demonstrated that developmental change in the central nervous system may affect the results of ABR in audiological evaluations. We examined statistically the reliability of ABR for the diagnosis of profound deafness in early childhood according to our experience over the past 12 years of follow-up in our facility. Subjects included 371 children among 1,041 children who were admitted to Kanariya-Gakuen (institute for pre-school deaf children) from April 1985 to March 1997. These children were examined with ABR to determine their hearing levels. In five cases with an abnormal hearing threshold determined by ABR and other audiological tests, repeated examinations carried out during a 5- to 6-month follow-up period revealed that they had normal hearing. Three of these children had been diagnosed previously with mental retardation and the remaining two were infants <5 months old. The specificity and sensitivity of ABR were calculated as 97.3% and 100%, respectively. The predictive value of a positive result was 94.7%. There remains the possibility of a false negative for such cases, although the rate seems to be very low (<0.2%). [ABSTRACT FROM AUTHOR]

The degeneration of spiral ganglion neurons after hair cell destruction following aminoglycoside ototoxicity is associated not only with the direct effect on the neurons, but also with a loss of neurotrophic factors provided by auditory hair cells. The neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), have been reported to be effective in enhancing neuronal survival against aminoglycoside ototoxicity in vivo. To determine whether 4-methylcatechol (4-MC), a potent inducer of nerve growth factor synthesis, can protect spiral ganglion neurons after aminoglycoside treatment in vivo, we studied the spiral ganglion neurons of gentamicin (GM)-treated mice with or without 4-MC administration. We found that the number of surviving spiral ganglion neurons of 4-MC-treated animals was significantly greater than for those treated with GM alone. Our results suggest that 4-MC promotes synthesis of NGF (and/or other neurotrophins), which enhances spiral ganglion neuron survival after gentamicin treatment. [ABSTRACT FROM AUTHOR]

The distribution of the Ca[sup 2+]-binding proteins, calbindin and calmodulin, in the adult inner ear has been described previously. We undertook immunohistochemical investigation of developmental changes in the distribution of calbindin and calmodulin in the vestibular organ of the musk shrew (Suncus murinus). Expression of calbindin was seen first in the hair cells and the vestibular ganglion on gestational day (GD) 19, in nerve fibres on GD23 and in the otoconia on GD26. On GD19 calmodulin was demonstrable only in the hair cells. On GD26 both Ca[sup 2+]-binding proteins showed a distribution of immunoreactivity in hair cells similar to that seen in adults. The developmental differences in distribution of these binding proteins may suggest different roles in the vestibule. Additionally, Ca[sup 2+]-binding proteins may be a useful index of hair cell maturity. [ABSTRACT FROM AUTHOR]

Terminal deoxyribonucleotidyl transferase (TDT)-mediated dUTP-digoxigenin nick end labelling (TUNEL) is being used more frequently to investigate programmed cell death (PCD). We have applied this method in order to examine how PCD is involved in the development of the mouse inner ear. In a series of studies, we identified a population of TUNEL-positive cells in the perinatal mouse ear that could not be regarded as apoptosis based upon morphological features of the nuclei. Theoretically, TUNEL detects DNA fragmentation, which can also occur in necrosis. Other authors regard TUNEL-positive cells in the sensory epithelia of the rat equilibrium organs between gestational day (GD) 19 and 7 days after birth (DAB) as apoptosis. We determined whether or not cells in the inner ear of perinatal and post-natal mice were TUNEL-positive due to apoptosis. We stained the inner ears of BALB/c mice aged GD17.5-4 weeks by the TUNEL method and analysed morphology by light microscopy and transmission electron microscopy (TEM). TUNEL-positive cells were distinct in the saccule from DAB3, and in the cochlea from DAB8. The number of TUNEL-positive cells in the hair cells of the saccule and in the cochlea increased with age, and seemed to reach a plateau just before 2 weeks of age. However, morphological analyses did not reveal findings characteristic of apoptosis. We conclude that these TUNEL-positive cells were labelled not because of apoptosis, but due to necrosis or post-mortem autolysis. We surmise that TUNEL staining can identify vulnerable cells of the inner ear that consume high levels of oxygen and easily undergo autolysis. [ABSTRACT FROM AUTHOR]

Recently, the effectiveness of cochlear implantation for hereditary deafness has been reported. We performed cochlear implantation for two patients with symptomatic hereditary deafness. Deafness in one patient was thought to be a result of albinism-deafness syndrome and in the other patient, a result of chronic progressive external ophthalmoplegia syndrome. Since their speech perception abilities improved dramatically, we believe that cochlear implantation should be actively performed for these two syndromes. [ABSTRACT FROM AUTHOR]

The volume of the air cavities in the paranasal sinuses is, even at present, not only the simplest but also the most important index employed in the evaluation of the paranasal sinus. We have measured the size of the paranasal cavities in 20 healthy Japanese subjects by reconstructing three-dimensional (3-D) computed tomography (CT) images. To avoid any bias in determining the cavity margin, we first measured bilateral maxillary sinuses of a macaque both by silicone injection and by 3-D reconstruction. Then the CT value for 3-D reconstruction was determined by comparison with the volume measured by direct injection. Each sinus of the healthy volunteers was then measured by 3-D reconstruction imaging. Paranasal sinuses were, individually and on the whole, apparently larger than previously reported: 90.1 ml in males and 72.5 ml in females, on average. Comparing with other body size indices, the increment of the size was quite apparent and the lower prevalence of sinusitis was assumed to play a role in this increased volume of paranasal sinuses in the modern Japanese population. [ABSTRACT FROM AUTHOR]

The serum concentrations of three separate tumor markers, squamous cell carcinoma antigen (SCC Ag), carcinoembryonic antigen (CEA) and Cyfra 21-1 were clinically correlated in 86 randomly selected patients with squamous cell carcinoma involving the head and neck. Positive findings for each tumor marker were totalled and statistically analysed. The upper limits of normal for SCC Ag, CEA and Cyfra 21-1 were set at 1.5, 2.5 and 2.0 ng/ml, respectively. Positivity rates were 20.6% for SCC Ag, 14.0% for CEA and 41.7% for Cyfra 21-1. Elevated Cyfra 21-1 concentrations correlated somewhat with age, whereas elevated CEA levels correlated with the site of tumor involvement. Overall, Cyfra 21-1 appeared to be the most useful marker in head and neck squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

A retrospective, case-control study was conducted to examine the relationship between the presence of human papillomavirus types 16 and 18 (HPV16/18) DNA and the risk of head and neck cancers. Twelve out of 74 (16.2%) head and neck cancers contained HPV16/18 DNA, while 3 out of 70 (4.2%) non-cancer controls showed HPV16/18 positivity by polymerase chain reaction. The presence of HPV16/18 DNA was associated with an increased risk of head and neck cancer formation, showing an odds ratio of 4.32, with a 95% confidence interval of 1.26-14.78. Although its epidemiological impact might be smaller than that of other factors like cigarette smoking, the presence of HPV16/18 DNA in the aerodigestive tract is suggested to be a risk factor for human head and neck cancers. [ABSTRACT FROM AUTHOR]

IgA nephropathy (IgAN) is a type of chronic glomerulonephritis characterized by IgA deposits mainly in the mesangial area. It does not have so favourable a prognosis as was initially thought. This nephropathy is one of the diseases affected by tonsillar focal infections, and there have been patients in whom tonsillectomy has been effective. In this study, 24 patients with IgAN were followed for more than 2 years after tonsillectomy and studied clinicopathologically. Remission of proteinuria was observed in 41.7% of the patients 6 months after surgery and in 50.0% 2 years after surgery. At 2 years after surgery, patients with minor and focal segmental renal lesions showed a significantly higher rate of remission of proteinuria than patients with diffuse renal lesions. There was no statistically significant difference between positive and negative patients in the rate of remission of proteinuria based on any parameter of the tonsillar provocation test at any time after surgery. [ABSTRACT FROM AUTHOR]

The post-operative complications and hearing results of surgical intervention for congenital aural atresia were investigated. Seventy-five ears with congenital aural atresia were operated on for hearing loss from 1982 to 1996. Tympanoplasty was performed on 37 ears and canaloplasty on the remaining 38. Hearing improvement rates were 70.3% and 31.6%, respectively. The post-operative complications included stenosis of the created auditory canal (29.3%), deterioration of the improved hearing (21.3%) and infection (12.0%). Reoperations were performed on 6 cases for restoring hearing, 16 for stenosis and 6 for infection. Reoperative findings demonstrated that scar formation in the canal caused the stenosis of the newly formed external canal and that lateralization of the new tympanic membrane and subsequent detachment from the ossicles caused the deterioration of improved hearing. Using cartilage and pedicled skin flap prevented stenosis at the orifice of the newly formed external canal. Maintaining hearing improvement requires creating a wide ear canal using as many pedicle flaps as possible and attaching a new tympanic membrane firmly to the ossicles. [ABSTRACT FROM AUTHOR]

Presents an overview of the supplemental issue to Acta Oto-Laryngologica published in 1999. Retirement of Professor Yu Masuda from the Department of Otorhinolaryngology; Issues concerning the field of otolaryngology; Recognition of the contribution of Masuda to expansion of the department.

Examines the changes of Penicillin-binding proteins in Streptococcus pneumoniae isolated from acute otitis media (AOM). Impact of S. pneumoniae on otolaryngology; Mechanism of the drug resistance of S. pneumoniae; Association of AOM with S. pneumoniae to middle ear infections.