Nasal and middle ear ciliary beat frequency in chronic suppurative otitis media

The middle ear mucociliary system has been shown to have an important function in the clearance of effusions. Little is known, however, about its role in chronic suppurative otitis media (CSOM). The ciliary beat frequencies of middle ear mucosal biopsies and nasal brushings of 27 patients with CSOM were analysed using a computerized photometric technique. The ciliary beat frequency in the middle ear mucosa was significantly less than that in nasal mucosa. Frequency in ears of smoking patients was significantly lower compared with non-smoking patients. Nasal brushings were taken from 27 otherwise healthy age and sex-matched non-smoking controls and the ciliary beat frequency was very similar to nasal samples from patients with CSOM. Ear controls were obtained from otosclerotic patients undergoing tympanotomy and the beat frequency was significantly higher than in the ear of patients with CSOM. It is concluded that middle ear ciliary function is significantly reduced in CSOM, particularly in patients who smoke.     

Configuration of experimentally produced cholesteatoma by transplantation of a free skin graft

Residual cholesteatoma was experimentally produced in guinea pigs by transplanting a free skin graft into the middle ear bulla. In group A, the graft was placed on the mucosa after scratching the surface with a pick, while in group B, it was placed on the bone surface following removal of the mucosa and drilling with a diamond burr. The group A procedure was conducted on the left ear and the group B procedure on the right ear in 12 guinea pigs. The animals were sacrificed at two, four and eight weeks after transplantation. In all 12 ears of group A, the graft kept its original flat shape, resembling an open type residue. In eight of 12 ears of group B, the graft grew forming a squamous pearl, while in the remaining four ears it retained a flat shape. The difference in configuration is thought to be due to the amount of granulation around the graft.     

Influence of the gas exchange function through the middle ear mucosa on the development of sniff-induced middle ear diseases

To investigate the influence of gas exchange function through the middle ear mucosa on the development of sniff-induced middle ear diseases, the authors examined the mastoid pneumatization among patients with sniffing habit using computed tomography, and also examined the change of negative middle ear pressure induced by sniffing using tympanogram. In 20 ears with cholesteatoma or adhesive otitis media, the areas of mastoid cavity measured at the level of the lateral semicircular canal were significantly smaller than those in 26 ears with otitis media with effusion (OME) or attic retraction and in eight normal ears with sniffing habit (P < .01 and P < .0001, respectively). In 26 ears with OME or attic retraction, the areas of mastoid cavity were significantly smaller than those in eight normal ears with sniffing habit (P < .0001). By contrast, in the four ears with sniff-induced middle ear disease, the recovery of negative middle ear pressure in 5 minutes without swallowing was less than 10 mm H2O, whereas in all seven ears with normal eardrum, negative middle ear pressure recovered by more than 20 mm H2O in 5 minutes. These findings suggested that impairment of gas exchange function through the middle ear mucosa, as well as eustachian tube dysfunction, might be closely related to the development of sniff-induced middle ear diseases.     

Middle ear mucosa pathophysiology and healing processes in children with otitis media with effusion (OME)

Most otitis media with effusion (OME) in children heals spontaneously, but it is sometimes persistent and intractable. The major factors determining these different courses of OME are unknown. Identifying such factors would be clinically helpful. Factors affecting on the outcome of OME were studied experimentally and clinically. In animal experiment OME was induced in rabbit by occluding the Eustachian tube. Clinical study was conducted by investigating a histology of the middle ear mucosa, sampled from 64 children with OME (87 ears) who underwent middle ear tube ventilation. Furthermore, these cases studied how the degree of mastoid pneumatization before and after treatment, changes in the volume of the middle ear air cavity and the course after removal of the middle ear ventilation tube affected lesions in the middle ear mucosa. In animals, histology of the middle ear mucosa showed that in the early stages, the subepithelial layer of the middle ear mucosa was characterized by edematous hypertrophy and enlarged blood vessels. In later stages, it became fibrous as a result of chronic inflammation. These results suggest that lesions of the subepithelial layer are unlikely to recover. In clinical cases, histological changes in mucosal samples were rated on a two-point scale: changes in the epithelium and changes in the subepithelial layer. Re-pneumatization, a sign of healing of middle ear mucosal inflammation, was seen 12 months to 18 months after surgery. Among patients in whom the tube was left inserted for more than 18 months, only 11% had unfavorable outcomes and the recurrence rate was low. All patients who had recurrence of disease despite more than 18 months of tube insertion had prolonged inflammation in the middle ear mucosa. There results indicate that the air cavity returns to approximately normal degree of pneumatization more than 18 months after surgery, and that the extent of lesions in the middle ear mucosa, especially the subepithelial layer, is closely related to the healing of OME.     

Gas exchange function of the middle ear in patients with otitis media with effusion

Gas exchange function through the middle ear mucosa was assessed using nitrous oxide (N2O) in patients with otitis media with effusion (OME), as well as in normal ears during elective surgery for unrelated disorders. In all normal ears except one (n = 43), an increase in pressure was observed after N2O inhalation. In 42 of 84 ears with OME, a pressure increase was observed, but not in the remaining 42 ears (50%), indicating that the gas exchange function in these latter ears was impaired. In 21 of the 42 ears showing no middle ear pressure increase following N2O inhalation, the middle ear pressure was again monitored after myringotomy and aspiration of the effusion A pressure increase was found in 16 ears, indicating that the impairment in gas exchange function in ears with OME may be reversible in most cases. Computed tomography of the mastoid was examined preoperatively in 66 ears, with the presence or absence of a middle ear pressure change well correlated in 57 ears with the presence or absence of mastoid aeration.     

Welfare implications of identification of cattle by ear tags

The damage caused by ear tags used for identification was studied by examining the ears of normal beef cattle and cull cows after slaughter, and by comparing the effects of metal and polyurethane ear tags in calves which had been double-tagged in the same ear. Metal tags were associated with more damage to the ears than polyurethane tags, the difference being most marked in the young calves, in which slight changes were found in 36.6 per cent and severe changes in 9.8 per cent of ears. There was a high incidence of blood around the point of insertion of the metal tags at three weeks old, but with the polyurethane tags only one calf showed slight evidence of blood around the point of insertion. In the beef cattle fitted with metal tags, a slight reaction was recorded in 40 per cent, a moderate reaction in 17 per cent and significant changes were found in 12 per cent of ears. By comparison, 16 per cent of ears with polyurethane tags showed only a slight reaction, and 80 per cent of the polyurethane tags were considered to be a good fit, compared with 37 per cent of metal tags. More changes were observed in the ears of the cull cows, with 23.5 per cent of ears with polyurethane tags being free from damage, compared with only 2.9 per cent of ears with metal tags.     

The role of micro-noise trauma in the etiology of aging-related changes in the inner ear

Eleven chinchillas between 1 and 2.4 years of age had the malleus/incus complex removed from one middle ear and then lived in the Washington University animal facilities for 4 years post-surgery. Each animal had one ear (termed ambient-noise) in which the conductive apparatus was intact; the other ear (termed noise-protected) had a 50-60 dB conductive hearing loss. The background sound level in the animal facility was 59 dBA with periodic brief sounds up to 102 dBA. After the 4-year experimental period, both ears were fixed, embedded in plastic and dissected for microscopic examination as flat preparations. The quantitative and qualitative findings in the noise-protected ears were compared to those in the ambient-noise ears. Both groups of ears sustained losses of sensory and supporting cells throughout the organ of Corti. A variable amount of age pigment was found to have accumulated in the outer hair cells and all supporting cells. In the noise-protected ears, inner hair cell loss ranged from 1.0 to 3.1% and averaged 1.7 +/- 0.8%; outer hair cell loss ranged from 1.8 to 6.4% and averaged 3.6 +/- 1.2%. In the ambient-noise ears, inner hair cell loss ranged from 0.7 to 2.8% and averaged 1.6 +/- 0.7%; outer hair cell loss ranged from 1.3 to 5.4% and averaged 3.6 +/- 1.2%. Within-animal comparison of cell losses in the noise-protected and ambient-noise ears revealed no significant difference between the two groups. It is concluded that long-term exposure to micro-noise does not accelerate the spontaneous loss of sensory cells which occurs with aging. Although not quantified, there was no obvious difference in the amount or cellular distribution of age pigment in the two groups. Thus, it appears that the formation of age pigment in the ear is the result of the cells' basic metabolic processes rather than the wear and tear from sensory transduction.     

External ear resonance as a screening technique in children with otitis media with effusion

External ear resonance can be quickly and accurately measured using real ear insertion gain equipment. It has been previously shown that external ear resonance characteristics are often altered by the presence of middle ear fluid. The external ear resonance characteristics of 84 children with a history of chronic middle ear disorder were determined. Results were compared to other audiological data and otological findings recorded during surgery. External ear resonance peak amplitude was significantly correlated with the presence or absence of middle ear fluid. It was found that peak amplitude of > or = 24 dB was associated with only 15% of dry ears and peak amplitude of < or = 22 dB associated with 79% of ears without fluid. The use of external ear resonance measures as a potential screening procedure is discussed.     

Neonatal mesenchyme temporal bone study: typical receding pattern versus increase in Potter's sequence

The fate of mesenchyme, which lines the fetal and newborn bony middle ear, is not well understood. The authors wished to test previous observations that a greater amount of mesenchyme was found in Potter's sequence (renal anomalies, pulmonary hypoplasia, and oligohydramnios). Using celloidin-embedded neonatal temporal bones (68 cases, 123 ears), with clinical and autopsy information, middle ear volumes were compared among diagnostic groups using analysis of variance. In 16 ears of Potter's sequence cases the volume of mesenchyme increased in proportion to the size of the middle ear. Conversely, in all other cases the volume of mesenchyme remained constant compared to increasing middle ear size. Both the volume of the bony middle ear and the volume of the air cavity increased at 15 mm3/500 g of body weight (gbw). Mesenchyme percentage decreased by 2%/500 gbw. Middle ear mesenchyme appears to recede rather than reabsorb. However, in Potter's sequence cases the volume of mesenchyme increases, raising issues of a missing renal signal that inhibits mesenchymal growth under normal circumstances.     

A Sos-derived peptidimer blocks the Ras signaling pathway by binding both Grb2 SH3 domains and displays antiproliferative activity

The goals of this study were to develop a mouse model for virally induced otitis media, and to study the immune response to infection. Intranasal inoculation of mice by reovirus was used to induce otitis media. Immunohistochemical evidence for the presence of reovirus in the nasopharynx, eustachian tubes, and middle ears and the amount of infiltrating B-cells and T-cells in those sites were serially evaluated by painlessly sacrificing animals over a 21 -day period. Reovirus antigen was detected in the middle ear mucosa by day 4 in 75% of infected animals, and histologic evidence for otitis media was found in 54% of all infected animals. A significant increase in B-cells in the nasopharynx and eustachian tubes was noted 7 to 10 days following infection. The number of infiltrating T-cells did not vary significantly from that in the control animals at any of the sites. These results provide a basis for further investigations of the immune response in otitis media.     

Post-traumatic regeneration of the epithelium of the gastric and intestinal mucous membranes of dogs

The work was devoted to the study of the sources of reparative regeneration of the epithelium of the gastric and intestinal mucosa. A number of surgical interventions on the stomach and intestine of 1 dogs were performed for the solution of this problem. On the basis of the investigations carried out the leading role in the regeneration of the gastric and intestinal mucosa was found to be played by uninjured epithelium surrounding the area of the surgical intervention. This was confirmed by the fact that a mucosa-free intestinal pedicle graft implanted into the defect of the wall of the stomach was covered by gastric mucosa; a stomach graft devoid of own mucosa became covered with intestinal mucosa when displaced in the form of a cylindrical "insertion" into the intestinal tube; mucosa-free stomach pouch became obliterated; this could be reliably attributed to the absence of the main source of regeneration -- uninjured mucosal epithelium along the periphery of the defect. No regeneration of the epithelium of the gastric mucosa from the implanted cells was revealed; this served as an additional confirmation of the fact that regeneration under conditions of the mentioned experiments occurred on account of creeping of epithelial cells surrounding the area of the surgical intervention over the free surface of mucosa.     

Ear manifestations in adolescents after closure of lip-jaw-palate- or isolated palatal clefts

We examined two groups of teenagers who had been surgically treated as small children for cleft palate. Most patients were between 13 and 21 years of age. One group had been looked after by the Dept. of Orthodontics at the University of Erlangen-Nürnberg, the other by the Dept. of Orthodontics at the University of Rostock. There were differences in sequence and time of the surgical closure between the two departments. Additionally, 60% of the people treated in Rostock had a velopharyngoplastic, which was rarely the case in Erlangen. In both groups only a few patients had been seen by an ENT-doctor regularly. Only some patients had been previously treated with tubes. There was one patient in each group with a bilateral, most likely genetically determined, sensorineural hearing loss. In Erlangen we examined 66 teenagers (132 ears). Six ears had been previously treated with one or more tympanoplasties. 10 ears needed further treatment due to a seromucotympanon, adhesions, perforations of the ear drum, suspicion of cholesteatoma or insufficient improvement of hearing after previous tympanoplasty. Another 18 ears showed signs of former inflammations. The control group in Rostock included 63 patients (i.e. 126 ears). 14 of the ears examined had undergone one or more tympanoplasties previously. 13 other ears needed further treatment for seromucotympanon, adhesions, perforations of the ear drum, insufficient improvement of hearing after tympanoplasty or cholesteatoma. Residuals due to prior inflammations were found in another 26 ears. Possible reasons for the different occurrence of middle ear problems in both groups are discussed.     

1,25(OH)2-vitamin D3 mediated changes in mRNA for c-myc and 1,25(OH)2D3 receptor in HL-60 cells and related subclones

The aim of this study was to clarify the change of the gastric mucosa following inoculation with Helicobacter pylori (H. pylori). Two pairs of cynomolgus monkeys received either H. pylori of human origin (group A) or H. pylori of monkey origin (group B) by intragastric inoculation at a dose of 10(9) CFU. After inoculation, endoscopical observation and biopsies were done every 7 days for one month. The bacteria in the biopsy samples were cultured quantitatively. The content of intracellular PAS-AB positive substance was quantitatively analyzed with the image analyzing system. Results were as follows: 1) Before inoculation, the gastric mucosa was endoscopically normal and free from H. pylori. 2) The quantity of H. pylori varied from 0 to 10(3) CFU/0.1 g tissue in group A and from 10 to 10(6) CFU/0.1 g tissue in group B. 3) Severe erosion was seen in group B, while mild mucosal erythema and erosion were observed in group A. 4) There was a correlation between the quantity of H. pylori and histological activity (Rauws' gastritis score). 5) The PAS-AB positive substance in H. pylori-positive mucosa was less than that in H. pylori-negative mucosa. In conclusion, gastric mucosal changes of varying degrees were brought about after inoculation of H. pylori depending on the quantity of bacilli in the gastric tissue.     

Auditory masking-level differences in the cat.

Trained 4 cats to avoid shock by responding to the intermittent occurrence of 1-kHz tone pulses at one ear, while a continual train of noise pulses was simultaneously presented either to the signal ear alone or to both ears. Using the masked threshold levels determined with monaural noise as a reference, the amount of unmasking produced by the addition of noise to the nonsignal ear was measured. Significantly lower tonal detection thresholds were observed when noise equal in intensity to that at the signal ear was added to the nonsignal ear. Additional unmasking occurred when the intensity of the noise at the latter ear was raised to a level 10 db higher than that at the signal ear. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduction of skin flap necrosis by transdermal application of buflomedil bound to liposomes

The influence of the vasoactive drug buflomedil hydrochloride bound to liposomes (2 mg/ml) was investigated in an arterial pattern skin flap model using the ear of hairless mice. For flap creation, the ear is cut at four-fifths of its base, which leaves the anterior artery as the only feeding vessel of the flap. Liposomes were locally applied daily for 30 minutes up to 5 days after flap creation. Microvascular perfusion in the proximal, central, and distal parts of the flap was measured by laser Doppler flowmetry. The border between perfused and nonperfused tissue was visualized by intravital fluorescence microscopy using fluorescein isothiocyanate (FITC)-labeled dextran (Mr 150,000) for contrast enhancement of microvessels. The area of nonperfused tissue was assessed by digital planimetry. Five days after flap creation the nonperfused area amounted to 23.8 +/- 3.1 percent of total flap surface in treated ears compared with 46.1 +/- 5.6 percent in untreated ears (p < 0.05) of the contralateral side. Additional preoperative treatment for 5 days did not further reduce the area of nonperfused tissue (treated ears, 23.0 +/- 1.3 percent; control ears, 44.6 +/- 5.1 percent). Microvascular perfusion was higher in the postoperatively treated ears in all parts of the flap from day 1 after flap creation until termination of the experiment. Five days after flap creation, perfusion as measured by laser Doppler flowmetry was reduced to 46.0 +/- 10.8 percent in the distal part in control ears compared with 91.9 +/- 8.3 percent (p < 0.05) in treated animals. Additional preoperative treatment for 5 days did not result in further improvement. It is concluded that local application of the vasoactive drug buflomedil docked to liposomes could be of therapeutic use in the treatment of ischemic tissue, including skin flaps.     

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit

The middle ear poses unique challenges when finding suitable materials for ossicular reconstruction, primarily because of its link to the external environment via the eustachian tube and, hence, its greater exposure to infectious agents. In this study, the biocompatability of titanium was examined in the middle ear of rabbits by using light and scanning electron microscopy. Implants were placed as middle ear prostheses or as free implants. These were inspected at 28 days, 84 days, 168 days, 336 days and 504 days following implantation for mucosal coverage, percent epithelization and any sign of foreign-body reaction. After 28 days, the prostheses were covered by regular mucosa. Although a majority of the free implants took up to 336 days for complete epithelialization, some of the free implants were not epithelialized even at day 504. There were no inflammatory cells observed on the surface of the material, nor were unusual amounts of fibrous tissue seen. In addition, the titanium material exhibited an affinity toward bone. The results of this animal experiment indicate that titanium is a favorable material for ossicular replacement prostheses.     

Thrombolytic therapy in Missouri hospital emergency departments: compliance with the National Heart Attack Alert Program guidelines

Adhesive interactions between leukocytes and endothelium are required for subsequent leukocyte extravasation toward inflammatory sites. Understanding the possible kinetic expression of vascular cell adhesion molecule-1 (VCAM-1) in the middle ear cavity during an inflammatory cascade in vivo may be important for clarifying local immunological responses in otitis media. Two inflammatory models were produced in the rat and involved acute middle ear mucosal and cutaneous inflammation induced after inoculation or intradermal injection of lipopolysaccharide (LPS). After intravenous injection of both 125I-labeled anti-VCAM-1 and 131I-labeled control monoclonal antibody (mAb), the kinetic expression of VCAM-1 in the middle ear and skin was assessed by local radionuclide uptake. The biodistribution of an 125I-labeled anti-VCAM-1 mAb as a potential detector of focal inflammation was examined in normal rats. Both inflammatory lesions were characterized by early and sustained (up to 24 h) expression of VCAM-1, with maximal expression at 4 h after LPS stimulation. The kinetics of VCAM-1 expression was similar among the middle ear mucosa or skin specimens studied and different stimulation methods. A similar biodistribution and clearance of radioactivity between 125I-labeled anti-VCAM-1 mAb and 131I- or 99mTc-labeled control mAb were observed. The present result suggest that functional VCAM-1 induced by LPS is expressed in both middle ear tissue and skin lesions and may play a role in the initial stage of inflammatory response produced. Although VCAM-1 upregulation is a very early event in the inflammatory cascade, 125I-labeled anti-VCAM-1 mAb may be useful for the early detection of focal inflammation in the middle ear.     

Gastric mucosal superoxide dismutases in Helicobacter pylori infection

BACKGROUND: The mucosal pathology of Helicobacter pylori infection may in part be due to excessive production of reactive oxygen metabolites (ROMs) by phagocytes. The influence of H pylori infection on mucosal superoxide dismutases, some major scavenger enzymes of ROM was investigated. In humans superoxidase dismutase is present in at least two forms-that is, mitochondrial manganese (Mn)-superoxide dismutase and cytoplasmic copper-zinc (CuZn)-superoxide dismutase. METHODS: The amount and activity of both superoxide dismutases were measured, respectively by enzyme linked immunosorbent assay (ELISA) and spectrophotometrical enzyme activity assay, in gastric biopsy homogenates of patients with normal mucosa (n = 39) and in patients with H pylori related gastritis (n = 71). Infection and gastritis were confirmed by a combination of culture, serology, and histology. RESULTS: The amount (p < 0.001) and activity (p < or = 0.05) of Mn-superoxide dismutase were increased by about twofold to three-fold, whereas the amount and activity of CuZn-superoxide dismutase showed a slight decrease in gastric mucosa of patients with H pylori gastritis, in both antrum and corpus, compared with normal mucosa of patients without H pylori infection. Mn-superoxide dismutase concentrations in biopsy specimens of histologically normal corpus from patients with an inflamed antrum were significantly higher (p < 0.01) than that of patients with a histologically normal antrum. CONCLUSION: H pylori infection has a differential effect on mitochondrial and cytoplasmic superoxide dismutase in the gastric mucosa, reflected by a pronounced increase in the cytokine inducible Mn-superoxide dismutase and a marginal decrease in the constitutive CuZn-superoxide dismutase.     

基于二维和三维信息融合的人耳识别

针对人耳识别中存在姿态、光照变化等问题,提出信息融合的方法,将二维人耳和三维人耳的信息进行融合,以克服姿态、光照对人耳识别的影响.对于二维人耳,由于姿态等的变化会导致人耳图像数据在高维空间中呈现出非线性流形结构,采用等距映射这种流形学习算法进行特征提取,对三维深度人耳则采用3D局部二值模式进行特征提取,然后分别进行二维和三维人耳识别,最后在决策层进行融合识别.在79人的人耳数据库上进行了实验,每人8幅带姿态的二维人耳图像和6幅带光照的三维人耳深度图像.实验结果表明,与单独的二维人耳和三维人耳识别相比,融合之后的识别效果和认证效果均有很大的改善.