Aim of this work is to establish evaluation criteria for identifying endolymphatic hydrops in the vestibule and cochlea using a magnetic resonance imaging (MRI) scanner. This is a retrospective ...diagnostic study. We evaluated 70 ears of 35 unilateral Ménière’s disease patients. We performed 3-T MRI 4 h after intravenous gadolinium injection. Otologists manually traced the outline of vestibule, cochlea, and endolymphatic space of the vestibule and cochlea on two-dimensional fluid-attenuated inversion-recovery (2D-FLAIR) images. The traced area was measured, and rates of endolymphatic space to the vestibule and cochlea were calculated. The same otologists judged whether the low signal intensity area of the cochlea was at the edge of the cochlea. For measuring the rate of endolymphatic space to the vestibule, when the cut-off value was 30%, the presence of endolymphatic hydrops was determined with sensitivity of 87.1% and specificity of 94.3%. In contrast, the rate of endolymphatic space to the cochlea produced low accuracy. Therefore, when the presence of endolymphatic hydrops in the cochlea was judged by whether the low signal intensity area in the cochlea was at the edge of cochlea, endolymphatic hydrops could be detected with sensitivity of 91.4% and specificity of 94.3%. We were able to identify endolymphatic hydrops in the vestibule when the rate of endolymphatic space to the vestibule was greater than 30%, and could detect endolymphatic hydrops in the cochlea when a low signal intensity area was located at the edge of the cochlea in 2D-FLAIR images.
Level of evidence
4.
Paroxysmal vertigo with nystagmus in children Okumura, Tomoko; Imai, Takao; Higashi-Shingai, Kayoko ...
International journal of pediatric otorhinolaryngology,
09/2016, Letnik:
88
Journal Article
Recenzirano
Abstract Introduction A pathological nystagmus is an objective sign that a patient feels vertigo. However, there have been few opportunities to observe and record pathological nystagmus during a ...paroxysmal vertigo attack. Furthermore, it can be difficult to obtain cooperation in pediatric patients. We present two cases of paroxysmal vertigo in children in whom we successfully recorded and analyzed their pathological nystagmus during a vertigo attack. Methods Of a total sample of 4349 patients seen at our hospital for dizziness in the last decade, a retrospective analysis revealed that 68 were children (<15 years old; 1.6%). Of these 68 children, we successfully identified pathological nystagmus during paroxysmal vertigo in only two (2.9%). Results Case 1 was a 4-year-old girl. She felt vertigo the strongest when her left ear was down in the supine position. We observed and recorded her nystagmus during a vertigo attack with her mother’s permission. Her positional nystagmus in the supine position was horizontal persistent apogeotropic nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Therefore, the diagnosis was right lateral canal type of benign paroxysmal positional vertigo, of which the pathophysiology was cupulolithiasis. The other patient was an 11-year-old boy. He had a family history of migraines. His vertigo attacks occurred after onset of a severe migraine and lasted between 2–48 h. During an attack that we observed, he showed nystagmus, which was direction-fixed right torsional and rightward in darkness. His mother had noticed that his eyes moved abnormally and that his left eye did not shift to the left side when he looked leftward. He was old enough to clearly express his own symptoms. Other neurological examinations were normal. The diagnosis was vestibular migraine. Conclusions We analyzed a pathological nystagmus during paroxysmal vertigo in two children. We conclude that children can be diagnosed with a combination of careful history taking and accurate examinations of a pathological nystagmus.
The Internet technologies make it possible to control home robots from remote locations. This paper proposes a cloud-based remote motion control system over a 20-km fiber-to-the-home (FTTH) network, ...i.e., a passive optical network (PON). The physical location of the cloud server, in which the controller is installed, greatly affects the stability of the control system. Remote position control of a rotary motor is performed as a fundamental experiment for robot control. The experimental results show that the controller accepts a 20-ms round-trip time delay of cloud networks in the proposed system.
Hepatocyte growth factor/scatter factor (HGF/SF) is a multifunctional polypeptide which acts as mitogen, motogen, or morphogen. In this study, we examined the effect of HGF/SF on human hair growth ...using organ and cell culture systems. HGF/SF was found to stimulate hair length and DNA synthesis in hair follicles at increasing concentrations up to 10 ng/ml (P < 0.05 and P < 0.01, respectively). HGF/SF stimulated 3Hthymidine incorporation by hair bulb-derived keratinocytes with the strongest response at 30 ng/ml of HGF/SF (P < 0.05). Cultured follicular papilla cells secreted HGF/SF, measured by an enzyme-linked immunoassay, in response to interleukin 1-alpha (IL1-alpha, 10 ng/ml), tumor necrosis factor-alpha (TNF-alpha, 10 ng/ml), or tetradecanoylphorbolacetate (100 nM) at levels ranging from 0.2 to 0.3 ng/mg protein/48 h. HGF/SF mRNA expressions, measured by the reverse transcription-polymerase chain reaction, were detected in follicular papilla cells, and were also stimulated by the three reagents. Transforming growth factor-beta (10 ng/ml) suppressed both protein and mRNA levels. These results suggest that hair follicle elongation induced by HGF/SF in organ culture occurs partly due to the mitogenic activity of HGF/SF expressed in follicular papilla cells on hair bulb-derived keratinocytes.
Hepatocyte growth factor/scatter factor (HGF/SF) is a multifunctional polypeptide that acts as a mitogen, motogen, or morphogen, depending on the biologic context. In this study, we examined the ...effect of HGF/ SF on hair growth using a serum-free organ culture system. Vibrissal hair follicles isolated from newborn mice were cultured at 31°C in 95% O2/5% CO2 for 72h in the presence of various cytokines or growth factors, and elongation of hair shaft, DNA, and protein synthesis in hair follicles were measured. Among the agents tested, only HGF/SF significantly increased hair follicle length (p < 0.00 1), 3H-thymidine (p < 0.001), and 35S-cysteine (p < 0.05) incorporation. The effect of HGF/SF was dose dependent, with maximal stimulation obtained at 10 ng/ml. The increase in hair follicle length and thymidine incorporation were specifically inhibited by a neutralizing antibody against HGF/SF. These results indicate that HGF/SF can promote hair growth and may have clinical utility in this regard.
Surgical site infection after cochlear implantation is a rare phenomenon. However, if infection occurs at the surgical site, control of inflammation becomes challenging owing to the presence of the ...implanted device, which is a foreign body. However, in certain cases, temporary removal of the implant may be indicated to allow healing to take place. In this study, we report successful wound closure using temporoparietal fascia flap (TPFF) in a single surgical procedure without removal of the implanted device. TPFF is a versatile flap bearing viable blood supply from the superficial temporal artery and is frequently used in oro-facial reconstructive surgery. This pedicle flap can be safely harvested from the antero-superior auricular region. In the present case, the skin defect overlying the implant was covered with a rotated TPFF, and a split-thickness skin graft was placed over the flap. Adequate wound closure and epithelialization were obtained. We posit that TPFF combined with a split-thickness graft can be safely used to cover an implanted device; however, controlling local infection prior to the procedure is mandatory.
The effect of hepatocyte growth factor/scatter factor (HGF/SF) on human hair follicle growth was examined using a serum-free organ culture system. The DNA synthesis in human hair follicles and ...elongation of the hair shaft were measured subsequent to the follicle isolation and culture at 31 °C in 95% O
2-5% CO
2 for 72 h. Results showed that HGF/SF significantly increased
3H-thymidine (
P < 0.001) incorporation and hair follicle length (
P < 0.05). The effect of HGF/SF was dose-dependent with a maximal stimulation at 10 ng/ml.
We have recently encountered five patients with a perilymphatic fistula (PLF) judging from typical episodes at the onset. At the first visit, vestibular symptom and positional nystagmus were observed ...in two cases. Progressive sensorineural hearing loss was observed in all five patients, in whom expiratory tympanotomy was performed. In only two patients could the fistula be identified with perilymphatic leakage during surgery. We covered both the oval and round windows with temporal fascia and fixed them with fibrin glue in all patients. Hearing was improved by more than 30 dB in four patients (80%) and by more than 20 dB in one patient (20%) according to the criteria of sudden deafness. All the five patients showed good control of vertigo and dizziness after surgery. We should be willing to perform exploratory tympanotomy for patients suspected as having a perilymphatic fistula at the early stage around the onset to improve hearing.
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