Scanning Electron Microscopy of Nerve Fibers in the Dog Cochlea

The nerve fiber arrangement inside the organ of Corti in the dog was studied. Thick sections were cut serially from celloidin-embedded cochleas and observed with a scanning electron microscope (SEM). The nerve fibers in the organ of Corti were clearly exposed in sections cut in the horizontal plane. The arrangement of nerve fibers in the dog showed considerable difference from that of other species. The tunnel basilar fibers in the dog curved basalward, and took a long longitudinal course to form a broad bundle in the center of the tunnel floor. This bundle has not been found in adult animals of other species. Two distinct types of tunnel radial fibers, upper tunnel radial fibers and underpassing radial fibers, were recognized. The latter type of radial fibers ran beneath the bundle of basilar fibers, and seemed to be characteristic of the dog cochlea. From the morphological characteristics, these underpassing radial fibers were thought to be efferent in nature

Scanning Electron Microscopy of the Celloidin-Embedded Inner Ear Sections

The nerve fibers running inside the organ of Corti were studied in cats by scanning electron microscopy (SEM). The fixed temporal bones were decalcified and embedded in celloidin according to the conventional method. Thick serial sections (100-150 μm) were cut parallel to the basilar membrane. After removing the celloidin, the sections were freeze-dried in t-butyl alcohol. Though some outer hair cells had been deformed, the nerve fibers were well preserved for analysis. Some new findings were observed in the present SEM study. The tunnel spiral bundle in a kitten took an atypical course on the floor of Corti\u27s tunnel apart from the previously reported site. In the barely-patent tunnels of Corti in kittens, nerve fibers were stuck together into thick bundles and took different courses compared to those in the mature cochleas. Filiform projections of nerve fibers were climbing around the first row of the outer hair cells in the immature cochlea. These were thought to be growing ends of efferent nerves which would later grow into nerve endings

Scanning Electron Microscopic Study of the Postnatal Development of the Rabbit Cochlea, with an Emphasis on Innervation

The development of nerve fiber arrangements of the organ of Corti was studied in rabbits 1, 3, 5, 7 and 12-days-old using thick sections from celloidin-embedded cochleas which were examined under a scanning electron microscope. The arrangements of nerve fibers varied with developmental age. The tunnel spiral bundle was thick and loosely collected in the immature cochlea. The outer spiral fibers were recognized even in the narrow space of Nuel in the one-day-old cochlea. As Nuel\u27s space is extending, the fibers course along the medial side of Deiters\u27 cells. The arrangement of the outer spiral fibers was irregular and sparse in the five-day-old cochlea, in contrast to the regular parallel pattern of the adult cochlea. Adult-like parallel arrangement of the outer spiral fibers was seen in the twelve-day-old cochlea. In the three-day-old cochlea, irregularly running nerve fibers were seen along the outer spiral fibers. They may be efferent axons which develop afterwards. Club-like immature nerve endings were recognized at the base of the outer hair cells in the seven-day-old cochlea. Some fibers climbed high up along the medial wall of the outer hair cells. A nearly mature pattern was seen in the twelve-day-old cochlea. This study confirms previous reports on the development of cochlear innervation

Scanning Electron Microscopy of Age-Related Changes in the C57BL/6J Mouse Cochlea

Hair cells and nerve fibers inside the organ of Corti of the C57BL/6J mouse, which is known as the precocious presbycusis model, were studied using the scanning electron microscope. For this study, we used thick serial sections cut from celloidin blocks. In the 5-week-old mice, hair cell loss was not seen. The upper tunnel radial fibers crossed the upper part of the tunnel of Corti and entered the Nuel\u27s space between the outer pillar cells. The fibers varied in diameter and showed many varicosities. The basilar fibers emerged into the tunnel of Corti beneath the upper tunnel radial fibers and crossed the floor of tunnel slightly curving basalward. The outer spiral fibers ran along the lateral wall of the Nuel\u27s spaces, sometimes buried in the cytoplasm of Deiters\u27 cells. The nerve endings were clearly seen on the modiolar sides of the outer hair cell bases in the basal turn. In the 30-, 42- and 60-week-old mice, hair cell degeneration was seen both at the basal and apical portions, more pronounced in the former. The outer hair cells were affected more than the inner hair cells. In the basal turn where most of outer hair cells had degenerated, the upper tunnel radial fibers disappeared while the basilar fibers remained. These results suggest that degeneration of the efferent fibers occur earlier than those of the afferent to the outer hair cells

Application of a Robotic Rehabilitation Training System for Recovery of Severe Plegie Hand Motor Function after a Stroke

We have developed a rehabilitation training system (UR-System-PARKO: Useful and Ultimate Rehabilitation System-PARKO) for patients after a stroke to promote recovery of motor function of the severe plegic hand with hemiplegia. A clinical test with six patients for the therapeutic effect of the UR-System-PARKO for severe plegic hand was performed. For all patients, the active ranges of motion (total active motion) of finger extension improved after training with the UR-System-PARKO. Moreover, the modified Ashworth scale (MAS) scores of finger extension increased. Thus, the training reduced the spastic paralysis. These results suggest the effectiveness of training with the UR-System-PARKO for recovery of motor function as defined by finger extension in the severe plegic hand

A Case of Acute Superior Mesenteric Artery Embolism with Severe Ischemic Liver Injury Successfully Treated by Endovascular Treatment

We describe an interesting clinical course of a patient who developed severe ischemic liver injury due to acute embolism of the superior mesenteric artery (SMA) and celiac artery. A 70-year-old man was hospitalized for abdominal pain and diarrhea. Abdominal computed tomography demonstrated a variant common hepatic artery arising from the SMA and multiple thromboembolic occlusions of visceral arteries, including the SMA and celiac artery. Laboratory data showed markedly elevated hepatic enzymes, which increased after admission despite the initiation of systemic anticoagulant and thrombolytic therapy. The patient was successfully treated by endovascular recanalization of the SMA occlusion via transcatheter embolus aspiration, thrombolysis, balloon angioplasty, and stent placement. Severe ischemic liver injury may occur in the setting of synchronous embolism of the SMA and celiac artery, and these phenomena may have a critical impact on the choice of treatment strategies and prognosis. Endovascular treatment appears to an effective treatment option

Phase Ib/II study of nivolumab combined with palliative radiation therapy for bone metastasis in patients with HER2-negative metastatic breast cancer

Radiation therapy (RT) can enhance the abscopal effect of immune checkpoint blockade. This phase I/II study investigated the efficacy and safety of nivolumab plus RT in HER2-negative metastatic breast cancer requiring palliative RT for bone metastases. Cohort A included luminal-like disease, and cohort B included both luminal-like and triple-negative disease refractory to standard systemic therapy. Patients received 8 Gy single fraction RT for bone metastasis on day 0. Nivolumab was administered on day 1 for each 14-day cycle. In cohort A, endocrine therapy was administered. The primary endpoint was the objective response rate (ORR) of the unirradiated lesions. Cohorts A and B consisted of 18 and 10 patients, respectively. The ORR was 11% (90% CI 4–29%) in cohort A and 0% in cohort B. Disease control rates were 39% (90% CI 23–58%) and 0%. Median progression-free survival was 4.1 months (95% CI 2.1–6.1 months) and 2.0 months (95% CI 1.2–3.7 months). One patient in cohort B experienced a grade 3 adverse event. Palliative RT combined with nivolumab was safe and showed modest anti-tumor activity in cohort A. Further investigations to enhance the anti-tumor effect of endocrine therapy combined with RT plus immune checkpoint blockade are warranted

Relationship Between Renal Dysfunction and Oral Mucositis in Patients Undergoing Concurrent Chemoradiotherapy for Pharyngeal Cancer: A Retrospective Cohort Study.

BACKGROUND/AIM: The aim of this retrospective cohort study was to investigate the association between renal dysfunction (RD) and the development of oral mucositis (OM) in patients undergoing concurrent chemoradiotherapy (CCRT) for pharyngeal cancer including radiation to the oral cavity. PATIENTS AND METHODS: Of 130 patients diagnosed as having pharyngeal cancer who received CCRT at the Okayama University Hospital Head and Neck Cancer Center, 44 were finally selected. RESULTS: During the observation period, 24 (54.5%) patients experienced severe OM (grade 3). The Cox proportional hazards regression model demonstrated that RD (hazard ratio(HR)=2.45, 95% confidence interval(CI)=1.067-6.116, p=0.035) and nasopharynx/oropharynx as center of the irradiated area (HR=2.56, 95% CI=1.072-5.604, p=0.034) were significantly associated with the incidence of severe OM (grade 3). CONCLUSION: In patients with pharyngeal cancer treated with CCRT including radiation to the oral cavity, RD at baseline can be a risk factor for developing severe OM