内淋巴囊的外源性抗原特异性免疫应答

目的　研究内淋巴囊对于外源性胸腺依赖性抗原的特异性免疫应答。方法　用SD大鼠 32只 ,以抗原全身免疫后 ,经耳蜗底周向外淋巴腔注入相同抗原 ,分别于此后 1、3、7、14天处死动物取颞骨作组织学处理。然后应用免疫组化等技术 ,观察内淋巴囊的细胞浸润 ,免疫细胞增殖及其对抗原的吞噬清除作用。结果　内耳抗原接种后第 1、3天 ,内淋巴囊出现单核吞噬细胞浸润 ,第 7天出现浆细胞和淋巴细胞浸润 ;内耳抗原接种后第 3、7天 ,内淋巴囊的IgG阳性细胞增多 ,同时抗原被捕捉、递呈和吞噬。结论　内淋巴囊对外源性抗原可产生特异性免疫应答 ,是内耳局部免疫应答的重要场所。     

内淋巴瘤的外源性抗原特异性免疫应答

目的 研究内淋巴囊对于外源性胸腺依赖性抗原的特异性免疫应答。方法 用SD大鼠32只，以抗原全身免疫后，经耳蜗底周向外淋巴腔注入相同抗原，分别于此后1，3，7，14天处死动物取颞骨作组织学处理。然后应用免疫组化等技术，观察内淋巴囊的细胞浸润，免疫细胞增殖及其对抗原的吞噬清除作用。结果 内耳抗原接事第1，3天，内淋巴囊出现单核吞噬细胞浸润，经7天出现浆细胞和淋巴细胞浸润，内耳抗原接种后第3，7天，内淋巴囊的IgG阳性细胞增多，同时抗原被捕捉，递呈和吞噬。结论 内淋巴囊对外源性抗原可产生特异性免疫应答，是内耳局部免疫应答的重要场所。     

豚鼠内淋巴囊上皮细胞的免疫组织化学特性

本文应用免疫组织化学技术探索了中间丝和Ｓ－１００蛋白在豚鼠内淋巴囊上皮细胞的表达，结果表明：囊上皮细胞不仅具有上皮细胞特异的中间丝角蛋白阳性反应，还具有间胚叶组织特异的中间丝波形蛋白强阳性反应。两特性的共存可能与该上皮具有吸收和分泌双重功能有关。Ｓ－１００蛋白强阳性反应表明此上皮细胞富含钙结合蛋白，可能与其调钙作用有关。     

大鼠内淋巴囊的增殖细胞

目的：了解大鼠内淋巴囊的细胞增殖状态。方法：选用１０只健康成年Ｓ－Ｄ大鼠,腹腔注射５－溴－２‘－脱氧尿嘧啶核苷后,取颞骨作组织学处理,用抗ＢｒｄＵｒｄ单克隆抗体,通过免疫组织化学技术,观察内淋巴囊Ｓ期细胞的定位与分析。结论：大鼠内淋巴囊具有细胞增殖功能,可能是内耳具有细胞更新功能的重要部位。     

内淋巴积水与肉淋巴囊免疫学研究进展

内淋巴积水的发病机理不清。近些年业，许多学注意与内淋巴囊的局部免疫反应具有十分密切关系。本就有关资料进行了综述。     

内淋巴囊的脉管分布

目的：通过对豚鼠内淋巴囊表面的脉管及其粘膜下层结构的研究,了解其对内耳功能的影响,方法：用碳素黑水加１０％甲醛进行左心室灌注,将豚鼠的颞骨标本用冬青油透明并进行显微检查及透射电镜检查。结果：内淋巴囊表面有非常丰富的血管网,而且与乙状窦有很密切的联系,内淋巴囊周围被毛细血管,微静脉,静脉和个别微动脉形成的一个细密的环状血管网所包绕。毛细血管周围有丰富的淋巴窦、毛细血管与淋巴窦构成一个完整、细密的网状     

内淋巴囊的神经分布

目的：通过实验从形态学上直接验证内淋巴囊上存在神经纤维,为梅尼埃病的病因病理学研究提供新的思路。方法：使用成年SD大鼠15只,经活体心脏灌注,取双侧颞骨,常规石蜡包埋处理并切片。用免疫组织化学方法标记,确认抗体神经特异性烯醇化酶（neuronal specific enolase, NSE）、胶质纤维酸性蛋白（glial fibrillary acidic protein,GFAP）、神经微丝（neurofilament, NF）在内淋巴囊(Endolymphatic Sac, ES)上的表达。结果：在光学显微镜下,NSE、GFAP、NF一抗在内淋巴囊上皮及上皮下表达为棕黄色阳性着色颗粒。结论：内淋巴囊近侧端、中间段和远侧段均有神经纤维分布,以近侧段最为丰富。     

内淋巴囊上皮细胞单克隆抗体的制作和特性

以显微解剖法取出的豚鼠内淋巴囊经超声波处理后，以其提取液作为原始抗原，探讨建立能够分泌识别内淋巴囊表面上皮细胞的单克隆抗体（ＭｃＡｂ）的系列杂交瘤。应用电镜免疫化学和Ｗｅｓｔｅｒｎ印迹法和聚丙酰胺凝胶电泳（ＳＤＳ－ＰＡＧＥ）测定，该抗体显示具有和内淋巴囊上皮细胞进行显著的免疫组织化学反应的活性，类似的反应出现在肾脏的近曲小管和亨氏袢的上皮细胞上，与其它１５个脏器（包括大脑、膀胱、胆囊、肺和肝脏等）     

内淋巴囊引流术治疗梅尼埃病

报告以内淋巴囊引流术治疗２４例梅尼埃病的结果，其中１４例随访２－３年，眩晕控制１０例，好转３例，无效１例。详细介绍了内淋巴囊引流术的手术方法，并对手术治疗的机理，适应证选择，以及并发症的以预防进行讨论。     

Cell proliferation in the endolymphatic sac in situ during the immune response of inner ear

Background Normally, few immunocompetent cell are present in the endolymphatic sac (ES). During an active immune response in the inner ear, large amount of inflammatory cells, including immunocompetent cells, are seen in the ES. The current study aimed at assessing cellular proliferation within the ES during induced immune response in the inner ear. Methods Fifteen healthy, female SD rats were sensitized systemically with keyhole limpet hemocyanin (KLH), followed by local inoculation in the cochlea through basal turn fenestration with the same antigen. On Days 3, 7 and 14 following inoculation, the animal was sacrificed after intraperitoneal administration of 5-bromo-2'-deoxyuridine (BrdUrd), and the temporal bone harvested. Following decalcification, infiltration by BrdUrd- and IgG-positive cells in the ES was studied on frozen sections with H & E and immunohistochemical staining. Results During the secondary immune response in the inner ear against T-dependent antigens, there is increased cellular proliferation in the ES. The proliferated cells may differentiate into immunocompetent cells at the same location. Conclusions These findings indicate that the ES plays an important role in immune response of inner ear.     

Detection of viral antigen in the endolymphatic sac

A study was devised to determine whether or not any immune defense mechanism is present when a virus invades the human endolymphatic sac (ES). The ES was removed from 14 fresh autopsy cases having no known premortem diseases in the middle and inner ears. Specimens were then examined for viral antigens including herpes simplex (HSV) type 1 and 2, mumps and cytomegalovirus using immunohistochemical methods. DNA examination by in situ hybridization was also performed for HSV HSV antigen and DNA were observed in 9 of the 14 cases studied. These findings suggest that the virus invades the ES but is impeded by an immune defense mechanism under normal conditions. Since disease may alter host defenses, further studies are warranted to study the relationship between HSV and patients with Meniere's disease.     

豚鼠内淋巴管与内淋巴囊微血管模式及解剖差异

为研究内淋巴管及内淋巴囊微血管分布模式，通过墨汁血管灌流技术和图像分析方法对１０只豚鼠的颞骨（２０侧）内淋巴管和内淋巴囊做全面观察分析。结果：①２０侧颞骨中有１７侧（８５％）内淋巴管、内淋巴囊有脑膜后动脉和前庭后动脉两条供血来源，其余３侧（１５％）则发现前庭后动脉缺如；②脑膜后动脉在内淋巴囊的分布频率明显高于前庭后动脉（Ｐ＜０．０１），但两者在内淋巴管的分布频率差异无显著性（Ｐ＞０．０５）。结论：内淋巴管、内淋巴囊的血供来源及微血管分布模式存在一定的解剖差异，脑膜后动脉是内淋巴囊血管网的主体     

The endolymphatic sac in the Mondini disorder

Summary The endolymphatic sacs are described in temporal bone specimens from a 31-year-old man with bilateral Mondini disorder. The ducts and sacs are thin-walled, cyst-like structures with complete absence of loose vascular perisac tissue, and are directly apposed to the bone of the vestibular aqueduct. Histological evidence of severe bone erosion is present in these specimens and is most marked in the intermediate and distal portions of the vestibular aqueduct. It is also present in the foveal region of the posterior temporal bone surface underlying the sac. Erosion of the bony wall of the paravestibular canaliculus (PVC) is demonstrable, with incorporation of the vein of the PVC inside the margin of the widened vestibular aqueduct. These findings suggest a causal relationship between pressure within the endolymphatic duct and sac and erosion of the surrounding bone. The absence of endolymphatic hydrops of the cochlea and vestibular organs in the Mondini disorder constrast significantly with the endolymphatic hydrops seen in Meniere's disease.Supported by The Hope for Hearing Foundation, UCLA     

Basilar membrane displacement related to endolymphatic sac volume

OBJECTIVE: To demonstrate that the amount of basilar membrane displacement toward the scala tympani and its attachment to the bony wall of the scala tympani (i.e., interscalar septum) in hydropic temporal bones is related to the intraosseous endolymphatic sac volume. STUDY DESIGN: A retrospective analysis of temporal bones from individuals with the histopathologic diagnosis of "endolymphatic hydrops." METHODS: Fifty-two temporal bones, from 38 patients, with the histopathologic findings of "endolymphatic hydrops" were analyzed microscopically. Data were obtained regarding the displacement of the basilar membrane, endolymphatic sac volume, hair cell loss, strial atrophy, ganglion cell loss, and last measured auditory thresholds. The relationships between these variables were examined statistically. RESULTS: Nineteen of the 52 temporal bones (36.5%) with endolymphatic hydrops showed displacement of the basilar membrane toward the scala tympani in the apical and middle segments of the cochlea. A reduced volume of the endolymphatic sac was significantly related to increased severity of basilar membrane deformation (Rho = -.646; P < or = .001). Multiple regression analysis showed that severity of basilar membrane deformation was the single best predictor of low frequency thresholds while loss of hair cells was the best predictor of pure-tone average threshold. CONCLUSIONS: The displacement of the basilar membrane in the apical and middle segments that may occur with endolymphatic hydrops, to the extent that it impinges on the interscalar septum, is related to a reduction in the intraosseous endolymphatic sac volume.     

Management of endolymphatic sac tumors: a case series report

Objective To study clinical characteristics of endolymphatic sac tumor (ELST) and its diagnosis and treatment. Methods ELST was diagnosed in 6 cases based on surgical and histological findings. These cases were reviewed for their clinical manifestations, differential diagnosis and surgical treatment techniques. Results There were 1 male and 5 females in this group, aged from 28 to 59 years (mean age=38.7 years). The tumor was in left ear in 4 cases and in right ear in the other 2 cases. Disease courses ranged from 5 to 30 years (mean duration= 12.6 years). Clinical presentations included sensorineural hearing loss (n=4), otorrhea and tinnitus (n=2), tinnitus and facial spasm(n=1), otorrhea with facial paralysis(n=l), and hearing loss with tinnitus (n=2). None of the cas-es was diagnosed as ELST preoperatively. Two cases were misdiagnosed as glomus jugulare tumor, 2 as chronic suppurative otitis media, 1 as sweat gland adenoma on biopsy and 1 as temporal bone tumor. Tumors were sprgi-tally resected in all 6 cases via the mastoidectomy (n=2) or combined oto-cervical or cranio-oto-cervical ap-proaches(n=4). Postoperative cerebrospinal fluid otorrhea occurred in 1 case. The tumors were confirmed on histo-logical examination to be a low-grade adenocarcinoma. All patients have survived at the time of this paper. Conclusion ELST is rare and commonly misdiagnosed and inadequately treated. Its prognosis is relatively favor-able because of its slow growth rate.     

Potassium level in endolymphatic sac of guinea pigs in vivo

Summary The value of K⁺ activity in the endolymphatic sac of guinea pigs in vivo, measured with ion-sensitive microelectrodes, was 16.7±5.1 (N = 20) mval.Supported by the Deutsche Forschungsgemeinschaft. We are grateful to Mrs. Seeck for helpful technical assistance     

The radiologic diagnosis of endolymphatic sac tumors

OBJECTIVE: To identify and classify radiologic criteria for the diagnosis of endolymphatic sac tumors. STUDY DESIGN: Retrospective case review. Tertiary referral center. METHODS: 31 adult patients (32 tumors) with imaging (computed tomography [CT], magnetic resonance imaging [MRI], and/or angiography) and histopathologic diagnoses of lesions that involved the posterior temporal bone from July 1995 to August 2004 were included in the study. Interventions were diagnostic. Main outcome measures were CT, MRI (T1, T1 with gadolinium enhancement and T2-weighted), and angiographic features of seven patients (eight temporal bones) with endolymphatic sac tumors were examined and compared to the radiologic findings of the 24 historical control patients with various lesions involving the posterior temporal bone. RESULTS: CT findings of endolymphatic sac tumors revealed lesions centered over the endolymphatic sac, retrolabyrinthine, and presigmoid regions of the temporal bone. Central calcific spiculation and posterior rim calcification was present in all lesions (100%) on CT examination. T1-weighted MRI scans showed hyperintense foci in seven of eight lesions (88%). T1-weighted post-gadolinium scans showed heterogeneous enhancement in all cases (100%). T2-weighted images showed heterogeneous signals in all lesions (100%). Angiography (traditional or magnetic resonance angiography [MRA]) identified exclusive external carotid supply for lesions less than 3 cm. Tumors greater than 3 cm were supplied by external carotid, internal carotid, and posterior fossa circulation arteries. CONCLUSIONS: Reliable radiologic criteria to preoperatively identify endolymphatic sac tumors exist. Preoperative diagnosis of posterior temporal bone lesions enables appropriate surgical planning and treatment of the pathology.     

Cholesterol granuloma surrounding the endolymphatic sac

We report a unique case of cholesterol granuloma (CG) surrounding the endolymphatic sac (ES). A 49-year-old man presented with the left side of sensorineural hearing loss, tinnitus, and vertigo. Magnetic resonance and computed tomography imaging revealed a CG surrounding the left ES. The patient initially underwent left transmastoid surgical resection of the tumor. At the time of surgery, brown fluid was aspirated from the tumor, but no other tumors were found. Histopathological examination revealed that the tumor contained cholesterol crystals, confirming the diagnosis of CG. At his 12-month postoperative follow-up, there was no evidence of recurrence. We discuss the radiology, pathology, and surgical removal of CGs surrounding ES.