[Therapeutic study on biofilm of the urinary tract using a severely complicated bladder model (biofilm model of the urinary tract)--experimental study using an automatic simulator of urinary antimicrobial agent concentration, and clinical study]

For the purpose of conducting a therapeutic study on biofilm of the urinary tract, we devised a computer-controlled severely complicated bladder model (biofilm model of the urinary tract) enabling us to simulate the time-course of the concentration of antimicrobial agents in the urine. Using this model, we investigated clarithromycin (CAM), which has been reported to have anti-biofilm action, at concentrations close to its urinary levels at the time of clinical use in order to predict its effect on biofilm of the urinary tract. On the basis of those experimental results, we also conducted a clinical examination. The following results were obtained. 1. The action of ciprofloxacin (CPFX, MIC: 8 micrograms/ml) alone, which shows anti-P. aeruginosa activity, caused apparent elimination of P. aeruginosa from the model. However, regrowth of the microbes occurred when CPFX was removed from the bladder model. Moreover, the biofilm was not eliminated by the antimicrobial action of CPFX, and this was surmised to be the cause of the regrowth. 2. CAM (MIC: above 128 micrograms/ml), which has no anti-P. aeruginosa activity, was similarly tested as anti-biofilm agent when added alone to the biofilm model. The P. aeruginosa recovered to its initial concentration within 48 hours, but the biofilm disappeared due to the action of CAM. 3. The combined action of CPFX and CAM caused microbial elimination from the bladder model without microbial regrowth, even after these antimicrobial agents were removed from the bladder model. After the action of CPFX and CAM, the biofilm disappeared, and no microbial adherence was noted. 4. Measurement of time-course of the alginate content, which is the main component of P. aeruginosa biofilm, in the presence of CAM found that the alginate content decreased below the limit of detection after day 5. 5. The clinical study of complicated urinary tract infection revealed the microbial elimination rate and the efficacy rate to be higher in the combined CPFX-CAM administration group than in the CPFX-only administration group. 6. Based on the above results, we surmise that the combined use of an antimicrobial agent which is active against the causative microbe and anti-biofilm agent such as CAM will show some degree of efficacy in eliminating biofilm of the urinary tract.

Fatal respiratory failure due to polymyositis

A patient presenting as severe respiratory failure due to alveolar hypoventilation resulting from respiratory muscle weakness is described. Diagnosis of polymyositis was established by electromyography and muscle biopsy. Steroid therapy was initiated and it ameliorated respiratory failure remarkably. Selective respiratory muscle involvement due to polymyositis has been suggested in this patient. Although fatal respiratory failure is a very rare complication in polymyositis, polymyositis should be considered as one of underlying diseases causing severe respiratory failure.

[Study on MIC breakpoint and method of antimicrobial chemotherapy for moderately complicated urinary tract infection--study using an automatic simulator of urinary antimicrobial agent concentrations]

We experimentally investigated an efficient administrating method of antimicribials prior to the clinical treatment of complicated urinary tract infection without catheter. An experimental model of moderately complicated urinary tract infection, which can simulate changes in the urinary concentration of antimicrobials by means of previously reported computer control method, was used for the experiment. The following results were obtained. 1. At first, for complicated UTI cases without an indwelling catheter, an investigation was made of the clinical therapy results to determine the upper MIC range of bacteria, including isolated strains, that can be nearly eliminated following treatment, by the administration method. We then estimated the clinical breakpoint. 2. By adjusting the size of the diverticulum in a urinary bladder model, we prepared a model which gave comparatively good agreement between the clinical and experimental breakpoints. 3. The clinical therapy results revealed that by the clinical breakpoint was higher in degree of coverage of the MIC distribution of causative bacteria associated with a higher actual clinical elimination rate and a higher efficacy rate. 4. It was surmised that an efficient administration method for complicated UTI without an indwelling catheter can be established if the urinary bladder model and the following approach are applied: prior to clinical treatment it should be determined what would be high enough to cover 70% of the MIC distribution of the estimated causative bacteria of UTI, and then an administration method which would yield that concentration as the experimental breakpoint should be devised.

[Glucocorticoid therapy in renal diseases--its indication and therapeutic schedule]

Glucocorticoid therapy is used to treat renal diseases because of the two pharmacological actions, i.e anti-inflammatory and Immunosuppressive ones. Indications for steroid therapy in renal diseases are mainly primary and secondary nephritis and the nephrotic syndrome. These include minimal change nephrotic syndrome, membranous nephropathy, membranoproliferative glomerulonephritis, focal glomerular sclerosis, rapidly progressive glomerulonephritis, IgA nephropathy (in part), lupus nephritis, acute interstitial nephritis and so on. There are two routes of steroid administration, orally or intravenously, to treat nephritis and the nephrotic syndrome. The standard therapeutic regimen is the oral administration of prednisolone (PSL), which usually consists of initial high dose therapy (40-60 mg/day), subsequent withdrawal of steroids and maintenance therapy. As for intravenous administration, high dose injection of methylprednisolone (usually 1000 mg on three successive days) is utilized and followed by high dose oral PSL.

Effects of aldehyde dehydrogenase and glutathione on the degradation of (E)-4-hydroxy-2-nonenal and N-hexanal in rat liver

The relative contribution of the aldehyde dehydrogenase (EC 1.2.1.3, ALDH) and glutathione (GSH) conjugate system to the degradation of (E)-4-hydroxy-2-nonenal (4HN), a toxic breakdown product arising from lipid peroxidation, was investigated in rat liver. Significant increases in the contents of 4HN and hexanal (HA) and a decrease of ALDH but not alcohol dehydrogenase (EC 1.1.1.2, ADH) activity were recognized in rat liver following administration of carbon tetrachloride (3 ml/kg, p.o.). Hepatic ALDH activity was correlated with HA production (r = -0.82, P < 0.01) but not with 4HN. When lipid peroxidation was induced by t-butyl hydroperoxide, the ratio of HA to 4HN production in the liver of rats pretreated with the ALDH inhibitor, cyanamide (100 mg/kg, i.p.) was higher than that in controls, whereas the ratio was lower in the liver of rats pretreated with the glutathione-depleting agent, phorone (250 mg/kg, i.p.). These results suggest that 4HN in rat liver is metabolized by the GSH-conjugate system in preference to degradation by ALDH.

Urinary excretion of pyridinium crosslinks of collagen in oophorectomized women as markers for bone resorption

To detect increased bone resorption in estrogen-deficient women, the urinary excretion of hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP), which are intermolecular crosslinkings of collagen fibers, were measured and their chronological changes were evaluated following oophorectomy. Seventy-five women were divided into three groups; 15 premenopausal women (mean age 44.0 years), 15 postmenopausal women (mean age 54.2 years) and 45 surgically menopausal women who had a normal menstrual cycle before surgery (mean age 42.2 years). There was a significant increase in HP and LP of the postmenopausal women (P < 0.001). In the oophorectomized women, both HP and LP were three times higher than those of premenopausal women within 1 year after oophorectomy, and decreased to the same level of the postmenopause between 2 and 3 years after surgery. In the six oophorectomized women after the administration of estrogen, HP and LP both decreased remarkably in all cases. The present study thus indicates that an increase of bone resorption which was evaluated by urinary HP and LP occurs in the early stage after oophorectomy. It may, therefore, be good to begin estrogen replacement therapy as soon as possible after oophorectomy.

Antiproliferative lymphokine production by human peripheral blood lymphocytes and lymph node lymphocytes detected by a modified double layer soft agarose clonogenic assay

The double layer soft agarose clonogenic assay using colony formation of target cells as an endpoint was adapted for the detection of antiproliferative lymphokine production from peripheral blood lymphocytes (PBL) and lymph node lymphocytes (LNL). The colony formation of cervical cancer cell lines, HeLa, CAC-1, and TMCC, in the upper layers was significantly inhibited by the inclusion of either PBL or LNL pretreated with PHA in the lower layers. Without stimulation by PHA, neither resident PBL nor LNL exhibited antiproliferative activity on the tumor cells in the upper layers. The antiproliferative activity against target cells increased in relation to the density of lymphocytes in the lower layers, and was dependent on protein synthesis by lymphocytes. Since the cell to cell contact between the effector cells and target cells is not possible in this assay, the reduction of colony formation should be attributed to soluble factor(s) that were secreted from the lymphocytes. Additionally, an antibody against IFN-gamma neutralized most of the antiproliferative activity, and equivalent levels of IFN-gamma were found to be present in the supernatant of PBL and LNL lower layers by a radioimmunoassay. The double layer soft agarose assay system should thus serve as a useful method for studying antiproliferative lymphokine production by lymphocytes.

Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities

Cognitive function was examined in 227 patients three months after admission to hospital for ischaemic stroke, and in 240 stroke-free controls, using 17 scored items that assessed memory, orientation, verbal skills, visuospatial ability, abstract reasoning, and attentional skills. After adjusting for demographic factors with standardised residual scores in all subjects, the fifth percentile was used for controls as the criterion for failure on each item. The mean (SD) number of failed items was 3.4 (3.6) for patients with stroke and 0.8 (1.3) for controls (p < 0.001). Cognitive impairment, defined as failure on any four or more items, occurred in 35.2% of patients with stroke and 3.8% of controls (p < 0.001). Cognitive domains most likely to be defective in stroke compared with control subjects were memory, orientation, language, and attention. Among patients with stroke, cognitive impairment was most frequently associated with major cortical syndromes and with infarctions in the left anterior and posterior cerebral artery territories. Functional impairment was greater with cognitive impairment, and dependent living after discharge either at home or nursing home was more likely (55.0% with, v 32.7% without cognitive impairment, p = 0.001). In a logistic model examining the risks related to dependent living after stroke, cognitive impairment was a significant independent correlate (odds ratio, OR = 2.4), after adjusting for age (OR = 5.2, 80 + v 60-70 years) and physical impairment (OR = 3.7, Barthel index < or = 40 v > 40). It is concluded that cognitive impairment occurs frequently after stroke, commonly involving memory, orientation, language, and attention. The presence of cognitive impairment in patients with strike has important functional consequences, independent of the effects of physical impairment. Studies of stroke outcome and intervention should take into account both cognitive and physical impairments.

Pathophysiological role of magnesium in familial Bartter's syndrome

We studied three siblings with Bartter's syndrome associated with hypomagnesemia; two of them showing marked hypomagnesemia and the other mild hypomagnesemia. Urinary potassium, sodium and chloride excretions were determined and distal fractional chloride reabsorption and free water clearance on water loading test were compared before and after magnesium supplementation. Baseline urinary potassium and magnesium excretions were elevated in spite of the decreased plasma levels, whereas distal fractional chloride reabsorption and free water clearance were depressed in all patients. Magnesium repletion resulted in significant decrease in urinary potassium, sodium and chloride and subsequent increase in plasma potassium in all patients. However, neither distal fractional chloride reabsorption nor free water clearance was affected. Hypomagnesemia may contribute to urinary potassium wasting and aggravate urinary sodium and chloride wasting in familial Bartter's syndrome by a mechanism independent of the defect in free-water formation by the active reabsorption of chloride in Henle's loop.

Antioxidative effects of black tea theaflavins and thearubigin on lipid peroxidation of rat liver homogenates induced by tert-butyl hydroperoxide

The antioxidative activity of theaflavins (TFs) and thearubigin (TR) purified from the infusion of black tea leaves was examined using the tert-butyl hydroperoxide-induced lipid peroxidation of rat liver homogenates. The concentrations which produced 50% inhibition of lipid peroxidation (IC50) by theaflavin (TF), theaflavin monogallate-A (TFM-A), and TR were 4.88 x 10(-4), 4.09 x 10(-4), and 4.95 x 10(-4%) (w/v), respectively. The anti-oxidative activity of these compounds was higher than that of glutathione, L(+)-ascorbic acid, dl-alpha-tocopherol, butylated hydroxytoluene, butyl hydroxyanisole, etc., but was lower than the activity of (-)-epicatechin gallate, (-)-epigallocatechin, and (-)-epigallocatechin gallate. As to the IC50 in molarity, the antioxidative activity of TFM-A was the second highest among all the samples used in this study. The antioxidative activity of lyophilized tea infusions was compared. The activity of black tea was about as potent as that of green tea. These results suggest that black tea infusion containing TFs and TR could inhibit lipid peroxidation in biological conditions in the same way as green tea infusion containing epicatechins.

Essential thrombocythemia terminating in acute leukemia with minimal myeloid differentiation--a brief review of recent literature

Essential thrombocythemia (ET), one of the chronic myeloproliferative disorders, is a clonal disorder of multipotent stem cells. Although most patients with ET have a prolonged benign course, a minority of patients may develop a blastic crisis similar to chronic myelogenous leukemia (CML). A case of ET terminating in blastic crisis 8 years after the initial diagnosis is presented. The blast cells were cytochemically and immunophenotypically consistent with the acute myelogenous leukemia with minimal myeloid differentiation subtype of the FAB classification. From the review of the literature on blastic transformation of ET, acute leukemia with an M4 or M7 phenotype occurred more frequently. In addition, three valuable factors to predict the leukemic transformation of ET appear to be karyotypic abnormalities, such as involvement of chromosome 21, previous therapies with a mutagenic potential, and the capability of bone marrow cells to form in vitro spontaneous colonies as in CML.

[Laboratory examination of contact factors]

The methods of measurement, clinical evaluation and application as molecular marker of contact factors are described. It is important to scrutinize the measurement methods and normal control of contact factors regularly in the institution. A slightly abnormal value and repeated measurement of APTT become valuable, which may reveal asymptomatic hereditary contact factor deficiencies. There is more thrombosis symptoms than bleeding in that cases. Acquired contact factors deficiency is recognized in disseminated intravascular coagulation or liver cirrhosis. Although the cases of the clinical application of molecular marker with contact factors is not enough, the diagnostic and therapeutical trials in hypercoagulopathy with sepsis are starting. There are many unknown clinical functions about contact factors, and careful assessment will be necessary in the previously reported cases of hereditary contact factors deficiency.

Dose-dependence of 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine (PhIP) carcinogenicity in rats

The dose-dependence of 2-amino-1-methyl-6-phenylimidazo-[4,5-b]pyridine (PhIP) carcinogenicity was investigated in F344 rats of both sexes administered the heterocyclic amine in the diet at concentrations of 25 or 100 p.p.m. for up to 104 weeks. Incidences of mammary adenocarcinomas were 7% (2/30) for 25 p.p.m. and 47% (14 of 30 rats) for 100 p.p.m. in females and those of colon adenocarcinomas were 43% (13/30) for males and 13% (4/30) for females of the 100 p.p.m. groups. No mammary adenocarcinomas were induced in males and no colon carcinomas were observed in the 25 p.p.m. groups of either sex. Furthermore, development of lymphocytic leukemia was apparently enhanced by PhIP in males. In a separate experiment, dose-dependent induction of aberrant crypts in the large intestine, considered as preneoplastic lesions, was evident after 8 weeks feeding of PhIP-supplemented diet at doses of 25, 100 or 400 p.p.m. Thus a clear dose-dependency was demonstrated for both colon and mammary carcinogenesis. Since PhIP is a particularly abundant heterocyclic amine and its carcinogenic organotropism overlaps with the types of neoplasias most commonly observed in western countries, the compound may be extremely important with respect to human cancer development.

[Torsion of the middle lobe after right upper lobectomy: a case report]

Following right upper lobectomy for a pulmonary carcinoma, torsion of right middle lobe occurred. There have been few reports in the literature of pulmonary torsion after lobectomy. A 68-year-old man had a right upper lobectomy for pulmonary carcinoma. On the seventh day after right upper lobectomy, he got high fever. At the same time a roentgenogram of the chest showed complete opacification like ground-glass in the upper lung field. Gradually the opacification increased and hemosputum also appeared. Bronchoscopy revealed 90-degree torsion of the middle lobe. In the treatment with respirator (CV 2000), his clinical conditions improved.

Effects of organic and inorganic Ca(2+)-antagonists on acetylcholine-induced contraction in molluscan (Mytilus edulis) smooth muscle

1. Effect of Ca(2+)-antagonist on the contractile response to acetylcholine (ACh) in molluscan (Mytilus edulis) smooth muscle was investigated. 2. ACh-induced contraction was remarkably reduced by exposure to Ca(2+)-deprived medium. 3. The organic Ca(2+)-blockers, verapamil, diltiazem and nicardipine, reduced the concentration-response curve for ACh in a concentration-dependent manner. 4. The inorganic Ca(2+)-blockers, MnCl2, NiCl2, CoCl2 and CdCl2, also reduced the concentration-response curve for ACh concentration-dependently. 5. ACh significantly increased the amounts of inositol 1,4,5-trisphosphate (IP3) in the ABRM. 6. ACh-induced contraction in the ABRM might therefore be mediated through an influx of extracellular Ca2+ and Ca(2+)-release from IP3 sensitive intracellular pools.

Simple, rapid and simultaneous measurement of eight different types of carbamate pesticides in serum using liquid chromatography-atmospheric pressure chemical ionization mass spectrometry

We have developed a method for simultaneous analysis of methylcarbamate pesticides in serum with an acute pesticide intoxication. This is performed by liquid chromatography-atmospheric pressure chemical ionization mass spectrometry. Rapid detection of eight types of methylcarbamate pesticide can be achieved with this method, it only requires an extremely simple pre-treatment of the sample. The specificity of this method is equal to that of gas chromatography-mass spectrometry, and it satisfies the clinical requirements for detection sensitivity and specificity. Although some problems with this analytical method remain to be solved, we consider it to be superior to any other analytical method previously reported.

[A case of benign clear cell tumor of the lung--a review of 17 cases in the Japanese literature]

We experienced a case of benign clear cell tumor of the lung. It is a rare and most unusual pulmonary neoplasm. Only 40 cases have been reported in the foreign literatures and 16 cases in the Japanese literatures. A 30-year-old man, who revealed a coin lesion in the chest roentogenogram at the health screening, underwent resection of the right lower lobe. Microscopically, the tumor cells are similar to clear cell carcinoma of the kidney and have glycogen in the cytoplasm. Ultrastructually, fibrous banded collagen structures were found in the intercellular space. These findings suggest possibility of neural tissue origin of the clear cells.

Combined hereditary factor XI (plasma thromboplastin antecedent) deficiency, von Willebrand's disease, and xeroderma pigmentosum in a Japanese family

We report a 28-year-old-Japanese male who had a skin tumor derived from variant type xeroderma pigmentosum (XP), combined with factor XI (FXI) deficiency and type IIB von Willebrand's disease (vWd). The patient had abnormal bleeding history on tooth extraction. FXI clotting activity (FXI:C) and antigen (FXI:Ag) were remarkably decreased (< 0.01 U/ml, < 0.02 U/ml, respectively). Factor VIII (FVIII) clotting activity, von Willebrand factor antigen (vWf:Ag), and ristocetin cofactor (RCoF) were 0.43 U/ml, 45%, and 57%, respectively. Ristocetin-induced platelet agglutination (RIPA) revealed hyper-aggregation compared with a normal control. Multimeric composition of vWf in plasma showed a reduction in high molecular weight forms. The family study revealed two other subjects with homozygous hereditary FXI deficiency and vWd, and five subjects with heterozygous FXI deficiency. The relationship between FXI deficiency and vWd is discussed and previously reported cases are reviewed.

Improvement in blastocyst hatching of mouse embryos cocultured with human placental cells

PURPOSE

Although the hatching of embryos is an important phenomenon, the mechanism of hatching remains controversial. Therefore, we attempted to develop a new coculture system with human placental cells to investigate the hatching of mouse embryos.

RESULTS

In our new system there was no difference in development from the two-cell stage to blastocysts between embryos cultured with a T6 medium and embryos cocultured with human placental cells at 1 x 10(5), 5 x 10(5), and 1 x 10(6) cells/ml. However, the hatching-rate cell number increased significantly in embryos cocultured with placental cells compared to embryos cultured without placental cells. [3H]Thymidine uptake did not show any significant difference from the beginning of in vitro culture to the hatching stage between the coculture group and the control group. Nevertheless, the [3H]uridine uptake was significantly different in the two groups, measuring 2167 +/- 532 cpm/10 embryos in the coculture group and 804 +/- 86 cpm/10 embryos in the control group at 114 hr after human chorionic gonadotropin injection (P < 0.01).

CONCLUSION

These results therefore seem to indicate that the hatching of blastocysts depends on the protein synthesis of the embryos and not on DNA duplications.

Comparison of cognitive changes in patients with Alzheimer's and Parkinson's disease

OBJECTIVE

To compare cognitive changes in the dementias of Parkinson's disease (PD) and Alzheimer's disease (AD).

DESIGN

Case series, group comparisons.

SETTING

Ambulatory care referral center.

PATIENTS

Consecutive sample of 14 patients with PD dementia and 27 with probable AD matched for overall intellectual function using a mental status test, as well as 14 non-demented PD and 12 mild probable AD patients, similarly matched for overall intellectual function. All demented patients met Diagnostic and Statistical Manual, Revised Third Edition, criteria for dementia.

MAIN OUTCOME MEASURES

Performance on a battery of neuropsychological tests assessing verbal and nonverbal memory, verbal fluency, and constructional ability.

RESULTS

Nondemented and demented patients with PD performed worse than their probable AD comparison groups on verbal fluency and visuospatial tasks. Cognitive changes attributable to dementia were similar in PD and probable AD but were not identical. The patients with probable AD demonstrated more marked change in memory performance with delay.

CONCLUSIONS

Our findings suggest that when dementia occurs in PD it is overlaid on cognitive changes that already exist in nondemented patients but that the dementing process in PD involves systems other than those responsible for cognitive change in nondemented PD patients. We hypothesize that in most cases, dementia in PD involves changes in a nondopaminergic neurotransmitter system but is not due to concomitant AD.

Purification and characterization of an enzyme releasing lacto-N-biose from oligosaccharides with type 1 chain

An enzyme specific for oligosaccharides with type 1 chain was purified 7,000-fold from the culture broth of Streptomyces sp. 142. The enzyme, lacto-N-biosidase, was induced and secreted into culture medium when the strain was cultured in the presence of porcine stomach mucin. The enzyme was purified by anion-exchange chromatography on Q Sepharose, cation-exchange chromatography on S Sepharose, fast protein liquid chromatography on a Mono S column, and gel filtration chromatography on TSK gel HW55S. To remove contaminating alpha-1,3/4-fucosidase and beta-N-acetylglucosaminidase, final purification was done by fast protein liquid chromatography on a Mono S column and affinity chromatography on N-acetylglucosamine agarose. The purified enzyme gave only one major protein band with an apparent M(r) of 60,000 on sodium dodesyl sulfate-polyacrylamide gel electrophoresis. The enzyme had maximum activity at pH 5.5 and was stable at the pH range of 4.0-10.0. Substrate specificity studies with oligosaccharides labeled with 2-aminopyridine showed that the enzyme specifically hydrolyzed lacto-N-tetraose and the N-acetyllactosamine type of triantennary sugar chain with the type 1 chain, but did not hydrolyze type 2 chain oligosaccharides or the type 1 chain oligosaccharides with fucose or sialic acid including lacto-N-fucopentaose I and II and alpha-2,3-sialyl lacto-N-tetraose. The enzyme released lacto-N-biose from asialofetuin, and almost all oligosaccharides in asialofetuin were found to have only type 2 chains. Sequential digestion of extended type 1 chain oligosaccharides with alpha-1,3/4-fucosidase and lacto-N-biosidase was possible.

Patterns of neuropsychological performance in Alzheimer's disease patients with and without extrapyramidal signs

We investigated the relationship between extrapyramidal signs (EPS) and the cognitive function in 90 patients meeting NINCDS-ADRDA criteria for probable Alzheimer's disease (AD) by dividing them into those showing no evidence of EPS and those showing at least one EPS on the Unified Parkinson's Disease Rating Scale. Cognitive function was assessed by neuropsychological tests of verbal memory, orientation, abstract reasoning, language, and construction. Patients with EPS were significantly more impaired than patients without EPS on tests of short-term learning and memory, orientation, naming, verbal fluency, and construction, but not on tests of long-term memory, abstract reasoning, or verbal comprehension. These results could not be explained by any differences in age, education, or disease duration between the groups. Since this pattern of neuropsychological impairment resembles that of patients with Parkinson's disease and other EPS syndromes, we hypothesize that EPS are associated with neuropathologic and neuropsychological changes that are superimposed over the classic features of AD.

Pathological specimens of rat temporal bone--comparison between different fixative solution

We investigated the difference in temporal bone specimens fixated by three sorts of fixative solution (10% formalin fixative, Wittmaack's fixative and Heidenhein-SuSa fixative). 1. 10% Formalin's fixative solution We found many pinkish precipitates, which are stained by hematoxy-eosin, in the scala media of the cochlea. Same substance is found in the perilymphatic space and endolymphatic space in the vestibulum. The fusion of the cells is indicated in the tectorial membrane, inner sulucus cell, outer sulucus cell especially in the apical turn of the cochlea. 2. Wittmaack's fixative solution The detachment of inner and outer sulucus cells are found from basilar membrane at the basal turn of the cochlea. The tendency in convex and concave form of the Reissner's membrane is most remarkable in these three fixative solution. 3. Heidenhein-SuSa fixative solution In this solution, no precipitates, no fusion of cells are found. No detachment of the inner or outer sulucus cells is also found. This study indicates that Heidenhein-SuSa fixation is most excellent fixative method.