[in Japanese]

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[in Japanese]

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Ataxia severity, cerebellar hemispheric blood flow, and ascorbate free radical, superoxide dismutase protein, superoxide scavenging activity, 8-hydroxy-2'-deoxyguanosine, noradrenaline, dopamine, homovanillic acid, and 5-hydroxyindol acetic acid in cerebrospinal fluid were compared before and after an 8-week course of repetitive transcranial magnetic stimulation (rTMS) in 10 patients with spinocerebellar degenerations (SCD). SCD patients showed higher ascorbate free radical, 8-hydroxy-2'-deoxyguanosine, and superoxide scavenging activity than
19 controls. In SCD patients, ascorbate free radical and ataxia severity declined, and noradrenaline and dopamine increased after rTMS. But in the one SCD patient who showed deterioration of ataxia severity after rTMS, ascorbate free radical increased and noradrenaline and dopamine decreased. Therefore, the therapeutic mechanism of rTMS may involve decreased oxidative stress and increased catecholamine levels.

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[in Japanese]

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Carcinoma of the base of tongue, laryngeal carcinoma and hypopharyngeal carcinoma exist in larynx or near place. Therefore, on the occasion of resection of these carcinomas, preservation of larynx is very difficult because of narrow surgical free margin and postoperative misswallowing. But, the combination of new method of surgical approach, conservative resection, new reconstructive surgery, and rehabilitation of speech and swallowing makes the preservation of larynx in many cases though selective. The rate of larynx-preservation by conservative surgical procedure is higher than that by radiotherapy, moreover the local control rate of these carcinomas is maintained as high as that by wide-resection and radical surgical procedure.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Here we describe two patients who aspirated barium sulfate into the lung during a radiographic contrast study. Patient 1, 84 yo male, with brainstem infarct, showed chronic aspiration sign in chest CT. He aspirated barium during a radiographic contrast study. After the aspiration, we followed his chest X-ray for 2 years. Barium spread to the peripheral lung area. Patient 2, 64 yo female, visited our hospital because of dysphagia, and we diagnosed Foix-Chavary-Marie syndrome. She aspirated barium during a radiographic contrast study just before the visit to us. We found several bright spots on chest CT 5 months after the event.
After barium aspiration, we have to diagnose differentially from other respiratory disease. The diagnosis becomes difficult. There are some case reports of severe respiratory failure after barium aspiration. Recently videofluorography has become common for patients with dysphagia. We have to consider the indication and the risk of aspiration when we do a radiographic contrast studies with barium for older patients or patients with neuromuscular disorders.

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