Protein-bound polysaccharide Kureha (PSK), one of immunopotentiators, was prescribed for 26 patients with head and neck cancer, from Sept., 1976. Skin sensitivity tests, including DNCB, PPD and PHA, were performed before the administration of PSK, and we found that the patients showed a negative response to more than one antigen.
In addition to irradiation and/or surgery, PSK, 273 g on the average, was administered to the patients for 3 months. Increase in the skin sensitivity of these patients, after 3months, was compared with that of the patients with benign sinus disease who underwent on antrotomy. It was found that increase in skin sensitivity was significantly lower in the cancerous patients with DNCB, but no significant difference was observed with PPD and PHA.
Clinical process in the PSK ingesting patients was variable over 65 years old, and was good under 64 yrs. But they were not significantly related to the change of the skin sensitivity response. Aggravation or metastasis of the primary foci was not seen in 5 out of 8 over 65 years old, and 11 out of 18 under 64 yrs.

View full abstract

Nine cases of reconstructive head and neck surgery with deltopectral flap (DP flap) and myocutaneous flap (MC flap) were reported. Reconstruction after hemiglossectomy with pectral MC flap was done successfully in two cases of recurrent tongue cancer. Reconstruction of the palate, buccal wall and mouth floor with extended pectral MC flap was failed because of the too long flap beyond the margin of pectral muscle. In such case the whole muscle flap should be adopted. In cases of parotid cancer and neck metastasis of tongue cancer, the exposed carotid artery after the resection of the involved skin was covered well with pectral MC flap. After the pharyngolaryngoesophagectomy the sternoclaid MC flap for reconstruction of esophagus and DP flap for the cover of the exposed wound were usefull. This reconstructive procedure seems to be beneficial in the cases of fatty female. After the pharyngoesophagectomy, the esophagus was reconstructed primarily with pectral MC flap successfully. In our series the reconstructive surgeries were carried out in the advanced cases behind time. The reconstructive surgery with DP flap or MC flap was so usefull that the radical operation should be carried out in the earlier cases to get a nice prognosis of head and neck cancers.

View full abstract

The vascular reconstruction was given to three cases with neck metastasis fixed to carotid artery. Primary lesion in all of 3 cases was laryngeal cancer and surgically treated 11 to 20 months before clinically manifesting the cervical metastasis.
End to end anastomosis with interposition was performed in one case, and patchangioplasty in 2 cases. Autologous vein (V. saphenamagna) was used for the transplantation.
Any complications were not encountered after the surgery. Microscopic sections of the removed carotid artery indicated the extension of the tumor into the external layer.
Preoperatively, it was not easy to determine the indication of this surgical treatment, even though angiography and CT scanning were applied. Careful palpation was one of the most useful examination for this point. Headache was probable to be one of the important sign of the tumor infiltration into carotid artery, because it was immediately disappeared after the surgery.
All of 3 cases were died of dissemination of the cancer 5 to 25 months after the reconstruction. One of the reasons of the poor prognosis as described above might be that the fact of the invasion of the cervical metastasis into carotid artery itself might indicate the advanced stage. However, the reconstructive surgery was probably helpful to prolong the survival period.

View full abstract

SJÖGREN's syndrome is a chronic benign disorder affecting middle aged females. The male with SJOGREN'S syndrome is rare and only 5 cases have been reported in recent 5 years.
A 56-year-old man with SJÖGREN's syndrome visited our department on May 21. 1979, complaining of left parotid swelling without feeling of thirst and dryness of the eyes. But in labolatory findings, he had the particular sign of SJÖGREN's syndrome in sialography and histopathological findings of parotid gland. In addition, he had remarkable diminition of the salivary secretion (total saliva flow rate) and of the tear flow (Schirmer test).

View full abstract

The primary nasopharyngeal mixed tumor has rarely been reported, although minor salivary glands are normally found in the nasopharynx. Recently, we experienced a case of primary nasopharyngeal malingnant mixed tumor.
A 79-year-old female had been suffered from the left impaired hearing for several months and the left nasal obstruction for several years. Physical examination revealed a large tumor in the nasopharyngeal space which pressed the soft palate forwards.
Under general anesthesia the tumor was surgically removed. At surgery, it was confirmed that the tumor originated from the nasopharynx.
Mixed tumor was diagnosed by microscopic tissue examination. And ultrastructurally, malignant cells were certified.

View full abstract

When the patients visited to our clinic, his chief complaints were left hemicramia, hearing loss and tinnitus. Otoscopic examination revealed granuloma formation in left external auditory meatus. X-ray picture showed radiolucent lesion over the left temporomandibular joint. Open biopsy was performed under general anesthesia. The tissue showed histologically giant cell tumor. About one month after the biopsy, tumor was totally extirpated for therapeutic purpose. Radiation was not applied to the case.
Previous reports of giant cell tumor in temporal bone were analysed and reviewed in this paper. The tumor affects more incidentally to male than female. Average age of the patients with the temporal giant cell tumor is higher than those with the tumor in other sites. And up to present, the histological grading of the giant cell tumor is not available to determine the clinical prognosis. For the therapy of the lesion, total extirpation is considered to be the most effective treatment.

View full abstract

A case of bilateral maxillary sinus carcinoma in a man, aged 68 is reported.
He complained of swelling of the left gingiva. Biopsy revealed squamous cell carcinoma. Left maxillary sinus carcinoma was diagnosed, and surgery with radiation therapy was performed. After five months, right maxillary sinus carcinoma was found. At present, five years after therapy he is alive and well. In review of the literature, 50 cases of bilateral maxillary sinus carcinomas are previously reported in Japan.

View full abstract

Gastric cancer rarely metastasized to the tonsil. Only 1 instance of tonsillar metastasis by a gastric cancer was found in the literature.
In this paper, it was emphasized that a tonsillar malignant tumor may represent the so-called latent primary carcinoma.
A 67-year-old man with a mass at the upper pole of the left palatine tonsil visited our department on April 11. 1980. By histological examination, metastatic carcinoma from a digestive system was suspected. Radiographic and ultrasonic examination revealed gastric cancer in the lower part. Distal partial gastrectomy and chemotherapy were performed, but he died 3 months after the operation.

View full abstract

A 79-year-old woman was referred to us in January 1980 with a nine-month history of nasal obstruction. Sinus x-ray films showed no abnormal findings except for a mass filling the right nasal cavity. No cervical adenopathy was present.
The tumor was approached surgically via a modified Denker incision and was found attaching to the Kiesselbach's area by a small pedicle. All tumor, which was a polypoid mass measuring 5×2.5×2cm, and septal muco-chondrial composite of the right side were resected. The surface of the tumor was eroded and devoid of epithelial covering.
Histologically, the tumor was characterized by storiform fibrous stroma and bizarre histiocytic cells, and the diagnosis of malignant fibrous histiocytoma was made. But, small nests of squamous cell carcinoma were identified by silver impregnation, so this neoplasm was re-diagnosed as pseudosarcoma.
The postoperative course was uneventful. The patient received no radiation and no chemotherapy because of her high old age, complete tumor excision and no regional adenopathy. She was dismissed from the hospital on the 12 th postoperative day. Currently, one and a half years after operation, she is doing well, with no evidence of recurrent tumor.

View full abstract

A 40-year-old male with sialodochitis fibrinosa of submandibular salivary gland was reported.
The patient was associated wi h urticaria and with positive skin test for many allergens.
A recurrent submandibular salivary gland swelling occured associated with attack of abdominal colic, which were suggestive of allergic internal disease. During the course of observation, blood eosinophils showed variation ranging from 0 to 11 % and serum IgE showed a moderate elevation.

View full abstract

One of the major complaints of hearing aid users is their inability to understand speech in noisy environments. We have developed a new hearing aid which has selective amplification-ability in the speech frequency band utilizing a compression amplifier which automatically compresses the lower frequency range as a function of the level and spectrum of the environmental noise. The output of the LPF is passed through a compression amplifier and then mixed with the signal passing through the HPF.
The results of speech discrimination tests using speech-in-noise on 70 hearing impaired subjects showed improvement in word discrimination scores in noise of over 15 % for 51 of 54 sensorineural subjects. On the other hand, results on 16 subjects with conductive or mixed hearing impairments showed scores between 75 and 100 which is no improvement at all, but their opinions were favorable and it proved that the sound was more natural and quiet compared with the conventional AGC hearing aids.

View full abstract