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Volume 48, Issue 4
Displaying 1-9 of 9 articles from this issue
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Kiyoshi HAMANO, Naoki TADA, Nobuko NAKAGAWA, Toyohiko MINAMI, Chiyonor ...2002 Volume 48 Issue 4 Pages 235-242
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSTwo cases which are considered to be typical examples of malignant otitis externa are herein reported. Both cases were elderly individuals who had untreated diabetes militus. Their chief complaints were severe otalgia caused by Pseudomonas aerginosa. Furthermore, they also suffered from palsy nerves vagus. One case recovered while the other did not. We first treated them as out-patients but they did not improve. As a result, both were hospitalized. The blood sugar levels of both patients were controlled and antibiotics was administered. In addition, a radical operation of the middle ear was performed and the external ear canal was also carefully washed. We also applied insulin locally to the external ear canal in the second case. As a result of controlling the blood sugar levels, their CRP levels decreased. Thereafter, their symptoms gradually improved. CT, MRI and RI effectively showed the extent of disease but did no help in the prognosis or in predicting the disease outcome. Careful examinations of the CRP levels were most helpful in following the course of the disease.View full abstractDownload PDF (17952K) -
A report of a caseKazuhiro YAMAMOTO, Tomoko KANDA, Masako NAKAI2002 Volume 48 Issue 4 Pages 243-246
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA 65-year-old male presented with stage II hypopharyngeal squamous cell carcinoma. He received standard fraction radiation therapy (66Gy: 2Gy/day) and 25mg/m2 carboplatin (CBDCA) given daily during 1st, 2nd, and 3rd weeks (total CBDCA dose 600mg/body). At 37 days after the last CBDCA therapy, he complained of dyspnea and high fever. The chest X-ray and CT findings revealed an interstitial pneumonia. He did not show a good recovery in spite of the intensive therapy, and died of interstitial pneumonia after about 2 months. We assume that the acute interstitial pneumonia of this case has been induced by CBDCA.View full abstractDownload PDF (8581K) -
Takeshi KUSUNOKI, Shozo NISHIDA, Takao SATOU, Kei SAITO, Kiyotaka MURA ...2002 Volume 48 Issue 4 Pages 247-250
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA 61-year-old man presenting with hoarseness as a chief complaint was introduced to our department by his local physician. At the first medical examination, this patient was found to have left recurrent nerve palsy and bilateral supraclavicular lymphnode enlargement. An echogram showed an impalpable thyroid tumor. Chest X-P and CT illustrated multiple nodular shadows in the lung fields and Talium scintigraphy showed an accumulation in the right clavicular region. From the results of preoperative examinations, the preoperative diagnosis was thyroid carcinoma with lung metastasis. We thus decided to perform a total thyroidectomy and postoperative iodine irradiation. However, the final diagnosis was thought to be thyroid metastasis due to lung adenocarcinoma rather than lung metastasis from thyroid carcinoma, since a postoperative pathologic examination of carcinoma tissue specimens did not demonstrate any colloid in the lumens (as seen in thyroid tumors). Cancer cells surrounded the blood vessels in the interstices, capsular and extracapsular tissue specimens. In an immunohistochemical study, a cytokeratin-8 antibody with a specific reaction to adenocarcinomas was positive in cancer lesions. However, no thyrogulobulin antibody could be observed in the cancer cells.View full abstractDownload PDF (9314K) -
Tetsuo ITOKAZU, Masaharu URA, Tatsuhito OWA, Yutaka NODA2002 Volume 48 Issue 4 Pages 251-254
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSTwo cases of internal jugular phlebectasia are reported. Both patients were 5-year-old boys. They were well developed and healthy, and they has no history of either an operation or trauma. A soft swelling appeared on the right side of the neck only during straining, or when the patients forcibly held their breath. However, no swelling could be seen or felt when they relaxed. A CT of the neck revealed the internal jugular vein to be dilated when the patients exerted pressure.View full abstractDownload PDF (7632K) -
Asako KISHIMOTO, Kouichiro MAKINO, Motoko INO, Chiyonori INO, Toshio Y ...2002 Volume 48 Issue 4 Pages 255-258
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSMalignant tumors with leukocytosis have only rarely been reported and the prognosis of such tumors is known to be very poor. We herein report a case of undifferentiated carcinoma of the thyroid with leukocytosis and hypercalcemia. The patient was a 77-year-old woman whose chief complaints were a mass of the anterior neck and dyspnea. A cytologic examination by an aspiration biopsy disclosed undifferentiated carcinoma of the thyroid. An examination of the blood showed leukocytosis (40700/mm3) and hypercalcemia (7.0mEq/L) by G-CSF (174μg/ml) and c-PTHrP (286pmol/1) producing tumor. The patient was treated with irradiation. Her general condition temporarily improved, while the white blood cell count and serum calcium level decreased. Unfortunately, the leukocytosis worsened and the patient died 5 months after the tumor suddenly increased in size. The leukocytosis recurred, however, the serum calcium level did not increase again.View full abstractDownload PDF (8118K) -
Naotaro AKIYAMA, Toshihiko KIKUCHI, Jun TAKANO, Tosihimitsu KOBAYASHI, ...2002 Volume 48 Issue 4 Pages 259-264
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA 23-year-old woman with Wegener's granulomatosis is herein reported. Her left eye slightly protruded and its bulbar conjunctiva showed congestion. Endoscopic sinus surgery was performed under general anesthesia. Multiple perforations were found in the nasal septum while granulomatous lesions were observed in the nasal cavity and the paranasal sinuses. A diagnosis of Wegener's granulomatosis was made based on the clinical features, pathological findings and the value of C-ANCA. Both steroids and cyclophosphamide were administered. The clinical course was favorable. The results obtained from the present study suggest that a careful endoscopic examination of the nasal cavity thus plays an important role in accurately diagnosing Wegener's granulomatosis.View full abstractDownload PDF (14621K) -
Jun TAKANO, Toshihiko KIKUCHI, Noriyuki SAKIHAMA, Ryota OKU, Eigo SO, ...2002 Volume 48 Issue 4 Pages 265-268
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSThe case of a 68-year-old man with poorly differentiated squamous cell carcinoma accompanied by an extension to the skull base is described in this study. He presented with left cheek pain and double vision. The CT and MRI findings demonstrated a tumor in the left sphenoid sinus and skull base. Endoscopic sinus surgery was performed and a pathological examination revealed the existence of poorly differentiated squamous cell carcinoma. Radiation therapy was performed, and the pain was successfully relieved. The literature on neoplastic lesions in the sphenoid sinus was also briefly reviewed.View full abstractDownload PDF (8314K) -
Junko TAKAHATA, Atsushi MATSUBARA, Keiichi IKENO, Hideichi SHINKAWA2002 Volume 48 Issue 4 Pages 269-275
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSEosinophils are thought to be related to the course of sinusitis and nasal polyps. In the present study, we investigated the influence of the infiltration of eosinophils and mast cells in tissue specimens based on a post-operative diagnosis of chronic sinusitis. Using specific antibodies, EG2 antibody for staining activated eosinophils and anti-triptase for staining mast cells, the number of both types of cells infiltrating the nasal polyp and ethmoid sinus mucosa was counted in 21 cases who underwent endoscopic sinus surgery for chronic sinusitis. The CT findings both before and after sinus surgery were compared. Only the number of EG2 positive cells infiltrating the ethmoid sinus showed a significant correlation (regression analysis, p<0.05). This indicates that the degree of infiltration of activated eosinophils in the ethmoid sinus accurately reflects the post-operative prognosis of chronic sinusitis.View full abstractDownload PDF (12561K) -
Kayoko HIRATA, Toshiyuki KOKATSU, Keiko ITO, Miki KURIHARA, Mitsuaki H ...2002 Volume 48 Issue 4 Pages 276-282
Published: July 20, 2002
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA randomized controlled trial was conducted to assess the effect of long-term low-dose macrolides therapy for chronic sinusitis. Patients with chronic sinusitis were randomly divided into two groups, i.e. the administration group and the non-administration group, using the envelope method. The administration group was treated for 8 weeks with the oral administration of 100mg/day of clarithromycin and 30mg/day of serrapeptase while the non-administration group was given 30mg/day of serrapeptase alone. The number of patients finally entered into the statistical analysis was 14 and 15 for the administration and non-administration groups, respectively. The subjective symptoms (rhinorrhea, postnasal drip, nasal obstruction, hyposmia and headache), objective signs (volume of rhinorrhea, quality of rhinorrhea, postnasal drip and nasal mucosal edema) and the X-ray findings on paranasal sinuses were scored and any differences between the scores before treatment and after treatment were regarded as an improvement. The difference between the improvement in the two groups was analyzed using Mann-Whitney's U test. Consequently, the improvement in the administration group was found to be significantly higher than in the non-administration group regarding subjective symptoms at 6 weeks (p<0.05) and regarding objective signs at 2 weeks (p<0.05), at 4 weeks (p<0.01), 6 weeks (p<0.01) and 8 weeks (p<0.05) and also for the X-ray findings at 8 weeks (p<0.05). In conclusion, long-term low-dose clarithromycin therapy is thus considered to be effective for treatment of chronic sinusitis.View full abstractDownload PDF (12031K)
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