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Volume 101, Issue 11
Displaying 1-7 of 7 articles from this issue
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Hirobumi Kumazawa, Yoshinao Tsuta, Akiyo Momodani, Kazuhito Yoshinaga, ...1998 Volume 101 Issue 11 Pages 1303-1310
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSSince the introduction of the tracheoesophageal fistula (LEF) technique for restoration of voice in 1983, we performed voice restoration using primary tracheoesophageal fistula in 83 patients undergoing laryngectomy. The success rate for voice restoration with TEF So.6% (good voice: 69.8%, fair voice; 10.8%). Thirty-one patients out of 51 patients who have been followed for over 3 years had 34 problems with TEF (15 granulations of TEF, 7 difficulties in insertion of voice prostheses, 4 stenoses of the tracheal stoma, 5 other reasons). However, most patients could use TEF by following appropriate procedures. Our results suggest that the Blom-Singer TEF procedure is a safe, simple and effective means of alaryngeal communication.View full abstractDownload PDF (1527K) -
Kentaro Ochi, Masao Mitsui, Shoji Watanabe, Hiroaki Nakashima, Toru Oh ...1998 Volume 101 Issue 11 Pages 1311-1315
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe effect of high-dose steroid therapy on sudden deafness were investigated in 19 cases. A daily intravenous administration dose of hydrocortisone sodium succinate was tapered from 800mg to 200mg as follows; 800mg, 800mg, 600mg, 600mg, 400mg, 400mg, 300mg, and 200mg. Another 19 cases, the control group, were treated with intravenous application of prednisolone, tapered from 50mg to 10mg in 10-mg steps and each dose applied for 3 days. There were no significant differences in the effect on hearing between the two groups as measured by three different analyses: criteria proposed by the Committee on Sudden Deafness of the Japan Health Ministry; magnitudes of improvement of mean thresholds at five frequencies from 250Hz to 4kHz in affected side; and the ratio of the magnitudes of improvement of mean thresholds in affected side to magnitudes of difference between the initial mean thresholds in affected side and those in contralateral side. These findings suggest that high-dose steroid therapy for sudden deafness is not so effective as it is for idiopathic facial palsy. This may be due to the difference in the mechanisms of development between the two conditions. No critical side effects were observed in our study, which would argue for the safety of our method of high dose steroid therapy for routine clinical use. It might be advisable to conduct additional clinical studies to determine the effect of high-dose steroid therapy for sudden deafness, because our study was conducted on a small number of patients and was not double-blind or randomized.View full abstractDownload PDF (544K) -
Yoshihiro Dake, Tadao Enomoto, Akira Shibano, Takema Sakoda, Yuko Sait ...1998 Volume 101 Issue 11 Pages 1316-1320
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSChlamydia Pneumoniae (C. pneumoniae) is a bacterium involved in infections of the upper airway as well as in lower respiratory diseases. It has been reported that infections from this bacterium are prevalent worldwide and that the proportion of the population having the antibody is high. It is, however, difficult to identify the pathogen by routine bacterial examination because it is an obligate cytozoic bacterium. In addition, the examination has been feasible in only a limited number of laboratories because the determination of the serum antibody titer has required preparation of the antigen as well as sophisticated skill. We conducted an epidemiological survey of 320 healthy males and females in their 20s living in the three cities of Osaka, Kobe and Oita using "HITAZYMER C. Pneumoniae, which is a recently developed kit for determination of anti-C. pneumoniae specific antibody. The statistical method used was the chi square test for the comparison of proportions. Mean proportion of the population showing positive antibody test was 58.1%. IgA antibody was positive in 42.8% and IgG in 46.5% of the above population. There were no statistically significant differences between districts of between genders in the percentages of cases positive for these antibodies. The results were comparable to those previously reported suggesting that C. pneumoniae is prevalent all over Japan. This kit was found to be an easy way to use the ELISA method and therefore to be clinically useful.View full abstractDownload PDF (488K) -
Mutsumi Kuga, Minoru Ikeda, Nobuo Kukimoto, Yuzuru Abiko1998 Volume 101 Issue 11 Pages 1321-1327
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe purpose of this study was to determine if there is a relationship between the appearance of facial paralysis and physical or psychological stress. Subjects were 55 patients (23 men, 32 women) with facial paralysis (32 with Bell's palsy. 23 with Ramsay Hunt syndrome) who visited the Department of Otolaryngology, Nihon University Itabashi Hospital, from August 1994 to March 1996. At the time of the initial visit, patients were asked if they had any physical or psychological stress one week before the occurrence of facial paralysis. The degree of psychological stress was rated by Niina's Psychological Stress Response Scale 50 Items Revised (PSRS-50R). Answers were obtained from 52 of the 55 subjects. Forty patients (76.9%) reported that they had felt physically fatigued, suggesting some type of relationship between the occurrence of facial paralysis and physical stress. Twenty-seven patients (51.9%) reported the existence of psychological stress. However, the evaluation of psychological stress by PSRS-50R did not reveal a high level of psychological stress in any patient, indicating lack of a strong relationship between the occurrence of facial paralysis and psychological stress. Stepwise regression analyses were made to study the relationship between the degree of paralysis at the time of the initial visit and factors which affect the prognosis of the paralysis. Those patients who reported physical fatigue before the appearance of facial paralysis had more abnormal values on the nerve excitability test than those who did not report such fatigue.View full abstractDownload PDF (2172K) -
Ko-ichi Yamamoto, Atsuhiko Uno, Takayuki Kawashima, Takako Iwaki, Kats ...1998 Volume 101 Issue 11 Pages 1328-1334
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSElectrically evoked auditory brainstem responses (EABR) were recorded in 31 postlingually deafened adults, who had recently received cochlear implants (mini-system, Gochlear Ltd). The wave consisted of three distinctpositive peaks labeled P1, P2 and P3 with latency of 1.35 (±0.14), 2.17 (±0.18) and 4.08 (±0.31) ms, respectively.The P3 threshold (EABR-T) and slope (EABR-S) were 0.9 (±0.47) mA and 0.6 (±0.28)μv/mA, respectively. Therelationships between the EABR parameters (EABR-T and -S of the P3 wave) and age, duration of deafness, promontory test and subjective respanse (T-and C-level) were investigated. The scattergram showed a strongnegative linear relationship between EABR-S and subjective T-level. This finding suggests that EABR-S is goodmeasure of postoperative perception.View full abstractDownload PDF (668K) -
Eiji Chida1998 Volume 101 Issue 11 Pages 1335-1347
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSDistortion product otoacoustic emissions (DPOAEs) were evaluated in 494 normal and 506 cochlear-impaired human ears. to determine whether DPOAEs depend on factors such as background noise, the shape of the pure tone audiogram, sex and aging, and whether a DPOAE test can perform well in distinguishing normal-hearing from hearing-impaired ears. The amplitudes of DPOAEs were measured at the frequency of 2f1-f2 (f1<f2, f2/f1=1.22, f2 at 1, 2 and 4kHz) using as stimuli two pure tones at level of 70dB from an ILO92 Otoacoustic Emission Analyzer. The correlation coefficients between the DPOAE level and the auditory threshold decreased as the background noise levels at 1kHz and 2kHz increased. Therefore, it appeared that ears with large background noise levels would be inadequate for the study of DPOAEs predicting the hearing state. The sensitivity (normal-hearing ears identified as normal hearing) and the specificity (hearing-impaired ears identified as hearing impaired) at the equal-sensitivity-specificity condition were 80.7-86.7% at 1, 2 and 4kHz, and the areas under the receiver operating characteristic (ROC) curves, which were used to estimate the test performance, were 0.88 for 1kHz, 0.91 for 2kHz and 0.92 for 4kHz. Since these results suggest that a DPOAE can be used as a reliable technique for objective auditory tests, it is thought that actual values (DPOAE level: 4.3dB at 1kHz, 5.0dB at 2kHz and 2.9dB at 4kHz) of false-positive (hearing-impaired ears identified as normal hearing) rates corresponding to 5% can be used in clinical evaluation to separate normal-hearing from hearing-impaired ears. There was, however, a significant age effect at 4kHz on DPOAEs in the ears with the same pure tone hearing threholds, and the areas of the ROC curves in subjects ranging from 10 to 29 years old were larger than in subjects over 50 years (1kHz: 0.88 to 0.94 versus 0.83 to 0.84, 2kHz: 0.95 versus 0.89, 4kHz: 0.95 to 0.96 versus 0.88 to 0.89). Therefore, it is thought that age-adjusted norms may be necessary for the accurate interpretation of DPOAE results.View full abstractDownload PDF (1934K) -
Hitoshi Sakuma1998 Volume 101 Issue 11 Pages 1348-1357
Published: November 20, 1998
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSExpression of cytokeratin (Ck) proteins in the guinea pig cochlea was examined using a recently developed immunohistochemical method for celloidin section. This method has allowed us to observe a whole cochlea with excellent morphological preservation in a visual field under the light microscope. Anti-Ck antibodies FIL-7 (AE-1, Signet Lab.) and NCL-CK19 (Novocastra Lab.) stained all supporting cells of the organ of Corti, in which pillar cells, Deiters' cells, Hensen's cells, and Boettcher's cells showed a strong reaction. The histochemical labeling of pillar and Deiter's cells showed a gradual increment from the base to the apex. The immunohistochemically stained area in Hensen's cells increased toward the apex, which was attributed mainly to the increase in both the number and size of Hensen's cells from the base to the apex. In an electron-microscopic examination, changes in histochemical labeling of Hensen's cells did not appear from the base to the apex. Close examination revealed that reaction precipitates were distributed along a filament structure which seemed to correspond to the cytokeratin filaments These results suggest that the Ck filaments give elasticity and flexibility to the supporting cells in the organ of Corti and provide mechanical strength to the organ of Corti at the upper turns, which vibrate with larger amplitudes, and that the Ck filaments in the supporting cells must be of considerable importance as a tuning mechanism. Immunohistochemical labeling for Ck was also observed in the spiral prominence cells, outer sulcus cells, interdental cells, and Reissner's membrane. The positively stained area in the outer sulcus increased from the apex to the base.View full abstractDownload PDF (2918K)
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