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Volume 103, Issue 9
Displaying 1-7 of 7 articles from this issue
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Hiroshi Nishino, Yoshiro Fujisawa, Takeharu Kanazawa, Kazuhiro Ishikaw ...2000 Volume 103 Issue 9 Pages 963-969
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe efficacy of chemotherapy for unresectable recurrent or metastatic squamous cell carcinomas of the head and neck can not be proved by survival periods. However, the efficacy of chemotherapy has been observed in some select patients. We investigated the effect of chemotherapy for unresectable recurrent squamous cell carcinomas of the head and neck. Four patients with a good performance status (PS) were treated with high-doses of leucovorin (LV), cisplatin (CDDP), and 5-fluorouracil (5-FU). The regimen consisted of 25mg/m2 of CDDP on days 1-5; 600mg/m2 of 5-FU of days 2-6; and 200mg/m2 of LV on days 1-6. Patients received 3 cycles of this regimen at 28-day intervals.Ten patients with a poor PS were treated with low-doses of CDDP and tegafur•uracil upon admission. The regimen of seven poor PS patients consisted of 8mg/m2 of CDDP on days 1-5 and 8-12, and 400mg/body of tegafur•uracil administered orally on days 1-14. The other three patients received chemotherapy on an outpatient basis for ten weeks. The weekly regimen consisted of 7.5mg/m2 of CDDP on days 3 and 6 and 400mg/body of tegafur•uracil administered orally on days 1-7. With respect to the LV+CDDP and 5-FU treatment, complete remission was obtained in one patient. Two patients showed no change (NC), while one patient developed a progressive disease (PD). This regimen is highly toxic, has severe side effects including myelosuppression, oral mucositis, and diarrhea, and has a survival period of between 16 and 32 weeks. The low-dose CDDP+tegafur•uracil treatment produced a partial response in three patients, NC in three patlents, and four patients developed a PD. This regimen doses not have any severe side effects and has a survival period of between 4 and 67 weeks.View full abstractDownload PDF (806K) -
Yu-ichiro Inomoto, Chiaki Suzuki2000 Volume 103 Issue 9 Pages 970-976
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThere are numerous reports on microfissures in the round window niche area, but not many reports have appeared on microfissures in the oval window niche area. In addition, few studies have compared microfissures between the oval and round window niche areas in the same subjects. Hence, the present study investigated the prevalence of microfissures in both areas in human temporal bones. The study was conducted on the 637 ears of 333 cases. Specimens were prepared according to the conventional methods: after fixation, decalcification and dehydration, each specimen was embedded in Celloidin, and the temporal bones were sectioned horizontally at 25μm internals. Every 10th section was stained with hematoxylin & eosin, and each section was analyzed under a light microscope. The prevalence of microfissures was analyzed in relation to the sex, left/right differences and age of the subjects. Microfissures were seen in the oval window niche area in 66.2%, and in the round window niche area in 92.0%. When a microfissure was seen in the oval window niche area, it was also detected in the round window niche area in every case. There were no sex or left/right differences in the prevalence of microfissures, and microfissures occurred bilaterally in most cases. The youngest subject with a microfissure in the oval window niche area was a 14-year-old, and the prevalence increased with age up to approximately 60 years. On the other hand, microfissures in the round window niche area were seen in a 3-year-old, and were seen in most cases over the age of ten. These findings suggest that microfissures are more likely to occur in the round window niche area as compared to the oval window niche area. However, the prevalence of microfissures in the oval window niche area was not low either, and it is important to pay attention to both the oval and round niche areas when microfissures are involved in the formation of perilymph fistulae. Given that the prevalence of microfissures in the oval window niche area increased up to about 60 years of age, not only growth, but also mastication, may be involved in the occurrence of microfissures.View full abstractDownload PDF (1792K) -
Kazunori Mori, Keiichi Chijiwa, Hirohito Umeno, Tetsuyoshi Umeno, Kiku ...2000 Volume 103 Issue 9 Pages 977-985
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe local control rate for T1-T2 carcinomas of the hypopharynx is rather high whereas the overall survival rate is unsatisfactory, irrespective of treatment modalities. Radical radiotherapy has yielded a local control rate of 40-70% and an overall 5-year survival of 30-50%, while surgical treatment with or without postoperative radiotherapy has yielded a local control rate of 60-90% and an overall 5-year survival rate of 30-60%. Based on these reasons, for the patients with minor hypopharyngeal lesions, such as T1-T2 carcinomas, in the Kurume University Hospital radiotherapy has often been selected as a first choice instead of partial pharyngectomy. If the primary lesion is exophytic and has a large volume, laser debulking surgery has been employed prior to radiother apy to improve the local control rate. The purpose of the present study is to describe the details of laser debulking surgery prior to radiotherapy (LDSR) for the treatment of T1-T2 carcinomas of the hypopharynx. In addition, the preliminary results for this treatment procedure will also be compared with the results of partial pharyngectomies preserving the larynx (PPPL) that were performed in the Kurume University Hospital.
In this study 20 patients (T1: 4, T2: 16) who had undergone PPPL and 16 patients (T1: 4, T2: 12) who had undergone LDSR were included.
For patients undergoing PPPL, the 5-year local control rate, 5-year larynx conservation rate and disease specific 5-year survival rate were 83.6%, 70.4%, and 75.0%, respectively, whereas for patients undergoing LDSR these were 87.1%, 93.8%, 87.5% respectively. Although the treatment outcomes by LDSR did not show a significant drastic improvement compared with those by PPPL, the quality of life of the patients undergoing LDSR was not aggravated. LDSR may thus be preferable to PPPL for selected cases of T1-T2 carcinomas of the hypopharynx.View full abstractDownload PDF (1865K) -
Kengo Kaneko, Tomoko Shimanuki, Tugikazu Komoda, Yasuhiro Kase, Toshit ...2000 Volume 103 Issue 9 Pages 986-992
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSMost of the nitric oxide (NO) in expiratory air is produced by the nose and its accessory sinuses, and nasal allergies related to NO have been often reported. In the present study, we postulated that nosebleeds may be somehow related to reactive oxygen species. The expression of NO synthase (NOS) by the nasal mucosa was evaluated using the RT PCR method, and the concentration of NO in air expired through the nose was measured. The activity of superoxide dismutase, which scavenges superoxide anions, was also evaluated. The genetic expression of iNOS was observed in the nasal mucosa, and a significantly lower level of expression was noted in subjects with a nosebleed, compared to that of the controls. This result was interpreted as indicating a decrease in NO levels as a result of the nosebleed, leading to an elevation in blood pressure. Transient elevations in blood pressure caused by oxidative stress may lead to the rupture of nasal vessels if hypertension prexists. Serum levels of superoxide dismutase increased significantly in subjects with nosebleeds. This finding might be related to the activity of the superoxide anion, which is released in large amounts during nosebleeds. Serum superoxide dismutase levels increase in response to the high concentration of superoxide anions. The concentration of NO in air expired through the nose was significantly lower in subjects with nosebleeds, compared to that of the control subjects. We suggest that NO production decreases in subjects experiencing nosebleeds and that this reduction is induced by prexisting hypertension and injure from reactive oxygen species, contributing to the resulting nosebleed.View full abstractDownload PDF (1619K) -
Yohko Baba2000 Volume 103 Issue 9 Pages 993-1000
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSDegenerative changes in the morphology of the stapedius muscle caused by aging using a collection of human temporal bones obtained by our department. The diameter of the muscle fibers, the variance in muscle fiber diameter, the ratios of intermuscular connective tissue and muscle to the area of the bone niche for the stapedius muscle, the number of muscle fibers around the tendon, and the adipose cell count were measured for each temporal bone. In total, 80 temporal bones were examined, excluding specimens with facial nerve degeneration, degenerative diseases, middle ear disease and leukemia.
Between the ages of 38 fetal weeks and 9 years, the muscle fibers and thin and the variance in fiber diameter is small. The areas of intermuscular connective tissue, muscle and the number of muscle fibers around the tendon do not change between 38 fetal weeks and 60 years. All of the parameters measured showed no significant changes between the ages of 10 and 60 years. The variance in muscle fiber diameter began to increase in specimens aged 70 years or older because some of the muscle fibers had begun to atrophy. Adipose cells were sometimes observed in very old specimens.
In contrast to the tensor tympani muscle, in which degenerative changes begin during childhood, atrophic degeneration of the stapedius muscle as a result of aging begins at a very late age. The difference in aging between the stapedius muscle and the tensor tyrnpani muscle is probably related to evidence suggesting that the stapedius muscle contracts in response to acoustic stimulation.View full abstractDownload PDF (2985K) -
Tsutomu Nonoyama, Yuichi Majima, Shinobu Arima, Kazuhiko Takeuchi, Yas ...2000 Volume 103 Issue 9 Pages 1001-1006
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSEndoscopic sinus surgery is commonly used to treat chronic sinusitis. Subjects were 79 chronic sinusitis patients-50 men and 29 women aged 17 to 79 years (average: 50.6 years) undergoing endoscopic sinus surgery in our department from January 1993 to December 1997. Mean follow-up was 17.5 months. We evaluated preoperative staging of chronic sinusitis based on Kennedy staging. Most were stage 3. This type of staging was not effective in predicting nasal polyp relapse. We found that cases with diffuse polyposis and associated disease such as bronchial asthma or aspirin-induced asthma tended to experience a polyp relapse. Our results suggest that postoperative treatment is important in maintaining patency of the ostiomeatal complex, nasal polyp or edematous mucosa relapse must be treated early in on in occurrence.View full abstractDownload PDF (646K) -
An Indicator for Assessing the Therapeutic Effect of Chemosurgery Using Trichloroacetic AcidTatsutoshi Suzuki, Kazuo Yao, Makito Okamoto2000 Volume 103 Issue 9 Pages 1007-1014
Published: September 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSAn immunohistochemical study was conducted on the degree of tryptase-positive, chymase-negative mast cells (MCT) and tryptase-positive, chymase-positive mast cells (MCTC) infiltration in the inferior turbinates of 15 patients with perennial allergic rhinitis who underwent septal reconstruction and bilateral inferior turbinectomy 85±21 days after unilateral chemosurgical Creatment using trichloroacetic acid (TCA). In samples without TCA treatment, many MCTS were observed in the mucosal epithelium near the basement membrane, especially in the area where many goblet cells were found, and some MCTS were found around the glands and vessels in the subepithelial layer. Most MCTCS were found in the subepithelial layer, and some in the epithelial layer. On the TCA treated side, part of the epithelium disappeared, becoming squamatized epithelium in which MCTS were scarcely observed. Statistically, the number of mast cell on the side of TCA treatment was significantly less than on the non treated side in the epithelial layer. In treated subepithelium layer, both MCTS and MCTCS were significantly fewer than on the non-treated side.
These pathological findings suggest that TCA surgery has clinical potential to improve allergic rhinitis symptoms.View full abstractDownload PDF (2524K)
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