Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
Volume 104, Issue 11
Displaying 1-7 of 7 articles from this issue
  • Tadashi Kitahara, Noriaki Takeda, Suetaka Nishiike, Atsuhiko Uno, Mune ...
    2001Volume 104Issue 11 Pages 1059-1064
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    We studied 28 patients with vestibular neuronitis treated at our hospital between 1997 and 1999. To determine the effects of steroid therapy on long-term canal prognosis and daily activity, we examined caloric tests and gave questionnaires to 12 steroid-treated and 16 nonsteroid-treated patients 2 years after onset. We found that canal improvement was 50% in the nonsteroid-treated group and 75% in the steroid-treated one. In cases with severe canal paresis (CP≥60%), canal improvement was 33% in the nonsteroid-treated group and 67% in the steroidtreated one. Steroid therapy at the acute stage of this disease significantly reduced the duration of spontaneous nystagmus and handicap in daily life due to dizziness induced by head and body movement, decreasing mood disturbance.
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  • Miki Takahara, Nobuyuki Bandoh, Masanobu Imada, Tatsuya Hayashi, Satos ...
    2001Volume 104Issue 11 Pages 1065-1070
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    Treatment outcomes of tonsillectomy were studied in 7 Japanese patients with psoriasis-3 males and 4 females aged 9 to 46 years (median: 23years) -followed up 2 to 9 years after tonsillectomy. All skin lesions disappeared in 3 patients, 80% of those in 2, and no change in the remaining 2 during follow-up. Of 5 in whom skin lesions improved, 4 were females and had a history of tonsillitis making skin lesions worse. In quantitative immunohistologic analysis on tonsillar tissues by CD20 and anti-ssDNA antibodies, areas of T cell-nodules were significantly expanded, but those of the B-lymphoid follicles were smaller, and the number of apoptotic cells increased in tonsils from patients with psoriasis and PPP compared to those with recurrent tonsillitis. The area of T cell-nodules and the number of apoptosis cells were significantly larger in tonsils from 4 patients with complete recovery after tonsillectomy compared to the remaining 9 without complete recovery. This suggests that histologic evaluation may be helpful in estimating the effectiveness of tonsillectomy.
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  • Yasue Uchida, Minori Yasue, Kiyomitsu Asahi, Hiromi Ueda, Tsutomu Naka ...
    2001Volume 104Issue 11 Pages 1071-1077
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    We statistically studied patients who visited our hearing aid clinic to determine what segment of the population may benefit from hearing aids.
    Subjects were 200 patients from 5 to 89 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, Nagoya University Hospital, between January 1998 and March 2000. This clinic lent out hearing aids. Subjects were divided into 2 groups those having their own hearing aids either new or earlier (HA group) and those giving up hearing aids after a trial (non-HA group). Mean better hearing levels in pure tone average were 50.6 dB in the HA group and 44.5 dB in the non-HA group. Mean better maximum speech recognition scores were 81.5% in the HA group and 85.3% in the non-HA group. The distribution of better hearing has shown that patients with mild hearing loss (better pure tone average <40dB) account for more than a quarter of all hearing aid clinic patients. Among patients with mild hearing loss, 60% had their own hearing aids. The need for rehabilitation in the mild hearing loss population thus appears large.
    Their intent to wear hearing aids influenced whether patients agreed or declined hearing aids after a trial. The period from use until patients made a decision was 2 weeks in 65 % of those declining use and 35 % of those agreeing to use. Over 15 % of those agreeing called for a trial period longer than 8 weeks.
    Hearing aid trials provide useful information for both patients and surgeons before choosing surgery for a difficult ear condition. In this research, 18 patients needed counseling about both amplification and surgery. Bridging between ear surgery and hearing aid wearing is a vital role of hearing aid clinics at university hospitals.
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  • Yuzuru Abiko, Minoru Ikeda, Ryo Hondo
    2001Volume 104Issue 11 Pages 1078-1088
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    Herpes simplex virus (HSV) involvement has been clarified as the cause of Bell's palsy by molecular biological techniques. To clarify the direct relationship between virus reactivation and paralysis development, both detection of the virus genome by DNA-diagnostic and quantitative analysis of its time-course change are needed. Using polimerase chain reaction (PCR) method and microplate-hybridization combined, we detected the virus genome in small amount of specimens from patients with Bell's palsy, quantified its number of copies, and examined timecourse changes. We attempted to type of HSV in positive specimens. Subjects were 16 patients with Bell's palsy positive for serum anti-HSV IgG antibody (enzyme immunoassay) who visited the outpatient clinic of Department of Otorhinolaryngology, Itabashi Hospital, Nihon University School of Medicine, within 14 days after onset without having any treatment. Tears and saliva from the parotid gland and the submaxillary gland were separately collected from the affected side and healthy side twice or more. A total of 244 specimens was subjected to DNA extraction, PCR, and microplate-hybridization, and HSV DNA was detected in 38 specimens (11.8%) from 5 patients (31%). From sampling time, the highest detection (28.5%) was obtained within 2 weeks after onset. Detection at 3 weeks and later (2.8%) was significantly lower (p<0.05). DNA was also found on the healthy side, but in comparison between sides, detection on the healthy side (18.9%) was significantly lower than that on the affected side (83.8%) (p<0.01). In quantitative determination of the virus genome, the amount (number of copies) was large on the affected side and largest early after onset regardless of the clinical course. Positive specimens underwent HSV-typing, and HSV-1 was found in all of them, suggesting that HSV-1 reactivation is a cause of Bell's palsy.
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  • Tatsuya Fukuiwa, Masato Ushikai, Ikuyo Miyanohara, Shoji Matsune, Yuic ...
    2001Volume 104Issue 11 Pages 1089-1092
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    Penicillin-resistant Streptococcus pneumoniae (PRSP) is a frequently detected pathogen of intractable acute otitis media and is associated with prolonged or recurrent infection. The use of antibiotics has made the incidence of secondary acute mastoiditis following acute otitis media relatively rare, but when it does occur, its severe complications may be life-threatening. We report a case of pediatric recurrent acute mastoiditis caused by PRSP in a 6-year-old boy suffering from PRSP acute mastoiditis on 4 occasions, twice undergoing simple mastoidectomy. Although we initially suspected PRSP to be the chief factor in iterative infection, immunological analysis demonstrated significantly decreased IgG and IgA antibodies in serum and the patient was diagnosed as having common variable immunodeficiency (CVID). As the first middle ear infection occurred at the age of 6 and there was no history of upper respiratory tract infection, CVID may be the main pathological factor of recurrent mastoiditis, although infection occurred only in the ear and did not involve other organs. This suggests that recurrent mastoiditis in the present case involved the coexistence of PRSP and CVID.
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  • Histopathological Assessment by Optical and Electron Microscopic Observation of Biopsy Specimens of Tonsils
    Nobuaki TANAKA
    2001Volume 104Issue 11 Pages 1093-1102_2
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
    Infection with HSV or EBV was studied by measuring serum antiviral antibody titers in adults with acute tonsillitis, and results were compared to light and electron microscopy findings of tonsil biopsy specimens. The clinical and laboratory features of acute tonsillitis caused by HSV or EBV were also studied. Subjiects were 42 patients with acute tonsillitis treated at the Department of Otorhinolaryngology at Tokyo Women's Medical University Daini Hospital between August 1997 and March 2000. They had failed to respond to antimicrobial agents prescribed by a physician, and had severe oropharyngeal mucosal lesions, liver dysfunction, skin eruptions, or cervical lymphadenopathy, with hospitalization required because of impaired food intake due to sore throat or deterioration in general condition. Subjects were 24 men (mean age: 30.8 years) and 18 women (mean age: 28.3 years) aged 16 to 78 years (mean: 29.8 years). A underwent, bacteriological and hematology tests and palatine tonsil biopsy specimens were obtained to examine tissue changes by light microscopy and electron microscopy due to detect HSV antigen by immunohistochemistry and EBV nucleic acids by EBV-encoded small nuclear RNA 1 and 2 (EBER) in situ hybridization (ISH). Among patients, the serum antiviral antibody profile indicated that 4 (9.5%) had acute tonsillitis due to primary HSV infection and 5 (11.9%) had acute tonsillitis due to primary EBV infection.
    The findings characteristic of acute tonsillitis due to primary HSV infection included stomatitis, skin eruptions, atypical lymphocytes, and liver dysfunction. Findings characteristic of acute tonsillitis due to primary EBV infection included petechiae of the soft palate, an increase of lymphocytes, atypical lymphocytes, and liver dysfunction.
    At the initial test, serum anti-HSV antibody was positive in 14 patients (33.3%), and more than half had no history of prior infection. Anti-EBNA antibody was positive in 32 (76.2%), and many had been infected previously. It should be noted that a decrease in positive HSV antibody means that acute tonsillitis due to primary HSV infection is not uncommon in adults and is expected to increase steadily.
    Light microscopy revealed histological changes in 2 patients. HSV antigen was positive in 2 (50%) with acute tonsillitis due to primary HSV infection, while EBER cells were positive in 5 (100%) with acute tonsillitis due to primary EBV infection, so special staining of the tissues was found to be useful. Electron microscopy failed to detect viral particles in ultrathin sections and no differences were seen in morphological changes or tissue damage between patients with positivity for HSV antigen and with EBER-positive cells. Detection of HSV antigen and EBV nucleic acids in pathological specimens from patients with acute tonsillitis requires careful judgment, but is considered useful for making an early diagnosis and for making a diagnosis in patients without an increase of the antiviral antibody titer and in those with reinfection or reactivation. Pathological examination (including special staining) and careful observation of clinical features may help to identify HSV or EBV infection and allow decisions to be made with regard to the therapeutic strategy and prevention of complications.
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  • [in Japanese], [in Japanese]
    2001Volume 104Issue 11 Pages 1104-1107
    Published: November 20, 2001
    Released on J-STAGE: October 22, 2010
    JOURNAL FREE ACCESS
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