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Volume 106, Issue 6
Displaying 1-6 of 6 articles from this issue
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Aki Nakamura, Hiroyoshi Iguchi, Masahiro Takayama, Makoto Kusuki, Kish ...2003 Volume 106 Issue 6 Pages 671-677
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSEncountering a metastatic carcinoma of the neck from an unknown primary site is not unusual, despite intensive examinations of the entire body. In previous reports, the pathological diagnosis of these carcinomas was usually squamous cell carcinomas and rarely adenocarcinoma.
We treated eight patients with metastatic carcinoma of the neck from unknown primary sites, including 4 cases of squamous cell carcinoma, 2 cases of adenocarcinoma, one case of small cell carcinoma, and one case of clear cell carcinoma. during a 10-year period from January 1992 to December 2001. We clinically examined these eight cases, and focusing on the two cases of metastatic cervical adenocarcinoma from unknown primary sites.
The 8 cases consisted of 5 cases of N2 and 3 cases of N3 disease. Three of the 5 N2 patients underwent a neck dissection. but all three of the N3 cases were judged to be inoperable. Disease-free survival was achieved in all 3 patients who underwent surgery.
In this paper, we review 36 reports on metastatic carcinomas of the neck from unknown primary sites and statistically analyze 1454 cases. Pathologically, the majority of them (81.1%) were squamous cell carcinoma; adenocarcinomas accounted for only 7.6% of the cases. Notably, 65.0%, of the patients with cervical metastatic adenocarcinomas were confirmed to have primary lesions outside the head and neck region.
The prognosis of primary unknown metastatic cervical adenocarcinoma is reportedly poor, and the optimal treatment is still unclar, although surgery is recommended for primary unknown metastatic cervical squamous cell carcinoma. However, we suggest that intensive treatment, including surgery, radiotherapy, and chemotherapy, of metastatic lesions of the neck may plav a kev role in improving patient prognosis.View full abstractDownload PDF (1298K) -
Isao Wada, Yasuhiro Kase, Toshitaka Iinuma2003 Volume 106 Issue 6 Pages 678-684
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSAlthough aural foreign bodies are very frequently seen in daily practice, few reports systematicically analyze a large case population.
We report 509 cases seen at our clinic during the 16 years from January 1986 to December 2001. All were clinically confirmed during the same period among a total of 68, 579 new visitors and cases with aural foreign bodies accounted for 0.74%. Cases seen during routine outpatient clinic hours were 161 (31.6%), and others seen in emergencies were 348 (68.4%).
Among these were 307 men (60.3%) and 202 women (39.7).
The right side involved 251 (49.3%), the left side 241 (47.3%), and bilateral 4 (0.8%).
Monthly distribution showed an average of 42.4 cases a month, peaking during the months of July and August, when temperatures are highest.
Age distribution showed an average of 25.4 years old, ranging from 1 month to 90 years of age. Those under 9 years numbered 18.2 (35.8%) and were the peak incidence by age.
In classification by organic and inorganic, organic materials accounted for 206 (40.5%) and inorganic for 288 (56.6%). Organic materials appeared to he related to monthly distribution, i. e. more cases in hot months.View full abstractDownload PDF (553K) -
Hiroshi Ogawa2003 Volume 106 Issue 6 Pages 685-691
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSResolution of negative middle ear pressure is important in treating otitis media with effusion (OME). We treated 34 children and 21 adults with OME by autoinflation using a nose tube and balloon in the 16 months from June 2001 to September 2002. Of these, 7 children and 5 adults had been treated for 3 years or longer, and had had grommets inserted.
In 49 ears of 27 early cases of children, 34 ears (69%) improved in tympanometric findings converting to type A from type B, C. and C., and 9 ears (18%) of type B converted to type C1. In 23 cars of 16 early cases of adults, 12 ears (52%) improved converting to type A from type B, C_??_, C_??_. and C1, and 3 cars (13%) to type C1 from type B. However, 4 ears of 4 children and 5 ears of 5 adults did not recover by autoinflation.
In 7 children with prolonged OME in whom grommets had been inserted, 5 recovered due to autoinflation, whereas only one of 5 adults recovered. Of 6 patients who had not recovered, 2 were associated with asthma and nasal polyposis and eosinophils infiltrated into the middle ear effusion. In other 2 patients, even when the middle ear effusion disappeared by grommets insertion, they had still dysfunction of the Eustachian tubes confirmed by sonotubometric examination. It seems no beneficial effects of autoinflation were maintained if patients had tubal dysfunction due to intensive inflammatory changes of the middle ear and tubal mucosa or other unknown origin. Two patients used the device irregularly and rarely.
There is a theoretical risk associated with this maneuver of causing baroinjury and forcing infected nasopharyngeal secretions into the middle ear, but we found no complications.View full abstractDownload PDF (1304K) -
Roles of Beta-catenin Overexpression and Adenomatous Polyposis Coli Mutation in Head and Neck CancerShin Takei, Yumi Ueno, Junichi Yoda, Shinji Tamura, Muneki Hotom, Keij ...2003 Volume 106 Issue 6 Pages 692-699
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSBeta-catenin is an undercoat protein of cadherin, a cellular adhesion molecule. Beta-catenin also functions as a transcriptional activator downstream of the Wnt signaling pathway. Intracellular beta-catenin is regulated by the formation of a complex with APC (adenomatous polyposis coli) protein. The activation of this pathway by stabilization with beta-catenin has been shown to be an important step in the development of colorectal carcinoma, which is mainly caused by inactivating mutations in the APC tumor suppressor gene or by activating mutations in exon 3 of the beta-catenin gene.
This study was conducted to clarify the contribution of beta-catenin accumulation and the mutation of the beta-catenin gene to the carcinogenesis of head and neck cancer. Beta-catenin accumulation was examined immunohistochemically in 49 frozen or formalin-fixed, paraffin-embedded samples of head and neck tumors. We also performed a direct sequence analysis of APC and beta-catenin to examine the cause of beta-catenin accumulation. Genomic DNA was extracted and purified from fresh tissue samples of head and neck cancers. We examined the APC mutation cluster region in 15 samples and analyzed beta-catenin exon 3 mutations in 31 cases.
Twelve out of 49 (24.5%) cases exhibited beta-catenin accumulation in our histochemical study, The 5 year survival rate was 0% in the beta-catenin accumulation group, compared to 50% in the non-acrumulation group, (p<0.01), This finding strongly suggests that beta-catenin may play an important role in the carcinogenesis or progression of head and neck cancer.
One of the 15 cases exhibited an APC missense mutation that led to the replacement of amino acids; this case died in 12 months Regarding the beta-catein mutation, non of the 31 samples exhibited a gene mutation in beta-catenin exon 3. Thus. the rate of APC and beta-catenin mutation in head and neck cancer may be very low.View full abstractDownload PDF (1365K) -
Hiroshi Hoshikawa, Rieko Goto, Masayuki Karaki, Kazunori Miyabe, Nozom ...2003 Volume 106 Issue 6 Pages 700-704
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSSubjects were 51 patients undergoing folded pharyngeal flap surgery for velopharyngeal incompetence at the Department of Otolaryngology of Kagawa Medical University between August 1985 and July 2001.
Causal diseases were cleft palate in 27 (53%), submucous cleft palate in 8 (16%), and congenital velopharyngeal incompetence in 16 (31%). In history, 31% with congenital velopharyngeal incompetence, 25% with submucous cleft palate, and 11%, with cleft palate had congenital abnormalities. In addition, 56% with congenital velopharyngeal incompetence, 38%, with submucous cleft palate, and 15% with cleft palate had mental retardation, indicating that it occurred with high frequency in patients with congenital velopharyngeal incompetence.
The postoperative improvement of nasality was investigated in 48 patients whose progress could be observed for more than 1 year. Of 39 preoperatively diagnosed with advanced velopharyngeal dysfunction, 34 (87%) showed improved nasality. Of 9 with preoperatively slight deficiency, 8 (89%) improved nasality. The blowing test showed no difference in results between patients who had advanced and slight deficiency. Articulation on speech level improved to be normal in 78% of patients with slight deficiency, but only in 46% of those with advanced deficiency. Improvement of articulation on a speech level was high (86%) in patients with submucous cleft palate, but low in patients with congenital velopharyngeal incompetenec who had mental retardation. Further study is required to detail postoperative prognosis factors.View full abstractDownload PDF (589K) -
Hideaki Shirasaki, Shin-ichirou Narita, Kazumasa Watanabe, Etsuko Kana ...2003 Volume 106 Issue 6 Pages 705-709
Published: June 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSOccurrence of airborne pollen in Sapporo was studied for the 8 years between 1995 and 2002. Observations on pollen seasons of cedar. birch, grass, and mugwort are presented. There are wide year-to-year variations in quantities of birch pollens. Simple linear regression by the least squares method was used for studying correlations between annual quantities of birch pollen and the meteorological factors. A highly significant (P=0.00004) positive correlation was found between precipitation in February of the preceding year and annual birch pollen concentrations with the coefficient of determination. R2=0.950. These results suggest that atmospheric birch pollen counts can be predicted from the meteorological factor in the preceding year.View full abstractDownload PDF (499K)
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