All issues
Volume 106, Issue 8
Displaying 1-6 of 6 articles from this issue
- |<
- <
- 1
- >
- >|
-
[in Japanese]2003 Volume 106 Issue 8 Pages 793-796
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESS -
Masahiro Kikuchi, Etsuo Yamamoto, Shogo Shinohara, Yousaku Shiomi, Kei ...2003 Volume 106 Issue 8 Pages 797-807
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSWe conducted a retrospective study to identify the clinical features and surgical observations of congenital cholesteatoma. Sixty patients were diagnosed and underwent surgery for congenital cholesteatoma between April 1987 and May 2002. All diagnoses were made on the basis of two operative findings: 1 the tympanic membrane manifested neither retraction, perforation, nor granulation. 2. the tympanic membrane was not continuous with the cholesteatoma. In this series, congenital cholesteatoma accounted for 7% of all cholesteatomas (853 ears). The patient age ranged from 2 to 48 years. The male to female ratio was 4:1. Seventeen patients had multiple cholesteatoma. Fifty-three patients exhibited closed-type cholesteatomas. while the remaining 7 patients had open-type cholesteatomas that had formed as a flat surface of the epidermis. Patients with open-type cholesteatomas presented with a much more pronounced conductive hearing loss and ossicular erosion or malformation. Twenty-two patients with relatively small cholesteatomas were analyzed to estimate the origin of their cholesteatomas. Of the 22 patients, 13 had anterior superior quadrant (ASQ-type) and 9 had posterior superior quadrant (PSQ-type) cholesteatomas. The mean age at the time of detection was older in the PSQ-type group than in the ASQ-type group and the frequency of ossicular erosion or malformation was more prominent in the PSQ-type group than in the ASQ-type group. The primary site of origin was thought to be the portion between the tympanic ostium of the auditory canal and the semicanal for tensor tympani in the ASQ-type group and near the incudostapedial joint in the PSQ-type group. A planned staged procedure was performed in 29 patients, 15 patients (52%) had residual lesions situated mostly on the oval window, the round window, an exposed facial nerve or an exposed lateral semicircular canal. The frequency of residual lesions in patients who presented with extended, multiple cholesteatoma and those with ossicular malformation was comparable to the frequency of patients who did not present with these features.View full abstractDownload PDF (1619K) -
Kiminori Sato, Hirohito Unieno, Tadashi Nakashima2003 Volume 106 Issue 8 Pages 808-814
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSInjection laryngoplasty is done based on the pathologic condition of the larynx. Autologous fat was harvested and endolaryngeal microsurgery conducted for injection laryngoplasty under general anesthesia.
For glottic incompetence caused by bilateral atrophy of vocal fold mucosa lamina propria, autologous fat was injected into vocal fold mucosa and into the muscle just below mucosa. For glottic incompetence with a unilateral midcord gap caused by unilateral atrophy of the vocalic muscle, fat was injected into the thyroarytenoid muscle at the membranous portion of the vocal fold. In a patient with a unilateral midcord gap and a large posterior gap, autologous fat was injected into the thyroarytenoid muscle lateral to the oblong fovea of the arytenoid cartilage to arytenoid adduction.
For glottic incompetence with a unilateral midcord gap and a large posterior gap, consequently afflicted with voice disorder and aspiration, fat was injected into the vocal fold, false vocal fold, aryepiglottic fold of the larynx, and the medial wall of the piriforrn sinus of the hypopharynx. Lipoinjection into the vocal fold, false vocal fold, and aryepiglottic fold enabled laryngeal closure. Lipoinjection into the piriform sinus lowered its capacity and residual food was reduced and pharyngeal clearance on the affected side was improved.
The injected portion and the amount of injected material should be modified at injection laryngoplasty based on the pathologic condition of the larynx.View full abstractDownload PDF (1936K) -
Masayoshi Kobayashi, Hiroshi Sakaida, Atsushi Yuta, Kazuhiko Takeuchi, ...2003 Volume 106 Issue 8 Pages 815-822
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSWe retrospectively analyzed 72 children suffering from respiratory disturbance during sleep at Mie University Hospital for sleep study or surgical treatment from 1992 to 2001. Their clinical symptoms included snoring (100% of 72 inpatients), sleep apnea (60%), mouth breathing (44%), and nasal obstruction (30%). Forty-seven reported sleep apnea and 28 (60% of total) corresponded to criteria for the sleep apena syndrome (apnea index: Al_??_5.0). Thesse symptoms were caused by adenoid vegetation and/or hypertrophy of the palatine tonsils. No significant correlation was seen among size of the adenoid, that of the palatine tonsil, body mass index, Al, and blood oxygen saturation (SpO2) during sleep. Surgical treatment with adenotomy and/or tonsillectomy was performed in 66 patients. After treatment, clinical symptoms diminished within a week, and Al and SpO2 during sleep improved significantly. Recurrence of snoring was observed 19, 23, and 21% of patients 1.3, and 5 years after treatment. Sleep apnea recurred in only 1 patient 7 years after adenotomy. seventy-five percent of children who had the clinical symptoms 1 month after treatment have shown the same symptoms continuously for a long time. In conclusion, surgical treatment for children's respiratory disturbance during sleep is effective and involves a low rate of symptom recurrence.View full abstractDownload PDF (773K) -
Kunitaka Shirasaka, Hiroshi Morikawa2003 Volume 106 Issue 8 Pages 823-830
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSCD80 and CD86, which are costimulatory molecules in T-cell activation, play important roles in the differentiation of Th1- or Th2-phenotypes. The results of blocking studies using neutralizing antibodies have suggested that CD80 and CD86 also play important roles in sensitization to cedar pollen antigen, but very few studies have examined the kinetics of CD80 and CD86 expression on antigen-presenting cells (APC).
We studied the kinetics of CD80 and CD86 expression on APC after allergen-stimulation in cedar pollinosis subjects.
A skin-prick test was performed in nine subjects with pollinosis and seven control subjects. Peripheral blood mononuclear cells (PBMC) were isolated and stimulated with Japanese cedar pollen extract. Zero to 8 days following in vitro stimulation, the expression of CD80 and CD86 in either CD14_??_ or CD19_??_ cells was analyzed by two-color flow cytometry. The expression of CD28, CTLA-4 and CD40L on CD4+ cells was analyzed by two-color flow cytometry after elinminating either CD14+ or CD19+ cells.
After in vitro stimulation, the expression of both CD80 and CD86 was significantly upregulated in pollinosis subjects compared to control subjects. However, the difference was observed in the kinetics of CD80 and CD86 expression following allergen stimulation. The expression of CD86 was upregulated earlier than that of CD80 after in vitro stimulation. In the absence of CD19_??_ cells, the expression of CD28, CTLA-4, and CD4OL in CD4_??_ cells was significantly lower than that in the absence of CD14_??_ cells.
These results indicate that CD19+ cells of pollinosis subjects expressed higher CD80 and CD86 than that of control subjects, and that the kinetics of CD80 and CD86 expression following stimulation differed. In pollinosis subjects, CD19_??_ cells may thus function as APC in allergen-induced activation of PBMC.View full abstractDownload PDF (1607K) -
Takeshi Beppu, Shin-etsu Kamata, Kazuyoshi Kawabata, Tomohiko Nigauri, ...2003 Volume 106 Issue 8 Pages 831-837
Published: August 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe indication and preferred dissection field for prophylactic neck dissection for submandibular gland cancer are controversial and have not been standardized. We reviewed 27 patients who underwent a definitive operation for previously untreated submandibular gland cancer. The 27 patients consisted of 13 patients with adenoid cystic carcinoma, 6 patients with mucoepidermoid carcinoma, 6 patients with adenocarcinoma, and 2 patients with squamous cell carcinoma. The diagnostic accuracies of malignancy and histology with fine needle aspiration cytology were 86% and 56%, respectively. In sixteen out of 21 cases without neck lymph node metastasis, a prophylactic neck dissection was performed and pathological neck lymph node metastases were detected in five cases. On the other hand, in five cases that did not receive a prophylactic neck dissection, latent neck lymph node metastasis was observed in 2 cases. In both cases of neck lymph node metastasis, pathological positive lymph nodes were observed in only level 2 or level 3. The rates of occult neck lymph node metastasis according to the T stage were 0% in TI, 33.3% in T2, 57.1% in T3 and 100% in T4. The rates of occult neck lymph node metastasis according to the histopathology were 46.2% in adenoid cystic carcinoma, 50% in mucoepidermoid carcinoma. 50% in adenocarcinoma, and 50% in squamous cell carcinoma. In conclusion, we believe that supraomohyoid neck dissection is suitable fur NO cases of submandibular gland cancer because of four reasons : 1) rate of occult neck lymph node metastasis in submandibular gland cancer is high, 2) pathological neck lymph node metastasis in No cases and latent neck lymph node metastasis were observed in level 2 and level 3, 3) the prognosis of cases with neck lymph node metastasis was poor, and 4) same skin incision can be used not only for the primary resection but also for the neck dissection.View full abstractDownload PDF (741K)
- |<
- <
- 1
- >
- >|