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Volume 108, Issue 1
Displaying 1-7 of 7 articles from this issue
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Masaru Aoyagi2005 Volume 108 Issue 1 Pages 1-7
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe important factors in the prognostic diagnosis of acute peripheral facial palsy are (1) the causal disease, (2) the site of injury and (3) the degree of injury, although the age of the patient, complication, treatment method and initial day of treatment are also important. Among these 3 factors, the degree of injury is most strongly related to the prognosis. However, the diagnosis of etiology is the most important for the selection of the treatment method. Above all, the differential diagnosis between Bell's palsy and zoster sine herpete (Ramsay Hunt syndrome), is the most significant. However, it is impossible to diagnose all patients with complete accuracy within 3 days after the onset of palsy, even using molecular biological examination including polymerase chain reaction analysis. The diagnosis of the site of injury does not contribute to the prediction of prognosis or the selection of treatment method, except for the determination of the approaching route of the facial nerve decompression for traumatic facial palsy.
The scoring system of facial movement (40-point method), nerve excitability test (NET), electroneurography (ENoG), transcranial magnetic stimulation (TMS) and stapedial reflex (SR) are commonly used to estimate the degree of injury. To estimate the accuracy of these examinations, sensitivity and specificity of the tests were calculated according to the findings within 3 days after the onset of palsy and the outcome of 116 patients with Bell's palsy and 31 with Ramsay Hunt syndrome. According to the results, none of these tests seem to be a perfect diagnostic examination for the completely precise prediction of prognosis. However, a patient is predicted to have a good prognosis, if the following 3 findings are observed: (1) more than 10 points in the 40-point scoring system of facial movement, (2) a positive response to TMS and (3) a positive response to SR An antidromic facial nerve response probably contributes to a precise prediction of prognosis within 3 days after the onset of facial palsy.View full abstractDownload PDF (4910K) -
Kan Kishibe, Shigeru Saitou, Yasuaki Harabuchi2005 Volume 108 Issue 1 Pages 8-14
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSNasal fracture is a common facial fracture. The diagnosis and evaluation of nasal fractures are commonly performed using X-ray and/or CT scans preoperatively and postoperatively. However, the diagnosis and intraoperative evaluation of nasal fractures using ultrasonography is not common. CT scans and ultrasonography studies were used to diagnosed twelve patients with nasal fractures, and ten patients were treated by closed reduction between November 2002 and February 2004.
Ultrasonography was used intraoperatively to confirm adequate bone restoration. The ultrasound examinations were performed using the conventional method, with the application of ultrasound gel. The ultrasonography results and the CT scan of the nasal bone were almost the same, and ultrasonography may be suitable and sufficient for the diagnosis of nasal fractures. Moreover, objective intraoperative evaluations can only be performed using ultrasonography. Thus, we believe that ultrasonography is a useful tool for the diagnosis of nasal fractures and the evaluation of medical treatment.View full abstractDownload PDF (6045K) -
Men-dar Wu, Masaru Kimura, Taeko Kusumi, Aiko Taguchi, Meiho Nakayama, ...2005 Volume 108 Issue 1 Pages 15-19
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWe developed a “Submucosal Ethanol/Steroid (E/S) Injection Method (SEIM)” using an injection prepared by dissolving steroid with powerful antiinflammatory effect, which has the excellent effect of contractile reduction in oral tissues.
In this clinical trial, the ablation effect of SEIM on the abnormally elongated uvula and the soft palate was examined in each one clinical case of obstructive sleep apnea syndrome (OSAS) and simple snoring.
In the OSAS, we found that the uvula was reduced from 15 to 10mm, the visual analog scale (VAS) of snoring was reduced from 10 to 4 points, and the respiration disturbance index of the apnea-hypopnea index (AHI) improved from 35.3 to 26.1 after treatment. In simple snoring, the uvula was reduced from 11 to 8.5mm and VAS was relieved from 7 to 2 points after treatment.
Our approach will produce a great clinical significance for not only OSAS or simple snoring but also treatment of the allergic rhinitis, etc, because the contractile tissue reduction can be attained safely in these diseases without open surgical wounds and unnecessary deformation or destruction of the mucosal structure.View full abstractDownload PDF (8203K) -
Takuro Kitamura, Masafumi Yoshida, Yasuo Morimoto, Koji Narui, Toru Ts ...2005 Volume 108 Issue 1 Pages 20-26
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSSleep apnea syndrome (SAS) is a risk factor in lifestyle-related disease known to be closely associated with traffic and occupational accidents. Because of its high morbidity in middle-aged men, early diagnosis and management by industrial physicians are important. We clarified the degree of knowledge and concern about SAS among industrial physicians.
We e-mailed questionnaires to 199 industrial physicians belonging to the Industrial Medical Promotion Society, and received responses from 51 (40 contracted and 11 part-time industrial physicians). Most answered that industrial physicians should participate in the management of SAS to prevent doze accidents, to control lifestyle-related diseases, to judge vocational fitness, and to lower economical expense. Fewer than 30% of physicians had conducted educational activities, and even fewer had practiced interviews and screening for SAS. Financial difficulty, lack of specialized hospitals for SAS, lack of labor, and a lack of concern among executives are major obstacles to SAS screening for employees.
We concluded that, despite the concern industrial physicians, SAS is practically disregarded in their work. Cost-and time-effective screening and guidelines for employees with SAS should be established to facilitate the management of SAS by industrial physicians.View full abstractDownload PDF (609K) -
Yoshihito Suda, Yutaka Hanamure, Fujihiko Kasano, Naoko Kashima2005 Volume 108 Issue 1 Pages 27-30
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSEctopic thyroid carcinomas in the submental portion arise usually from a thyroglossal duct cyst. We report a rare case of that lacking a thyroglossal duct cyst. The patient, a 32-year-old man, had two submental tumors with good mobility. CT, MRI, and US revealed two solid tumors. Fine needle aspiration cytology (FNAC) suggested thyroid papillary carcinoma metastasis. The thyroid gland itself showed normal morphology. The submental tumors were extirpated. Pathological examination revealed ectopic normal thyroid tissue and papillary carcinoma. As the edge of the extirpated tumor showed positive papillary carcinoma cells, reoperation was performed to remove the residual tumor using Sistrunk's technique. To the best of our knowledge, this is the 45th case of ectopic thyroid carcinoma with no thyroglossal duct cyst and second case of that in the submental portion in the English and Japanese literature. FNAC was the most important to diagnose and differentiate the submental tumors.View full abstractDownload PDF (2304K) -
Gen Sugita, [in Japanese], Masato Fujimori, [in Japanese], Katuhisa Ik ...2005 Volume 108 Issue 1 Pages 31-37
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSObject: Co-stimulatory molecules are important for cell-cell interactions between immune cells, not only for cell activation, but for suppression. Several new co-stimulatory molecules have recently been discovered, and in this study we used immuno-histological and -cytological methods to investigate the distribution of such molecules in the germinal center of human tonsils.
Materials and Methods: Tonsils surgically removed from patients with sleep apnea and habitual tonsillitis were examined. Expression of co-stimulatory molecules in immune cells was investigated immuno-histologically in frozen sections, and immuno-cytologically by flow cytometry.
Results: PD-L1 was found to be expressed on both GCDCs (germinal center dendritic cells) and FDCs (follicular dendritic cells). ICOS and PD-1 were expressed on activated CD4 T cells located in the light zone of the germinal centers. 4-1BB was expressed on the FDCs, in human tonsils, but not on activated T cells.
Conclusion: GCDCs and FDCs are likely to function not only T cell activation but in negative regulation of T cells through PD-L1 expression. ICOS molecules contributing to positive signals, and PD-1 to negative signals were simultaneously expressed on a subset of activated T cells, suggesting that signal balance between ICOS and PD-1 is important for T-cell fate.View full abstractDownload PDF (4670K) -
[in Japanese]2005 Volume 108 Issue 1 Pages 38-41
Published: January 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSDownload PDF (274K)
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