Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 110, Issue 2
Displaying 1-5 of 5 articles from this issue
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Review article
Original article
  • Therapeutic Effects and Prognostic Factors in Tonsillectomy Patients with IgA Nephropathy
    Takashi Goto, Nobuyuki Bandoh, Tomoki Yoshizaki, Miki Takahara, Satosh ...
    2007 Volume 110 Issue 2 Pages 53-59
    Published: February 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.53
    JOURNAL FREE ACCESS
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    Introduction : Because upper respiratory tract infections, particularly tonsillitis, often precede IgA nephropathy (IgAN), IgAN is now recognized as a tonsil-related disease, and reports have shown that tonsillectomy is effective in preventing disease progression in IgAN patients. IgA may thus play an important role in IgAN pathogenesis and development. B cell activation factor belonging to the TNF family (BAFF) is expressed by monocytes, macrophages, and dendritic cells, and may be the mechanism by which macrophages and dendritic cells directly regulate human B-cell activation. BAFF acts as a potent B-cell growth factor and costimulator of immunoglobulin production, including IgA. We studied therapeutic effects and serum BAFF levels as prognostic factors.
    Patients and Methods : Subjects were 41 patients undergoing tonsillectomy and followed up for at least 1 year. Serum samples were obtained from 38 with IgAN and 29 with recurrent tonsillitis as a properative control groups. The remission group consisted of patients with normal renal function without hematuria and proteinuria. Serum BAFF levels were measured by ELISA kits at our laboratory.
    Results : Overall remission was 39.0%. The disappearance of hematuria increased for long-term follow-up groups, but proteinuria was unchanged. Serum BAFF levels among the two groups did not differ significantly. Among IgAN patients, higher BAFF levels were associated with higher serum IgA/C3 levels. The correlation was weak (p=0.026, r=0.407). Using 3.2 ng/ml as a cut off point, we compared cumulative improvement in those with high pretreatment BAFF levels to those with low pretreatment levels. Those with high pretreatment BAFF levels had inferior cumulative improvement in hematuria.
    Conclusion : Tonsillectomy was effective in improving hematuria. BAFF appears to be a key factor in tonsillectomy among IgAN patients.
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  • Clinical Evaluation of Patients with Vocal Cord Palsy
    —Rate and Timing of Phonation Recovery by Disease Differences—
    Katsuro Sato, Hiroko Sato, Yutaka Yamamoto, Osamu Hayasaka, Sugata Tak ...
    2007 Volume 110 Issue 2 Pages 60-64
    Published: February 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.60
    JOURNAL FREE ACCESS
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    Vocal cord palsy (VCP) is common in otolaryngological clinics, as are postoperative patients with VCP at general and university hospitals. Although VCP treatment strategies have been discussed, decisions on treatment methods and timing are complicated by the spontaneous recovery exhibited by some patients. We studied clinical features of VCP patients and their histories. Subjects were 171 VCP patients seen at our phonation clinic during a 15-year period-18% of all phonation clinic cases. By gender, 69% were male and 31% were female, ranging in age from 4 to 89 (mean, 58) years. Some 18% were bilateral and 82% unilateral, with 71% of unilateral cases on the left. Postoperative VCP occurred in 59% of patients in common surgical procedures for esophageal and thyroid tumors. During follow-up, 58% spontaneously recovered phonation. Postintubation VCP had the best recovery at 82%. Half with phonation recovery had spontaneous recovery from VCP and the other half had compensation. Most VCP resolved within 1 year, but compensation occurred after 1 year, meaning that in treatment planning and explanation, to VCP should be considered curable within 1 year and compensation attained 1 year after VCP.
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  • Effect of Ejnell's Laterofixation of the Vocal Fold for Bilateral Fixation at the Median Position
    Satoru Miyamaru, Ryosei Minoda, Eiji Yumoto
    2007 Volume 110 Issue 2 Pages 65-70
    Published: February 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.65
    JOURNAL FREE ACCESS
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    We reviewed the effect of Ejnell's laterofixation of the vocal fold for bilateral fixation at the median position. Subjects were 10 patients undergoing bilateral vocal fold fixation at the median position from October 1998 to September 2005. We evaluated outcome using indices of FEV1.0/PEFR (ml/L/min) and PEFR (%), which reflect the severity of upper airway obstruction and whether tracheostoma could be closed if tracheostomy preceded Ejnell's procedure. Mean FEV1.0/PEFR and PEFR in 5 patients undergoing breathing capacity examination before and after surgery improved from 13.21 to 9.85 and 30.9 to 51.9, respectively. Six of the 8 undergoing tracheostomy prior to Ejnell's procedure tolerated decannulation. Another 2 whose tracheostoma could not be closed had complications, one having COPD and the other poorly controllable diabetes mellitus, with swollen false vocal fold and arytenoids and granulation.
    Our results suggest that Ejnell's laterofixation of the vocal fold is effective in treating bilateral vocal fold fixation at the median position. A patient's complications should, however, be taken into consideration before proceeding to Ejnell's laterofixation.
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Educational lecture
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