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Volume 110, Issue 7
Displaying 1-5 of 5 articles from this issue
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Original article
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Madoka K Furukawa, Akira Kubota, Hideaki Hanamura, Masaki Furukawa2007 Volume 110 Issue 7 Pages 503-505
Published: July 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSReal-time tissue elastography (elastography) is a new ultrasonography procedure that display tissue elasticity. We evaluated the usefulness of elastography in the diagnosis of cervical lymph node metastasis and its treatment results in patients with head and neck cancer.
Metastatic lymph nodes tended to produce little distortion when displayed as hard tumors, and produced distortion, displayed as soft tumors, after radiation therapy and/or chemotherapy.
Elastography thus is useful as a potential new diagnostic procedure in the diagnosis of neck lymph node metastasis in head and neck cancer.View full abstractDownload PDF (2444K) -
Takamasa Tagawa, Toshiki Tomita, Hiroshi Yamaguchi, Hiroyuki Ozawa, Ko ...2007 Volume 110 Issue 7 Pages 506-512
Published: July 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSFrom 1989 to 2005, 28 patients—20 men and 8 women—with cervical lymph node metastasis from an unknown primary carcinoma were treated and studied retrospectively. In histological diagnosis, open biopsy was conducted in 11 patients and non-open biopsy (FNA or frozen section diagnosis during surgery) in 17. Blind biopsy under general anesthesia was conducted in 10 patients, showing one primary tumor in the nasopharynx. Tonsillectomy for diagnosis was not done. In region of maximum-size lymph node metastasis, the upper cervical region accounted for 22 cases (79%). The N stage of cervical lymph nodes was as follows : N2a in 4, N2b in 14, N2c in 3, and N3 in 7. The histopathological diagnosis of cervical lymph node was as follows : squamous cell carcinoma in 21, adenocarcinoma in 3, mucoepidermoid carcinoma in 2, and others in 2. Therapy was as follows : only neck dissection in 7, neck dissection with postoperative radiation therapy in 13, and irradiation and chemotherapy in 8. All patients treated with irradiation and chemotherapy had been judged to be inoperable. Seven patients were found to have a subsequent primary tumor. Primary tumor sites were as follows : tonsils in 3 and upper gingiva, base of tongue, lung, and nasopharynx in 1 each. FDG-PET was conducted in 7 patients but revealed no primary tumor. Overall 5-year survival in this study was 46%. We should pay particular attention to the tonsils for detecting primary tumors in patients with cervical metastasis from an unknown primary carcinoma.View full abstractDownload PDF (632K) -
Eiichi Ishida, Yukio Katori, Kenichi Watanabe, Hisaichi Yano, Hidetosh ...2007 Volume 110 Issue 7 Pages 513-519
Published: July 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSAcute epiglottitis causes sudden upper airway obstruction that may become lethal, and must be diagnosed and treated quickly and precisely. We review clinical features of 71 cases of acute epiglottitis in 6 years, focusing in cases requiring emergency airway management. Retrospective analysis was done for 1) age and gender, 2) month of onset, 3) symptoms, 4) smoking history, 5) diabetes history, 6) cause and background, 7) first medical institution visit, 8) duration from symptom onset to hospital visit, 9) oropharyngeal findings, 10) laryngendoscopic findings, 11) pharyngeal culture, and 12) deterioration after hospitalization.
We found that 2 cases deteriorated in laryngendoscopic findings after hospitalization despite treatment. Even if the first medical findings are mild, it is necessary to respond to patients with the possibility to deterioration in mind. Five cases required emergency airway management—3 with tracheostomy and 2 cases with endotracheal intubation. If symptoms of laryngeal edema, oxygen desaturation, and dyspnea are present, emergency airway management should be prepared soon after hospitalization.View full abstractDownload PDF (2650K) -
Shun-ichi Imamura, Hideyuki Honda, Masanori Miyata, Akihito Mizukoshi, ...2007 Volume 110 Issue 7 Pages 520-526
Published: July 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSRecently, acute low-tone senseorineural hearing loss (ALHL) has become common, and its good prognosis is known well. On the other hand, several reports have suggested that ALHL is frequently associated with Meniere's disease. We retrospectively examined the clinical course of 357 cases that were diagnosed and treated as ALHL at our hospitals. Forty-four of these cases that showed high-tone hearing loss in association with age-related changes were classified as atypical cases.
The clinical futures of 49 “poor prognosis cases”, who experienced recurrent hearing loss and/or profound hearing loss, are reported. Eight of the 49 cases who experienced recurrences had progressive hearing loss upto middle or high tones.
Seventeen cases complained of vertiginous sensation, and 8 of these cases experienced recurrent attacks of vertigo and were diagnosed as having Meniere's disease. The former seventeen cases accounted for 34.7% of the “poor prognosis cases”, and the latter eight accounted for 16.3% of these cases. Our results suggest that the hearing loss is more frequently associated with Meniere's disease in cases who experience recurrent hearing loss.
Thus, cases initially diagnosed as ALHL may include some cases of progressive hearing loss and Meniere's disease. Even in cases in which hearing improvement is obtained, careful clinical observation is necessary, especially in older patients with bilateral affliction and atypical presentation.
ALHL has been generally considered to have a good prognosis, however our examination revealed a relatively high frequency of recurrences, progressive hearing loss and complication by vertigo. We recommend, based on this evidence, that careful explanation of this disease is necessary at time of initial informed consent.View full abstractDownload PDF (2169K)
Educational lecture
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[in Japanese]2007 Volume 110 Issue 7 Pages 534-537
Published: July 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSDownload PDF (2209K)
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