Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 116, Issue 5
Displaying 1-17 of 17 articles from this issue
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Review article
Original article
  • A Clinical Study on 8 Cases of Sarcoidosis with a Cervical Mass as a Symptom
    Yusuke Mada, Fumie Ihara, Yuji Ueki, Akiyoshi Konno
    2013 Volume 116 Issue 5 Pages 592-599
    Published: May 20, 2013
    Released on J-STAGE: August 21, 2013
    DOIhttps://doi.org/10.3950/jibiinkoka.116.592
    JOURNAL FREE ACCESS
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    Sarcoidosis is a multiorgan granulomatous disease of unknown origin, which frequently involves the lung and the eyes. It is rare that sarcoidosis causes cervical lymphadenopathy and a chronic continuous salivary gland swelling. In the present study, we examined how to diagnose sarcoidosis in patients complaining of a cervical mass and its clinical presentation according to 8 cases which we experienced. We undertook biopsy of the cervical lymph nodes in 7 cases, and biopsy of the parotid gland in 1 case. In cases non-caseating epithelioid cell granuloma was proved, diagnosed as sarcoidosis histopathlogically. In 6 patients, the sarcoidal lesion was in other organs, whereas in 2 patients the sarcoidal lesion was confined in the head and neck. Bilateral hilar lymphadenopathy and an elevated level of angiotensin-converting enzyme which are typical in sarcoidosis were confirmed in only one of our patients. Therefore, the diagnostic value of these tests is low for the diagnosis of sarcoidosis in the patients whose chief complaint is a cervical mass. Because 4 out of 7 cases were positive for the tuberculin test, it is imperative to distinguish between sarcoidosis and cervical tuberculous lymphadenitis by combining the culture of acid-bacilli and TB-PCR with histopathological evaluation of the biopsy specimen. We experienced one patient in whom the sarcoidal lesion developed in the skin and the eyes 20 years after the onset of cervical lymphadenopathy. It is important to follow the patients carefully, even if we diagnose the disease as sarcoidosis confined in the head and neck.
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  • Migraine-Associated Vertigo with Hearing Loss and Recurrent Vertigo Attack.
    Fumiyuki Goto, Tomoko Tsutsumi, Kaoru Ogawa
    2013 Volume 116 Issue 5 Pages 600-605
    Published: May 20, 2013
    Released on J-STAGE: August 21, 2013
    DOIhttps://doi.org/10.3950/jibiinkoka.116.600
    JOURNAL FREE ACCESS
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    The clinical features of Ménière's disease and migraine-associated vertigo are quite similar. Both disorders are characterized by repeated vertigo spells. Several diagnostic criteria are used to diagnose migraine-associated vertigo. None of these criteria has been internationally defined, although the criteria proposed by Neuhauser are wieldy accepted. Hearing impairment is believed to be a key factor for diagnosing Ménière's disease. We report herein on a case of repeated vertigo spells with sensorineural hearing loss in the right ear. Initially, the condition was diagnosed as Ménière's disease. Treatment for improving endolymphatic hydrops did not have an effect on the vertigo spells. On careful questioning, we noted the coexistence of migraines without any aura. Treatment with Ca antagonists to prevent the migraine attacks successfully stopped the patient's vertigo spells. On the basis of this clinical course, it is safe to assume that the patient had migraine-associated vertigo with sensorineural hearing loss rather than Ménière's disease. For a patient experiencing migraines together with sensorineural hearing loss, an accurate diagnosis requires careful evaluation. The coexistence of migraines should be carefully ruled out, even if Ménière's disease with hearing loss is strongly suspected.
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  • Rupture of an Internal Carotid Artery Pseudoaneurysm after Irradiation for a Nasopharyngeal Carcinoma -Case Report-
    Yukiko Hanada, Hisanori Sasai, Aya Kamakura, Megumi Nakamura, Yoshihar ...
    2013 Volume 116 Issue 5 Pages 606-611
    Published: May 20, 2013
    Released on J-STAGE: August 21, 2013
    DOIhttps://doi.org/10.3950/jibiinkoka.116.606
    JOURNAL FREE ACCESS
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    The primary treatment of nasopharyngeal carcinoma (NPC) has been external radiotherapy. Rupture of an internal carotid artery (ICA) pseudoaneurysm is a rare complication of irradiation therapy for a nasopharyngeal carcinoma.
    A 78 years old man had a history of NPC treated with radiotherapy in 1993. He was admitted to the hospital because of epistaxis. Angiography showed an ICA pseudoaneurysm pointing medially to the nasopharynx. Coil embolization of the ICA was performed, but cerebral infarction occurred.
    Internal carotid artery (ICA) pseudoaneurysms are an uncommon but potentially lethal condition. Angiography is the mainstay of diagnosis of the aneurysm and planning the embolization of the ICA. We should be more aware of this complication in NPC patients.
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  • Assessment of Treatment Effect for Acromegaly with Sleep Disordered Breathing
    Aya Sakai, Hirohisa Toga, Osamu Tachibana, Takaki Miwa
    2013 Volume 116 Issue 5 Pages 612-618
    Published: May 20, 2013
    Released on J-STAGE: August 21, 2013
    DOIhttps://doi.org/10.3950/jibiinkoka.116.612
    JOURNAL FREE ACCESS
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    Acromegaly is caused by excessive secretion of growth hormone (GH) and presents with a variety of clinical manifestations, including facial disfigurement and abnormally large hands and feet, as well as diabetes mellitus, hypertension, and sleep-disordered breathing (SDB). Although SDB is known to be associated with serious symptoms, there have been few study reports, and no clear consensus has been reached regarding the method of assessment of individual treatments. We report herein on the results of surgical intervention with transsphenoidal surgery (TSS) for acromegaly and assessment of the treatment effect after the intervention.
    We studied 6 patients who received a diagnosis of acromegaly complicated with SDB and underwent TSS at our hospital. Polysomnography (PSG) was performed before and after TSS, and the polysomnograms were analyzed. We also examined changes in the levels of GH and insulin-like growth factor-1 (IGF-1) on blood biochemistry.
    In 6 cases of acromegaly with SDB, we were able to confirm endocrinologic improvement of TSS with blood biochemistry. However there was no meaningful improvement in the PSG index for SDB.
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