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Volume 95, Issue 5
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YASUHIRO KASE, MASAAKI YAMANE, KEIICHI ICHIMURA, TOSHITAKA IINUMA, [in ...1992 Volume 95 Issue 5 Pages 655-664
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSRecently, the usefulness of CT and MRI in diagnosing parapharyngeal tumors has been established. At the same time, several modalities for these imagings, i.e. plane and enhanced CT, T1, 2 weighted MRI and Gadolinium enhanced MRI, have been developed. We compared the image findings of 12 tumors involving the parapharyngeal space with their operative records. T1 was most suited to diagnosing the sites of origins of tumors because of its superior depiction of the internal carotid artery and parapharyngeal fat. Enhanced CT was also superior in depicting these structures, but in cases where the parapharyngeal fat was diminished, or the parapharyngeal fat had been invaded by malignant tumor, enhanced CT was inferior to T1. The spatial resolution of T2 was poor, T2 was thus not useful in diagnosing the sites of origins of tumors. Because tumor intensity tended to be similar to that of fat in Gadolinum enhanced MRI imaging, Gadolinum was not as useful as T1. In diagnosing the extents of tumors, we examined the depiction of both tumorfat and tumor-muscle interfaces. With regard to the depiction of the tumor-fat interface, enhanced CT and T1 were most useful. In diagnosing the tumor-muscle interface, Gadolinium enhanced MRI was most suitabled. The net result is that MRI is superior to CT.View full abstractDownload PDF (3595K) -
TOSHITAKA IINUMA, TOSHIYOSHI TANAKA, YASUHIRO KASE, KEN-ICHIROU ISHIO, ...1992 Volume 95 Issue 5 Pages 665-673
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe postoperative mucocele of the maxillary sinus typically occurs after 11-15 years after the initial Caldwell-Luc operation with the complaints of swollen and painful cheek. Typical signs and symptoms will be divided into two groups, the one which is associated with expansive lesions and the another with pains along the various branches of the maxillary nerve. In the clinical setups, cases with the similar signs and symptoms, and yet lacking difinite mucoceles, are often encountered. The present treatise will compare 86 definite cases and 27 simulating cases as to the history, signs and symptoms, various modalities of imaging (CT & MRI), and the possible causes leading to simulating cases.
The age at onset, gender, affected side, and period after the initial sinus surgery all showed no differences between the two, i.e., definite and simulating cases.. Among signs and symptoms, the definite case showed more of swelling-related matters whereas the simulating case more of painrelated except toothache.
The past history of surgeries for the mucoceles on the similar sides to the present lesion is more often seen in the simulating case (64.3%) than in the definite case (18.3%).
The findings by imagings in the simulating cases are as follows; obliterated sinus (25.0%), healthy, aerated postop. cavity (35.7%), postop. cavity with mucosal thickening (32.1%), and cystlike aerated cavity (7.1%).
The possible causes leading to the simulating cases are as follows; causes unknown (39.3%), recurrent infection in the postop. cavity (28.6%), dental origin (10.7%), atypical neuralgia (10.7%) and the case shortly after the proceeding sinus surgery (within 12 months, 10.7%).
The psychosomatic aspect and polysurgical tendency are also discussed but without corresponding cases this time.View full abstractDownload PDF (1938K) -
HIROKAZU KANATA, YOSHIHIRO TSURUTA, KAZUTAKA UEDA, OSAMU TANAKA, HIROS ...1992 Volume 95 Issue 5 Pages 674-680
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSUsing paraffin embedded specimens taken from 32 patients with histologically benign nasosinal papillomas, we conducted nuclear DNA analysis by flow cytometry and studied the biological degree of malignancy in this disease.
Aneuploidy, which is frequently observed in malignant tumors was not seen in any of these nasosinal papilloma cases. Age did not affect either S+G2M% or polyploid%, two parameters that reflect cell proliferation capacity. Both parameters, S+G2M%and polyploid%, were higher in inverted papillomas which are more likely to become malignant than epithelial papillomas. In recurrent cases of nasosinal papilloma both S+G2M% and polyploid% were higher than in nonrecurrent cases. Moreover, the polyploid% was significantly different, supporting speculation that this can be used as a parameter for predicting recurrence of nasosinal papilloma.View full abstractDownload PDF (984K) -
KAZUYOSHI UENO, MASARU OHYAMA1992 Volume 95 Issue 5 Pages 681-685
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSIn this study, neuraminidase (sialidase) and 6 different lectins, wheat germ agglutinin (WGA), Limax flavus agglutinin (LFA), Sambucus nigra agglutinin (SNA), Maackia amurensis agglutinin (MAA), peanut agglutinin (PNA), and Amaranthin, were used to histochemically characterize the carbohydrate structure of glycoconjugate in the murine eustachin tube pharyngeal orifice. A microwave irradiation technique was used to reduce the incubation time and background staining. After neuraminidase treatment, WGA, LFA, MAA, Amaranthin, and PNA stained epithelial goblet cells, glandular mucous cells, cell surfaces, and the mucous blanket. Without neuraminidase treatment, SNA and PNA did not stain any secretory cells. These results revealed that sialoglycoconjugates in the murine eustachian tube pharyngeal orifice are produced from epithelial goblet cells and glandular mucous cells, are present on cell surfaces and within the mucous blanket, and that their terminal trisaccharide linkage appears to be the sequence Neu5Ac (α2-3) Gal (β1-3) GalNAc.View full abstractDownload PDF (1674K) -
AKIO YASUHARA, HISAYOSHI ISHIZAKI, HIROSHI MORITA, HIROYUKI MINETA, MI ...1992 Volume 95 Issue 5 Pages 686-696
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe incidence and factors associated with multiple primary cancer were surveyed and analyzed from April 1978 through December 1990 in our clinic. Fifty nine cases with multiple primary cancers were selected for study from among 579 cases with malignant head and neck region tumors. The cancers involved the larynx in 17 cases (8.4%), oral cavity in 14 (19.4%), oropharynx in 13 (41.9%), hypopharynx in 7 (8.0%) and nasal cavity or paranasal sinus in 7 (8.0%). Twenty one cases (35.6%) arose synchronously within one year. From our observations, heavy drinking and smoking were most strongly suspected to be risk factors for induction of malignancy. Most
multiple primary cancers in the head and neck region were observed to coexistent in a "so called multicentric zone" consisting of the oral area, pharyngeal area, larynx, esophagus, stomach, and tracheobronchial tree. To avoid overlooking concealed cancer in the multicentric zone, upper gastro-intestinal endoscopy, bronchial endoscopy, chest X-ray and sputal examination should be performed for screening of patients with head and neck malignancies.View full abstractDownload PDF (830K) -
SHIGERU KIKUCHI, TATSUYA YAMASOBA, TOSHITAKA IINUMA1992 Volume 95 Issue 5 Pages 697-705
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSSeventy-three cases of adult cholesteatoma, including 52 cases with pars flaccida type choles-teatoma and 21 with pars tensa type cholesteatoma, were examined using high resolution computed tomography, in both axial (lateral semicircular canal plane) and coronal sections (cochlear, vestibular and antral plane). These cases were classified into two subtypes according with the presence of extension of cholesteatoma into the antrum. Sixty cases with chronic otitis media with central perforation (COM) were also examined as controls.
The various locations of the middle ear cavity were measured in term of size with comparisons among pars flaccida type cholesteatoma, pars tensa type cholesteatoma and COM.
The results were as follows:
1) The width of the attic was significantly larger in both pars flaccida type and pars tensa type cholesteatoma than in COM.
2) With pars flaccida type cholesteatoma there was a significantly larger distance between the malleus and lateral wall of the attic than with COM. In contrast, the distance between the malleus and medial wall of the attic was significantly larger with pars tensa type cholesteatoma than with COM.
3) With cholesteatoma extending into the antrum, regardless of the type of cholesteatoma, there were significantly larger distances than with COM at the following sites; the width and height of the aditus ad antrum, and the width, height and anterior-posterior diameter of the antrum. However, these distances were not significantly different between cholesteatoma without extension into the antrum and COM.
The hitherto demonstrated qualitative impressions of bone destruction in cholesteatoma were quantitatively verified in detail using high resolution computed tomography.View full abstractDownload PDF (1207K) -
A STUDY BY QUESTIONNAIRE FROM 434 HOSPITALS IN JAPANYUICHI MAJIMA, YASUO SAKAKURA1992 Volume 95 Issue 5 Pages 706-714
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSInformation concerning surgical treatment of adult patients with chronic sinusitis was obtained through questionnaires from 434 hospitals in Japan. The hospitals were authorized for an inservice otorhinolaryngological training institute by the Oto-Rhino-Laryngological Society of Japan. The questionnaires were sent to the hospitals in December, 1989, and answers were obtained from 370 hospitals within 2 months, an 85.3% response rate. The following results were obtained. In 96.2% of the hospitals, permaxillary sinus surgery was performed on patients whose maxillary and ethmoid lesions were severe. With moderate lesions of both the maxillary and ethmoid sinuses, permaxillary sinus surgery and endonasal sinus surgery were performed in 76.0% and 24.9%, respectively. Application of an endoscope for sinus surgery was reported by 89 hospitals.
In January, 1990, a further survey was sent to the 89 hospitals where endoscopic sinus surgery was performed. Questionnaire responses were obtained from 75 hospitals. Rigid endoscope was used most frequently and operative microscope was also used. Endoscopy was applied to all of the sinus surgery procedures in 21.6%, and to a portion of the procedures in 74.3% of the hospitals. About 50% of the hospitals performed endoscopic surgery in fewer than 30% of sinus surgery cases. When questioned as whether endoscopic surgery had been successful, 42.6% said yes, 10.7% said no, and 42.6% were unsure.View full abstractDownload PDF (716K) -
IKUO INOKUCHI1992 Volume 95 Issue 5 Pages 715-725
Published: 1992
Released on J-STAGE: December 15, 2008
JOURNAL FREE ACCESSIt is essential to establish an objective and quantitative method for evaluating facial palsy and to measure the extent of paralysis in order to evaluate therapeutic efficacy, determine prognosis, select appropriate treatment and observe the process of recovery.
This study utilized Moiré topography, which displays three-dimensional facial symmetry with high precision and is based on light interference theory, to determine the extent of facial palsy in 38 patients (20 men and 18 women) 5 months to 73 years of age. A stereoscopic lattice type Moire camera (FM3013) was connected to a CCD camera and to the monitoring device for confirming Moiré stripes. Moiré photographs were taken with a thermal imager (FTI-200). The photos were visually and objectively evaluated on the basis of the Moiré pattern and were then input into a personal computer with a digitizer for data processing and analysis. To view the functions of facial nerve branches, five Moiré photographs were taken: at rest, wrinkling the forehead, closing the eyes lightly, blowing out the cheeks and grinning.
Results indicated that the number of stripes and their polarization adequately reflected the function of individual facial nerve branches. Thus, a well-defined Moiré pattern could clarify the characteristics of the site and the degree of facial palsy and of recovery from paralysis. It is an analytical method that can be quickly applied and seems especially useful in infants and young children, in whom point-based assessment is difficult. It is possible to quantitatively evaluate facial palsy in terms of the Asymmetry Index (AI), which is 20-25% for severe paralysis, 12-19% for partial paralysis, and 5-10% for an essentially normal condition. However, the numerical value of the AI overlap in all three paralysis categories, indicating that quantitative assessment of paralysis would be difficult.
Moiré topography is an excellent method of determining the extent of facial palsy, compensating for the short falls of examination-based assessment and permitting reproducible visual, objective, and quantitative evaluation.View full abstractDownload PDF (3948K) -
HIDEHISA SUZUMURA, YUKIYOSHI HAMAGUCHI, YASUO SAKAKURA1992 Volume 95 Issue 5 Pages 726-731
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSA sensitive sandwich ELISA method has been developed in order to quantitate the Pseudomonas aeruginosa elastase (PE) of ear discharge from chronic suppurative otitis media (CSOM) patients. Samples were incubated with EDTA-2Na before ELISA in order to inhibit the PE activity which hydrolyzes anti-PE IgG antibody into smaller molecular fragments. Quantitation of PE in middle ear effusions (MEE) from 10 patients with chronic otitis media with effusion (OME) were also performed. In CSOM, 12 0f 14 samples revealed a significant amout of PE from 0.6μl/ml to 62.lμl/ml, which was significantly higher than those in MEE (p<0.05). In MEE, 8 of 10 samples were under the detection limit. Two samples in CSOM with Pseudomonas aeruginosa infection had high levels of PE. The quantitation was linear, with a concentration from 5ng PE/sample to 500ng PE/sample. This ELISA system is a sensitive method for quantitation of PE requiring only very small samples.View full abstractDownload PDF (879K) -
KAZUO MURAI, MAKOTO OGASAWARA, TOSHIYA WATANABE, TAKESHI KANAI, YOSHIH ...1992 Volume 95 Issue 5 Pages 732-737
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe tinnitus masking test, in which the minimum masking levels of tinnitus by various pure tones and band noises are measured and used to produce tinnitus masking curves, is one of the methods for evaluating the character of tinnitus. At present, the tinnitus masking test is usually performed using a pure tone audiometer.
In this study, tinnitus masking curves were produced using a self-recording audiometer (Bekesy audiometer) in 22 cases of tinnitus, and the basic nature of the tinnitus masking curves from the self-recording audiometer was investigated and compared with those from a pure tone audiometer. The results showed no changes in the masking level, and the amplitudes of the tinnitus masking curves from the self-recording audiometer were observed to be at the tinnitus pitches. The amplitude of the tinnitus masking curve showed a negative correlation with tinnitus loudness as measured by the loudness balance test for tinnitus, that is, the amplitude tended to decrease as the tinnitus became louder. This suggests that the loudness of the masking tone influences the tinnitus masking phenomenon.View full abstractDownload PDF (488K) -
DETECTION AND GENOTYPIC ANALYSIS OF EPSTEIN-BARR VIRUS ASSOCIATED WITH NASOPHARYNGEAL CARCINOMA IN JAPANESE PATIENTSSHINJI TAMURA1992 Volume 95 Issue 5 Pages 738-747
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSEpstein-Barr virus (EBV) is known to be associated with two human malignant diseases, nasopharyngeal carcinoma (NPC) and endemic Burkitt's lymphoma. In this study, the genotypes of EBV in tissues from 13 NPC patients in Japan were analyzed by Southern blot hybridization using EBV genome fragment probes.
Ten of the cases contained reiterated sequences (EBV BamHI-H, -Bl*, -K fragments), showing that only one genotype was detected in each specimen. One of these had a BamHI fragment containing a fused sequence of BamHI-Y and -H. In all except one case, a single-sized EBV-joined terminus was observed in each NPC specimen, implying evolution of the carcinoma from a single EBV-infected cell. One metastatic lymph node (which was not a primary epipharyngeal tumor) contained EBV with heterogenous termini suggesting production of linear virion DNA.
The type C variant resulting trom loss of a BamHI site between the BamHI-W1* and -I1* regions was observed in 7 of the 10 cases, and the other 3 cases had a separated BamHI-Il* fragment. As reported by Lung et al. (Virology, 177: 44-53, 1990), the type C variant appears to be dominant among Japanese strains, as it is in Southern China. In contrast to their findings, however, the "f" variant with an extra BamHI site in the BamHI-F region which they found to be strongly associated with NPC specimens from Southern China, was detected in only one case. The present study, therefore, did not support the specific association of the "f" variant with NPC in Japanese patients.
We conclude that the EBV in NPC tissues exists in variants. Further studies along these lines, could help to explain the epidemiology of EBV.View full abstractDownload PDF (2269K) -
JUNICHI YODA1992 Volume 95 Issue 5 Pages 748-758
Published: 1992
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSCytotoxic activities of rIL-2-stimulated effector cells from peripheral blood mononuclear cells (PBMC-LAK), and those from the regional lymph node cells (LN-LAK) from patients with head and neck malignant tumor were examined by 4-hour 51Cr release assay. Cytotoxicity of LAK cells from involved lymph node (LN(+)-LAK) were significantly lower than those of PBMC-LAK. LAK cells from non-involved lymph node (LN(-)-LAK) had a significantly higher cytotoxicity against Daudi cell than PBMC-LAK. Cytotoxic activities against K562 cell and autologous tumor cells mediated by LN(-)-LAK were not significantly different from those by PBMC-LAK. However, autologous tumor cell lysis by LN(-)-LAK from lymph nodes showing follicular lymphoid hyperplasia (FLH) pattern was higher than that by PBMC-LAK. The effector cells against autologous tumor cells were characterized CD56+ cells and CD8+ cells (CD8+CD11b-cells) by phenotypic analysis and negative selection assay using immunomagnetic isolation technique.View full abstractDownload PDF (1999K)
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