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CHIHIRO HATTA, MINORU ISHIDA, TATUJI MATSUMOTO, YOSHIO SUGIYAMA, NOBUK ...
1993 Volume 96 Issue 6 Pages
879-885,1045
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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We had 18 patients (15 males and 3 females) with lethal midline granuloma (polymorphic reticulosis) in the period from 1981 to 1990. This number was about 5.6% of the total number of patients with malignant head and neck tumors that we encountered during this period. An average of 9.1 months separated the first appearance of disease and the beginning of treatment. Most of the 18 patients underwent both radiation therapy and chemotherapy (COP, CHOP, MACOP-B), but, since their disease had reached an advanced stage, 3 underwent radiation therapy only, 3 underwent chemotherapy only, and 1 received no radical therapy at all. Of the 18 patients, 13 died of the disease. In of 6 of these, the disease was confined to the local lesion. The 5-year cumulative survival rate was 15.7% (Kaplan-Meier). Fourteen autopsy studies revealed that tumor cells had invaded the liver (92.8%), lung (92.8%) and spleen (71.4%) and in all cases it was in leukemic patterns. Fifteen cases were studied for tumor surface marker phenotype, but none was found to be positive for L26, CD43, Leu M1 (CD15), or MAC 387. Five cases were positive for UCHL-1 (CD45RO) and 10 cases were positive for lysozyme. All cases were positive for Ki-1 (CD30).
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KANAE HORI, YOZO ORITA, HIDEKAZU YAMAMOTO, TAKESHI AKISADA, YUKIHIRO S ...
1993 Volume 96 Issue 6 Pages
886-890,1045
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Total laryngectomy can be used to prevent aspiration pneumonia in patients with severe dysphagia, though caution is required with regard to the indications.
In this paper, we describe 3 patients in whom severe dysphagia developed as a result of cerebrovascular disorders, and who repeatedly developed aspiration pneumonia. We managed them with total laryngectomy, and this has prevented aspiration pneumonia in all three.
Oral feeding became possible in two of these patients, and home care became possible for one.
This report includes a discussion based on the literature, and includes preoperative evaluation and indications for laryngectomy.
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JUN YUZA
1993 Volume 96 Issue 6 Pages
891-902,1045
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Laryngeal motoneurons (LMNs) innervating the intrinsic laryngeal muscles also control glottal movements such as swallowing, respiration and phonation. The present study was performed on decerebrate cats to clarify the laryngeal control mechanisms during respiration and phonation using extracellular single unit recordings from the nucleus ambiguus. First, functional differences among LMNs during the respiratory phases were investigated by analysis of the activity of LMNs innervating laryngeal adductor (TA-LCA: thyroarytenoid-lateral cricoarytenoid) or abductor (PCA: posterior cricoarytenoid) muscles; Second, laryngeal control mechanisms during phonation were investigated by the analysis of neural activity of TA-LCA motoneurons during vocal fold vibration elicited by a constant air flow through the glottis. In both cases, motoneuronal excitability changes were expressed by measuring fluctuation of peak latencies of action potentials antidromically elicited by selective stimulation of the recurrent nerve or its peripheral branch.
In 14 out of 24 TA-LCA motoneurons, neuronal excitability was increased during the expiratory phase, whereas in the remaining 10, it was increased during the later half of the inspiratory and the early half of the expiratory phase. On the other hand, 9 out of 13 PCA motoneurons showed increased neuronal excitability during the end of the expiratory and the beginning of the inspiratory phase, while the remaining 4 showed increased excitability during the inspiratory phase. These results suggest that there are functional differences among the homogeneous laryngeal motoneurons.
In seven TA-LCA motoneurons, neuronal excitability was decreased by vocal fold vibration elicited by phonation throughout the whole respiratory cycle. On the other hand, when the bilateral superior laryngeal nerves were cut, neuronal excitability was increased during phonation throughout the whole respiratory cycle. These results indicate that TA-LCA motoneurons receive inhibitory inputs from the superior laryngeal nerve and excitatory inputs from the recurrent laryngeal nerve during the vocal fold vibration elicited by phonation.
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CLINICAL STUDY OF CASES WITH RAPIDLY PROGRESSED DEAFNESS
MASATOSHI HIRAYAMA, TETSUYA SHITARA, MAKITO OKAMOTO, HAJIME SANO, SHIN ...
1993 Volume 96 Issue 6 Pages
903-913,1045
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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In a series of 127 patients with idiopathic bilateral sensorineural hearing loss (IBSH) at the Hearing Clinic in the Department of Otolaryngology, Kitasato University Hospital, 20 cases showed rapid progression of hearing impairment. These patients had been treated with the same therapeutic regimen used in sudden deafness (S.D.). Improvement of hearing loss after treatment was generally less effective in the cases with rapidly progressed IBSH than in the cases with S.D. However, hearing improvement was achieved in some cases with rapidly progressed IBSH when the treatment had started in the early stages after the onset of rapidly progressive hearing loss. The mode of fluctuating hearing loss in the cases with rapidly progressed deafness was assumed to be similar to that in the group of all cases with IBSH.
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HIDEKI OGASAWARA, KENJI MORIMOTO, KAN ISHII, SHINYA SOHMA, KOUJI ASAKU ...
1993 Volume 96 Issue 6 Pages
914-921,1047
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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The present study was carried out in order to determine factors which influenced the prognosis of sudden deafness and to try to predict the prognosis of sudden deafness, analyzed statistically by multivariate analysis. A total of 143 patients with sudden deafness diagnosed and treated at the department of otolaryngology, Ebetsu Municipal General Hospital and Obihiro Kohsei Hospital between 1986 and 1991, were selected for this study.
Statistical analysis disclosed the following.
1. A good hearing level at the initial visit, a low-frequency hearing loss, the absence of vestibular symptoms and an initial visit within seven days after onset, indicate a good prognosis for sudden deafness.
2. Multivariate analysis showed that the hearing level at the initial visit most strongly influences sudden deafness, followed by the number of days from onset to initial visit, vestibular symptoms and the difference between low- and high-frequency hearing level, in that order.
3. Furthermore, multivariate analysis showed that the prognosis of sudden deafness can be predicted at a level of 78.3%, considering the above four factors. This facilitates treatment of patients with sudden deafness.
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MASAAKI KASHIWAMURA, NOBUKIYO SATOH, SATOSHI FUKUDA, MITSUGU KAWANAMI, ...
1993 Volume 96 Issue 6 Pages
922-930,1047
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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According to current cochlear concepts, spontaneous otoacoustic emissions (SOAEs) are thought to be the product of outer hair cell (OHCs) movement. Furthermore, efferent neurofibers from the olivocochlear bundle primarily innervate OHCs. Thus, we designed this investigation to determine changes in SOAE under conditions of contralateral acoustic stimulation. Fourty-two normal ears of 34 subjects with uni-or bilateral SOAEs were examined.
The sound pressure level (SPL) of SOAE was measured 3 times in each subject and was initially averaged. The white noises of 30 or 40dBSPL, believed not to affect the other side, were then loaded contralaterally and the SPL of SOAEs were measured and compared with the nonloaded data. The SPL of single SOAEs were actually suppressed with 40dBSPL stimulation while the SPL of multiple SOAEs showed typical changes.
Interestingly, no significant suppression of SOAEs was noticed under conditions of contralateral acoustic stimulation of the impaired ear. These data suggest that contralateral acoustic stimulation could affect OHC function via the olivocochlear bundle.
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JUICHI ITO, YASUNARI TOKUDA, MICHIO KAWANO
1993 Volume 96 Issue 6 Pages
931-935,1047
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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A multichannel cochlear implantation was performed in an 8-year-old child and the following results were obtained. The surgical procedures were not particularly difficult as compared to cochlear implantation for adults. Postoperative rehabilitation requires a longer time than in adult patients. Cochlear implants are useful not only for the recognition of environmental sound but also for the recognition of speech. Cooperation with the medical facility, as well teachers and family members, is essential.
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HIDEAKI MOTOSUGI
1993 Volume 96 Issue 6 Pages
936-945,1047
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Immunohistochemical studies were performed to determine the distribution of neuropeptides and tyrosine hydroxylase in rat and human pterygopalatine ganglia.
In the rat pterygopalatine ganglion, the most commonly found peptide in ganglion cells was vasoactive intestinal polypeptide (VIP) (99%) followed by neuropeptide Y (NPY) (54%) and enkephalin (ENK) (11%). Substance P (SP) -, calcitonin gene-related peptide (CGRP) -, ENK-, and NPY-immunoreactive (IR) varicose nerve fibers were found around ganglion cells. SP- and CGRP-IR varicosities were in synaptic contact with somatic spines or somata of ganglion cells. The combination of retrograde labeling and immunohistochemical study revealed that some of the ganglion cells projecting to the nasal mucosa were surrounded by SP-IR fibers. These results indicate that SP- and CGRP-IR axon collaterals of the trigeminal ganglion cells may form direct synaptic contact with ganglion cells projecting to the nasal mucosa. ENK-IR varicosities were probably derived from parasympathetic preganglionic neurons.
In the human pterygopalatine ganglion, almost all ganglion cells were VIP-IR. They were not, however, immunoreactive with other peptides investigated in this study. VIP-, SP- and CGRP-IR varicose nerve fibers were found around ganglion cells. A few NPY- and ENK-IR varicose fibers were also observed around ganglion cells. The origins of these peptide-IR varicose nerve fibers are still unknown, but it is suggested that the human pterygopalatine ganglion is innervated by a greater variety of peptide-IR nerve fibers than that of the rat and forms different neuronal circut.
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SHIGETADA SUZUKI, MASAKO NOTOYA, HIROMI TEDORIYA, MITSURU FURUKAWA
1993 Volume 96 Issue 6 Pages
946-951,1049
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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The prevalence of MHL in 202, 1 to 6 year-old children with communication disorders who visited our clinic in 1991 was investigated. 1) 31% of the subjects had MHL bilaterally. The prevalence of MHL was 44% at age 1 year, 20% at age 2 years, 36% at age 3 years, 24% at age 4 years, 39% at age 5 years, 33% at age 6 years. 2) 88% of children with MHL had OME, 10% had mild sensorineural hearing loss, and 2% had cerminous plug. 3) The prevalence of MHL in children with mental retardation and autistic disorders was 9%, that with stuttering was 9%, that of OME accompanied by moderate and severe hearing disorders was 6%. 4) The primary causes in 191, except for those with stuttering, were as follows; the prevalence of MHL was 30%, that of mental retardation and autistic disorders was 24%, and that of articulation disorders was 28%. 5) On the other hand, the prevalence of MHL in children with retarded language development and articulation disorders was 30%, which was significantly higher than that of the other communication disorders. Accordingly, the results of this study suggest that MHL in early childhood greatly influences communication disorders.
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HIROYUKI TAKEZAWA, TETSUO HIMI
1993 Volume 96 Issue 6 Pages
952-958,1049
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Antibody titers against H. influenzae, S. pneumoniae, S. pyogenes, S. mitis, S. sanguis, and S. salivarius in middle ear effusions (MEE) of 46 children (60 ears) with chronic otitis media with effusion (OME) are reported. H. influenzae, S. pneumoniae and S. pyogenes are predominant microorganisms in acute suppurative otitis media. S. mitis, S. sanguis, and S. salivarius are major species of normal adenoid flora. Specific antibodies against the above bacterial species were detected in all samples.
In the chronic group, IgG titers against H. influenzae, IgG and IgM against S. pneumoniae, IgG and IgM against S. pyogenes, and IgG against S. salivarius were statistically higher than in the acute and subacute groups.
IgG, IgM and IgA titers against S. mitis and S. pneumoniae in MEE with chronic sinusitis were higher than those from sinusitis free children. Anti-S. sanguis and S. pyogenes IgG and IgA of sinusitis free patients' MEE were higher than those with chronic sinusitis. The antibody titers against H. influenzae did not differ statistically between those with and without sinusitis.
The presence of anti-bacterial antibodies inhibits acute infection in MEE, and the difference in titers with sinusitis may be caused by bacterial numbers in the adenoids and the host's response to the bacteria.
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HIROYUKI TAKEZAWA, [in Japanese]
1993 Volume 96 Issue 6 Pages
959-968,1049
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Quantification of bacterial flora in middle ear effusions (MEE) and adenoids in children with otitis media with effusion (OME) was performed. IgG, IgA and IgM titers against H. influenzae, S. pneumoniae, S. mitis, S. sanguis, and S. salivarius were measured in MEE, sera and the supernatant of adenoid lymphocyte cultures. The adenoid lymphocytes were stimulated by each inactivated bacteria species for 7 days, before antibody titers were measured.
Seven species were detected in 6 of 18 MEE samples (33.3%). Six of these species were also detected in the adenoids of the same cases. Bacterial identification of flora in adenoids was as follows. S. pneumoniae: 8, H. influenzae: 4, B. catarrharis: 4, S. mitis: 9, S. sanguis: 8, S. salivarius: 12 of cases.
The antibody titers against bacteria from adenoids in MEE and the supernatant were significantly higher than those of the group in which no species were detected. These specific antibodies in MEE inactivate bacteria from the adenoid, but the immune complex probably plays some part in chronic inflammation of the middle ear.
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HIROTAKA HARA
1993 Volume 96 Issue 6 Pages
969-976,1049
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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Whether or not vestibular adaptation occurs upon exposure to altered gravity is an important human problem. Studies have been performed to ascertain whether morphological changes in vestibular organs occur in animal models upon exposure to microgravity.
On the other hand, the morphological changes which occur in vestibular organs under hypergravity have not yet been fully elucidated and morphological changes in the otoconia of the chick embryo exposed to hypergravity during the embryonic period remain to be thoroughly examined.
The purpose of this paper is to clarify the effects of hypergravity on vestibular organs, especially its effects on otoconial formation in the developing chick embryo. Thus, we designed an apparatus which creates artificial gravity, creating approximately 2G gravity by means of centrifugation. The utricular macula was chosen for study because it can be prepared for examination with a minimum of dissection artifacts. The data presented show that morphological changes were confined to otoconial size alterations according to scanning electron microscopic observations. Giant otoconia were observed along the marginal zones of utricles.
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1993 Volume 96 Issue 6 Pages
977-991
Published: June 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 6 Pages
991-999
Published: June 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 6 Pages
1000-1010
Published: June 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 6 Pages
1010-1018
Published: June 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 6 Pages
1018-1029
Published: June 20, 1993
Released on J-STAGE: December 22, 2010
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[in Japanese]
1993 Volume 96 Issue 6 Pages
1030-1033
Published: June 20, 1993
Released on J-STAGE: October 22, 2010
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