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Volume 96, Issue 7
Displaying 1-18 of 18 articles from this issue
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KEIICHI ICHIMURA, KENICHI NIBU, YUICHI SHIMAZAKI, YASUHIRO KASE, TOSHI ...1993 Volume 96 Issue 7 Pages 1051-1057,1221
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSNasal valve, originally defined by Mink (1903), has changed its concept and is now regarded as slit-like opening between the caudal end of the upper lateral cartilage and the septum. Contrary to Caucasians whose smallest area of the nose lies at the nasal valve, the narrowest part of Japanese nose situates at the area between the anterior portion of the inferior turbinate and the septum. Thus, we have fewer chance to experience patients with stenotic nasal valve.
Six patients complaining nasal obstruction resulted from nasal valve stenosis, mainly due to dislocated or collapsed upper lateral cartilage, underwent surgery during the last 2 years and a half. Cases of septal deformity, even if it produced valve stenosis, were excluded in this study. Surgical intervention was directed toward reconstruction of normal anatomic relationships, usually by widening the nasal valve angle and preventing collapsibility. Three underwent open rhinoplasty with gull-wing columellar skin incision, whereas 3 others were operated on via transnostril approach. History of midfacial trauma caused us to choose open rhinoplasty for restoring the function and structure. Immediate postoperative result was excellent in the aspect of appearence and subjective data regardless of surgical approach. Open rhinoplasty provided a splendid longterm result without remarkable complications. On the other hand, 2 cases operated via transnostril approach complained recurrence of stuffy nose.View full abstractDownload PDF (2433K) -
A COMPARISON USING THE SAME SUBJECTSNORIKO NISHIZAWA, NOBORU SAKAI, YUKIO INUYAMA, KATSUHIKO TANAKA, MAKOT ...1993 Volume 96 Issue 7 Pages 1058-1064_1,122
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe behaviors of esophageal speech and tracheoesophageal shunt (TE shunt) speech were compared using two laryngectomized subjects who were able to perform both phonation methods. Through X-ray fluorography and fiberscopic observation of the PE segment, it was confirmed that the location and the shape of the vibrating PE segment (pseudoglottis) were consistent during esophageal speech and TE shunt speech in each patient. It was suggested that the mechanism of formation of the pseudoglottis does not differ between the two phonation methods. The aerodynamics were examined using one of the two subjects. There was a positive relationship between subpseudoglottic pressure and vocal pitch and also between subpseudoglottic pressure and pseudoglottic resistance. The vocal pitch and pseudoglottic resistance were significantly higher in esophageal speech than TE shunt speech, when compared within the same subpseudoglottic pressure range. It was suggested that the tension and the effective mass of the pseudoglottis was modulated differently between the two phonation methods.View full abstractDownload PDF (2343K) -
TAISUKE KOBAYASHI1993 Volume 96 Issue 7 Pages 1065-1072,1221
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSCombined rupture of Reissner's membrane and the round window membrane (double-membrane rupture) as a cause of acute profound sensorineural hearing loss was investigated in guinea pigs. Action potentials (APs) of the cochlear nerve in response to tone pip stimuli (1, 2, 4, 8kHz) were recorded before and after rupture of Reissner's membrane at each turn of the cochlea. Then the round window was perforated to create leakage of the perilymph. Ninety minutes later, AP was again recorded. After these procedures, the animal was sacrificed for histological study to confirm the rupture of Reissner's membrane.
The ears with double-membrane rupture showed a larger decrease in AP amplitude at all test frequencies than did control ears with round window rupture alone. The ears in which Reissner's membrane was ruptured at the second turn showed more a pronounced decrease in AP amplitude than those ruptured at the third and apical turns. It was concluded that double-membrane rupture could be a cause of sudden deafness, but that the disturbance of cochlear function depends on where Reissner's membrane ruptures.View full abstractDownload PDF (3634K) -
YASUHIRO KASE, TOSHIYOSHI TANAKA, TOSHITAKA IINUMA1993 Volume 96 Issue 7 Pages 1073-1078,1221
Published: July 20, 1993
Released on J-STAGE: March 19, 2009
JOURNAL FREE ACCESSThis investigation was designed to verify the possible feed-back mechanism which works to compensate for changes in the nasal volume of one side by the other side. Acoustic rhinometry, with which nasal volume is easily evaluated, was used in this investigation. Acoustic rhinometry was performed at 4 points in time (immediately after, and three, six and nine minutes after, the setting of experimental conditions). This investigation was composed of two studies. In the first study, ten healthy subjects (nine males and one female, 26-49 years of age, mean age 30 years) were evaluated to estimate the effect of decreased unilateral nasal patency upon the other side. In this study, one nasal cavity was occluded with an acryle plug, and the nasal volume of the other side was evaluated by acoustic rhinometry before and after the occlusion. In the second study eight healthy subjects (five males and three females, 24-34 years of age, mean age 29 years) were evaluated to estimate the effect of increased unilateral nasal patency upon the other side. This study covered a period of three days. A small piece of cotton soaked in a vasoconstrictor solution (1/10000 adrenalin or 0.05% naphazolin nitrate) was put in one nasal cavity (the right on the first day, the left on the second day) and the other side was evaluated before and after administration of the solution. On the third day of the control study, a similar piece of cotton soaked in physiological saline solution was put in one nasal cavity, and the other side was evaluated. In the first study, upon occlusion of the unilateral nasal cavity, the nasal volume of the other side was increased (paired T-test, p<0.01), and on removing the plug, that of the other side was decreased (p<0.05). In the second study, the nasal volume of the side which was not administered vasoconstrictor showed a decrease (p<0.001 and p<0.05, each side, respectively), but in the control study the nasal volume of the other side was not significantly different. These results suggest the existence of a feed-back mechanism by which the nasal volume of one side of the nasal cavity influences the nasal volume of the other side as a compensatory reflex.View full abstractDownload PDF (1051K) -
KIYOYUKI OHI, NAOKI INAMURA, MAMORU SUZUKI, NAOHIRO SUZUKI, MOTOAKI IS ...1993 Volume 96 Issue 7 Pages 1079-1085,1223
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThree patients with non-clostridial gas gangrene of the neck are reported. Patient 1 was a 57-year-old man, patient 2 a 63-year-old woman, and patient 3 a 44-year-old man. All three were treated by thorough debridement and precise administration of antibiotics.
We also discuss 26 cases (including our 3) of gas gangrene of the head and neck, reported in Japan from 1975 to 1992, from which the following data were obtained:
1. The 26 patients consisted of 17 males and 9 females.
2. They ranged in age from 2 to 88 years, with a mean 56.5 years.
3. Causes included acute pharyngolaryngeal inflammation (46%), dental disease (27%), trauma (8%) and unknown etiology (19%).
4. As a result of bacteriological assessment, the condition was found to be attributable to Clostridium in only 2 patients, and in the remainder the condition was non-clostridial.
5. The mortality rate was 15%. The patients who died were at least 80 years old, and their prognosis had been poor.
6. CT was useful for diagnosis and treatment.View full abstractDownload PDF (2886K) -
TAKASHI FUJII, TAKEO SATO, KUNITOSHI YOSHINO, KATSUNORI UMATANI, SATOS ...1993 Volume 96 Issue 7 Pages 1086-1093,1223
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSFrom January 1988 to December 1990, 186 patients with laryngeal cancer or hypopharyngeal cancer underwent total laryngectomy in our hospital. We studied voice restoration in 110 of these patients by means of a direct interview method at the end of 1991. Seventy-six cases were excluded because of death (70) or being lost to follow-up (6). About 80% of the patients (89/110) attended esophageal speech classes, with a success rate of 78% (69/89). Seventy-four percent (51/69) had no problems with daily oral communication using esophageal speech.
Neither radiation therapy nor post operative pharyngocutaneous fistula formation influenced the success rate. Neither did the site of the primary tumor in the larynx or hypopharynx exert an influence, although patients with laryngeal cancer were superior to those with hypopharyngeal cancer in terms of the quality of esophageal speech. It was found that age was the most important factor. Patients below 60 years old had a 90% success rate, between 60 and 75 the rate was 60% and above 75 it was only 10%. Unfortunately, 15% (17/110) of the laryngectomized patients used a pen and pad alone. Most were too old to attend esophageal speech classes.View full abstractDownload PDF (744K) -
YASUHISA CHIBA1993 Volume 96 Issue 7 Pages 1094-1098,1223
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSAlmost all patients who undergo palatine tonsillectomy for chronic tonsillitis and/or tonsillar hypertrophy manifest postoperative changes in their condition and laboratory data. In some patients, high preoperative transaminase levels decrease postoperatively. I studied 17 patients who had abnormal serum transaminase levels 10 days before tonsillectomy. Before tonsillectomy, serum glutamate oxaloacetate transaminase (GOT) levels were abnormal in half and serum glutamate pyruvate transaminase (GPT) were abnormal in all. Before operation, laboratory values of serum GPT were higher than those of serum GOT in all 17 patients. After tonsillectomy, the abnormal GOT levels in all patients gradually improved to the normal range before the 11th postoperative day and GPT levels did so before the 25th day. Measurement of intracellular transaminase activity of the palatine tonsil suggested that the migration of intracellular transaminase from tonsillar cells to serum would not elevate the serum transaminase level. Postoperative changes in serum transaminase and serum cholinesterase were different from the recovery process observed in fatty liver. The high transaminase level observed in patients with tonsillectomy is suspected to be due to other organs, rather than continuous inflammation of the palatine tonsil.View full abstractDownload PDF (507K) -
MAMORU MIYAGUCHI, JUNJI TAKEDA, HIROSHI FURUTA, NARUHIKO UOZUMI, KAZUN ...1993 Volume 96 Issue 7 Pages 1099-1104,1223
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe effects of granulocyte colony stimulating factor (G-CSF) were evaluated in 9 patients with malignant lymphoma of the head and neck. The effects of 31 cycles of cytotoxic chemotherapy were treated with G-CSF. G-CSF was given by one of the following three routes: 1) administration before or with cytotoxic chemotherapy, 2) administration after cytotoxic chemotherapy with leukocyte counts of more than 2000/mm3, and 3) administration after leukocyte counts had dropped to less than 2000/mm3. The first group consisted of one cycle of CHOP therapy and 2 cycles of VAMA therapy. The second group consisted of 10 cycles of CHOP therapy. The third group consisted of 13 cycles of CHOP therapy and 5 cycles of VAMA therapy.
Leukocyte nadirs occurred on around day 14 for CHOP therapy and around day 21 for VAMA therapy without G-CSF treatment. In the first group, the leukocyte nadirs occurred earlier with G-CSF treatment. Additional G-CSF treatments were given in two of the three cycles. In the second group, the leukocyte counts did not drop below 2000/mm3 in three of the ten cycles. Additional G-CSF treatments were given in five of the remaining seven cycles. The two other cycles went without additional treatment. The mean volume of G-CSF was 305±86μg. In the third group, the leukocyte counts increased to more than 2000/mm3 immediately after G-CSF administration in CHOP therapy. The mean volume was 227±78μg, significantly less than that of the second group. The leukocyte counts also exceeded 2000/mm3 3-5 days after G-CSF administration in 5 cycles of VAMA therapy. These data indicate that the most appropriate administration of G-CSF is 50-75μg/body/day×3-5 days after leukocyte counts fall below 2000/mm3.View full abstractDownload PDF (552K) -
A REVIEW OF 74 CASESHIROYUKI KANETAKE, MASAKATU TODA, YOU KAWAMOTO1993 Volume 96 Issue 7 Pages 1105-1111,1225
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSPrognoses and prognostic factors in 74 patients with primary lymphoma of the thyroid gland were analyzed. From 1968 to 1991, 74 patients with non-Hodgkin's lymphoma originating in the thyroid gland were treated at Noguchi Thyroid Clinic Hospital. Patients consisted of 53 females and 21 males, with a median age of 64.5 years.
Survival curves were calculated by the Kaplan-Meier method and significance was tested by generalized Wilcoxon test. The overall 5-year and 10-year survival rates were 81.8% and 62.5%, respectively. The survival rate in stage II disease was significantly (P=0.004) lower than that in stage I. By the LSG classification, there was no significant difference in survival curves between follicular lymphoma and diffuse lymphoma. Using the Working Formulation, there was no significant difference in survival curves between cases with low and intermediate grade histology. Histologic subtype of the tumor did not appear to be a significant determinant of prognosis.
Patients with vocal cord paralysis had poorer survival rates than others (P=0.001). Extrathyroidal spread of the tumor by direct soft tissue invasion had a distinctly adverse effect on prognosis.View full abstractDownload PDF (698K) -
MUNEHARU ITO1993 Volume 96 Issue 7 Pages 1112-1124,1225
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSIn order to detect vestibular endolymphatic hydrops, the directional preponderance of the VOR gain (VOR-DP%) during sinusoidal rotation (freq. 0.1Hz; Amp. 120deg) was calculated and compared between pre- and post-intravenous injections of furosemide (20mg). Abnormal changes in VOR-DP% (>=10%) from the pre-injection level were referred to as positive in this furosemide VOR test (FVOR). The following results were obtained from this study.
(1) Positive responses were obtained in 31 of 61 (51%) patients with definite Meniere's disease, in 11 of 21 (52%) patients with delayed endolymphatic hydrops and in 7 of 10 (70%) with syphilitic labyrinthitis. In contrast, the majority of patients responded negatively with sudden deafness or other peripheral vestibular disorders.
(2) Following the endolymphatic shunt operation, in 2 out of 3 patients (67%) in whom vertiginous attacks had been decreased or disappeared after the operation results changed from positive to negative.
(3) The positive rate in Meniere's disease was dependent on the frequency of the vertiginous attacks before the test or the duration from the last attack to the test.
(4) Combined with the glycerol dehydration test or electrocochleography, the FVOR test could detect endolymphatic hydrops of Meniere's disease at a high positive rate.
(5) There were no side-effects of the furosemide on the inner ear, such as deterioration of hearing acuity or tinnitus.
In conclusion, the FVOR test is useful for detecting and following up fluctuating vestibular endolymphatic hydrops, which occur in disorders such as Meniere's disease, delayed endolymphatic hydrops and syphilitic labyrinthitis.View full abstractDownload PDF (1106K) -
TAKEO FUSE, MASARU AOYAGI, TOSHIHISA SUZUKI, YOSHIO KOIKE1993 Volume 96 Issue 7 Pages 1125-1132,1225
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSTransiently evoked otoacoustic emissions (TEOAE) should be used clinically as an objective and noninvasive screening test for auditory dysfunction in children. The features of TEOAE measured by “ILO88” with non linear click stimuli are discussed.
The following results were obtained:
1) The normal range of a power spectrum was determined using 42 adults with normal hearing and compared with data for sensorineural hearing disturbance. The power spectrum of TEOAE in adults with normal hearing sloped downward at high frequency and was the same for right and left ears in both males and females. For comparison with sensorineural hearing disturbance, a significant correlation between the audiogram and power spectrum of TEOAE was sought.
2) Patients with otitis media with effusion (109 ears in 67 children) were examined by audiometry, tympanometry and TEOAE. The hearing disturbance threshold of 45 cases with TEOAE was lower than that in cases with no TEOAE. In tympanometry, low intratympanic pressure was noted in the absence of TEOAE.
3) TEOAE and spontaneous otoacoustic emission were examined in 42 adults with normal hearing and 27 neonates using the same probe and level of stimuli to clarify differences in TEOAE according to age. The amplitude of TEOAE and the highest peak of the frequency component at 4kHz in neonates exceeded those of adults. The peak stimuli recorded with the intracanal probe in neonates was also larger than that of adults. Three out of 15 neonates had spontaneous otoacoustic emission and essentially the same proportion was noted in young adults. The mechanical properties of the ear canal in neonates would thus appear to amplify stimuli more than in adults and consequently the ear canal may be related most closely to differences in amplitude and the spectrum of TEOAE.View full abstractDownload PDF (665K) -
MICHIO TOMIYAMA1993 Volume 96 Issue 7 Pages 1133-1140,1225
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe efficacy of a combination of cefaclor and fosfomycin otic solution was investigated in 81 children with acute otitis media, who needed myringotomy for severe erythema and swelling of the tympanic membrane. The patients were followed up for one year to investigate correlations between test findings of early treatment and both clinical course and prognosis. These drugs were used for 10 days, and the effects of combined use were evaluated from findings in the tympanic membrane after the 10-day period. Three stages were assessed; cured, recovered and unchanged. In cured and recovered cases, the administration was evaluated to be effective. Within 2 weeks after the start of treatment, views of the ears, nose and epipharynx were roentgenographically examined for shadows of mastoid pneumatization and the paranasal sinuses, and the presence or absence of adenoid vegetation. After the antibiotic administration, the patients were instructed to visit us at least once every 3 months to rule out recurrence of acute otitis media and otitis media with effusion (possibly occurring one year after treatment). The following results were obtained.
1. The two drug combination was effective in 99% of patients, produced no side effects, and was deemed extremely useful.
2. The course of acute otitis media tended to be significantly prolonged in patients with mastoid pneumatization and paranasal sinus shadows as revealed by roentgenography.
3. With regards to the prognosis of acute otitis media, the condition tended to evolve into refractory otitis media with effusion in patients with mastoid pneumatization shadows, and in patients with mastoid pneumatization shadows or a past history of acute otitis media with a tendency for recurrence of acute otitis media.
4. The patients with bilateral mastoid pneumatization shadows and those with lateral mastoid pneumatization shadows in which the growth of mastoid pneumatization in the affected ear was more suppressed than that in the contralateral ear, showed a tendency for recurrence of acute otitis media or evolution into refractory otitis media with effusion.View full abstractDownload PDF (847K) -
1993 Volume 96 Issue 7 Pages 1141-1150
Published: July 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 7 Pages 1150-1158
Published: July 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 7 Pages 1158-1166
Published: July 20, 1993
Released on J-STAGE: December 22, 2010
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1993 Volume 96 Issue 7 Pages 1167-1181
Published: July 20, 1993
Released on J-STAGE: December 22, 2010
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[in Japanese]1993 Volume 96 Issue 7 Pages 1182-1185
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
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[in Japanese]1993 Volume 96 Issue 7 Pages 1186
Published: July 20, 1993
Released on J-STAGE: October 22, 2010
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