All issues
Volume 97, Issue 6
Displaying 1-9 of 9 articles from this issue
- |<
- <
- 1
- >
- >|
-
TAKASHI FUJIMOTO, MINORU KINISHI, MITSUHIRO MOHRI, MUTSUO AMATSU1994 Volume 97 Issue 6 Pages 1009-1018
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSOver the past 17 years, we have been performing tracheoesophageal (TE) fistulization for voice restoration following total laryngectomy. The purpose of this technique is to divert the exhaled air through the TE fistula into the hypopharynx where the inferior constrictor muscle forms the retropharyngeal prominence on which the neoglottis is located. It is generally accepted that both pulmonary power and laryngeal adjustment control voice frequency and intensity change in laryngeal phonation. Regularity at various pitches and voice intensities was seen in TE phonation, despite laryngeal adjustment being lost. Regular voice production with various pitches and intensities requires a regulatory mechanism for both pulmonary power and the neoglottis. This study was designed to clarify the mechanism of neoglottic adjustment in TE phonation.
Ten speakers with TE fistula were subjected to aerodynamic and electrophysiological investigations. Tracheal pressure, fundamental frequency, intensity, and airflow rate were measured for easy phonation, a high-pitched voice, and a loud voice. Resistance and efficiency of the neoglottis were calculated from the data obtained. Electromyograms of the inferior constrictor muscle and tracheal pressure were simultaneously recorded when the pitch or intensity of the voice increased.
Six of the ten subjects examined were able to produce a high-pitched voice. Tracheal pressure increased in all six, the airflow rate in four, and neoglottal resistance in five, as compared with the data obtained during easy phonation.
Nine of the ten subjects examined were able to produce a loud voice. In all nine, both tracheal pressure and the airflow rate increased as compared with the values measured during easy phonation. Neoglottal resistance had no deffinite pattern in relation to voice intensity changes.
Electrophysiological study demonstrated that the activity of the inferior constrictor muscle increased as tracheal pressure increased so as to raise the pitch or increase the intensity of the voice.
These results indicate that the adjustment of neoglottic closure and stiffness produced by the inferior constrictor muscle has the role of varying the frequency or intensity of the voice.View full abstractDownload PDF (800K) -
MASAHIRO OGAWA, SHOJI TAKOODA, WATARU NISHIJIMA, REIKO TSUNODA1994 Volume 97 Issue 6 Pages 1028-1033
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSSalivary duct carcinoma is an uncommon neoplasm which was first described by Kleinsasser et al. in 1968. They pointed out the histologic resemblance of this tumor to ductal carcinoma of the breast and termed it salivary duct carcinoma. Since then, about sixty cases, including some with suspicious pathologic pictures, have been reported. The characteristic microscopic features of salivary duct carcinoma are composed of comedo necrosis, a cribriform and papillary pattern of intraductal growth and aggressive infiltration to adjacent structures. Salivary duct carcinoma, which is the highest-grade malignancy among salivary gland tumors, must be treated aggressively with curative extended surgery. We present the case of a 74-year-old woman with salivary duct carcinoma of the parotid gland. She complained of left facial palsy and left subaural mass. For this advanced tumor involving facial palsy and subaural cutaneous invasion, en block resection with cutaneous reconstruction with a deltopectoral flap and postoperative radiation therapy was performed. She is alive without evidence of recurrence more than four years after this combined therapy.View full abstractDownload PDF (2440K) -
TETSURO SAKA, YUZO YAMAMOTO, TAKASHI ITOH, ISAO INOUE, MASASHI IMANAKA ...1994 Volume 97 Issue 6 Pages 1034-1040
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSSome papillary carcinomas of thyroid glands contain not only typical papillary structures but also various histological features in the same tumor. To investigate how areas with variable histological features differ in proliferative activity and how these differences influence the biological behavior of the whole tumor, we measured DNA contents by cytofluorometry in six papillary carcinomas with different histological features in the same tumor. DNA ploidy patterns were determined and the percentage of S plus G2M phase cells (S+G2M fraction) was calculated only in diploid tumors to assess the proliferative activity. The following conclusions were drawn.
1) It was demonstrated that there were differences in proliferative activity among areas with variable histological features in 4 of six tumors.
2) In the tumors which invaded adjacent tissues, the proliferative activity of the invasive area tended to be higher than that of the original area of the tumor. Therefore, the possibility exists that more precise evaluation of the biological behavior of the tumor can be obtained by measuring DNA contents of the tumor cells in invasive areas.
3) There was the gap in S+G2M fractions among some tumors with the same histological differentiation. Accordingly, DNA analysis of tumors would be of value in estimating proliferative activity.View full abstractDownload PDF (2455K) -
TOMOKAZU YOSHIZAKI, MITSURU FURUKAWA1994 Volume 97 Issue 6 Pages 1041-1046
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSExtracorporeal shock wave lithotripsy (ESWL) was undertaken on 11 patients with sialolithiasis. In three patients, fragmented calculi were excreted via the duct of the gland. In four patients, though fragmented calculi were excreted from the gland to the duct, complete disappearance was not achieved. It was therefore necessary to remove the fragmentaed calculi by intraoral ductotomy. However, without ESWL, submandibular glandectomy would have been unavoidable.
As for the two patients who had an intraducted stone and the one patient who had a 20mm stone in his submandibular gland, ESWL was not effective. No severe complications occurred either during or after ESWL. ESWL is beneficial for the treatment of salivary stones, especially of the intraglandular and transitional zone type, and for stones smaller than 10mm.View full abstractDownload PDF (1345K) -
KATSUHIDE INAGI, HIRO-OMI TAKAHASHI1994 Volume 97 Issue 6 Pages 1047-1055
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSIntractable recurrent ulcer of the oral cavity and pharynx was defined as irregular ulcerative lesions occurring only in the oral cavity and pharynx, showing no specific findings on clinico hematological examinations, which recurred easily and were resistant to various treatments for at least one month. Twenty-two cases with intractable recurrent ulcer were studied histologically.
The following results were obtained:
1. Five histological types (LP type, LPE type, NL type, NLE type and NLP type) were identified, according to the invasive cells present, using H. E staining.
2. Subclasses of the invasive lymphocytes were classified using UCHL 1 and L26. As a result, both LP type cases showed dominant T lymphocyte invasion.
3. Appearances of the activated T lymphocytes and langerhans cells were studied using anti Human HLA-DR and epithelial and endothelial expression of HLA-DR were observed. As a result, the characteristic fingings of each histological type were demonstrated.
These results suggest that cellular immunity may participate in the occurrence and progression of intractable recurrent ulcer. However, its role in the causes and effects of ulcer cannot be confirmed at this point.View full abstractDownload PDF (4177K) -
NOBUKO KAWASHIRO, NOBUAKI TUCHIHASHI, AKIO ARAKI, KEIJIRO KOGA, YUSHI ...1994 Volume 97 Issue 6 Pages 1056-1061
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSWe experienced 10 pediatric cases born between November of 1988 and November of 1992, whose ABR were normal at the time of discharge from the NICU, who subsequently developed hearing impairment. These children underwent thorough evaluations and the causes of their hearing loss are discussed herein. All 10 were born at full term, birth weights ranged from 2500g to 3826g, and all had severe cardiovascular and/or pulmonary disorders. Eight of the 10 had
persistent pulmonary hypertension of the newborn (PPHN). During the four year period in which these 10 infants were born, a total of 25 PPHN cases were diagnosed in our NICU, i. e. the rate of hearing loss in PPHN infants was 32% (8/25). All 10 infants were intubated and maintained on mechanical ventilation for an average of 30 days. Five cases also required high frequency oscillation and six received extracorporeal membrane oxygenation (ECMO). During the same time period there were only eight surviving ECMO cases such that the rate of hearing loss was 75% (6/8). All 10 were treated with an aminoglycoside, furosemide and a muscle relaxant. As These infants are at very high risk for hearing impairment, follow-up at 6 and 12 months of age is
essential.View full abstractDownload PDF (452K) -
SHIN-ICHIRO NARITA, HIROKO SAITO, KOHJI ASAKURA, HIDEAKI SHIRASAK, [in ...1994 Volume 97 Issue 6 Pages 1062-1069
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSWe performed a study of eosinophil migratory responses in nasal lavage fluid from patients with nasal allergy after allergen challenge. We also measured the concentration of eosinophil cationic protein (ECP) and histamine in nasal lavage fluid after the challenge.
The concentrations of ECP and histamine in nasal lavage fluid increased after allergen challenge. The total number of cells, eosinophils and the ratio of EG2 positive eosinophils also increased after the challenge. These responses were enhanced in the group with severe symptoms. Furthermore, the ratio of EG2 positive eosinophils was increased even in the group with mild symptoms. In some cases, the concentration of ECP and the ratio of EG2 positive eosinophils increased again 6-8 hours after allergen challenge. Our results suggest a possible relation between the activation of eosinophils and the nasal symptoms of nasal allergy.View full abstractDownload PDF (1117K) -
YUKIKO IINO, SHIN-ICHI OKURA, JUNJI SHIGA, MINORU TORIYAMA, KOICHIRO K ...1994 Volume 97 Issue 6 Pages 1070-1078
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSLow-dose and long-term administration of erythromycin (EM therapy) has been reported to be very effective for patients with intractable chronic sinusitis including sinobronchial syndrome. However, we sometimes encounter patients whose sinusitis is extremely resistant to EM therapy. Therefore, the present study was carried out to determine the correlation between the clinical efficacy of EM therapy and the histopathological features of the ethmoidal mucosa and nasal polyps of patients treated with erythromycin. Patients with significant lymphocytic infiltration in the submucosal area responded well to EM therapy. Furthermore, patients with neutrophilic infiltration within and beneath the ciliary epithelium tended to show improvement with this therapy.
On the other hand, EM therapy was minimally effective in patients whose subepithelial layer showed marked eosinophilic infiltration. In patients showing excellent and good clinical results, histological changes in the paranasal mucosa after therapy were as follows: a decrease in the number of inflammatory cells, reduced interstitial edema, increased fibrosis and normalization of the secretory glands. From these results, we conclude that erythromycin may suppress chronic inflammation except for an allergic reaction characterized by marked eosinophilic infiltration.View full abstractDownload PDF (1974K) -
KENJI OHTUKA, HIROSHI TOMITA, YUKI YAMAUCHI, HIDETO KITAGOH1994 Volume 97 Issue 6 Pages 1079-1089
Published: 1994
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThere are some patients, though few in number, who complain of taste disturbance after tonsillectomy.
Actual measurement of the distance between the lingual branch of the glossopharyngeal nerve, which controls taste in the posterior portion of the tongue, and the lower pole of the palatine tonsil, using a cadaver, showed the distance to be only 2-4mm, thereby suggesting the danger of direct or indirect disturbance of this nerve by tonsillectomy.
Among the 3, 583 outpatients complaining of taste disturbance whom we have treated at our taste disorder clinic in the last 15 years, 11 (0.31%) were found to be suffering from taste disorder triggered by tonsillectomy.
Among these 11 causes, the causes of taste disturbance have been identified in 8 cases. In three cases, the taste disturbance was caused by direct or indirect damage to the lingual branch of the glossopharyngeal nerve, whereas in another two cases, the disturbance was attributable to medication following tonsillectomy. In the remaining three cases, the diagnosis was a taste disturbance initiated by tonsillectomy but actually caused by a lack of dietary zinc.
It is therefore important that patients be informed of the risk of post-operative taste disorder following tonsillectomy, at the time informed consent for tonsillectomy is obtained. It is equally important to measure the taste threshold values for each taste nerve and the serum zinc value as part of the preperational examination, and to ask the patients what drugs, if any, they take habitually.View full abstractDownload PDF (1706K)
- |<
- <
- 1
- >
- >|