All issues
Volume 98, Issue 4
Displaying 1-18 of 18 articles from this issue
- |<
- <
- 1
- >
- >|
-
A COMPARATIVE STUDY OF PRIMARY-SURGICAL AND PRIMARY-RADIOTHERAPEUTIC REGIMENSMAKITO OKAMOTO, HIROOMI TAKAHASHI, KAZUO YAO, KATSUHIDE INAGI, MEIJIN ...1995 Volume 98 Issue 4 Pages 571-578,753
Published: April 20, 1995
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSThe results of two treatment regimens for HCEC were compared. Surgery played a main role in the first regimen (Group A), in which patients underwent total pharyngo-laryngo-esophagectomy (with bilateral neck dissection and primary reconstruction by pectoralis major myocutaneous flap or gastric tube) after receiving 20Gy of irradiation therapy. Chemotherapy was combined in some patients. In the second regimen (Group B), radiation was employed as the main treatment in order to conserve the larynx. Chemotherapy (UFT 300 to 600mg/day; in some patients one or two courses of intra-venous cisplatinum therapy) was combined with radiation therapy (60Gy) to improve the effectiveness of this regimen. In case of radiation failure, a salvage operation was performed. We investigated 60 HCEC patients who visited the Kitasato University Hospital during the period from 1983 to 1992. The tumor was located in the PC. PS. PW, and Ce areas in 3, 48.5, and 4 patients, respectively. There were 25 cases in group A and 35 in group B. Five-year cumulative survival rates were 52% and 55%, respectively. In group B. tumor remained or recurred after the initial treatment in 13 patients. Three patients refused to receive salvage operation. Four of the 10 patients who received salvage operation became tumor free. The larynx preservation rate was 71% in group B. From the standpoint of improving QOL, the group B regimen is recommended.View full abstractDownload PDF (843K) -
TERUMICHI FUJIKURA, HIROKUNI OTSUKA1995 Volume 98 Issue 4 Pages 579-588,753
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSRecently monocyte chemotactic and activating factor (MCAF) has been reported to be a potent histamine releasing factor (HRF) for human basophils. In this study we investigated the localization and biological activity of MCAF in human nasal mucosa.
To investigate the localization of MCAF within the nasal mucosa we performed specific immunohistochemical staining of sections of large pieces of the inferior turbinate obtained by conchotomy from patients with nasal allergy and without nasal allergy and compared them. Sections of nasal mucosa from allergic subjects stained with anti-MCAF mAb demonstrated the presence of many MCAF-positive cells in the lamina propria especially around small vessels and excretory gland, but only a few positive cells were found in the nasal mucosa of normal subjects.
We cultured allergic nasal mucosa and sinus mucosa from patients with chronic inflammation for 2 days and detected MCAF by western blot analysis of the culture supernatants. One portion separated from sinus mucosa supernatunt by column chromatography also released histamine from human basophils. Mean release was 3-4% and the difference from the control was statistically significant (p<0.05). In the human nasal mucosa it seemed to exist IgE independent histamine releasing system sustained by MCAF producing cells.
These results suggested that MCAF is one of the important mediators causing histamine release in the late phase reaction and in protracted inflammation of the nasal mucosa.View full abstractDownload PDF (1678K) -
ISAO HOSHINO1995 Volume 98 Issue 4 Pages 589-598,753
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWhen vestibular organs are abnormally stimulated, autonomic reactions such as nausea, vomiting, palpitation, etc., occur, indicating the existence of fiber connections from the vestibular organs to the autonomic centers. The relationship between the “vomiting center” in the medulla oblongata as described by Borison and Wang and the vestibular nucleus remains obscure. To investigate the central mechanism of vomiting caused by vestibular stimulation, the intragastric pressure, gastric peristalsis and respiration during electric stimulation of the medullary vomiting center and the semicircular canal nerve were recorded in 12 adult cats. Evoked potential was also recorded while electrically stimulating the semicircular canal nerve.
When the peripheral labyrinth was stimulated, a conflicting result was founded, namely, that the pressure in the stomach increased or decreased.
Retching or vomiting-like behavior was observed in several sites when the dorsolateral portion of the reticular formation of the medulla was stimulated. It was found that neural structures in the dorsolateral portion of the reticular formation of the medulla were associated with the semicircular canal nerve, but retching or vomiting-like behavior was not always observed during stimulation there.View full abstractDownload PDF (2568K) -
STUDY OF STANDING EXACTITUDE BY CENTER OF PRESSUREHIROTAKA NAKANO, MASAHIRO TAKAHASHI1995 Volume 98 Issue 4 Pages 599-605,753
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSIn so far as stance is maintained during various activities, the center of pressure must be maintained with a certain area. This area is the range of the center of pressure. It is influenced by standing conditions and vision. In this study we used a force platform to measure the range of the center of pressure in 10 normal adults during maximal voluntary shifting from right to left, back and forth under 6 conditions (standing conditions: both legs apart, both legs together and standing on one leg; vision: eyes open and eyes closed). We also recorded the center of pressure while standing still for 30 seconds under the above 6 conditions. The scatter of the center of pressure and the range of the center of pressure were compared. Under easy standing conditions, the range of the center of pressure was very large and the center of pressure was concentrated in a small area.
The more difficult the standing condition, the smaller the range of the center of pressure, and the wider the scatter of the center of pressure. Under very difficult standing conditions, the range of the center of pressure was almost as large as the area in which the center of pressure was scattered. Since the range of the center of pressure is closely connected with the scatter of the center of pressure, it may be possible to determine the accuracy of stance regulation by analyzing the range of the center of pressure and the scatter of the center of pressure.View full abstractDownload PDF (526K) -
CLINICAL AND PATHOLOGICAL INVESTIGATIONTAKESHI YABE, HIROSHI MORIYAMA, YOSUKE KAMIDE, YOSHIO HONDA1995 Volume 98 Issue 4 Pages 606-612,755
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSFifty-nine cases of tympanosclerosis were investigated clinically and pathologically, and the following results were obtained:
1) The male to female ratio was about 1: 1.8
2) Calcification in the tympanic membrane was most common in the upper quadrants of the pars tensa, and never seen in the pars flaccida.
3) Calcification in the middle ear cavity was most common around the malleus.
4) Chronic otitis media was the most common complication of tympanosclerosis.
5) Preoperative audiometry revealed a stiffness curve with elevated bone conduction thresholds.
6) 54% of the patient had chronic otitis media in the contralateral ear.
7) Microscopic examination revealed calcification in the submucosa of the middle ear.
8) Postoperative hearing was improved in 49 ears (79.7%). Because there was no difference in the average postoperative hearing gain after type I and type III tympanoplasty, type III tympanoplasty is recomended to remove sclerotic masses completely.View full abstractDownload PDF (1236K) -
COMPARISON OF NORMAL VOLUNTEERS AND PATIENTS WITH UNILATERAL VESTIBULAR NERVE SECTIONSHINICHI MIZUNO, KIMITAKA KAGA, TOSHIHIRO TSUZUKU, HIDEAKI SAKATA1995 Volume 98 Issue 4 Pages 613-618,755
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSHorizontal eye movements in response to either earth vertical axis rotation (EVAR) or off vertical axis rotation (OVAR) by a 10° tilted axis were recorded in six normal subjects and three patients with unilateral vestibular nerve section. Both trials consisted of acceleration at approximately 400 deg/sec2 until an angular velocity of 180 deg/sec was reached followed by deceleration at -4 deg/sec2 until rotation ceased. This is the so-called dumped rotation procedure. Total numbers of nystagmic beats and the duration of perrotatory nystagmus in these two different trials were compared.
The results were as follows: 1) Total numbers of nystagmic beats in OVAR were significantly larger than in EVAR. 2) The duration of perrotatory nystagmus in OVAR was significantly longer than in EVAR.
Only the horizontal semicircular canals were stimulated by angular acceleration in EVAR, whereas both otolith organs and semicircular canals were stimulated on changing the position of the head around the direction of the gravity in OVAR.View full abstractDownload PDF (554K) -
II. OBJECTIVE ASSESSMENT AND RESULTSTORU KIKAWADA, SHIGEO MASUDA, MASAFUMI NAKAYAMA, SHIGEKI AKITA, YOJI K ...1995 Volume 98 Issue 4 Pages 619-626,755
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSTo optimize success in sinus surgery, we use a combined macro-micro-endoscopic technique (COMMET). This technique effectively combines use of the headlamp, microscope, and endoscope according to the demands of each anatomical region.
Between April 1991 and March 1994, we successfully performed this technique on 461 patients (798 sides). According to CT scans, about 40% of the patients had pansinusitis, and about 30% of the patients had anterior and posterior ethmoiditis combined with inflammation of other sinuses. Hence, severe cases requiring total ethmoidectomy accounted for about 70% of all sides. All patients were operated on under general anesthesia.
The objective of this operation was restoration of drainage and ventilation, and then to allow recovery of the reversible mucosal lesions. The goal of surgery was to normalize all paranasal sinuses. In many patients, there is little correlation between postoperative objective findings in the paranasal sinuses and subjective improvement. Therefore, postoperative subjective impmovement cannot be used as the criterion for evaluating the improvement of sinus disease.
Hence, we established an objective grading system based on CT and endoscopic findings and evaluated improvements in each sinus after drainage and ventilation had been restored. The rates of normalization over 1 year following surgery (mean follow-up time was 19-20 months) were 64% in the frontal sinus, 72% in the anterior ethmoid sinus, 68% in the maxillary sinus, 90% in the posterior ethmoid sinus and 80% in the sphenoid sinus.
The results differed from sinus to sinus, suggesting that there are different factors impairing recovery in each sinus. Analysis of these factors indicated that two points are very important in improving the recovery rate in response to endonasal sinus surgery. One is to open all diseased cells and sinuses. The other is to preserve the mucosa of the ethmoidal roof, at least the periosteum, especially in the anterior ethmoid region.View full abstractDownload PDF (1347K) -
AGE-RELATED CHANGES AND SEX DIFFERENCESSATOSHI AOYAGI1995 Volume 98 Issue 4 Pages 627-641,755
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSA morphological study of the human ventricular fold was conducted with special reference to age-related changes and sex differences. The laryngeal specimens examined were obtained from 54 autopsy cases consisting of 27 males and 27 females ranging in age from 20 to 79 years. Each specimen was frontal-sectioned between the anterior and posterior ends of the ventricular fold to yield 8 equal portions. The surface of the entire ventricular fold was reconstructed based on examination of all of the sections, and extent of squamous metaplasia was 3-dimensionally evaluated and expressed in the form of a histological map. In the cases in which smoking history was ascertained, extent of squamous metaplasia was evaluated by the same method. In all of the cases the distribution of the different types of tissues such as glandular, adipose and connective, was examined in the midportion of the specimen (section No. 5). The following conclusions were drawn as a result.
1. The development of squamous metaplasia reached a peak in the middle-age group, particularly in males. The 3-dimensional extension of metaplasia was classified into 4 patterns, however, there were no age-specific differences in pattern, and the posterior-dominant-type and widespread-type were the most common in all age groups. The extension of metaplasia varied with smoking history, suggesting that smoking promotes the extension of squamous metaplasia.
2. Glandular tissue decreased with age, more markedly in females. The distribution of the glandular tissue was classified into 4 patterns. Atrophy of glandular tissue with age occurred in the central area of the ventricular fold, extending to the marginal portion.
3. Collagen fibers decreased slightly with age. Elastic fibers appeared frequently in the lateral portion near the laryngeal ventricle in the aged group.View full abstractDownload PDF (2676K) -
NOBUYOSHI OHTORI, MASAYA FUKAMI, KIYOSHI YANAGI, KAZUYASU ASAI, HIROSH ...1995 Volume 98 Issue 4 Pages 642-649,757
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSOlfactory disturbance is the one of the most important symptoms of chronic sinusitis. In the present study, we followed up the postoperative clinical course of olfactory disturbance in patients who underwent surgery for chronic sinusitis.
Ninety patients with severe olfactory disturbance or anosmia who underwent endoscopic endonasal surgery for chronic sinusitis with severe olfactory disturbance or anosmia in the preceding three-year period were enrolled in this study. We obtained a high postoperative improvement rate of 78.8%. We compared and examined our cases' postoperative clinical course concerning their olfactory disturbance and various factors in other patients before and after surgery, and obtained the following results:
a) Young patients, 30 years old or under at the time of surgery, showed significantly higher rates of improvement than patients who were 50 years old or more at the time of surgery.
b) Even though revision surgery was performed, the improvement rates were almost the same as after the initial surgery.
c) Although the Alinamin intravenous olfaction test is regarded as an olfaction threshold test, we have seen quite a few cases in which improvement was achieved despite the absence of a preoperative response to the Alinamin intravenous olfaction test.
d) There was no clear correlation between the presence of preoperative lesions of the ethmoid sinus and the olfactory cleft and the improvement rates.
e) The cases with unsatisfactory results concerning the paranasal sinuses and nasal cavitythose accompanied by postoperative abhesions of the olfactory cleft, recurrence of polyps, etc., -showed significantly lower improvement rates than cases with satisfactory postoperative results.
During surgery in patients with severe olfactory disturbance, we conclude that it is particularly important to adequately clean the lesions of the olfactory cleft and the anterior and posterior ethmoid sinus endoscopically. This ensures leaving clear the olfactory cleft.View full abstractDownload PDF (2065K) -
STUDIES OF A ONE STAGE IPSILATERAL RECONSTRUCTIVE PROCEDURESATOSHI KATSUNO1995 Volume 98 Issue 4 Pages 650-658,757
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSRecent advance in vascular surgery have made vascular reconstruction of the carotid artery possible. Since 1990, the authors have performed en bloc resection of the carotid artery and vascular reconstruction of the carotid artery, using a temporary shunt tube, in 10 cases. Among these 10 cases of tumors involving the carotid artery, two cases had carotid body tumors and the other eight cases had metastatic lymph nodes from head and neck cancers.
Transient motor paralysis occurred in three cases and disorientation in one after the operation. None has developed severe neurological complications such as death, coma or permanent hemiplegia. Despite preoperative irradiation, local infection was noted in only one case after the operation. Rupture of the vein graft was prevented by using a DP flap to cover dead space at the anastomotic site. The two patients with a carotid body tumor are alive without evidence of recurrence. Among eight patients with cancer, three are still alive and disease free (respectively 44, 30 and 16 months). Two patients died of local recurrence, two of distant metastasis and the other of acute heart failure. Local tumor control was possible in six out of eight patients. We were able to safely perform en bloc resection of the carotid artery and vascular reconstruction of the carotid artery using a temporary shunt tube. In conclusion, we anticipate increasing curability of advanced tumors involving the carotid artery using this procedure.View full abstractDownload PDF (1818K) -
MICHIO TOMIYAMA1995 Volume 98 Issue 4 Pages 659-668,757
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSChanges in nasopharyngeal flora were investigated in children with acute otitis media and with acute exacerbations of chronic sinusitis in whom antibiotic therapy of relatively long duration was required until substantial improvement in clinical findings was achieved.
1. The antibiotics used were two cephalosporins, i.e., cefaclor (CCL) and cefixime (CFIX), administered to 18 patients each for 1 week and to 26 and 20 patients, respectively, for 2 weeks. Bacteriologic examination of the nasopharyngeal mucosa was performed at the first visit and at 1 week in those who underwent antibiotic therapy for 1 week, and at the first visit and at 1 and 2 weeks in those treated with antibiotics for 2 weeks.
2. The elimination rates for the infecting microorganisms in the patients in the CCL-treated group were 30% for Haemophilus influenzae. 83% for Staphylococcus aureus, 100% for Streptcoccus pyogenes and 100% for Streptcoccus pneumoniae at 1 week, and 18% for H. influenzae, 100% for S. aureus and 100% for S. pyogenes at 2 weeks of antibiotic therapy. Replacement of S. aureus and S. pyogenes by H. influenzae was observed.
3. The elimination rates for infecting bacteria in the patients in the CFIX-treated groups were 61% for H. influenzae. 50% for S. aureus, 75% for S. pyogenes, 80% for S. pneumoniae and 100% for Moraxella catarrhalis at 1 week, and 72% for H. influenzae, 0% for S. aureus, 100% for S. pyogenes, and 0% for S. pneumoniae at 2 weeks of antibiotic therapy. The elimination rate for H. influenzae at 2 weeks was significantly higher than the corresponding value for the CCL-treated group. Replacement of H. influenzae by S. aureus and S. pneumoniae and of S. pyogenes by S. aureus was detected.
4. There was one patient with acute otitis media in the CFIX-treated group in whom a clinical relapse occurred due to H. influenzae persisters in the nasopharynx. Thus the diagnosis in this patient was so-called “recurrent otitis media”.
5. H. influenzae tended to persist after exposure to therapeutically adequate concentrations of CCL, as did S. aureus and S. pneumoniae following treatment with CFIX. Thus, it would seem that ample heed must be given to persistence, particularly of H. influenzae and S. pneumoniae, the most common causative agents of acute otitis media in childhood.
6. A significant rise in the MICs of the cephalosporins was observed in 4 of 43 patients in whom the same type of organism was isolated from the nasopharynx at weekly intervals during antibiotic therapy. Since cephalosporin therapy brought about a substantial improvement in clinical symptoms in all 4 of these patients with a definite reduction in the infecting bacterial population, the development of drug resistance was considered to be due to selection of a small number of resistant strain among the drug susceptible majority of the microbial population against which the cephallosporins were destructive.View full abstractDownload PDF (1037K) -
YUKO TAKAHASHI1995 Volume 98 Issue 4 Pages 669-680,757
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWith a microtesting system which can measure the mechanical properties of small tissue membranes. we have measured the mechanical properties of the round window membrane on the guinea pigs and the human. We also found that, as a result of formalin-fixation, round window membranes become weaker and that this effect of formalin-fixation is greater on human round window membranes than on those of guinea pigs.
Since the protein in collagen fibers, which are the main constituent of round window membranes, is coagulated and fixed with formalin, we consider that the strength of the membranes decreases and that this is more evident in human membranes, which contain more collagen fiber.
Having compared the mechanical properties of the fresh round window membranes of guinea pigs with those of humans, we found that the human membranes are approximately five times stronger than those of guinea pigs. This difference is considered to stem from the species differences.
Also, having compared the mechanical properties of the tympanic membranes with those of the round window membranes each species, we found that the round window membranes of guinea pigs are almost the same as their tympanic membranes in terms of strength, whereas human tympanic membranes are stronger and harder than the round window membranes.
In view of the minimum pressure causing destruction of human round window membranes, as deduced from the experiment on guinea pigs, it is possible that human round window membranes may be ruptured in the perilymphatic fistula.View full abstractDownload PDF (2990K) -
MOTOYUKI HASHIBA, KEIKO YASUI, HIROTAKA WATABE, TORU MATSUOKA, SHUNKIC ...1995 Volume 98 Issue 4 Pages 681-696,759
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSAbnormalities of smooth pursuit eye movement (SPEM) have been estimated, mainly using the wave form on an electro-oculogram, in a qualitative way. Many methods for quantitative analysis of SPEM have been designed, though most are still uncommon in present clinical use. Using a personal computer, we developed a method of automatic quantitative analysis of ocular tracking eye movement recorded by electro-oculography (EOG). The design concept of this method is based on the observation that eye movement during ocular tracking consists of two different kinds of eye movements, one is SPEM and the other is saccade. The combination of SPEM and saccade (composite eye movement: CEM) commonly appears during ocular tracking. These two kinds of eye movement are essentially different not only in behavior but also about involved neural pathway in the central nervous system. From this point of view, we believe that the two kinds of eye movements involved in ocular tracking should be evaluated separately.
The analysis method is outlined as follows. A horizontal sinusoidally moving visual target was employed to elicit ocular tracking eye movements. The test frequencies were set at 0.1, 0.2, 0.4 and 0.8Hz, and the amplitude of target motion was 15 deg at each frequency. The 20 seconds of eye movement data measured by EOG were fed into the computer through a digital-analog converter for further analysis. Using our original saccade detection algorithm, based on the physiological behavior of saccades, the saccadic components were detected and removed from the eye movement wave. The remaining parts, fragments of SPEM, were connected by means of interpolating defective parts. The reconstructed wave was a slow cumulative eye position curve (SCEP). Sinusoidal target motion, CEM and SCEP were processed by the FFT (Fast Fourier Transformation) method. Bode plots were applied to summarize the gain and phase of responses to SCEP and the target motion wave.
These processes enable us to estimate abnormalities of SPEM such as low gain, abnormal phase shift and large trends in tested duration. We conclude that the method described here is useful for quantitative estimation of SPEM in clinical neuro-otological examinations.View full abstractDownload PDF (1290K) -
1995 Volume 98 Issue 4 Pages 697-705
Published: April 20, 1995
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSDownload PDF (1021K) -
1995 Volume 98 Issue 4 Pages 705-714
Published: April 20, 1995
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSDownload PDF (1186K) -
1995 Volume 98 Issue 4 Pages 714-728
Published: April 20, 1995
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSDownload PDF (1807K) -
1995 Volume 98 Issue 4 Pages 728-742
Published: April 20, 1995
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSDownload PDF (1700K) -
[in Japanese]1995 Volume 98 Issue 4 Pages 744-747
Published: April 20, 1995
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSDownload PDF (254K)
- |<
- <
- 1
- >
- >|