Practica Oto-Rhino-Laryngologica

An Electron Microscopic Study of the Development of the Olfactory Mucosa in the Mouse

Masuhiro Noda

1981 Volume 74 Issue 9special Pages 1965-1982
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_1965

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The morphological development of the olfactory mucosa in the mouse during embryogenesis from day 10.5 of embryonic age (vaginal plug=day 0) to birth, and in the postnatal period from birth up to 2 weeks was studied using the scanning electron microscope (SEM). The SEM findings were also compared with light and transmission microscopic findings. The observed chronological changes are summarized as follows:
1. The early development changes appear at day 10.5 to 11.5 of embryonic age (EA). The definite olfactory pits are formed at this stage. The surface at the bottom of the pits is covered with cells with numerous microvilli. There is a considerable number of cilia among these microvilli.
2. The rudiments of the olfactory vesicle, in the form of spherical process with a few cilia, appear on the postero-lateral wall of the nasal cavity at day 12.5 EA.
3. The fairly developed olfactory vesicles and the olfactory cilia are recognizable among these rudiments at day 15.5 EA. The supporting cells around the olfactory vesicle can be identified by this stage. They are densely covered with long microvilli. The basal cells can also be differentiated. At a lower magnification, a border between the olfactory part and the respiratory part is apparent. However, a higher magnification shows considerable intermingling of immature respiratory cells and olfactory cells.
5. During the neonatal period the olfactory cilia further increase their number and also change their shape. Swelling and plates begin to appear at the distal ends of the cilia, and nodules are formed at their middle portions.
6. The morphology of the mucosal surface at 2 weeks after birth is almost identical with that of the adult mouse.

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Ultrastructural Observations of Human Facial Nerve

Michinori Kurokawa

1981 Volume 74 Issue 9special Pages 1983-1998
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_1983

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Specimens of facial nerve obtained during surgical decompression were observed by electronmicroscope and evaluated clinicopathologically in 2 cases of Bell's palsy, 1 case of herpes zoster oticus, 1 case of facial paralysis with acute middle ear infection and 4 cases of traumatic facial paralysis.
It was found to be possible in some cases of facial paralysis to predict the recovery with the facial nerve specimen before the electric examination, especially the EMG and evoked EMG will demonstrate some early regenerative potentials. In Bell's palsy, surgical decompression may be indicated not only in early cases, but also in late cases. In some cases of traumatic facial palsy, it is necessary to perform a nerve graft even if the facial nerve has not been severed.

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Morphological Study of Middle Ear and Eustachian Tube Part-one

Normal Structure of Epithelial Cells of Middle Ear and Eustachian Tube-A Scanning Electron Microscopic Study

Mariko Yamashita

1981 Volume 74 Issue 9special Pages 1999-2012
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_1999

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Mucosa of the middle ear and the Eustachian tube were studied by the scanning electron microscope (SEM) in humans, dogs, rabbits and guinea pigs. The following results were obtained:
1. Ciliated cells surrounded by nonciliated cells with microvilli were very few on the mucous of the middle ear. Distribution of ciliated cells was very various at the site of the tympanic bulla.
2. Near the tympanic orifice of the Eustachian tube, less ciliated cells and numerous goblet cells were observed.
3. The middle portion of the tube was found to be the most active. It was here that goblet cells and a large number of ciliated cells were found. Cilia were dense, uniform bent toward the pharyngeal end, and covered by a mucous blanket.
4. Near the pharyngeal end, goblet cells were numerous, while cilia were scanty and not uniform in length.
5. No significant difference could be seen among the four materials (humans, dogs, rabbits, guinea pigs).
Our findings support the concept that middle ear clearance is carried out by an active mucociliary mechanism as in other parts of the upper respiratory system.

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Scanning Electron Microscopic Observation of Vestibular Sensory Cells by Means of the Cracking Method

Ryozo Yabuta

1981 Volume 74 Issue 9special Pages 2013-2021
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2013

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The frozen crack surface of the vestibular sensory epithelium in the guinea pig were observed by the scanning electron microscope.
The specimens were prepared by “Os-DMSO-Os method” which was introduced by Tanaka and Naguro.
Type 1 cells were surrounded by nerve chalice which was an afferent nerve ending and were floated in that nerve chalice.
The afferent nerve endings were observed in contact with nerve chalice.
Type 1 cells were seen mainly on the central part of the semicircular canal cristae.
The organelles in the vestibular sensory cells were observed with field emission scanning electron microscope and three-dimensional architectures of mitochondria, endoplasmic reticulum and Golgi apparatus could be observed.

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The Ultrastructure of the Endolymphatic Sac

Shuji Miyawaki

1981 Volume 74 Issue 9special Pages 2022-2030
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2022

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Luminal surface structures of human and dog endolymphatic sacs were observed with the scanning electron microscope. Based on morphological views, we recognized three portions in both human and dog endolymphatic sacs as described in previous investigations. Those were the proximal, intermediate (rugose) and distal portions. The intermediate portion where light and dark cells were recognized, was found to be the most active and highly differentiated part.
The morphological structure seemed to be more complicated in this portion because in addition to these light and dark cells, flat duct type cells and fusiform cells were also seen. Additionally, vesicles which appeared to be secreted were seen in this intermediate portion.
Both the distal and the proximal portions were lined with flat type cells. Among these flat type cells groups of dome like cells were seen in the endolymphatic sacs of humans. On the other hand, centrioles were observed on some flat cells in the dog endolymphatic sac.

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Scanning Electron Microscopy of the Nerve Endings in the Organ of Corti

Mangape Dominggus

1981 Volume 74 Issue 9special Pages 2031-2040
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2031

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Scanning Electron Microscopic (SEM) study of the innervation of the organ of Corti has been carried out for many years. Various methods had been used in attempt to observe the more details about the endings of nerve fibres on the sensory hair cells.
In the literature, we found many reports concerning about these nerve endings, but there is no detail report about the differences of these nerve endings' structure from each turn of the organ of Corti. The purpose of this study has mainly been to present the SEM findings of the nerve endings from each half-turn.
Inner ear from 15 guinea pigs were studied. Dissection was performed using a small double-sided adhesive tape. This method could provide a more favorable field to observe nerve endings, since the organ of Corti has almost always separated at space of Nuel.
Our findings revealed an illustrative comparison of variations of the nerve endings and the Deiters cells in each half-turn, beginning from the lower basal turn to the upper fourth turn. Nerve endings at the lower pole of outer hair cells are reduced in size and number as the upper turn is approached more closely. On the contrary, the Deiters cells are increased in size toward the upper turn, therefore nerve endings on the upper turn are often covered by the Deiters cells.
Small high nerve endings on the cell side of outer hair cells were also described.

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Complications of Tracheal Intubation

Hisashi Sasaki

1981 Volume 74 Issue 9special Pages 2041-2066
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2041

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Endotracheal intubation provides an excellent method of controlling the patient's airway during anesthesia. This technique is also very useful in the case of reanimation and in other kinds of operations. However, we have occasionally experienced various complications as a result of the endotracheal intubation using a cuffed tube. In our clinic, such complications as sore throat, vocal cord paralysis, intubation granuloma and membraneous tracheitis have been experienced.
In this report, we evaluated three kinds of complications due to the endotracheal intubations. The complications evaluated included 39 cases of recurrent nerve palsy, 4 cases of laryngeal granuloma and 7 cases of membraneous tracheitis. The three most common cases of those complications were an imappropriate tube size, an over-inflated cuff and/or a prolonged intubation.
In addition, some specimens were studied by using the scanning electron microscope and results obtained were compared to the clinical complications.

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Tympanometry under General Anesthesia

Akinori Kishimoto

1981 Volume 74 Issue 9special Pages 2067-2074
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2067

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Tympanometries of 18 patients were measured under GOF anesthesia and NLA anesthesia in order to obtain information about the functioning of the middle ear under general anesthesia.
Tympanometry is a relatively simple method to measure the middle ear pressure. So far, there are few reports concerning the influence of general anesthesia on the middle ear. This report is designed to estimate the general anesthetic effect, especially of nitrous oxide anesthesia, on the middle ear pressure and function as it relates to the gas effusion theory. Theoretically calculated pressure of the middle ear agreed with the measured values. Some conclusions were obtained about the relationship between change of pressure in the middle ear and the strength of the tympanic membrane.

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Xeroradiography in the Head and Neck Regions

Ryozo Yabuta, Koji Yajin, Yoshiro Sugimoto, Yasuo Harada

1981 Volume 74 Issue 9special Pages 2075-2081
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2075

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Xeroradiographies of 55 cases in the head and neck regions were discussed.
Xeroradiography is more convenient than the conventional roentgenography in the cases of calcification of the lymph node, larynx, trachea, and salivary calculus. A disadvantage of the technique is that radiation dosage from Xeroradiography greater than that from conventional roentgenography.

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On the Prevalence Rate of the Chronic Sinusitis

Koji Yajin, Yasuo Harada, Yoshiro Sugimoto, Hideto Okazaki, Nobuharu T ...

1981 Volume 74 Issue 9special Pages 2082-2095
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2082

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The authors reported on the prevalence rate of the chronic paranasal sinusitis of 10201 school children in the city of Hiroshima and in Yoshida town (the rural area of Hiroshima Prefecture) from the 1st April to the 10th July 1980. The chronic paranasal sinusitis was diagnosed by the local findings of the middle nasal meatus and its adjacent areas. The following results were obtained.
1. The total prevalence rate of this period was 2.79%.
2. The prevalence rate of the male children was more than that of the female in both areas. The rate was 3.59% to 1.96%.
3. The elder were children, the less were the rates in both areas.
4. The more children in Yoshida town suffered from the chronic paranasal sinusitis (the rate: 6.81%) than in Hiroshima city (the rate: 2.19%).
The factors of natural conditions and nutrition influenced the prevalence rate in our study.
The main factors, however, were thought to be the difference of the mean temperaature and nutrition between two areas.

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Statistical Observations of the Parotid Tumors

Yoshiro Sugimoto, Katsuhiro Hirakawa, Koji Yajin, Yoshinori Kikuya, Ta ...

1981 Volume 74 Issue 9special Pages 2096-2103
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2096

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Eighty-three cases of parotid tumor were treated in our clinic during the past thirteen years.
They were reviewed according to histology, sex, age, symptoms, surgical procedure, postoperative complication and end results. Of the 83 parotid tumors, 59 were benign and 24 were malignant. No decisive conclusions could be obtained as to the malignancy or stage of parotid tumors by any single preoperative evaluation procedure including scintigraphy using ^99mTc pertechnetate and ⁶⁷Ga-citrate, computed tomography (CT), or ultrasonics. Therefore, it was concluded that preoperative evaluation of parotid tumors should be confirmed by a synthesis of these procedures, and the proper surgical treatment should be chosen at the earliest possible stage.

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Statistical Observation of Carcinoma of the Maxillary Sinus Seen in a Recent Ten-Year Period

Katsuhiro Hirakawa, Nobuharu Tagashira, Yoshiro Sugimoto, Tatsuo Yoshi ...

1981 Volume 74 Issue 9special Pages 2104-2110
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2104

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Eighty-seven cases of carcinoma of the maxillary sinus, treated from 1969 to 1978 at Hiroshima University Hospital, were investigated clinically.
The following results and conclusions were obtained: [1] Men were affected more frequently than women, in a ratio of 1.7:1. The greatest incidence was in the 50- to 60-year age groups. [2] Histologically, squamous cell carcinoma was by far the most common malignant tumor. [3] All cases, excluding two malignant lymphomas, were classified based on TNM system. The results were: T₁, 1; T₂, 19; T₃, 59; T₄, 6. The incidence of cervical metastasis was rather small (13%). [4] Overall three- and five-year survival rates were 40.0% and 31.6% respectively. Three- and five-year rates by stage were: T₁₊₂, 53.3% and 43.7%; T₃, 36.6% and 26.8%; T₄, 0% and 0%. [5] The most successful treatment was a combined therapy consisting of local chemotherapy, radiation and necrotomy, followed by radical surgery. Three- and five-year survival rates for this treatment were 56.3% and 43.8% respectively.

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Statistical Observations on Cases with Unilateral Shadow of Maxillary Sinus

Katsuhiro Hirakawa, Yoshiro Sugimoto, Koji Yajin, Yashinori Kikuya

1981 Volume 74 Issue 9special Pages 2111-2117
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2111

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Two hundred and twelve cases of unilateral shadow of maxillary sinus, experienced at Hiroshima University Hospital from 1976 to 1978, were clinically evaluated.
Chronic sinusitis was the most common diagnosis but maxillary carcinoma was found in 18 cases (8.5%). During this period, the number of cases of maxillary carcinoma with unilateral shadow was larger than that with bilateral shadow.
Diagnosis and treatment of the maxillary carcinoma in the early stage are very difficult because of the anatomy of the maxilla, but detailed information about the malignancy and stage of maxillary carcinoma should be obtained by using ortho-pantomography, computed tomography, scintigraphy, etc. Even if no signs of malignant tumor are obtained, exploratory surgery and histological examination definitely should be performed.

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A Case of a Foreign Body in the Epipharynx

Minoru Takeuchi, Koji Yajin

1981 Volume 74 Issue 9special Pages 2118-2123
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2118

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We have recently experienced a case of the foreign body which stayed in the epipharynx of a five year old girl for two years. The patient had an episode of swallowing a plastic toy two years ago. No symptoms, however, was seen before the patient complained of a purulent nasal discharge and conductive hearing impairments of both sides (average 35dB).
The foreign body was partialy covered with granulation in the epipharynx.
We emphasized that for the examination of foreign bodies, especially in children, a fiberoptic instrument and/or CT scanner was of good use. The statistical review was additionally reported.

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A Case of Alveolar Soft Part Sarcoma

Masakaze Nakata, Yoshinori Kikuya, Yasuyuki Kihara, Nobuharu Tagashira ...

1981 Volume 74 Issue 9special Pages 2124-2129
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2124

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A 70-year-old female was presented to the hospital with complaints referable to nonpainful, bleeding mass in the nasopharynx. The elastic hard and fixed tumor was removed by the approach of transpalatine. Radiotherapy was performed after operation. But the patient expired of recurrence about three years after initial diagnosis.
The histological examination revealed alveolar soft part sarcoma. It is an infrequently encountered neoplasm which is considered rare in the head and neck, though 34 cases of the similar tumors have been reported in Japan.

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Case Reports of Carcinomas of the Larynx, Epipharynx and Maxillary Sinus in Siblings

Katsuhiro Hirakawa, Nobuharu Tagashira, Koji Yajin, Yasuo Harada

1981 Volume 74 Issue 9special Pages 2130-2134
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2130

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The literature contains very few references to the occurrence of carcinoma in head and neck region in siblings.
Carcinoma of the larynx, epipharynx and maxillary sinus in siblings were reported.
These cases were very few, so it could not be determined that genetic factors or circumstances played a role in the genesis of these diseases.

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Benign Solitaly Schwannoma of Lateral Neck

Nobuharu Tagashira, Mamoru Suzuki, Shigeru Nanbu

1981 Volume 74 Issue 9special Pages 2135-2141
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2135

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Two cases of benign solitaly schwannoma of the lateral neck were reported.
Case 1, 44 year-old woman, complained of solid mass without other symptoms in the left submandibular region. The tumor was surgically extirpated. In view of postoperative evidence of Horner's syndrome, it was thought the tumor might be arise from the cervical sympathetic nerve.
Case 2, aged 60 woman, complained of a large mass in the right lateral neck. At surgery, the tumor was situated in the course of the vagal nerve and removed by sectioning the vagal nerve. The recurrent nerve paralysis was noted postoperatively. The histological sections of the tumors in both cases showed benign schwannoma.

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Tracheal Reconstruction with Nasal Septal Grafts-Report of Two Cases

Yasuo Harada, Koji Yajin, Hideto Okazaki, Yuzuru Murakami, Tatsuzo Tai ...

1981 Volume 74 Issue 9special Pages 2142-2150
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2142

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Two cases of tracheal reconstruction were reported. These reconstructions were done using nasal septum composite grafts and the silicon T-tube in thyroid carcinoma involving the cervical trachea and the larynx. Case one was recurrent and sustained the tracheostomy and the reconstruction with nasal septum composite graft after tumor extirpation.
The other case resulted from the thyroidectomy with radical neck dissection and was reconstructed with nasal septum composite graft. Both reconstructed tracheal spaces using silicon T-tube were well preserved, and in one case, scanning electron microscopic findings of the reconstructed tracheal membrane revealed a well ciliated mucous membrane.

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A Case of Duplicated Malignant Lymphoma and Maxillary Cancer

Tomoko Amano, Ryozo Yabuta, Koji Yajin

1981 Volume 74 Issue 9special Pages 2151-2155
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2151

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A rare case of duplicated primary neoplasm (malignant lymphoma in head and neck region, and left maxillary cancer) was reported.
A 55-year-old man complained of multiple tumors in the neck on both sides and of a left nasal obstruction. Cervical tumors were diagnosed as malignant lymphoma histiocytic type by excisional biopsy. The homogeneous cloudy shadow in the left maxillary sinus with partial bone defect of the lateral wall was roentgenologically observed and pathological findings of the nasal tumor were also suspected as malignant lymphoma. Therefore, the shadow of the left maxillary sinus was supposed to be malignant lymphoma. After chemotherapy and radiotherapy for malignant lymphoma, cervical tumors disappeared, but the left nasal obstruction and headache remained and became more apparent. Four months after treatment for malignant lymphoma, the probe operation clarified the squamous cell carcinoma in the left maxillary sinus.

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A Case of So-called Carcinosarcoma of the Hypopharynx

Tomoko Amano, Yuzuru Murakami, Koji Yajin

1981 Volume 74 Issue 9special Pages 2156-2160
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2156

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A case of pseudosarcoma of the hypopharynx was reported. The patient was an 80 year-old woman who had complained of dyspnea and dysphagia. When she was first examined at our clinic, there was an egg-sized tumor at the hypopharynx with submental invasion. After FAR therapy (5-Fu, Vitamin A, radiation), the tumor was markedly reduced.

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A Case of Secondary Tonsilar Tuberculosis

Seiichi Kawamata, Yoshiro Sugimoto, Koji Yajin

1981 Volume 74 Issue 9special Pages 2161-2166
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2161

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A case of secondary tonsilar tuberculosis was reported. A man, aged 82, complained of pharyngeal pain and dysphagia on the right side. The right tonsil was ulcerated and coated with white fur. After the appearance of tubercular bacilli and typical tubercular lesions, the patient was treated by antitubercular agents, streptomycin, INH and RFP. Although the local findings and complaints disappeared within a month after treatment, the primary lesions (in both the pulmonary fields) continued for 6 months.

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A Case Report of Recurrent Esophageal Foreign Bodies in a Pica Child

Tatsuo Yoshioka, Yoshiro Sugimoto, Koji Yajin, Katsuhiro Hirakawa, Tak ...

1981 Volume 74 Issue 9special Pages 2167-2172
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2167

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The case of a four-year-old boy who had recurrent episodes of foreign bodies in the esophagus (pebbles) was reported. The patient who had surgery for congenital esophageal atresia suffered from pica due to iron deficiency.
After giving iron-acid to the patient, the episodes of pica and recurrent foreign bodies disappeared.

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Two Cases of Nodular Fasciitis

Kenzo Hirata, Yuzuru Murakami, Katsuhiro Hirakawa, Koji Sera, Yasuo Ha ...

1981 Volume 74 Issue 9special Pages 2173-2177
Published: September 25, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.9special_2173

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Two cases of nodular fasciitis were reported. The first patient was a 51-year-old man, who complained of a tumor of the left submandibular region which had enlarged progressively. The tumor was extirpated surgically. Histologically, a diagnosis was made as nodular fasciitis.
The second was a 30 year-old woman. She complained of a tumor of the left lateral neck, occipital pain and numbness of the left arm. The tumor was extirpated surgically. Before histological diagnosis was made, the growth recurred. So the left radical neck dissection was performed. Finally histological diagnosis was established as nodular fasciitis.
Some literature concerning nodular fasciitis was reviewed.

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