Practica Oto-Rhino-Laryngologica

Saccadic Eye Movement in Patients with Parkinson's Disease

Atsuko Mizutani, Takashi Fukaya, Kiyoharu Inoue

1983 Volume 76 Issue 4 Pages 1189-1194
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1189

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Ocular movement abnormalities were studied in patients with Parkinson's disease and normal controls. In Parkinsonian subjects, the reaction time and maximum velocity of command horizontal saccadic eye movement were the same as those in control subjects. The hypometric saccade on the eye-tracking test was seen in all the Parkinsonian subjects.

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Radiological Screening of Maxillary Cancer by Maxillo-temporal Panoramic Tomography (MTPT)

Atsushi Shinkawa, Nobuyuki Komatsu, Makoto Sakai, Hirosato Miyake, Hir ...

1983 Volume 76 Issue 4 Pages 1195-1208
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1195

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Fourteen cases of maxillary cancer were studied radiologically. Three routine films, i. e. occipito-mental (o-m), occipito-frontal (o-f) and MTPT views were taken in each patient, but the MTPT view appeared to be the most informative in the present study.
The characteristic findings of MTPT films of maxillary cancer were increased radiolucency or high density in the maxillary maxillo-ethmoidal septum and the medial wall of the maxillary antra, which it was impossible to detect by the o-m or o-f view. The routine use of this MTPT appeared to be the most suitable for early diagnosis of maxillary cancer.

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A Quantitative Evaluation of the Therapeutic Effect of Massive Dose Administration of Lysozyme on Chronic Sinusitis Using a Densitometer

Harumi Suzaki, Takashi Futaki

1983 Volume 76 Issue 4 Pages 1209-1215
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1209

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X-ray opacity of the maxillary sinuses were evaluated using a densitometer in patients with chronic sinusitis whose subjective complaints and local findings of the nasal cavity were improved by massive dose administration of lysozyme (540mg/day).
X-ray films of the waters view were used for the following analysis. The density of the middle points within the orbita was used as the index of the orbital density. The density of the trisected points within the maxillary sinus was used as the index of the maxillary density. The remainder of these two indices was calculated to facilitate the comparison within a subject. The sets of data were compared between pre- and post-treatment. As a result of the densitometric estimation of the film, it was objectively shown that massive dose administration of lysozyme was significantly effective for chronic sinusitis.
Densitometric analysis of film minimizes the errors caused by radiographic conditions and subjective variations among the examiners. It is an excellent and useful method for quantitative evaluation of the therapeutic effect within a subject.

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Simultaneous Primary Multiple Cancers of the Maxillay Sinus and Thyroid Gland

Osamu Tanaka, Tsutomu Hoshiya, Yukikazu Hyo, Takashi Matsunaga

1983 Volume 76 Issue 4 Pages 1217-1223
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1217

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Only three cases of primary multiple cancers of the maxillary sinus and thyroid gland were reported in the past Japanese literature. This report deals with a case of multiple cancers in a 71-year-old woman which occured simultaneously in the maxillary sinus and thyroid gland. She complained of left nasal bleeding without other symptoms. On otolaryngological examination, a bloody, little-finger's head sized tumor mass was observed in the left nasal cavity, and the anteromedial wall of the left maxillary sinus was seen to be destroyed on X-ray and CT scan examinations. Histologically, the tumor in the left maxillary sinus was diagnosed as poorly differentiated adenocarcinoma.
She received a combination therapy consisting of 4, 000rads Linac irradiation, intraarterial NK 631 pepleomycin and necrotomy in one month. However, five months after the initial treatment, the tumor recurred at the base of the maxillary sinus and a left submandibular lymphnode was found to be swollen. When partial maxillectomy and left modified neck dissection were performed, one of the metastatic lymphnodes showed the feature of papillary carcinoma of the thyroid gland and the others were adenocarcinoma of the left maxillary sinus.
No signs of carcinoma of the thyroid gland were found clinically or on laboratory examination. Two months after the operation, left hemithyroidectomy for the small tumor located at the upper region of the left thyroid lobe was performed. The tumor was 8mm in diameter and histologically the same as the above papillary carcinoma. The malignancy became uncontrollable and she died about four months afterwards.

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A Case of the Tolosa-Hunt Syndrome Associated with Chronic Ethmoiditis

Yumi Sasaki, Masahiko Tamaki, Naoaki Yanagihara

1983 Volume 76 Issue 4 Pages 1225-1230
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1225

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A 53-year-old male, complaining of the left deep orbital pain and numbness of the left forehead, showed typical ophthalmologic signs of the Tolosa-Hunt syndrome; external ophthalmoplegia, deterioration of the visual acuity and sinking of the upper visual field. The study of CSF, carotid angiography and blood examination disclosed no abnormality. Having left-sided nasal obstruction and recurrent epistaxis, rhinological examination was necessitated. There was a polyplike mass in the left middle meatus, and massive opacity in the left ethmoidal sinuses was found on radiological examination. Surgical exploration performed suspecting an ethmoidal malignancy invading into the cavernous sinus and/or the superior orbital fissure revealed only chronic mucosal inflammation. The diagnosis of the Tolosa-Hunt syndrome was established based on the fact that the ophthalmologic disturbances were alleviated rapidly after administration of steroid. Non-specific inflammation of the cavernous sinus has originally been thought to be the cause of this syndrome. Based on the clinical evidence as well as the review of the literature, we assumed that inflammation in paranasal sinuses produced inflammation around the cavernous sinus.

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HRP and Flectrophysiological Studies on Central Input System to Lateral Vestibular Nucleus in Cats

Inferior Olivary Nucleus-Lateral Vestibular Nucleus System

Juichi Ito

1983 Volume 76 Issue 4 Pages 1231-1251
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1231

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Central projections to the lateral vestibular nucleus (LVN) in cats were examined using a retrograde transport of horseradish peroxidase (HRP). Furthermore, electrophysiological studies were performed to elucidate the influence of the inferior olivary nucleus (IO) on the LVN neuron and possible neurotransmitters involved in the transmission from the IO to the LVN using the microiontophoretic technique. When HRP was microiontophoretically applied to the immediate vicinity of the LVN neuron, which was monosynaptically activated by vestibular nerve stimulation, HRP-labeled cells were found in the following areas: bilateral fastigial, bilateral dentate and ipsilateral interpositus nuclei of cerebellum; bilateral medial, bilateral descending and contralateral lateral vestibular nuclei; bilateral gigantocellular and ipsilateral lateral reticular nuclei; and contralateral dorsal cap and β nucleus of the IO. HRP-labeled Purkinje cells were observed in the ipsilateral cerebellar nodulus, ligula and flocculus. Effects of IO stimulation were examined on 168 LVN neurons monosynaptically elicited by vestibular nerve stimulation using decerebellate cats anesthetized with α-chloralose. Forty-three neurons were monosynaptically activated by IO stimulation and excitatory responses were dose-dependently inhibited with iontophoretic application of atropine, an anticholinergic drug. The conditioning stimulus to the IO preceding the test stimulus to the vestibular nerve inhibited the orthodromic spike upon the test stimulation in 22 neurons and the inhibition was antagonized with iontophoretic application of bicuculline, a GABA antagonist. In 9 LVN neurons, IO stimulation produced an antidromic spike. Histological examination showed that excitatory and/or inhibitory effects on the LVN neurons were observed when the stimulus was applied to the dorsal cap and/or β nucleus of the contralateral IO. These results suggest that the LVN neurons monosynaptically activated by vestibular nerve stimulation receive both excitatory input mediated by acetylcholine and inhibitory effect mediated by GABA from the contralateral dorsal cap and β nucleus of the IO.

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Studies on Square Drawing Test

II. On micrographism

Keiko Kado

1983 Volume 76 Issue 4 Pages 1253-1274
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1253

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The deviation phenomenon occurring in vestibular dysfunction can be observed in ocular movements and in the movements of the extremities (arms and legs). Blindfolded vertical writing test is generally used clinically as the most keen and preservable test among the various tests to detect abnormalities in hand and arm movements.
The Square Drawing Test (SDT), which is a vertical writing test, has been devised because it can be performed easily, quantitatively and internationally. This test does not require knowledge of Chinese characters.
The Square Drawing Test is administered not only for detecting deviation of vestibular origin but also for revealing ataxic and abnormal drawings of central origin. “Micrographism” is one of the abnormal findings of SDT in vertigo of central origin causes.
Micrographism was studied on the actual record of SDT collected at both Yamaguchi University Hospital and Shimonoseki Saiseikai Hospital for 3 years (from January 1979 to December 1981).
During that period, 1, 683 patients with complaints of vertigo or unsteadiness were examined otoneurologically. A temporary practical definition of micrographism in square drawing was having reduction of 20% or more of the length of every line of number 4 square (i. e. R-4 and L-4 by right-hand and left-hand drawing, respectively) than that of the mean values of normal subjects. Of the 1, 683, there were 59 having definite micrographism (3.5%). Of these 59, 39 were clinically diagnosed as having central origin vertigo (66%). Reproducibility of the test results and clinical usability were discussed and commented on. Topographical and differential diagnosis of the vertigo will become clinically possible.

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Influence of α-and β-adrenoceptor Stimulants on the Nasal Mucosa and in the Nasal Provocation Test

Yoichiro Kubota, Yuko Shiba, Tetsuzo Fujitani

1983 Volume 76 Issue 4 Pages 1275-1282
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1275

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The purpose of our present study was to investigate the direct actions of α- and β-stimulants on the nasal mucosa and their protective effects on allergen-induced nasal symptoms.
The preparations under investigation were isoproterenol as a β-stimulant and phenylephrin as an α-adrenostimulant. The dosages of isoproterenol were 0.09 and 0.18mg and for phenylephrine 2.25mg to each nasal cavity. Nasal provocation was performed using the disk method, after administering the drugs or isotonic saline solution as control. Combined rhinomanometry was used for objective evaluation of nasal obstruction. Nasal airway resistance was measured before and after application of the drugs or saline solution, and 10min. after provocation. The number of sneezes was recorded, and serection and swelling of the turbinate were observed by rhinoscopy for 5min. after provocation. Isoproterenol itself did not increase nasal airway resistance, and there was no significant difference between the application of isoproterenol and that of saline.
The increase in nasal airway resistance caused by provocation was inhibited after spraying isoproterenol. A dose of 0.19mg of isoproterenol completely inhibited the increase in nasal airway resistance and the allergen-induced nasal symptoms.
Phenylephrine itself produced 50% decrease in the nasal airway resistance. Following challenges with allergen, the nasal airway resistance decrease produced with phenylephrine returned to the baseline. Phenylephrine did not inhibit the allergen-induced nasal symptoms.
These results have suggested that the function of the α-adrenoceptor on the blood vessels and the β-adrenoceptor on the mast cells or basophils are normal.
We consider that topical use of an adequate dose of β-adrenostimulant does not dilate blood vessels and has a mast-cell stabilizing effect in the nose, whereas α-adrenostimulant regulates disturbed nasal blood flow only.

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Histaglobin Aerosol in Treatment of Allergic Rhinitis

Tetsuzo Fujitani, Hiroshi Ogasawara, Iwao Nakagawa, Issei Toriyama, Ma ...

1983 Volume 76 Issue 4 Pages 1283-1290
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1283

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A quarter vial of histaglobin aerosol (HG) and a quarter vial of histaglobin containing 0.5mg of dexamethason aerosol (HG+Dex) was given to 23 and 13 patients of perennial rhinitis, respectively three times a week for 4 weeks.
Fourteen of the former patients and 8 of the latter had improvement in nasal symptoms. No significant difference was found between the two groups.
Manifestation of improvement of the patients with HG+Dex was earlier than that of those with HG alone.
In four of the 11 patients with HG+Dex and 2 of the 20 patients with HG the RAST score was reduced. Nine of the 20 patients with HG and 3 of the 11 patients with HG+Dex had improvement in the histaminopexic power.
Histaglobin aerosol treatment is as useful as corticosteroid aerosol for patients suffering from allergic rhinitis.

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A Clinical Study of Fosfomycin in Sinusitis Paranasalis

Masashi Tomioka, Masami Usami, Ayako Sakamoto

1983 Volume 76 Issue 4 Pages 1291-1305
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1291

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Fosfomycin FOM, 2g/day, was administered orally to 25 patients of acute or chronic sinusitis paranasalis and acute exacerbation. The following results were obtained from clinical and laboratory examinations.
1) Eleven patients were evaluated at the fourteenth day, according to the unified criteria. According to the physicians' evaluation, excellent results were seen in 3 patients, good results in 8. According to the unified criteria for judgment, excellent results were seen in 7 patients, good in 3 and moderate in 1 with respect to improvement in subjective and objective symptoms, and in terms of X-ray findings, an excellent result was seen in 1, good in 5, moderate in 2 and poor in 3. Improvement in X-ray findings was inferior to that of subjective and objective symptoms. Microorganisms isolated disappeared in 9 but different microorganisms appeared in 2 patients.
2) Fourteen patients were evaluated at seventh day. According to the physicians' evaluation, excellent results were obtained in 5, good in 1, moderate in 6 and poor in 2. According to the unified criteria for judgment, excellent results were found in 4, good in 4, moderate in 4 and poor in 2. Eight cases were evaluated for microorganisms. Isolated microorganisms disappeared completely in 6, and different microorganisms appeared in 2. The clinical results of these 14 patients were inferior to those of the patients who received administration for 14 days.
3. The MICs against Haemohilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus were in the ranges of 1.56-6.25, 3.13-6.25 and 1.56-12.5μg/ml, respectively. And the MICs against Streptococcus pyogenes and Klebsiella pneumoniae were 3.13, 25μg/ml, respectively. Fosfomycin was effective in four organisms which caused sinusitis paranasalis, except Klebsiella pneumoniae.
4. The peak values of FOM in the serum and tissue were 6.3μg/ml and 4.1μg/ml, 2 hours and 15 minutes after administration of 1g of FOM.
5. As to the side effects of FOM, diarrhea was noted in 6 of the 24 patients. Diarrhea started 2 to 5 days after administration. Regarding laboratory findings, slight elevation of s-GPT was observed in 2 of the 11 patients.

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Effects of Hangekobokuto on Women with Abnormal Sensation in the Throat

Mikikazu Yamagiwa, Haruki Fukuo, Yasuo Sakakura, Yasuro Miyoshi

1983 Volume 76 Issue 4 Pages 1307-1319
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1307

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Hangekobokuto is a prescription of crude drugs and mainly contains pinelliae and magnolia. It has been used for the therapy of women with abnormal sensation in the throat in Kanpo medicine (Chinese traditional medicine inherited and developed in Japan).
The authors administered Tsumura-Hangekobokuto (7.5g daily for two weeks) to a consecutive series of 50 female patients and evaluated the efficacy of the drug by analysing the patients' subjective signs and symptoms.
The drug was effective in 52% of the patients in a week, in 58% in 2 weeks and in 66% in 3 weeks (one week after the cessation of the drug). Side effects were minimal, and only one patient reported nausea.
It was indicative that modern and traditional medicine might produce a higher rate of efficacy and usefulness in the therapy of abnormal sensation in the throat.

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1983 Volume 76 Issue 4 Pages 1321-1328
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1321

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[title in Japanese]

[in Japanese]

1983 Volume 76 Issue 4 Pages 1329-1336
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1329

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[title in Japanese]

[in Japanese]

1983 Volume 76 Issue 4 Pages 1337-1342
Published: April 01, 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.1337

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