Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 76, Issue 9
Displaying 1-20 of 20 articles from this issue
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  • Progress in the Management of Vascular Disease
    Kanji Iwahashi
    1983 Volume 76 Issue 9 Pages 2041-2056
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2041
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    The rapid progress of vascular surgery during the past few decades was exceeded the expectations of the most surgeons and investigators.
    New diagnostic techniques such as the Doppler ultrasonic flowmeter, improved vascular substitutes of various types, and new surgical techniques have expanded the field of vascular surgery.
    Endarterectomy, bypass techniques for treating arterial occulusive disease, and surgical resection and replacement of aortic aneurysms have been perfected. Recently, more noninvasive techniques such as percutaneous transluminal angioplasty, have been developed. The availability of the Fogarty embolectomy catheter now makes it possible, under local anesthesia, to extract emboli from all the most common sites, except the renal and other visceral arteries. Dotter first reported percutaneous transluminal angioplasty as a technique for treating atherosclerotic vascular stenoses and occlusions in 1964. Grüntzig described nonsurgical recanalization of superficial femoral artery occlusions and stenoses in the superficial femoral and pelvic arteries with the use of the Grüntzig balloon catheter. Bypass techniques and other forms of organ protection during thoracic aortic and carotid artery cross-clamping provide protection from temporary or permanent dysfunction.
    A variety of disease entities can lead to arterial and venous stenoses, occlusions or dilatation, but here we are concerned exclusively with the problem of arteriosclerosis, Buerger's disease, venous thrombosis and inferior vena cava obstruction with Budd-Chiari syndrome. We treated 7 patients with inferior vena cava obstruction with the Budd-Chiari syndrome. Two patients were treated by a direct surgical approach to the inferior vena cava block, transcardiac membranotomy, and patching with autogenous pericardium after an open resection. Five were treated with a dilator, Fogarty and Grüntzig balloon catheter to fracture the membrane.
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  • A Report of a Case of Bilateral Facial Palsy Associated with Chronic Renal Failure
    Yasushi Matsumoto, Koshiro Nakamura, Hiroshi Fujita, Naoaki Yanagihara
    1983 Volume 76 Issue 9 Pages 2057-2063
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2057
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    A 32-year-old male patient had bilateral facial palsy associated with chronic renal failure and repeated hemodialysis over ten years. He complained of left facial palsy of sudden onset on December 12, 1979. The palsy was diagnosed as Bell's palsy of slight degree. A week later, he noted right facial palsy. Electrodiagnostic examination indicated that the facial nerve had undergone progressive degeneration. However, surgical decompression of the facial nerve was not permitted because of severe anemia and bleeding tendency. The palsies were gradually alleviated and about 75% recovery was attained one year after the onset. About four months later, left palsy increased again. Three months thereafter, an intrameatal mass was found in the left ear and probe examination revealed an epidermoid carcinoma. It was concluded that chronic renal failure, hemodialysis and the intrameatal carcinoma were significantly related to the etiology and affected the clinical course of the facial palsies.
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  • Research on Minimal Inhibitory Concentration (MIC) of Several Antibiotics in Chronic and Reccurrent Otitis Media
    Hiromu Mori, Michiyuki Kita, Haruo Takahashi, Shinji Nonaka, Hajime Na ...
    1983 Volume 76 Issue 9 Pages 2065-2070
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2065
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    The minimal inhibitory concentrations (MIC) of several antibiotics were investigated using staphylococcus aureus, pseudomonas aeruginosa and proteus mirabilis which were obtained by fractional cultivation of specimens from 138 cases of chronic and reccurrent otitis media.
    Thirteen of the 77 colonies (17%) of staphylococcus aureus showed higher MIC's than 25μg/ml and they were observed in children younger than 8 or adults in their thirties.
    When the MIC's for pseudomonas aeruginosa were higher than 6.25μg/ml, the conditions of the patients from whom the specimens were taken proved to be clinically intractable.
    For proteus mirabilis, the MIC's of the cephem antibiotics of the new generation were generally low.
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  • Sudden Deafness Occurring in 63 Ears in 1982
    Masatake Yui, Michiyuki Kita, Haruo Takahashi, Shinji Nonaka, Hajime N ...
    1983 Volume 76 Issue 9 Pages 2071-2076
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2071
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    We treated 63 patients with sudden deafness from January to December, 1982.
    The clinical course and results of viral studies in these cases were compared with those of 106 patients with sudden deafness treated from 1976 to 1981.
    1) These 63 patients were 24 male 39 female, aged 11 to 81 years. The highest incidence was in the fifth decade.
    2) Viral studies were positive in 22%, which is lower than in the past 6 years.
    3) Vertigo and viral infection showed in correlation with the prognosis in this study.
    4) Some confusing cases were analyzed separately, since it was difficult to differentiate them from those of sudden deafness: fluctuating hearing loss, Ménière's disease, acute sensorineural hearing loss of low frequencies.
    5) Influenza A virus positive patients had a good prognosis.
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  • Influence of the Initial ENG Recording Date on Nystagmus (Second report)
    Masaki Ohnishi, Toshiaki Yagi, Yuzuru Kobayashi, Fumio Sakaguchi, Hito ...
    1983 Volume 76 Issue 9 Pages 2077-2081
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2077
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    Since only a small number clinics are capable of recording ENG on the first visit of patients with vertigo and/or equilibrium disturbance, we studied the relationship between the changes of spontaneous nystagmus in ENG and the number of days from the first visit to the day recording was done. In the first report, we found that there was no relation between the incidence of nystagmus and the number of days until the date of recording within two weeks from the first visit. However, this result represented only the qualitative nature of nystagmus in ENG. In order to clarify this relationship more precisely, quantitative analysis became necessary. In the present study, we analyzed the relationship between the frequency and the slow-phase velocity of nystagmus and the number of days until recording. ENGs were recorded in 1, 260 patients with vertigo and/or disequilibrium and were analyzed. We found a close relationship between the frequency as well as the slow phase of nystagmus and the number of days from the first visit, namely, the frequency and the slow phase of nystagmus significantly decreased with days past. We conclude that the present status of ENG recording in most clinics is insufficient. ENG recording should be carried out as early as possible.
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  • A Case of Osteoma of the Frontal Sinus Removed by the Coronal Incision Method
    Yoshiki Yamasaki, Noriko Sonobe
    1983 Volume 76 Issue 9 Pages 2083-2088
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2083
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    A 51-year-old female teacher was seen by us with presenting symtoms of right-sided exophthalmus, blepharoptosis, blurred vision, swelling in the right frontal region and headache. Sinus x-ray revealed a bone tumor in the frontal region. Careful scrutiny of x-ray films taken by various projections suggested the infeasibility of Killian's operation. Hence the tumor was removed through a frontal craniectomy performed with an aid from a neurosurgeon. It measured 5×3×3cm and weighed 27gr. Histopathological examination demonstrated the tumor to be an osteoma.
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  • A Report of a Case of Amyloidosis of the Larynx
    Setsuko Morinaka, Eiichi Fujimura, Akira Takagi, Susumu Suehiro, Yasuy ...
    1983 Volume 76 Issue 9 Pages 2089-2097
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2089
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    Amyloidosis of the larynx is a rare disease. Our patient was a 56-year-old female, suffering from hoarseness for three years. Amyloidosis was proved histologically by biopsy of the left false vocal cord. The solitary tumor, localized to the larynx, was surgically extirpated. Electron microscopy revealed the typical fibrillar amyloid structure.
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  • Theoretical Basis of Vocal Efficiency
    Nobuhiko Isshiki, Masanao Ohkawa
    1983 Volume 76 Issue 9 Pages 2099-2103
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2099
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    Vocal efficiency as one of the criteria for evaluating the vocal function has been a subject of investigation in phoniatrics, since van den Berg (1956) calculated it on the basis of measurements of the subglottic pressure, air-flow rate, and SPL of voice.
    Recent advances in instrumentation have made it more practical to measure the subglottic pressure, both DC and AC components of the expiratory air flow and SPL of voice. A variety of indices were proposed to represent or substitute the real vocal efficiency which is the ratio of the acoustic power to the subglottic power. They are the SPL in dB divided by the air flow rate, SPL in dB minus logarithm of the square of the air flow rate or, AC/DC where AC is the effective value of AC component of expiratory air flow and DC is the mean flow rate.
    On the basis of the definition of efficiency (American Standard Terminology), it is emphasized that the efficiency should be the ratio of useful output of the quantity to its total input, and therefore, be without dimension. Technical problems associated with measurement of vocal intensity and AC components of air flow such as the resonant effect of the vocal tract are also discussed.
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  • Effects of a β-Adrenergic Stimulant on the Upper and Lower Airways
    Nobuo Usui
    1983 Volume 76 Issue 9 Pages 2105-2110
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2105
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    We examined the type of reactions shown by the nasal cavity and bronchi when persons with airway hypersensitivity inhaled β-adrenergic stimulants through the nasal cavity and evaluated whether a β-adrenergic stimulant possessed any nasal mucosal volume changing effects.
    The subjects of study, patients with airway hypersensitivity, were divided into two groups.
    Physiological saline solution, 3ml, was administered to the 16 patients of Group 1 and Salbutamol, 3ml, was administered to the 32 patients of Group 2 through the nasal cavity over 3 minutes, using an ultrasonic nebulizer.
    The nasal resistance and oral respiratory resistance were measured, and spirography and the flow-volume curve test were carried out before inhalation and 5 minutes after completion of inhalation.
    No significant differences could be observed in spirography in terms of %FVC or FEV1.0% values before and after inhalation of physiological saline solution, or before and after inhalation of the β-adrenergic stimulant.
    No changes in flow-volume curves could be observed in the physiological saline solution inhalation group, but a significant increase in the V50 values after inhalation could be observed in the β-adrenergic stimulant inhalation group.
    With respect to the nasal conductance, which is the inverse function of the nasal resistance, no significant difference could be observed before and after inhalation in both the physiological saline solution inhalation group and the β-adrenergic stimulant inhalation group.
    The above findings showed that inhalation of the β-adrenergic stimulant through the nasal cavity possessed bronchodilatory actions, and changes in the nasal mucosal volumes could be established.
    Therefore, there is no functional significance in the β-adrenergic receptors in the smooth muscles of the blood vessel wall of the nasal mucous membrane, and even if there is any significance, it is considered to be extremely small.
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  • A Case Report of Localized Amyloidosis of Upper Air Passages
    Keisuke Masuyama, Michio Toya, Takeru Ishikawa
    1983 Volume 76 Issue 9 Pages 2111-2119
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2111
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    Localized amyloidosis of the airway is a rare condition. The present study describes a case of amyloidosis of the false vocal cord and nasopharynx.
    A 74-year-old male was referred to our outpatient clinic for the purpose of further examination of a mass in the larynx. On examination, the left false vocal cord was found to be swollen and an irregular bulging of the back of the soft palate was also observed.
    Histological examination revealed massive deposits of homogenous, eosinophilic hyaline-like substance in the sub-epithelial connective tissue.
    Under general anesthesia through the tracheotomy opening, laryngofissure was performed on April 2, 1981. After splitting of the thyroid cartilage in the midline, the inner aspect of the larynx was exposed. The lesion occupied the left false vocal cord area but the surface was not ulcerative. The tumorous lesion was removed as much as possible along with the overlying mucosa.
    The resected raw surface was covered by suturing the remaining mucosa.
    Further histological examination showed that the hyaline-like substance was Congored positive and metachromatic. Congo-red stain with polarization was also positive.
    No other part of the body including the rectal mucosa showed signs of amyloid deposits.
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  • A Case of Brachial Plexus Neurinoma
    Norio Takagi, Katsura Yamamoto, Kiyoko Kobayashi, Kiyotaka Higaki, Koj ...
    1983 Volume 76 Issue 9 Pages 2121-2125
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2121
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    A case of brachial plexus neurinoma was reported with a review of the literature.
    A 31-year-old woman had an enlarging mass of 4 to 5cm in the right supraclavicular area for about six months. Tingling, radiating into the right shoulder and the arm, appeared on moving the mass. The ovoid, elastic hard gray tumor was removed intracapsularly from the sheath of the lower trunk of the right brachial plexus. The tumor was revealed to be a neurinoma of the Antoni A and B mixed type on histological examination. Her postoperative course was benign exept for slight weakness of the grasping power of her right hand which gradually improved in two weeks.
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  • Two Cases of Congenital Intra-Thyroid Cysts
    Megumi Kumai, Shinichi Kawabori, Tokuji Unno
    1983 Volume 76 Issue 9 Pages 2127-2134
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2127
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    Two cases of congenital cystic lesion in the thyroid gland were reported. Case 1, a 74-year-old male, was surgically treated for a cyst which was located in the thyroidal isthmus and surrounded by normal thyroid tissue. The inner surface was covered with a single flat epithelium.
    Case 2, a 6-year-old female, visited us because of a gradually increasing tumor in the right anterior neck. The cyst wall, 2mm in thickness, was lined with columnar ciliated epithelium. Many lymph follicles were observed in the subepithelial layer. The boundary from the normal thyroid tissue was not clear. The content consisted of many lymphocytes. The postoperative course of these two patients were uneventful.
    Embryonal development of the thyroid gland and surrounding tissues are complicated. Congenital cysts in this region originate from the 3rd or 4th pouches, ultimobranchial body or thyroglossal duct.
    We diagnosed these two cases as thyroglossal duct cysts based on the clinical findings and histological examination.
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  • Intercellular Junctions in the Human Vascular Stria and Spiral Ligament
    Masayoshi Tachibana, Susumu Nakae, Mitsuo Machino, Hiroyuki Morioka, O ...
    1983 Volume 76 Issue 9 Pages 2135-2139
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2135
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    The intercellular junctions of the vascular stria and spiral ligament in the human cochlea were examined by means of the freeze-fracture technique.
    It appeared that the vascular stria and the spiral ligament of the human shared common anatomical characteristics with that of the guinea pig as far as the intercellular junctions are concerned and we could not find any reason not to assume that the electrophysiological nature of the vascular stria of the human is basically identical to that of the guinea pig.
    The tight junctions observed at the apical portion of the marginal cell could be classified as “intermediate to tight”. The junctions observed between the basal cells were classified as “very tight”. Thus the vascular stria is barred from both endolymph and perilymphatic tissue (spiral ligament) by the tight junction.
    Virtually all the component cells of the vascular stria and the spiral ligament seemed to be interconnected by gap junctions. These cells might share a common intracellular ionic environment.
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  • Change in Serum Protein Fraction in Vestibular Neuronitis
    Keiko Nishikawa, Toru Sekitani, Hideki Ohyama, Tatsuya Okuzono, Masuto ...
    1983 Volume 76 Issue 9 Pages 2141-2144
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2141
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    Measurement of the serum protein fraction, especially of α1-globulin and α2-globulin in 8 patients with vestibular neuronitis, was made in order to evaluate changes in titres of the serum protein fraction, in which the possibility of the involvement of upper respiratory tract infection was indicated.
    Controlled comparison of this data was made with that of 13 persons who had sufferred from benign laryngeal polyps.
    Analysis of the two sets of data was made in terms of two dimensional standard co-ordinates, which showed some difference in the value of the serum protein fraction between the two groups; but no significant difference in the serum protein fraction was observed in terms of an increase in the globulin fraction except for two patient.
    Further investigation and evaluation will be continued.
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  • Human Laryngeal Cancer Transplantation to Nude Mice
    Toshio Yamashita, Osamu Ninoyu
    1983 Volume 76 Issue 9 Pages 2145-2150
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2145
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    Operative specimens of human laryngeal carcinoma were successfully transplanted into athymic nude mice.
    Histological observation of seven transplants showed that the mutation rate increased in early transplants, but was stabilized in the fifth transplant or thereafter.
    Using the 6th transplant, the growth rate was compared between male and female mice and no significant difference was found. This result indicated that there was no sexual participation in laryngeal carcinoma.
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  • Quantitative Measurement of the Degree of Hoarseness
    Eiji Yumoto
    1983 Volume 76 Issue 9 Pages 2151-2168
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2151
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    As the degree of judged hoarseness increases, the noise component of the spectrogram increases and replaces the harmonic structure. The relationship between these two components has been quantified as harmonics-to-noise (H/N) ratio. The computation is straightforward; 50 consecutive pitch periods of a sustained vowel /a/ are averaged; H is defined to be the energy of the average waveform, while N is the mean energy of the differences between the individual periods and the average waveform.
    The noise the present method measures is not only those components between the harmonic components of the spectrum but also those which overlap the harmonic components. In addition, cycle-to-cycle pitch perturbations (jitter) contribute to the noise component.
    The subjects of this study consisted of 42 normal and 89 pathological cases with varying degrees of hoarseness pre- and post-operatively.
    The H/N ratio of the normal group ranges from 7.0 to 17.0 dB with a mean of 11.9dB. We expect 95% of normal subjects to have a H/N ratio greater than 7.4dB. According to this criterion with a 5 % false alarm rate, 63.2% of the preoperative phonatory samples were differentiated from normals.
    The H/N ratio, the spectrographic classification and jitter showed a significant correlation with the psychophysical measurement of the degree of hoarseness (r=0.809, 0.805 and 0.712, respectively). The result suggested that jitter is less suitable for assessing the degree of hoarseness than the H/N ratio and the spectrographic classification. Since the spectrographic evaluation is subjective and arbitrary, the H/N ratio is the best quantitative index of the degree of hoarseness. The H/N ratio also proved useful for objective assessment of the result of treatment for hoarseness.
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  • Effect of Interferon (IFN-α) on the Cytotoxicity of Natural Killer (NK) Cells of the Bearer of Malignant Tumor in the Head and Neck
    Noriko Kane, Mitsuo Mukudai, Yoshihiro Dake, Hiromu Kakiuchi, Daisuke ...
    1983 Volume 76 Issue 9 Pages 2169-2175
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2169
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    Along with recent advances in tumor immunology, it has been widely accepted that natural killer (NK) cells come under one of the lymphocytic subsets and are cytotoxic to tumor cells. These cells are commonly found in not only healthy persons, but slso in tumor bearers. For the past years, our interest was in the understanding of the cytotoxicity of NK cells of head-and-neck tumor bearers. It was revealed that the cytotoxicity of NK cells decreased as tumor grew, although there was predominant cytotoxicity at the initial stages of tumor growth.
    The present research was intended to study the in vitro effects of interferon (IFN-α) produced by the tonsil lymphocytes infected with the Newcastle-disease-virus, which is one of the NK activators
    The general proceduer was 51Cr-release-assay previously described. After the pretreatment of the lymphocytes with IFN-α for 2 hours, it was found the cytotoxicity of the cells, which were target cells derived from maxillary cancer, increased apparently. This evidence in vitro may draw our attention to the clinical use of IFN for the treatment of malignant tumors.
    Further investigation in not only basic, but also applied immunology should be out, because the real mechanism is still unknown.
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  • Effects of Isosorbide on Meniere's Disease
    Yasuyuki Ishikawa, Kazuhito Nakanishi
    1983 Volume 76 Issue 9 Pages 2177-2186
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2177
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    The therapeutic effects and safety of Isosorbide were clinically studied in 22 patients with Meniere's disease. Subjective and objective symptoms were checked every two weeks. Isosorbide was effective in 13 of 16 patients (81%) after 6 weeks of ingestion. Of the subjective symptoms, vertigo, nausea and vomiting, headache, and stiff shoulder were significantly alleviated. In contrast, the effects on cochlear symptoms were limited. With regard to objective symptoms, Isosorbide was effective in terms of positionsl nystagmus test but not for the hearing test. Side effects such as dizziness, nausea, and discomfort in the throat, chest and epigastrium were observed in 6 patients (29%).
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  • A Clinical Study of Histaglobin Nebulizer Therapy for Children with Nasal Allergy Dose and Interval of Treatment
    Toshihiko Yokoyama, Misao Isono
    1983 Volume 76 Issue 9 Pages 2187-2195
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2187
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    The effect of histaglobin nebulizer therapy was evaluated on 47 patients, aged 3 to 15 years, suffering from nasal allergy. The subjects were randomly divided into two groups: group A received 1/2 vial, twice a week for a total of 12 times and group B was treated with 1/4 vial, 3 times a week for a total of 24 times. The clinical evaluation was performed by comparing the two groups. The results obtained were as follows:
    1) There were significant differences between the two groups with respect to intranasal findings and to diary cards recorded by patients or their parents.
    2) The overall rating was excellent in 8.7%, good in 21.7%, fair in 52.2%, not effective in 13.0% and aggravated in 4.3% for group A, and was excellent in 4.2%, good in 8.3%, fair in 45.8%, and not effective in 41.7% for group B.
    3) No side effect was found in any subject with nebulizer therapy with histaglobin.
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  • Fundamental and Clinical Studies on Aerosol Therapy of Histaglobin for Nasal Allergy
    Hitoshi Saito, Hiroshi Takenaka, Hideki Kida, Akinori Hoshino, Tomio T ...
    1983 Volume 76 Issue 9 Pages 2197-2208
    Published: September 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2197
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    The ciliary movement of the cultured nasal mucosa taken from mice did not show any particular damage after Histaglobin (HG) treatment (1 vial/ml) for 30min.
    The effect of a larger dosage of HG nebulizer was examined for perennial allergic rhinitis. The trial design for patients over 16 years was 4 week treatment with a nebulizer of HG of 1/2 vial over 3 times a week, and half the dose in the younger patients. A multicenter trial of 96 patients revealed 67% efficacy by the total judgment.
    More frequent treatment showed a better improvement. The patients with severe symptoms showed better improvement than those with mild symptoms. Nasal provocation test, histaminopexic action, radioimmunosorbent test and eosinophils in nasal secretion and in blood showed significant betterment after HG nebulizer therapy.
    In summary, it was proved that the nasal mucosa could absorb HG locally and that local application with a nebulizer seemed to show better efficacy than intramusclar injection.
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