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Volume 144
Displaying 51-59 of 59 articles from this issue
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Yojiro Kawamura, Toshikazu Shimane, Taisuke Nakamura, Yuko Shimotatara ...2015 Volume 144 Pages 104-105
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSIn this study, we examined the possibility of definitive diagnosis of schwannoma prior to surgery in patients admitted to our hospital between April 2009 and December 2013. There were 37 cases of suspected schwannoma, of which 11 cases were finally diagnosed as not having schwannoma. Of these 11, 5 cases were diagnosed preoperatively as not having schwannoma and 5 were diagnosed intraoperatively as not having a schwannoma; in the remaining 1 case, the diagnosis was made postoperatively. The results revealed determination of the following as important for the differential diagnosis: clinical course (rate of growth of the tumor), tumor mobility (pain and hardness), MRI findings (tumor location and shape, and presence/absence of contrast enhancement), ultrasound findings (tumor blood vessel distribution), and findings on fine-needle aspiration cytology. If all of these fundamental findings are reconfirmed during the initial examination of referred patients, we believe that a definitive diagnosis may be made in many cases.View full abstractDownload PDF (94K) -
Kenji Hosono, Homare Akahane, Tadao Okayasu, Hiroki Ohyama2015 Volume 144 Pages 106-107
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSMyoepithelial carcinoma of the salivary gland is a rarely occurring tumor. We report a case of myoepithelial carcinoma of the parotid gland. A 66-year-old male visited our hospital with a left parotid mass. CT revealed a mass measuring 5.0×4.0 cm in size in the left parotid gland. Aspiration biopsy of the mass was indeterminate. Partial resection of the left parotid gland was performed under the diagnosis of suspected parotid gland carcinoma (cT4aN0M0). Then, surgery to remove the enlarged regional swollen lymph nodes was performed at the same time. Histopathological examination of the surgical specimen showed proliferating atypical spindle-shaped cells. Immunohistochemical study revealed positive staining of the carcinoma cells for cytokeratin, vimentin, and S-100 protein, and slightly positive staining for p53, p63 and MIB-1 (Ki-67). Histopathologically, the resected tumor was diagnosed as myoepithelial carcinoma (pT4aN2b). Since we judged it as a high-grade carcinoma, post-operative radiation therapy was administered at 60 Gy. Eight months later, the patient was found to have multiple metastases in the lung. The lung metastases did not show any response to PF (cisplatin, 5FU) therapy. We therefore started treatment with TS-1 (120 mg/body) to maintain a good QOL of the patient. He developed adverse events 8 months later, therefore, the treatment was switched to UFT (300 mg/body). Finally, the patient died 2 years and 9 months after the operation without local recurrence.View full abstractDownload PDF (398K) -
Two Cases in which Critical Bone Marrow Suppression was Caused in the First Course of TS-1 TreatmentAkihiro Takaoka, Tomonori Terada, Nobuhiro Uwa, Takeshi Mohri, Kota Ki ...2015 Volume 144 Pages 108-109
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSWe report herein on two cases in which critical bone marrow suppression was caused in the first course of TS-1 treatment.
A 79-year-old man with hypopharyngeal cancer of the right piriform fossa (cT2N0M0) underwent an operation with larynx-preserving partial pharyngectomy at our institution.
Two months later, a neoplastic lesion was observed in the posterior wall from the oropharynx to the hypopharynx. It was diagnosed by biopsy as a squamous cell carcinoma, and was considered as a local recurrence. The salvage operation was planned. Oral administration of TS-1 (70 mg/m2/day) was started for the purpose of induction chemotherapy under hospitalization. However, serious bone marrow suppression happened on the 13th day. The patient developed multiple organ failure, and died two days later. On the basis of result of the autopsy, the sepsis following agranulocytosis was considered to be the cause of death.
A 70-year-old-man with hypopharyngeal cancer of the right piriform sinus (cT4aN2bM0) underwent operation with a total laryngopharyngectomy. Multiple pulmonary metastasis and right cervical lymph node recurrence occurred 8 months postoperatively. Oral administration of TS-1 (74 mg/m2/day) was started. After a 2-week course of the TS-1, we had planned a break for one week.
However, a feeling of general malaise developed and the patient suddenly visited the hospital on the 5th day of the wash out period. A blood test revealed remarkable bone marrow suppression, and multiple organ failure occurred with sepsis. The patient was admitted of intensive care units for multidisciplinary treatments.
These two cases suggest that, even if a normally-accepted dose of TS-1 is given, severe bone marrow suppression may occur. Therefore strict and thorough observation is believed necessary in any such cases involving TS-1 treatment.View full abstractDownload PDF (229K) -
Takayuki Uehara, Hiroyuki Maeda, Yukashi Yamashita, Masahiro Hasegawa, ...2015 Volume 144 Pages 110
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSPatient profiles, compliance with palliative radiotherapy and the treatment outcomes were investigated in head and neck cancer patients who received palliative radiotherapy from 2006 to 2012. Clinicians selected patients who received palliative radiotherapy considering the clinical stage and the general body condition. There were no patients with severe acute or late toxicities during treatment and the completion rate of palliative radiotherapy was 79.3%. The palliative irradiation group showed significantly better overall survival rates as compared to the no-treatment group. Paliative irradiation of the primary tumor and lymph node metastases at the dose of over 50 Gy contributed to long-term disease-free survival and improvement of the quality of life (QOL), including reduction of tumorigenic pain and dysphasia. Thus, palliative radiotherapy may be a useful treatment option for patients with advanced head and neck cancer under the careful management.View full abstractDownload PDF (61K) -
Satoshi Koyama, Kazunori Fujiwara, Takahiro Fukuhara, Eiji Tekeuchi, H ...2015 Volume 144 Pages 112-113
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSIntroduction: The salivary duct carcinoma (SDC) is an uncommon aggressive malignant tumor of the salivary glands with frequent metastasis leading to a poor prognosis. SDC resembles high-grade breast ductal carcinoma and frequently overexpress human epidermal growth factor receptor-2 (HER-2). We report herein on a case of recurrent metastatic SDC treated with trastuzumab-based chemotherapy. A 77-year-old female was diagnosed as having a malignant tumor of the right parotid gland and underwent total parotidectomy and bilateral neck dissection. The resected tumor was histologically investigated and diagnosed as an SDC. No amplification of the HER-2 gene was found but overexpression of the HER-2 protein was detected (2+). Multiple metastases at the bilateral axillary and superior mediastinal lymph nodes were detected 10 months after surgery. We treated the patient with triweekly chemotherapy with a combination of trastuzumab and docetaxel for 4 cycles. However CT scan showed disease progression after chemotherapy. Conclusion: It is important to check out not only the overexpression of HER-2 protein with IHC, but HER-2 gene amplification also should be checked before trastuzumab-based chemotherapy for SDC.View full abstractDownload PDF (86K) -
Yasuaki Katsube, Kiyoaki Tsukahara, Rei Motohasi, Minoru Endo, Hiroki ...2015 Volume 144 Pages 114-115
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSDeep neck abscesses represent a severe infection that requires prompt treatment. We report herein on cases of deep neck abscess requiring surgical drainage. The subjects of this study were 25 patients treated in our department between January 2009 and June 2013. They consisted of 12 males and 13 females ranging in age from 5 to 89 years with an average of 60 years. Hypertension and diabetes were predominant in their medical histories and the major causes of the abscesses were pharyngolaryngitis, tonsillitis and dental infections. All patients underwent emergency surgery on the day of consultation. In bacteriological examinations, 19 patients tested positive with aerobic bacteria being detected in four patients and anaerobic bacteria in 17. Tracheotomy was jointly conducted in 20 patients and four patients underwent repeat surgery. The mean length of hospital stay was 31 days and three patients were in hospital for eight weeks or longer. All three were elderly patients aged 75 or above and two had also undergone tracheotomy. Diabetes did not contribute to prolonging hospital stays. Among the factors prolonging hospital stays were advanced age, tracheotomy and the accompanying swallowing difficulty.View full abstractDownload PDF (146K) -
Hisashi Ishihara, Seiichirou Makihara, Tomomi Miyatake, Munechika Tsum ...2015 Volume 144 Pages 116-117
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSLongus colli calcific tendinitis is a secondary inflammation caused by the deposition of hydroxyapatite crystal in the longus colli tendon. It causes acute neck pain, limitations of neck movement and swallowing pain. The symptoms are usually resolved in 1 to 2 weeks when treated with analgesics and anti-inflammatory medications. A 45-year-old man visited our hospital with a complaint of severe neck pain and stiffness despite 3 days of therapy with loxoprofen prescribed by the first doctor he visited. Computed tomography (CT) imaging showed small calcification localized at the anterior C1-C2 level and a low density area in the retropharyngeal space without ring enhancement. A definitive diagnosis of longus colli calcific tendinitis was made. Cimetidine (100 mg twice daily) was added to his loxoprofen dosage. His neck pain improved remarkably in one day after commencing cimetidine treatment. And 3 days after starting the treatment his neck could be moved without limitation. On day 11 of the treatment, CT imaging showed reduction in the calcified deposit, and he was already completely asymptomatic. Cimetidine is an H2 receptor antagonist, and has been used for treatment of gastric ulcers. Furthermore, many studies have reported the treatment efficacy of cimetidine on calcific tendinitis of the shoulder. However, few studies have yet been reported on the longus colli tendon. Our report suggests that cimetidine may be effective against calcific tendinitis of the longus colli tendon as well as the shoulder. Because of the severe pain associated with this condition, patients often take large doses NSAIDs and need to be prescribed an anti-ulcer agent. In such a case, cimetidine may deserve consideration.View full abstractDownload PDF (296K) -
Yuka Kitani, Kaoru Yamamoto, Mariko Hirama, Nobuhiko Oridate2015 Volume 144 Pages 118-119
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSA 55-year-old man was referred to our hospital with the chief complaint of difficulty in opening his mouth and dysphasia. His breathing stopped on fiberscopic examination and cardiopulmonary resuscitation was performed. Based on the symptoms and history of trauma, he was clinically diagnosed as having tetanus. Respiratory care, debridement surgery of a wound bed, anti-tetanus immunoglobulin injection, and administration of penicillin G were required. He was discharged from hospital without any untoward sequelae. The number of patients contracting tetanus is decreasing. However the rate of deaths from this disease is 15–40%, so a tetanus vaccination is required. It should be noted that a patient having tetanus could visit otolaryngology clinic due to their trismus and that a prompt diagnosis based on clinical manifestations is required.View full abstractDownload PDF (115K) -
Shin Takei, Noboru Yamanaka, Muneki Hotomi, Takaaki Kimura, Kiyonori K ...2015 Volume 144 Pages 120-121
Published: 2015
Released on J-STAGE: November 28, 2015
JOURNAL OPEN ACCESSWe investigated the efficacy of a novel single 2 g dose of azithromycin for the treatment of adult patients diagnosed as having acute pharyngotonsillitis or acute rhinosinusitis. Eighty-eight cases with acute pharyngotonsillitis and 174 cases with acute rhinosinusitis were included in the multicenter single group non-blinded clinical trial from Oct 29, 2010 to Mar 30, 2012. This study was approved by the Institutional Review Board of the Ethical Committee of Wakayama Medical University.
We assessed the severity of disease by using the scoring system based on symptoms and local findings. Clinical efficacy rates at 4 days after the treatment were as follows; “Complete response” in 54 cases (62.1%), “Efficacy A” in 22 cases (25.3%), “Efficacy B” in 10 cases (11.5%), and “Ineffective” in 1 case (1.1%) in acute pharyngotonsillitis and “Complete response” in 54 cases (32.1%), “Efficacy A” in 38 cases (22.6%), “Efficacy B” in 59 cases (35.1%), “Ineffective” in 13 cases (7.7%), and “Aggravation” in 4 cases (2.4%) in acute rhinosinusitis. The eradication rates of pathogens at 4 days after the treatment were 85.7% in acute pharyngotonsillitis and 50.8% in acute rhinosinusitis.
Among patients categorized as “Complete response” or “Efficacy A” at 4 days after the treatment, all cases in acute pharyngotonsillitis were involved in “Complete response” at 8 days after the treatment, and 88.1% of acute rhinosinusitis were involved in “Complete response” or “Efficacy A”.
These results show the high efficacy of single 2 g dose of azithromycin in treating adult acute pharyngotonsillitis and acute rhinosinusitis. Data clearly indicated the usefulness of the clinical scoring system: from which a score at 4 days after the treatment may predict the prognosis of acute infectious disease, and be helpful for decision making on antimicrobial treatments.View full abstractDownload PDF (1988K)