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Toru Ohashi, Tomoyuki Okada, Kentaro Ochi, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
1-8
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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Serial EcochG recordings were obtained for long periods from the same ear in 24 Ménière's patients. Subjects consisted of 12 operated and 12 non-operated patients an d they all presented the dominant negative SP at the first recording of EcochG.
The fluctuation of responses (especially SP) during long periods w as evaluated.
As for SP, from three to four years after the first recording dominant neg a tive SP disappeared only in one ear in the operated case and two or the non-operated cases. However, dominant negative SP or abnormally increased SP/AP ratio has been unchanged for long periods in 21 other ears. The fluctuation of responses corresponding to changes in stage of the disease, pre- or post-operative stage and remission or exacervation stage, could hardly be observed. Results for AP were similar to those for SP.
It is assumed conclusively that the generation of negative SP dominance may chiefly result from the malfunction of hair cells, which may be caused from abnormal changes in inner ear fluids associated with endolymphatic hydrops or caused from other unknown disturbances in the cochlea.
The mech a nic factors of the basal membrane displacement due to the elevation of endolymphatic pressure can hardly be considered as a cause of SP abnormality.
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Tamotsu Urushibata, Sumio Sugano, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
9-15
Published: October 25, 1991
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A specific neuronal group in the nucleus of the optic tract (NOT) is considered to play an important role in the development horizontal optokinetic nystagmus (OKN). We obtained morphological evidence on such data. In the present study, γ-Aminobutylic acid (GABA) positive cells and terminals were detected in the NOT in the rat. However, GABA positive cells in the NOT receiving projections directly from the retinal ganglion cells could not be identified. Also, the GABA reaction was not positive for the neurons in the NOT projecting to the Inferior olivary nucleus (JO). In the NOT, although GABA positive cells exists, they seem to act indirectly as intrinsic interneurons, when processing or transmitting the Information from the retina, and to the IO.
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Sumio Sugano, Tamotsu Urushibata, Isao Kato, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
16-21
Published: October 25, 1991
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To determine the role of gamma aminobutyric acid (GABA) in the projection from the retinal ganglion cells to the nucleus of the optic tract (NOT), NOT of a rat in which the eyeball had been removed was observed by electron microscopy. In the observation of the nerve synapse bonding region in the NOT on the opposite site to the enucleated eyeball, Colonnior's symmetrical type was recognized, but the asymmetrical type was also recognized; they occurred at a ratio of 4: 3. The spherical type was more frequent than the flattened type in the NOT. In the electron microscopic observation of the NOT on the contralateral side, far more advanced vacuolation was confirmed in the neurons when compared with those of the collateral side. The optic nerves in rats do not intersect completely because the vacuolation showing a retrograde degeneration was observed also on the collateral side.
From these results, the inhibitory axon terminals in the NOT cannot be conclu d ed to have GABA activity.
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Tatsuya Torigoe, Tamotsu Urushibata, Mikio Ishikura, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
22-27
Published: October 25, 1991
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Follicular dendritic cells (FDC) are specialized cells found only within lymphoid follicles, and are significant factors in the humoral immuno system at the germinal center in the lymphatic tissue. However, evidence of the localization of FDC and other lymphatic cells in the human tonsil is lacking. We examined and analyzed the labelling pattern in the human tonsillar tissue produced by six monoclonal antibodies raised against DRC-1, PC OKT-4, OKT-8, Leu-7 and macrophages, and visualized using the avidin-biotin-peroxidase Complex (ABC) immunohistochemical technique.
FDC using the Anti-DRC antibody show e d nonstructural net formation in the whole germinal center, and the nuclei could not be stained. A positive figure was recognized in the cell membrane. Electronmicrographic evidence showed that FDCs extended their dendrites to the whole portion of the follicule and kept in contact with several distinct lymphocytes.
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Jun Iida, Koichiro Tsutsumi, Hiroya Iwatake, Sadamu Minami, Isamu Take ...
1991 Volume 1991 Issue Supplement48 Pages
28-33
Published: October 25, 1991
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Seventeen cases of unilateral false cord hypertrophy in males between 42 and 81 years old (average 60.3years) were analysed by means of CT examination of the larynx. The hypertrophic site was on the left side in 16 cases and right side in 1 case by laryngoscopy. Eleven patients complained of hoarseness, and six had discomfort of the larynx.
The axial CT scan of the patients revealed concavity of the thyroid lam ina and various asymmetry of the thyroid cartilage, such as rotation, deviation and different length of the lamina. In these findings, predominant site of the thyroid lamina in the horizontal direction was in agreement with the hypertrophic site except in one case.
In conclusion, unilateral false cord hypertrophy may be associated with the same site of growing the thyroid lamina.
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Kumi Nakajima, Yukio Toda, Junji Watarai, Kiyomi Yoshino, Kaoruko Taka ...
1991 Volume 1991 Issue Supplement48 Pages
34-38
Published: October 25, 1991
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The therapeutic effects of neurotropin (NSP) on sudden deafness were compared with those of usual therapy (steroid) from January until December,1987. We defined the improvement for patients over 50 years old and with a 20-50 dB hearing level on first medical examination in NSP. Of the 78 cases given this therapy complete recovery was seen in 40cases, and marked recovery and mild recovery in 6 cases each. Improved rate was 78.0% in NSP therapy and 53.1% in steroid therapy.
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Immunohistochemical Evidence of Histamine and Globulin on Nasal Mucosa
Sonoko Kai, Keisuke Uesugi, Junji Watarai, Fumio Iwao, Tamotsu Urushib ...
1991 Volume 1991 Issue Supplement48 Pages
39-47
Published: October 25, 1991
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We examined the differences between human IgG and human histamines on the epithelial surface of rabbit nasal mucosa. Examination of the IgG and histamine in rabbit nasal mucosa immumohistologically, revealed that they are both located in the same place on the epithelial surface. The behavior of IgG and histamine in allergic nasal mucosa was examined, but we detected no differences between IgG and histamine. In many clinics the histaglobin (HG) nebulizer is used, and is recognized to be effective. However the patients must come to the hospital for nebulizer treatment, and this makes it very complicated. We have prepared a new capsule, which is made of HG and hydroxypropylcellulose (HPC). The capsule is set in a nasal spray, and inhaled alternately into both nostrils only once a day, because the powder in the capsule remains in the nasal mucosa for a long time. We evaluated the clinical effects of the nasal spray in 15 allergic rhinitis and 14 rhinitis patients. There were no differences in effectiveness between the nasal spray and the nebulizer.
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Shigeki Sato, Sadao Ogino, Kentaro Ochi, Toru Ohashi, Isao Kato, Isamu ...
1991 Volume 1991 Issue Supplement48 Pages
48-51
Published: October 25, 1991
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We treated 45 BPPV (benign paroxismal positional vertigo) patients with physical therapy to cure the vertigo. In this physical therapy, the patients were held in a supine position and their heads were moved to the right and left (neck torsion). In each position, their vertigo and nystagmus were examined with a Frenzel glass or electronystagmograph (ENG). Their nystagmus and vertigo were also examined by the method reported by Brandt and Daroff, and the results obtained by the two methods were compared. All patients were cured of vertigo and nystagmus by our physical therapy as determined by either method. Our therapy was useful and sufficient enough to treat patients with BPPV, because it was simple, patients complained of little anxiety, and it was effective for all patients in the current study.
We should explain to the patient the features of BPPV and the effect of physical therapy to remove their anxiety and encourage them to continue to receive therapy.
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Ichiro Akao, Isao Kato, Isamu Takeyama, Tsutomu Kamo, Toru Shimizu
1991 Volume 1991 Issue Supplement48 Pages
52-56
Published: October 25, 1991
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A 64-years-old female with symptoms of bilateral lesion of medial longitudinal fasciculus (MLF) syndrome was examined by neuro-otological study using electronystagmography (ENG). The neurological studies at the first examination demonstrated left blepharoptosis and abduction of left eye position in the midline gaze.
Abnormal findings on eye movement were as follows: paralysis of bilateral ocular abduction, nystagmus in the bilateral abducted eye during horizontal gaze, disturbance of convergence, disturbance of bilateral rapid upward gaze, and nystagmus to upward and downward gaze direction. These findings suggest lesion of bilateral MLF and left oculomotor nuclei and this lesion belongs to the anterior type of Cogan's classification. Moreover, the MRI study disclosed the same focus as the infarction. When the disturbance of upward gaze remained, upbeat nystagmus was developed by the caloric test with bilateral chilling stimulation. It may disclose that there was tract of vestibuloocular reflex (VOR) in the vertical direction other than the MLF tract.
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Isao Kato, Jun Iida, Hiroya Iwatake, Sadamu Minami, Noriko Kihara, Isa ...
1991 Volume 1991 Issue Supplement48 Pages
57-61
Published: October 25, 1991
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Two patients who had fallen into hypotension after surgical operation are reported. They were treated with intubation of a cuffed tube and intermittent, positive pressure ventilation. Later, tracheal stenosis occurred as a result of prolonged intubation. Both were successfully operated with end-to-end anastomosis of the trachea following segmental resection of stenotic trachea.
Possible causes of a tracheal stenosis such as airway infection, inflation pressure, steroids and hypotention were discussed.
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Microscopic Surgery of Transseptal Approach to the Sphenoidal Sinus
Hiroshi Iwasawa, Isao Kato, Tomoyuki Okada, Koichiro Tsutsumi, Mutsumi ...
1991 Volume 1991 Issue Supplement48 Pages
62-66
Published: October 25, 1991
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We reported a case of sphenoidal sinus mucocele showing anterior carvernous sinus syndrome. A 65-year-old male was admitted complaining of severe pain in the trigeminal region and double vision. Examination revealed a mucocele in the both sphenoidal sinus, showing remaining sinuses being intact. Transseptal approach to the sphenoidal sinus was performed. The patient's symptoms completely disappeared after operation. Therefore, we stressed based on the present case the usefulness of microsurgery for sinus operations.
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Motonori Kikuchihara, Koichiro Tsutsumi, Fumio Kurata, Isamu Okawa, Is ...
1991 Volume 1991 Issue Supplement48 Pages
67-73
Published: October 25, 1991
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Histological effects of combination chemotherapy including CPAF (a combination of CDDP, PEP, THP-ADM and 5-Fu) regimen as neo-adjuvant chemotherapy were studied in 9 cases of squamous cell carcinoma of the tongue. The clinical effect, was CR in 7cases, PR in 2 cases. The response rate was 100%. Histologically,4 cases were classified as Grade IV Change,2 cases as Grade III change,2 cases as Grade II
a and II
b change according to the classification of Ohboshi-Shimozato.
Side effects were recognized in all cases. Nausea, vomiting and alopecia were the most common (88.9%).
The decrease of WBC counts below 3000 /mm
3 was observed in 4 cases and was mostly transient.
These results indicate that the CPAF regimen as neo-adjuvant chemotherapy is effective, not only for the palliative treatment of squamous cell carcinoma of the tongue, but also for the reduction of tumor bulk.
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Kiyomi Yoshino, Yukio Toda, Tatsuya Torigoe, Kumi Nakajima, Junji Wata ...
1991 Volume 1991 Issue Supplement48 Pages
74-81
Published: October 25, 1991
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We reviewed 56 children (111 ears) with otitis media effusion who had consulted us during the six years between 1979 and 1984, and followed up for more than three years.
The ear drum, hearing level and tympanometry were examined at the initia l and last time. Then we evaluated and classified these cases under four groups in view of prognosis.
Of the 111 ears,40% were cured,15% had trace effusion,32% required of servation and 13% took a poor course. The age at the first examination was between 0 and 9 years old with a peak at 5 years old, and decreased in the children over 8 years old. In the children over 10 years old, evaluations were affected by sinusitis. On the other hand, in the children under 10 years old, adenoids influenced these evaluations. The cleft of palate was influenced at all ages.
Atelectasis was detected in 8 ears, but all cases improved by tube insertion or tympanostomy. Active treatment and long-term follow up are important to prevent progression to irreversible state.
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Kaoruko Takahashi, Hiroshi Iwasawa, Shigeki Sato, Jun Iida, Tomoyuki O ...
1991 Volume 1991 Issue Supplement48 Pages
82-87
Published: October 25, 1991
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We reported a case of a 42-year-old female who showed the jumbling phenomenon due to left labyrinthine dysfunction after GM local treatment for O. M. C.
This patient complained of otorrea and deafness, then we gave her CCL orally, GM and steroids locally as eardrops 7 times. A few days after this treatment she noticed the fullness of the ear, vertigo, nausea and vomiting.
This patient complained of difficulty i n walking on dim light and apparently felt oscillation movements of a fixed target when she moved her head to the affected ear side either actively or passively.
She has had a 12 to 13 year history of left chronic otitis media. Neurological examination of this patient showed left hearing loss and vestibular dysfunction.
There was on spontaneous nystagmus, but the DP (dir e ctional preponderance) to the right side was found. ETT and OKN were normal in this patient.
Usually, the jumbling phenomenon appears in cases that there is a loss of bilateral vestibular function. However, the jumbling phenomenon appeared in our case although she suffered from unilateral vestibular disorder.
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Hiroaki Nakashima, Motonori Kikuchihara, Hideo Otake, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
88-92
Published: October 25, 1991
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Hemangioma of the head and neck with phlebolithialis is not common, especially in the neck region. We reported one case of cavernous hemangioma with phlebolithialis in the anterior neck region and discussed the clinical diagnosis and treatment of this case.
This case was a 26-year-old male who complained of a right anterior neck swelling. The preoperative diagnosis was difficult, because this tumor was adjacent to the thyroid grand, and examinations were required to differentiate the thyroid tumor. The diagnosis could not be established by x-ray examination and we could not differentiate it from thyroid tumor preoperatively and postoperative histopathological examination revealed cavernous hemangioma containtng phlebolithialis.
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Difficult Case of Endotracheal Intubation for Anesthesia
Hisako Hashimoto, Isamu Okawa, Jun Iida, Sadamu Mimami, Mutsumi Kenmoc ...
1991 Volume 1991 Issue Supplement48 Pages
93-96
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We report a 22-year-old male who complained of articulation disorders and swelling around the submental region resulting from large epidermoid cyst of the floor of the mouth. Endotracheal intubation for anesthesia was difficult in this case, because of swelling of the floor of the mouth.
Careful examination of the airway before the induction of anesthesia was important in this case.
The large cyst was extracted by surgical intervention. Since then, there has been no reccurrence 2 years after surgery.
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Hiroya Iwatake, Junji Watarai, Jun Iida, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
97-103
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We report 41 cases of acute epiglottitis treated in our hospital during the past 14 years from 1975 to 1988.
Twenty six cases were in males and 15 cases were in females between 11 and 70 years old, with a mean age of 37.3 years old. There was a tendency to increase in the cases of acute epiglottitis, because 21 cases (51.2%) occurred during the recent three years. The length of time from onset of symptoms to hospitalization and diagnosis was from 8 hours to 7 days with an average of 2.5 days.
The incidence of presentin g symptoms was sore throat (100%), dysphagia (91.2%), fever elevation (63.4%), dyspnea (31.7%), hoarseness (24.4%). The swelling of epiglottis was demonstrated by indirect laryngoscopy in all cases, and the epiglottis findings were classified into two categories which were abscess type (34 cases) and edema type (7 cases).
Soft-tissue lateral neck radiograph showed swelling of epiglottis and aryepigottic fold in 11 out of 24 cases.
The bacterial cultures were performed in 16 cases, and only one case was positive for H. influenzae. All cases received intranvenous antibiotics and 38 cases were treated with steroid therapy. Emergency tracheostomy was performed in three cases. The mean duration of hospitalization was 9.2 days with a range from 3 to 38 days, and no deaths occurred.
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Keisuke Uesugi, Isao Kato, Hiroshi Iwasawa, Shigeki Sato, Ichiro Akao, ...
1991 Volume 1991 Issue Supplement48 Pages
104-111
Published: October 25, 1991
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We report two patients with oculopalatal myclonus after pontine hemorrhage. The first patient, a 43-year-old man, had right hemiplegia and dysarthria. CT revealed a high density area at the pontine and left mid brain. One day after admission, locked-in-syndrome was recognized. About six months later, he had the abnormal ocular movements which were rhythmic, continual, horizontal oscillation. We regard this abnormal ocular movement as ocular myoclonus. Electro-nystagmography(ENG) findings were: PPRF disturbance and oculo motor nerve palsy. Caloric test revealed no response.
The second patient, a 39-year-old man, had consciousness dow n and left hemiplegia and right facical palsy. CT revealed a high density area at the pontine and right mid brain. He had been noted to have Foville-Millard-Gubler syndrome. About one month later, oculopalatal myoclonus were recognized. ENG findings were: one and a half syndrome was considered.
Ocular myoclonus is a continuous, rhythmic to-and-fro pendular oscillation with similar synchonous movement of the palatal and face. Many previous reports supported the importance of Guillain-Mollaret's triangle in appearance of ocular myoclonus. Histopathologically pseudohypertrophy of the inferior olivary nucleus was recognized. The oculopalatal myoclonus in these cases was suggested to be due to functional disturbance of the pontine tegmentum including PPRF and MLF.
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Kentaro Ochi, Toru Ohashi, Shigeki Sato, Junji Watarai, Isamu Takeyama ...
1991 Volume 1991 Issue Supplement48 Pages
112-117
Published: October 25, 1991
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Caustic ingestion may cause severe necrosis of upper digestive tract. Combined pharyngeal and esophageal stricture is unusual, but when it occurs, reconstructive surgery neccessitates difficult techniques. There are special problems in these cases involving on the function of both deglutition and phonation.
A 45-year-old female with severe pharyngoesophageal involvement was treated by colon interposition with particular emphasis placed on the cervical anastomosis. From the point of natural process of deglutition, it is thought that the posterior pharyngeal wall may be a better position for anastomosis than the vallecula. However, in this case, we placed the vallecula for anastomosis and met with good results.
The scarring tissue between epiglottis and po s terior pharyngeal wall may serve to inhibit the aspiration in the this case.
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Isamu Okawa, Junji Watarai, Motonori Kikuchihara, Hideo Otake, Isamu T ...
1991 Volume 1991 Issue Supplement48 Pages
118-121
Published: October 25, 1991
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Four cases of adenoid cystic carcinoma of the maxillary sinus were treated with radiation therapy, chemotherapy and surgical resection of maxilla. However, in spite of combined treatments local recurrence and distant metastasis occurred. We emphasized that follow up and multidisciplinary therapy, should be done after primary treatment.
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Tomoyuki Okada, Mitsuyo Akagi, Junji Watarai, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
122-127
Published: October 25, 1991
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We report a rare case of arteriovenous fistula with aneurysm on the right occipital artery area, in a 35-year-old male complaining of right ear hearing loss. These findings suggested that the hearing loss trigger was traumatic in origin.
Arteriovenous fistula was increasing in size, arterio v enous fistula stole the blood flow from both the occipital artery system and the vertebral artery system, and aneurysm tend to make an embolism.
The arteriovenous fistula is generally treated by two methods i. e., surgical operation and artificial embolization. We chose surgical removal of arteriovenous fistula, because the blood flow was more voluminous on the occipital artery of the feeder, the lesion was not solitary, and the occult feeder existed.
The surgery was evaluated as successful one year after treatment, although his hearing loss remained unchanged.
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Atsushi Sakuma, Isao Kato, Sadao Ogino, Tomoyuki Okada, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
128-132
Published: October 25, 1991
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A 24-year-old man was admitted because of severe dehydration. He had primary position upbeat nystagmus (PPUN) associated neurological signs of both lower brain stem and cerebellar disorders. ENG examination on the fourth hospital day revealed normal saccadic eye movements, gaze nystagmus in all directions, bilateral decrease of slow phase OKN velocities from ranges of slow stimulus velocity, and bilateral diminution of caloric nystagmus. ENGs and neurological signs strongly suggested brain stem lesions.
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Masahiko Suzuki, Motonori Kikuchihara, Kentaro Ochi, Hiroya Iwatake, J ...
1991 Volume 1991 Issue Supplement48 Pages
133-139
Published: October 25, 1991
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Four cases of fibrous dysplasia of the maxillary bone are reported. In these cases, three cases were monostotic type and one case was polystotic type.
Case 1. A 21-year-old woman complained of sw elling on the right side of her zygomatic region. The diagnosis of fibrous dysplasia was made histologically under exploratory and conservative operations. No recurrence was seen postoperatively.
Case 2. A 57-year-old woman suffered from swelling of the left zygomatic region and nasal obstruction. The tumor was located in the maxillary sinus and was removed completely.
Case 3. A 13-year-old boy developed swelling of the left zygomatic region. Under roentgenological examination, a tumor was seen to the left maxilla, mandible, ethmoid, sphenoid, zygomatic arch, frontal bone and temporal bone.
Case 4. A 7-year-old boy complained of swelling deformity on the right side of his face. Diagnosis of the facial bone was made histologically under exploratory operation.
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Sadamu Minami, Jun Iida, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
140-145
Published: October 25, 1991
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We experienced 14 cases of Ludwig's angina disease between March,1974 and February,1987. Of the 14 patients,9 were men, and 5 were women (mean age 36.3 years old). Except for two unknown cases all were related to dental disease, most of which were due to wisdom teeth and the first and the second molar teeth. In the operation for the swelling part,11 cases were cut out and 3 cases were not cut out. Of the 11 cut cases 6 cases were festered. The bacteria in the pus were identified a-strept which was popular. As for fever of the patients, all the patients had a fever over 37.0°C except in one case. Most patients visited hospital with in 3 to 5 days of onset, with an average of 5 days. Average stay in hospital was 25.5 days. They left the hospital within half a month except for the severe case such as diabetes mellitus. For therapy, the body should be rested, and extensive spectoral antibiotics should be administered for the protection of anaerobic bacterial infection. We have to consider the rapid advance of infection and the significance of the local incisions.
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Sadao Ogino, Isao Kato, Syoji Watanabe, Kaoruko Takahashi, Isamu Takey ...
1991 Volume 1991 Issue Supplement48 Pages
146-150
Published: October 25, 1991
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Medial longitudinal fasciculus (MLF) plays on important role in the conduction of signals related to the horizontal eye movements.
Here we report a 60-year-oldfe malew ithb ilateralM LF syndromec ausedb y multiple sclerosis. In the neurological study, her left eye remained deviated on the left side on straight forward gaze, and convergent eye movements were absent. EOG showed that both eye movement slowed down during nasalward adduction, and were normal during temporalward abduction. No abnormalities were quantitatively recognized in vertical axis. This suggests that the neural tracts of vertical eye movements will be transmitted through routes other than MLF.
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Takashi Tazawa, Motonori Kikuchihara, Hiroaki Nakashima, Ichiro Akao, ...
1991 Volume 1991 Issue Supplement48 Pages
151-156
Published: October 25, 1991
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A 19 year old female whose chief complaint was pulsating tumor in the left auricular region is reported. The patient was aware of the tumor present in the left auriclar region when she was an the elementary school girl, but had not received treatment. The patient visited our department on February 19,1988. An indolent dark red tumor 2.6×1.6 cm in size was detected at the left auricular region by the initial examination, and the tumor was elastic and soft by palpation. This tumor was suspected as vascular in origin, since pulsation was palpated but disappeared by pressing the anteaural region. Carotid angiography was performed, and a diagnosis was made as auricular arteriovenous deformation with the superficial, occipital and auricular arteries as inflow arteries. Extirpation of the tumor was carried out under general anesthesia on September 6,1988. All communicating arteries and veins were sectioned by ligation, and the tumor was exfoliated and extracted. The patient has been put to observation at our clinic and there has been no recurrence at present 8months after the surgery.
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Tomohide Hoshikawa, Jun Iida, Noriko Morita, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
157-160
Published: October 25, 1991
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We report 13 cases of congenital cervical cysts removed operatively during a 14 year period in our clinic.
Cervical cysts are caused by remains of the thyroglossal duct. Average age was 34.9years old. (males: 38.3 years old, females: 32.0 years old). Sex distribution was even (6were males and 7 were females).
Chief complaints were median swelling or cervical cyst. Four cervical cysts, were located in the upper portion of the hyoid bone,5 cases were located in the lower portion of the hyoid bone and 2 cases were located in the hyoid bone. Only 2 cases had a fistula. We operated in all cases, We removed the hyoid bone with the cyst in 6 cases, and we did not find any recurrence.
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Syoji Watanabe, Kiyomi Yoshino, Yukio Toda, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
161-166
Published: October 25, 1991
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Infectious mononucleosis (IM) is commonly seen in adults but rarely in infants and children. A rare case of Epstein-Barr virus (EBV) encephalitis following IM is reported here.
A 15-year old female, suffering from high fever, pain and swelling of the left neck for about 20 days was admitted to our hospital. Various symptoms and signs such as series of those of IM due to initial infection of EBV were observed.
Five days later, a patient became unconsious and accompanied with frequent tonic convulsion. Soon emergent treatments were performed and her condition changed for the better.
In the cerebrospinal fluid, at that time, pleocytosis which was mainly due to lymphocytosis was observed.
As a result, viral infection was strongly suspected. An increased titer of the EBV antibody, which was presence of VCA-IgM and an increase of VCA-IgG, strongly suspected an initial infection of EBV. Thus, Ara-A and s teroid therapy were applyed to this patient. This therapy proved to be effective and she has recovered completely without any after effects.
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Mitsuyo Akagi, Hiroaki Nakashima, Hiroshi Iwasawa, Isamu Takeyama, Ken ...
1991 Volume 1991 Issue Supplement48 Pages
167-170
Published: October 25, 1991
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We report a rare case of intraoral foreign bodies.
A 61 year-old woman felt pain in the oral cavity immediately after eating fresh squid and visited our hospital.
We diagnosed as intraorl foreign bodies on examinations, since many white spindle shaped foreign bodies were observed in her oral cavity. We removed these foreign bodies with perimucosal tissue using forceps. The microscopic examination revealed the foreign bodies were the sperm bulb of the fresh squid.
We emphasized that fresh squid should be eaten with care.
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Foreign Body in the Bronchus
Ryosuke Miyasaka, Jun Iida, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
171-174
Published: October 25, 1991
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Tracheo-bronchial foreign bodies of the dental material are rare, a though all cases are recognized as esophagus foreign bodies.
Since 1985, we experienced 2 cases of tracheo-bronchial foreign bodies which are teeth and false teeth.
The first case was in a 51-year-old man who had aspirated a false tooth into the right bronchus.
The second case was in a 60-year-old man who had aspirated a tooth into the right bronchus.
Because these two cases became unconsious, they how the foreign bodies, were swallowed, remained unknown.
We emphasized the danger of misswallowing of foreign bodies in an unconsious condition.
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Mutsumi Kenmochi, Tomoyuki Okada, Hiroshi Iwasawa, Isao Kato, Isamu Ta ...
1991 Volume 1991 Issue Supplement48 Pages
175-179
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We report a rare case of rhinogenic meningistis during follow up of sphenoidal sinusitis.
The patient was a 30-year-old male who had a headache and high fever.
On examination, the cerebrospinal fluid showed high cell count (m o stly polymorpho nuclear cells) and CT scanning revealed infection in sphenoidal sinus, others were normal.13 days after admission, operation was performed by transseptal approach to sphenoidal sinus. This method could be used safely, in a wide operative field and had many merits. The patient recovered completely 12 weeks after admission.
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Masao Mitsui, Ichiro Akao, Tatsuya Torigoe, Motonori Kikuchihara, Jun ...
1991 Volume 1991 Issue Supplement48 Pages
180-185
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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An 89-year-old female with frontal sinus carcinoma was referred to us with repeated nasal bleeding and swelling in the right margo supraorbitalis.
The histopathological study of the specimen i n the nasal cavity revealed epidermoid carcinoma. The patient was treated with irradiation because of her age. The patient has been alive 4 months after the initial treatment. A 48-year-old male with ethmoidal sinus carcinoma had the complaint of repeated nasal bleeding and swelling in the right margo supraorbitalis. The patient was treated with surgical operation, followed by irradi ation, and chemotherapy.
This surgical operation was performed by an approach from the nasal side and the scalp side because of infiltration into the bone of the skull base. The postoperative histopathology revealed adenocarci n oma.
The patient has been alive 3 months after the initial treatment without any evidence of recurrence of the tumor. Eighty five patients with carcinoma of the paranasal sinuses have been treated in our university. Primary carcinoma of frontal sinus was found in only 1 case (1.2%) and that in ethmoidal sinus was found in 17 cases (20%). In this way, primary carcinoma of frontal and ethmoidal sinus is a rare disease and treatment undecided. At present, the usual methods of treatment are surgical operation, irradiation, and chemotherapy.
Furthermore we should try the skull base operation in this disease.
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Miya Asakura, Hiroshi Iwasawa, Hisako Hashimoto, Hiroaki Nakashima, Sy ...
1991 Volume 1991 Issue Supplement48 Pages
186-190
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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A 39 year-old female with systemic lupus erythematodes (SLE) has been under medical care. Her complaints were right facial palsy and floating sensation. She developed the right gaze palsy and the right monoocular paresis to left gaze. Left monoocular nystagmus was observed but horizontal gaze and convergence were normal. Brain CT scan revealed that neither hemorrhage nor infarction was proved. Damage of the right medial longitudinale fasciculus and parapontaine was suspected. Reticular formation were possibly responsible by abnormal eye movements, so-called one and a half syndrome.
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Fumio Kurata, Motonori Kikuchihara, Isamu Okawa, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
191-195
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We experienced four patients who underwent free jejunal reconstruction after radical surgery treatment for the hypopharyngeal, cervical esophageal carcinoma in our hospital. After operation of the pharyngolaryngoesophagectomy and modified neck resection the free jejunum with blood vascular base were transplanted as a reconstructive pharyngoesophagus, and superior thyroid artery was used on the arterial side and internal jugular vein on the venous side.
The patient could eat at a bout 2 weeks after operation, and the average period of ingestion was 14.5 days. The average period of hospitalization was 37 days.
The advantage of free jejunal reconstruction was short hospitalization because operative damage was minimal and ingestion, could be resumed earlier afr operation.
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Takeshi Suzuki, Isao Kato, Tatsuya Torigoe, Isamu Takeyama
1991 Volume 1991 Issue Supplement48 Pages
196-200
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We report a patient with idiopathic glossopharyngeal neuralgia and of severe pain in the field of the glossopharyngeal nerve. The characteristics of idiopathic glossopharyngeal neuralgia resemble those of idiopathic trigeminal neuralgia. However, idiopathic glossopharyngeal neuralgia is unusually rare in comparison with idiopathic trigeminal neuralgia. The patient's complaint was of intolerable sore throat, for about 2 years. However, no evidence of the organic change was found by routine examinations, and general antiinflammatory drugs (aspirin) were ineffective. Therefore, the glossopharyngeal neurolectomy was perfomed by the transoropharyngeal approach. She was cured from the initable neuralgia completely after the operation.
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Hitoshi Miho, Toru Ohashi, Kentaro Ochi, Shigeki Sato, Sadao Ogino, Is ...
1991 Volume 1991 Issue Supplement48 Pages
201-206
Published: October 25, 1991
Released on J-STAGE: November 27, 2012
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We report a case of inner ear malformation (Michel dysplasia) associated with left total deafness in an 8-year-old boy. He had normal vestibular function and right normal hearing. The dysplasia of the left temporal bone and inner ear was revealed by a radiological study, especially computed tomography. A left cochlear aplasia, and dysplasia of left vestibule and semicircular canals which made a vacant cavity, and a narrowed internal auditory canal were demonstrated.
Our case could n o t be classified according to the reported radiological and pathological classifications. We would like to advocate that inner ear malformations should be classified based on anatomical constitution determined by modern radiologic techniques, rather than denoting them with eponym.
It should beem phasized that, there is a poor correlation between the osseous radiographic changes and vestibular function of the severe case of aplasia or dysplasia in cochlea, vestible and semicircular canals. Therefore, we considered that there is little significance clinically in making a detailed classification.
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