Based on the observation of 65 patients admitted for epistaxis from July 2000 to June 2007, we noted a higher frequency in men than women (male/female ratio about 2 to 1), a higher incidence among the middle-aged and olderly than in younger patients, and a higher epistaxis frequency in winter. Among subjects, 25 (38.5%) had bleeding in Kisselbach's area, 13 (20%) in the inferior turbinate or meatus, 7 (10.8%) in the middle turbinate or meatus, 5 (7.7%) in the olfactory cleft, 1 (1.5%) in the bottom of the common nasal meatus, 1 (1.5%) in the posterior nasal septum, and 13 (20%) at unidentifiable sites. All were treated with gauze packing. Ten patients (15.4%) were treated with postnasal packing using Belloq's tampon or epistaxis balloon. None underwent surgical arterial ligation or arterial embolization. Complications seen in 51 (78.5%) included hypertension, heart disease, liver disease, diabetic mellitus, postoperative heart disease (artificial valve replacement), and chronic renal failure. Anticoagulation therapy was conducted for 18 (27.7%) and wafarin therapy for 11 (16.9%). Epistaxis that complicates warfarin therapy is becoming increasingly common. Prothrombin time (international normalized ratio: INR) was measured routinely and ranged from 1.3 to 3.8, averaging 2.23. In all patients but one, warfarin was stopped temporarily until epistaxis was controlled. No thromboembolic complications occurred. When epistaxis is encountered in the elderly, it thus becomes to consider both local treatment for epistaxis and the possibility of systemic disease.
In this study we recorded the electroencephalograms (EEGs) of humans during exposure to the odorant stimuli. The EEGs were divided into superficial components and deep components by a source derivation (SD) method, and each superficial and deep component of the EEGs was divided into an inspiratory phases and an expiratory phase. The subjects were 13 euosmic adults. Strawberry ice syrup (strawberry smell), β-phenylethyl alcohol (rose smell), and prosultiamine (Alinamin smell) were used as odorant stimuli. We analyzed the power spectrum of each EEG by fast Fourier transform (FFT) and calculated the spectrum density (power value) for each frequency band (δ, θ, α 1, α 2, β 1, β 2). Stimulation with each of the three odorants decreased the power value of the θband. Division of the EEGs into an inspiratory phase and an expiratory phase showed that all three olfactory stimuli decreased the power value of the θband. A decreased power value of the θband in the expiratory phase was found in a deep component in response to the strawberry and rose odors, and appeared to be a response to an agreeable smell. The change in the θband appeared to be related to recognition of the smell in the inspiratory phase. The decreased power value of the α1 band was concentrated in the right region on the scalp in the breathing phase, the inspiratory phase, and the expiratory phase. It showed a significant response only to the strawberry smell. The decreased β1 power value occurred in response to the strawberry in the deep component of the breathing phase. Division of the EEGs into an inspiratory phase and an expiratory phase showed that there is a difference of EEG responses in kinds of odor stimuli. And also division of the EEGs by SD method there is a difference between superficial and deep components in EEGs.
Objectives: The purpose of this study was to examine the oncologic outcome of patients who reveived multimodality therapy for maxillary sinus cancer that had invaded the base of the middle portion of the skull. Study Design: Retrospective study. Patients and Methods: The medical records of 13 patients with maxillary sinus cancer that had invaded the base of the middle portion of the skull were analyzed retrospectively. These were 7 men and 6 women, and their median age was 60 years. The mean follow-up period was 73 months. The pathological diagnosis was squamous cell carcinoma. Two patients had nodal disease. Of the 13 patients, 9 had lesions around the foramen rotundum, 3 had lesions around the foramen ovale, and 3 had lesions around the foramen lacerum. All patients underwent simultaneous multimodality therapy consisting of surgery through a sublabial incision, radiotherapy, and regional chemotherapy. Selective neck dissection was performed in patients with nodal disease. Results: The 5-year overall survival rate was 76%, and the 5-year local control rate was 68%. Conclusion: Multimodality therapy consisting of surgery, radiotherapy, and regional chemotherapy is an effective method of treating maxillary sinus cancer with invasion of the base of the middle portion of the skull.