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Volume 49, Issue 1
Displaying 1-10 of 10 articles from this issue
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Satoshi YOKOO, Yoshiki OHTSUKA, Masahiro UMEDA, Takahide KOMORI2000 Volume 49 Issue 1 Pages 1-6
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSDefects after resection of buccomucosal malignant tumors are, in relation to the safety margin, often not limited to the full-thickness cheek but extend to the oral commissure and upper and lower lips. A functional and aesthetic reconstruction for such extensive defects using the Goldstein's tissueexpanding vermilion musculocutaneous flap (vermilion advancement flap) for lip reconstruction in combination with free radial forearm flap for cheek and oral commissure reconstruction is reported in detail.
This procedure was performed as a one-stage operation in two patients with recurrent buccomucosal squamous cell carcinoma. The patients showed good orbicularis oris muscle ring continuity, vermilion configuration and recovery of the sensation of the vermilions. At present, 2-3 years after operation, satisfactory results are observed both functionally and aesthetically.View full abstractDownload PDF (3891K) -
Yukihiro MICHIWAKI, Mika YOKOYAMA, Yoshie KINUMATSU, Ken-ichi MICHI, T ...2000 Volume 49 Issue 1 Pages 7-10
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSTo clarify relationship between texture of the food and swallowing function, the influence of hardness of the test material on the severity of dysphagia was examined. Four test materials with different levels of hardness were used in the study, using mixture of agar and iopamidol. The subjects were 24 patients who underwent aspiration or penetration using videofluorography. All of them had neurovascular disease such as infarction (16 patients), bleeding (7 patients) and Parkinson's disease (2 patients).
As a result, the softest diet had the highest risk of aspiration, while the hardest material was safer than the others. These results revealed that the hardness of diet affected the severity of dysphagia. To divide diets based on easiness of swallowing would help patients with dysphagia to eat more safely and satisfactorily.View full abstractDownload PDF (1314K) -
Yukihiro MICHIWAKI, Mika YOKOYAMA, Yoshie KINUMATSU, Kohji TAKAHASHI, ...2000 Volume 49 Issue 1 Pages 11-15
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSAspiration pneumonia is a mortal disease of patients with dysphagia. Although videofluorography has been usually used to diagnose the disease, the videofluorography should be replaced by a small and noninvasive equipment because of radiation exposure and the need for a large machine in a radiation shield room. An experimental study was performed to develop a new diagnostic equipment with light emitting diode (LED).
The new system used 9 LEDs with 880nm of wavelength, 900mA of light source and photo diode (PD), including Indocyanine green as the dye solution. The Indocyanine solution diluted 20 times effectively reduced the electric intensity at the PD. Further improvement of combination of LED and PD would enable development of a new diagnostic aid for aspiration.View full abstractDownload PDF (1296K) -
Basic Study for the Time AnalysisMika YOKOYAMA, Yukihiro MICHIWAKI, Koji TAKAHASHI, Motoko OZAWA, Ayako ...2000 Volume 49 Issue 1 Pages 16-24
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSAlthough videofluorography (VF) is a popular method for examining swallowing dysfunction, there has been no basic study concerning the precision of its time analysis particularly from the viewpoint of volume and kinds of test materials, and measurement points. Two types of errors should be considered: first, errors when imaging swallowing with VF, and second, errors when analyzing the time from VF images. The purpose of this study was to clarify the precision of time analysis using VF images.
The subjects were eight normal volunteers. The measurement points were the time of hyoid bone elevation, pharyngeal delay time, pharyngeal passing duration and cricopharyngeal opening duration. The interrater variations, influences of the reproducibility of swallowing action, effects of changes in head position, chewing, and individual differences were measured. The results showed that there were no interrater differences and swallowing motions were significantly reproducible. Extreme changes in head position and chewing action affected the measurement value. In conclusion, it was found that the precision of time analysis for the swallowing function was reliable when the head position was stable within 15° of the direct vertical position and feeding pattern was standardized.View full abstractDownload PDF (3272K) -
Yoshimi ISHIKAWA, Yu KATADA2000 Volume 49 Issue 1 Pages 25-28
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA case of bilateral coronoid hyperplasia of the mandibular is presented. The patient was a 12-yearold male complaining of limitation of the mandibular movement. Interincisal opening of the patient was limited to 20 mm.
Orthopantomogram and the other X-ray findings did not reveal bilateral coronoid hyperplasia of the mandibular distinctly. Thus additional examination was conducted using 3-dimensional computed tomography (3-D CT), and the images were very useful for the diagnosis of this lesion. By measuring the coronoid length on 3-D CT images, both of the coronoid process were 31mm in length from the base to the top. Tthere was the bony torous on the bilateral zygoma. It was found that the cause of limitation of the mandibular movement was the coronoid process collided with the zygoma.
Bilateral coronoidectomy and removal of the bony torous of the zygoma was performed by the intraoral approach under general anesthesia. This operation immediately resulted in an increased interincisal opening of 42 mm. Following jaw-stretching exercise, the patient still has interincisal opening of 40mm two years postoperatively.View full abstractDownload PDF (2852K) -
Motohiro KOBAYAKAWA, Masaro MATSUURA, Yasuhiro MATSUMOTO, Jun ISHIWATA ...2000 Volume 49 Issue 1 Pages 29-32
Published: January 10, 2000
Released on J-STAGE: November 25, 2011
JOURNAL FREE ACCESSA case of a benign lymphoepithelial lesion of the sublingual gland is presented. The patient was a 45-year-old female with a solitary mass in the right sublingual region. Histopathologic examination revealed lymphocytic proliferation and lymphoid follicles. Ducts and proliferative duct-like structures were found in the lymphoid tissues, but epimyoepithelial islands were not evident. The results of immunohistochemical examination suggested that proliferative duct-like structures differ from normal ductal epithelial cells.View full abstractDownload PDF (2721K) -
Diagnostic Values of Effectiveness of Carbamazepine, the Presence of Distinct Trigger ZonesJun SATO, Ken-ichi NOTANI, Takao UENO, Keiji KONDOH, Tohru SAITOH, Hir ...2000 Volume 49 Issue 1 Pages 33-38
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThis study was conducted to investigate the relationship of the effectiveness of carbamazepine and the presence of the distinct trigger zones for the final diagnosis of trigeminal neuralgia using 51 patients who were suspected to have trigeminal neuralgia at the first visit and received carbamazepine. These patients were found to have trigeminal neuralgia (45 cases), psychologic pain (5 cases) or trigeminal neuritis (1 case).
The final diagnosis of trigeminal neuralgia was established in 39 out of 40 (98%) patients who were susceptible to carbamazepine and in six of 11 (55%) patients who were not susceptible to this agent. The final diagnosis of trigeminal neuralgia was established in all 23 patients who had the distinct trigger zones and in 22 out of 28 (79%) patients without the distinct trigger zones. In addition, 95-100% of the patients who were susceptible to carbamazepine and/or had the distinct trigger zones were found to have trigeminal neuralgia, whereas only 3 (38%) of 8 patients who were not susceptible to carbamazepine nor had the distinct trigger zones had this disease. On the other hand, it was difficult to differentiate idiopathic trigeminal neuralgia from symptomatic trigeminal neuralgia by the effectiveness of carbamazepine or the presence of the distinct trigger zones.
These results suggest that the effectiveness of carbamazepine and the presence of the distinct trigger zones are useful factors to establish the differential diagnosis of trigeminal neuralgia.View full abstractDownload PDF (994K) -
Tetsuhito KAWASE, Atsushi SOTOHATA, Atsushi SHINOHARA, Yoshiaki KAZAOK ...2000 Volume 49 Issue 1 Pages 39-42
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA 54-year-old male was scheduled for mandibular dentigerous cystectomy. His preoperative laboratory data showed a remarkable decrease in blood platelets (64, 000/μl). Therefore, platelet transfusion of 20 units was performed.
Following anesthesia, a sharp drop of blood pressure, along with tachyarrhythmia and bradycardia ensued. There was recovery after the anesthetist administered vasoconstrictants and antiarrhythmic agents.
Myoglobinuria was noticed just after the operation (100 minutes after the administration of anesthesia).
His body temperature increased to 37.5°C, but did not rise higher than that at the end of operation.
CPK rose to 59, 495 IU/L on the first postoperative day, and serum myoglobin increased to an unmeasurable value. However, the patient did not have any major organ failure.
The calcium-induced calcium release rate measured by the skinned fiber method was normal 17 months postoperatively.View full abstractDownload PDF (1063K) -
Masayuki TAKAHASHI, Naoya MIYASHITA, Yutaka KIMIJIMA, Toshifumi ANDO, ...2000 Volume 49 Issue 1 Pages 43-47
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA case of subacute necrotizing lymphadenitis arising in the left-side of the neck in a 29-year-old female is presented.
The patient was referred to our hospital with a 7-week history of slight fever and multiple swellings on the left-side of the neck. A physical examination revealed multiple, mobile, lymph nodes 0.5-2.5 cm in size in the left cervical region. A CT scan and ultrasonic examination also revealed swollen lymph nodes. Treatment with antibiotics was ineffective. Excisional biopsy of one of the cervical lymph nodes was performed for the diagnosis of the disease. WBC, ESR and chest X-ray were normal, but the anti-EBV titer was abnormal.
This patient bred cats and had been bitten by mites or fleas on her legs before she developed this disease. Thus it was thought that this disease may have been mediated by a vector.View full abstractDownload PDF (3482K) -
Kazuhiko YAMAMOTO, Takehiro ENDOH, Tadaaki KIRITA, Kenji MISHIMA, Yosh ...2000 Volume 49 Issue 1 Pages 48-52
Published: January 10, 2000
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA 49-year-old female was referred to our department for the evaluation of trismus, but she quit visiting us before the final diagnosis. She came to us complaining of a white lesion on the tongue 7 years later. The lesion was clinically diagnosed as tongue cancer and extirpated under general anesthesia. Histological examination revealed severe epithelial dysplasia with the invasion of squamous cell carcinoma. In general, her oral mucosa was severely atrophic, and trismus and dysphagia were observed. Histological examination of the oral mucosa without tumor showed marked atrophy of the epithelium and subepithelial proliferation of dense collagen fiber. Immunohistochemical staining of Ki-67 showed the increase of positive staining cells. These findings were consistent with those of oral submucous fibrosis. Two years later, she underwent surgery due to another tongue cancer. No recurrence or development of an other lesion has been found in the past 5 months. This is a rare Japanese case of oral submucous fibrosis developing multiple oral cancer.View full abstractDownload PDF (2764K)
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