Akio Hatanaka

Two Japanese Corynebacterium ulcerans isolates from the same hospital: ribotype, toxigenicity and serum antitoxin titre

Two toxigenic Corynebacterium ulcerans isolates recovered from pharyngeal swabs of two patients from the same hospital in Japan during 2001-2002 were characterized by PFGE and ribotyping. Toxin production in different culture media was examined and serological analysis of patient sera was performed. The two isolates could not be distinguished by PFGE; however, their ribotypes were distinguishable. One of the isolates could represent a novel ribotype. Analysis of toxin production in different culture media demonstrated that the two isolates produced varying amounts of the diphtheria toxin. Serological analysis showed a greater than sevenfold increase in the serum antitoxin titre during the course of infection in one patient.

A mutation in Wolfram syndrome type 1 gene in a Japanese family with autosomal dominant low-frequency sensorineural hearing loss

Conclusion. Our findings suggest that Wolfram syndrome type 1 gene (WFS1) mutation is an important cause of autosomal dominant low-frequency sensorineural hearing loss (LFSNHL) in Japan. Objective. DFNA6/14 is caused by a heterozygous mutation of WFS1 and is a common cause of autosomal dominant LFSNHL among populations in both Europe and the US. The purpose of this study was to investigate WFS1 mutations among Japanese patients whose phenotypes were consistent with those of DFNA6/14. Material and methods. Using audiometry and genetic analysis, we searched for WFS1 mutations in three unrelated Japanese patients with LFSNHL and a familial history of autosomal dominant hearing loss. Results. One patient carried a heterozygous G2700A mutation at codon 844 in exon 8, resulting in substitution of a threonine for an alanine (A844T). Genetic analysis of the available members of the patients family showed that the A844T mutation segregated with LFSNHL, but was not detected in any of 140 control chromosomes. It thus appears likely that the A844T mutation is causative for hearing loss in this group. Speech audiometry, self-recording audiometry and auditory brainstem responses showed the patient to have cochlear deafness without retrocochlear dysfunction. No mutation was found in the other two patients.

A full digital, high definition video system (1080i) for laryngoscopy and stroboscopy.

OBJECTIVE This study aimed to estimate the effectiveness of a full digital, high definition video system for laryngeal observations. METHODS A newly available, full digital, high definition video camera and high definition video monitor were used. With an endoscopic adaptor and rigid telescope, laryngoscopy and stroboscopy were performed on patients with various kinds of laryngeal lesions. RESULTS All laryngeal lesions were observed and recorded by the full digital, high definition video camera without incident. The image quality for laryngoscopy and stroboscopy was far superior to that of a conventional video system, including video-endoscopy. Even tiny structures or lesions could clearly be visualised on the monitor. The still image obtained from the full digital, high definition video camera was 1920 x 1080 pixels and was comparable to that obtained from a still camera. CONCLUSIONS Full digital, high definition video cameras are now commonplace products and can easily be applied to patients with laryngeal disorders. They provide superior laryngeal images, compared with conventional video systems. Furthermore, high definition video systems are cheaper than proprietary medical video systems. We consider our system to represent an accessible technique of gaining superior laryngeal observation in otolaryngological clinics.

Pros and cons of tinnitus retraining therapy

Conclusions. A significant reduction in the Tinnitus Handicap Inventory (THI) was obtained as early as 1 month after implementation of tinnitus retraining therapy (TRT). Over half of our patients either could not tolerate the tinnitus control instrument (TCI) or obtained a poor result in the TRT trial. Candidates for TRT should thus be restricted to patients who can use the TCI. Objectives. TRT has been regarded as a promising therapy for tinnitus, although there have been very few studies to determine which patients are most likely to benefit from TRT. The aim of the present study was to demonstrate TRTs pros and cons based on our experience. Subjects and methods. The subjects were 217 patients with intractable tinnitus. Of those, 84 tolerated TRT and 79 were followed for 6 months. The remaining subjects did not undergo TRT. Japanese translations of the THI and visual analogue scale of annoyance caused by tinnitus (VAS) were administered to evaluate the effect of TRT. Results. The average THI score at the beginning of the treatment was 48.8, but it was 36.3 (p<0.01) 1 month after starting the treatment and 28.3 (p<0.005) after 6 months.

The selection of treatment strategy for stage III, IV laryngeal and hypopharyngeal squamous cell carcinoma: —an evaluation of predictable parameters for concurrent chemoradiotherapy—@@@―化学放射線同時併用療法の選択基準についての考察―

In the treatment strategy for advanced laryngeal or hypopharyngeal cancer, it is not so easy to decide whether patient should be performed concurrent chemoradiotherapy (CCRT) or wide resection with total laryngectomy. One hundred-fifty three patients were divided into two groups according to the modality for primary site ; CCRT group and the other wide resection group, and we retrospectively examined whether we could predict the case of having high sensitivity and curative possibility to CCRT. Clinical parameters ; T stage, subsite of tumor, tumor volume, existence of laryngeal paresis and tumor growth pattern, all of them were not predictable. The response to induction chemotherapy was not also predictable. Relapse free survival rate, regional free survival rate and disease specific survival rate were 58.2%, 55.2% and 30.1% in CCRT group and 91.6%, 76.4% and 61.1% in wide resection group and there were significant differences between them.