Fumiaki Shido

Non-Hodgkin's lymphoma of Waldeyer's ring and nasal cavity. Clinical and immunologic aspects

Twenty‐nine cases of non‐Hodgkins lymphoma of Waldeyers ring (W‐NHL) and nasal cavity or paranasal sinus (N‐NHL) were studied for tumor‐surface marker phenotype and histopathologic correlation with clinical features. Immunostaining procedures on tissue sections by using xenoantisera and monoclonal antibodies to human B‐ and T‐cells enabled the authors to demonstrate precise surface marker phenotypes of tumor cells and, moreover, the histologic localization of normal or neoplastic B‐ and T‐cells in preserving the original structure of lymphoid organs or tumor tissues. In 22 cases of W‐NHL, 19 (86%) had B‐cell markers and 3 (14%) had T‐cell markers, whereas 6 of 7 cases (86%) of N‐NHL had T‐cell markers. Tumor cells in T‐cell iymphomas in W‐NHL and N‐NHL reacted with antibodies to peripheral T‐cells except one case of W‐NHL. Rappaport “histiocytic” subtype was heterogeneous with respect to both surface marker characteristics and morphologic features, i.e., seven had B‐cell markers and four had T‐cell markers, and they were all subdivided into “large cell” or “large cell, immunoblastic” in Working Formulation and “large cell” or “pleomorpphic” in Lymphoma Study Group classification. The actuarial survival curve for all T‐cell lymphoma patients was characterized by a rapid initial decline and a subsequent plateau, which contained two of the long survivors. In contrast, the B‐cell lymphoma group had a more graded decline. The median and actuarial survivals of the T‐cell lymphoma group were far inferior to those for the lymphoma group that expressed B‐cell markers.

Tonsillectomy-induced changes in anti-keratin antibodies in patients with pustulosis palmaris et plantaris: a clinical correlation

SummaryTiters of anti-keratin antibodies (AKA) involving IgG and IgM fractions were determined by a solid-phase enzyme-linked immunosorbent assay (ELISA) and were found to be significantly higher on average in patients with pustulosis palmaris et plantaris (PPP) than in normal controls. Positive rates of IgG-AKA and IgM-AKA in sera of PPP patients were 50% and 66%, respectively. Following tonsillectomies, patients with high IgM-AKA titers that decreased after surgery were found to benefit by a marked improvement in their skin lesions. There was a close relationship between the degree of this improvement in the skin lesions and the changes in IgM-AKA titers after the operation. These results suggest that PPP may be a tonsil-related immunological skin disease.

Spontaneous Dna Synthesis in Tonsillar Lymphocytes and Its Clinical Implications

Spontaneous DNA synthesis (SDS) in tonsillar lymphocytes was investigated in 58 cases by [3H]-thymidine incorporation under a certain culture condition without any mitogens. Tonsillar lymphocytes showed an extremely higher uptake of [3H]thymidine than peripheral blood lymphocytes. Cells exhibiting SDS were mainly B cells, but, however, they needed the helper functions of T cells and glass-adherent cells to synthesize DNA. SDS in tonsillar lymphocytes decreased with age and was lowest in the 21-30 year age group. SDS in cases with complications such as chronic sinusitis, nasal allergy or secretory otitis media was significantly higher than that in cases with no complications.

Sternocleidomastoid Muscle-Clavicle Myoosseous Flap for Single-Stage Reconstruction of Postoperative Tracheal Defects in Patients with Invasive Thyroid Tumor

In this report, we present 3 cases with thyroid carcinoma with tracheal invasion. In all cases, the tracheal defects were simultaneously reconstructed using a sternocleidomastoid muscle-clavicle myoosseous flap. We were able to close the tracheostomas without trouble, and no stenotic lesions or late complications were noted. This myoosseous composite flap has proved itself to be a reliable material for laryngotracheal reconstruction in some cases with thyroid carcinoma.

Cell-size distribution of human tonsillar lymphocytes

SummaryCell-size distributions of human tonsillar lymphocytes (TL) and adenoid lymphocytes (AL) were determined using a computerized cell-size analyser. In comparison with peripheral blood lymphocytes, TL, and AL comprised a greater number of large lymphocytes. Child TL were characterized by an enrichment of not only B-lymphocytes but also of large lymphocytes. A decrease in the number of large B-lymphocytes with advancing age was considered to be indicative of the morphological profile of tonsillar involution.

Amino acid transport in human tonsillar lymphocytes with regard to patient's age and tonsillar diseases.

SummaryAmino acid transport in human tonsillar lymphocytes was investigated in 32 patients of various ages and with different tonsillar diseases. Tonsillar lymphocytes appeared to possess at least four different transport systems for neutral amino acids including the activated Na+-dependent A system transport. The transport activity of neutral amino acid was significantly higher in child cases than in adult cases. In adult cases with focal tonsillitis, tonsillar lymphocytes were taken from patients with rheumatoid arthritis (RA) and skin diseases as secondary lesions who showed good improvement of the skin lesions after tonsillectomy. These lymphocytes were revealed to have more activated Na+-dependent transport than those from patients with skin diseases who showed poor improvement of the skin lesions after the tonsillectomy, and those from patients with recurrent tonsillitis. The characteristics of amino acid transport in human tonsillar lymphocytes and changes influenced by age and tonsillar diseases are discussed.

Peripheral Facial Nerve Palsy; A Statistical Study.

A statistical analysis of the prognostic factors of peripheral facial nerve palsy was performed on 110 patients with Bells palsy and 24 patients with Hunts syndrome admitted to the Department of Neurotology at Nakamura Memorial Hospital from 1981 to 1989. The patients treated within 13 days after the onset got to be recovered significantly better than those treated after 14 days. The final recovery rate was significantly higher in patients with Bells palsy than those with Hunts syndrome. High evoked electro nerve potential and low nerve excitability differences were good prognostic signs in both disease. Steroid and acyclovir were significantly effective in the patients with Hunts syndrome.

Pediatric otolaryngological diseases found on screening tests in Hokkaido rural district.

Otolaryngological examinations were carried out on 1017 children (1-13, mean 4.9 years old) in 5 rural towns in Hokkaido. In addition to the usual ENT examinations, tympanometric examination and cytological study of nasal secretions were performed in all children.The incidence of abnormal nasal findings and nasal eosinophilia increased, whereas that of abnormal ear findings and abnormal tympanograms decreased with age. There was no correlation between the occurence of nasal eosinophilia and abnormal tympanograms. A history of allergy, included asthma, also showed no correlation with the incidence of abnormal ear findings. The incidence of upper respiratory tract infection was lower in the older children.These findings suggest that allergy is not related to otological abnormalities, including otitis media with effusion.

Acute sensorineural hearing disturbance with vertigo caused by circulatory insufficiency of anterior and posterior inferior cerebellar arteries; A case report.

A 77-year-old male complained of acute left hearing disturbance with vertigo. A diagnosis of circulatory insufficiency of the left anterior inferior cerebellar artery (AICA) and the posterior inferior cerebellar artery (PICA) was made from the results of examinations and the clinical course.Otoneurological examination showed profound sensorineural hearing disturbance and spontaneous horizontal and rotatory nystagmus toward the right in both eyes indicating left peripheral vestibular dysfunction.Vertebral angiography showed occlusion of the basilar artery leading to circulatory insufficiency of the left AICA and PICA.After conservative treatment, the hearing disturbance and vertigo were reduced as the blood flow increased in the left AICA and PICA.Although sensorineural hearing disturbance with vertigo of sudden onset is usually diagnosed as sudden deafness in clinical practice, RICA and PICA circulation should be assessed for a precise diagnosis.

Treatment of cochlear tinnitus by transtympanic injections of local anesthetic and /or steroid.

Transtympanic injections of 1ml of 4% lidocaine (40mg) and/or 0.4% dexamethasone (4mg) into the middle ear cavity were performed in 96 patients (109ears) with cochlear tinnitus.1) Tinnitus was completely abolished or markedly decreased in 20 ears (18%), moderately decreased in 26 ears (24%), and slightly decreased or not changed in 63 ears (58%).2) Cochlear tinnitus caused by trauma showed the best results.3) Side effects due to transient loss of peripheral vestibular function after labyrinthine anesthesia occurred in almost all cases, but recovery was complete after a short time.In conclusion, transtympanic injections of these drugs were effective in about 40% of patients with cochlea.r tinnitus, and there were no significant complications.