Itaru Yamamichi

The Site of Involvement of Hypertension within the Cochlea:A Comparative Study of Normotensive and Spontaneously Hypertensive Rats

The function and morphology of the cochlea of the spontaneously hypertensive rat (SHR) were examined and compared with the age-paired normotensive Wistar Kyoto rat (WKY). Electro- cochleographic study revealed that the function of the cochlea in the SHR declined with increasing age to a greater extent than that of WKY. Electronmicroscopic study revealed that the primary site of the cochlear deterioration of the SHR was the vascular stria, followed by the organ of Corti. Some hypotheses to explain this phenomenon are proposed for further study.

Primary reconstruction by modified cervical island skin flap following resection of oral and pharyngeal cancer

SummaryReconstruction of the intraoral defect following cancer surgery often causes formation of fistula, impairment of lingual movement, and prolonged hospitalization by secondary reconstruction. To reduce such complications, the modified cervical island skin flap method as a one-stage intraoral reconstruction was used in 18 patients. Lateral cervical island flap was used in 15 cases and the median flap in three. This method proved to be successful for 17 patients. One patient who received a preoperative full dose of irradiation developed a fistula. There were two types of healing of the skin flap. The postoperative external appearance and function of the tongue were commendable.

Anterior Inferior Cerebellar Artery Syndrome; A Report of 3 Cases

Anterior inferior cerebellar artery (AICA) syndrome involves sudden hearing loss, vertigo, and several neurological symptoms and is being reported with increasing frequency due to diagnostic adavances. Herein, we describe 3 cases of anterior inferior cerebellar artery syndrome. Case 1 was a 67-year-old woman with sudden onset of vertigo. Initially, we treated her for sudden deafness with vertigo. Hearing loss improved almost completely by steroid and prostaglandin E1 administration. However, MRI demonstrated cerebellopontine infarction. Case 2 was a 53-year-old woman with hypertension and hyperlipidemia. She had dizziness and headache. CT and MRI demonstrated infarction of the cerebellum and brain stem. Hearing loss and dizziness were improved by steroid administration, control of blood pressure, and antithrombus therapy. She did not have cerebellar symptoms. Case 3 was a 58 year-old man with hypertension, who developed vertigo and vomiting. He demonstrated also hearing loss and ataxia. MRI demonstrated infarction of the cerebellum and brain stem, and otoneurological examination supported these findings. Vertigo and ataxia improved considerably. However, hearing loss was not completely improved. Steroid and prostaglandin E1 administration may improve hearing loss of anterior inferior cerebellar artery syndrome.

Primary MALT Lymphoma of the Parotid Gland.

Only 1-2% of salivary gland tumors are malignant lymphomas, and malignant lymphomas are rare among the parotid tumors. A 58-year-old female complained of anteroauricular swelling. Flowcytometric examination of the biopsy specimen revealed MALT (mucosa-associated lymphoid tissue) lymphoma. Superficial parotidectomy and upper neck dissection were performed, and involvement of one superficial cervical lymph node was found. After the operation, subcutaneous swelling of the forearm was excised, which was revealed to be associated with the lymphoma. We performed three courses of CHOP therapy after the operation. Eight months post operatively, no recurrence has been detected.

Quantitative Analysis of 5-FU Concentration in the Tissues of Patients with Head and Neck Cancer Following Oral Administration

5-FUDSの最終経口投与より, 平均約17時間後に採取した頭頸部領域の組織の38% (24/64) にその移行が認められたが, 平均0.141μg/g湿重量という低濃度であった. 頭頸部領域で比較的移行率の高かった組織は, 扁桃腺, 顎下腺などの口腔, 咽頭領域であった. 頸部リンパ節へは29% (4/14) の移行を示した.担癌組織と非担癌組織で5-FUの検出率を比較してみると, 担癌41% (14/34), 非担癌30% (9/30) であり, 担癌組織への移行がやや多い傾向にあった. 癌の中心部と周囲部とにわけ得た症例で, 両者の5-FU濃度を比較してみると, 中心部高濃度例は31%, 周囲高濃度例69%であり, 癌周囲への移行が良い傾向にあった.5-FUDSの投与日数が多いほど, 組織内移行率も良くなる傾向にあったが, 10日以上の投与でも検出されない場合もあった. 体重当りの投与量や組織摘出時間で検討したが, 5-FU検出群と非検出群で有意差はなかった.最終投与より17時間後という遅い時期でも頭頸部組織内に5-FUが低濃度ながら認められたことは, 投与早期にはより高濃度の5-FUの移行が, より多くの症例に検出されることが考えられ, その有効性は想像に難くない. しかし, 5-FUの癌に対する最小有効濃度はどのくらいか, という点に関しては今後に問題が残る.