Kaori Hashimoto

Efficacy of Long-Term Administration of Isosorbide for Ménière’s Disease

The long-term therapeutic efficacy of isosorbide, an oral hyperosmotic diuretic, was clinically evaluated in 30 patients (14 males and 16 females) who were followed up in our clinic for more than 2 years. The patients ranged in age from 14 to 73 years, with a mean age of 49.2 years. Isosorbide was given orally, continuously or intermittently, for 27-297 weeks, depending on each patients condition. The efficacy of the drug was determined according to the evaluation criteria of the American Academy of Ophthalmology and Otolaryngology (AAOO) and the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS) for Ménières disease. Definitive episodes were successfully controlled in 15 of the 20 patients (75%) who received isosorbide continuously according to both the AAOO and the AAO-HNS criteria. Of the 10 patients who were given the drug intermittently, definitive episodes were successfully controlled in 6 patients (60%) according to the AAOO and in 7 patients (70%) according to the AAO-HNS criteria. During the treatment periods, hearing improved in 6 patients (20%), and tinnitus subjectively lessened in 15 patients (50%). Although some patients complained of abdominal discomfort, the side effects of this drug were minimal. Among the patients who responded well to the treatment, the doses of isosorbide could be tapered to a daily dose of 30 ml, less than one half of the usual daily of this drug. The results suggest that most patients should be asked to continue this medical treatment for at least several months before a decision can be made regarding whether the medical response is good or poor.(ABSTRACT TRUNCATED AT 250 WORDS)

The relationship between orthostatic dizziness and hypotension in male medical students.

We carried out a questionnaire survey regarding symptoms of orthostatic dysregulation (OD) and administered the Schellong test (orthostatic test) to 123 normal male medical students aged 21-29 years to investigate the relationship between orthostatic dizziness and hypotension. OD was identified in 15 (12.2%) of the subjects based on the questionnaire results. Orthostatic dizziness was noted in 40.7% of the subjects (50/123). The occurrence of orthostatic dizziness was most significantly related to systolic pressure decrease during the procedure for the Schellong test. These results suggest that the testing procedure introduced by Schellong can be useful, and clinically applicable to the assessment of orthostatic dizziness, since it presents the advantage of being simple enough to carry out in clinical practice.

Psychosomatic aspects of patients complaining of dizziness or vertigo with orthostatic dysregulation

Eighty-five patients (26 males and 59 females) with orthostatic dysregulation who visited our clinic complaining of dizziness or vertigo between December, 1990 and August, 1996 were analyzed using the Japanese Edition Cornell Medical Index-Health Questionnaire and the Yatabe-Guilford Personality Test. The condition of OD was most commonly noted in 29 patients (34.1%) with dizziness or vertigo of indeterminate etiology, followed by in 14 (16.5%) with Menieres disease, in ten (11.8%) with hypotension and CNS disorder each, and in 22 (25.9%) with other disorders. The percentage classed as Type III (possible neurotic) or Type IV (probable neurotic), was 46.1% in males and 47.4% in females. The percentage classed as Type B or Type E, suggestive of emotional or psychological disturbance, was 38.5% in males and 37.3% in females. There was good correlation between the Japanese Edition Cornell Medical Index-Health Questionnaire and the Yatabe-Guilford Personality Test results as to psychosomatic aspects. We conclude that, in the treatment of patients with orthostatic dysregulation, it is necessary to consider both physical and psychological aspects of the condition.

Age‐related Alterations in the Auditory Brainstem Responses and the Compound Action Potentials in Guinea Pigs

The auditory brainstem response (ABR) and the eighth nerve compound action potential (CAP) were measured using click stimuli to investigate the agerelated alteration in the auditory function in 66 guinea pigs consisting of four age groups. With advancing age, a gradual elevation of the thresholds in both the ABR and CAP was clearly seen, together with the prolonged latencies for waves I, II, III, and IV to clicks at 95 dBpeSPL in the ABR. There were some individual differences in either threshold elevation or latency prolongation of both the ABR and CAP in aged guinea pigs. These findings suggest that the effect of individual differences on degenerative aging processes of the auditory system should be considered in selected aged animals, although a significant elevation of the neural auditory threshold is clearly found with advancing age as a whole.

Rosai-dorfman disease with extranodal involvement

Rosai‐Dorfman disease is a rare condition of marrow hematopoietic stem‐cell origin. Patients can show extranodal involvement as well as lymphatic involvement, but only about 5% of extranodal cases involve intracranial lesions. A 53‐year‐old male was admitted to our hospital with bilateral cervical lymphadenopathy. Intracranial tumors and bone lesions were also detected. Cervical lymph node biopsy and intracranial tumor resection were performed, and histopathological examination revealed Rosai‐Dorfman disease. The patient showed good clinical course without significant enlargement of the tumor. This study describes the case of a patient with Rosai‐Dorfman disease presenting with massive cervical lymphadenopathy mimicking malignant neoplasm. Laryngoscope, 124:701–704, 2014