Keigo Tatemoto

Bilateral parotid gland metastases as the initial manifestation of a small cell carcinoma of the lung.

Small cell carcinoma of the lung is a common, highly malignant neoplasm that accounts for approximately 25% of all bronchial carcinomas, and is characterized by a prospensity to disseminate widely throughout the body at an early stage of its clinical c0urse.l Common metastatic sites of this carcinoma are the liver, abdominal lymph nodes, bone, brain, adrenal glands, skin, kidneys, and pancreas.2 The metastasis of this tumor to the parotid gland is unusual. The following report describes a case in which bilateral parotid gland metastases were the initial manifestation of a small cell carcinoma of the lung.

A Case of Vocal Cord Cyst With Cryptococcal Infection

t c c A c F ryptococcus neoformans is an opportunistic fungus that is found abundantly in the excreta of pigeons. The lung s the most common site of infection. Cryptococcosis of the larynx is very rare. The first case f laryngeal cryptococcosis was reported by Reese and olclasure in 1975. Only 7 cases have been reported in the nglish literature previously. However, this is the 1st report of cryptococcal infection f the vocal cord cyst in the world.

Magnetic resonance imaging for aspirated peanut in the bronchus

Peanut inhalation in the right main bronchus of a 15-month-old boy was diagnosed using a T1-weighted image produced by magnetic resonance imaging (MRI) because of the high fat content of the peanut. The T1-weighted MRI image may also be useful in diagnosing other kinds of aspirated nuts with high lipid content as well as peanuts. This method does not involve any X-ray exposure.

Clinical Analysis of Tracheostomy in Infant

Tracheostomy was performed in 7 patients during a 3-year period (2002-2004) at our hospital. The causative diseases were central nervous system disorders (3 cases), laryngo-tracheal stenosis (1 case), Edwards syndrome (trisomy 18) (1 case), werdnig-Hoffmann disease (1 case), Trauma (1 case). Five cases were neonates less than one day old. A vertical incision is made in the midline of the trachea. A 4-0 nylon suture is then placed through the tracheal wall on either side of the vertical incision. Complications after surgery included 3 cases of stomal granulation. Staphylococcus aureus (MRSA) was detected in the peristomal region in 2 of these three. Therefore, MRSA infection seemed to be one of the factors precipitating the development of granulation.

Acute hearing disturbances in a patient with diabetes mellitus.

A 67-year-old female with diabetes mellitus developed sensorineural hearing loss first in one ear, then in the other.Diabetic microangiopathy was suspected to be the cause, so fibrinolytic therapy with Abbokinase was administered three times to improve the circulation to the inner ear.This therapy was effective, and hearing was improved in both ears. During the course of fibrinolytic therapy, α2-plasminogen inhibition (α2-PI) was suppressed to about 63%, but there were no complications, such as hemorrhage.

FACIAL BONE FRACTURE

We experienced 102 cases of facial bone fracture during 16 months of 1986 to 1987. These cases were analyzed statistically concerning causes, age and locations of the fracture. These fractures have increased rapidly in number. The causes were classified into three types; occurrence during sport, traffic accident and fighting, which were equal in number. There were 85% males and 15% females in the patient cohort, which were concentrated at the ages of 10-20 years. A large part of the fractures was mostly consisted of maxillo-facial components (95%). These trends were similar to the previous report of our clinic (1972-1979). On the other hand, not only severe dysfunctioning cases but also complicated cases increased in number, so that the several clinical aspects were reported. Case 1: 17-year-old male presented with retraction of left cheek caused by Rugby foot ball, whose malar bone was dislocated backward and anticlockwise, was treated with oroantral reduction and with the intermaxillary packing of silicon blocks. Case 2: 10-year-old boy with complaint of double vision occurred by head blow to right eye. Pure type blowout fracture of the orbital floor was presented, which was reconstructed by silicon plate from the incision of the lower eyelid. Case 3: 59-year-old male presented with 6 month history of diplopia and retraction of left eye ball, had been under the conservative care by an eye doctor. X-ray examination showed the intraorbital soft tissue was blown out into the ethmoidal sinus. However the transethmoidal reduction was performed, the result was not satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

[Facial bone fracture--statistical analysis and clinical aspects].

We experienced 102 cases of facial bone fracture during 16 months of 1986 to 1987. These cases were analyzed statistically concerning causes, age and locations of the fracture. These fractures have increased rapidly in number. The causes were classified into three types; occurrence during sport, traffic accident and fighting, which were equal in number. There were 85% males and 15% females in the patient cohort, which were concentrated at the ages of 10-20 years. A large part of the fractures was mostly consisted of maxillo-facial components (95%). These trends were similar to the previous report of our clinic (1972-1979). On the other hand, not only severe dysfunctioning cases but also complicated cases increased in number, so that the several clinical aspects were reported. Case 1: 17-year-old male presented with retraction of left cheek caused by Rugby foot ball, whose malar bone was dislocated backward and anticlockwise, was treated with oroantral reduction and with the intermaxillary packing of silicon blocks. Case 2: 10-year-old boy with complaint of double vision occurred by head blow to right eye. Pure type blowout fracture of the orbital floor was presented, which was reconstructed by silicon plate from the incision of the lower eyelid. Case 3: 59-year-old male presented with 6 month history of diplopia and retraction of left eye ball, had been under the conservative care by an eye doctor. X-ray examination showed the intraorbital soft tissue was blown out into the ethmoidal sinus. However the transethmoidal reduction was performed, the result was not satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Partial laryngectomy. Prognosis and introduction of a new method of reconstruction of the larynx.

The five year survival rates of 55 patients with laryngeal cancer who were treated with partial laryngectomy were 90.2, 73.4 and 0% for glottic, supraglottic and subglottic cancers, respectively.Fourteen cases of recurrence or death due to cancer were reported. The interval between partial laryngectomy and recurrence varied from 6 months to l3 years and 8 months. Eight of the 14 patients lived for five years or more after total laryngectomy.The survival rates of the different T classes show glottic T2 cancer could be treated with partial laryngectomy. Patients with recurrence after radiation treatment are also good candidates for partial laryngectomy.A new method of reconstruction after vertical laryngectomy using a sternocleidomastoid musculocutaneous flap was described.