Madoka Furukawa

Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis.

Ultrasonography, computed tomography, and magnetic resonance imaging were performed to differentiate preoperatively between schwannomas of the vagus nerve and schwannomas of the cervical sympathetic chain by observing the position of schwannomas in regard to the surrounding blood vessels. Ultrasonography also permitted direct visualization of the vagus nerve, so its position relative to the schwannoma could be examined.

GSTM1 gene polymorphism as a possible marker for susceptibility to head and neck cancers among Japanese smokers

Increased risk of lung cancer has been reported in individuals with glutathione S-transferase M1 (GSTM1) gene deletion, with limited evidence for head and neck (HN) cancer. Here, we report the results of a case-control study in Japanese HN cancer patients (n = 158) and community controls (n = 174). GSTM1 null genotype (GSTM1(-)) was distributed more in smoker patients than in control subjects (56.7% vs. 48.5%) but not in non-smoker patients (48.3%). In smokers, GSTM1(-) was detected at increased frequency in non-larynx cancer (62.7%, odds ratio 1.77, 95% CI 1.04-3.01) but not in larynx cancer (48.1%). In larynx cancer GSTM1(-) was presented at higher frequency in patients < 60 years old than in those > or = 60 years old (78.6% vs. 36.8%). These findings suggest that the GSTM1 gene polymorphism potentially modifies the risk for HN cancer depending on smoking history, the region of cancer and age.

Benign and Malignant Oncocytoma of the Salivary Glands with an Immunohistochemical Evaluation of Ki-67

We present two cases of benign oncocytoma derived from the parotid gland and minor salivary gland and one case of malignant oncocytoma from the parotid gland. The proliferative activity of the tumor cells was evaluated immunohistochemically for Ki-67. The average frequency of Ki-67-positive cells was 3.3% in the benign oncocytomas and 6.5% in the malignant oncocytoma. The higher frequency of Ki-67-positive cells in the malignant oncocytoma might reflect active cell proliferation. Ki-67 immunostaining may be useful in distinguishing a benign oncocytoma from a malignant oncocytoma.

Statistical Analysis of Malignant Tumors Detected as the Cause of Vocal Cord Paralysis

It is well known that vocal cord paralysis is sometimes the only sign of an otherwise symptom-free malignant tumor. We report 69 cases of vocal cord paralysis caused by malignant tumor experienced at our clinic over the past 18 years. They consisted of 28 cases of thyroid cancer, 21 lung cancer, 14 esophageal cancer, 3 mediastinal tumors and 3 tumors of miscellaneous origin: 41 cases were male and 28 female. In the 65 patients with unilateral paralysis, the left side was affected in 45 and the right in 20. The remaining 4 patients had bilateral paralysis. There was a marked sex difference in the origin of malignant tumors; the incidence of lung cancer was higher in males with paralysis on the left side, while that of thyroid cancer was higher in females. Ultrasonography (US) of the neck, chest X-ray, CT scan of the chest and contrast esophagography should be performed for the detection of malignant tumors in cases with left paralysis, while US of the neck and chest X-ray appear to be sufficient in cases of right paralysis.

Analysis of DNA ploidy using fresh frozen tissues of head and neck squamous cell carcinomas

The DNA ploidy of fresh frozen tissues of head and neck squamous cell carcinomas was determined by flow cytometry to investigate whether DNA ploidy is correlated with various clinical and pathological parameters. The subjects were 51 patients who had been treated radically by our department. The DNA ploidy pattern was classified into three types, diploid, single aneuploid and multiploid, according to the DNA index and the DNA histogram. This is our original classification. No particular correlation could be detected between the DNA ploidy pattern and sex, age, primary tumour site or disease stage. The degree of tissue differentiation tended to be poorer in aneuploid tissues than in diploid tissues. The efficacy of chemotherapy was higher in aneuploid cases than in diploid cases. The recurrence rate was significantly lower in diploid cases than in multiploid cases. When disease stage, degree of histological differentiation, efficacy of the chemotherapy and the DNA ploidy pattern were subjected to multivariate analysis for correlation with the prognosis, the DNA ploidy pattern showed the highest correlation. The results suggest that the DNA ploidy as analyzed by flow cytometry can be used as an important prognostic factor.

Ultrasonography of the oral cavity and pharynx during articulation and swallowing

Abstract We used ultrasonography to detect organs such as the tongue and the soft palate, which are related to articulation and swallowing, and the tongue and the soft palate could be detected on ultrasonography; thus, we suggested that noninvasive ultrasonography might be useful to examine patients with dysarthria or dysphagia.

Peptidergic Innervation in Human von Ebner's Glands: An Immunohistochemical Study

The occurrence and distribution of several neuropeptides were studied in human von Ebners glands. Immunoreactivity for substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY), galanin, and somatostatin was found in the nerve fibers around the acini, ducts, and blood vessels. VIP-immunoreactive varicose fibers were numerous compared with the other five neuropeptides. Most NPY fibers were associated with the vasculature in the gland. These findings suggest that the neuropeptides may regulate the secretion and vascular tone in human von Ebners glands.

Impact of combined modality treatment with radiotherapy and S-1 on T2N0 laryngeal cancer: Possible improvement in survival through the prevention of second primary cancer and distant metastasis.

BACKGROUND In patients with head and neck cancer, the management of second primary cancer (SPC) is particularly important for improving survival because of its high incidence and associated mortality. We evaluated the impact of combination chemotherapy on survival and SPC. METHOD We retrospectively analyzed data from 49 patients treated with definitive radiation therapy (RT) for T2N0M0 laryngeal squamous cell carcinoma between 2003 and 2011. Among them, 22 patients received combined modality treatment with radiotherapy and S-1 (RT+CT group). RESULTS The median follow-up period was 71months (32-111months). A significant difference in overall survival (OS, P<0.01) was observed between the RT+CT group (n=22) and the RT alone group (n=27) though no significant differences were observed in local control and disease specific survival. Univariate analyses showed that an older age (P<0.05) and a higher grade (P<0.05) were associated with OS. Multivariate analysis identified chemotherapy as the most significant predictor of survival (OR, 0.056; 95% CI, 0.008-0.353, P<0.01). A significantly lower incidence of distant metastasis (DM)+SPC (5-year incidence: 5% vs. 19%, P<0.05) and fewer deaths from these causes (1 vs. 8: P<0.05) were observed in the RT+CT group. Multivariate analysis showed that chemotherapy was the most significant factor for the incidence of DM+SPC (OR, 0.074; 95% CI, 0.0065-0.84; P<0.05). CONCLUSION The findings of this study suggest the possibility that combined modality treatment with radiotherapy and S-1 improve survival by preventing distant metastasis and second primary cancer.

Suspected Aerogenous Lung Metastases From Nasopharyngeal Cancer

A 44-year-old man experiencing repeated episodes of epistaxis and respiratory aspiration was diagnosed with nasopharyngeal cancer. Although the tumor completely disappeared after chemoradiation, six pulmonary nodules developed in the right lower lobe within a year. Right lower lobectomy was performed. All nodules were metastases of the nasopharyngeal cancer. Surgery was performed despite a poor prognosis, and there has been no recurrence 12 years postoperatively. Aerogenous metastases were suggested owing to right lower lobe localization and the patients symptoms and prolonged survival. The possibility of aerogenous spread and the efficacy of local therapy should be further studied.

Treatment problems of cancer in the head and neck region preceded by cancer in other organs

Abstract We evaluated patients who developed cancer in the head and neck region after radical treatment of cancer in other organs. As the preceding cancer, esophageal cancer most markedly affected the selection of treatment principles because the area of radical operation and radiotherapy for this cancer overlaps with that for cancer in the head and neck region as the second cancer.