Noriyuki Honda

Advantage and disadvantage of KTP-532 laser tonsillectomy compared with conventional method

OBJECTIVE The purpose of this prospective study is to define the advantages and disadvantages of KTP laser tonsillectomy compared with those of the conventional method. METHODS Eighteen adult patients (ten male and eight female, ranging in age from 14 to 44 years) underwent KTP-532 laser tonsillectomy on one side and standard dissection surgery on the other side under general anesthesia. RESULTS By KTP laser tonsillectomy, there was a reduction in intraoperative blood loss and average time for removing one tonsil. On the second day of tonsillectomy, subjective pain on the KTP laser surgery side was less than that on the conventional surgery side. By the days 5-8, however, this effect disappeared and many patients indicated the laser side was more painful. There was no postoperative bleeding after KTP laser tonsillectomy. Laser surgery appeared to lead to slow wound healing during the whole post-operative course with significant difference compared with the conventional method. Disadvantages of postoperative pain and the possibility of secondary infection due to slow wound healing could be prevented by application of antibiotics and an anodyne. CONCLUSION Considering safety and reliability during surgery, KTP laser was considered useful for adult tonsillectomy.

Basic Study on the Effect of Nasally Administered Salmon Calcitonin Preparation on the Nasal Ciliary Epithelium

Nasal administration of drugs is an administration method which is worthy of attention. In such therapy, local administration should not damage the nasal mucous membranes. In the present study, we conducted an investigation by the tissue culture test method of the functional and morphological effects of new nasal calcitonin preparation, which is being developed as a nasal spray agent for osteoporosis, on the nasal ciliary epithelium. The nasal septal mucous membranes of C3H-strain mice were used, and 5 types of nasal calcitonin preparations with a microcrystalline cellulose base and additives added were used. The various drugs were added to nasal mucous membrane slices in RPMI-1640 culture medium; ciliary activity before addition and 0.5, 2, and 4 hr after was electrophotometrically measured; and morphological observation was then carried out by SEM. In the various additive groups, virtually no effect on ciliary activity was observed, and the same results were obtained when 3 and 9 times the estimated clinical spray dosage was added. Moreover, in morphological observation by SEM, in the various additive groups, no morphological changes in samples of nasal ciliary specimens were observed after 4 hr of culturing at the maximum administered dosage (9 times the estimated clinical spray dosage). Based on these findings, it was concluded that the series of calcitonin preparations with various additives had no hazardous effect on the nasal ciliary epithelium.

A New Version of Platysma Myocutaneous Flap Including the External Jugular Vein; A Comparison with Farr's Modified Method with Special References to the Viability of Flaps and Combinations with Neck Dissection

A new version of the platysma myocutaneous flap, which includes the external jugular vein and the preserved facial artery, was utilized in eight patients. The viable area of transferred skin was 64% on average. This rate was statistically better than that in 46 cases using Farrs modification with conservative or radical neck dissection, and was almost the same viability rate as that in cases without neck dissection. It was, therefore, concluded that this new version is a useful local flap especially for intra-oral defects measuring 30-40 cm2.

Effect of Fosfomycin on Nasal Ciliary Activity.

The effect of fosfomycin on the nasal ciliary activity of the C3H mouse was examined by a photo-electric method.Ciliary activity was observed from 30 min to 24 hrs after incubation in RPMI-1640 including fosfomycin (1% to 5%). Ciliary activity was affected time- and dose-dependently. Investigation with several osmotic pressures suggested that the major impediment factor was osmotic pressure. Osmotic pressure of about 3, equivalent to 5% fosfomycin in water, did not severely affect the ciliary activity for at least 2 hrs after the incubation. Therefore, 5% fosfomycin in water is clinically advisable for in vivo concentration in consideration of dilution with nasal discharge and retention-time in the nasal cavity.