Shinichiro Kawakami

Clinical and Immunological Study of IgA Nephropathy before and after Tonsillectomy

The clinical course and the changes of the levels of immunological factors after tonsillectomy in several cases of IgA nephropathy associated with chronic tonsillitis are presented in this paper. In the first study, here called Part I, 16 cases of IgA nephropathy were observed with regard to the clinical course and the changes of immunological factors after the operation. Postoperatively, proteinuria disappeared in 9 cases and improved in 3 and the levels of serum IgA, the circulating immune complex (CIC) and serum polymeric IgA decreased. In the next study, Part II, 10 cases of IgA nephropathy were investigated regarding the changes of the levels of serum IgA, C3, C4, CH50, APCH50 and CIC after the provocation test and tonsillectomy. A tendency of decreasing levels of C3 and APCH50 combined with an increase of CIC was observed within one week after provocation. Decreases in the levels of serum IgA, polymeric IgA, C3 and APCH50 were also observed after the operation. From these results, it is suggested that the tonsillar lesion has a tendency to continue the pathogenetic effect on the disease and exacerbate its clinical symptoms.

Evaluation of facial palsy by moiré topography index.

We investigated the usefulness of moiré topography for evaluating facial nerve function in 51 patients with facial palsy and 10 normal volunteers. This method visualizes the shape of objects in three dimensions. We devised three moiré indexes as a simple method of quantifying the severity of facial palsy: the nasolabial groove moiré index, the oral angle moiré index, and the inner canthus moiré index. We compared the results obtained by the moiré indexes with findings obtained using the House-Brackmann grading system and found that they were highly correlated. These three moiré indexes included all the standard factors of the House-Brackmann grading system, allowing us to develop the total moiré index.

Evaluation of facial palsy by Moiré topography.

To evalute facial nerve function, several visual assessment methods have proposed by May, Yanagihara, Stennert, House, Brackman, among others, and the score method is widely accepted as a simple and useful method for examination to evaluate roughly the degree of facial palsy. However, it is difficult to capture fine changes with the score method when precise evaluation is required, and it is limited as a form of objective and reporducible assessment. Therefore, it is not a very suitable method to follow up the process of the recovery in facial nerve palsy.

Dynamic evaluation of facial palsy by moire topography video: second report

By using moire topography video, the feature of facial expression can be well analyzed. The dynamic change of moire strips pattern enables the observation of facial movement in three dimensions and contributes to the better evaluation of patients with facial palsy. Using this method, several special features on the facial expression of patients with facial palsy were demonstrated.

Evaluation of facial palsy by moire topography

Society of Facial Research is used frequently. It is of great value clinically, but the method has several weak points concerning objective and quantitative assessment. This study uses moire topography to solve these problems. mA moire camera, FM3013, of the lattice irradiation type was used for measurement of the face. Five moire photographs were taken: at rest, wrinkling the forehead, closing the eyes lightly, blowing out the cheeks and grinning. The degree of facial palsy was determined by the Asymmetry Index (AI) as a measure of the degree of facial deviation. Total AI was expressed as the average AI based on calculations of the measurement in 5 photos. Severe paralysis is represented by an AI of more than 20%. Partial paralysis has a range of 20-8%. Nearly normal is judged to be less than 8%. Ten normal individuals are measured as control and show an AI of 3% or less. Moire topography is useful in assessing the recovery process because it has the benefit of making the site and grade of palsy easily achieved by the AI and the deviation in its patterns. The authors propose that the moire method is better for an objective and quantitative evaluation than the societys method.

Vibration analysis of the tympanic membrane with a ventilation tube and a perforation by holography

For severe otitis media with effusion, insertion of a ventilation tube is performed for the purpose of ventilation of the middle ear cavity and normalization of the eustachian tubular function and middle ear mucosa. The ventilation tube is left in place for as long as several months or even a few years. However, the influence of the indwelling tube on vibration of the tympanic membrane is unknown. Therefore, the authors observed the influence by means of time-averaged holography using human tympanic membranes. The following results were obtained. After insertion of a ventilation tube, vibration pattern of the tympanic membrane was not obviously changed, but the vibration amplitude of the tympanic membrane was decreased, especially at 500 Hz. Generally speaking, the change caused by insertion of a ventilation tube was very small. Also, the vibration pattern of perforated tympanic membrane was not changed, but the vibration amplitude of perforated tympanic membrane was decreased at the low frequency area.

Dynamic evaluation of facial palsy by moire topography video

Several visual assessment methods have been proposed for evaluating facial nerve function. They are of value clinically, but they have drawbacks when objective, quantitative, and reproducible assessment is required. To solve these problems, we used moire topography, which helps visualize information in three dimensions. We previously reported that one could evaluate the severity of facial palsy by observing characteristic patterns of the moire strips produced by facial movement. Accordingly, we developed a new form of the dynamic evaluation by recording the dynamic changes in moire strip patterns on the face on a videotape.

Three-dimensional holographic display of images of otological specimens.

Three-dimensional displays of anatomical structures and clinical findings are very persuasive and instructive. Using multiplex holograms, we designed a display of three-dimensional images of otological specimens. Multiplex holograms, reported by Cross of the United States in 1975, enable reconstruction of three-dimensional moving images and are used for artistic display as well as for teaching in medicine and general education. Multiplex holograms were recorded in a two-step process. The first step is to make a series of original cine-pictures of an object from different horizontal directions, rotating it on a turntable. In the second step, one frame of the original film is recorded on a narrow strip hologram. All frames of the original film are recorded one after another and a complete multiplex hologram can be synthesized. In the reconstruction stage, the multiplex hologram is formed into a cylinder and illuminated from below by a small white light source. Reconstructions of the three-dimensional bright images of the object inside the cylindrical holographic screen are shown.

Development Of Pulse Holo-Camera For Observation Of Vibration Of Human Eardrum

For the purpose of observing the vibration of the human tympanic membrane clinically, a holocamera was test designed and manufactured. At the stage of test design, an experiment revealed the deterioration of laser light in its coherency when it came out through the optical fiber. As the method of improving the deteriorated coherency, two laser beams both of which were passed through the optical fiber bundle, were used for the illumination beam as well as the reference beall under a certain condition. This procedure made possible to manufacture a pulsed holo-camera well suitable for the clinical use