Shun-ichi Sakai

Analysis of Body Sway Pattern after Alcohol Ingestion in Human Subjects

Movements of the centre of gravity during 60 s of standing with eyes closed and eyes open were analysed before and after alcohol ingestion up to 8 h in 37 healthy human subjects. Blood alcohol and acetaldehyde concentrations (BAC and BAcHC) were measured simultaneously. Among the parameters analysed, area of posturogram was the most sensitive indicator; it increased to 3.8 times that of the control value at 60 min, after 3.5 ml/kg of ingested whisky (mean BAC of this group was 1.4 mg/ml), with the eyes open. The Romberg ratio, which denotes eyes closed relative to eyes open, remained constant. By contrast, there was little change in stabilometry in cases of 1.2 ml/kg of whisky ingestion (mean BAC at 60 min was 0.58 mg/ml). It is considered that body sway starts to increase when the BAC level exceeds 0.6 mg/ml on average; this value is only higher than the threshold of positional alcohol nystagmus. Correlation coefficients between BAC and each parameter of the stabilogram in the eyes open condition, such as area, X- and Y-axis diameters, and velocity of body sway, were 0.53, 0.45 and 0.48, respectively (p less than 0.01). There was no positive correlation between BAcHC and these parameters.

A study of the late effects of radiotherapy and operation on patients with maxillary cancer: A survey more than 10 years after initial treatment

One hundred seventy‐one maxillary carcinoma patients who survived more than 10 years after initial treatment were surveyed. Performance status was unrestricted in 35.1% of the patients, slightly restricted in 34.5%, moderately restricted in 21.1%, restricted in 7.0%, and very restricted in 2.3%. Radiation‐induced cataracts on the affected side occurred in 100% of the patients treated with radiation. Good visual acuity was maintained in only 65.8% of the patients, even on the contralateral side. Fifty‐five percent of the patients retained symmetric facial animation due to our policy of conservative therapy. Restricted mouth opening occurred in 32.2% of the patients, taking liquid diet in 21.1%, and middle ear effusion in 26.3%, which were closely linked to maxillectomy operation. This study suggests that avoiding excess radiation dosage, strict control of radiation field, adaption of two portals with 60 grades wedge pair filter, use of appropriate protectors, limiting removal at the maxillactomy, and postoperative care for trismus or tympanic effusion are necessary.

Treatment Policy for Maxillary Sinus Carcinoma

Some 908 cases of malignant tumors of the nose and paranasal sinuses treated from 1957 through 1974 were statistically analysed. The most common tumor site was the maxillary sinus (91.4%) and the most common histological figure was carcinoma (92.4%). The crude and relative survival rates for each treatment mode were calculated in January 1975. The number of cases and the 5 year relative survival rates of the main groups were as follows: I. Primary cases of malignant tumors (761 cases) 29.2% A. Carcinoma (709 cases) 29.3% B. Sarcoma (45 cases) 27.4% II. Primary cases of maxillary sinus carcinoma (561 cases) 26.1% A. Period 1957-66 (282 cases) 22.8% 1. Combination of irradiation and surgery (114 cases) 36.9% 2. Irradiation alone (168 cases) 12.7% B. Period 1967-69 (130 cases) 34.5% 1. Irradiation with 5-FU intra-arterial infusion (25 cases) 36.1% 2. Irradiation with intra-arterial infusion of other radiosensitizers (35 cases) 35.7% 3. Irradiation only without infusion (45 cases) 35.2% C. Period 1970-71, Linac X-ray irradiation (61 cases) 15.9% D. Period 1972-73, Irradiation with 5-FU infusion (80 cases), 3 year relative survival rate 39.3% The stage-grouping of maxillary sinus carcinoma based on the classification of tumor spread in the TNM system was recommended for the comparison of survival rates. The best mode of treatment in our experience is the combination of Co-60 gamma-ray irradiation and continuous intrarterial infusion of 5-FU. A curettage during irradiation is recommended. A maxillectomy should be performed only for irradiation failure cases.

Diagnosis and Tnm Classification of Maxillary Sinus Carcinoma

In order to detect a malignant lesion in the maxillary sinus at an early stage, the following points should be borne in mind. Suspicion of cancer should be aroused by the presence of continuous bloody nasal discharge, buccal paresthesia, buccal swelling, ocular pain and/or toothache. One should be more suspicious of cancer in the presence of swelling of the lateral wall of the nasal cavity or bulging of the inferior nasal meatus. Radiopacity of the unilateral maxillary sinus should be watched with special attention. In many cases in which the tumour was invisible, a positive result was successfully obtained by a blind punch biopsy through the inferior nasal meatus. X-ray findings are important together with clinical findings, and by using various projections we were able to obtain the expected results.Our TNM classification of the carcinoma of the maxillary sinus is as follows: T1: Tumour confined to the maxillary sinus, with no evidence of bone involvement.T2: Tumour causing destruction of the bony wall,...

Recent trials in the treatment of maxillary sinus carcinoma, with special reference to the chemical potentiation of radiation therapy.

Four hundred cares of Maxillary Antrum Carcinoma, which were treated at Osaka University Hospital during 1957-68, were reviewed. Special emphasis was laid on the prospective controlled trial to evaluate the chemical potentiation of radiotherapy. In the cases treated up to the end of 1966, external radiotherapy followed by radical operation was applied in general. The 5-year survival rates of these were 30% for the combined group, and 13% for the group receiving radiotherapy alone. Although results have been showing improvement due to technical advancement, including high energy radiotherapy, the 5-year survival rate of the total cases treated between 1961 and 1966 was less than 30%. Since the beginning of 1967, a controlled trial has been under way to evaluate the chemical potentiation of radiotherapy, by arterial infusion of 5-Fluorouracil, Cyclohexanol succinate or Ametohepazone, or by oral administration of Cyclohexanol succinate. Of these, there has been found improved recurrence-free rates in the art...

Positional nystagmus and body sway after alcohol ingestion

Positional nystagmus and body sway were measured for 8 hours following alcohol ingestion in 27 human volunteers. The intensity of positional alcohol nystagmus phase I (PAN-I) correlated well with blood alcohol concentration (BAC) along the time axis; the correlation coefficient between PAN-I and BAC 1 hour after alcohol ingestion was 0.62 (P less than .01). The minimum threshold BAC resulting in PAN-I was 0.23 mg/mL. Body sway was measured by stabilometry. The circumscribed area of posturography before and after alcohol ingestion was compared. Temporal changes in body sway and BAC were also closely correlated. The BAC threshold for increased body sway was estimated to be somewhere between 0.5 and 0.8 mg/mL, considerably higher than the threshold for PAN-I. Measurements of blood acetaldehyde, the dehydrated product of ethanol metabolism, showed no correlation with either the intensity of PAN or changes in body sway. The intensity of PAN and body sway measured at the time of peak BAC 1 hour after alcohol ingestion, however, showed significant positive correlation (r = .50, n = 25; P less than .01).

Malignant fibrous histiocytoma in the maxillary sinus. Xanthoma-like change of the tumor after radiotherapy

A case of malignant fibrous histiocytoma (MFH) in the right maxillary sinus is reported. Patient was a 30‐year‐old male, and was diagnosed as pleomorphic type of MFH by biopsy before therapy. The tumor shrunk and changed into xanthoma‐like tumor after radiotherapy. A case like the present case has not been reported previously in the literature.

Clinical Observations in the Acute Phase of Cerebellar Hemorrhage and Infarction

Three cases of cerebellar hemorrhage and 5 of cerebellar infarction, diagnosed by brain CT, were examined from the early phase of the onset. All of our cases were mild to moderate in severity and were cured satisfactorily within 3 to 8 weeks of medical treatment. Dizziness and nausea were the commonest symptoms and cerebellar and other CNS signs could be detected only for a short period in some of the cases. Although neuro-otological examinations, especially gaze nystagmus, eye tracking and positional nystagmus tests, were useful for diagnosing the central vestibular lesion, no definite indication could be drawn in order to differentiate between cerebellar hemorrhage and infarction. Therefore, it is considered difficult in such mild cerebellar strokes to establish correct diagnosis by physical examinations alone. It was concluded that if central vestibular disorder is suspected, prompt brain CT examination is necessary in order to diagnose mild cases of cerebellar vascular diseases.

The Contact Nd-YAG Laser for Oral and Oropharyngeal Malignant Tumors

Nine oral and oropharyngeal squamous cell carcinomas were removed with a contact Nd-YAG laser. Clinical and morphological studies on wound healing and effects of the Nd-YAG laser were performed. The wounds were not sutured and patients did not complain of any severe symptoms. The wound healing was prolonged to 3-6 weeks. Cells and glands degenerated at a depth of 2-3 mm by the direct effects of the laser. The epithelium exhibited acantholysis 5 mm from the site of laser injury. Scanning electron microscopy showed no coagulation or other coated material in the wound created by a surgical knife, while the wound surface by laser consisted of carbonization, well-coated and non-coated areas. These findings varied with the laser power. The coagulation and thermal effects of the Nd-YAG laser resulted in autolysis of tumor cells at least within 5 mm of the cutting surface. The contact Nd-YAG laser was useful for the removal of the malignant tumor in the oral cavity and oropharynx where it is difficult to maintain a generous safety margin.

Effect of Aldosterone Antagonist on the DC Potential in the Endolymphatic SAC

The effect of aldosterone and canrenoate, known as an aldosterone antagonist, on the DC potential in the endolymphatic sac (ESP) was examined in the guinea pig. Intravenous administration of aldosterone (1 mg/kg) induced no change in the ESP for 60 minutes after the injection. However, canrenoate, an aldosterone antagonist, produced a dose-dependent decrease in the ESP. Pretreatment with aldosterone attenuated the decrease in the ESP by canrenoate. The results suggest the possibility that aldosterone may play a role in the endolymph absorption of the endolymphatic sac.