Takema Sakoda

Transient evoked otoacoustic emissions in newborn infants: Effects of ear asymmetry, gender, and age.

Our aim was to examine the effects of gender, ear asymmetry, and age of infants on various parameters of transient evoked otoacoustic emissions (TEOAEs). Three hundred thirty-two infants (181 males, 151 females) were tested using the ILO292 Otodynamics Analyzer (Otodynamics Ltd, England) as a screening procedure. The subjects were divided into two age groups: group 1, newborn infants prior to hospital discharge (mean age of 4 days), and group 2, infants at the 1-month-old health checkup (mean age of 35 days). Responses to TEOAE stimuli were recorded at 1.0, 1.5, 2.0, 3.0, and 4.0 kHz. There were significant effects of gender and ear (left/right) on the signal-to-noise ratio, response level, and whole-wave and band reproducibility values in TEOAEs. The right ear had higher values of whole-wave reproducibility, response level, signal-to-noise ratio, and band reproducibility than the left ear. Females displayed higher whole-wave reproducibility, response level, band reproducibility, and signal-to-noise ratio values than males. There was no significant difference in response level, signal-to-noise ratio, and band reproducibility between the two age groups. The findings of the present investigation may contribute toward future improvements in neonatal hearing screening based on the community.

67Ga citrate and99mTc(v)-DMSA scintigraphy in a case of maxillary sinus liposarcoma

Scintigraphic images with67Ga citrate and99mTc(v)-dimercaptosuccinic acid and MR image of a 16-year-old male with maxillary sinus liposarcoma (predominantly myxoid type) are reported. The MR image clearly indicated the exact location, size and anatomical relationship of the tumor. Scintigraphic evaluation was useful in suggesting the malignant nature of the tumor and showed no distant metastasis. Both examinations were effective in treating this case.

Presence and connections of auditory neurons in the rostrodorsal and rostrolateral parts of the thalamic reticular nucleus.

Objective Auditory neurons have been identified in the caudoventral part of the thalamic reticular nucleus (TRN). We examined the acoustic input to single cells in the rostrodorsal part of the TRN. Material and Methods In α-chloralose-anesthetized cats, we extracellularly recorded the responses of single neurons in the rostral TRN to acoustic and light stimuli. Next, to examine efferent projections of auditory neurons in the rostral TRN, we injected wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) into other thalamic nuclei where auditory neurons were detected, including the lateral posterior nucleus (LP), the lateral medial and suprageniculate nuclei and the centromedian nucleus. Finally, intracortical microstimulation of the LP was performed to demonstrate antidromic activation of the auditory neurons in the rostral TRN. Results In the rostral TRN, 2 types of response to auditory stimuli were observed: brief, short-latency bursts (13–20 ms; mean 16.5 ms) and longer bursts with a long latency (38.8–50 ms; mean 44.8 ms). Injection of WGA-HRP into the medial LP labeled cells only in the rostrodorsal TRN, while extending the injection to the other nuclei labeled cells in the rostrodorsal and rostrolateral parts of the nucleus. Auditory neurons in the rostral TRN were activated antidromically by microstimulation of auditory neurons in the LP, with a latency of 1.2 ms. Conclusions These results strongly suggest that auditory neurons in the rostrodorsal TRN project to auditory neurons in the LP. The rostral auditory TRN may be involved in transmission of auditory information via the non-specific association system of the thalamus.

Effects of antihistamine on up-regulation of histamine H1 receptor mRNA in the nasal mucosa of patients with pollinosis induced by controlled cedar pollen challenge in an environmental exposure unit

In the present study, we examined the effects of antihistamine on the up-regulation of H1R mRNA in the nasal mucosa of patients with pollinosis induced by controlled exposure to pollen using an environmental exposure unit. Out of 20 patients, we designated 14 responders, whose levels of H1R mRNA in the nasal mucosa were increased after the first pollen exposure and excluded 6 non-responders. Accordingly, the first exposure to pollen without treatment significantly induced both nasal symptoms and the up-regulation of H1R mRNA in the nasal mucosa of the responders. Subsequently, prophylactic administration of antihistamine prior to the second pollen exposure significantly inhibited both of the above effects in the responders. Moreover, the nasal expression of H1R mRNA before the second pollen exposure in the responders pretreated with antihistamine was significantly decreased, as compared with that before the first pollen exposure without treatment. These findings suggest that antihistamines suppressed histamine-induced transcriptional activation of H1R gene in the nasal mucosa, in addition to their blocking effect against histamine on H1R, resulting in a decrease of nasal symptoms. These findings further suggest that by their inverse agonistic activity, antihistamines suppress the basal transcription of nasal H1R in the absence of histamine in responders.

A Case of Deep Cervical Abscess Caused Perforation at Gastroenterological Endoscopy

We reported a rare case of perforation of the piriform sinus caused by gastroenterological endoscopy examination, leding to deep cervical abscess. The patient was a 56-year-old man who complained of dyspnea, high-grade fever and neck pain after gastroenterological endoscopy examination. Computed tomography revealed a deep cervical abscess and obstruction of the airway. We immediately, performed drain-age under general anesthesia, and found a perforation at the piriform sinus. He was treated with frequent wound washing and the daily intravenously instillation of antibiotics for anaerobic bacteria, and was discharged 31 days after the operation. Early diagnosis and operation are important for the management of deep cervical abscess.

Laryngeal Carcinosarcoma Recurring with Innominate Artery Fistula: A Case Report

Innominate artery fistulas require a surgical procedure, although the prognosis is usually very poor because of complications such as re-bleeding and infection. A 50-year-old man presented with laryngeal carcinosarcoma (T1a, N0, M0). Partial laryngectomy was performed but there was a recurrence; therefore, total laryngectomy, total thyroidectomy, right radical neck dissection, left functional neck dissection, skin-combined resection and D-P flap were performed. On postoperative day 6, after intense coughing, copious hemorrhage from the tracheostoma was demonstrated. Immediately, bleeding was arrested by pressing the tracheostoma. Fistula of the innominate artery was then repaired using left great saphenous vein, but recurrent perforation of the innominate artery developed. Therefore, innominate artery transection and omentopexy were performed. These results demonstrate that in cases of trachea-innominate artery fistula, innominate artery transection should be performed first.

Sudden Sensorineural Deafness of both Sides with Diabetes Mellitus(DM); A Report of Different Results on Each Side.

We have an interesting case of sudden sensorineural deafness of both sides with DM. The hearing loss of the left side and diabetic control were progressively aggravated by steroid therapy. We suspected that this was a case related to viral infection. Anti-parainfluenza 3 virus titer increased by anti-virus titer examination. Therefore, we changed from steroid to γ-globulin therapy and performed intensified conventional insulin treatment. Diabetic control was improved and the right side showed excellent recovery. However, the left side experienced deafness. In general, DM produces individual immune dysfunction. Thus, we consider that the hearing loss in both sides was progressively aggravated because of steroid therapy, which induced excessive individual immune dysfunction and viral activation.

Carcinoid Tumor Originating in Oropharynx; A Case Report.

Carcinoid tumors are rare in the otorhinolaryngeal area. There have been no reports of oropharyngeal carcinoid, as far as we know. Recently we treated a patient with this tumor.A 68-year-old woman visited our hospital because of a mass on her hard palate. A biopsy was performed. The histological diagnosis was atypical carcinoid. Partial maxillectomy, including the soft and hard palate, was done. No further treatment, such as radiation therapy or chemotherapy, was given. There has been no sign of recurrence for over one year after surgery.

Synchronous reconstruction of the face and hard plate after total maxillectomy in two patients.

Synchronous reconstruction of the defect of the face and hard palate afterr maxillectomy was performed with free myocutaneous flaps. A 58-year-old male and a 65-year-old male were treated for maxillary cancer (T4N0) with total maxillectomy and resection of facial skin (include the orbital contents in the latter case). The defects were reconstructed synchronously with two types of free myocutaneous flap: rectus abdominis (the former case), latissimus dorsi (the latter case). They were able to eat two weeks after surgery and did not suffer from speech disturbance. The greatest advantage of using free myocutaneous flaps for such reconstruction is the availability of enough muscle to fill the dead space and sufficient skin and the chief disadvantage is the risk of herniation after removal of the rectus abdominis.