Taketoshi Fujita

Effects of Vasoactive Agents and their Antagonists Measured by Acoustic Rhinometry

The purpose of this study was to assess the effects of a agonists on the human nasal mucosa. Volumetric changes in the nasal cavity after application of phenylephrine (PNL), oxymetazoline (OMZ), and epinephrine (EPR) were investigated using acoustic rhinometry. The reactions of the nasal mucosa were extremely modified after pretreatment by α1 and α2 antagonists, phenoxybenzamine (POB) and yohimbine (YOH), and local anesthetic, xylocaine (XLC). Decongestion of the nasal mucosa evoked by α stimulants was considered to originate mainly from the direct activation of α1 receptors. Decongestion of the middle and posterior parts began later than the anterior part and was more gradual because of the time necessary to transport the drug particles to the posterior areas. Contralateral volume changes were probably controlled by the afferent signals from the ipsilateral side of the nose.

Effects of 250 and 500 Hz tone exposure on the inner ear of guinea pigs as determined by electrophysiological techniques.

The electrophysiological study of cochlear microphonics (CM), whole nerve action potential (AP) and endocochlear potential (EP) were examined. (1) With the extension of the exposure time of 500 Hz tone, a decrease of CM maximum output voltage in test frequency from 2 to 6 kHz was observed. (2) N1 potential of AP decreased very significantly by 500 Hz tone exposure. (3) A very pronounced decrease of the absolute value of the negative potential of the EP in 500 Hz exposure was seen.

Petrous Bone Cholesteatoma with Sudden Leakage of CSF : A Case Report

A case of petrous bone cholesteatoma with sudden leakage of cerebrospinal fluid (CSF) was encountered. An 82-year-old man complained of sudden chill and left otorrher. Computed tomography of the brain demonstrated a large area of air density in the lateral ventricles. Imaging examinations showed a tumorlike shadow, with extensive bony destruction, located in the petrous bone. Cholesteatoma was removed by a combination of lateral trans-suboccipital and trans-mastoid approaches. At surgery, the cholesteatoma was invading the pons and leakage of cerebrospinal fluid through the internal auditory canal was found. Obliteration with temporal muscle and fibrin glue was performed.

A case of tiger bite injury with unilateral internal jugular vein reconsruction

We reported a very rare case of tiger bite injury. The patient was a 57-year-old male who was a keeper at Asahiyama zoological park in Asahikawa city. He was attacked by an Amur tiger which seriously injured upper half of his body, including intracranial trauma. We performed an operation to save his life. There was severe bleeding from the cervical wound because the left internal jugular vein was severed, therefore, it was clamped and occluded with ligatures. We treated his many wounds, but the intracranial bleeding was not relieved. We considered that ascending intracranial pressure by occlusion of the left internal jugular vein caused the bleeding. Left internal jugular vein reconstruction was performed by neurosurgeons. They used an artificial graft initillay, and then used the greater saphenous vein as a graft. We considered the patients left internal vein as the dominant side.

Long-Term Clinical Outcome of Treatment for Epistaxis with Nd-YAG Laser in Osler's Disease.

The Nd-YAG laser was used to treat 3 patients with hereditary hemorrhagic telangiectasia (Oslers disease). Long-term clinical outcome (2-6 years period) after endonasal laser photocoagulation (ELP) for epistaxis was estimated. Repeated ELP (7-17 times over 6 years) was effective in decreasing the frequency and severity of nasal hemorrhage in 2 patients, though septal cartilage perforation resulted from the laser treatments. The other patient did not benefit from ELP performed 3 times over 2 months. Because of the formation of new lesions, repeated treatment was necessary at 2- to 14-month intervals, and the interval was prolonged after several treatments. Repeated ELP is necessary for successful treatment of epistaxis associated with Oslers disease.

Glomus tympanicum tumor; A case report. Benefits of preoprative diagnostic imaging.

The patient was 67-year-old female who complained of pulsatile tinnitus in the right ear. Otoscopy revealed a reddish mass that extended to the annulus.CT, MRI and angiography localized it in the middle ear cavity and distinguished it from the jugular bulb. The tumor was completely resected by posterior hypotympanotomy after embolization of the superior tympanic artery. Absence of tumor recurrence was con-firmed 8 months after surgery. We discuss the benefits of preoperative diagnostic imaging methods.

Nd-YAG laser photocoagulation in Osler's disease.

Oslers disease (=hereditary hemorrhagic telangiectasia) is an autosomal dominant genetically transmitted disease characterized by abnormal peripheral blood vessels. Intranasal dermoplasty and estrogen therapy have proved to be successful for nasal bleeding. However, these therapies have several complications and sometimes fail to control bleeding. Recently, Nd-YAG laser therapy has been reported to be effective in Oslers disease. We describe here a patient with Oslers disease who has had repeated nasal bleeding for about 10 years. We treated him with laser photocoagulation using a contact Nd-YAG laser at low power settings (30-35W, 0.5 sec). Laser therapy diminished the frequency and severity of hemorrhage without complications. Nasal mucosal tissue of the inferior turbinate showed massive fibroblastic infiltrations and capillary vessel clots with fibrin after laser operation. The Nd-YAG laser appears to be a useful therapeutic procedure for this disease.