Takumi Hayashi

A Case of Harada's Disease Exhibiting Impairment of Bilateral Vestibular Function

We report the case of a 42-year-old male with Haradas disease who showed impairment of bilateral, vestibular and cochlear function. He showed bilateral sensorineural hearing loss on an audiogram and canal paresis in Caloric response. The systemic administration of betamethasone was effective: his visual acuity and hearing level normalized and vertigo subsided.

Olfactory Neuroblastoma with Intracranial Invasion; A Case Report.

A 40-year-old female was operated on for nasal polyps, but the tumor had extended already into the cranial space. Olfactory neuroblastoma was diagnosed. After chemotherapy we conducted transnasal dissection for the skull base lesion and performed craniotomy for the intracranial one. Postoperative irradiation of 50 Gy was given. Although no local recurrence or distal metastasis has been continuing found during the four years since treatment, careful follow up is necessary because of the high rate of local recurrence.

Tofisopam Treatment of Patients with Vertigo and Dizziness

The therapeutic effect of Tofisopam (150 mg/ day p.o) was evaluated in 39 patients with vertigo or dizziness. The subjective symptoms and objective findings were recorded before and four and eight, weeks after the start of treatment. After eight weeks there was marked improvement in 30.6%, moderate improvement in 19.4%, slight improvement in 41.7%, and no change in 8.3%. Clinical improvement was not quite so high after four weeks of treatment. There was no significant difference in response between peripheral vertigo and autonomic dysfunction. Clinical improvement tended to be slightly lower in patients over 50 years old than in younger patients and higher in females than in males.Many subjective symptoms, as well as vertigo and dizziness, were also reduced, such as stiff shoulder, stiff neck, headache, paresthesia and feverish sensation. The objective signs which were greatly improved were : righting reflex and gaze and positional and positioning nys-tagmus. Schellongs test, which had been positive in ten patients, became nagative in eight of them. Only one patient had any side effects : abnormal liver function tests. Tofisopam is con-siderd to be useful in the treatment of vertigo and dizziness.

Bacteriological Study and Observation by the Scanning Electron Microscope of the Tips of the Intraarterial Catheters

Bacteriological studies and observation by the scanning electron microscope of the tips of the intraarterial catheters were made on patients with malignancies of the head and neck who were treated by intraarterial injection. Seven of the 28 samples (25 %) were positive bacterial contamination, but no clinical symptoms of infection developed at all. There were two achromobacter xylosoxidans, 2 staphylococcus epidermidis, 2 propionibacterium acnes and one pseudomonas cepacia. Positive bacterial contamination (Pseudomonas cepacia) was seen in ony 1 of the 9 patients who were compelled to remove the intraarteral catheters. Scanning electron microscopic findings of the tips, and the inside catheters showed granular and fern-like materials, but none showed bacteria. Predominant peaks of Na, Cl, P, S levels were detected by an X-ray microanalyzer. In conclusion, no relationship was observed between the trouble of tubing and the bacterial contamination, but care should be paid to avoid the contamination.