Toshiyuki Yamashita

Bilateral extraocular muscle atrophy in myotonic dystrophy type 1

External ophthalmoplegia is a rare sign in myotonic dystrophy type 1 (DM1). DM1 is caused by the expansion of an unstable CTG repeat in the DMPK gene on chromosome 19q13.3. Herein we report on a 31-year-old man with DM1 who developed unusual clinical symptoms: external ophthalmoplegia, upper limb-girdle muscle atrophy, and talipes equinovarus. Subsequent MRI revealed extremely atrophic extraocular muscles as compared with an age-matched healthy individual, indicating that this MRI finding confirms the pathologic relevance of extraocular muscle atrophy for ophthalmoplegia found in this DM1 patient. A 31-year-old man was referred with dysarthria, diplopia, and dyspnea. A peculiar cry and difficulty in feeding were present from birth. At age 5 years, he was unable to run fast, and his voice sounded nasal. At age 9 years, bilateral talipes equinovarus and ophthalmoplegia were recognized. He noted a dyspnea at age 20 years and a progressive dysarthria since age 25 years. These symptoms have …

Clinical Study of Laryngeal Cancer

One hundred and nine cases of laryngeal cancer were treated between 1987 and 1997 in the Department of Otorhinolalyngology at Obihiro Kousei Hospital. The average age of the patients was 65. 4 years old, and the male to female ratio was 21: 1. Based on histopathological diagnosis, 108 cases were reported as squamous cell carcinoma and one case was reported as spindle cell carcinoma. There were 15 cases of supraglottic carcinoma, 91 cases of glottic carcinoma and 3 cases of subglottic carcinoma. There were 33 cases in stage I , 35 cases in stage II, 22 cases in stage III and 19 cases in stage J Y. The five-year survival rates of the patients for stages I to IV were 100%, 90%, 66% and 65% respectively.

The effect of histamine on laryngeal mucosal blood volume in guinea pigs.

The present study was undertaken to investigate laryngeal microvascular reactivity to histamine in normal guinea pigs.Twelve guinea pigs were sedated with intraperitoneal sodium pentobarbital, a fissure was made in the larynx, and the intra-laryngeal space was opened. A probe of a spectro-photometric analyzer was placed lightly on the mucosa of the vocal fold and fixed.Hemoglobin (Hb) concentration and oxygen saturation of Hb were measured continuously by reflectance spectrophotometry; 10μl of isotonic saline was dropped on the laryngeal mucosa in the controls, and 10μl of histamine (104μg/ml) on the mucosa of the experimental animals.The results were as followed; 1) Visual inspection after histamine provocation showed laryngeal mucosal swelling and dilatation of the microvessels. 2) After histamine provocation, Hb concentration increased (p<0.01) and oxygen saturation of Hb decreased (p<0.01). 3) After saline dropping, these two parameters showed no significant change.Thus, histamine caused swelling of the laryngeal mucosa and increased the mucosal blood volume. This method is useful for observing allergic reactions in the laryngeal mucosa.

Mucosal blood flow in nose, pharynx, larynx and middle ear. A review of the literature.

The measurement of mucosal blood flow is important for assessing condition in the nose, pharynx, larynx and middle ear. Recently the measurement of mucosal blood flow has been made very accurate by the development of new methods of measurement (e. g. Laser-Doppler flowmeter, RI clearance method, spectrophotometric analyzer).Earlier works on the assessment of mucosal blood flow in the nose, pharynx, larynx and middle ear are reviewed.

Electromyographic Biofeedback in the Treatment of Abnormal Sensation in the Throat

One of the causes of abnormal sensation in the throat is psychological. We selected 7 patients in whom it appeared that psychosomatic or neurotic tendencies triggered for abnormal sensation in the throat. We used frontal muscle electromyographic biofeedback for relaxation therapy and autogenic training; the abnormal sensation disappeared or decreased in 6 patients.