Yo Kimura

Clinical evaluation of sizofilan as assistant immunotherapy in treatment of head and neck cancer.

Sizofilan (SPG), a simple glucan produced in a culture medium by Schizophyllum commune Feries, was used as an assistant immunotherapy in 15 patients with head and neck cancer. The cumulative 5-year survival rate was 86.7% in the SPG-treated group and 73.4% in the control group. Immunological parameters showed that the SPG group quickly recovered the cellular immunity damaged by radiation, chemotherapy and surgical procedure. SPG was found to be effective as an assistant immunotherapeutic agent in the treatment of head and neck.

Quantitative Analysis of Ocular Movements in Parkinson's Disease

In the present study, oculomotor abnormalities were investigated in 24 patients with idiopathic Parkinsons disease. Pursuit gain, slow and fast phase velocity of optokinetic nystagmus (OKN), saccade latency, amplitude and velocity, as well as vestibulo-ocular reflex (VOR) gain were quantitatively analyzed. Twenty-one out of 24 patients showed some abnormalities in their ocular movement. A reduction in pursuit gain, impaired OKN and a significantly increased saccade latency were observed in 11 patients. In 12 patients, hypometric saccade was seen, while a decrease in saccade velocity was observed in 10 patients. All patients registered normal values for VOR gain. Only one patient who had impaired smooth pursuit and decreased saccade velocity before treatment with a dopaminergic drug showed a remarkable improvement in these ocular abnormalities after treatment. These results suggest the possibility of dopaminergic control on these ocular movements.

Ocular abnormalities in amyotrophic lateral sclerosis

It has long been known that the oculomotor system is not involved in amyotrophic lateral sclerosis (ALS). In early stages. Some authors suggest oculomotor abnormalities in some patients. In the present study, quantitative analysis of ocular movements including smooth pursuit eye movements, optokinetic nystagmus (OKN), visual suppression of vestibular nystagmus (VS), and horizontal saccades were investigated in 9 patients with ALS. These patients were neurologically diagnosed as having ALS in the early stage. The results were as follows: The velocity of saccade was markedly reduced in 4 patients. In addition, there were abnormalities of smooth pursuit (one patient), OKN (one patient) and visual suppression (2 patients). Furthermore, these abnormalities were observed more often in patients with bulbar signs. In conclusion, the results suggest a existence of ocular abnormalities in ALS, even at early stages.

Cystic lymphangioma and plunging ranula treated by OK-432 therapy: a report of two cases.

Among head and neck angiotumors, cystic lymphangioma occurs in infancy in most cases and it is rare in adulthood. Plunging ranula is one of the diseases which need to be distinguished from lymphangioma, though operation is the first choice therapy for both of these. In the present study, we report on 2 cases in whom we conducted intralesional injection of OK-432 for cervical lymphangioma and ranula found in 20 and 35 year-old female patients. We obtained excellent improvement. First of all, we punctured the tumors and sucked out the liquid content as much as possible, and then used OK-432 in the same volumes to those drawn out. No swelling was observed in either patient after 1 month, and cysts disappeared in CT 4 and 12 months after injection, respectively; at present, the prognosis is satisfactory, without recurrence. The intralesional injection of OK-432 is considered an effective method, as the speed of complete disappearance by this therapy is high. Cosmetically it is superb, leaving no lesions in the skin of the injection site.

Eosinophil and Eosinophil Cationic Protein in Allergic Rhinitis

To evaluate the roles of eosinophils in allergic rhinitis, eosinophil cationic protein (ECP) levels in sera and nasal secretions were measured in 28 patients with allergic rhinitis. In patients, blood eosinophil counts and serum ECP levels were significantly higher than in controls (p < 0.05). However, there was no statistically significant correlation between blood eosinophil count and serum ECP level (r = 0.025). The number of eosinophils and the ECP level in nasal secretion were also measured. In patients, the ECP level increased with the number of eosinophils, and the ECP level in nasal secretion was significantly higher than in controls (p < 0.05). These results suggest that eosinophils and ECP play important roles in allergic rhinitis.

Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in Northeast Japan

In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self‐administered questionnaires, a case‐control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (± 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3‐fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

Deltopectral Flap for One-Stage Reconstruction of Pharyngocutaneous Fistulae Following Total Laryngectomy

Postoperative pharyngocutaneous fistulae are troublesome complications after total laryngectomy. To manage this complication, we devised an operative method consisting of a one-stage repair using a deltopectal flap. With this technique we can immediately cover both skin and pharyngeal defects. We have applied this method to 5 patients all of whom have successfully recovered their swallowing function.

Effect of Aging on Smooth Pursuit Eye Movement

Examination of smooth pursuit eye movement is useful for detecting central nervous system disorders. It is important to take patients age into consideration when evaluating smooth pursuit eye movement. The purpose of the present study was to clarify the effect of aging on smooth pursuit eye movement. Thirty healthy volunteers (three groups of 10 volunteers, in their fifties, sixties, and seventies and over, respectively) served as subjects, and 10 healthy young volunteers (23 to 33 years old: mean age 26) served as controls. The pursuit target was driven by sinusoidal waveform with various amplitudes and frequencies. Target peak velocities ranged from 12.6 to 94.2 degrees/s. Eye movement signals were recorded d.c. EOG and pursuit gain (ratio of eye peak velocity to target peak velocity) was measured by a computer. Pursuit gain decreased with increasing target frequency and velocity in all age groups. This tendency was more remarkable in the older groups than in the young controls; in particular, it was more frequently seen at a frequency of 0.5 Hz. On the other hand, there was no significant relationship between pursuit gain and the target amplitude. In the group in their seventies and over, pursuit gain was saturated at about 60 degrees/s.

Diagnostic Specificity of Anti-neutrophil Cytoplasmic Antibodies (ANCA) in Otorhinolaryngological Diseases

The incidence and titer of ANCA were examined with 871 sera from patients with otorhinolaryngological diseases at our hospital. The cytoplasmic pattern of ANCA (c-ANCA) whose titer was more than 16 was detected only in the sera of patients with Wegeners granulomatosis (WG). The incidence of c-ANCA in active WG was more than 90%. The perinuclear staining pattern of ANCA (p-ANCA) was detected in almost 40% of patients with Sjögrens syndrome, 2.0% of inflammatory diseases and 1.0% of tumorous diseases. A high diagnostic value of c-ANCA in WG was found in patients with otorhinolaryngological diseases.

Trapezius Osteomyocutaneous Flap in Reconstructive Surgery for Mandibular and Oral Defects

A scapular-trapezius osteomyocutaneous flap was used for mandibular reconstruction in 4 cases of oral cavity carcinoma after segmental resection of the mandible. In 3 cases, both the flap and bone took well, and the functional and morphological results were satisfactory. In one case, impaired venous return resulted in flap necrosis; a second reconstruction was performed using a rib-latissimus dorsi osteomyocutaneous flap. Functional disturbances of the donor site were minimal and, because the donor site was on the back, the cosmetic result was excellent. This flap is a bone-attached compound flap using the transverse cervical artery and veins as the vascular bundle, and is thought to be useful in the reconstruction of mandibular defects associated with extensive tissue defects of the oral cavity.