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Ultrasonography of the carotid artery is routinely used to diagnose carotid artery stenosis and to screen the severity of atherosclerosis. During the performance of the ultrasonography, thyroid lesions or neck lymph node swelling are often observed. In this study, a total of 30,351 persons underwent carotid artery ultrasonography for thyroid and neck lesions as well as the carotid artery from 2008 to 2012. Criteria for further examination were either nodules with high echoic lesions indicating calcification, nodules 2cm or greater in diameter, malignant findings such as irregular shape, ill-defined border character, low and heterogeneous internal echoes, or diffuse swelling in the thyroid. Furthermore, neck lymph node swelling was also included in the criteria. Further examination was required in 650 (2.2%) of all 30,351 persons. In our hospital, 394 (60.6%) patients of the 650 were able to be examined with detailed ultrasonography and/or fine needle aspiration biopsy for thyroid and neck lesions. Finally, 73 patients (0.24%) were diagnosed as having malignant tumors consisting of 67 thyroid papillary carcinoma, two malignant lymphoma, one laryngeal carcinoma, one oropharyngeal carcinoma, one hypophryngeal carcinoma and one parathyroid carcinoma. Findings of the carotid artery ultrasonography for further examination were nodules with high echoic lesion in 370 (56.8%), nodules of 2cm or greater in diameter in 197 (30.2%), malignant findings in 120 (18.4%), diffuse swelling in 38 (5.8%) in the thyroid, and neck lymph node swelling in 38 (5.8%) of the 650 patients. The frequency of the malignant findings and neck lymph node swelling in the carotid artery ultrasonographic findings in thyroid carcinoma patients was significantly higher compared to those in patients with benign thyroid lesion. The tumors in 56 thyroid carcinoma patients which were detected with the carotid artery ultrasonography showed a significantly smaller and earlier stage in pT and pN compared to those in 21 thyroid carcinoma patients who consulted with subjective symptoms. These findings suggested that screening for thyroid and neck lesions in the performance of carotid artery ultrasonography is useful and needs to be widely adopted to reveal head and neck malignant tumors and early stage thyroid carcinomas.

Introduction: Because upper respiratory tract infections, particularly tonsillitis, often precede IgA nephropathy (IgAN), IgAN is now recognized as a tonsil-related disease, and reports have shown that tonsillectomy is effective in preventing disease progression in IgAN patients. IgA may thus play an important role in IgAN pathogenesis and development. B cell activation factor belonging to the TNF family (BAFF) is expressed by monocytes, macrophages, and dendritic cells, and may be the mechanism by which macrophages and dendritic cells directly regulate human B-cell activation. BAFF acts as a potent B-cell growth factor and costimulator of immunoglobulin production, including IgA. We studied therapeutic effects and serum BAFF levels as prognostic factors., Patients and Methods: Subjects were 41 patients undergoing tonsillectomy and followed up for at least 1 year. Serum samples were obtained from 38 with IgAN and 29 with recurrent tonsillitis as a properative control groups. The remission group consisted of patients with normal renal function without hematuria and proteinuria. Serum BAFF levels were measured by ELISA kits at our laboratory., Results: Overall remission was 39.0%. The disappearance of hematuria increased for long-term follow-up groups, but proteinuria was unchanged. Serum BAFF levels among the two groups did not differ significantly. Among IgAN patients, higher BAFF levels were associated with higher serum IgA/C3 levels. The correlation was weak (p =0.026, r = 0.407). Using 3.2 ng / ml as a cut off point, we compared cumulative improvement in those with high pretreatment BAFF levels to those with low pretreatment levels. Those with high pretreatment BAFF levels had inferior cumulative improvement in hematuria., Conclusion: Tonsillectomy was effective in improving hematuria. BAFF appears to be a key factor in tonsillectomy among [gAN patients.

We performed preoperative radiochemotherapy including local irradiation with total dose of 40 Gy along with concomitant combination chemotherapy with carboplatin and tegafur.uracil for 11 head and neck squamous cell carcinomas and evaluated the clinical and histopathological effects as well as the side effects. Seventy-three percent of patients accomplished significant clinical effects equal to or more than PR and significant histopathological effects in surgically resected tissues. Side effects were seen in only one patient with severe hypoleukocytemia, no patients with renal dysfunction, and 34% of patients with severe oral mucositis. These results suggest that our radiochemotherapy may be useful for preoperative treatment for patients with locally advanced head and neck squamous cell carcinomas.

Treatment outcomes of tonsillectomy were studied in 7 Japanese patients with psoriasis--3 males and 4 females aged 9 to 46 years (median: 23 years)--followed up 2 to 9 years after tonsillectomy. All skin lesions disappeared in 3 patients, 80% of those in 2, and no change in the remaining 2 during follow-up. Of 5 in whom skin lesions improved, 4 were females and had a history of tonsillitis making skin lesions worse. In quantitative immunohistologic analysis on tonsillar tissues by CD20 and anti-ssDNA antibodies, areas of T cell-nodules were significantly expanded, but those of the B-lymphoid follicles were smaller, and the number of apoptotic cells increased in tonsils from patients with psoriasis and PPP compared to those with recurrent tonsillitis. The area of T cell-nodules and the number of apoptosis cells were significantly larger in tonsils from 4 patients with complete recovery after tonsillectomy compared to the remaining 9 without complete recovery. This suggests that histologic evaluation may be helpful in estimating the effectiveness of tonsillectomy.