Search

The Global Yield Gap Atlas (GYGA) is an international project that addresses global food production capacity in the form of yield gaps (Yg). The GYGA project is unique in employing its original Climate Zonation Scheme (CZS) composed of three indexed factors, i.e. Growing Degree Days (GDD) related to temperature, Aridity Index (AI) related to available water and Temperature Seasonality (TS) related to annual temperature range, creating 300 Climate Zones (CZs) theoretically across the globe. In the present study, the GYGA CZs were identified for Japan on a municipality basis and analysis of variance (ANOVA) was performed on irrigated rice yield data sets, equating to actual yields (Ya) in the GYGA context, from long-term government statistics. The ANOVA was conducted for the data sets over two decades between 1994 and 2016 by assigning the GDD score of 6 levels and the TS score of 2 levels as fixed factors. Significant interactions with respect to Ya were observed between GDD score and TS score for 13 years out of 21 years implying the existence of favourable combinations of the GDD score and the TS score for rice cultivation. The implication was also supported by the observation with Yg. The lower values of coefficient of variance obtained from the CZs characterized by medium GDD scores indicated the stability over time of rice yields in these areas. These findings suggest a possibility that the GYGA-CZS can be recognized as a tool suitable to identify favourable CZs for growing crops. [ABSTRACT FROM AUTHOR]

Background: Parotid gland carcinoma is a rare and complicated histopathological classification. Therefore, assembling a sufficient number of cases with long-term outcomes in a single institute can present a challenge. Method: The medical records of 108 parotid gland carcinoma patients who were treated at Kyushu University Hospital, Fukuoka, Japan, between 1983 and 2014 were reviewed. The survival outcomes were analysed according to clinicopathological findings. Results: Forty-six patients had low clinical stage tumours (I–II), and 62 patients had high clinical stage tumours (III–IV). Fifty-two, 10 and 46 patients had low-, intermediate- and high-grade tumours, respectively. Twenty-seven of 65 cases had positive surgical margins. In high clinical stage and intermediate- to high-grade tumours, adjuvant radiation therapy was correlated with local recurrence-free survival (p = 0.0244). Intermediate- to high-grade tumours and positive surgical margins were significantly associated with disease-specific survival in multivariate analysis (p = 0.0002 and p = 0.0058). Conclusion: The results of this study show that adjuvant radiation therapy is useful for improved local control in patients with high clinical stage and intermediate- to high-grade tumours. [ABSTRACT FROM AUTHOR]

Objective:To investigate the clinicopathological and prognostic significance of the expression of cathepsin L and its inhibitor headpin, in oral squamous cell carcinoma.Design:Immunohistochemical studies were performed on 56 oral squamous cell carcinoma samples. We evaluated the relationship between cathepsin L and headpin expression versus patients' clinicopathological factors and survival.Results:The group that was positive for cathepsin L expression tended to have positive metastatic neck lymph nodes and a poorer prognosis. Headpin expression was not related to metastasis or prognosis. Well differentiated squamous cell carcinoma had higher levels of headpin expression compared with poorly differentiated squamous cell carcinoma.Conclusion:Cathepsin L expression is related to the invasive and metastatic potential of oral squamous cell carcinoma. [ABSTRACT FROM PUBLISHER]

Background:Metastasis to regional lymph nodes via lymphatic microvessels plays a key role in cancer progression, and is an important prognostic factor in many cancers. Recent evidence suggests that tumour lymphangiogenesis promotes lymphatic metastasis.Aims:To investigate whether tumour lymphatic microvessel density correlates with clinicopathological factors and serves as a prognostic indicator of supraglottic laryngeal carcinoma progression.Methods:The lymphatics of 84 supraglottic laryngeal carcinoma cases were investigated by immunohistochemical staining for podoplanin (also termed D2-40). The relationships between (intra- and peritumoural) lymphatic microvessel density, clinicopathological parameters and clinical prognosis were analysed.Results:There was a significant relationship between high intratumoural lymphatic microvessel density and aggressive tumour node stage (p < 0.0001), distant metastasis (p = 0.037) and poor prognosis (p = 0.011), and between high peritumoural lymphatic microvessel density and node stage (p = 0.004) and poor prognosis (p = 0.029). Patients with high lymphatic microvessel density also had significantly worse disease-free survival (p = 0.003) and overall survival (p = 0.005). Intratumoural lymphatic microvessel density was found to be an independent prognostic factor for overall survival (p = 0.008) and disease-free survival (p = 0.005) (multivariate analysis).Conclusion:Lymphatic microvessel density (detected by podoplanin immunohistochemistry), especially intratumoural density, may be an independent predictor of lymphatic tumour spread and survival in supraglottic laryngeal carcinoma patients, and may be useful to guide decisions regarding additional surgery. [ABSTRACT FROM PUBLISHER]

Objective: This study aimed to clarify the local immune status in the larynx in the presence of infection or carcinogenesis associated with human papilloma virus. Methods: Cytological samples (for human papilloma virus detection) and laryngeal secretions (for immunoglobulin assessment) were obtained from 31 patients with laryngeal disease, during microscopic laryngeal surgery. On histological examination, 12 patients had squamous cell carcinoma, four had laryngeal papilloma and 15 had other benign laryngeal disease. Cytological samples were tested for human papilloma virus DNA using the Hybrid Capture 2 assay. Results: High risk human papilloma virus DNA was detected in 25 per cent of patients (three of 12) with laryngeal cancer. Low risk human papilloma virus DNA was detected only in three laryngeal papilloma patients. The mean laryngeal secretion concentrations of immunoglobulins M, G and A and secretory immunoglobulin A in human papilloma virus DNA positive patients were more than twice those in human papilloma virus DNA negative patients. A statistically significant difference was observed between the secretory immunoglobulin A concentrations in the two groups. Patients with laryngeal cancer had higher laryngeal secretion concentrations of each immunoglobulin type, compared with patients with benign laryngeal disease. The study assessed the mean laryngeal secretion concentrations of each immunoglobulin type in the 12 laryngeal cancer patients, comparing human papilloma virus DNA positive patients (n = 3) and human papilloma virus DNA negative patients (n = 9); the mean concentrations of immunoglobulins M, G and A and secretory immunoglobulin A tended to be greater in human papilloma virus DNA positive cancer patients, compared with human papilloma virus DNA negative cancer patients. Conclusion: These results suggest that the local laryngeal immune response is activated by infection or carcinogenesis due to human papilloma virus. The findings strongly suggest that secretory IgA has inhibitory activity against infection or carcinogenesis associated with human papilloma virus in the larynx. [ABSTRACT FROM AUTHOR]

Objective: To review previous reports and to discuss the management of branching polycystic and giant thyroglossal duct cysts. Case report: We present two cases of thyroglossal duct cyst: one a branching, polycystic thyroglossal duct cyst in an 11-year-old boy, and the other a giant thyroglossal cyst in a 41-year-old man. Such cysts are rare. Both patients were operated upon according to the methods of Sistrunk and Horisawa, and both had a satisfactory post-operative course. Discussion: We discuss the most important aspects of such cyst removal procedures. Conclusion: Our experience suggests that surgery to remove an anomalous thyroglossal duct cyst should be performed using a technique based on the anatomy of the hyoid bone region. [ABSTRACT FROM AUTHOR]

This study examined the local immune status and tumour marker expression in secretions and related tissue specimens from the laryngeal ventricle, comparing individuals with and without head and neck cancer. Laryngeal secretion and mucosal tissue specimens were collected during laryngeal microsurgery or surgical laryngectomy. The laryngeal secretions were found to contain immunological factors such as immunoglobulins G and A and secretory immunoglobulin A. A high level of the tumour marker Cyfra 21-1 was also detected in laryngeal secretions and mucosal tissue. Lows levels of secretory immunoglobulin A and Cyfra 21-1 were seen in the laryngeal mucosal tissue of controls and patients who had previously undergone radiation therapy. The level of secretory immunoglobulin A in laryngeal secretions closely correlated to the level of this immunoglobulin in mucosal tissue. These results indicate that local immunity is present in the human larynx; furthermore, it is strongly affected both by the presence of malignancy and by laryngeal cancer treatments such as irradiation. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to introduce the technique of tetra-probe, 24-hour pH monitoring for laryngopharyngeal reflux disease. Methods: Tetra-probe, 24-hour pH monitoring was performed for 30 suspected cases of laryngopharyngeal reflux. The proximal probe was placed in the hypopharynx, just above the upper oesophageal sphincter, the second probe was placed in the middle oesophagus, the third probe was placed a few centimetres above the lower oesophageal sphincter, and the distal probe was placed in the stomach. Results: As the pH at the four sensor sites could be monitored simultaneously, gastric acid levels and gastroesophageal and laryngopharyngeal reflux could be examined. This pH monitoring technique enabled the pH relationship between the four sensor locations to be well documented, enabling gastric acid levels and patterns of reflux to be assessed. This procedure was also able to be used as a functional examination to evaluate anti-reflux medication efficacy. Conclusions: Tetra-probe, 24-hour pH monitoring is a reliable functional examination for laryngopharyngeal reflux. [ABSTRACT FROM AUTHOR]

Tympanic membrane perforation causes a sound conduction disturbance, and the size of this conduction disturbance is proportional to the perforation area. However, precise evaluation of perforation size is difficult, and there are few detailed reports addressing this issue. Furthermore, such evaluation becomes more difficult for irregularly shaped perforations. This study conducted a quantitative evaluation of tympanic membrane perforations, using image analysis equipment. A significant correlation was found between the degree of sound conduction disturbance and the perforation area; this correlation was greater at low frequencies following a traumatic perforation. The conductive disturbance associated with chronic otitis media was significantly greater at low frequencies. Circular perforations caused only minor conduction disturbance. Perforations in the anteroinferior quadrant were associated with greater conduction disturbance. Traumatic spindle-shaped perforations and malleolar perforations were associated with greater conduction disturbance. [ABSTRACT FROM AUTHOR]

Epithelioid sarcoma is an aggressive, malignant tumour of the soft tissue which tends to arise in proximity to large tendons and aponeuroses. We report the case of a patient presenting with an epithelioid sarcoma arising in the neck. A 56-year-old man was referred with a three-year history of a sensory disorder as well as a slowly growing mass in his right neck. The patient underwent resection of the tumour by means of a conservative neck dissection. The final diagnosis, based on the histological and immunohistochemical findings, was epithelioid sarcoma. Radiotherapy was performed after the operation. The post-operative course was uneventful, and there was no local recurrence or distant metastasis. [ABSTRACT FROM AUTHOR]

This report describes the case of a patient with cricopharyngeal dysfunction with significant piriform sinus expansion. An 80-year-old man presented with a three-year history of dysphagia. Palsy of the cricopharyngeal chalasis was identified by electromyography under both videofluorography and manofluorography. Although a widening procedure was performed in the cricopharyngeal region using a bougie, the patient gained only minor relief from his dysphagia. After the patient had had adequate time to recover spontaneously (six months), a cricopharyngeal myotomy was performed. As a result, his dysphagia resolved and the post-operative course was uneventful. The clinical and histopathological findings in this case suggested that significant piriform sinus expansion had resulted from the cricopharyngeal dysfunction, due to cricopharyngeal myopathy. [ABSTRACT FROM AUTHOR]

This study reviewed 24 cases of parapharyngeal space tumour treated at Kurume University Hospital between 1990 and 2007. Histological diagnoses were generally obtained from the excised tumour (22/24). Seventy-seven per cent of the parapharyngeal space tumours were benign and 23 per cent were malignant. Thirty-eight per cent (eight of 22) of these tumours were pleomorphic adenomas and 23 per cent (five of 22) were schwannomas. A transparotidectomy and transcervical approach were used in 88 per cent (15/17) of benign tumours. A mandibular swing approach was used for one malignant tumour. Post-operative complications were identified in 16 of 22 patients. The most common complication, facial nerve paralysis, was identified in eight patients, and seven of these patients demonstrated first bite syndrome. In consideration of the high incidence of post-operative complications, the surgical approach should therefore be carefully selected when treating patients with parapharyngeal space tumours. [ABSTRACT FROM AUTHOR]

This study reviewed 161 patients with supraglottic squamous cell carcinoma who underwent radical therapy at Kurume University Hospital between 1989 and 2003. The five-year survival rate was 89 per cent in patients with stage III disease and 75 per cent in stage IV patients, thus demonstrating favourable results even for patients with advanced cancer. The five-year local control rate and the laryngeal preservation rate were poor in patients with T3 tumours (being 75 per cent for both), but the overall five-year local control rate for all patients was 86 per cent. Laser surgery plus chemo-radiotherapy was the most frequently used treatment. The local control rates and laryngeal preservation rates were poor in patients with tumour infiltration to the glottis and the laryngeal ventricle. In conclusion, the indications for combination laser therapy for supraglottic carcinoma should in future be extended, and the type and number of chemotherapy courses for this cancer should be further clarified. [ABSTRACT FROM AUTHOR]

Cholesterol granuloma is an intractable ear disease. Many studies of this condition have been published since the initial report by Manasse. However, the pathogenesis of this condition is unclear. This study reviewed the treatment of middle-ear cholesterol granuloma in 16 patients undergoing surgical treatment at Kurume University Hospital. The relationship between patients' pre-operative tympanic membrane findings and post-operative course was analysed. Patients with swollen tympanic membranes had significantly poorer outcomes. Patients with retracted tympanic membranes and those undergoing ossicular chain reconstruction had significantly better outcomes. The patients' overall hearing success rate at approximately two weeks post-operatively was 75 per cent. However, by six months post-operatively, the overall hearing success rate had declined to 62.5 per cent. Patients with poor hearing two weeks post-operatively did not acquire better hearing. [ABSTRACT FROM AUTHOR]

Previously, the treatment of carcinoma of the external auditory canal has mainly involved surgical resection. In order to enable organ preservation and to obtain cancer-free surgical margins, we introduced the use of superselective, intra-arterial, rapid infusion chemotherapy combined with radiotherapy to treat this condition. We reviewed our patients' tumour stages, feeding arteries and clinical outcomes. Tumours were staged according to the Pittsburgh staging system. Chemotherapy was administered intra-arterially in the angiography suite via transfemoral catheterisation of the feeding arteries. Four patients underwent superselective, intra-arterial, rapid infusion chemo-radiotherapy. A complete response was obtained in all four patients. The overall toxic side effects were modest. Superselective, intra-arterial, rapid infusion chemotherapy can be an effective, organ-preserving treatment for external auditory canal carcinoma, with a high cure rate. [ABSTRACT FROM AUTHOR]

Labyrinthine fistula is one of the most common complications of chronic otitis media associated with cholesteatoma. The optimal management of labyrinthine fistula, however, remains controversial. Between 1995 and 2005, labyrinthine fistulae were detected in 31 (6 per cent) patients in our institution. The canal wall down technique was used in 27 (87 per cent) patients. The cholesteatoma matrix was completely removed in the first stage in all patients. Bone dust and/or temporalis fascia was inserted to seal the fistula in 29 (94 per cent) patients. A post-operative hearing test was undertaken in 27 patients; seven (26 per cent) patients showed improved hearing, 17 (63 per cent) showed no change and three (11 per cent) showed a deterioration. The study findings indicate that there are various treatment strategies available for cholesteatoma, and that the treatment choice should be based on such criteria as auditory and vestibular function, the surgeon's ability and experience, and the location and size of the fistula. [ABSTRACT FROM AUTHOR]

Objectives: The paraglottic space and cricoid area of the larynx are made up of loose, areolar tissue composed of loose elastic and collagenous fibres and adipose tissue. They contain the main blood vessels of the larynx. We examined the correlation between the histopathological extension of glottic carcinoma into the paraglottic space or cricoid area and the development of cervical lymph node metastasis. Study design: We reviewed the medical charts of 45 patients (44 men and one woman) who had undergone total laryngectomy for squamous cell carcinoma of the glottis between 1991 and 2003. Methods: Macroscopic and microscopic study of the removed larynges of the same patients was performed, and the histopathological evidence for invasion of the paraglottic space or cricoid area was analysed. Results: Eight of the 24 patients (33 per cent) with invasion of the paraglottic space or cricoid area had cervical lymph nodemetastasis. In contrast, only one of the 21 patients (5 per cent) without any evidence of invasion of either space had lymph node metastasis. This difference was statistically significant (p < 0.05). In the 36 patients free of cervical lymph node metastasis, recurrence in the neck occurred in six (38 per cent) of the 16 patients with paraglottic space or cricoid area invasion, but in only one (5 per cent) of the 20 patients without paraglottic space or cricoid area invasion (p < 0.05). Conclusion: In patients with glottic carcinoma, invasion of cancer into the paraglottic space or cricoid area is an important prognostic factor for the development of cervical lymph node metastasis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to clarify the significance of cluster of differentiation 9 glycoprotein gene expression in human parotid gland tumours. Methods: We retrospectively analysed immunohistochemical staining for cluster of differentiation 9 glycoprotein in parotid gland tumours. Results: Cluster of differentiation 9 glycoprotein was consistently detected in the normal parotid gland. Regarding benign parotid gland tumours, cluster of differentiation 9 glycoprotein was present in 13 of 18 pleomorphic adenomas, in allWarthin tumours tested (21/21) and in all cases of basal cell adenoma tested ( four of four). In contrast, positive staining for cluster of differentiation 9 glycoprotein was less often observed in malignant parotid tumours. Cluster of differentiation 9 glycoprotein was present in 11 of 14 mucoepidermoid carcinomas, in two of five acinic cell carcinomas and in two of five adenoid cystic carcinomas. Conclusions: There was a statistically significantly reduced expression of cluster of differentiation 9 glycoprotein in malignant parotid gland tumours, compared with benign parotid gland tumours (p , 0.05). These results suggest that a low level of cluster of differentiation 9 glycoprotein expression in parotid gland tumours may be associated with malignancy. [ABSTRACT FROM AUTHOR]

Objectives: Double-probe, 24-hour pH monitoring remains the 'gold standard' for the diagnosis of laryngopharyngeal reflux disease, even though there is no consensus on how to interpret the data collected. Methods: Tetra-probe, 24-hour pH monitoring was performed in 56 patients with suspected laryngopharyngeal reflux, in order to investigate patterns of laryngopharyngeal and gastroesophageal reflux. Results: The number of reflux episodes and the total and percentage time periods spent with pH < 4.0 were correlated with the distance of the probe from the lower oesophageal sphincter. The number of reflux episodes and the total and percentage time periods with pH < 4.0 were greater when patients were upright (i.e. during the daytime). There were few laryngopharyngeal reflux events recorded for pH levels of <4.0; however, there were a significant number of laryngopharyngeal reflux events recorded for pH levels of < 5.0, a level capable of causing laryngopharyngeal reflux disease. When a pH level of < 5.0 was used, the number, total time and percentage time of laryngopharyngeal reflux episodes was greater during the supine period (i.e. during sleeping) in a quarter of the cases, compared with results when a pH of < 4.0 was used. Conclusions: It is valid to use a pH level of 5.0 as indicative of laryngopharyngeal reflux in the hypopharynx. [ABSTRACT FROM AUTHOR]

This paper reviews 22 cases of minor salivary gland carcinoma of the oral cavity or oropharynx which were treated at Kurume University Hospital between 1976 and 2005. Minor salivary gland carcinoma was observed in eight of 362 patients with cancer of the oral cavity (2 per cent), and in 14 of 275 patients with cancer of the oropharynx (5 per cent). The five-year and 10-year survival rates of patients with oropharyngeal minor salivary gland carcinoma were 90 per cent. No statistically significant difference was observed between survival rates for oropharyngeal minor salivary gland carcinoma and for oropharyngeal squamous cell carcinoma (p = 0.06). The five- and 10-year survival rates of patients with oral cavity minor salivary gland carcinoma were 75 and 37 per cent, respectively. No statistically significant difference was observed between survival rates for oral cavity minor salivary gland carcinoma and oral cavity squamous cell carcinoma. Patients' survival results correlated well with the clinical stage of their lesions. A significant difference in survival was observed, comparing stage IV with stages I, II and III (p = 0.04). In contrast, no significant relationship was found between either survival and tumour type or survival and treatment. Adjuvant therapy is recommended for patients with grade III adenoid cystic carcinoma with perineural infiltration or intravascular infiltration. [ABSTRACT FROM AUTHOR]

A six-year-old girl developed posterior glottic stenosis following surgery for lateral curvature. She was post-operatively intubated for 17 days and had inspiratory stridor after extubation. Laryngoscopy revealed an adhesion at the posterior commissure which severely limited abduction of the bilateral vocal folds and arytenoids. Initially, tracheal fenestration was performed and the scar tissue of the posterior commissure was vaporised using a CO2 laser under endolaryngeal microsurgery. However, despite this procedure the stenosis reformed and an interarytenoid adhesion developed. Endolaryngeal microsurgery was performed again three months later. Using endoscopic microscissors, the posterior commissure and interarytenoid scar tissue were submucosally separated and the bilateral corniculate cartilages of the superior arytenoids were debulked using CO2 laser. A posteriorly based mucosal flap obtained from the postcricoid region was extended to approximate to the mucosa of the posterior commissure. The mucosal flap was sutured to the inferior subglottic mucosa by two 4-0 polyglactin absorbable sutures. Three months later, the patient's respiratory and phonatory function was satisfactory. Based on the successful results of the present case, the authors highly recommend the use of a posterior mucosal flap for the treatment of posterior glottic stenosis. This procedure does not require the use of either a laryngofissure or a laryngeal stent. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the significance of the expression of p21WAF1/Cip1 and proliferating cell nuclear antigen (PCNA) in human laryngeal squamous cell carcinomas. Forty-eight patients (25 supraglottic, 23 glottic) who had undergone operations between 1998 and 2003 were included in this study. The Envision immunohistochemistry method was utilized to stain these tissue specimens. The results showed that the immunostaining of p21WAF1/Cip1 do not show any correlation with differentiation, N stage, metastasis, survival, recurrence or the laryngeal site of involvement. A significant inverse correlation was detected between p21WAF1/Cip1 and the T stage. In contrast, the percentage of PCNA labelled cells showed a significant correlation with the T stage, but not with other clinicopathological parameters. There were differences in the expression of p21WAF1/Cip1 and PCNA between the supraglottic and the glottic carcinomas. In conclusion, our findings suggest that p21WAF1/Cip1 and PCNA may play an important role in the progression of carcinoma of the supraglottic larynx. [ABSTRACT FROM AUTHOR]

We report a new surgical procedure to treat intractable aspiration: closure of the larynx, using double hinged flaps of the vocal folds and false vocal folds.The anterosuperior portion of the thyroid cartilage is ablated. A small horizontal incision is made just above the anterior commissure and is continued posteriorly along the laryngeal ventricle; these incisions are continued across the posterior wall of the glottis. Incisions are made into the bilateral vocal folds and false vocal folds in order to create the hinged flaps. The glottis and the supraglottis are closed by approximating the bilateral vocal folds and false vocal folds hinged flaps. Superiorly or inferiorly based sternohyoid muscle pedicles are then inserted into the dead space between the approximated bilateral vocal folds and false vocal folds hinged flaps. The removed lamina of the thyroid cartilage is obliterated between both sternohyoid muscle flaps to enforce the closure of the larynx. [ABSTRACT FROM AUTHOR]

Objective:To report magnetic resonance imaging findings in a patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss.Case report:A 13-year-old girl had bilateral and symmetric low-frequency sensorineural hearing loss. Upon genetic testing, a heterozygous c.1105A > G (p.K369E) mutation of the SLC26A4 gene was detected. Mild endolymphatic hydrops in the right cochlea and marked endolymphatic hydrops in the left vestibulum were seen by magnetic resonance imaging 4 hours after an intravenous gadolinium injection.Conclusion:This is the first reported case of a patient with the SLC26A4 gene mutation c.1105A > G (p.K369E) who had low-frequency sensorineural hearing loss. Co-occurrence of cochlear and vestibular endolymphatic hydrops suggests an association with that pathology. [ABSTRACT FROM PUBLISHER]

Objective:We report three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging findings in a patient with relapsing polychondritis.Method:Case report.Result:A 76-year-old woman initially presented with bilateral auricular swelling together with dyspnoea. Three months later, she experienced left hearing loss and recurrent vertigo. A biopsy of the auricle was performed and relapsing polychondritis was diagnosed. The patient underwent three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging 4 hours after intravenous injection of a standard dose of gadolinium. Gadolinium enhancement was visible throughout the vestibule and the endolymphatic space could not be visualised, suggesting breakdown of the blood–labyrinth barrier.Conclusion:This is the first radiological report to demonstrate breakdown of the blood–labyrinth barrier in a case of relapsing polychondritis with inner ear impairment. [ABSTRACT FROM AUTHOR]

An anterior glottic web in adults comprises a bridge of scar tissue commonly formed as a result of iatrogenic laryngeal injury. Traditionally, procedures such as transcervical midline thyrotomy and keel placement have been used to repair this condition. However, we recently repaired an anterior glottic web using a new surgical procedure involving a silicone tube instead of a keel. We herein report this case, in which we placed a silicone tube at the anterior commissure after resection of an anterior glottic web, under endolaryngeal microsurgery, without performing a tracheostomy. [ABSTRACT FROM AUTHOR]

Objective: Recurrent dislocation of the temporomandibular joint is difficult to treat with nonsurgical methods. A new nonsurgical method for the treatment of this condition is presented. Methods: Routine dental arch bars were applied to the teeth, and two latex elastic bands were placed between the two arch bars on either side of the dental arch. Muscular exercises (i.e. active mouth opening) were then performed regularly over approximately three months. Results: Patients were followed up for two to five years, and the treatment proved successful in five of five cases (i.e. no recurrence was seen). The advantages of this treatment are its simplicity and the lack of special equipment needed. No surgery is required, although patients must perform regular muscular exercises. Surgical complications such as trismus and facial nerve palsy are avoided. The disadvantages of this method are the requirement for patient compliance, and its lack of usefulness in patients without teeth. Conclusions: The described method is useful for patients complaining of recurrent dislocation of the temporomandibular joint. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the inner ear of a patient with an enlarged vestibular aqueduct and acute hearing deterioration, using three-dimensional fluid-attenuated inversion recovery (3D FLAIR) magnetic resonance imaging (MRI). BACKGROUND: Three-dimensional fluid-attenuated inversion recovery MRI has been recently developed to detect haemorrhage and high concentrations of protein. Application of this method to inner-ear diseases has not been fully described. METHOD: We used 3D FLAIR MRI to evaluate a patient with an enlarged vestibular aqueduct and acute hearing deterioration. RESULTS: On 3D FLAIR MRI, this patient had high signals in the endolymphatic duct and sac, the vestibule and the cochlea and was diagnosed as having a high protein concentration in the inner ear. These high signal areas were not detected by T1- and T2-weighted MRI. CONCLUSION: This is the first published case in which a high protein concentration in the cochlea of a patient with an enlarged vestibular aqueduct was detected by 3D FLAIR MRI. These findings strongly supported the theory of the pathophysiology of hearing deterioration in patients with an enlarged vestibular aqueduct, which states that hyperosmolar fluid in the enlarged endolymphatic sac refluxes into the cochlea, resulting in damage to the hair cells. Thus, these finding may help clarify the cause of hearing deterioration in the presence of a large endolymphatic duct and sac. [ABSTRACT FROM AUTHOR]

Objective:To determine the clinical effect of post-operative radiotheraphy and systemic chemotherapy for the treatment of salivary duct carcinoma.Study design:Retrospective review.Design:The medical records of 26 patients treated by surgery with or without radiotheraphy and/or systemic chemotherapy for salivary duct carcinoma were retrospectively reviewed to investigate the role of post-operative adjuvant treatment for the patients' prognosis.Results:The overall three-year and five-year survival rates were 54 and 48.1 per cent, respectively. There was no correlation with the clinical stage and the patients' prognosis. The overall three-year survival of the patients with or without post-operative radiotheraphy was 64 and 33 per cent, respectively (p = 0.29). The overall three-year survival of the patients with or without post-operative chemotherapy was 53 and 56 per cent, respectively (p = 0.78).Conclusion:Post-operative adjuvant therapy did not improve the patients' overall prognosis with salivary duct carcinoma. Developing novel treatment modalities may be necessary to improve the prognosis of this aggressive disease. [ABSTRACT FROM PUBLISHER]

Purpose:The management of extrapulmonary small cell carcinoma has not been standardised to date. This study reviewed the clinical course, management and survival outcomes of patients with extrapulmonary small cell carcinoma in the head and neck region.Methods:Nine patients with extrapulmonary small cell carcinoma in the head and neck were included in this study.Results:Five patients received radical surgery followed by adjuvant chemotherapy or radiotherapy or both. Two other patients were treated with chemotherapy consisting of CPT11 plus cisplatin or CPT11 plus cisplatin plus VP-16 three times. Two other patients received chemoradiotherapy consisting of S-1 or CPT11 plus cisplatin. The median overall survival was 14.5 months, with a three-year survival rate of 23.7 per cent.Conclusions:The prognosis of extrapulmonary small cell carcinoma is generally poor. Further prospective multicentre studies are required for better understanding of disease entities and response to treatment modalities. [ABSTRACT FROM PUBLISHER]

Background:Liposarcomas rarely occur in the parapharyngeal space and only a few case reports exist. For curative therapy of liposarcoma, surgical excision remains the dominant modality. Although a wide surgical margin is important to prevent local recurrence, wide excision is often difficult in the head and neck region.Case report:We report a case of a 19-year-old female with a well-differentiated liposarcoma arising in the parapharyngeal space. We removed the tumour surgically utilising a cervical–parotid approach. The histological diagnosis was well-differentiated sclerosing liposarcoma. There is no recurrence after five years and nine months of follow up.Conclusion:The patient's age and the tumour site made it difficult for us to make a quantitative diagnosis before the operation. Well-differentiated liposarcoma rarely develop distant metastasis, but often recur locally. The benefit of adjuvant radiotherapy for well-differentiated liposarcoma is still not clear and careful and long-term follow up is necessary. [ABSTRACT FROM PUBLISHER]

Background:Hyalinizing clear cell carcinoma is a rare minor salivary gland neoplasm. The treatment of choice is surgical resection with or without post-operative radiotherapy. This tumour often demonstrates a good prognosis.Case report:We report a case of hyalinizing clear cell carcinoma arising in the nasopharynx. A 27-year-old female presented with progressive hearing disturbance and tinnitus. On examination, an expansile mass was observed in her nasopharynx. Biopsy was performed and the pathology results returned as clear cell carcinoma.Results and conclusion:Surgical resection was performed trans-orally accompanied by trans-palatal approach. She has no recurrence during more than two years of follow up. [ABSTRACT FROM PUBLISHER]

Purpose:The object of this study was to analyse our experience with the effects of concurrent chemoradiotherapy for oropharyngeal squamous cell carcinoma, the treatment results of this therapeutic strategy and a salvage treatment for recurrent oropharyngeal squamous cell carcinoma.Methods:Seventy-five patients with oropharyngeal squamous cell carcinoma were treated with chemoradiotherapy. The study included twenty-five of these patients who had recurrent oropharyngeal squamous cell carcinoma after chemoradiotherapyResults:The three-year actuarial survival rates for 75 patients by disease stage were as follows: stage II, 100 per cent; stage III, 71.1 per cent; stage IV, 51.7 per cent and overall, 58.2 per cent. The mean time of detection of recurrence was 6.2 months. The total salvage rates of recurrence were 21 per cent. The one and three-year tumour-free actuarial survival rates of those patients who received salvage treatment were 83 and 33 per cent.Conclusions:Surgical salvage was only feasible for early recurrent tumour. Close follow-up surveillance of early recurrence is essential after primary treatment of patients with chemoradiotherapy. [ABSTRACT FROM PUBLISHER]

To compare the culture sensitivities of MRSA detection, we collected 988 paired umbilical and nasal cultures from screened neonates. MRSA positivity rates were 79.1% from umbilicus and 41.9% from nares ( P = .01). The umbilicus was a more useful culture site than the nares for surveillance of MRSA among neonates upon admission.

In some patients with Kawasaki disease, a prior myocardial infarction causes ventricular tachycardia in the chronic post-myocardial infarction phase. We report the case of a 41-year-old man with symptomatic and haemodynamically unstable ventricular tachycardia in whom substrate ablation was performed for the ventricular tachycardia before insertion of an implantable cardioverter-defibrillator.

Background: Dementia involves a progressive decline in many functional areas. Policy and practice guidelines should cover the entire course of the disease from early detection to the end-of-life. The present study aimed to evaluate the contents of national dementia strategies with a focus on palliative care content., Methods: We employed qualitative content analyses. Sixteen national dementia strategies from 14 countries were reviewed. Using open coding, the contents were compared to the domains and recommendations of the palliative care in dementia white paper of the European Association for Palliative Care (EAPC)., Results: Although palliative care was not explicitly referred to in eight of the 14 countries and only to a limited extent in three countries, a number of domains from the EAPC white paper were well represented, including "person-centered care, communication, and shared decision making"; "continuity of care"; and "family care and involvement." Three countries that referred to palliative care did so explicitly, with two domains being well represented: "education of the health care team"; and "societal and ethical issues." The strategies all lacked reference to the domain of "prognostication and timely recognition of dying" and to spiritual caregiving., Conclusions: National dementia strategies cover part of the recent definition of palliative care in dementia, although they do not frequently label these references as "palliative care." In view of the growing numbers of people dying with dementia, preparation for the last phase of life should be added to national strategies.

The relationship between varicella-zoster virus and idiopathic associated laryngeal paralysis was examined in five patients, using complement fixation or enzyme immunoassay testing. In all cases, significant changes in serum levels of varicella-zoster virus antibody were observed. Videofluoroscopy was useful in assessing the severity of the dysphagia and in making an accurate diagnosis; both laryngeal elevation and weakness of pharyngeal wall contraction were also observed. In two cases in which antiviral therapy was delayed, the outcome was poor, with increased levels of varicella-zoster virus immunoglobulin M found on enzyme immunoassay. The outcome of the condition may thus depend both on the speed of antiviral therapy commencement following onset of symptoms, and on the levels of varicella-zoster virus immunoglobulin M antibody (measured by enzyme immunoassay). Our study suggests that varicella-zoster virus should be considered in the differential diagnosis of patients with idiopathic associated laryngeal paralysis, and rapid antiviral therapy should be initiated when necessary.