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Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is defined by p16 positivity and/or HPV DNA positivity. Because survival of patients with HPV-related OPSCC after chemoradiotherapy is favorable, a de-intensified treatment is expected to lead to less morbidity while maintaining low mortality. The association of tumor p16 and HPV DNA status with survival after radiotherapy alone remains unknown. We retrospectively examined survival of 107 patients with locally advanced OPSCC after radiotherapy alone (n = 43) or chemoradiotherapy (n = 64) with respect to tumor p16 and HPV DNA status, using Cox’s proportional hazard model. Survival after radiotherapy alone was significantly worse in p16-positive/HPV DNA-negative locally advanced OPSCC than in p16-positive/HPV DNA-positive locally advanced OPSCC. In bivariable analyses that included T category, N category, TNM stage, and smoking history, the survival disadvantage of p16-positive/HPV DNA-negative locally advanced OPSCC remained significant. There was no significant difference in survival after chemoradiotherapy between p16-positive/HPV DNA-positive locally advanced OPSCC and p16-positive/HPV DNA-negative locally advanced OPSCC. Survival in p16-positive/HPV DNA-positive locally advanced OPSCC after radiotherapy alone was similar to that after chemoradiotherapy, which stayed unchanged in bivariable analyses after adjustment of every other covariable. Survival of p16-negative/HPV DNA-negative locally advanced OPSCC was poor irrespective of treatment modality. Survival in p16-positive locally advanced OPSCC differs depending on HPV DNA status. Radiotherapy alone can serve as a de-intensified treatment for p16-positive/HPV DNA-positive locally advanced OPSCC, but not for p16-positive/HPV DNA-negative locally advanced OPSCC.

Seikan Tunnel is in special condition that is under the seabed. So the lining concrete is not affected by water pressure directly as the surrounding areas of the tunnel were grouted the waterproof zone. In this paper, the current soundness of the lining is evaluated by focusing long term convergence measurement, visual inspection and measuring stress of lining, for the purpose of grasp of the long term properties of the tunnel and proper maintenance. As the result, in most cases, the displacement is small. On the other hand, in some of section which has been measured displacement relatively large, lining stress is basically equal to the design strength. However it is smaller than compression strength. In addition, the authors also evaluate soundness of the future of lining, by consideration of forecasting displacement and stress. 長大海底トンネルである青函トンネルは，トンネル周辺地盤に注入を実施して形成した止水ゾーンにより，強大な水圧を覆工コンクリートに直接作用させないように設計されている．このような特殊な条件下にあるトンネルの長期的挙動の把握および今後の適切な維持管理のため，トンネル本坑の内空変位の長期計測，外観検査，覆工コンクリートの応力計測に基づき，覆工コンクリートの健全性を評価した．その結果，内空変位量は全体的に小さく，急激な変位の進行も認められないこと，また，一部の内空変位量が大きい箇所では，覆工コンクリートに設計基準強度相当の応力が生じているものの，当該箇所の圧縮強度よりも十分小さいこと，さらに，今後予想される覆工コンクリートの応力増加を考慮しても，その健全性が損なわれることはないことが明らかとなった．

The head and neck cancer patients with more co-morbidities and those dependent on tube feeding are at a high risk of severe infections during chemotherapy. Therefore, prophylaxis with colony-stimulating factors and/or antibiotics should be considered for those patients.To investigate the risk factors for severe infection during chemotherapy in head and neck cancer patients.A retrospective study was conducted of 129 patients with head and neck cancer who received taxane-based and platinum-based chemotherapy between 2008-2013. Logistic regression models were used to evaluate risk factors.Febrile neutropenia occurred in 50 patients out of the 129 (39%), severe infections occurred in 24 patients (19%), and bacteremia in two patients (2%). In univariate analysis, low serum albumin levels and tube feeding were significantly associated with severe infections (p = 0.015 and0.001, respectively). In multivariate analysis, the odds ratios for a higher modified Charlson co-morbidity index and tube feeding were 2.80 and 9.74, respectively. These two were independent predictive factors for severe infections (p = 0.020 and 0.001, respectively).

Perineuriomas are uncommon benign peripheral nerve sheath tumors that include soft tissue, sclerosing, reticular, and intraneural variants. Soft tissue perineuriomas arise in a wide anatomic distribution and mostly in patients older than 20 years of age. We report an atypical perineurioma in a 7-year-old girl. The tumor, located in the tongue, was uniformly hypercellular. The tumor cells were spindle-shaped with a slender, elongated, bipolar, wavy cytoplasmic process formation and wavy elongated nuclei, and the architecture was composed of predominantly short fascicles with areas exhibiting a vague storiform pattern. Although the tumor cells generally appeared bland, the tumor showed worrisome features including an infiltrative pattern and occasional mitotic figures. Psammoma bodies were observed in the periphery of the tumor. Immunohistochemically, the cells were positive for epithelial membrane antigen, vimentin, claudin-1, and GLUT-1, but negative for S-100 protein, CD34, and type IV collagen. The authors document a case of soft tissue perineurioma with atypical histological features that occurred in the tongue of a child.

Hydrogen sulfide (H(2)S) formed from l-cysteine by multiple enzymes including cystathionine-gamma-lyase (CSE) is now considered a gasotransmitter in the mammalian body. Our previous studies have shown that H(2)S activates/sensitizes Ca(v)3.2 T-type Ca(2+) channels, leading to facilitation of somatic and visceral nociception, and that CSE-derived endogenous H(2)S participates in inflammatory pain. Here, we show novel evidence for involvement of the endogenous H(2)S-Ca(v)3.2 pathway in neuropathic pain. In the rat subjected to the right L5 spinal nerve cutting (L5SNC), a neuropathic pain model, i.p. administration of dl-propargylglycine (PPG) and beta-cyanoalanine, irreversible and reversible CSE inhibitors, respectively, strongly suppressed the neuropathic hyperalgesia/allodynia. The anti-hyperalgesic effect of PPG was reversed by intraplantar administration of NaHS, a donor for H(2)S, in the L5SNC rat. Intraplantar administration or topical application of mibefradil, a T-type Ca(2+) channel blocker, reversed hyperalgesia in the L5SNC rat. The protein levels of Ca(v)3.2, but not CSE, in the ipsilateral L4, L5 and L6 dorsal root ganglia were dramatically upregulated in the L5SNC rat. Finally, silencing of Ca(v)3.2 in DRG by repeated intrathecal administration of Ca(v)3.2-targeting siRNA significantly attenuated the neuropathic hyperalgesia in the L5SNC rat. In conclusion, our data suggest that Ca(v)3.2 T-type Ca(2+) channels in sensory neurons are upregulated and activated/sensitized by CSE-derived endogenous H(2)S after spinal nerve injury, contributing to the maintenance of neuropathic pain. We thus propose that Ca(v)3.2 and CSE could be targets for the development of therapeutic drugs for the treatment of neuropathic pain.

Relapsing polychondritis (RP) is characterized by inflammation and subsequent degeneration of cartilage. We report a 61-year-old woman who had RP with audio-vestibular manifestations. She was also diagnosed as having a myelofibrosis with myeloid metaplasia (MMM). Bilateral endolymphatic hydrops (EH) was confirmed by dominant -SP/AP of the electrocochleogram (ECochG). When thalidomide and prednisolone were prescribed for the treatment of MMM, symptoms of RP -- including the inner ear dysfunction -- were ameliorated. Isosorbide, one of the osmotic diuretics commonly used for the treatment of Meniere's disease (MD) in Japan, was also effective in keeping her free from inner ear dysfunction. This is the first report to confirm the existence of EH in a patient with RP with audio-vestibular manifestations. We suppose that an immunological imbalance due to MMM, in conjunction with a specific immunogenetic background, may have played a role in the pathogenesis of RP and the formation of EH in this patient.

One-hundred and four patients with previously untreated tongue cancer seen in our department between 1986 and 1998 were enrolled in a clinical study. The DNA ploidy patterns observed in fresh frozen specimens obtained from 41 patients were analyzed, and prognostic factors were investigated. According to the TNM classification (UICC 1997), 43 patients had stage I tumors, 29 had stage II tumors, 17 had stage III tumors, and 15 had stage IV tumors. The 5-year cause-specific survival rates for each stage were 94.7%, 64.4%, 50.0% and 45.7%, respectively. The most frequent cause of death associated with the original disease was the recurrence of the disease in cervical lymph nodes (19/27, 70.4%). The occurrence of late cervical metastasis was high among patients with a T2N0 disease. Patients with stage II disease should undergo elective neck dissection or be carefully monitored using ultrasonography. Among the 41 cases in which the DNA ploidy pattern was analyzed, diploid patterns were found in 30 cases and aneuploid patterns were found in 11. The 5-year cause-specific survival rate and the 5-year locoregional control rate were significantly lower for the aneuploid cases (18.2%, 38.9%) than for the diploid cases (66.5%, 69.8%) (p = 0.0003, p = 0.0339). The incidence of distant metastasis was significantly higher among the aneuploid cases (6/11, 54.5%) than among the diploid cases (3/30, 10.0%) (p = 0.0058). The ploidy pattern, as determined by flow cytometric DNA analysis, may reflect the malignancy grade of tongue cancers.

A 35-year-old man who underwent canal down operation for a left middle ear cholesteatoma 30 years earlier, suffered from meningitis. He also developed hoarseness and dysphagia while he was hospitalized. CT and MRI scans showed a mass causing these syndromes. To control infection by Pseudomonas aeruginosa and to confirm the focus of infection, we planned a two-stage operation. We first removed a part of the cholesteatoma and left a drainage tube.After irrigation through the drainage tube and antibiotics therapy for two months, he underwent a second operation to remove the cholesteatoma completely without leakage cerebrospinal fluid.

A 47-year-old woman complaining of a sore throat was referred to our hospital. Previously, the patient had been operated on twice for parapharyngeal tumors in other locations. Magnetic resonance imaging of the area revealed a well-defined round mass in the parapharyngeal lesion that was surgically removed. Histopathological analysis of the surgical specimen revealed a hemangiopericytoma. Subsequently, the tumor recurred twice over the next six years, and multiple distant metastasis, including lung, liver and bone, proved to be fatal. Autopsy specimens from each metastasis lesion showed homogeneous cells of markedly different grades, suggesting that the process of tumor evolution and progression can generate biological diversity, and that the parent tumor is heterogeneous.In conclusion, this clinical course is useful for suggesting biological diversity in the primary tumor.

We report a case of bilateral chylothorax following left modified neck dissection, which is a rare operative complication of neck surgery.A 69-year-old woman presented left neck mass three months after a local excision of tongue carcinoma. We performed a left modified neck dissection without injury to the thoracic duct and there was no evidence of chylous fistula of the neck postoperatively. On the fourth postoperative day she complained of general fatigue and mild dyspnea. A chest X ray examination showed massive left pleural fluid.We diagnosed bilateral chylothorax by CT scan examination and thoracentesis on the eighth postoperative day. Pleural effusion decreased after fasting and removal of the suction drainage tube at the supraclavicular region that possibly disturbed the thoracic duct. Thus, we treated the patient conservatively following previously reported cases.

We report a pseudo-malignant Warthin's tumor with inflammatory changes. A 25 year-old man had been complaining of a painless right sub-auricular swelling for 2 years and 6 months. On examination, there was a 3.5×3.5cm firm mass in the right parotid region, fixed deeply but not to the skin. There was no associated lymphadenopathy. Magnetic resonance imaging of the area revealed a mass of mixed intensity in the right parotid gland involving both the superficial and deep lobes and extending beyond the confines of the capsule. A clinical diagnosis of a malignant parotid tumor was made. A total parotidectomy was performed sacrificing of a buccal branch of the facial nerve. A peroperative frozen section of the tissue was read as an abscess. However postoperative histological examination showed a Warthin's tumor with severe inflammation, partial fibrosis and necrosis. There was no evidence of malignancy.

We report an extremely rare case of a pleomorphic adenoma in the ethmoid sinus. A 46-year-old woman complaining of nasal obstruction was referred to our hospital for treatment. Rhinoscopy revealed a pink-gray tumor in the right nasal cavity. It was resected surgically via a lateral Rhinotomy approach under general anesthesia. The tumor was found to arise from the posterior ethmoid sinus. Histologically, it was diagnosed as a pleomorphic adenoma.In Japan, there have been only two other case reports of pleomorphic adenoma definitely diagnosed in the ethmoid sinus.

Objective To investigate the relation between the vestibular system and vasopressin (AVP). Material and methods We examined the effects of electrical and caloric vestibular stimulation on plasma AVP levels in anesthetized rats. Plasma AVP levels of patients with intractable Meniere's disease who were subjected to endolymphatic drainage and steroid instillation surgery (EDSS) or intratympanic gentamicin (GM) injection were measured before and after these interventions. Results Electrical vestibular stimulation increased plasma AVP levels in a current intensity-dependent manner. Plasma AVP levels were also increased by caloric stimulation with cold water. Plasma AVP levels decreased rapidly after EDSS, and were maintained at a low level even 6-12 months following EDSS or intratympanic GM injection. Conclusions Vestibular activation or inhibition-induced imbalance of intervestibular activities increased plasma AVP levels in rats. Therefore, vestibular disorder would seem to increase plasma AVP and thus worsen endolymphatic hydrops. EDSS rapidly decreased plasma AVP and would seem to reduce hydrops. Inhibition of vertigo spells by EDSS or intratympanic GM injection would reduce a possible stress response, resulting in a decrease in plasma AVP levels a long time after the treatments. This resultant decrease in AVP would beneficially inhibit the formation and/or maintenance of hydrops and thus prevent vertigo spells.

When treating dizzy patients, the psychiatric aspect should be carefully addressed regardless of whether a well-defined organic disease is present. In this prospective study, we aimed to elucidate the role of paroxetine, a selective serotonin reuptake inhibitor, in the treatment of dizziness.Forty-seven patients who complained of dizziness were treated with 20 mg of paroxetine per day. The depressive state of the patient was evaluated by the Zung Self-Rating Depression Scale (SDS). Treatment outcomes were measured with self-assessment of subjective handicaps in daily life using a dizziness and unsteadiness questionnaire. The questionnaire consisted of five factors related to emotional or bodily dysfunction that could be affected by dizziness. Changes in Self-Rating Depression Scale scores and subjective handicaps were assessed at 4 and 8 weeks after the start of paroxetine.In patients having well-defined organic diseases with high Self-Rating Depression Scale scores, paroxetine improved all five subjective handicap factors as well as Self-Rating Depression Scale scores. The decline in Self-Rating Depression Scale scores showed a significant correlation with improvement of subjective handicaps, which was related to emotional problems but not factors related to bodily dysfunction. Paroxetine was also effective for an improvement of factors related to emotional problems and Self-Rating Depression Scale scores in patients not having organic diseases but with high Self-Rating Depression Scale scores. In patients either with or without organic diseases with low Self-Rating Depression Scale scores, paroxetine had no effect on any subjective handicap factors and Self-Rating Depression Scale scores.In the treatment of dizzy patients, paroxetine was effective at relieving subjective handicaps caused by dizziness, specifically, in patients with high Self-Rating Depression Scale scores.

A 54-year-old woman complained of positional vertigo. During 3 months’ observation, the patient showed mostly geotropic or apogeotropic nystagmus due to right canalolithiasis or cupulolithiasis, however, she sometimes showed nystagmus which suggested left horizontal canalolithiasis. We suspected that she suffered from bilateral horizontal canal type benign paroxysmal positional vertigo (BPPV) and performed Lempert’s maneuver for both directions, however, they were ineffective. She underwent canal plugging for right horizontal canal. After surgery she showed no positional nystagmus of right horizontal canal origin. However, apogeotropic nystagmus of the left horizontal canal origin was still observed. This nystagmus changed to geotropic nystagmus and finally disappeared following Lempert’s maneuver for the left side. Bilateral horizontal canal BPPV is difficult to be resolved, probably because physical treatment for one side would move debris to the cupula in the other canal. Canal plugging combined with Lempert’s maneuver to the other side is one treatment option for intractable bilateral horizontal canal BPPV.

Space Environment Reliability Verification Integration System (SERVIS) project aims at establishing technologies for high performance and low cost satellite system and components with stateof-the-art commercial parts. New Energy and Industrial Technology Development Organization (NEDO) has entrusted the development of the SERVIS to Institute for Unmanned Space Experiment Free Flyer (USEF). Two verification satellites, SERVIS-1 and -2 will be launched in 2003 and 2006, respectively. CRAFT is an autonomous fault tolerant computer developed as one of the experimental equipment for SERVIS-2 satellite. It incorporates advanced commercial parts and commercial technology in order to realize high performance, small size and light weight component with low cost. CRAFT is being developed in order to built low cost satellite bus system. It will realize high reliability data handling system with high performance and low cost commercial devices by exploiting unique fault tolerant technology, which has higher reliability than majority voting system.

We have developed a star sensor with a short baffle of 140 mm. Our baffle provides a Sun rejection angle of 35 degrees with stray light attenuation less than the intensity level of a visual magnitude of Mv = +5 for a wide field of view lens of 13x13 degrees. The application of a new light shielding technique taking advantage of total internal reflection phenomena enables us to reduce the baffle length to about three fourths that of the conventional two-stage baffle. We have introduced two ideas to make the baffle length shorter. The one is the application of a nearly half sphere convex lens as the first focusing lens. The bottom surface reflects the scattering rays with high incident angles of over 50 degrees by using the total internal reflection phenomena. The other is the painting of the surface of the baffle with not frosted but gloss black paint. The gloss black paint enables most of the specular reflection rays to go back to outer space without scattering. We confirm the baffle performance mentioned above by scattering ray tracing simulation and a light attenuation experiment in a darkroom on the ground.

Metastatic disease to the parotid gland is rare and its diagnosing procedures are not established. We assessed several parameters, including the prior history of malignancy, fine needle aspiration cytology (FNAC) and magnetic resonance (MR) imaging and determined the most useful combinations for diagnosing metastatic parotid tumors. The primary tumors were squamous cell carcinomas of the eyelid, larynx, tonsil and of unknown origin, malignant melanoma of the auricle and small cell lung carcinoma. In three of four patients with parotid lymph node metastasis who underwent MR imaging, rim enhancement of the tumor was observed on gadolinium (Gd)-enhanced fat-suppressed T1-weighted MR images (sensitivity 75%). In the histopathologic examinations, the tumor was encapsulated and massive infiltration of normal lymphocytes was found peripheral to the capsule. These were not seen in the patients with metastasis to the parotid parenchyma via hematogeneous dissemination or with advanced-stage parotid node metastasis. The FNAC diagnosis accorded with the tumor histology in five of six patients (sensitivity 83%). Three of the six patients had a prior history of malignancy in other sites (sensitivity 50%). The triad of FNAC, prior history of malignancy and enhanced MR images was identified as the combination most useful in the diagnosis of metastatic parotid tumors (sensitivity 100%).

We surgically treated a 75-year-old man who suffered from metastatic adenocarcinoma from the colon associated with primary thyroid lymphoma measuring 1 cm maximum in diameter. Radiologic findings were correlated with histopathology of excised specimens. Ultrasonography could discriminate between these two tumors based on the margin characteristics and the lesion echogenicity: the metastatic tumor was shown as an ill-defined hypo to iso echoic mass, while the malignant lymphoma was detected as a well-defined markedly hypoechoic mass. In addition, we could confirm that early-stage primary thyroid lymphoma even as small as 1 cm shows the same radiologic appearance as that of a bulky lymphoma.

Background. To explore the flow cytometric diagnosis of malignant lymphoma, we examined the deoxyribonucleic acid (DNA) ploidy, proliferative activities, and immunophenotype of surgical biopsy- and fine-needle aspiration (FNA)-derived materials. Our goal was to determine the possibility of making a diagnosis of malignant lymphoma by flow cytometric analysis of FNA-derived materials. Methods. The DNA ploidy and proliferative indices including the percentage of S-phase fraction (SPF), G2 + M fraction (G2M), and Ki-67-positive fraction (Ki-67) were analyzed on the fresh materials from 84 consecutive patients with suspected malignant lymphoma. Flow cytometric analysis of surface antigens was simultaneously performed. Fourteen of the patients underwent FNA and subsequent surgical biopsy of the same lymph nodes for flow cytometric analysis. Results. The proliferative indices of intermediate-grade non-Hodgkin's lymphomas (NHL) (n = 28) and high-grade NHL (n = 23) were significantly higher than those of the reactive hyperplasia (n = 25). The total for SPF + G2M of 6% was a satisfactory threshold for differentiating these NHL from reactive hyperplasia (sensitivity of 84%, specificity of 88%, and accuracy of 86%). However, low-grade NHL (n=3) and Hodgkin's lymphoma (HL, n = 5) could not be discriminated by employing this parameter. DNA aneuploidy was seen in 13 of the 28 intermediate-grade NHL and 8 of the 23 high-grade NHL, whereas it was not seen in 25 reactive hyperplasia, 3 low-grade NHL, and 5 HL. The percentage of CD19-positive cells in B-cell NHL or CD3-positive cells in T-cell NHL was significantly higher compared with those for reactive hyperplasia. The percentage of CD16 + CD56-positive cells in natural killer (NK) cell NHL was extremely high, with a mean of 91.8%. Flow cytometric results for FNA-derived materials showed excellent correlation with those for surgical biopsy-derived specimens. Conclusions. Analyses of DNA ploidy, proliferative activities, and immunophenotype by flow cytometry (FCM) are useful for diagnosing intermediate- and high-grade NHL. Fine-needle aspiration is a less invasive approach than surgical biopsy, and, when combined with FCM, it may have a place in the diagnosis of NHL.

We correlated the histopathology of 32 cases of salivary gland tumors with MR imaging and flow cytometric DNA analysis. All malignant tumors were invasive and/or had an ill-defined margin. Fifty-seven percent of the pleomorphic adenomas were shown as a high signal intensity area on T2 weighted images. Fifty-six percent of Warthin tumors were shown as a low or iso signal intensity area on T2 weighted images associated with the cystic portion. Sixty-seven percent of malignant tumors were characterized by DNA aneuploidy and/or a total percentage of the S-phase fraction plus the G2 + M fraction higher than 10%. It was less than 10% and the Ki-67 positive fraction was higher than 20% in all pleomorphic adenomas. The Ki-67 positive fraction was less than 20% in 78% of Warthin tumors. The histopathology of all malignant tumors, 86% of the pleomorphic adenomas, and 89% of Warthin tumors was correctly predicted by the combination of MR images and flow cytometry. We suggest that the MR images combined with flow cytometric analysis of fine needle aspiration-derived materials is useful in the pre-operative histopathologic diagnosis of salivary gland tumors.

Water revitalization for a space station can consist of membrane filtration processes and a distillation process. Water recycling equipment using membrane filtration processes was manufactured for ground testing. It was assembled using commercially available components. Two systems for the distillation are studied; one is an absorption type thermopervaporation cell and the other is a vapor compression distiller. Absorption type thermopervaporation able to easily produce condensed water under zero gravity was investigated experimentally and through simulated calculation. The vapor compression distiller was studied experimentally and it offers significant energy savings for evaporation of water.

大阪市およびその近郊に居住し, われわれの呼吸器外来を受診, 治療された慢性非伝染性閉塞性肺疾患とくに慢性氣管支炎および肺氣腫218例につき, medical research councils committee on etiology of chronic bronchitisの調査表に準じた調査と, 一連の細菌, 血液, 血清免疫学的検討, 心肺機能, X線検査を行なつてきた. 今回はこの中年令45-65才, %FEV170%以下, 合併症のない男子49, 女子19例の成績を検討した. えられた成績は大氣汚染の影響が考慮される大阪市における慢性氣管支炎の実態を明らかにし, 男子群における成績は同時に, 最近Fletcher, Burrow. らの欧米の大都市, London, Chicago. におけるほぼ同様の検討とも対比して, 大都市のこれら慢性非伝染性肺疾患の病像には多くの共通点のみられること, および地理的, 社会的, 人種的要約に支配される差異を認め報告した.

A prospective, open-label clinical trial was conducted for two aims: first, to evaluate the role of fluvoxamine, one of selective serotonin reuptake inhibitors, in the treatment of dizziness for the first time and to investigate its effective mechanisms. Second, to test the hypothesis that dizziness in patients without abnormal neuro-otologic findings would be induced by psychiatric disorders rather than by unnoticed neuro-otologic diseases. Nineteen patients with neuro-otologic diseases (Group I) and 22 patients in whom standard vestibular tests revealed no abnormal findings (Group II) were treated by fluvoxamine (200 mg/day) for eight weeks. Subjective handicaps due to dizziness using a questionnaire, anxiety and depressive symptoms measured with the Hospital Anxiety and Depression Scale (HADS), and stress hormones (vasopressin and cortisol) were examined before and 8 weeks after treatment. Overall, fluvoxamine decreased subjective handicaps of both Groups I and II. Fluvoxamine decreased HADS of only patients whose subjective handicaps were reduced (=responders) in both groups, suggesting that fluvoxamine was effective for dizziness via psychiatric action rather than a recovery of vestibular function through serotonergic activation. In non-responders of Group II, pre-treatment HADS was higher than in Group I non-responders and it was not decreased by the treatment, suggesting that dizziness of Group II non-responders was due to severe psychiatric disorders rather than unnoticed neuro-otologic diseases. Anxiety and depression components of HADS showed a good correlation at both pre- and post-treatment periods. No post-therapeutic decrease was observed in either vasopressin or cortisol even in responders, suggesting that dizziness was not the sole cause of stress in chronic dizziness patients. In conclusion, patients with or without physical neuro-otologic deficits who report chronic dizziness accompanied by anxiety and depression (as measured by HADS) showed improvements across a full range of subjective handicaps and psychological distress, while patients with physical neuro-otologic defects and minimal anxiety or depression did not benefit. The main causes of dizziness in patients without physical neuro-otologic findings were psychiatric disorders.

Background Leukocytosis without infection in patients with malignancies is known as the leukemoid reaction. The mechanisms involved in this phenomenon remain uncertain. Methods We describe the clinical, biochemical and immunohistochemical findings in a patient with recurrent tongue carcinoma accompanied by marked leukocytosis as high as 96200/mm3. Results The serum granulocyte colony stimulating factor (G-CSF) concentration was increased to 204 (normal: < 30) pg/ml, which paralleled to the elevation of white blood cell (WBC) count and the tumor growth. The G-CSF content of the tumor tissue was also elevated (131 pg/mg protein) compared to that in control patients (6.63±2.63 pg/mg protein). Production of G-CSF from the tumor was evidenced by immunohistochemical staining with monoclonal antibody against human recombinant G-CSF. Conclusions We suggest that the G-CSF production of the tumor participates in the mechanisms of the leukemoid reaction. © 1997 John Wiley & Sons, Inc. Head Neck19: 251–356, 1997.

The radiation seemingly associated with the Gross and Bernstein dispersion relation for plasma oscillation in a static magnetic field was found. Measurements were made, using a 3 cm microwave radiometer, on extraordinary waves radiated from the plasma perpendicularly to the applied magnetic field. Data, presented graphically, agreed with theoretical results. When the p-type radiations existed, the cyclotron radiation power was several decibels above the level of black body radiation. (L.N.N.)