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A dispersion spectrum in a 3.2 Tbit/s waveform generation was controlled / compensated by a 200 GHz optical frequency comb synthesizer and optical frequency comb analyzer simultaneously.

The authors studied 23 patients with cerebellar degeneration including multiple systemic atrophy (MSA) and cerebellar cortical atrophy (CCA) by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS allowed noninvasive measurement of the signal intensities derived from N-acetylaspartate (NAA), creatine + phosphocreatine (CRE), and choline-containing compounds (CHO). There was significant reduction of the NAA/CRE level in the frontal cortex, putamen, cerebellar hemisphere and cerebellar vermis of patients with MSA, and in the frontal cortex, cerebellar hemisphere and cerebellar vermis of patients with CCA as compared with those of normal controls. There was significant reduction of the NAA/CRE level also in the putamen of patients with MSA as compared with that of patients with CCA. These results indicated the presence of a degenerative process and/or functional impairment in the frontal cortex and putamen of patients with MSA and in the frontal cortex of patients with CCA, in addition to a degenerative process in the cerebellum. There was a significant correlation between the NAA/CRE level and the severity of clinical signs. 1H-MRS is valuable in providing information regarding the pathophysiology and the progress of cerebellar degenerative diseases.

Generally, an infant with impaired hearing meets many difficulties in the process of growing up. A patient with bilateral atresia of the ear (first and second branchial arch syndrome) was followed over a long period of time. The patiant was fitted with a hearing aid in the right ear initially. External canalplasty was subsequently performed, and we were able to fit her with binaural hearing aids. After the operation, based on the consults of a questionaire, she reported to enjoy having a conversation with her friends. Binaural hearing was a decided improvement on the previous situation. Sound lateralization ability was measured by a self recording apparatus (Rion Co., TD-01). This test demonstrated that both the air (fitting of the binaural hearing aids) and bone sound lateralization abilities were close to those in normal subjects.

Five patients with sensorineural hearing loss, who harbored a point mutation in the mitochondrial transfer RNA (tRNA) gene tRNA(Leu) (UUR), from five unrelated family pedigrees were examined. In these families diabetes and deafness were maternally inherited. Bilateral hearing was more severely impaired at higher frequencies. Audiometric test results revealed that hearing loss involved the cochlea. Hearing gradually deteriorated; the progression rate ranged from 1.5 to 7.9 dB per year. Proportion of mutant mitochondrial DNAs (mtDNAs) in the leukocytes was not related to the rate or degree of hearing loss, although hearing loss appeared at a younger age in patients with higher heteroplasmy. We speculate that after the proportion of damaged mtDNAs, mostly as a result of mutation, exceeds the expression threshold for deficiencies in mitochondrial protein synthesis and oxygen consumption, a drop in adenosine triphosphate level could lead to an imbalance of ion concentration, resulting in cell death in the cochlea.

Two cases of temporal bone metastasis by hypopharyngeal carcinomas are reported. One patient was a 43-year-old Japanese male who developed palsy of left oculomotor, trochlear, trigeminal, abducens and facial nerves. Carcinoma infiltrated the petrous portion of the left temporal bone. Tumor had destroyed a part of the facial canal and invading tumor cells were in contact with the perineurium. The other patient was a 59-year-old male who had no obvious facial nerve or otologic symptoms during the clinical course of his disease. Postmortem findings showed that carcinoma had invaded the right temporal bone and had produced extensive destruction of the facial canal. Degenerative findings were evident in the nerve. In the cases presented here, tumor resulted either from metastatic lymph nodes or had invaded through the suture of the temporal and sphenoid bones around the foramen lacerum to the middle cranial fossa and then infiltrated the temporal bone.

ウェーブレット変換を用いたe-OAE波形解析手法を考案し, 正常聴力耳における対側耳白色雑音負荷前後のe-OAE波形の変化を検討した。 500Hz-3000Hzの間の6つの中心周波数におけるウェーブレット変換での検討で, 負荷音圧にほぼ比例した振幅低下と位相前進を認めた。 また, 雑音負荷によって逆に振幅が増大する例, 同一耳・同一周波数帯域でも時間域により振幅・位相変化の特性が異なる例を認めた。 これらは, ウェーブレットを用いた手法の有効性を裏付けると共に, 遠心線維の作用・e-OAEに対するactive processの関与について, 新たな知見を加えるものであると考察した。

We propose a novel optical dispersion measurement system using dual-heterodyne mixing to measure the relative phase. The system can realize parallel measurement of the relative phases between adjacent frequencies by introducing optical modulators to generate optical sidebands from a laser light source and an arrayed waveguide grating to separate the sidebands. To realize a wide dispersion range, different frequency intervals for the adjacent frequencies were combined in the system. One is the three-frequency optical dispersion measurement system (three-frequency measurement), which has been developed to measure the relative phase between adjacent peaks of an optical frequency spectrum with intervals of 25 GHz generated without any frequency scanning. The other is the four-frequency optical dispersion measurement system (four-frequency measurement) with intervals of 2 GHz generated from the three-frequency sets to expand the measurement range. The experimental results using single-mode optical fibers of different lengths from 0 to 90 km indicated the dispersion slope to be 16.8 ps/nm/km with a measurement range of 2500 ps/nm and an uncertainty of less than 1 ps/nm. The proposed system provides advantages to enable parallel measurement on a frequency axis without a high-speed (GHz) photodetector, even though GHz spacing on the optical scale is used, thus reflecting the dual-heterodyne mixing.

We studied the MRI findings of 2 desmoid tumors in the supraclavicular fossa. One case was a 30 year-old woman and another was a 22 year-old man. The Tumor of Case 1 consisted almost totally of collagen fibers and showed a low signal intensity in both T1 and T2-weighted images. In comparison, the tumor of case 2 was found to be more hypercellular, similar to a benign fibrous histiocytoma. The intensity of both T1-weighted and T2-weighted images of Case 2 was higher than those of Case 1. MRI was available to evaluate the extent of the tumor, but no specific signal intensity was noted.

Novel optical dispersion spectroscopy has been developed with a dynamic range of 2500 ps/nm and a resolution of < 1 ps/nm. It was realized using dual-heterodyne mixing with 25 GHz- and 2 GHz-optical frequency combs.

予後良好であった突発性難聴5症例のclick evoked otoacoustic emissions (EOAE) とdistortion product otoacoustic emissions (DPOAE) の変化について検討した。 EOAEはILO88を, DPOAEはILO92を用いて測定した。 EOAEとDPOAEは聴力レベルの回復にしたがって反応が強くなった。 5例中4例においては聴力レベル相応の反応が検出されたが, 1例においては初診時に聴力レベルから期待される以上の良好な反応が認められた。 DPOAEはEOAEの反応が認められない聴力レベルの難聴でも検出することができ, 周波数特性が高いため, 特に高音域の内耳機能の評価に有用であると思われた。

In magnetic resonance imaging, cerebral infarcts are depicted as hyperintensity areas on T2-weighted images, whereas old intracerebral hemorrhages appear as hypointensity areas with or with

Five patients were treated for pleomorphic adenoma of the submandibular gland: 2 males and 3 females, aged 24 to 53 years. The tumors were on the right side in 3 cases, on the left in 2. All 5 patients complained of a painless mass in the submandibular lesion. Ultrasound sonography and CT scan were useful in the diagnosis In 3 patients Ga scintigraphy showed abnormal accumulation although the histopathological diagnosis was benign tumor. It was presumed that the proliferating activity is higher in pleomorphic adenomas of the submandibular gland than in those of the parotid gland. All patients were treated surgically.

Bilateral parotid gland tumors are uncommon. We report the first known case of pleomorphic adenoma on the left and monomorphic adenoma on the right. Histologically, the left tumor had the typical features of a pleomorphic adenoma. There were many areas of epithelial tumor cells associated with typical myxoid areas. In the right tumor, the trabecular pattern contained epithelial tumor cells, and neither myxoid nor chondroid components were seen. The diagnosis was trabecular adenoma. Among bilateral parotid gland tumors, Warthins tumor is the most common, and pleomorphic adenoma is very rare. We review the literature on bilateral pleomorphic parotid gland adenomas and discuss the reason for their rarity.

An 18-year-old boy visited our clinic complaining of painful swelling of the right cheek. CT scan and angiograms revealed a hypervascular lesion in the right maxillary sinus. The tumor was removed surgically under general anesthesia. Microscopic examination revealed histologic features compatible with angiofibroma. The reported cases of extranasopharyngeal angiofibroma are reviewed, and the pathogenesis, clinical features and treatment are discussed.

Although optimal blood pressure control is important for managing stroke patients, the use of antihypertensives in stroke patients often causes cerebral blood flow reduction leading sometimes to deterioration of symptoms. Effects of arotinolol, a β-blocker with a moderate α-blocking action, on the regional cerebral blood flow (rCBF) were investigated in 10 hypertensive patients with a history of stroke by using a noninvasive 133Xe inhalation method. The rCBF was measured before and after administration of 15 mg/day arotinolol (three times a day) for 2–3 weeks. After the administration, the blood pressure was reduced in all the patients showing a change in average values of from 176/105 mmHg to 152/90 mmHg. The rCBF in the infarcted and healthy hemispheres was 44.3 ± 4.4 and 44.6 ± 5.0 ml/100 g/min before arotinolol and 44.9 ± 6.4 and 45.3 ± 6.5 ml/100 g/min after arotinolol, respectively. No significant rCBF change was observed after arotinolol in both hemispheres. During the administration, none of the patients suffered from dizziness or other ischemic symptoms. The above results suggest that arotinolol exerts little influence on the cerebral circulation and may be useful for the management of hypertension in stroke patients.

Objective To determine whether flushing of the facial skin in response to alcohol consumption (alcohol flushing) is a warning sign of hypertension. We also sought the relationship between alcohol flushing and other risk factors that may contribute to the development of hypertension. Methods We first investigated the relationship of the aldehyde dehydrogenase 2 (ALDH2) genotype to alcohol flushing for 53 normal volunteers. We evaluated the relationships among hypertension, alcohol consumption, and facial flushing for 1011 middle-aged Japanese men (aged 40-68 years; mean 51.6 ± 5.5 years), on the basis of their responses to questionnaires and health records. Results The first examination of 53 normal volunteers showed that there were differences in the degree of alcohol flushing between the ALDH2 genotypes (P< 0.01). Hypertension was observed in 27.4% of the study population (277 of 1011), and was correlated positively to alcohol consumption (P< 0.01). The prevalence of hypertension differed significantly among these four groups: there was a 22.4% prevalence (70 of 312) among subjects with no flushing, a 33.8% prevalence (113 of 334) among those with slight flushing, a 27% prevalence (84 of 311) among those with visible flushing, and an 18.5% prevalence (10 of 54) among subjects who were almost completely intolerant to alcohol (P< 0.05). In particular, heavy drinkers who consumed ≥ 1.5 Go (a traditional Japanese unit equivalent to 27 g ethanol) a day had a high prevalence of hypertension with slight and visible skin flushing [42% (63 of 150) and 40.7% (24 of 59), respectively]. That a family history of hypertension, greater age, heavy alcohol consumption, obesity, and symptoms of intoxication including flushing were correlated significantly to the prevalence of hypertension for all groups was demonstrated by multiple logistic regression analysis (P

Auditory function after gamma knife stereotactic radiosurgery (GK) was evaluated in 22 patients with newly diagnosed unilateral acoustic neurinoma who had had some measurable hearing preoperatively. No tumor growth was observed in any patients. The preservation rates for useful hearing (n = 13) and any measurable hearing (n = 22) were 62% and 86%, respectively, at 2 years after GK. Postoperative hearing dysfunction was attributed to progressive cochlear impairment in 13 patients and to progressive injury in the retrocochlear auditory pathway in 5 patients. Hearing tended to be well preserved when caloric response was unchanged postoperatively. Preservation of hearing was not associated with the initial tumor volume, decrease of tumor size, maximum tumor dose, or peripheral tumor dose.

We report on two patients who showed absence of auditory brainstem response (ABR) but broad compound action potentials on electrocochleograms and almost normal otoacoustic emissions, together with absence of caloric response and preservation of per rotatory nystagmus for both ears. Patient 1, a 53-year-old woman, had noted auditory and vestibular problems since the age of 15 years, and Patient 2, a 68-year-old woman, had noted problems of the same age of 30 years. They could hear words and understand sentences if spoken slowly, but they could not discriminate monosyllables very well. Their auditory examinations disclosed mild threshold elevation in pure-tone audiometry and markedly poor scores in speech audiometry and good scores in auditory comprehension test. They were diagnosed as having auditory nerve disease of unknown cause.

Abstract We examined the relation between in vivo thrombogenicity and the morphology of carotid lesions to clarify the role of platelet deposition in carotid atherothrombosis. We evaluated 60 subjects (120 carotid bifurcations) who had at least one established risk factor for atherosclerosis by using indium 111 platelet scintigraphy and high-resolution B-mode ultrasonography. We evaluated platelet accumulation in the carotid arterial wall by means of a dual-tracer method that used In 111–labeled platelets and technetium 99m–labeled human serum albumin. The tracer accumulation was assessed both visually and semiquantitatively by using the platelet accumulation index, ie, the ratio of radioactivity of the amount of In 111–labeled platelets deposited on the vascular wall to the amount of radioactivity in labeled platelets circulating in the blood pool. The morphology of the carotid lesions was analyzed with B-mode ultrasonography in terms of the presence of ulceration, the maximum percent stenosis, the echogenicity of plaque, and the plaque score, which indicates the severity of systemic atherosclerosis. Platelet accumulation increased with increase in plaque score ( P P r =.28, P r =.42, P

The goal of this study was to elucidate the association between the development of periventricular white matter lucency and autoregulation of cerebral blood flow in hypertensive patients through the arteriovenous oxygen saturation difference method. We studied 51 hypertensive patients who had previously suffered from minor strokes (lacunar infarction, 43; deep basal minor hemorrhage, 8). Patients were divided into three groups based on the findings of periventricular white matter lucency. We measured the absolute value of resting cerebral blood flow using the argon inhalation method, and stepwise reduction of blood pressure was obtained with patients on a tilting table. Intracerebral venous blood sampling was accomplished by direct cannulation into the jugular vein up to the jugular bulb. We calculated several cerebral circulatory parameters, such as cerebrovascular resistance and cerebral oxygen consumption, and also delineated individual autoregulation curves. Cerebrovascular resistance was significantly greater in patients with severe periventricular white matter lucency than in patients without it (P < .05). Impaired autoregulation was also significantly more prevalent in patients with more severe periventricular lesions (P < .05). Multiple regression analysis revealed that the impaired autoregulation was significant and an independent determinant of the severity of such periventricular lesions (R = .34, P < .05). In conclusion, our findings indicated that hypertensive patients with severe periventricular white matter lucency were more likely to have impaired autoregulation of cerebral blood flow and suggest that stricter blood pressure control is required in such patients to prevent deterioration of the cerebral microcirculation.

Hemispheric mean cerebral blood flow (CBF), together with its CO2 reactivity in response to hyperventilation, was investigated in 18 patients with transient ischemic attacks (TIAs) by intraarterial 133Xe injection method in a subacute-chronic stage of the clinical course. In 8 patients, the lesion responsible for symptoms was regarded as unilateral internal carotid artery (ICA) occlusion, and in 10 patients, it was regarded as unilateral ICA mild stenosis (less than 50% stenosis in diameter). Resting flow values were significantly (P less than 0.05) decreased in the affected hemisphere of TIA due to the ICA occlusion as compared with the unaffected hemisphere of the same patient, regarded as the relative control. It was not decreased in the affected hemisphere of TIA due to the ICA mild stenosis as compared with the control. With respect to the responsiveness of CBF to changes in PaCO2, it was preserved in both TIAs, due to the ICA occlusion and ICA mild stenosis. Vasoparalysis was not observed in either types of TIAs in the subacute-chronic stage. However, in the relationship of blood pressure and CO2 reactivity, expressed as delta CBF(%)/delta PaCO2, pressure-dependent CO2 reactivity as a group was observed with significance (P less than 0.05) in 8 cases of TIA due to the ICA occlusion, while no such relationship was noted in 10 cases of TIA due to the ICA mild stenosis. Moreover, clinical features were different between TIAs due to the ICA occlusion and ICA mild stenosis, i.e., more typical, repeatable TIA (6.3 +/- 3.7 times) with shorter duration (less than 30 minutes) was observed in TIAs due to the ICA mild stenosis, while more prolonged, less repeatable TIA (2.4 +/- 1.4 times) was observed in TIAs due to fixed obstruction of the ICA. From these observations, two different possible mechanisms as to the pathogenesis of TIA might be expected, e.g., TIA of microembolic origin due to the ICA mild stenosis, and TIA of hemodynamic origin due to fixed obstruction of the ICA, for whom the bypass surgery might be beneficial, i.e., all TIAs are not based on the same mechanism.

Bi-hemispheric cerebral blood flow (CBF) measurements during rest and hyperventilation, with intra-arterial 133Xe injection method, were investigated in 19 cases, angiographically diagnosed as unilateral internal carotid artery (ICA) occlusion, including 8 cases with TIAs and 11 cases with completed strokes as the onset. Indices of cerebral vascular resistance and CO2 reactivity with decreasing arterial PCO2 were also investigated. A significant decrease (P less than 0.05) of hemispheric mean CBF was noted in the ischemic hemisphere, but normal flow values in the unaffected hemisphere and preserved CO2 responsiveness during hyperventilation were observed in both the affected and unaffected hemispheres in patients with TIAs. Moreover, a direct relationship between CBF and blood pressure, observed in 11 cases with completed strokes, was not recognized in 8 cases with TIAs. A degree of the abnormalities of the affected hemisphere in cerebral circulation was suggested to be somewhat different between TIAs and completed strokes in ICA occlusions, and bi-hemispheric CBF measurements would be an useful method for evaluating the various indices of the CBF in ICA occlusions.

The contribution of hematocrit (Ht) changes on cerebral blood flow (CBF) and brain oxygenation in ischemic cerebrovascular disease is still controversial. In the present study, effects of Ht variations on CBF and oxygen delivery were investigated in patients with ischemic cerebrovascular disease. CBF was measured by the Xe-133 intracarotid injection method in 27 patients, whose diagnoses included completed stroke, reversible ischemic neurological deficit, and transient ischemic attack. Ht values in the patients ranged from 31 to 53%. There was a significant inverse correlation between CBF and Ht in these Ht ranges. Oxygen delivery, i.e., the product of arterial oxygen content and CBF, increased with Ht elevation and reached the maximum level in the Ht range of 40–45% and then declined. The CBF-Ht and oxygen transport-Ht relations observed in our study were similar to those in the glass-tube model studies by other workers rather than to those in intact animal experiments. From these results, it is conceivable that in ischemic cerebrovascular disease, the vasomotor adjustment was impaired in such a manner that the relations among Ht, CBF, and oxygen delivery were different from those in healthy subjects. Further, an “optimal hematocrit” for brain oxygenation was also discussed.

Measurement of mobility of lumbar spine for numbers of population in Nagasaki prefecture has been conducted in this department of hygiene, using Iino's spinometer, to assess the physiological aging of community residents. A statistical analysis was carried out with the data for some of the population on the change in mobility of the lumbar spine due to aging and on the relation between the angle of lumbar spine at natural erect posture and the values of lumbar spine mobility. The subjects were farmers and fishermen consisting of 629 males and 537 females ranging in age from the 20's to the 60's. The angles of lumbar spine at flexion and extension were expressed in plus and minus signs, respectively.The results were summarized as follows:(1) The angle of lumbar spinal column in the erect position (physiological lordosis, AEP), angles at maximal flexion (AF) and at maximal extension (AE), ranges of maximal flexion (RF) and of maximal extension (RE) and total range of both motions of flexion and extension (RIFE) showed that they change with age. Significant differences were found in the range of maximal flexion and the total range of maximal flexion and extension by age and sex, decreasing with age and greater in males than in females.(2) Between each characteristic positive or negative correlationship was found to some extent.(3) After removal of the change due to the age, the following partial correlationships were found.The angle at the erect position correlated positively to the angle at the maximal flexion and negatively to the motion range in the flexion, meaning that the decrease of physiological lordosis results in the increase of the angle at the flexion, however, it results in the decrease of the motion range in the flexion. The angle at the erect position correlated positively to the angle at the extension and the motion range in the extension, meaning that the decrease in the physiological lordosis results in the increase of the angle and the motion range in extension. However, the angle at the erect position correlated negatively to the total flexion-extension range, suggesting that the decrease of the physiological lordosis has a disadvantageous influence upon the mobility of the lumbar spine.

A case of hypopharyngeal lymphangioma is reported. A 48-year-old female visited our clinic complaining of ill-sensation in neck portion. The laryngoscopic examination revealed a gray-brown colored mass in the left pyriform sinus. Other examinations, including CT and contrast medium roentgenography, showed that the mass was located only in the pyriform sinus.Surgical removal of the mass was done by means of lateral pharyngotomy. Pathological examination revealed the cavernous lymphangioma.

The effect of small, deep ischemic lesions on the ipsilateral cortical circulation was investigated in 10 patients with persistent mild or moderate neurological deficits due to infarcts in the internal capsule. rCBF studies by the 133Xe intracarotid injection method were performed 14-180 days after the onset of the infarction. The rCBF functional image was made up from the data of 133Xe dynamic images measured by an Anger-type gamma camera and the rCBF values were calculated by the initial slope method. The average value of mean rCBFs (mCBF) in 10 patients was 44.9 +/- 7.1 ml/100g/min (average PaCO2; 39.9 +/- 4.3 mm Hg). In the rCBF functional images, a focal hypoperfusion area was observed in all cases and localized around the central sulcus, especially in the precentral and central areas. Significant decreases of mCBF and the tendency to decrease of the rCBFs in the hypoperfusion focus were noted in the patients with the larger infarcts in comparison with those with the smaller ones. These results suggest that a small, deep ischemic lesion such as a capsular infarct may have remote effects on the ipsilateral cortical circulation, due probably to the damage of a number of fibers passing through the lesion.

Information concerning the effectiveness of superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis on cerebral blood flow (CBF) and its CO2 reactivity is still limited and incomplete, and an objective assessment of the postoperative effects on cerebral hemodynamics of the procedure in inaccessible occlusive carotid artery disease is needed. In this study, our initial experience concerning the pre- and postoperative CBF measurements, together with CO2 reactivity in patients undergoing STA-MCA anastomosis, is reported.

The purpose of this study is to develop a useful gamma camera system for atraumatic rCBF measurement by the 133Xe intravenous injection (i.v.) method. A super high sensitivity slant hole (SHS-SL) collimator was designed for this purpose. The gamma camera used with this collimator was able to move close to the patient's head and obtain satisfactory count rates (130 kcpm-178 kcpm in a hemisphere) with a low dosage (10 mCi) of 133Xe. To validate this rCBF measurement system three studies were carried out: a comparative evaluation was performed against the flow values with the intracarotid 133Xe injection (i.c.) method, reproducibility of flow values was assessed from two serial i.v. measurements, and flow values were compared with clinical severity of the patients. The comparative study showed good correlation in the hemispheric and regional values between the two methods; r values 0.98 and 0.64-0.93 for gray matter flow and 0.96 and 0.78-0.93 for initial slope index. In the reproducibility study, the variation coefficients in the hemispheric and regional values between the two serial measurements were 5.0% and 7.3%-14.2% for gray mater flow, 5.2% and 7.9%-12.9% for initial slope index. The reproducibility in this study was as good as those with the i.c. method reported previously. The hemispheric flow values from our gamma camera system correlated well with the clinical severity of cerebrovascular disease. These results show that the gamma camera system with the SHS-SL collimator is useful for atraumatic rCBF measurement.

This study was conducted to examine the effect of the intramuscular injection of levallorphan tartrate (1.0 mg), a mixed agonist-antagonist opiate, on the neurological signs, symptoms, and vital signs in 19 patients with acute ischemic stroke. A temporary improvement of hemiplegia or hemiparesis was observed within several minutes after levallorphan injection in 13 of the patients. There were no significant alterations in blood pressure or pulse rate after injection. The findings indicate that levallorphan may have a temporary improving effect on neurological deficits in acute ischemic stroke. In addition, observation of the response to levallorphan may serve to predict the prognosis of the final neurological outcome in this type of patient.