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ABSTRACT: Objective. To study the clinical and pathological characteristics of patients with organized hematoma with malignant features in maxillary sinuses. Subjects and Methods. This was a retrospective study of five patients who were treated surgically for organized hematoma. The preoperative CT and MRI findings were studied clinically. The expressions of CD31, CD34, and periostin in surgical samples were investigated by immunohistochemistry. Results. The clinical features of organized hematoma, such as a mass expanding from the maxillary sinus with bone destruction, resembled those of maxillary carcinoma. However, CT and MRI provided sufficient and useful information to differentiate this condition from malignancy. Surgical resection was the first-line treatment because of the presence of a firm capsule. Characteristic histopathological findings were a mixture of dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Conclusion. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Organized hematoma is characterized pathologically by a mixture of bleeding, dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. CT and MRI show heterogeneous findings reflecting a mixture of these pathological entities.
International Journal of Otolaryngology 01/2013; 2013:539642.
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ABSTRACT: Immunoglobulin G4 (IgG4)-related sclerosing sialadenitis is a recently recognized disease entity characterized by high serum IgG4 concentration and IgG4-producing plasma cell expansion in affected organs, which show fibrotic or sclerotic changes. However, little is known about the roles of CD4+ and CD8+ T cells or interleukin (IL)-17 in this disease. The purpose of this study was to evaluate the characteristics of CD4+ and CD8+ T cells and IL-17 in patients with IgG4-related sclerosing sialadenitis.
A retrospective clinical study at the Yamagata University School of Medicine.
The patient group consisted of six males and four females with an average age of 57.9 years (range, 38 to 73years). Subsets of T helper (Th)1, Th2, T cytotoxic type (Tc)1, and Tc2 cells from patients with IgG4-related sclerosing sialadenitis were examined by using intracellular cytokine flow cytometry. Expression of IL-17 in the patients' lesions was also investigated immunohistochemically.
Six patients with IgG4-related sclerosing sialadenitis with high ratios of IgG4/IgG and prominent infiltration of IgG4-positive plasmacytes in the involved salivary glands had systemic complications, including pancreatitis, retroperitoneal fibrosis, and/or inflammatory pseudotumor of the lung after the initial swelling of the salivary glands. Populations of Th1 and Tc1 cells were significantly greater in IgG4-related sclerosing sialadenitis than in the controls (P < .05), but Th2 and Tc2 cell populations were not significantly increased. Expression of IL-17 was observed in the lesions of affected patients.
Increases in Th1 and Tc1 cell populations and IL-17 expression might be involved in the mechanism of pathogenesis of IgG4-related sclerosing sialadenitis. Laryngoscope, 2012.
The Laryngoscope 07/2012; 122(10):2169-74. · 1.75 Impact Factor
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ABSTRACT: The efficacy of combined high-dose steroid and PGE1 treatment initiated immediately after the onset of sudden deafness was analyzed with the outcome of 174 patients begun on treatment within 7 days of the onset of sudden deafness. Four potential prognostic factors (days from onset to treatment, age, initial hearing level, presence of vertigo) and hearing outcome were examined with a multiple logistic regression analysis. Days from onset to treatment and age significantly correlated with hearing improvement. The efficacy of the treatment of patients begun on treatment within 3 days of the onset was significantly better than that of patients on treatment 4-7 days after the onset (p < 0.001). In the examination of patients younger than 50 years, the efficacy of the treatment of patients begun on treatment within 3 days of the onset didn't differ significantly from that of patients on treatment 4-7 days after the onset. On the other hand, in the examination of patients aged 50 years and older, the efficacy of the treatment of patients begun on treatment within 3 days of the onset was significantly better than that of patients on treatment 4-7 days after the onset (p < 0.001). These results suggest that significant efficacy may be expected from the combined high-dose steroid + PGE1 treatment, if its use is started within 7 days of the onset of sudden deafness, and started within 3 days of the onset of sudden deafness in patients 50 years old and older.
Nippon Jibiinkoka Gakkai Kaiho 05/2012; 115(5):540-5.
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The Laryngoscope 01/2012; 122(1):131-3. · 1.75 Impact Factor
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ABSTRACT: We present the case of a dermoid cyst with an oral and a submental component in a 21-year-old Japanese woman who presented with complaints of a mass in the oral cavity and difficulty in chewing and swallowing solid foods for about 2 years. MRI shows a 55 × 65 mm well-circumscribed cystic mass extending from the sublingual area to the mylohyoid muscle. Under general anesthesia and with nasotracheal intubation, the patient underwent surgical removal of the mass. Although the cyst was large and extending mylohyoid muscle, intraoral midline incision was performed through the mucosa overlying the swelling and the cyst was separated from the surrounding tissues with appropriate traction and countertraction and successfully removed without extraoral incision. Oral approach in surgical enucleation is useful procedure to avoid cosmetic problems in large and extending mylohyoid muscle cyst.
Case reports in otolaryngology. 01/2012; 2012:634949.
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ABSTRACT: Liposarcoma most commonly arises in the retroperitoneum and lower extremities. Liposarcoma of the head and neck region is a rare and potentially life-threatening malignancy. Those originating in the right retrocervical space cause special diagnostic and therapeutic difficulties. In present report, a case of differentiated liposarcoma of the right cervical region with intestinal carcinoid is reported. The tumor continued to grow slowly over 3 years before a definitive diagnosis was established. Extended extirpation of the tumor and modified radical neck dissection, postoperative radiotherapy followed by chemotherapy were performed and proved to be efficacious in that no recurrence was observed for 2 years. Recommendations for earlier and correct diagnosis and treatment of this rare neoplasm are discussed.
Auris, nasus, larynx 10/2010; 38(3):421-5. · 0.58 Impact Factor
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ABSTRACT: Our results confirmed that OK-432 therapy is simple, easy, safe, and effective and can be used as a substitute for surgery in the treatment of benign neck cysts. In OK-432 therapy, inflammatory cytokines may play important roles in shrinkage of the cystic spaces.
The aim of this study was to evaluate the outcome and mechanism of action of OK-432 therapy in benign neck cysts.
We tried OK-432 therapy in 83 patients with benign neck cysts between April 1997 and August 2009. We aspirated as much of the fluid content of each cystic lesion as possible, and then replaced the volume of aspirated fluid with about half the volume of OK-432 solution. We evaluated the mechanism of action of OK-432 in 43 of the patients. The intracystic fluid in the cysts was aspirated before and after OK-432 therapy, and cytokine production in each aspirate was analyzed by ELISA.
Disappearance of the lesion was observed in 63 of 83 patients (76%). Marked reduction was observed in 13 of the 83 patients (16%). Partial reduction was observed in two patients (2%) and no response was seen in five (6%). Local discomfort at the injection site and low-grade fever were side effects observed in half of the patients, but such problems resolved within a few days. No local scarring or deformity of the injected sites occurred in any patient. We performed OK-432 therapy on an outpatient basis without hospitalization. Levels of various cytokines, including tumor necrosis factor, interleukin-8, interleukin-6, interferon gamma, and vascular endothelial growth factor, were significantly elevated in each aspirate after OK-42 therapy.
Acta oto-laryngologica 05/2010; 130(11):1287-92. · 0.98 Impact Factor
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Ear and hearing 03/2009; 30(1):148-149. · 2.06 Impact Factor
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ABSTRACT: To clarify the contribution of the skull contents to the transmission of bone vibratory stimuli, and to examine the characteristics of such stimuli, we compared auditory thresholds and distortion-product otoacoustic emission (DPOAE) levels with a bone vibrator placed on various sites of the head, including the eye. The best audiometric thresholds and the highest DPOAE levels were obtained with the vibrator placed on the mastoid of the measuring side, or on the "ultrasound-window" of the temple. The audiometric thresholds obtained with the bone vibrator on the eye were similar to those of the forehead, and about 10 dB higher than at the best sites. DPOAEs were clearly present when elicited by a combination of air-conducted stimuli presented through an insert earphone and with the bone vibrator placed on the eye. These results indicate that vibratory sounds can be transmitted through the skull contents to the inner ear. The intracranial transmission pathway of the vibratory stimuli may play a significant role, particularly at low frequencies, and possibly also when the vibratory stimuli are applied on the skull bone.
Ear and hearing 08/2008; 29(5):667-73. · 2.06 Impact Factor
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Journal of Dermatological Science 07/2008; 52(1):64-6. · 3.72 Impact Factor
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Min Yin,
Kazuo Ishikawa,
Kouhei Honda,
Takuya Arakawa,
Yasuaki Harabuchi,
Tatsumi Nagabashi,
Satoshi Fukuda,
Atsushi Taira,
Tetsuo Himi,
Narihiro Nakamura, [......],
Manabu Ichinohe,
Hideichi Shinkawa,
Yoshihiko Nakada,
Hiroaki Sato,
Kiyoto Shiga,
Toshimitsu Kobayashi, Tomoo Watanabe,
Masaru Aoyagi,
Hiroshi Ogawa,
Koichi Omori
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ABSTRACT: To analyze the clinical characteristics, 5-year survival, and prognostic factors of squamous cell carcinoma (SCC) of the external and middle ear.
A multi institutional study. Ninety five cases of patients from 10 institutions were reviewed on their age and sex distribution, initial complaints, stages, tumor locations, treatments, and outcomes. Prognostic factors were discussed based on the Pittsburgh staging system.
This disease seems to appear in the elderly with a peak age of 50-69 years. Males appear to be more predisposed than females with an odd ratio of 1.7. The initial complaints were not typical, while 12.6% of patients presented a history of recurrent otitis externa or chronic otitis media. Regional metastasis was recognized in 13.7% of patients, while no distant metastasis was confirmed. SCC located in the external ear could be detected in an earlier stage than that in the middle ear. The overall 5-year survival was 66.8% in total, and decreased significantly with stage. SCC in stages I and II was susceptible to each therapeutic strategy with a 5-year survival of 100%. Operation combined with radiotherapy and/or chemotherapy was the major treatment for stages III and IV SCC, while radiotherapy and chemotherapy were applied mainly for those who had been considered inappropriate for operation. The overall survival was 67.2% for stage III and 29.5% for stage IV, and operation with pathologically tumor free margin could improve the survival to 72.7% when combined with radio- and chemotherapy. Stage, completeness of operation with tumor free margin, recurrence, and metastasis have significant influence on survival.
Local infiltration seems to be the main behavior of SCC in the external and middle ear. Early diagnosis and treatment were important because SCC in the earlier stage is susceptible to be cured. For tumors of advanced stage, operation should be performed with pathologically tumor free margin, and operation combined with radiotherapy and chemotherapy could improve the survival. Tumor stage adds more influence on survival than its location. Recurrence and metastasis mainly occur in advanced stages and result in a poor survival.
Auris Nasus Larynx 10/2006; 33(3):251-7. · 0.76 Impact Factor
