Skeletal analysis of craniofacial deformities in brachycephaly: comparison with craniofacial deformities in plagiocephaly.

The deformities of craniofacial bones in brachycephaly (n = 2) and plagiocephaly (n = 2) were compared using three-dimensional skull replicas. In brachycephaly the bilateral deformities of the cranial base were similar to the unilateral deformities on the affected side in plagiocephaly. Shortening of the anterior-middle cranial fossas and expansion of the middle cranial fossas suggest downward and anterior displacement of both temporomandibular (TM) joints resulting in the underdevelopment of the middle-inferior facial bones, though this is less conspicuous in brachycephaly for three reasons.

Video-assisted rigid endoscopic laryngosurgery: application to cases with difficult laryngeal exposure.

In some cases of microlaryngosurgery, laryngeal exposure with a direct laryngoscope is difficult because of a variety of reasons. In such cases, we now use a long rigid endoscope inserted into the side tube of the direct laryngoscope together with a video system. The lesion can be removed while the phonosurgeon observes the magnified images of the larynx on the video monitor.

Microlaryngosurgery for benign posterior glottal lesions using a posterior glottis direct laryngoscope.

When endolaryngeal microscopic laryngosurgery (microlaryngosurgery) with a direct laryngoscope is used to remove lesions of the posterior glottal area under endotracheal general anesthesia, the endotracheal tube interferes with the surgical field. To overcome this problem, we developed a special direct laryngoscope with a concave groove on the upper portion of its distal tip. The concave groove is used to move the endotracheal tube anteriorly, making it possible to obtain a good surgical field in the posterior glottal area.

Effect of vibration on auditory organ systems in low-birth weight infants treated with high-frequency oscillatory ventilation: 5 year outcome.

Background: To determine the effects of vibration exposure caused by high-frequency oscillatory ventilation (HFOV) on the auditory organ systems in low-birth weight (LBW) infants.

Methods: Between 1989 and 1990, 30 LBW infants who received assisted ventilation with HFOV (n = 14) or conventional mechanical ventilation (CMV; n = 16) in the level III neonatal intensive care unit at Tokyo Metropolitan Ohtsuka Hospital were enrolled in this study. The effects of vibration exposure on the auditory system structures were investigated with auditory brainstem responses (ABR) at 37-41 weeks of postconceptional age and at 6, 12, 18 and 24 months of age until they passed and follow-up studies were performed at least until 5 years of age.

[Hypersensitivity peumonitis in a patient with rheumatoid arthritis].

We report a case with rheumatoid arthritis and hypersensitivity pneumonitis. A 66-year-old female was admitted to our hospital because of fever, cough, and progressive dyspnea on October 10, 1997. She had a history of rheumatoid arthritis from 1987 and was treated with cyclophosphamide when she developed pulmonary symptoms in September 1997.

Usefulness of cerebral blood flow (CBF) measurements to predict the functional outcome for rehabilitation in patients with cerebrovascular disease (CVD).

Purpose: The objectives of this study were to (1) elucidate the relationship between the mean CBF in the whole brain (Av.mCBF) before rehabilitation of CVD patients and the BI score before and after rehabilitation, (2) determine whether the efficacy of rehabilitation can be predicted by measurement of the Av.mCBF, and (3) investigate what part of the brain was most important to improving the BI score.

Granular cell tumors arising nearly simultaneously in the larynx and subcutaneous cervical region.

Granular cell tumors are benign, relatively rare lesions that can occur in any organ in the body. Tumors are known to occasionally arise in two or more different organs. We report the case of a 60-year-old woman in whom granular cell tumors arose almost simultaneously in her subcutaneous cervical region and her larynx.

[Pneumoperitoneum with systemic sclerosis].

We report a case of systemic sclerosis (SSc) complicated with benign pneumoperitoneum without apparent pneumatosis cystoides intestinalis (PCI). A 43-year-old woman was admitted to our hospital because of prominent abdominal distension in April 1997. Raynaud's phenomenon has been detected since 1991.

Observations of laryngeal lesions with a rhinolarynx electronic videoendoscope system and digital image processing.

Laryngeal lesions were observed with the Olympus ENF-200 rhinolarynx electronic videoendoscope attached to the Olympus EVIS-200 system, an electronic videoendoscope system of Olympus Optical Co, Ltd. The electronic videoendoscope differs from conventional flexible fiberscopes in having a small light-sensitive charge-coupled device (CCD) chip built into the tip of the endoscope portion. This model has a small CCD chip in its 5-mm-outer diameter tip, and can be introduced into the laryngeal cavity by inserting it through the nasal passages.

[A case of systemic sclerosis complicated with pneumoperitoneum and pneumatosis cystoides intestinalis].

Here we report a case of systemic sclerosis (SSc) complicated with pneumoperitoneum and pneumatosis cystoides intestinalis (PCI). A 58-year-old woman who had been treated with oxygen therapy for chronic respiratory failure caused by interstitial pneumonia was admitted to Tokyo Metropolitan Ohtsuka Hospital because of abdominal fullness. On admission, laboratory data showed accelerated erythrocyte sedimentation rate, mild anemia, hypoalbuminemia, and elevated level of lactose dehydrogenase (LDH).

[A case of primary Sjögren's syndrome accompanied by transverse myelitis].

Here we report a case of Sjögren's syndrome (SS) accompanied by transverse myelitis. A 46-year-old woman with 7-year history of primary SS was admitted to Tokyo Metropolitan Ohtsuka Hospital in September 1997 because of muscular weakness in lower extremities. She had had a low grade fever, numbness, and pain in bilateral lower extremities since July 1992.

Multidirectional observations of the larynx using transurethral rigid endoscopes during direct laryngoscopy.

Microscopic direct laryngoscopy (microlaryngoscopy) under general anaesthesia is the optimal method of observing the larynx. However, as microlaryngoscopy does not allow precise observations of the ventricle, inferior surface of the vocal fold and subglottis, multidirectional observations of the larynx using transurethral rigid endoscopes were performed during direct laryngoscopy. This endoscopic technique has been shown to be clinically useful in the diagnosis and treatment of laryngeal lesions.

Skeletal analysis of craniofacial asymmetries in plagiocephaly (unilateral coronal synostosis).

Why do the craniofacial bones grow asymmetrically in patients with plagiocephaly (unilateral coronal synostosis)? We obtained three-dimensional skeletal replicas of two patients with the condition and analysed the deformities of the facial bones. From this analysis we deduced that the asymmetric deformation of the facial bones in these patients was caused by a combination of three rotations: rotation of the calvaria toward the affected side because of premature synostosis of the coronal and sphenofrontal sutures; rotation of the facial bones on the horizontal plane toward the unaffected side caused by anterior displacement of the TM (temporomandibular)-joint on the affected side; and downward rotation of the facial bones toward the unaffected side caused by inferior displacement of the TM-joint on the affected side.

[A case of microscopic polyangitis accompanied by hearing loss as the initial sign of the disease].

Here we report a case of microscopic polyangitis (MPA) with anti-neutrophil cytoplasmic antibodies against myeloperoxidase (MPO-ANCA) accompanied by perceptive dominant hearing loss as the initial sign of the disease. A 52-year-old woman was admitted to Tokyo Metropolitan Ohtsuka Hospital in April 1996 because of bilateral progressive hearing loss. On admission, she had presented bilateral perceptive hearing loss, fever, myalgia, and weight loss.

[An autopsy case of anti-neutrophil cytoplasmic antibodies associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma].

Here we report an autopsy case with anti-neutrophil antibodies (ANCA) associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma. A 69-year-old woman was admitted to Tokyo Metropolitan Ohtsuka Hospital in October 1995 because of leg edema. She had presented cough in 1990 and diagnosed as interstitial pneumonia, esophageal varices and liver chirosis.

[An adult case of dermatomyositis complicated with cecum perforation and panniculitis].

The case of dermatomyositis complicated with cecum perforation and panniculitis occurred in a 62-year-old woman was reported. She was admitted to Keio University Hospital with a history of proximal muscular weakness, and dysphagia. Physical examination showed erythema over the face and shoulder.

Verrucous carcinoma of the larynx presenting as a hairy whitish tumor.

A patient was encountered with verrucous carcinoma of the larynx that presented as a hairy whitish tumor. There was a recurrence because simple excision with forceps by endolaryngeal microsurgery was performed in the first operation. However, in the second operation endolaryngeal microscopic laser surgery using a direct laryngoscope was performed and followed by adjuvant chemotherapy with oral UFT, a combination of uracil and tegafur in a molar ratio of 4:1.

[Pediatric fiberoptic bronchoscopy via the laryngeal mask airway].

Fiberoptic bronchoscopy was performed on 11 children aged from 6 months to 3 years and weighing between 2.1 and 12.5 kg using the laryngeal mask airway (LMA).

[A case of systemic sclerosis associated with interstitial pneumonia with various autoantibodies: improvement by intravenous cyclophosphamide therapy].

A 41-year-old woman was admitted to Tokyo Women's Medical College Aoyama Hospital in January 1994. She presented cough and dyspnea in September 1991. The diagnosis of interstitial pneumonia was made based on TBLB.

Isolated non-Hodgkin's malignant lymphoma of the larynx presenting as a large pedunculated tumor.

This paper presents a case of non-Hodgkin's lymphoma (NHL) of the larynx. The patient was an 86-year-old man who complained of foreign-body sensation and dysphagia. Laryngoendoscopic examination revealed a large pedunculated mass arising from the left aryepiglottic fold.

Conservative therapy for nonspecific granuloma of the larynx using a beclomethasone dipropionate inhaler.

Nonspecific granuloma of the larynx is a benign tumor that usually occurs on the posterior glottis. Conventional treatment for this laryngeal lesion has consisted of surgical resection. However, this lesion has a strong tendency to recur postoperatively and may require multiple repeated operative procedures.

[A case of Sjögren's syndrome and systemic lupus erythematosus complicated with necrotizing angiitis of the gallbladder].

A 71 year-old man with Sjogren's syndrome and systemic lupus erythematosus was admitted to our hospital because of abdominal pain and fever. Laboratory investigation showed an ESR of 76 mm/hr, elevation of CRP and marked leukocytosis. Abdominal ultrasound and CT scan showed enlargement of the gallbladder and intravesicular sludge without stones.

[Pre-Cushing's syndrome with intermittent hypokalemia: report of a case].

An adrenal tumor was discovered in a patient with intermittent hypokalemia for 8 years. She had no clinical features of Cushing's syndrome. The case was regarded as pre-Cushing's syndrome by endocrinological evaluation.

[Significance of prostate fluid carcinoembryonic antigen in the diagnosis of prostate cancer].

Clinical studies of carcinoembryonic antigen (CEA) in prostate fluid were performed on 121 men; 29 patients with prostate cancer, 65 with benign prostatic hypertrophy, 10 with prostatitis and 17 without any prostatic diseases. The CEA level in prostate fluid in the prostate cancer group was significantly higher than that in any other group. However, it could not demonstrate any particular advantage when compared with the prostate specific antigen (PSA) in serum.