Biomedical subjects
Publications and source records attributed to E Chida.
A 57-year-old woman with sarcoid nodules in muscles of the lower leg was reported. A star-shaped low signal intensity in the lesion on MR imaging, supposedly corresponding to fibrous scar, appears characteristic of this condition, although its specificity is still uncertain.
Here we report a new type of hypersensitivity pneumonitis caused by inhalation of spores of Pholiota nameko. P. nameko is a kind of mushroom which is of Japanese delicacy. Among people who are working in nameko cultivation, we found three patients suffering from hypersensitivity pneumonitis, and identified that it was caused by inhalation of spores of P. nameko. Every patient was engaged in indoor nameko cultivation inside a building equipped with a air and moisture conditioning system for two to ten years. In the indoor environment, it was thought that they were exposed to and inhaled a high density of nameko spores. Among 15 healthy indoor nameko growers, we found 6 who had precipitating antibody against extracts from nameko spores; however, there were no antibody positive people in 17 outdoor nameko growers. As seen in dairy farmers, it was clarified that there is a percentage of precipitin positive nameko growers who are asymptomatic. This is concrete evidence that changes of mushroom cultivation style can induce a new type of hypersensitivity pneumonitis. These findings were considered to be an important experience from the view points of environmental pulmonary diseases and industrial medicine.
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To improve hoarseness or misswallowing caused by unilateral recurrent laryngeal nerve paralysis, medialization of paralyzed vocal cord has frequently been performed. This method includes such techniques as injection method, insertion method, and arytenoid adduction, each presenting its merits and demerits. The insertion method which can be done while monitoring the patient's voice seems advantageous in that the technique is easy to perform and generally guarantees the voice improvement. Among insertion methods, Isshiki thyroplasty type I is the one most representative as well as popularized. However, since a silicone shim is inserted in this operation, it may be accompanied by the risks of carcinogenicity, foreign body reaction, and induction of collagen disease of silicone. Therefore we planned to use a ceramic as a safe substitute instead of silicone. There has been no article reporting the use of ceramic in this type of surgery. We used a fibrin glue to fix the ceramic shim and for hemostasis, which was found very useful. Hitherto, 2 cases of unilateral recurrent laryngeal nerve paralysis underwent Isshiki thyroplasty type I using ceramic shim with satisfactory results.
In many studies, Evoked Otoacoustic Emissions (EOAEs) have been routinely documented in subjects with normal middle ear function showing tympanogram (TG) A type. However, middle ear dysfunction may influence the measurements of EOAEs. We investigated the EOAEs in ears with secretory otitis media (SOM) in order to understand the effects of middle ear dysfunction on EOAE measurements. We present data from 73 SOM ears of 38 subjects aged 3 to 58 (mean = 9.4 years) and data from 61 ears of 54 subjects with sensorineural hearing loss as a control. Generally, the EOAE thresholds of ears with mild sensorineural hearing loss have a good correlation with the audiometric hearing threshold level. On the other hand, the EOAE thresholds of ears with SOM were on the average higher than those expected from the audiometric hearing threshold level. In this paper, we classified TG B type further into TG B1 type and TG B2 type according to our criteria. Though neither TG B1 type nor TG B2 type revealed peaks in the tympanogram (-300mmH2O < or = < or = 200mmH2O), the 2 groups differ in that TG B1 type seems to have its peak at pressures under -300mmH2O on tympanography while TG B2 type seems to have no peaks in that pressure range. As a consequence of this classification, most of the EOAE thresholds of SOM ears showing TG B2 type were scaled out (> or = 40 or 50 dB nHL).(ABSTRACT TRUNCATED AT 250 WORDS)
According to current cochlear concepts, spontaneous otoacoustic emissions (SOAEs) are thought to be the product of outer hair cell (OHCs) movement. Furthermore, efferent neurofibers from the olivocochlear bundle primarily innervate OHCs. Thus, we designed this investigation to determine changes in SOAE under conditions of contralateral acoustic stimulation. Fouty-two normal ears of 34 subjects with uni- or bilateral SOAEs were examined. The sound pressure level (SPL) of SOAE was measured 3 times in each subject and was initially averaged. The white noises of 30 or 40dBSPL, believed not to affect the other side, were then loaded contralaterally and the SPL of SOAEs were measured and compared with the non-loaded data. The SPL of single SOAEs were actually suppressed with 40dBSPL stimulation while the SPL of multiple SOAEs showed typical changes. Interestingly, no significant suppression of SOAEs was noticed under conditions of contralateral acoustic stimulation of the impaired ear. These data suggest that contralateral acoustic stimulation could affect OHC function via the olivocochlear bundle.
The clinical features and chest X-ray appearances of chronic type hypersensitivity pneumonitis closely resemble those of idiopathic interstitial pneumonia. Therefore, it is very difficult to make a correct diagnosis without detailed information. Our study showed that bronchoalveolar lavage and lung biopsy are useful examinations for the differential diagnosis of these two diseases. The characteristic finding of bronchoalveolar lavage of chronic type hypersensitivity pneumonitis is still lymphocytosis, as is also seen in the acute type. The pathological findings of chronic type hypersensitivity pneumonitis are alveolitis with marked lymphocyte infiltrations and granuloma formation although the number of granulomas is low. Recently, we experienced five patients with chronic type farmer's lung. The average age of these five patients was significantly older than that of acute type farmer's lung. They had engaged in farming after the onset of their disease, which suggested continuous chronic exposure to mouldy hay. It is concluded that patients with hypersensitivity pneumonitis, especially aged people, should avoid antigen exposure and should be followed up the progress of the disease with intensive care.
Although otologic involvement by leukemic infiltration was supposed to be unusual, increasing number of cases have been reported in recent years, probably due to the advance of chemotherapy, improved remission rate and longer survival of leukemic patients. Two cases of myelogenous leukemia with infiltration of mastoid bone were reported. One is 15-year-old girl with acute myelogenous leukemia, which had been well controlled for 1 year, developed a sudden onset of facial nerve palsy. The other is 30-year-old female with chronic myelogenous leukemia and blastic crisis, complained hearing loss. As both cases had exudate in the tympanic cavity, the punctures were carried out through the eardrum. The pathological study of these exudate cells revealed the involvement of mastoid bone by leukemia. The cytologic examination of exudate in the tympanic cavity is simple, time-sparing and of little burden to the patient. This technique is very useful and supposed to take the place of the exploratory surgery of mastoid cavity which is previously considered necessary for the correct diagnosis.