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Biomedical subjects

Tadashi Nakashima

Publications and source records attributed to Tadashi Nakashima.

At least 19 recordsLinked to original sources
PubMed2006

A case of nasopharyngeal actinomycosis leading to otitis media with effusion.

Nasopharyngeal actinomycosis is extremely rare, and to our knowledge, only seven cases have previously been reported. Diagnosis of actinomycosis is made by clinical finding, observation of the bacteria and histopathological examination. Treatment for actinomycosis is surgical debridement and administration of antibioticus, especially penicillin for several weeks with good prognosis. We report a case of nasopharyngeal actinomycosis, which lead to otitis media with effusion. Endoscopic surgery and prolonged penicillin administration for 2 months were effective for treatment of actinomycosis in the nasopharynx.

Actinomycosis↗
PubMed2006

Age related changes in the distribution of laryngeal glands in the human adult larynx.

OBJECTIVE: To understand the defense status of glandular tissue in the human adult larynx, we examined the glandular distribution, concentration and the ratio of the mucous glands in the subglottic and supraglottic larynx. METHODS: One-hundred and seven adult larynges were examined. The area of the mucosa and glands were measured using an image analyzing system. The correlations of the concentration as well as the ratio of the mucous glands with age were analyzed. RESULTS: The ratio of the areas occupied by the glandular acini of the subglottis was almost equal to that of infants as we reported earlier. The concentration of the laryngeal glands decreased in higher-aged adults at the level of the supraglottis, but not at the level of the subglottis. CONCLUSIONS: In comparison to infants, the ratio of laryngeal glands of the human subglottic larynx is rather constant in human adults. However, the supraglottic larynx seems to be influenced by increasing age. The changes deserved in the laryngeal glands predominantly occur in the supraglottic larynx.

Adult↗
PubMed2006

Antitumor effects of systemic and local immunization with a CTL-directed peptide in combination with a local injection of OK-432.

PURPOSE: The accumulation of T cells into the tumor site is crucial for the elicitation of in vivo antitumor effects after cancer vaccination. In this study, we investigated the antitumor effects and associated mechanisms of action that were induced by systemic and local immunization with a CTL-directed peptide in combination with a peritumoral injection of a streptococcal preparation, OK-432. EXPERIMENTAL DESIGN AND RESULTS: The human SART3(315-323) peptide, which has the potential to induce human leukocyte antigen-A24-restricted CTLs, not only has the same amino acid sequence as the mouse SART3, but also has the capacity for binding to H-2K(d) molecules. Therefore, the SART3(315-323) peptide could be used as a tumor antigen-derived peptide in H-2(d) mice. Systemic immunization with the SART3(315-323) peptide and the subsequent peritumoral injection of both the SART3(315-323) peptide and OK-432 effectively induced peptide-specific and colon26 carcinoma-reactive CTLs in BALB/c mice. The combination therapy suppressed the growth of s.c. established colon26 carcinoma. The accumulation of both CD8(+) and CD4(+) T cells into the tumor site was more apparent in mice treated with the combination therapy than in those treated with other protocols. In addition, the level of IgG reactive to the administered SART3(315-323) peptide increased in mice that were treated with the combination therapy. CONCLUSION: These results indicate that antitumor effects could be efficiently induced by a combination therapy that included systemic and local immunization with a CTL-directed peptide together with a local injection of OK-432.

Amino Acid Sequence↗
PubMed2006

Human adult deglutition during sleep.

OBJECTIVES: Clearance of the pharynx by deglutition is important in protecting the airway. The pattern of deglutition during sleep was investigated. METHODS: Deglutition during sleep was examined in 8 normal human adults via time-matched recordings of polysomnography and surface electromyography (EMG) of the thyrohyoid and suprahyoid muscles. RESULTS: During sleep, deglutition was episodic, and was absent for long periods. The mean number of swallows per hour (+/-SD) during the total sleep time was 2.9 +/- 1.3. The mean period of the longest absence of deglutition was 50.6 +/- 10.2 minutes. Most deglutition occurred in association with spontaneous electroencephalographic arousal in rapid eye movement (REM) sleep and non-REM sleep. Deglutition was related to sleep stage. The mean number of swallows per hour was 7.2 +/- 3.5 during stage 1 sleep and 2.0 +/- 0.7 during stage 2 sleep. There was little deglutition during stages 3 and 4. The deeper the sleep stage became, the lower the mean deglutition frequency became. The mean number of swallows per hour was 2.7 +/- 2.2 during REM sleep. The EMG amplitude dropped to the lowest level of recording and hypotonic EMG activity increased during REM sleep. CONCLUSIONS: Deglutition, a vital function, is infrequent during sleep.

Adult↗
PubMed2006

Expression and distribution of CD44 and hyaluronic acid in human vocal fold mucosa.

OBJECTIVES: Expression of CD44 (a cell surface receptor for hyaluronic acid) and the distribution of hyaluronic acid were examined in the human vocal fold mucosa. METHODS: Light microscopic investigation was carried out on 10 normal larynges of newborn, infant, younger adult, and older adults with Alcian blue staining, a hyaluronidase digestion study, and immunohistochemistry for CD44. RESULTS: Before the appearance of hyaluronic acid in the newborn vocal fold mucosa, CD44 was expressed on the stellate cells in the macula flava and on the fibroblasts in Reinke's space. During infancy, hyaluronic acid appeared and was distributed in the vocal fold mucosa. Many more stellate cells in the macula flava showed CD44 expression, and a large amount of hyaluronic acid was present around the infant stellate cells; however, the fibroblasts in Reinke's space expressed little CD44. During adulthood, hyaluronic acid was distributed in the vocal fold mucosa. Almost all of the stellate cells in the macula flava showed CD44 expression, and much hyaluronic acid existed around the stellate cells in the adult macula flava. However, fibroblasts in the adult Reinke's space expressed little CD44, and hyaluronic acid density in that space was lower than that in the macula flava. CONCLUSIONS: Stellate cells in the macula flava and CD44 cooperatively play important roles in maintaining hyaluronic acid in the human vocal fold mucosa as a vibrating tissue.

Adult↗
PubMed2006

Histopathologic changes in laryngeal mucosa of extremely low-birth weight infants after endotracheal intubation.

OBJECTIVES: Advances in medicine have improved the survival of infants with increasingly lower birth weights. The histopathologic changes of intubation-related laryngeal injury in extremely low-birth weight infants (less than 1,000 g) have not been well known. We examined histopathologic changes in infant larynges, including extremely low-birth weight infants, after endotracheal intubation. METHODS: Forty-four infants, including 21 extremely low-birth weight infants, who had been intubated for periods ranging from 10 minutes to 138 days, were examined in a whole organ serial section study. RESULTS: As the duration of intubation increased, the ulceration was found to be larger and deeper. The injury at the subglottis and posterior glottis was greater than that at other portions. The perichondrium of the cartilage was exposed in many cases intubated longer than 8 days. Repaired epithelium that was composed of squamous epithelium was present in 6 of 7 larynges that had been intubated more than 20 days, indicating that not only injury but also the healing process occurred during long intubation. There were no obvious relationships between the degree of intubation injury and the birth weight of the infants. CONCLUSIONS: Prolonged intubation is better tolerated by infants than adults. The intubation-related laryngeal injuries of extremely low-birth weight infants were histopathologically the same as those of infants of other birth weights.

Disease Progression↗
PubMed2006

Comparison of preoperative fine-needle aspiration cytology diagnosis and histopathological diagnosis of salivary gland tumors.

We investigated 115 patients with salivary gland epithelial tumors who had undergone preoperative fine needle aspiration cytology (FNAC) of salivary glands and had been diagnosed by postoperative histopathological examination. We compared the findings of preoperative FNAC with their histopathological types in salivary gland tumors, and discuss the results and problems. The diagnostic accuracy, sensitivity, and specificity of preoperative FNAC of salivary glands were 98.2%, 88.2%, and 100%, respectively. The percentage of inadequate specimens was 6.1%. The rates of agreement in the diagnosis of pleomorphic adenoma, Warthin tumor, and basal cell adenoma were 96%, 92.9%, and 55.5%, respectively. The rate of agreement of histopathological types in the malignant tumors was 30%. We realized again not only that the diagnostic accuracy of preoperative FNAC for salivary gland tumors was high, but also that it was a safe, easy-to-perform, clinically very useful diagnostic procedure. However, this study exposed several problems which are the inadequate sampling rate and the difficulty in diagnosing malignant tumors. We have been making efforts to take appropriate specimens by writing comments on the cytological report indicating a re-examination, or by the presence of the clinical laboratory technician at the FNAC procedure. We consider it necessary to adequately re-aspirate the solid portion after cyst fluid aspiration, or to re-perform FNAC at a later date, and to improve the diagnostic accuracy by further experience with more patients.

Biopsy, Needle↗
PubMed2006

[A retrospective study of malignant parotid tumors].

The clinical features of 74 patients (39 men, 35 women; mean age, 62 years) with malignant parotid tumors were retrospectively investigated. According to the TNM Classification, 4 patients were classified as T1, 9 as T2, 6 as T3, and 55 as T4. Fifty cases were staged as N0, 9 as N1, 14 as N2 and 1 as N3. Tumors located in both lobes of the parotid gland were the most frequent type of tumor (49%). Twenty-four percent of the 74 patients exhibited facial nerve palsy before treatment. Facial palsy was found predominantly in cases with a higher T classification or with deep lobe occupation. Histopathologically, sixteen tumor types were observed; mucoepidermoid carcinoma was the most common. The overall five-year and ten-year survival rates determined using the Kaplan-Meier method were 65% and 61%. The factors influencing a poor outcome were T4 classification (p=0.0189), an N+ stage (p<0.0001), and facial palsy (p<0.0001). As for the major histopathologic types, the five-year survival rates were 69% for mucoepidermoid carcinoma, 48% for adenocarcinoma, 71% for adenoid cystic carcinoma, and 100% for acinic cell carcinoma and malignant mixed tumor. With respect to the treatment modality, patients who were classified as T1 or T2 and whose tumors were located in the superficial lobe without facial nerve invasion could be satisfactorily treated with only a superficial lobectomy conserving the facial nerve. A total parotidectomy with total removal of the facial nerve seemed necessary for T3 and T4 cases, especially those with adenocarcinoma or mucoepidermoid carcinoma. Modified neck dissection may be necessary for N0 cases, especially those with adenocarcinoma, adenoid cystic carcinoma or undifferentiated carcinoma. Nerve grafting after total nerve resection is recommended for a better quality of life.

Adolescent↗
PubMed2006

[Indications for pharyngeal surgery in adult with sleep-disordered breathing patients].

We assessed the indications for pharyngeal surgery, including tonsillectomy and uvulopalatopharyngoplasty (UPPP) for patients with sleep-disordered breathing (SDB). The indications for surgery can be divided into two groups. In the first group, the indicated surgery is a radical treatment of SDB. The characteristics of this group were (1) grade 1 tonsillar hypertrophy, (2) bilateral (side to side type) oropharyngeal stenosis, as determined using a snoring sound test, and (3) no risk of facial disfiguration. In this group, the improvement in AHI (Apnea Hypopnea Index) was 76.2%, while the improvement in AI (Apnea Index) was 95.7%. In the second group, the treatment was designated as supplemental. The characteristics of this group were (1) bilateral oropharyngeal stenosis, (2) tonsillar hypertrophy larger than grade 2, and (3) unsuccessful treatment with NCPAP (Nasal Continuous Positive Airway Pressure) or oral appliances. In this group, the improvement in AHI was 50.7%, but, surgery remained an effective means of treating SDB.

Adult↗
PubMed2006

[Autologous tumor-specific immunotherapy for recurrent malignant melanoma of the nasal cavity].

Malignant melanoma usually occurs in tissues containing large numbers of melanocytes, such as the skin, mucosa and eye, and is one of the most highly malignant tumors known. No satisfactory treatment results have ever been reported. We report here an effective course of immunotherapy consisting of the local injection and intra-venous administration of autologous tumor-cell-stimulated cytotoxic T lymphocytes in a patient with recurrent malignant melanoma. The patient was a 45-year-old woman. She had been diagnosed as having malignant melanoma in 1996 and under went radio-chemotherapy at our hospital. Seven years later, recurrences were recognized in bilateral nasal cavities. Following systematic chemotherapy, 23 local injections of cytotoxic T lymphocytes were performed. Mediastinal lymphonode metastasis was recognized in March, 2004, so 15 additional intravenous administrations of cytotoxic T lymphocytes were performed. At present, no obvious regrowth has been recognized. Immunotherapy using cytotoxic T lymphocytes may be a useful strategy for controlling recurrent malignant melanoma.

Female↗
PubMed2006

[To study the expression of dendritic cell phenotypic antigen in cervical lymph nodes in hypopharyngeal carcinoma].

OBJECTIVE: Dendritic cells express many cell phenotypic antigens, they have different special function in the process of antigen present. The purpose of this study was to determine some DC phenotypic antigen in cervical lymphnodes in hypopharyngeal carcinoma and evaluate the relationship between the DC phenotypic antigen expression in hypopharyngeal carcinoma metastasis and prognosis. METHOD: Envision HIS method was performed to detect the cell surface markers S-100, CD1a and CD83. 144 cervical lymph nodes obtained from 37 cases of hypopharyngeal carcinoma were evaluated. Furthermore, the relationship between CD45RO+ T lymphocytes and dendritic cells was observed. RESULT: The number of S-100+ DCs, CD1a+ DCs and CD83+ DCs in the cases of lymphnode metastasis were fewer than those in non-lymphnode metastasis. There is a significant metastasis difference in statistics between lymphnode metastasis groupe and non-lymphnode metastasis group. The number of CD83+ DCs located at cancerous nest area were fewer than those at peritumor area in lymphnode metastasis groupe. There is a significant difference in statistics between them. The number of CD83+ DCs in the cases of survival group were more than those in obituary group. CD45RO+ T cells mainly distribute around CD83+ DCs. CONCLUSION: The expression of dendritic cells phenotypic antigens were significant difference in different areas in lymphnodes, may play difference role in tumor immunity against hypopharyngeal carcinoma. Dendritic cells phenotypic antigens were the important markers to predict the prognosis of the patients with hypopharyngeal carcinoma.

Aged↗
PubMed2005

Analysis of voice function following autologous fat injection for vocal fold paralysis.

OBJECTIVE: This study demonstrates that intravocal fold injection of autologous fat obtained by liposuction technique is simple, and the functional results durable for patients with unilateral vocal fold paralysis due to injury to the recurrent laryngeal nerve. STUDY DESIGN: 41 patients with unilateral paralysis of the vocal fold due to injury to the recurrent laryngeal nerve received intravocal fold injection of autologous fat. Autologous fat, harvested from the lower abdomen by liposuction technique, was filtered out and injected through a needle into the vocal fold by using endolaryngeal microsurgery. Clinical follow-up after the injection was carried out from 1 month to 2 years. RESULTS: Voice function dramatically improved compared with the parameters examined before the operation. Vocal function continued to improve as time passed during the second year after injection. CONCLUSIONS: Intravocal fold injection of autologous fat obtained by liposuction technique is simple, and the functional results durable for patients with unilateral vocal fold paralysis due to injury to the recurrent laryngeal nerve. SIGNIFICANCE: The effectiveness continued for more than 2 years in most patients.

Adipose Tissue↗
PubMed2005

Vitamin A-storing stellate cells in the human newborn vocal fold.

OBJECTIVES: Vocal fold stellate cells (VFSCs) in the newborn vocal fold were examined and compared with VFSCs in the adult vocal fold. METHODS: Light and electron microscopic investigation of VFSCs was carried out on 5 human newborn larynges. RESULTS: The VFSCs were distributed in human newborn maculae flavae. They were stellate or oval in shape, and possessed cytoplasmic processes. The VFSCs in some cells formed a gap junction with each other. A few lipid droplets were present in the cytoplasm, but they were much fewer than those of an adult. The nucleus-cytoplasm ratio was high, and the intracellular organelles were not very well developed. Free ribosomes were well developed in the cytoplasm. The VFSCs in some cells showed strong cytoplasm staining with periodic acid-Schiff stain and type III collagen. There were vesicles along the periphery of the cytoplasm of the VFSCs, and newly released amorphous materials were seen, but fewer were observed on the cell surface. The newborn VFSCs had started to synthesize extracellular matrices such as collagenous fibers, reticular fibers, elastic fibers, and glycosaminoglycan. CONCLUSIONS: The VFSCs in the newborn maculae flavae were immature, but had already started the synthesis of extracellular matrices essential for the viscoelastic properties of the vocal fold mucosa.

Extracellular Matrix↗
PubMed2005

Endoscopic sinus surgery for antrochoanal polyp using CO2 laser and/or microresector: a long-term result.

Endoscopic sinus surgery procedure using CO2 laser and/or microresector for paediatric and adult chronic sinusitis with antrochoanal polyp (ACP), with long-term follow-up, was examined. Twelve children and 13 adults underwent the surgical procedure. The following two techniques were used to remove the antral portion of an ACP with a 70 degrees endoscope: (1) CO2 laser--The base of the ACP was vaporized and removed via an enlarged natural ostium with a pipe-guide handpiece with a deflective tip. (2) Microresector--The ACP was resected via an enlarged natural ostium and/or nasoantral window opened under the inferior turbinate with the curved and straight blade of a microresector. In the endoscopic follow up for 10 to 57 months, no patient who underwent the primary surgery required reoperation for ACP recurrence. One out of the seven patients who underwent secondary surgery required a revised operation with microresector and CO2 laser.

Adolescent↗
PubMed2005

Radiotherapy of the neck influences the distribution of laryngeal secretory glands.

To elucidate the influence of radiation therapy on the larynx in patients who receive radiotherapy to the neck, we observed the changes in the distribution of the laryngeal glands. Human adult larynges from patients with either laryngeal or hypopharyngeal cancer were histopathologically examined, and the changes in the glandular distribution as well as in the ratio of serous or mucous type cells were surveyed using an image analysis system. The mean ratio of the area occupied by glandular acini in the subglottic larynx was 0.182 in the non-radiation group and 0.098 in the radiation group (p < 0.001). Although no statistical difference was observed, the average density of the glands decreased and the average ratio of serous-type/mucous-type glandular cells decreased in the irradiated larynx. The glandular acini are often replaced with fibrous connective tissue and the ratio of serous-type glandular cells decreases. These results indicate that not only the voice function but also the local defence function of the larynx might be impaired after radiotherapy.

Adult↗
PubMed2005

[Clinical review of mucoepidermoid carcinomas].

Mucoepidermoid carcinoma is a rare head and neck cancer tumor, composed of both mucous and epidermoid cells. We retrospectively reviewed the case of 36 such patients hospitalized in the last 24 years (between 1978 and 2002) at Kurume University Hospital, focusing on origin, treatment, and treatment outcome. In this study, 33 patients undergoing currative treatment were studied in detail. Tumors originated in major salivary glands in 24 and in the oral cavity, paranasal cavity, and oropharynx in 3 each. Salivary gland carcinomas were graded, clinically and histopathologically based on the criteria of Goode et al. as follows: low (n = 3), intermediate (n = 3), and high (n = 18). All patients underwent radical surgery. Lymphnode metastasis was detected in 9, distant metastasis in 6 (lung: 4; liver: 1; bone: 1), and local recurrence in 5 patients. Lymphnode recurrence was detected in 3. Survival was calculated with Kaplan-Meier's methods. Five-year overall survival was 64%, i.e., 56% in salivary gland malignancy, 67% in oral cavity malignancy, 100% in paranasal cavity malignancy and 100% in oropharynx malignancy. Five-year survival was 76% in T2, 75% in T3, 51% in T4. Five-year survival in NO was 80% and 22% in N+ cases, with a statictically significant difference (p < 0.05). Five-year survival was 71% in stage I, 83% in stage II, and 54% in stage IV. Five-year survival in low and intermediate grade was 100%, whereas that in high grade was 43%. The 21 patients undergoing modified neck dissection has a 5-year survival of 52%. In 20 patients undergoing postoperative radiotherapy, 4 died of local recurrence. In 31 patients not undergoing chemotherapy, 6 died of distant metastasis. These results emphasize the necessity of radiotherapy and chemotherapy after surgical treatment for head and neck mucoepidermoid carcinoma.

Aged↗
PubMed2005

[Toxic shock-like syndrome of the neck, a case report].

Streptococcal toxic shock-like syndrome (TSLS) is known to progress rapidly into septic shock and have a high mortality of 40%. We report a rare case of neck infectious disease caused by Group A hemolytic streptococcus pyogenes. A 65-year-old man, hospitalized for eyelid swelling and dyspnea suffered shock, dyspnea, and pressure reduction on the day he was hospitalized and died of multiple organ failure 18 days later. Despite treatment with antibiotics, tracheostomy, immunoglobulin, etc. We suspected that he had been infected via a laceration of the external auditory meatus. Accurate diagnosis followed by prompt, radical treatment is essential if TSLS is to be treated successfully.

Aged↗