Biomedical subjects

Tetsuro Onitsuka

Publications and source records attributed to Tetsuro Onitsuka.

4 recordsLinked to original sources

PubMed2007

Electromyographic findings after different selective neck dissections.

OBJECTIVES: The objective was to compare electrophysiologic investigations of the upper trapezius muscle (UT) after different selective neck dissections (SND) and analyze the differences between types of SND and the preservation and excision of the cervical nerves (the C2-4 rami of the cervical plexus). STUDY DESIGN: Retrospective study of 54 patients (average age, 65.1 +/- 9.6 yr, 45 males) with 70 SND. METHODS: Patients underwent needle electromyography (EMG) of the UT by 4 months after surgery. The findings were rated according to the 5 point EMG scale system from 1 (total denervation: positive sharp wave or fibrillation potential at rest and electrical silence at voluntary contraction) to 5 (normal pattern). RESULTS: The average EMG scale was 1.7 +/- 1.1, 58.6% for score 1 and only 5.7% for score 5. There was not a significant difference in the EMG scale between the types of SND, whereas the group in which the cervical nerves were excised was significantly lower than in that in which it was preserved. The average EMG scales in the former and latter were 1.5 +/- 0.8 and 2.0 +/- 1.3, 68.8%. CONCLUSIONS: The study data confirm that complete or incomplete denervation of the UT was caused by axonal injury of the spinal accessory nerve, even though it was spared, because of traction of the nerve during neck dissection. Second, the excision of the C2 to 4 rami of the cervical plexus caused worse damage of the UT. It is suggested that it is important to preserve the cervical nerves to avoid denervation of the UT.

Accessory Nerve↗

PubMed2006

Primary nasopharyngeal mucoepidermoid carcinoma in Japanese patients: two case reports with histochemical and immunohistochemical analysis and a review of the literature.

Mucoepidermoid carcinoma is a common neoplasm of the salivary glands. Salivary gland-type neoplasms are very rare in the nasopharynx, and there are only few reports on mucoepidermoid carcinoma of the nasopharynx. Two additional cases of mucoepidermoid carcinoma arising from the nasopharynx are reported here. Case 1: the patient was a 57-year-old Japanese woman who had bloody sputum. Case 2: the patient was a 51-year-old Japanese woman who underwent resection of a nasopharyngeal tumor. Histologically, both tumors were also low-grade mucoepidermoid carcinomas with clear cells. Histochemically, the gland-like nests and mucous cells were positive for mucin staining. Immunohistochemically, the lesions were positive for cytokeratins (CKs), p63, and MUC1, but negative for alpha-smooth muscle actin and EBER mRNA. The Ki-67 labeling indices of the two tumors were 10.4% and 4.3%, respectively. The two present cases and a review of the English literature indicate that salivary gland-type neoplasms arising from the nasopahrynx are extremely rare. The prognosis of salivary gland-type carcinomas of the nasopharynx is still unknown.

Biomarkers, Tumor↗

PubMed2006

Quality of life after neck dissection.

OBJECTIVE: To assess the impact of modifications to radical neck dissection on postoperative quality of life. DESIGN: Cross-sectional study using a self-administered neck dissection questionnaire and an arm abduction test. SETTING: Department of Otolaryngology-Head and Neck Surgery, Kobe University Hospital. PATIENTS: Seventy-four patients who had undergone neck dissection for the treatment of head and neck cancer. MAIN OUTCOME MEASURES: Arm abduction test results and responses to questions on quality of life related to neck dissection. RESULTS: Forty-one patients underwent bilateral neck dissections, and 33 patients underwent unilateral neck dissection. Level V nodes were dissected in 74 necks. Among them, the spinal accessory nerve (SAN) was resected in 29 necks. Patients who had neck dissections that spared the SAN had better shoulder function. When the SAN was preserved, patients without dissection of level IV and V nodes had better scores on measures of pain and constriction of the neck. Sacrifice of the sternocleidomastoid muscle and/or the SAN had a significant effect on daily activities, work, and leisure. The arm abduction test scores and answers to questions regarding shoulder function were significantly correlated. CONCLUSIONS: Modifications to radical neck dissection contribute to improvements in the postoperative quality of life after neck dissection. A multicenter study using the arm abduction test and questionnaire used in this study is currently in progress to further evaluate the impact of modifications to radical neck dissection on quality of life after surgery.

Accessory Nerve↗

PubMed2006

Primary adenoid squamous cell carcinoma of the oral cavity.

Adenoid squamous cell carcinoma (ASCC) is an uncommon but well-recognized variant of squamous cell carcinoma that was first described by Lever in 1947. ASCC has been reported to originate in the sun-exposed skin of the head and neck and in other sites. An additional case of ASCC is reported here. The patient was a 64-year-old Japanese woman who requested examination of a reddish lesion on the left floor of the mouth. The biopsy material was diagnosed as squamous cell carcinoma. Clinical examination showed a well-circumscribed, 20 x 10 mm-sized lesion, which was categorized as cT2cN0cm 0. Tumor resection was therefore performed. Histologically, most parts of the lesion were conventional squamous cell carcinoma in situ, but the invasive part consisted of ASCC with gland-like or reticular appearance. The latter part was negative for mucin staining. Immunohistochemically, this lesion was positive for pancytokeratin, high-molecular-weight keratin, cytokeratin (CK) 7/8, CK19, E-cadherin and p53, but negative for vimentin, CK20, and S-100 protein. The Ki-67 labeling index was 50.3% in the ASCC part and 34.5% in the carcinoma in situ part. These findings and a review of the literature indicate that a gland-like feature of ASCC is associated with the loss of cell adhesion in the center of the cancer nests, and it can be confirmed simply by mucin staining to be neither an adenosquamous carcinoma nor ductal involvement of conventional squamous cell carcinoma.

Cadherins↗