Phonatory function following esophagectomy for esophageal cancer

BACKGROUND/AIMS: Quality of life can be adversely affected in many patients who suffer phonation disorders such as hoarseness and dysphonia following esophagectomy. The present study investigated postoperative phonation disorders in 15 patients who underwent esophagectomy for esophageal cancer. METHODOLOGY: None of the patients had signs of hoarseness before or after surgery. Aerodynamic testing to assess phonatory function testing and laryngoscopy for observing laryngeal movements were performed before and after surgery. As a control, the same tests were conducted in 20 patients treated for gastric cancer by gastrectomy. RESULTS: For esophagectomy patients, mean postoperative flow rate was significantly increased and maximum postoperative phonation time was significantly decreased after operation. Laryngoscopy confirmed postoperative paralysis of left laryngeal movements and excessive adduction of the right, unaffected vocal cord during phonation in 8 of 15 esophagectomy patients, although hoarseness was not reported by any patient. No significant changes were observed for mean postoperative flow rate or maximum postoperative phonation time following surgery in gastrectomy patients. CONCLUSIONS: Surgical procedures in the vicinity of the recurrent laryngeal nerve appear to be the cause of postoperative phonation disorders in patients undergoing esophagectomy for esophageal cancer, and these disorders can occur in the absence of symptoms such as hoarseness and dysphonia.     

Immusorba TR and Immusorba PH: Basics of Design and Features of Functions

Abstract: Immusorba was reported by Yamazaki et al. to be the world's first practical immunoadsorbent in 1982. Since then, this immunoadsorbent has accumulated an abundance of clinical achievements. Immusorba has such unique functions that it is used in treating various diseases and holds possibilities for application to more diseases. Immusorba was designed as an artificial receptor for rheumatoid factor (RF) based on structural analysis of heat-denaturated globulin. Subsequently, new substances that it can adsorb have been found as seen in reports on the adsorption performance of Immusorba to anti-acetylcholine receptor antibodies (anti-AChR Abs) and antiganglioside antibodies. Along with this, Immusorba has been used in treating a wide range of diseases. The greatest characteristic of Immusorba is that its adsorption capability is selective rather than specific, making it effective against a great number of diseases.     

"Hetero to homo" allogeneic bone marrow transplantation from a related donor with two HLA loci mismatch

We describe a 46-year-old HLA-homozygous female patient with CML who received a bone marrow transplant from her son, who had two HLA (A, B) loci mismatch. After conditioning with total body irradiation plus cyclophosphamide, the patient received 4.8 x 10(8) bone marrow cells/kg. Cyclosporin and short-term methotrexate were used for GVHD prophylaxis. She successfully established rapid engraftment with no acute GVHD, and later developed chronic but mild GVHD. Family members with two HLA loci mismatch may be considered as candidate donors for "hetero to homo" bone marrow transplantation.     

The Metabolism of Biogenic Monoamines during Embryogenesis and Metamorphosis in Two Anuran Species

This study investigated the pathways to many monoamines and their metabolites in the central nervous system of the frogRana nigromaculataand the toadBufo bufo japonicusduring embryonic development and metamorphosis. Metabolites were analyzed by three-dimensional HPLC. The two species provided evidence of similar pathways, with slightly different timetables for the development of their monoamine systems. During embryonic development, the main metabolic pathways in entire embryos were tyrosine (TYR) → [3,4-dihydroxyphenylalanine inBufo] → 3-hydroxytyramine → norepinephrine or epinine (EPIN) → epinephrine, TYR → tyramine → (octopamine inRana) and TYR → 3-O-methyldopa for catecholamines, and tryptophan → kynurenine and 5hydroxytryptamine (5-HT) → [5-hydroxyindoleacetic acid andN-methyl-5-hydroxytryptamine (N-MET) inBufo]. The monoamine system in the brain was similar during metamorphosis to that during embryogenesis with a few exceptions. The most striking change was the development of the bufotenine (5-hydroxy-N,N-dimethyltryptamine) pathway from 5-HT via N-MET. EPIN and norepinephrine inRanaand octopamine in both species disappeared during metamorphosis. These results are discussed in relation to the roles of the various pathways in development.     

Usefulness of lower extremity 2D TOF MR venography with respiratory compensation technique, and effect of patient positioning on the visualization of deep veins in the leg

We evaluated the usefulness of two-dimensional time-of-flight (2D TOF) MR venography (MRV) of the lower extremity using the respiratory compensation (RC) technique. In addition, six variations in patient positioning of the leg and knee were investigated to determine the best method of visualizing the deep popliteal veins and lower leg. All data sets were reviewed and graded for visualization of the deep veins at the pelvis, thigh, and leg portion (4-point scale) by two radiologists and three radiological technologists. The same veins demonstrated with various positions of the patient were also evaluated in the same manner. In conclusion, 2D TOF MRV with RC resulted in increased uniformity of vein signal in the pelvic area. Furthermore, we should position the patient's leg so as not to compress the vein at the posterior portion of the leg, and not to over-extend the knee joint. This enabled the best results to be obtained in MRV of the lower extremity.