Functional effects of intraoral reconstruction with a free radial forearm flap

Postoperative articulation was investigated in patients who underwent glossectomy and reconstruction with free radial forearm flaps. The methods of evaluation consisted of scores for intelligibility of 100 Japanese syllables and 3 groups of glossal sounds. The glossal sounds, based on palato-lingual contact (lingogram), were useful to evaluate function of the respective parts of the tongue. One patient who had had a partial glossectomy and resection of the floor of the mouth achieved an overall score of 80.5% one year postsurgery, and his glossal sounds were also excellent. Three patients who underwent removal of the floor of the mouth and hemiglossectomy, excluding the root of the tongue, had overall scores ranging from 45.6% to 82.1%. Two of these had particularly low scores for the glossal sounds produced with the rear part of the tongue, and this suggested the necessity for suspension slings to prevent depression of the reconstructed tongue and the floor of the mouth. The hemiglossectomy with partial mandibulectomy had an acceptable score of 68.7%. Chronologically, the glossal sounds produced with the rear part and the blade of the tongue often tended to improve postsurgery.     

The relationship of DSM-III-R personality disorder to clinical variables in patients with major depression: Possible difference between personality disorder clusters

Abstract The relationship of DSM-III-R personality disorder (PD) to demographic and clinical variables was investigated based on 96 consecutive outpatients with major depression. No significant difference in the variables was found between those with and those without PD. Those with PD from each cluster were compared with those without PD in terms of the variables. In these comparisons many relationships of PD to the variables were found, and these relationships were different between the three PD clusters detailed in DSM-III-R. Patients with cluster B PD demonstrated a prominent uniqueness in his/her relationship to the variables. This uniqueness was similar to what had been reported previously with regard to patients with PD. There was no significant difference in the variables between those with cluster C PD and those without PD. Those with cluster A PD may have a negative family history of affective disorders.     

A Case of Bleeding Caused by Rectal Stone after Uretero-ileoceco-proctostomy

Abstract: A rare case of anal bleeding caused by rectal stone after uretero-ileoceco-proctostomy is reported. A 66-year-old man was admitted to our hospital complaining of anal bleeding. He had a history of cystoprostatectomy with uretero-ileoceco-proctostomy for prostatic adenocarcinoma 25 months prior to the present admission. Mucosal bleeding from the point of stone formation around the staples at the uretero-ileoceco-rectal anastomosis was found by sigmoidoscopy and the bleeding was treated endoscopically by thrombin spraying and clipping. Furthermore, the stones and staples at the uretero-ileoceco-rectal anastomosis were endoscopically removed with forceps. To our knowledge, severe mucosal bleeding from the point of stone formation around the staples at the site of intestinal anastomosis has not previously been reported.     

A Case of Endometriosis of the Appendix

A 51-year-old woman visited our clinic her chief complaint being right hypogastric discomfort. An abdominal ultrasonography revealed a circular, cystic mass in the right hypogastric region. A colorectal radiography disclosed a semi-globular shadow defect at the end of the cecum and did not visualize the appendix. A colorectal endoscopy revealed a submucosal tumor accompanied by a central dimple which seemed to represent the ostium appendicis vermiformis. Based on a preoperative diagnosis of submucosal tumor, the patient underwent a partial resection of the cecum. A histopathological examination of tissue removed led to a diagnosis of endometriosis of the appendix. In Japan, 7 cases of endometriosis of the appendix have been reported to date. In those cases, endometriosis of the appendix was detected as a lesion accompanying endometriosis of some other site or during laparotomy was based on a diagnosis of acute appendicitis. Unlike these cases, the patient presented here had been diagnosed by a preoperative colorectal radiography and endoscopy as having a submucosal tumor of the appendix.