Uraguchi K, Kariya S, Oka A
… +6 more, Tsumura M, Ishihara H, Miyatake T, Hirata Y, Makihara S, Nishizaki K
Nihon Jibiinkoka Gakkai Kaiho
· 2016 Oct · PMID 30035932
Brainstem/cerebellar infarction is known to cause various cranial nerve symptoms that may require otorhinolaryngological evaluation. Acute-phase cerebellar infarction is evaluated by MRI with diffusion-weighted imaging (...Brainstem/cerebellar infarction is known to cause various cranial nerve symptoms that may require otorhinolaryngological evaluation. Acute-phase cerebellar infarction is evaluated by MRI with diffusion-weighted imaging (MRI-DWI). However, in the acute phase, MRI-DWI may show false-negative results, because of which patients are referred to the department of otolaryngology for further evaluation of the cranial nerve symptoms. We investigated 250 cases of brainstem/cerebellar infarction in 245 patients who were admitted to our hospital between 2010 and 2015. Of the 250 cases, eight cases were diagnosed at the department of otolaryngology after detailed evaluators for dizziness or dysphagia, and three of them were false negative on initial MRI-DWI. In total, we examined 16 cases detected as false negatives upon initial MRI-DWI. Of the 16 cases, 12 were brainstem infarctions, three were cerebellar infarctions, and one was infarction of the brainstem and cerebellum. All 16 cases were evaluated by initial MRI-DWI within 12 h of onset. Careful observation of the neurological findings and follow-up MRI-DWI are useful for the detailed evaluation of patients suspected to have a cerebellar infarction.
Fine-needle aspiration cytology (FNAC) is considered a safe procedure, but it causes massive neck swelling and airway obstruction rarely. Neck swelling after FNAC is caused by two mechanisms: by hematoma or by release of...Fine-needle aspiration cytology (FNAC) is considered a safe procedure, but it causes massive neck swelling and airway obstruction rarely. Neck swelling after FNAC is caused by two mechanisms: by hematoma or by release of vasodilator substances in thyroid cells and nerve terminals. The latter condition was previously reported as an acute and frightening swelling of the thyroid, but is not named appropriately. For convenience, we therefore refer to the condition as dTSaFNA (diffuse thyroid swelling after fine-needle aspiration) in this report. dTSaFNA is usually transient and rarely results in airway obstruction. We report one case of thyroid hematoma and two cases of dTSaFNA. All three cases were treated in hospital and recovered completely.
HIV-associated salivary gland disease (HSD) is one of the initial symptoms of HIV infection. HSD occurs in about 5%～10% HIV patients. Usually, HSD shows multilocular soft cystic lesions in parotid glands; however, it do...HIV-associated salivary gland disease (HSD) is one of the initial symptoms of HIV infection. HSD occurs in about 5%～10% HIV patients. Usually, HSD shows multilocular soft cystic lesions in parotid glands; however, it does not show bilateral parotid abscesses. We report the case of a 32-year-old man with HIV infection that initially presented as bilateral parotid abscesses. He came to our hospital with a 1-week history of bilateral parotid swelling. He did not have a history of HIV infection, diabetes mellitus, or tuberculosis infection. We performed incision and drainage, bacterial culture, and serological examination, which showed HIV infection. This is a rare case of HSD starting as bilateral parotid abscesses. Because cystic enlargement of the bilateral parotid glands is an unusual condition in the HIV-negative population, HIV testing should be recommended in such cases.
We investigated the accuracy of the prediction of Japanese cedar-pollen dispersion at the Oita University Faculty of Medicine Complex for use in future prediction models. We compared the predicted and actual total poll...We investigated the accuracy of the prediction of Japanese cedar-pollen dispersion at the Oita University Faculty of Medicine Complex for use in future prediction models. We compared the predicted and actual total pollen counts per year, the initial day of pollen scattering, and the daily pollen counts from 2005 to 2014. Total pollen counts per year were predicted by the amount of sunshine in the Hita area, which was considered to be the source of pollen in our previous study, during the previous July. The initial day of pollen scattering was predicted using the variation pattern in air temperature. Daily pollen counts were predicted by performing a multivariate analysis using the type-II quantification method. The differences between the actual and predicted total pollen counts per year increased after 2011. The correlation coefficient between the total pollen count and the amount of sunshine duration in the Hita area during the previous July greatly decreased in the same period, and was surpassed by the correlation coefficient for the Nakatsu area. We speculated that the primary source of pollen had moved from the Hita refion to the Nakatsu region. The average difference between the predicted and actual initial day of pollen scattering was 3.2 days. This difference was decreased when we reanalyzed the data using the Nakatsu area as the source of pollen. With regard the prediction of the daily pollen counts, the overall accuracy was 60%-70%, but the accuracy for the full-scale scattering period was 40%-60%. Our results suggest that the prediction of atmospheric Japanese cedar-pollen dispersion must be routinely reviewed. In addition, when estimating total pollen counts and the initial day of pollen scattering, it is necessary to consider the pollen source area. This method must be examined further for its accuracy in predicting the daily pollen counts.
Clinicians frequently encounter patients experiencing a floating sensation of unknown cause, referred to as floating dizziness. We developed a clinical examination to quantify gravity perception as a first step to test o...Clinicians frequently encounter patients experiencing a floating sensation of unknown cause, referred to as floating dizziness. We developed a clinical examination to quantify gravity perception as a first step to test our hypothesis that a gravity perception disturbance causes floating dizziness. Our preliminary experiments revealed a linear relationship between head-tilt angle (HTA) and head-tilt perception (HTP) at a head roll tilt of <30°, with correlation coefficients of 0.991 and 0.999 between HTA and HTP in the whole body and head-tilt conditions, respectively. Using these observations, we established a method to evaluate the HTP gain (HTPG), which is the slope of a linear regression line produced by the relation of subjective visual vertical (SVV) with HTA during head tilt, as an index of gravity perception. We named this method head-tilt SVV (HT-SVV). When HTPG was>1, the subjects' HTP overestimated their HTA and vice versa. HT-SVV measurements of 329 healthy subjects gave an average and standard deviation (1.02±0.12) and reference value (0.80～1.25) for HTPG, a difference between left and right HTPG (4.7%±3.7%, <10.0%), and an absolute value for SVV in the upright head position (1.1°±0.8°, <2.5°). The next step is to make the HT-SVV system easier and faster to use as well as to collect more data from patients experiencing dizziness, including floating dizziness, to clarify the clinical significance of HT-SVV.