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Hajime Hirose

Publications and source records attributed to Hajime Hirose.

At least 19 recordsLinked to original sources
PubMed2006

Long-term result of the new endoscopic vocal fold medialization surgical technique for laryngeal palsy.

OBJECTIVE: The conventional surgical method for a case of unilateral laryngeal nerve paralysis with large glottal gap requires an external cervical incision. In the present study, we developed an endoscopic technique of vocal fold medialization that can make the external incision unnecessary. This procedure of autologous transplantation of fascia into the vocal fold (ATFV) was developed for the successful treatment of unilateral laryngeal nerve paralysis. However, the method seemed to be effective only for patients with a relatively mild glottal gap. STUDY DESIGN AND METHODS: In the present study, we modified the method of medialization using the ATFV technique to obtain effective closure of a large glottal gap. To overcome this difficulty, an attempt was made to extend the site of transplantation more posteriorly so as to adduct the vocal process of the arytenoid cartilage in the body of the vocal fold. RESULTS: This new technique was applied to eight cases of patients with unilateral laryngeal paralysis with severe dysphonia. None of the patients showed any evidence of falling off of the graft. Elongation of the maximum phonation time and a decrease in airflow rate during phonation were obtained with improvement in voice quality in all patients 1 year after the surgery. CONCLUSIONS: This method, with its less invasive approach, proved to be useful for the treatment of large glottal gap due to unilateral laryngeal nerve paralysis.

Aged↗
PubMed2006

[A case of quadruple cancers of esophagus, stomach, lung and buccal mucosa improving the quality of life by loco-regional cancer therapy].

The patient is an 86-year-old man who was presented with right submandibular mass and tarry stool. He was diagnosed having right buccal carcinoma with right cervical lymph node metastasis, gastric cancer with double lesions, and suspected right superior lung cancer by endoscopy and computed tomography. We started with an operation for the right buccal carcinoma. After the operation, superficial-esophageal carcinoma was found. Due to his old age and a lack of physical strength in the operation, we performed an endoscopic mucosal resection for esophageal cancer and argon plasma coagulation for gastric cancer. Symptomatic therapy was only performed for lung cancer. He died from lung cancer 18 months later. However, he had a good quality of life during the progress without recurrence, and the gastric cancer was also controllable without symptoms. It was difficult to decide the treatment for duplicated multiple organ cancers caused by numerous factors such as in our case. We assume that patient's quality of life is the most appropriate factor to be considered in selecting the treatment for elderly patients.

Aged, 80 and over↗
PubMed2005

Communication strategies and interpersonal skills of instructors of esophageal speech: an observation study.

OBJECTIVE: In this article, the way that the Instructor of Esophageal Speech (IES) works is considered from an interactive-analytic perspective. METHODS: The observation project data were gathered during 6 months in 2004 at the training sessions of the Ginreikai-Asian Federation of Laryngectomees' Association using the Six Category Intervention Analysis framework (6CIA) by a trained communication specialist as an active-observer. RESULTS: Mean scores of each of the six categories and a series of percentage distributions were extracted from the usage-frequency data and interpreted together with the results of Chi-square analysis of usage-frequency units. We found the IES used more frequently authoritative categories and used less facilitative categories. Our results of the data analysis show that the 30 IES used more authoritative interventions and used more frequently the prescription and information giving than the confrontation or cathartic interventions. CONCLUSION: The results of the present study show that the 6CIA framework has its potential and value as an analytic tool to explore the IES' actual behavior in a specific therapy related context. PRACTICE IMPLICATIONS: We argue for the utility of the 6CIA as an analytic framework to investigate the interpersonal behavior of the IES in the Japanese cultural setting.

Aged↗
PubMed2005

A pilot study of the translation, cultural adaptation and validation of the EORTC head and neck cancer quality of life questionnaire module (QLQ-H&N35) for use in Japan.

Development of the Japanese version of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-head and neck 35 (H&N35) module for use in Japan. Phase 1: The First Intermediary Japanese version was produced according to the EORTC Quality of Life (QOL) Unit translation project guideline. The Second Intermediary version was a result of the backward translation project and two peer-to-peer discussion settings by health care professionals related to the project. Phase 2: Focus group discussions with team members and semi-structured interviews with 108 participants to produce the final Japanese version. Our cultural-adaptation and validation yielded scores that are reliable by internal consistency (Cronbach's alpha) and the validation results showed acceptable correlation results by Pearson's Product Moment Correlation Coefficient (r). The questionnaire was well accepted and the response rate was high (93.9%). Convergent validity was moderate to high (from r=0.55 to 0.97, P<0.01) and discriminant validity was low; Cronbach's alpha coefficients of most scales had good reliability (alpha> or =0.70), except that of pain scale. In Japan, however, some correlation patterns between scales differed from that in the original European countries and cultures. The use of both qualitative and quantitative methods was important in developing the Japanese version of the QLQ-H&N35 module. We conclude that the Japanese version has good psychometric validity, thus it is recommended for further study to assess health-related quality of life (HRQOL) in Japanese head and neck cancer patients.

Asian People↗
PubMed2005

Simultaneous operation of ischemic heart disease, abdominal aortic aneurysm, and rectal cancer.

A 68-year-old man with ischemic heart disease, abdominal aortic aneurysm, and rectal cancer was referred. Coronary angiography indicated triple-vessel disease with jeopardized collaterals, and dipyridamole myocardial scintigraphy disclosed no viability in the inferior, posterior, and lateral walls. Abdominal computed tomography scanning revealed an infrarenal abdominal aortic aneurysm, 65 mm in diameter, with an expanding rate of 8 mm/year. Barium enema revealed stenosis 4 cm in length 5 cm inward from the anal verge, and an endoscopic finding was ulcerated type tumor with a clear margin and circumferential stenosis. Histological examination of a biopsy specimen revealed adenocarcinoma, and the clinical stage in the Japanese classification of colorectal carcinoma was II according to other examinations. Simultaneous operations were scheduled because of the jeopardized collaterals of the coronary arteries, rapid expansion of the aneurysm, and subileus due to the cancer. The patient underwent simultaneous off-pump coronary artery bypass grafting to the left anterior descending artery with the in situ internal thoracic artery through a median sternotomy, abdominal aortic aneurysm repair with a tube graft through a median laparotomy, and the Miles' operation with total mesorectal excision. Although infection of the perineal wound was postoperatively recognized, it remained local and was healed with irrigation only. The patient is doing well 12 months after the operation, without myocardial ischemic symptoms or recurrence of the cancer.

Adenocarcinoma↗
PubMed2005

Surgical outcome of elephant-trunk anastomosis between the left carotid and subclavian arteries in aortic arch repair including the postoperative physical status of the left arm.

We studied the outcome of our modified aortic arch replacement procedure in which the distal end of the graft is anastomosed between the left common carotid artery and the left subclavian artery including the postoperative physical status of the left arm in comparison with the conventional technique. We assessed the surgical outcome of 26 patients who underwent our new technique and 11 patients who underwent the conventional one. Postoperative clinical symptoms and physical status of the left arm were also evaluated. No operative deaths were observed in the new technique group and one operative death was observed in the conventional group (9.1%). No significant differences between the two groups in postoperative clinical symptoms and the physical status of the left arm were observed. Our "distal anastomosis to the proximal level of the left subclavian artery" technique made aortic arch replacement easier and steadier with a satisfactory surgical outcome in comparison with the conventional method. The postoperative clinical symptoms and physical status of the left arm in the new technique group were identical to those in the conventional group.

Aged↗
PubMed2005

Limited dissection of abdominal aortic aneurysm in a patient with multiple myeloma.

Dissection limited to the abdominal aorta contributes 4% of all aortic dissections, and inflammatory injury of the aortic media is one of factors associated with dissection. In multiple myeloma, leukocytoclastic vasculitis of the skin has been known. We describe limited dissection of an abdominal aortic aneurysm with dense lymphocyte infiltration in a 62-year-old man with multiple myeloma. Although it is unclear whether the lymphocyte infiltration in the aortic wall, which was denser than that of atherosclerotic aneurysm, was associated with multiple myeloma, the excessive aortic wall inflammation may have somewhat influenced aneurysm formation or aortic dissection.

Aortic Dissection↗
PubMed2005

Endoscopic vocal cord medialization: a new surgical technique without neck incision for laryngeal palsy.

Different types of surgery have been reported for glottal insufficiency due to unilateral vocal cord paralysis. We recently developed a new surgical technique of fascia implantation known as vocal cord medialization. This new method achieves a wide glottal gap during phonation, without the use of an external approach. This new technique is described in detail herein, together with the satisfactory results we obtained in six cases of unilateral vocal cord paralysis with a wide glottal gap during phonation. We recommend this technique in cases of unilateral vocal cord paralysis in which both a satisfactory clinical result and an aesthetically pleasing cosmetic result are required.

Fascia↗
PubMed2005

Autologous transplantation of fascia into the vocal fold: long-term result of type-1 transplantation and the future.

OBJECTIVES: Since 1997, we have performed the autologous transplantation of fascia into the vocal fold (ATFV) procedure on cases of sulcus vocalis. In what follows, we report the long-term results of our new surgical approach and discuss the role of these transplantations. We also review and report some complications that can be caused by ATFV. Finally, we discuss the ATFV technique as a contribution to the phonosurgery of the future. STUDY DESIGN: Prospective study. METHODS: We were able to obtain long-term results from 10 volunteer cases (2 female and 8 male, age: 15-71, mean 46.5 years old) who could be followed up for at least 3 years after transplantation. All were cases of pathologic sulcus vocalis.We measured maximum phonation time (MPT) and carried out pre- and postsurgical clinical observation and laryngeal stroboscopy in all cases. These measurements and observations were made before the ATFV and at 6 months, 1 year, 2 years, and 3 years after surgery. RESULTS: In stroboscopic observation 1 year after the ATFV, satisfactory glottal closure and excellent mucosal wave were observed for all cases, and there was no case with hyperadduction of the false vocal folds. MPT measures remained at an improved level 2 years and 3 years after the transplantations. Paired-sample t tests showed that the improvement relative to preATFV levels was significant for all postsurgical measurements up to 3 years. CONCLUSIONS: We conclude that ATFV is a successful surgical procedure for sulcus vocalis and scarred vocal folds. Other phonosurgical clinical applications may also be envisioned.

Adolescent↗
PubMed2005

The effect of storage on the survival of cancer cells in blood and efficient elimination of contaminating cancer cells by a leukocyte depletion filter.

Preoperative autologous blood pooling has been employed in patients with malignant tumor. However, it has not been reported how the survival period of tumor cells contaminating the preoperative pooled blood changes corresponding to the storage period. Intraoperative blood salvage (IBS) is used together with preoperative blood pooling. However, IBS in oncologic surgery is generally regarded as a contraindication. In the current study, using cytokeratin 19 (CK-19) mRNA reverse transcription polymerase chain reaction method, we examined the survival period of cultured cancer cells in the pooled blood and the efficacy of irradiation and leukocyte depletion filter in eliminating cancer cells in the blood. Expression of CK-19 mRNA was observed in the pooled blood stored for 21 days. The number of cancer cells decreased to about 1/10 in the blood stored for 14 days. We irradiated blood with cancer cells with doses of 25 Gy or 100 Gy. No change was observed in the amplified CK-19 signal strength immediately after and 1 day after irradiation at 100 Gy. After filtration of blood with cancer cells through the leukocyte depletion filter, no CK-19 mRNA was detected. Blood filtration with the leukocyte depletion filter was effective in eliminating cancer cells in the blood.

Blood Preservation↗
PubMed2004

Primary peritonitis associated with streptococcal toxic shock-like syndrome: report of a case.

Several reports over the past 15 years describe severe group A streptococcal infections causing septic shock, soft-tissue necrosis, and multiple organ failure; a phenomenon known as streptococcal toxic shock-like syndrome (TSLS). However, primary peritonitis associated with TSLS is rare. We report the case of a 40-year-old man admitted with pain in both thighs, hypotension, and severe abdominal pain. His daughter had been diagnosed with streptococcal pharyngitis 3 days earlier. We performed an emergency laparotomy for peritonitis, and culture of the ascites was positive for group A beta -hemolytic streptococcus (GAS). Further serotyping of the isolated GAS strain revealed the T-type 22 and the pyrogenic exotoxin gene, spe-C. The criteria for TSLS were clearly met, including the isolation of GAS from ascites, hypotension, liver failure, renal failure, coagulopathy, myositis, and a generalized erythematous macular rash with desquamation.

Acute Disease↗
PubMed2004

Translocation of Salmonella typhimurium in rats on total parenteral nutrition correlates with changes in intestinal morphology and mucus gel.

OBJECTIVE: We tested whether alterations in intestinal morphology and mucus gel correlate with differences in Salmonella typhimurium translocation between rats treated with total parenteral nutrition (TPN) and rats given a diet of chow. METHODS: Twenty-seven male Wistar rats were assigned to one of two groups: one received TPN for 14 d and the other (control) received standard rat chow and water ad libitum. Salmonella typhimurium (5 x 10(8) cells; GIFU 12142) was injected into a closed ileal loop. Portal venous blood (PVB), inferior vena cava blood (IVCB), and mesenteric lymph nodes (MLNs) were sampled for evaluation of bacterial translocation. Sections of the loop were prepared and stained with hematoxylin and eosin, periodic acid-Schiff (PAS), and fluorescein isothiocyanate-labeled Ulex europaeus agglutinin I (FITC-UEA-I) for image analysis. Perimeter, mucosal thickness, villus area, and positively stained mucus area were measured. A fluorescent antibody study was also done. RESULTS: Organisms were found in cultures of 1 in 13 control rats and 9 in 14 TPN rats. There were more bacteria in MLNs than in PVB or IVCB. There was no increase in the number of bacteria over time in PVB, IVCB, or MLNs. Perimeter and villus area (P < 0.001) and mucosal thickness (P < 0.01) were significantly smaller in the TPN group than in the control group. The positively stained mucus area was significantly smaller in the TPN group than in the control group (P < 0.05 with PAS, P < 0.01 with FITC-UEA-I). Salmonella typhimurium invaded specifically through Peyer's patches. In all culture-negative samples, bacteria were trapped by the mucous layer, with a very small number attached to the epithelial surface. CONCLUSION: Significant villous atrophy and reduction of mucus play an important role in the rapid translocation of S. typhimurium through Peyer's patches in rats after 2 wk of TPN.

Animals↗
PubMed2004

Experimental studies to estimate the intestinal viability in a rat strangulated ileus model using a dielectric parameter.

This study aimed at establishment of adequate evaluation of intestinal viability before release of the strangulated intestine by measuring electrical properties. In rats a 20-cm segment of the distal ileum and mesentery was strangulated. The intestine was strangulated for 0, 2, 15, 45, 90, and 120 min. The conductance and capacitance obtained by impedance analyzer were used to calculate tan(delta)m in the strangulated intestine. ATP was measured as well. In another experiment, after various periods of strangulation, tan(delta)m was measured just before release of the strangulation. Rats were divided into Group A (survived for 7 days) and Group D (died within 7 days). There was a positive correlation between tan(delta)m and ATP levels (P < 0.01). And tan(delta)m was significantly greater in Group A than in Group D (P < 0.05). There were no deaths at a tan(delta)m value of 2.36 or more and no survivors at a tan(delta)m of less than 2.20 except for one rat. These results suggested that tan(delta)m may be a useful index of the viability of the strangulated intestine before reperfusion.

Adenosine Triphosphate↗