研究者詳細 - 小川　郁

論文 - 小川　郁

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Tracheoesophageal diversion versus total laryngectomy for intractable aspiration

Tomita Toshiki, Tanaka Kazuhito, Shinden Seiichi, Ogawa Kaoru

Journal of Laryngology and Otology 118 （ 1 ） 15 - 18 2004年01月

ISSN 0022-2151

This study evaluates the outcome and surgical stress associated with surgery for intractable aspiration. A retrospective review was conducted to compare the results between tracheoesophageal diversion and total laryngectomy. The operative time, intra-operative bleeding, time until drain removal, feeding conditions and surgical complications were compared between the two groups. Of the 19 patients, 31.6 per cent underwent tracheoesophageal diversion and 68.4 per cent received total laryngectomy. The operative time and drain insertion periods were statistically shorter in the tracheoesophageal diversion group, while the amount of intra-operative blood loss was smaller in the tracheoesophageal diversion group. The complication rate and the feeding conditions before and after surgery for the two groups did not show any statistically significant difference. Tracheoesophageal diversion was thus found to be a simple, safe, and reliable therapeutic modality for the control of intractable aspiration. Moreover, it induced less surgical stress than total laryngectomy.

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Cervical emphysema secondary to pneumomediastinum as a complication of childbirth

Nakagawa Hideki, Yamauchi Miwa, Kusuyama Toshiyuki, Fukuda Hiroyuki, Ogawa Kaoru

Ear, Nose and Throat Journal 82 （ 12 ） 948 - 951 2003年12月

ISSN 0145-5613

Pneumomediastinum and cervical emphysema usually occur following esophageal or chest trauma. Rarely do they occur as a complication of childbirth, and only approximately 200 such cases have been reported in the literature worldwide. We describe a new case, and we review the clinical picture, pathophysiology, and management of these conditions. In view of the head and neck symptoms of pneumomediastinum and cervical emphysema during labor - which include dyspnea, cough, sore throat, pain on swallowing, and dysphagia - otolaryngologists might be consulted and should therefore be aware of these conditions in order to recognize and treat them.

CCND1 Amplification Predicts Sensitivity to Chemotherapy and Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

Ishiguro Ryuichiro, Fujii Masato, Yamashita Taku, Tashiro Masatsugu, Tomita Toshiki, Ogawa Kaoru, Kameyama Kaori

Anticancer Research 23 （ 6 D ） 5213 - 5220 2003年11月

ISSN 0250-7005

Background: Cyclin D1 has been reported to be associated with poor prognosis in head and neck squamous cell carcinoma (HNSCC). Patients and Methods: FISH was performed on 58 patients. Thirty-two received neoadjuvant chemotherapy (NAC) as primary treatment and 21 with hypopharyngeal squamous cell carcinoma (HPC) received chemoradiotherapy. Results: CCND1 amplification was identified in 31 (53%) patients and the incidence was higher in HPC (p=0.0068). Four (31%) out of 13 patients with CCND1 amplification responded to NAC whereas the response rate in the non-amplified group was 79% (p=0.011). CCND1 amplification with a homogeneously staining region (HSR) was accompanied by cyclin D1 protein overexpression (p<0.0001). HPC showed HSR more frequently (p=0.033) and the survival rate of the subgroup with HSR was lower than that without (p<0.05). Conclusion: Detection of CCND1 amplification using FISH may be a useful marker of sensitivity to NAC and chemoradiotherapy for HNSCC.

Hearing improvement after tumor removal in a vestibular schwannoma patient with severe hearing loss

Inoue Y., Ogawa K., Kanzaki J.

European Archives of Oto-Rhino-Laryngology 260 （ 9 ） 487 - 489 2003年10月

ISSN 0937-4477

We herein report on the hearing improvement obtained after tumor removal in a vestibular schwannoma patient with preoperative severe hearing loss and good otoacoustic emission. Hearing recovery after tumor removal is an uncommon occurrence. As a result, hearing preservation surgery is usually not performed for patients with severe hearing loss. However, patients with a good OAE seem to have a better chance to recover their hearing than those with a poor OAE, even if they have severe hearing loss. As a result, the cochlear function should be evaluated, especially regarding the OAE, before determining the indications for hearing preservation surgery.

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Effect of single-drug treatment on idiopathic sudden sensorineural hearing loss

Kanzaki Jin, Inoue Yasuhiro, Ogawa Kaoru, Fukuda Satoshi, Fukushima Kunihiro, Gyo Kiyofumi, Yanagihara Naoaki, Hoshino Tomoyuki, Ishitoya Jun Ichi, Toriyama Minoru, Kitamura Ken, Murai Kazuo, Nakashima Tsutomu, Niwa Hideto, Nomura Yasuya, Kobayashi Hitome, Oda Makoto, Okamoto Makito, Shitara Tetuya, Sakagami Masafumi, Tono Tetsuya, Usami Shin Ichi

Auris Nasus Larynx 30 （ 2 ） 123 - 127 2003年05月

ISSN 0385-8146

Objectives: In order to evaluate the effect of a medical administration for the sudden deafness patients, single-drug treatment for idiopathic sudden sensorineural hearing loss (ISSHL) was assessed at multi-centers participating in the Acute Severe Hearing Loss Study Group sponsored by the Ministry of Health, Labor and Welfare of Japan. Methods: The subjects consisted of ISSHL patients who were (1) 20 years of age or older, (2) diagnosed within 2 weeks after the onset of hearing loss, (3) showing a mean hearing level of 40-90 dB at five frequencies from 250 to 4000 Hz, (4) previously untreated, and (5) with normal for age in hearing of the opposite ear. The drugs used in this study were ATP, alprostadil, hydrocortisone and amidotrizoate, which were administered intravenously, and beraprost sodium and betamethasone, which were given orally. Two drugs were assigned to each center, one of which was selected according to the code hidden in envelopes and administered for 1 week. The treatment after the single-drug administration was conducted at the discretion of each center. The hearing gain and recovery rate at 1 week after the initiation of single-drug treatment and at 1 month or over when the hearing level was fixed, were evaluated based on the criteria for hearing recovery prepared by the Acute Severe Hearing Loss Study Group. Results: There was no statistically significant difference in the recovery rate among drugs either at 1 week after the initiation of single-drug treatment or at the time of fixed hearing level. At the time when the hearing level was fixed, a statistically significant difference in the complete recovery rate was detected only between amidotrizoate and beraprost sodium. Conclusion: From these results, we could not find any specific drugs recommended for ISSNHL. In evaluating the effect of the drugs, however, several problems in the clinical trial for ISSHL should be considered.

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The inhibitory effect of matrix metalloproteinase inhibitor ONO-4817 on lymph node metastasis in tongue carcinoma

Yamashita Taku, Fujii Masato, Tomita Toshiki, Ishiguro Ryuichiro, Tashiro Masatsugu, Tokumaru Yutaka, Imanishi Yorihisa, Kanke Minoru, Ogawa Kaoru, Kameyama Kaori, Otani Yoshihide

Anticancer Research 23 （ 3 B ） 2297 - 2302 2003年05月

ISSN 0250-7005

Background: ONO-4817 is a novel matrix metalloproteinase (MMP) inhibitor which has a broad inhibitory spectrum for MMPs. We investigated the inhibitory effect of ONO-4817 on cervical lymph node metastasis of tongue carcinoma. Materials and Methods: HSC-3-M3, a cell line derived from human tongue carcinoma with high metastatic potential for lymph node, was used. The direct cytotoxicity of ONO-4817 was assessed by MTT assay and the gelatinolytic activity by gelatin zymography and film in situ zymography (FIZ). The inhibitory effect on lymph node metastasis was examined by orthotopic implantation model with nude mice. Results: ONO-4817 had no direct cyototoxicity on HSC-3-M3 cells. Gelatin zymography and FIZ demonstrated a suppression of MMP-9 activation and a marked inhibition of gelatinolysis. Additionally, a suppression of cervical lymph node metastasis was shown by therapeutic experiment. Conclusion: The MMP inhibitor, ONO-4817, is a candidate for adjunctive therapy of cervical lymph node metastasis in tongue carcinoma.

Adenoviral GDNF gene transfer prevents motoneuron loss in the nucleus ambiguus

Saito Kouichiro, Shiotani Akihiro, Watabe Kazuhiro, Moro Kazuhisa, Fukuda Hiroyuki, Ogawa Kaoru

Brain research 962 61-67 2003年03月

研究論文（学術雑誌）, 共著

Adenoviral GDNF gene transfer prevents motoneuron loss in the nucleus ambiguus

Saito Koichiro, Shiotani Akihiro, Watabe Kazuhiko, Moro Kazuhisa, Fukuda Hiroyuki, Ogawa Kaoru

Brain Research 962 （ 1-2 ） 61 - 67 2003年02月

ISSN 0006-8993

We examined neuroprotective effects of an adenoviral vector encoding glial cell line-derived neurotrophic factor (AxCAhGDNF) on the lesioned adult rat motoneurons in the nucleus ambiguus. After vagal nerve avulsion, AxCAhGDNF, AxCALacZ (adenovirus encoding β-galactosidase gene) or PBS was inoculated into the jugular foramen. Four days after the avulsion and treatment with AxCALacZ, the animals expressed β-galactosidase activity in the lesioned motoneurons in the nucleus ambiguus. The animals avulsed and inoculated with AxCAhGDNF showed immunolabeling for GDNF in the nucleus ambiguus on the treated side and expression of virus-induced human GDNF mRNA transcripts in the brainstem tissue that contained the nucleus ambiguus of the treated side. The treatment with AxCAhGDNF after avulsion prevented the loss of lesioned motoneurons in the nucleus ambiguus, ameliorated the choline acetyltransferase immunoreactivity, and also suppressed the activity of nitric oxide synthase in these neurons. These results indicate that adenovirus-mediated GDNF gene transfer may prevent the degeneration of motoneurons in humans after either vagal nerve injury or recurrent laryngeal nerve injury.

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Adenoviral GDNF gene transfer prevents motoneuron loss in the nucleus ambiguus

Saitou Kouichirou, Shiotani Akihiro, Watabe Kazuhiko, Moro Kazuhisa, Fukuda Hiroyuki, Ogawa Kaoru

Brain research 962 （ 1 ） 61-67 2003年02月

研究論文（学術雑誌）, 共著

CHEP with the Total Removal of the Arytenoid on the Tumor-bearing Side

Shiotani Akihiro, Araki Koji, Moro Kazuhisa, Ikeda Asako, Okubo Keisuke, Saito Koichiro, Ogawa Kaoru

Journal of Otolaryngology of Japan 106 （ 11 ） 1100 - 1103 2003年

ISSN 0030-6622

A supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) consists of the resection of the whole thyroid cartilage and paraglottic space, while preserving the cricoid cartilage, the hyoid bone, most of the epiglottis and the arytenoids. Laryngeal reconstruction is achieved be suturing the cricoid cartilage and the hyoid bone. This procedure is mainly indicated for large T2 glottic carcinomas and provides a complete resection and laryngeal preservation without requiring a permanent tracheostomy. Although bilateral arytenoids are usually preserved to ensure better laryngeal function after CHEP, we unavoidably had to remove the arytenoid on the tumor-bearing side during a complete resection performed in a 56-year-old male with a rT2 tumor who had undergone radiation and demonstrated impaired vocal fold motion. Despite the resection of one arytenoid, the final laryngeal function proved to be satisfactory. CHEP should be utilized as an alternative surgical modality for conventional vertical partial laryngectomies or total laryngectomies. CHEP with the total removal of the arytenoid on the tumor-bearing side may be a useful laryngeal preservation procedure for the treatment of patients with glottic carcinoma associated with an impaired vocal fold motion or a fixed vocal fold.

中耳手術の聴力改善判定基準をめぐって—耳硬化症の場合—

小川郁

Otology Japan 13 39797 2003年

研究論文（学術雑誌）, 単著

Adenoviral GDNF gene transfer prevents motorneuron loss in the nucleus ambiguus

Saito Kouichiro, Shiotani Akihiro, Watabe Kazuhiro, Moro Kazuhisa, Fukuda Hiroyuki, Ogawa Kaoru

Brain Reserch 962 （ 39449 ） 61-67 2003年

研究論文（学術雑誌）, 共著

A wearable sense of balance monitoring system towards daily health care monitoring

Matsushita Soichiro, Oba Toshihiko, Otsuki Kazuoki, Toji Masao, Otsuki Junichi, Ogawa Kaoru

176 - 183 2003年

We implemented a wearable system for detecting accelerations of the user's head while standing still for the purpose of developing a daily health care application. A 2- axis accelerometer was attached on the top of the user's head to separately detect faint accelerations in both the front to back and right to left directions. The total weight of the headset device is only 195 grams including a 9V NiMH battery. This paper presents the results of several experiments performed with the headset system. First, we observed healthy subjects under normal conditions and recorded typical accelerations in the range of 10-30 milli-Gs, which was sufficient to be detected by the system's sensitivity. We then performed numerical analysis on traces of acceleration patterns for a specific user in different conditions. From these analyses we found that the total length of 2-dimensional acceleration pattern trace and a high frequency spectrum (2Hz-10Hz) of right/left acceleration were related to the physical condition of the user. The wearable headset device can be carried to anywhere the user goes and the diagnosis of the wearer's physical condition only requires that the user stand still for 30 seconds, showing that this system can be used for daily health care monitoring.

Evidence-Based Therapeutic Strategy for Sudden Sensorineural Hearing Loss

Ogawa Kaoru

Otolaryngology - Head and Neck Surgery (Tokyo) 75 （ 12 ） 849 - 860 2003年

ISSN 0914-3491

頭頚部癌におけるSentinel node navigationの試み　―喉頭癌への応用―

塩谷彰浩，藤井博史，北川雄光，小川郁

癌の臨床 48 885-890 2002年12月

研究論文（学術雑誌）, 共著

耳鳴の心理的苦痛度・生活障害度の評価法に関する検討

新田清一，小川郁，井上泰宏，田副真美，浅野恭子

Audiology Japan 45 （ 6 ） 685-691 2002年12月

研究論文（学術雑誌）, 共著

小児喉頭乳頭腫　―手術療法および補助療法としての漢方療法―

塩谷彰浩，大久保啓介，福田宏之，小川郁

喉頭 14 69-73 2002年12月

研究論文（学術雑誌）, 共著

Effect of prostaglandin E1 on idiopathic sudden sensorineural hearing loss

Ogawa Kaoru, Takei Satoshi, Inoue Yasuhiro, Kanzaki Jin

Otology and Neurotology 23 （ 5 ） 665 - 668 2002年09月

ISSN 1531-7129

Objective and Study Design: The authors conducted a prospective, randomized, double-blinded clinical trial for the purpose of elucidating the effects of prostaglandin E1 (PGE1) on idiopathic sudden sensorineural hearing loss. Setting and Patients: With the approval of the institute ethics committee, a total of 57 consecutive patients with diagnoses of idiopathic sudden sensorineural hearing loss were included in the study. The patients in the PGE1 group received continuous infusion containing 60 μg PGE1 and 100 mg hydrocortisone for 7 days, and the patients in the placebo group were treated with continuous infusion containing an inactive placebo and 100 mg hydrocortisone. Results: No significant differences were observed in the improvements of pure-tone average and subjective symptoms between the PGE1 and the placebo groups. However, the hearing improvement at high frequencies (4 kHz and 8 kHz) was significantly higher in the PGE1 group than in the placebo group, especially in the patients with severe tinnitus. Conclusions: These results failed to prove a beneficial effect of PGE1 in the treatment of idiopathic sudden sensorineural hearing loss. Further studies will be needed to clarify the pharmacologic actions of PGE1 in the cochlea.

症例をどうみるか「一側性心因性難聴の1症例」

松延毅，橋口一弘，浅野恭子，井上泰宏，小川郁

JOHNS 18 （ 9 ） 1691-1695 2002年09月

研究論文（学術雑誌）, 共著

Effect of prostaglandin E1 on idiopathic sudden sensorineural hearing loss: a double-blinded clinical study

Ogawa Kaoru, Takei Satoshi, Inoue Yasuhiro, Kanzaki Jin

Otology neurotology 23 （ 5 ） 665-668 2002年08月

研究論文（学術雑誌）, 共著

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