Nihon Jibiinkoka Gakkai kaiho
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Nippon Jibiinkoka Gakkai Kaiho · Mar 2017
[Tonsillectomy in Cases with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome].
The periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is an autoinflammatory disease, characterized, as its name suggests, by periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. This syndrome is the most common cause of recurrent fever in children, however the rate of recognition of this syndrome is still low. Tonsillectomy has been suggested as an effective treatment, even though the precise, pathophysiology underlying this syndrome remains unknown. In this study, we investigated the outcomes in patients who underwent tonsillectomy. In particular, we examined the surgical outcomes and clinical features of the patients who underwent tonsillectomy. A total of 19 patients with PFAPA syndrome underwent tonsillectomy at our hospital from July 2013 to May 2016. ⋯ Therefore, it is important to carefully evaluate the risks and benefits in each case. The indications for tonsillectomy have not yet been clearly established. It is essential to continue further investigations to establish effective therapeutic strategies for this syndrome.
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Nippon Jibiinkoka Gakkai Kaiho · Nov 2016
Case ReportsA Case of Immunogloblin A Vasculitis Caused by Infection in Tracheotomy Wound.
Immunogloblin A (IgA) vasculitis is the most common systematic vasculitis disorder characterized by leykocytoclastic vasculitis , for example, purpura with white blood cell destruction vasculitis caused by allergic mechanisms. The main symptoms of this disease are purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis. We report the case of a 66-year-old man with IgA vasculitis. ⋯ On the basis of these clinical courses we diagnosed IgA vasculatis caused by wound infection. This case illustrates that it is important to consider the possibility of IgA vasculatis if skin eruption is observed concurrent with wound infection.
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Nippon Jibiinkoka Gakkai Kaiho · Sep 2016
Case ReportsThree Cases of Neck Swelling after FNAC (fine-needle aspiration cytology).
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. ⋯ We report one case of thyroid hematoma and two cases of dTSaFNA. All three cases were treated in hospital and recovered completely.
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Nippon Jibiinkoka Gakkai Kaiho · Feb 2016
Comparative Study[Otologic Manifestations in Patients with ANCA Associated Vasculitis-Comparative Analysis among Microscopic Polyangiitis, Granulomatosis with Polyangiitis and Eosinophilic Granulomatosis with Polyangiitis].
Anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitides (AAVs) include microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA), the incidences of which are reported to be increasing in Japan. We reviewed the clinical records of 20 cases with systemic AAVs (five cases with MPA, nine cases with GPA, and six cases with EGPA), who visited our otolaryngology department with otological symptoms from 2004 to 2014, and compared the otological characteristics among the diseases. Otologic symptoms appeared as an initial symptom(s) in 40% of MPA cases, 56% of GPA cases, and 83% of EGPA cases. ⋯ It is noteworthy that in a significant number of AAV patients with ear disease, otological symptoms are supposed to appear as an initial symptom(s). Therefore, otolaryngologists have a major role to achieve early diagnosis of AAV. The patients with adult-onset inflammation of the middle ear, inner ear or both should undergo careful examinations, and they should be closely followed even if the diagnosis is uncertain.
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Nippon Jibiinkoka Gakkai Kaiho · Nov 2015
[Aural Stimulation with Capsaicin Ointment Improved the Swallowing Function in Patients with Dysphagia: Evaluation by the SMRC Scale].
Cough and swallowing reflexes are important airway-protective mechanisms against aspiration. Angiotensin-converting enzyme (ACE) inhibitors, one of the side effects of which is cough, have been reported to reduce the incidence of aspiration pneumonia in hypertensive patients with stroke. ACE inhibitors have also been reported to improve the swallowing function in post-stroke patients. ⋯ Thus, aural stimulation with capsaicin represents a novel treatment for dysphagia. It is also suggested that repeated alternative aural stimulation with capsaicin for a week, rather than a single application, is needed to improve the swallowing function in patients with severe dysphagia. By the same mechanism as that underlying the effect of ACE inhibitors, aural stimulation with capsaicin may reduce the incidence of aspiration pneumonia in patients with dysphagia.