Clinical implications of taste thresholds in patients with odontogenic maxillary sinusitis.

Patients with odontogenic maxillary sinusitis (OMS) often complain of reduced taste sensitivity as well as nasal obstruction. The filter paper disc method (the conventional gustatory test) was applied to nine patients who underwent sinus surgery to open the inferior nasal meatus and sinus drainage, on three different days: 1day prior to surgery, 7days postoperative, and 28days postoperative. The same test was applied to nine non-clinical participants with or without clipping the nose to interfere with smooth nasal airflow on two different days. Acquired recognition thresholds for the four basic tastes of sweet, salty, sour, and bitter were assessed. In OMS patients, the recognition thresholds for all four tastes were markedly decreased at 7 and 28days postoperative, and subjective taste sensitivity and the elimination of nasal obstruction was improved. The mean recognition threshold for the four tastes correlated negatively with taste satisfaction scores. Clipping the nose in non-clinical participants induced increases in gustatory detection and recognition thresholds. Despite the small sample size and different ages and sexes of the study subjects, it was demonstrated that nasal obstruction in OMS patients and nose clipping in non-clinical subjects reduce taste reactivity, and surgical intervention to promote nasal airflow recovers impaired taste reactivity.

Imaging findings of necrotizing sialometaplasia of the parotid gland: case report and literature review.

Although necrotizing sialometaplasia (NS) of the parotid gland is rare and occasionally presents as a lesion that mimics a malignant tumour, imaging findings in cases of NS have been rarely reported. We describe here a case of NS in which there was an increasing lesion manifesting overnight on the parotid gland in an 83-year-old male. We also investigated the use of pre-operative imaging based on previous reports and discuss the importance of these images in helping to guard against overzealous treatment. It is critically important to closely examine whether there are aspects of NS, such as the present case, in pre-operative MRI findings that can be useful in proper diagnosis and treatment.

School refusal and depression with school inattendance in children and adolescents: comparative assessment between the Children's Depression Inventory and somatic complaints.

School refusal has become a relatively common problem of increasing magnitude in Japan. Although clarification of the relationship between 'school refusal' and 'depression with school inattendance' is crucial in light of the difference in treatment modalities involved, it is not clear whether the two are to be regarded along the same tangent or as disparate entities. For clarification, a comparison was made between clinical diagnosis, Children's Depression Inventory (CDI) scores, and scores for the three subordinate scales of the CDI in 34 cases of school refusal, 10 cases of depression with school inattendance, and normal students. Significant difference in CDI score was noted between the three groups: highest among depression cases, followed by school refusers, and lowest in normal students. A larger proportion of school refusers expressed somatic complaints together with low CDI scores. The typical case of school refusal appears to exhibit somatic complaints in the foreground rather than depression, both clinical characteristics and CDI scores indicate school refusal and depression to be separate entities. Although many approaches are being taken in the treatment of school refusal, the results appear to justify primacy of the psychotherapeutic approach with the possible adjuvant use of pharmacological agents, for the phenomenon as it presents in Japan.

Treatment of chronic aortic dissection by transluminal endovascular stent-graft placement: preliminary results.

PURPOSE: To investigate efficacy of stent-graft repair for the treatment of patients with chronic aortic dissection. MATERIALS AND METHODS: Fifteen patients with chronic aortic dissection were treated with endovascular stent-grafts. Entry tears were located in the descending thoracic aorta in all patients. The mean maximum diameter of the descending thoracic aorta was 47 mm +/- 8. The mean diameter of the true lumen at the same level was 20 mm +/- 5. The mean interval between diagnosis and stent-graft procedure was 32 months +/- 91. Stent-grafts were fabricated from expanded polytetrafluoroethylene and Z-stents. RESULTS: Stent-grafts were placed successfully in all patients. Two stent-grafts were required in one patient. Entry closure and thrombosis of the false lumen of the descending thoracic aorta were also achieved in all patients. No procedure-related complications were observed except for postimplantation syndrome, including fever and leukocytosis. The diameter of the true lumen was significantly increased (mean, 31 mm +/- 6) at the level of the descending thoracic aorta (P <.01) and the diameter of the aorta was significantly decreased (mean, 44 mm +/- 8) at the same level (P <.01). There were no deaths and no instances of aortic rupture during the subsequent average follow-up period of 24 months. Secondary stent-graft procedures were required to treat the abdominal component of dissection during follow-up in one patient. CONCLUSIONS: Stent-graft repair of chronic aortic dissection is a safe and effective method and may be an alternative to surgical graft replacement in selected patients. However, further evaluation is mandatory before this method is widely employed.

Effect of breath holding on blood flow measurement using fast velocity encoded cine MRI.

Breath-hold MR measurement of cardiac output was compared with results from respiratory triggered MR acquisitions, since flow measurement during breath-holding may be different from physiological blood flow. Cardiac output during large lung volume breath-holding (4.47 +/- 0.63 l/min in the aorta and 4.53 +/- 0.59 l/min in the pulmonary artery) was significantly lower than that measured during normal breathing (6.09 +/- 0.49 l/min and 6.48 +/- 0.67 l/min, P < 0.01). In contrast, no significant difference was found between measurements conducted with small lung volume breath-holding (5.87 +/- 0.53 l/min and 6.41 +/- 0.75 l/min) and normal breathing. In conclusion, breath-hold MR flow measurement using small lung volume by shallow inspiration can provide a blood flow quantification that is close to physiological blood flow. Magn Reson Med 45:346-348, 2001.

Maternity blues and attachment to children in mothers of full-term normal infants.

OBJECTIVE: This study was conducted for evaluating incidence of maternity blues in Japan, in addition to clarifying the relationship between maternity blues and maternal attachment, and the factors involved. METHOD: A questionnaire survey was conducted on 417 mothers having given birth at the Nagoya Daini Red Cross Hospital. The questionnaire consisted of Zung's self-rating depression scale, and a 'postpartum maternal attachment' scale, consisting of subscales on 'core maternal attachment' and 'anxiety regarding children'. The survey was conducted 5.2 days +/-1.46 postpartum. RESULTS: ZSDS scores over 40 amounted to 66.8% of the responses. Analysis of the two scales revealed significant correlation/inverse correlation between 'maternity blues' and 'anxiety regarding children'/ 'core maternal attachment'. Path analysis revealed 'maternity blues' to be influencing 'core maternal attachment' and 'anxiety regarding children'. CONCLUSION: It was found that the incidence of maternity blues may be higher in Japan than was believed previously, and that an intimate association exists between 'maternity blues' and 'postpartum maternal attachment'.

Portal vein embolization with steel coils and absolute ethanol: a comparative experimental study with canine liver.

Portal vein embolization (PVE) is expected to have an adjuvant effect on the treatment of human liver tumors with transcatheter hepatic arterial embolization (TAE). In this experimental study, PVE was tried using two kinds of embolic materials, steel coils (coils) and absolute ethanol (ethanol). The aim of this article is to compare the effectiveness between the two methods. Five dogs and 12 dogs were treated with coils and ethanol, respectively. The second order portal branches were embolized. Embolization effects of each embolic material on the hepatic vessels and the liver parenchyma were studied angiographically and histologically. PVE with coils achieved immediate occlusion of the embolized vessels in all dogs. Unexpectedly, unembolized vessels were also constricted and/or obstructed in 4 of 5 dogs during a 4-week follow-up period. Histological examination showed no hepatic necrosis in all dogs. By contrast, in the dogs treated with ethanol, venous occlusion was achieved immediately after embolization with ethanol of 0.4 mL/kg or more. The embolized vessels remained occluded and no obstruction of unembolized vessels was observed until 4 weeks after embolization. Hepatic necrosis was observed in the segments where portal veins were occluded. The degree of parenchymal damage was proportional to the injected ethanol dose. Judging from these results, ethanol is likely to be more suitable than coils as an embolic material for PVE. PVE with coils is often dangerous because unembolized vessels might be occluded unexpectedly. For the clinical use of PVE with ethanol, the appropriate dose of injection should be investigated.