[A combination of low-dose carboplatin (CBDCA) and radiation therapy in head and neck cancer patients--response and hematologenic toxicity].

A combination of carboplatin (CBDCA) and radiation therapy was performed in patients with head and neck cancer. The intravenous administration of CBDCA at a weekly dose of 100 mg/body was combined with external irradiation at a dose of 1.8 Gy/day x 5/week during the same therapy period. We evaluated the effects of this method not only on survival and neoadjuvant chemotherapy in patients with advanced cancer but also on local control and prevention of distant metastases in patients with early cancer. The subjects consisted of 31 patients with head and neck cancer who visited the Department of Otolaryngology, Showa University Hospital, Kanto Rosai Hospital and Yokohama Rosai Hospital between March 1993 and March 1995. Squamous cell carcinoma was found in all but one patient who had adenocarcinoma in the parotid gland. The patients were 27 males and 4 females ranging between 40 and 81 years of age (mean, 59 years). Twenty-six patients had previously untreated tumor, while 5 patients had recurrent tumor. The clinical stage was Stage I in 6, Stage II in 10, Stage III in 5 and Stage IV in 10 patients. The original site of cancer was the larynx in 9, hypopharynx in 6, nasopharynx in 6 and elsewhere in 10 patients. The combined therapy was repeated for 2-9 courses (mean, about 5 courses). The total dose of CBDCA was 500 mg on average with a maximum of 900 mg. The total effective rate of the combined therapy was 93.3% with 12 cases of complete response (CR) and 16 cases of partial response (PR). The effective rate in patients with previously untreated tumor was 92% because one patient showed a minor response (MR) and one patient showed no change (NC). The effective rate in patients with recurrent tumor was 100%. Concerning the clinical stage, all patients with Stage I-III disease showed CR or PR, while MR was found in 1, NC in 1 and progressive disease (PD) in 1 of 10 patients with Stage IV disease, resulting in an effective rate of 71.4%. There were no CRs in Stage IV patients. Therapy was terminated due to side effects in 2 patients. Excellent safety was confirmed by laboratory data.

MR of the endolymphatic duct and sac: findings in Menière disease.

PURPOSE: To compare the visibility of the endolymphatic duct and sac on high-resolution MR images with the symptoms and clinical course in patients with Menière disease. METHODS: Twenty-two patients with unilateral Menière disease were sorted into two groups on the basis of the clinical stage of their disease at the time of imaging. Group 1 included patients in the acute phase, who presented with vertigo. Group 2 comprised patients in the nonacute phase of the disease, who were studied 9 days or more after an episode of vertigo. RESULTS: During acute attacks, the endolymphatic duct and sac were not adequately visible in the affected ear but were visible in the unaffected ear. During remission, the endolymphatic duct and sac were not observed in clinically advanced patients, but they were seen in patients in the early and intermediate stages. CONCLUSION: High-resolution MR imaging can be used to evaluate the endolymphatic duct and sac: visible abnormalities and lack of a visible endolymphatic duct and sac correlate with the clinical course of Menière disease.

Magnetic resonance imaging of the olfactory apparatus.

The magnetic resonance imaging visualization of the olfactory apparatus is reported in this article. We used a superconductor-type magnetic resonance device (Siemens Magnetom H15 (1.5 T) with a surface coil. The subjects were patients with posttraumatic anosmia. The olfactory bulbs were clearly visualized in the frontal plane magnetic resonance images, the olfactory bulbs and the foramina of the cribriform plate were visualized in the sagittal section, and the olfactory bulbs, tracts, and other structures were visualized in the coronal sections. The olfactory nerves could not be seen.

High-resolution MR imaging of the inner ear: findings in Menière's disease.

Symptoms in Menière's disease are characterized by hydrops of the endolymphatic system with recurrent rupture of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of the endolymph which may be due to an obstruction of the membranous endolymphatic duct and sac, located in the vestibular aqueduct. The membranous endolymphatic duct and sac are not expected to be visualized using conventional tomography and high-resolution computed tomography (HR-CT), whereas, these are identified with high resolution MRI (HR-MRI). By HR-MRI, we proposed to demonstrate morphological alternation in 12 patients with Menière's disease, this group was compared with a group of 20 healthy subjects. The degree of visualization on HR-MRI of the membranous endolymphatic duct and sac running through the vestibular aqueduct in the bony canal was assessed. There was a distinct decrease in visualization of the membranous endolymphatic duct and sac in the Menière's group. The results confirm the value of the HR-MRI technique to identify an anatomical abnormality, which is directly correlated with the lesion in cases of unilateral Menière's disease.

[MR imaging of the inner ear; findings of Ménière's syndrome].

Symptoms in Ménière's disease are explained by hydrops of endolymphatic system with recurrent ruptures of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of endolymph which may be due to an obstruction of the endolymphatic duct and sac, located in the vestibular aqueduct. Non-visualization or narrowing of the vestibular aqueduct of the paper have been demonstrated by conventional tomography and high resolution computed tomography (HR-CT). But the endolymphatic duct and sac can not be obtained by HR-CT and conventional tomography. Whereas, on MRI, these are identified. By MRI, we prospectively tried to demonstrate morphological alterations in 10 patients with Ménière's disease and in 4 patients with vestibular neuronitis. These were compared with a group of 20 normal men. Visualization of the endolymphatic duct and sac (vestibular aqueduct) on MRI was assessed. There was a distinctly decreased visualization of the vestibular aqueduct in the Ménière group and vestibular neuronitis group. We were able to confirm a statistically proven usefulness of the MRI technique in identifying an anatomical abnormality which is directly in correlation with the side of the lesion in cases of unilateral Ménière's disease.

Measurements of internal auditory meatus by polytomography. 1. Normal subjects.

Polytomography permits clear visualisation of the internal auditory meatus (IAM), the normal range of measurements of which is important for radiograph interpretation. Previous reports indicate wide variation in vertical diameter and in the length of the posterior canal wall although in any one individual there is usually little variation between the two sides. We studied the relationship of both the vertical diameter and the length of the posterior walls of the IAM to the growth of the skull and pneumatisation of the temporal bone in 300 patients with no evidence of a lesion of the VIII nerve. No statistically significant correlation was observed between these factors.

Sex differences in odor identification ability: a cross-cultural analysis.

To ascertain the generality of a sex difference noted in odor identification ability, the University of Pennsylvania Smell Identification Test (UPSIT) was administered to four groups of subjects: Black Americans (n = 438), White Americans (n = 1559), Korean Americans (n = 106), and Native Japanese (n = 308). The women of all four groups outperformed the men to the same relative degree. The Korean American group performed better than the Black and White American groups, which, in turn, outperformed the Native Japanese. Analyses of the proportions of subjects correctly answering each of the test items revealed considerable similarity of relative item difficulty among the subject groups. Taken together, these data suggest that sex differences in odor identification ability are probably not due to ethnic or cultural factors, per se.