A case report of Sjögren's syndrome with repeated false cord swelling.

We present a 42-year-old female patient who had repeated swelling of the bilateral false cords. The patient complained of dryness of the eyes and oral mucosa, and was diagnosed as having Sjögren's syndrome. She underwent partial resections of the bilateral false cords 4 times in 3 years to evaluate the nature of the disease and to relieve airway obstruction. Histologic examinations revealed severe atrophic changes of the laryngeal glands and cystic dilation of the ducts of the glands, associated with marked lymphocytic infiltration and lymphoid hyperplasia. These findings suggest that the etiology of the swelling of the false cords was related to Sjögren's syndrome.

[A statistical study of clinical cases of malignant tumors first manifested by vocal cord paralysis].

One of the most important problems in dealing with vocal cord paralysis is to clarify the cause of paralysis. In those case where the definite cause is unknown, it is possible that an occult type of malignant tumors exists along the course of the vagus or recurrent laryngeal nerves. For the past 16 years, 62 out of 560 cases with vocal cord paralysis were diagnosed to have malignant tumors first manifested by paralysis of vocal cord. They consisted of 25 cases of thyroid carcinoma, 18 lung carcinoma, 13 esophageal carcinoma, 3 mediastinal tumors and 3 tumors of miscellaneous origin. Among these, 36 were male and 26 were female and the mean age was 63 years old. In 40 cases, paralysis was found on the left side, in 18 on the right and bilaterally in the remaining 4. There was a marked sexual difference in the origin of malignant tumors, i.e. the incidence of lung carcinoma was higher in male with paralysis on the left side, while that of thyroid carcinoma was higher in female. In some cases with thyroid carcinoma, vocal cord paralysis was noted more than a year before the detection of the tumor. Ultrasonography of the neck, chest x-ray, CT scan of the chest, fluoroscopy of the pharyngo-esophagus should be performed for the detection of malignant tumors in cases with left vocal cord paralysis, while ultrasonography of the neck and chest x-ray should be sufficient in right paralysis, although additional fluoroscopy of the pharyngo-esophagus seemed preferable in male.

[Combination chemotherapy of cisplatin, vincristine and peplomycin for patients with head and neck carcinoma].

The effectiveness of combined CDDP chemotherapy with other anticancer drugs in patients with head and neck carcinoma was investigated. The response rate for COP therapy (CDDP, Vincristine, Peplomycin) was better than those for CDDP administration only or CP (CDDP Peplomycin) therapy for carcinomas of the head and neck. Forty-seven cases treated with COP therapy, were analyzed in detail. (1) Non-treated fresh cases showed a better response than recurrent cases. In other words, the induction chemotherapy is useful. (2) The grade of differentiation of squamous cell carcinoma had no correlation with the response. (3) No relationship between the primary site and the respose rate was detected. (4) Nephrotoxicity was considered to be the dose-limiting factor of CDDP therapy. COP therapy did not show any remarkable side effects. COP chemotherapy is therefore concluded to be effective for the treatment of squamous cell carcinomas of the head and neck.