Illuminating dark fishing fleets in North Korea.

Illegal, unreported, and unregulated fishing threatens resource sustainability and equity. A major challenge with such activity is that most fishing vessels do not broadcast their positions and are "dark" in public monitoring systems. Combining four satellite technologies, we identify widespread illegal fishing by dark fleets in the waters between the Koreas, Japan, and Russia. We find >900 vessels of Chinese origin in 2017 and >700 in 2018 fished illegally in North Korean waters, catching an estimated amount of Todarodes pacificus approximating that of Japan and South Korea combined (>164,000 metric tons worth >$440 million). We further find ~3000 small-scale North Korean vessels fished, mostly illegally, in Russian waters. These results can inform independent oversight of transboundary fisheries and foreshadow a new era in satellite monitoring of fisheries.

Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.

OBJECTIVE: This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Case series with planned data collection. MATERIALS AND METHODS: Thirty-three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1-cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum values of the dry swallowing pressures at the velopharynx, mesohypopharynx, upper esophageal sphincter (UES), and distance from the nostril to each point of maximum values with and without the THM were measured. RESULTS: The distance from the nostril to the UES was statistically shorter when swallowing with the THM than without the THM (paired t test, P=0.009). The maximum pressure at UES was greater when swallowing with the THM than without the THM, although there was no statistically significant difference (paired t test, P=0.051). There was no difference in the pressures and the distance between swallowing with or without the THM at any other site. CONCLUSIONS: These findings suggest that the THM may not have a potential to facilitate compensatory swallowing power when swallowing.

Relationship between airborne pollen count and treatment outcome in Japanese cedar pollinosis patients.

In Japan, information on daily Japanese cedar pollen counts is made public during pollen season. If symptom severity and treatment outcome are predictable according to these pollen counts, management of seasonal allergic rhinitis may become more precise. The aims of the study were to evaluate the relationship between airborne pollen counts, symptom severity and treatment outcome in Japanese cedar pollinosis patients. In the randomized study, patients with moderate to most severe Japanese pollinosis were treated with fexofenadine (60 mg BD) or fexofenadine and nasal corticosteroids for 2 weeks. During the same period daily airborne pollen counts were measured. A total of 105 adult patients were enrolled. No difference of treatment efficacy was seen among groups. Detailed results of efficacy and safety were previously described elsewhere. In univariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study tended to affect symptom severity (P = 0.053) and the mean cumulative amount of airborne pollen during the treatment period tended to show difference among five treatment outcome categories (P = 0.066). In multivariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study was identified as the only significant factor of symptom severity (P = 0.0327) and cumulative amount of airborne pollen during the treatment period (P = 0.027) and allergic history (P = 0.027) were significant factors of treatment outcomes. No serious adverse effect was reported during the study. The amount of airborne pollen may be predictive of both symptom severity and treatment outcome.

Surgical anatomy of the sphenoid sinus on the CT using multiplanar reconstruction technique.

OBJECTIVE: To clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures as are relevant to performing an endoscopic sphenoidotomy. METHODS: Various dimensions of 224 CT images of the sphenoid sinus and surrounding structures from 122 Japanese adult patients were measured using the multiplanar reconstruction technique. RESULTS: The mean distance from the nasal sill to the sphenoid ostium was nearly 66 mm, and that from the sphenoid ostium to the posterior wall of the sphenoid sinus was nearly 14 mm. The angles from the sphenoid ostium to both the carotid artery and the optic canal varied among the patients. The sphenoid ostium was located at almost the vertical midpoint of the anterior wall of the sphenoid sinus. CONCLUSION: The present study provides anatomical information about the sphenoid sinus and surrounding structures that is essential for avoiding complications in performing an endoscopic sphenoidotomy.

Effect of a large-sized silicone sheet upon recovery of mastoid aeration after mastoidectomy.

OBJECTIVE: To evaluate the effect of our large-sized silicone sheet upon postoperative recovery of mastoid aeration in ears after surgery including mastoidectomy and soft-wall reconstruction (SWR). STUDY DESIGN AND SETTING: Retrospective chart review in a tertiary care center. SUBJECTS AND METHODS: Recovery of mastoid aeration was assessed by CT 4 to 12 months after surgery on 72 ears (69 patients), in which the silicone sheet covering from the eustachian tube (ET) to the mastoid was placed after SWR procedure with mastoidectomy were done for their chronic otitis media. Results were compared with those with a small silicone sheet. RESULTS: Recovery of mastoid aeration was significantly better in the large-silicone-sheet group than in the small-silicone-sheet group (chi(2) value = 11.7146, P = 0.0006). CONCLUSION: This preliminary study suggested that our large-sized silicone sheet may be effective for postoperative recovery of mastoid aeration even in ears operated with SWR procedure.

Influence of topical application of basic fibroblast growth factor upon inner ear.

BACKGROUND: Basic fibroblast growth factor (b-FGF) has recently been shown to have a positive effect on the treatment of postoperative mastoid cavity problem, but its ototoxicity has not been investigated. OBJECTIVE: To investigate the effect of b-FGF on the inner ear of guinea pigs. STUDY DESIGN AND SETTING: In groups A (n = 10) and B (n =11), b-FGF was applied into the left external auditory canal and the middle ear, respectively. The right ear served as a control. At 1 week after b-FGF administration, the endocochlear DC potential (EP) was measured, and morphology of the cochleae was examined by scanning electron microscopy. RESULTS: In group A, the EP values of experimental ears and controls were 90.0 +/- 8.4 (mV, mean +/- SD) and 89.4 +/- 4.3 (P > 0.05). In group B, the values were 86.5 +/- 11.4 and 87.5 +/- 6.1, respectively, (P > 0.05). Morphological findings showed no damage on the cochlear. CONCLUSION: Application of b-FGF to the external and middle ears does not seem to have an apparent risk of ototoxicity.

Measurement of angle and length of the eustachian tube on computed tomography using the multiplanar reconstruction technique.

OBJECTIVE: To compare the anatomic features of the eustachian tube (ET) between children with and without otitis media with effusion (OME) and with adults. METHODS: The angle and length of the ET in children with OME (54 ears, OME children) and without OME (50 ears, normal children), as well as those of normal adults (90 ears), were measured on computed tomography using the multiplanar reconstruction technique. RESULTS: The angles of ET in the OME children group, the normal children group, and the normal adult group were 20.4 +/- 3.5 degrees and 21.2 +/- 4.8 degrees , 19.9 +/- 3.4 degrees and 20.0 +/- 3.6 degrees , and 27.3 +/- 2.7 degrees and 27.3 +/- 2.8 degrees on the right and the left sides, respectively. There was no significant difference between the right and the left side in any group (P = .541, P = .952, P = .978). The lengths of ET in the OME children group, the normal children group, and the normal adult group were 37.2 +/- 3.0 mm (mean +/- SD) and 37.6 +/- 3.2 mm, 37.5 +/- 3.3 mm and 38.0 +/- 3.2 mm, and 42.5 +/- 2.8 mm and 42.9 +/- 2.9 mm on the right and the left sides, respectively. There was no significant difference between the right and left sides in any group (P = .670, P = .597, and P = .545). Both the angles and lengths were significantly greater in the normal adult group than in either the OME children group or the normal children group (one-way analysis of variance and Fisher's protected least significant difference tests, P < .05), but there was no significant difference in either the angle or length of the ET between the OME and normal children groups (P > .05). In the OME and normal children groups, the angle was observed to constantly increase with age, and the values were found to be within the range of the adult size in all the patients older than 7.5 years and 7.7 years in the OME children group and the normal children group, respectively. As well as the angle, the lengths were observed to constantly increase with age, but the increase appeared to be greater at a younger age (until approximately 3 to 4 years) than at an older age, and the values were found to be within the range of the adult size in all the patients older than 6.8 years and 7.7 years in the OME children group and the normal children group, respectively. CONCLUSION: The angle and length of the ET are more horizontal and shorter in infants than in adults. However, there is no statistical difference between the angle and length of the ET in infants with and without OME. These results lead us to believe that a short and horizontal ET may not be a main etiologic factor related to high susceptibility to OME in infants and children.

Does topical application of 5-fluorouracil ointment influence inner ear function?

OBJECTIVE: To investigate the effect of 5-fluorouracil (5-FU) ointment on the inner ear of guinea pigs. STUDY DESIGN AND SETTING: In group A (n = 7), 5-FU ointment was applied into the left external auditory canal. In group B (n = 10), 5-FU ointment was applied to the left middle ear through myringotomy. In both groups, the right ear served as a control. One week later the endocochlear DC potential (EP) was measured and morphology of the cochleae was examined using scanning electron microscopy (SEM) and light microscopy. RESULTS: In group A, there was no significant difference between the EP values of the experimental side and the control side. In group B, there was a statistically significant difference between them (P < 0.05). Morphologic findings showed no damage. CONCLUSION: 5-FU ointment application to the external ear seems to be safe but its application to the middle ear may pose some risk of ototoxicity.

A case of actinomycosis causing unilateral tonsillar hypertrophy.

We report a case of unusual presentation of actinomycosis in the tonsil causing massive unilateral enlargement in a 78-year-old female. To our knowledge, only three cases of actinomycosis causing unilateral tonsillar enlargement have been published previously. Since this anaerobic organism is difficult to culture, the diagnosis is made by observing its associated sulfur granules in the biopsy specimen. In the present case, treatment consisting of tonsillectomy and antibiotic therapy (penicillin) for several days produced a good prognosis.

A case with tracheo-innominate artery fistula. Successful management of endovascular embolization of innominate artery.

Tracheo-innominate artery fistula (TIF) is known as a fatal complication after tracheostomy. We report a 9-year-old girl with early hypoxic encephalopathy who had a tracheo-innominate artery fistula with exsanguinating hemorrhage from her tracheostoma 10 months after tracheostomy. After temporary control of bleeding, embolization of the innominate artery was performed. The patient has remained well 1 year after the procedure. We reviewed the aetiology, diagnosis and management of the tracheo-innominate fistula, and findings suggest that endovascular embolization of the innominate artery may be an appropriate treatment for patients with tracheo-innominate artery fistula.

Clinical efficacy of 5-fluorouracil (5-FU) topical cream for treatment of cholesteatoma.

OBJECTIVE: In order to clarify clinical efficacy of commercially available 5-fluorouracil (5-FU) topical cream, a clinical study was conducted. METHODS: Two to three cubic millimetres of 5-FU topical cream (Kyowa, Roche) was applied on 50 cases of various types of cholesteatoma (50 patients) two to five times with the interval of 2 weeks, and its clinical efficacy was evaluated by the criteria we developed. RESULTS: In total, 59% of the cholesteatomas showed good effect, 29% of them showed fair effect, and the effect was poor in the remaining 12%. It was particularly effective in cholesteatomas in the EAC, attic cholesteatomas with an aerated mastoid, and in recurrent-type cholesteatomas. CONCLUSION: 5-FU topical cream appeared effective for the treatment of cholesteatomas.

Difference in attachment of the tensor veli palatini muscle to the eustachian tube cartilage with age.

To test a hypothesis that ventilation of the eustachian tube (ET) varies with age, we investigated the relationship between age and the attachment of the tensor veli palatini muscle (TVPM) to the lateral lamina of the ET cartilage in 12 normal human temporal bones obtained from individuals 3 months to 81 years old. We used computer-aided 3-dimensional reconstruction and measurement methods. We found that the length of the TVPM attachment and its ratio to the length of the ET, especially that of the cartilaginous portion of the ET, increases with age from infancy to adulthood, and decreases with age from young adulthood to later life. These findings are thought to be related to postnatal development and aging. The possibility of differences in ventilation function with age is discussed.

Functional anatomy of levator veli palatini muscle and tensor veli palatini muscle in association with eustachian tube cartilage.

The anatomic relationships among the levator veli palatini muscle (LVPM), the tensor veli palatini muscle (TVPM), and the eustachian tube (ET) cartilage were investigated by computer-aided 3-dimensional reconstruction and measurement methods. The study used 13 normal temporal bone-ET specimens obtained from 13 individuals (range of age at death, 3 months to 88 years). This study revealed several anatomic features of the anterior cartilaginous portion of the ET. First, the LVPM is always located inferolateral to the inferior margin of the medial lamina (ML) of the ET cartilage. Second, the LVPM has a large cross-sectional area throughout the extent of the anterior cartilaginous portion of the ET. Third, although the LVPM lies close to the ML of the ET cartilage (0.44+/-0.16 mm in children and 1.02+/-0.58 mm in adults), there is no region of attachment. Finally, the TVPM is not attached to the lateral lamina (LL) of the ET cartilage of the anterior quarter of the cartilaginous portion. Accordingly, it could be assumed that the most anterior cartilaginous portion of the ET is opened primarily by the contraction of the LVPM, which causes a superior-medial rotation of the ML. Furthermore, since the contraction time of the LVPM is reported to be longer than that of the TVPM, the anterior cartilaginous portions of the ET may remain open, even after the middle to posterior cartilaginous portions are closed after relaxation of the TVPM. This process would produce a pumping action of the ET in the direction from the middle ear to the pharyngeal side. The pumping function may be beneficial to clearance of the middle ear.

Functional anatomy of the tensor veli palatini muscle and Ostmann's fatty tissue.

This study examined morphological features of the tensor veli palatini muscle (TVPM) and Ostmann's fatty tissue that may be important for eustachian tube (ET) ventilation. Histologic sections through the midcartilaginous ET from 17 human temporal bone-ET specimens (age range. 3 months to 88 years) were used to assess 1) the presence or absence of attachment of the TVPM fibers to either the perichondrium of the ET cartilage lateral lamina (LL) or a tendinous membrane along the medial margin of the TVPM, 2) the angular relationship between the TVPM fibers and the vertical axis of the ET lumen, and 3) the location of the TVPM and Ostmann's fatty tissue. The TVPM fibers were attached to the LL perichondrium in 14 cases; an attachment was absent in 3 cases because of fatty atrophy of the TVPM. However, the TVPM fibers were inserted into the tendonlike membrane in all cases. The angle of insertion of TVPM fibers into the membrane was significantly more acute (relative to the vertical ET axis) in the inferior aspect than in the superior aspect of the membrane both in young children (3 months to 4 years; mean +/- SD, 39.0 degrees +/- 15.1 degrees superiorly to 23.8 degrees +/- 17.0 degrees inferiorly) and in older subjects (8 to 88 years, 30.4 degrees +/- 11.6 degrees superiorly to 15.7 degrees +/- 11.2 degrees inferiorly; t-test, p < .001). The location of Ostmann's fatty tissue accompanied the TVPM throughout the cartilaginous ET. These data suggest that contraction of the TVPM moves the LL inferolaterally to open the superior aspect more than the inferior aspect of the lumen and that Ostmann's fatty tissue will limit the opening of the ET lumen, especially that of its inferior aspect.

Postnatal development of static volume of the eustachian tube lumen. A computer-aided three-dimensional reconstruction and measurement study.

Eleven human temporal bone-eustachian tube (ET) specimens obtained from 11 individuals (ages, 3 months to 88 years) were studied to investigate the static volume of the ET lumen. The volumes were measured by computer-aided 3-dimensional reconstruction and measurement methods. Four of the 11 individuals were children, and the remaining 7 were adults. The total volume of the ET lumen was significantly larger in the adults than in the children (p < .01). This difference was produced by significant growth of the volume of the cartilaginous and junctional portions (p < .01). The lumen of the bony portion, by contrast, did not change with age. Increased volume of the ET lumen, especially of the cartilaginous and junctional portions, would be expected to increase both ventilation and clearance. Therefore, the small volume of ET lumen of the cartilaginous and junctional portions in children may be a predisposing factor for otitis media.

Cellular proliferation of mucosa-associated lymphoid tissue with otitis media: a preliminary study.

Histopathologic and immunohistochemical analyses were used to investigate the cellular proliferation of mucosa-associated lymphoid tissue (MALT) in human temporal bones with and without evidence of otitis media (OM). Anti-proliferating cell nuclear antigen (PCNA) antibody (clone PC10) was applied after the antigen retrieval procedure. Positive PCNA expression was observed in temporal bones that had been stored for 10 to 31 years in 80% ethanol. In specimens with purulent OM, the MALT had faint germinal centers (GCs). Positive PCNA expression in the MALT was moderate and scattered. In specimens with mucous OM, the MALT had complete GCs. Positive PCNA expression in the MALT was moderate to strong, and the distribution of PCNA-positive cells was associated predominantly in the GCs, the mucosal epithelial layer, and/or the subepithelial layer. In specimens with serous OM, the MALT also had complete GCs. However, the PCNA expression was weak and scattered, and appeared to be similar to that of the MALT in the temporal bones without OM. These results indicate that the cellular proliferation of MALT in the temporal bone might reflect the activity that produces secretory IgA against invasion of foreign antigens. However, further studies are needed to elucidate whether the PCNA expression within MALT in the eustachian tube and middle ear is associated with a mucosal immune response to inflammation as in OM.

Imaging of the patulous Eustachian tube: high-resolution CT evaluation with multiplanar reconstruction technique.

OBJECTIVE: To evaluate the 3D anatomy of the ET and its surrounding tissues in cases with or without patulous Eustachian tube (ET) using CT with the multiplanar reconstruction (MPR) technique. MATERIAL AND METHODS: Twenty patients with a patulous ET and 25 without middle ear problems were investigated. After performing a temporal bone CT examination, MPR images of the ET were reconstructed and measurements were made. RESULTS: The ET lumen and its surrounding tissues were clearly identified. In the patulous ET group, the ET lumen was open throughout the cartilaginous portion and the volume of the low-density area was smaller in size than in the controls. In unilateral patulous ET patients, the anatomical features were found to be similar on both sides, in spite of the fact that the non-involved side did not show symptoms associated with a patulous ET. CONCLUSION: For the first time, we were able to obtain clear reconstructed images of the patulous ET and its surrounding structure and to study its anatomical features. This method is useful for obtaining a better understanding of the ET and ET-related diseases such as patulous ET.

Influence of effortful swallow on pharyngeal pressure: evaluation using a high-resolution manometry.

OBJECTIVE: To evaluate the effect of effortful swallow on pharyngeal pressure while swallowing saliva and water using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Case series with planned data collection. SETTING: Nagasaki University Hospital. SUBJECTS AND METHODS: Eighteen asymptomatic Japanese adult volunteers were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned from the velopharynx to the upper esophagus to record pressures while swallowing. The maximum values of the pressure while swallowing saliva (dry swallowing) and 5 mL of water were measured at the velopharynx, meso-hypopharynx, and upper esophageal sphincter (UES) with and without effortful swallows. RESULTS: The maximum values of dry swallowing pressures (mm Hg) at the velopharynx, meso-hypopharynx, and UES were significantly higher with effortful swallow (155.7 ± 59.7, 256.7 ± 78.7, and 276.5 ± 87.5, mean ± standard deviation) than without it (115.3 ± 60.8, 172.9 ± 57.0, and 195.8 ± 61.3). Those of water swallowing pressures were also statistically higher with effortful swallow (169.3 ± 69.1, 236.6 ± 77.2, and 267.3 ± 79.1) than without it (119.2 ± 59.7, 189.5 ± 70.7, and 221.3 ± 72.7). CONCLUSION: The present results provide quantitative evidence of effortful swallow as well as physiological information. It also is hoped to be an aid to future clinical and investigative studies.