Contralateral external carotid-middle cerebral artery bypass for carotid artery resection.

Resection of the common carotid or internal carotid artery is occasionally unavoidable in cases of advanced head and neck carcinoma with carotid artery involvement. To prevent the consequent decrease in cerebral perfusion, we have developed a contralateral external carotid-middle cerebral artery bypass grafting technique. From 1990 through 1995, six patients with advanced head and neck cancer involving the carotid artery underwent total tumor resection combined with vascular reconstruction using the contralateral external carotid- middle cerebral artery bypass grafting. No bypass-related complications occurred in any patient postoperatively. Cerebral hemodynamics after surgery indicated that this bypass graft worked steadily over a long term and supplied sufficient volume of blood to the cerebral cortex on the opposite side in every case.

Effects of tachykinin receptor antagonists, FK224 and FK888, in a guinea-pig model of nasal allergy.

The effects of two tachykinin receptor antagonists, FK888 (selective antagonist at the tachykinin NK-1 receptor) and FK224 (dual antagonist at NK-1 and NK-2 tachykinin receptors), on the frequency of sneezing, decrease of nasal patency, and increase of vascular dye leakage induced by antigen challenge upon the guinea-pig nasal mucosa were studied. The animals were sensitized with ovalbumin intraperitoneally. FK224 inhibited and FK888 tended to inhibit the decrease of nasal patency induced by antigen challenge. The increase of vascular dye leakage from nasal mucosa induced by antigen challenge tended to be inhibited by both FK224 and FK888. But both of them did not inhibit the increase of sneezing induced by antigen challenge. We conclude that in the guinea-pig model of nasal allergy, tachykinin receptors mediate plasma leakage and swelling of nasal mucosa induced by antigen challenge, but the participation of an axonal reflex via tachykinin receptors is rather small compared to the direct vascular effect of chemical mediators.

Distribution of choline acetyltransferase (ChAT) immunoreactive nerve fibers in the nasal mucosa; especially in the respiratory epithelium.

The distribution and morphological construction of cholinergic nerve fibers in the respiratory nasal mucosa of the rat and human were investigated using choline acetyltransferase (ChAT) activities by means of light microscopy, confocal laser scanning microscopy and electron microscopy. It was observed that ChAT-immunoreactive (IR) nerve fibers were distributed to form fine varicosities around the blood vessels and seromucous glands under the epithelium and at the basement membrane and within the epithelium. Electron microscopy showed that the ChAT-IR nerve fibers within the epithelium terminated as free nerve endings. Some of them were in close contact with goblet cells. The distribution of ChAT immunoreactive fibers resembled that of vasoactive intestinal polypeptide-IR nerve fibers.

A case of nodular fasciitis arising in the auricle.

Nudular fasciitis is an uncommon benign proliferative lesion in the head and neck, and is extremely rare in the auricle. A case of nodular fasciitis arising in the auricle of 53-year-old man is reported by immunohistochemical and electron microscopical studies. Initially, he had noticed a small painless nodule on the posterior side of right auricle, and it grew up rapidly in size over 2 months. A biopsy revealed nodular fasciitis. This lesion was resected totally with the auricular cartilage. Histological examination revealed proliferation of spindle-shaped cells and immunohistochemical-positive staining was observed with actin, and focally positive staining was seen with vimentin. Electron microscopically some tumor cells contained dilated rough endoplasmic reticulum and myofilament-like bundles in cytoplasm.

Distribution of vasoactive intestinal polypeptide immunoreactive nerve fiber in the rat nasal mucosa.

The distribution of vasoactive intestinal polypeptide (VIP)-immunoreactive nerve fiber of the respiratory nasal mucosa of the rat was examined by use of immunohistochemistory with light, laser confocal scanning and electron microscopy. On light microscopy, it was observed that VIP immunoreactive nerve fibers distributed under and within the epithelium in addition to around the blood vessels and glands. The laser confocal scanning microscope revealed the network of VIP-immunoreactive nerve fibers at glands, but it was denser around glands than within glands. The VIP-immunoreactive nerve fibers formed fine varicosities and was distributed below the middle portion of the epithelium. Some fibers were observed as if they were surrounding goblet cells. Electron microscopy showed that the VIP-immunoreactive nerve fibers within the epithelium were terminated as free nerve endings. Some of them were in close contact with goblet cells.

Thallium-201 single-photon emission tomography in the treatment follow-up of nasopharyngeal carcinoma.

In order to assess the usefulness of thallium-201 single-photon emission tomography (SPET) in the treatment follow-up of nasopharyngeal carcinoma (NPC), a total of 75 201T1 SPET studies were performed in 18 patients with histologically proven NPC. The findings were compared with those of magnetic resonance imaging (MRI) before and after therapy. Four patients received radiotherapy alone while the other 14 received concurrent chemo-radiotherapy. Treatment response was classified as complete (CR) or partial (PR) based on the findings of MRI and 201T1 SPET. Intense 201T1 uptake by the tumour was seen in all 18 patients before treatment. After treatment, MRI showed seven CRs and 11 PRs, whereas 201T1 SPET showed 13 CRs and five PRs. In 12 patients, the results of 201T1 SPET were in agreement with those of MRI. In six patients MRI showed PR but 201T1 showed CR. Follow-up (mean 10.6 months) MRI and 201T1 SPET studies of these six patients revealed that tumour gradually decreased and finally vanished in three patients. This preliminary study indicates that 201T1 SPET has potential in the assessment of early response to treatment of patients with NPC when compared with MRI.