[Voice rehabilitation after total laryngectomy using the Provox voice prosthesis].

Esophageal speech is the first choice for vocal rehabilitation in laryngectomized patients. However, shunt speech is a needed alternative for patients who cannot succeed at esophageal speech. Many kinds of voice prostheses, with good results, have been reported. Provox was selected for 15 laryngectomized patients who were treated in our department. Voice rehabilitation was successful in 13 patients. However, removal of the prosthesis was required in one patient because of stomal stenosis. Voice rehabilitation was not successful in one patient who exhibited esophageal stenosis. The rate of voice rehabilitation was not influenced by the extent of surgery, the dose of radiation, etc.. The maximum phonation time was more than 10 minutes in the 13 patients who succeeded at shunt speech. Prosthetic rehabilitation was requested by two patients who had been successful at esophageal speech. These results suggest that prosthetic voice rehabilitation may be indicated for a wide range of conditions.

Nine cases of piriform sinus fistula with acute suppurative thyroiditis.

OBJECTIVE: Acute suppurative thyroiditis is a disease of an infection originated from the piriform sinus via congenital fistula. The purposes of this study are the establishment of accurate and necessary examinations for the diagnosis and necessary treatment for complete remission of this disease. METHODS: We reported nine cases with acute suppurative thyroiditis who were treated by operation. Preoperative examinations and operative procedures for nine cases were investigated. RESULTS: A congenital fistula was detected in seven of nine patients preoperatively, and in all seven patients, the fistula was detected during the operation. Serum thyroglobulin was elevated in four of five patients who were examined the serum level. Ultrasonogram was performed in eight cases, and localized swelling of the thyroid lobe was observed in all cases. No inflammatory recurrence was observed in eight cases, and recurrence was observed in one case where complete fistelectomy was not performed. CONCLUSION: Measurements of serum thyroglobulin, ultrasonography, and pharyngoesophagography were useful in the diagnosis of acute suppurative thyroiditis. Complete removal of the fistula with or without affected thyroid lobe is necessary to prevent recurrent suppuration.

Activation of caspase-3, proteolytic cleavage of DFF and no oligonucleosomal DNA fragmentation in apoptotic Molt-4 cells.

A variety of endonucleases has been implicated in apoptotic DNA fragmentation. DNA fragmentation factor (DFF) is one of the endonucleases responsible for DNA fragmentation. Since an oligonucleosomal DNA ladder is not induced in apoptotic Molt-4 cells, we investigated whether or not the absence of ladder formation is related to an inability of DFF endonuclease in the cells. Semiquantitative RT-PCR analysis showed that the mRNA level of DFF-40 and DFF-45 in Molt-4 cells was approximately the same, compared with in other cells, which exhibit different levels of the fragmentation in apoptosis. When Molt-4 cells were induced to undergo apoptosis by neocarzinostatin (NCS) treatment, both caspase-3 activation and DFF-45 cleavage were observed. Furthermore, DFF immunoprecipitated from Molt-4 cells exhibited DNA degradation activity. These results suggest that functional expression of DFF is not sufficient for the induction of DNA fragmentation in Molt-4 cells.