甲状軟骨形成術Ⅰ型と声帯内自家脂肪注入術との治療成績の検討

Objective: Type-I thryroplasty, also known as medialization thyroplasty (MT) and autologous fat injection laryngoplasty (FIL) are one of the main surgical treatments for unilateral vocal fold paralysis (UVFP). Both procedures have the same concept of completing the glottal closure by medializing the vocal fold, although the surgical approaches are quite different. In order to assess these surgical effects, we examined the treatment outcomes and benefits of the two surgeries. Methods: We collected data from the 135 phonosurgeries that we performed out of 375 patients with UVFP at Osaka Voice Center, Osaka Kaisei Hospital from January 2009 to February 2013. After excluding cases with glottal level differences on phonation, either MT or FIL were performed on 80 cases. The inclusion criteria for the present study were: (1) patients had no history of previous phonosurgery, and (2) functional evaluations were available before/after surgery. Consequently, 43 participants (12 for MT and 31 for FIL) were enrolled in this study. Surgical effects were evaluated by means of the maximum phonation time (MPT), pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and harmonic to noise ratio (HNR) just before, one month, and 6 months after surgery. Results: Both MT and FIL showed significant improvement in MPT (MT, p = 0.005; FIL, p < 0.001) and PPQ (MT, p = 0.047; FIL, p = 0.041) at 1 month postoperation. We also compared the variation of each variable between the two procedures, but there were no significant differences in these parameters. However, MPT, APQ, and HNR at the post-MT after 6 months worsened compared to those at 1 month posttreatment, whereas MPT showed only a slight decrease from the 1st month to the 6th month in those with FIL. Conclusion: Both MT and FIL were effective for the voice recovery in patients with UVFP. Our findings suggest that surgical results in FIL might be better than those in MT 6 months after surgery, although there were no significant differences between these two procedures 1 month postoperation.博士（医学）・乙第1490号・令和2年12月24日Copyright © 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V

First mesopause temperature measurements using sodium lidar observations in the Antarctic region

The mesopause temperature structure was observed using a sodium temperature lidar system at Syowa Station (69°00\u27 S, 39°35\u27 E), beginning in February 2000. The laser transmitter was newly developed and included two injection-seeded Nd: YAG lasers. Regular observations were performed using the two-frequency technique as demonstrated by C.Y. She et al. (Geophys. Res. Lett., 17, 929, 1990), with a spatial resolution of about 1 km and a temporal resolution of 6 min. The temperature structures of the 85km to 105km region of the upper atmosphere were measured by Na D_2 Doppler profile-fitting as well as the two-frequency technique. Temperatures derived from the two techniques agreed well and were consistent with the MSIS 90 model temperature structure. Night-time temperature variations over a 15-hour period were measured in May 2000. A large temperature fluctuation with an interval of about 4 hours, and an amplitude of 60 K (probably caused by gravity waves) was observed. From the average night temperature profile, the mesopause was determined to be located at 102km, and have a temperature of 180K. These values are similar to winter values observed in the northern hemisphere

難治性の良性発作性頭位めまい症はヘッドアップした姿勢で就寝することにより治り得る：6ヶ月間のランダム化比較試験

Objectives: The aim of the present study was to assess head-position management for intractable idiopathic benign paroxysmal positional vertigo (BPPV) when lying down. We hypothesized that head-up sleep (HUS) could prevent free-floating otoliths from entering the semicircular canals. Study design: A prospective two-arm multicenter randomized controlled trial. Methods: BPPV was diagnosed in 611 patients (611/1,520; 40.2%) according to the 2015 diagnostic guidelines issued by the International Classification of Vestibular Disorders. Among them, 201 patients were intractable (201/611; 32.9%), 88 of whom were idiopathic and subsequently enrolled in the study. Patients randomly received intervention with HUS at greater than 45° (n = 44) or head-down sleep (HDS; n = 44) when lying down. Before treatment, they completed several examinations, including subjective visual vertical (SVV). The specific diagnoses for the 88 patients with BPPV included horizontal type cupula (n = 40), horizontal type canal (n = 13), posterior type (n = 26), and probable and/or atypical BPPV (n = 9). Results: Patient backgrounds did not differ significantly between the HUS and HDS groups. Visual analog scale (VAS) scores of vertiginous sensation were significantly lower in the HUS group than in the HDS group at both the third month and sixth month post-treatment. Positional/positioning nystagmus observed just before treatment disappeared significantly more often in the HUS group than in the HDS group until the sixth post-treatment month. Further, especially in HUS group, VAS scores in SVV- group (n = 24) were significantly lower than those in the SVV+ group (n = 20) sixth month post-treatment. Conclusions: Controlling free-floating otoliths is not easy due to aging of the otolith organs. Repeatedly returning the endless free-floating debris from the canals to the utricle through physical means is not a good strategy. Therefore, HUS when lying down at home could be recommended as an initial treatment for patients with intractable idiopathic BPPV. Level of evidence: 1b.博士（医学）・甲第764号・令和3年3月15日© 2019 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made

Oseltamivir (Tamiflu®)-induced pneumonia

SummaryWe report the first case of oseltamivir-induced pneumonia. A 50-year-old man was diagnosed with influenza and prescribed oseltamivir. He had a persistent high fever, and developed a productive cough with peripheral blood eosinophilia and his chest radiograph showed ground glass opacity. Bronchoalveolar lavage fluid and histological findings obtained from transbronchial lung biopsy suggested eosinophilic pneumonia with component of cryptogenic organizing pneumonia. Drug lymphocyte stimulation test against oseltamivir was positive. In spite of discontinuation of oseltamivir, his condition did not ameliorate. He was treated with prednisolone for oseltamivir-induced lung injury and the symptoms improved immediately. We should recognize oseltamivir-induced pneumonia as a differential diagnosis in the case of developing pneumonia following treatment with oseltamivir

Oseltamivir (Tamiflu®)-induced pneumonia

SummaryWe report the first case of oseltamivir-induced pneumonia. A 50-year-old man was diagnosed with influenza and prescribed oseltamivir. He had a persistent high fever, and developed a productive cough with peripheral blood eosinophilia and his chest radiograph showed ground glass opacity. Bronchoalveolar lavage fluid and histological findings obtained from transbronchial lung biopsy suggested eosinophilic pneumonia with component of cryptogenic organizing pneumonia. Drug lymphocyte stimulation test against oseltamivir was positive. In spite of discontinuation of oseltamivir, his condition did not ameliorate. He was treated with prednisolone for oseltamivir-induced lung injury and the symptoms improved immediately. We should recognize oseltamivir-induced pneumonia as a differential diagnosis in the case of developing pneumonia following treatment with oseltamivir

Comparison of Humidified Hydrogen and Partly Pre-Reformed Natural Gas as Fuel for Solid Oxide Fuel Cells applying Computational Fluid Dynamics

A three-dimensional computational fluid dynamics (CFD) approach based on the finite element method (FEM) is used to investigate a solid oxide fuel cell (SOFC). Governing equations for heat, gas-phase species, electron, ion and momentum transport are implemented and coupled to kinetics describing electrochemical as well as internal reforming reactions. The model cell design is based on a cell from Ningbo Institute of Material Technology and Engineering in China and the electrochemical area-to-volume ratios are based on experimental work performed at Kyushu University in Japan. A parameter study is performed focusing on the inlet fuel composition, where humidified hydrogen, 30 % pre-reformed natural gas (as defined by IEA) and 50 % pre-reformed natural gas (as defined by Kyushu University) are compared. It is found that when 30 % pre-reformed natural gas is supplied as fuel the air mass flow rate is halved, compared to the case with humidified hydrogen, keeping the inlet and outlet temperatures constant. The current density is decreased but the fuel utilization is kept at 80 %. It is found that the cathode support layer has a significant oxygen gas-phase resistance in the direction normal to the cathode/electrolyte interface (at positions under the interconnect ribs), as well as an electron resistance inside the cathode (at positions under the air channel) in the same direction. The methane steam reforming reaction is shown, both according to the experiments and to the models, to proceed along the main flow direction throughout the cell

Association between FSH, E1, and E2 levels in urine and serum in premenopausal and postmenopausal women

Objective: We aimed to establish correlations for the levels of follicle-stimulating hormone (FSH), estrone (E1) and estradiol (E2) between urine and serum in premenopausal and postmenopausal women using immunoassays. Methods: In this study of 92 women (61 postmenopausal, 31 premenopausal), both urine and blood specimens were collected on the same day and stored at 4 °C for analysis by chemiluminescent immunoassay, radioimmunoassay and/or electrochemiluminescent immunoassay. Results: There were correlations in the levels of FSH, E1 and E2 between urine and serum in both postmenopausal (r = 0.96 for FSH, r = 0.91 for E1, r = 0.80 for E2) and premenopausal (r = 0.98 for FSH, r = 0.92 for E1, r = 0.90 for E2) women. It is indicated that the correlations were stronger in the premenopausal group compared with the postmenopausal group, especially for FSH. Conclusion: The levels of FSH, E1 and E2 in urine correlated with those in the serum in premenopausal and postmenopausal women. Urine samples could be used instead of serum samples to measure hormone levels, which would reduce the difficulty of conducting large survey studies