巻号一覧
前身誌
106 巻, 2 号
選択された号の論文の16件中1～16を表示しています
- |<
- <
- 1
- >
- >|
論説
-
中川 尚志, 末田 尚之, 大門 康子, 鍋島 一樹2013 年 106 巻 2 号 p. 97-100
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありThe study subjects comprised 56 patients with squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear. The mean age was 65 years (ranging between 41 and 93 years). There were 30 males and 26 females. The trial centers were Kyushu University Hospital from Jan ‘98 to Mar ’06 and Fukuoka University Hospital from April ‘06 to Mar ’11. Subjects who were followed up for longer than 12 months, with the exception of those who died from disease, were included in the study. The mean follow-up period was 37 months. The numbers of patients at T1N0, T1N1, T2N0, T2N1, T3N0, T3N1, T4N0 and T4N1 were 1, 0, 12, 3, 7, 2, 20 and 11, respectively. Twenty-nine percent of the patients (n = 16) had lymph node metastasis. There was one case of M1 at T2N1M1. Treatment strategy was determined by the extent of tumor, which was evaluated with both CT and MRI before any treatment.
The 5-year-survival rates of T3 and T4 patients were 89% and 52%, respectively. However, the 5-year-survival rate of T1 and T2 decreased to 68% and was lower than that of T3. Four T1 and T2 patients of died of disease at follow-up periods of 16, 18, 18 and 37 months. Markers of epithelial-mesenchymal transition (EMT) in SCC tumor cells were examined in 7 out of 16 cases and 3 cases out of 4 who died of disease were included in the study. Staining for vimentin was positive and laminin was diffusely stained in all cases.
抄録全体を表示PDF形式でダウンロード (344K)
カラー図説
-
吉田 忠雄, 曾根 三千彦, 中島 務2013 年 106 巻 2 号 p. 102-103
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありPDF形式でダウンロード (1067K)
臨床
-
藤森 貴世子, 坂 直樹, 瀬尾 徹, 大田 重人, 阪上 雅史2013 年 106 巻 2 号 p. 105-108
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありSound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal was first described by Minor et al. in 1998, and was named superior canal dehiscence syndrome (SCDS). A 27-year-old man presented with dizziness and oscillopsia induced by loud sounds. A pure-tone audiogram showed right conductive hearing loss at low tone frequencies with hypersensitivity to bone-conducted sound at low frequencies. Vestibular evoked myogenic potentials (VEMP) testing demonstrated large amplitudes in the right ear. A high-resolution computed tomography scan of the temporal bones revealed a dehiscence of bone overlying the superior canal. The image showing dehiscence was taken at an angle approximately 45° to the sagittal plane, in close parallel alignment with the superior semicircular canal. Based on these findings, SCDS was suspected as the cause of the dizziness.
抄録全体を表示PDF形式でダウンロード (527K) -
小林 賀子, 萩原 晃, 船戸 宣利, 井谷 茂人, 鈴木 衞2013 年 106 巻 2 号 p. 109-113
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありA 50-year-old man was referred to our hospital with epistaxis from the right nostril. His left nostril had been packed with several pieces of gauze for a long time. Acute liver and kidney failure made control of the epistaxis difficult. Toxic shock syndrome (TSS) is associated with complications such as multiple organ failure or shock due to exotoxins, such as toxic shock syndrome toxin-1 (TSST-1), produced by Staphylococcus aureus. Definitive diagnosis of TSS is difficult, because the diagnostic criteria of the Centers for Disease Control and Prevention (CDC) are stringent. Although our present patient did not fulfill the diagnostic criteria, TSS was strongly suspected. TSS after sinus surgery has been frequently reported. Few studies have been published about TSS caused by gauze packing for epistaxis. It is necessary to be borne in mind the possibility of TSS not only after surgery, but also after gauze packing for epistaxis.
抄録全体を表示PDF形式でダウンロード (599K) -
野田 謙二, 児玉 悟, 馬渕 英彰, 野田 加奈子, 鈴木 正志2013 年 106 巻 2 号 p. 115-121
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありInvasive fungal sinusitis is considered to have a poor prognosis. We report herein on a case of invasive fungal sinusitis successfully treated with endoscopic sinus surgery (ESS) but which relapsed 4 months after surgery. A 65-year-old man presenting with left cheek pain was found on computed tomography to have a heterogeneously enhanced mass in the anterior wall of the maxillary sinus and bone defects. We suspected a malignant tumor and performed diagnostic ESS. Fungus and necrotic mucosa were observed in the posterior wall of the maxillary sinus while necrotic mucosa and bone destruction were observed in the anterior wall. Endoscopic findings indicated a diagnosis of invasive fungal sinusitis and the patient underwent removal of the mucosa of the maxillary sinus with a modified endoscopic medial maxillectomy. Pathology confirmed invasive fungal sinusitis and Aspergillus fumigatus was detected on bacterial testing. The patient’s left cheek pain disappeared after surgery and micafungin was systemically administered for one month. However, follow-up CT at 4 months after surgery revealed recurrence in the orbit. Voriconazole was systemically administered and ESS was performed to confirm the diagnosis. Since we suspected that the fungus had invaded the lateral aspect of the maxillary bone, a total maxillectomy was performed, followed by systematic administration of voriconazole for 2 months. The patient was free from recurrence at the one-year follow up. This case suggests that, depending on the clinical course, aggressive surgery such as a total maxillectomy might be required for invasive fungal sinusitis.
抄録全体を表示PDF形式でダウンロード (2040K) -
平賀 幸弘, 黄 淳一2013 年 106 巻 2 号 p. 123-130
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありThirty-seven cases of major salivary gland carcinomas, treated in our hospital during the past 16 years from July 1995 to June 2011, were studied and reviewed histopathologically and statistically. They comprised 27 cases with parotid carcinomas and 10 cases with submandibular carcinomas. Thirty-five patients had undergone surgery, followed by chemotherapy in 7 patients and radiation therapy in 20. Because of the advanced ages of two patients in their 90’s with submandibular carcinoma, they were treated with radiation alone. The mean age of the group was 62.1 years. There was no difference based on sex and the side of occurrence. The mean duration of the complaint was 33.6 months, and the mean tumor diameter was 34.6 mm. The results of cytological examinations from 35 cases with fine-needle aspiration biopsy delivered a sensitivity of 62.9% and a false-negative rate of 37.1%.
Histopathological findings revealed the numbers of carcinoma ex pleomorphic adenoma as the greatest in all cases, salivary duct carcinoma in parotid carcinomas and also carcinoma ex pleomorphic adenoma in submandibular carcinomas. The mean operation time was 171.7 minutes and the mean intraoperative blood loss was 125.5 ml. In both parameters there was a statistically significant correlation. The complication with the highest postoperative rate was facial nerve palsy (37%). The 5-year cause-specific survival rate (CSS) was 78.5% in all cases, and 80.7% in parotid carcinomas and 72.9% in submandibular carcinomas, although these latter rates were without statistical significance. On the other hand according to the classifications of the stage of the cancer, the 5-year CSSs were 100% for Stage I, 80% for Stage II, 50% for Stage III, and 71.2% for Stage IV. Furthermore patients with parotid carcinomas with facial nerve palsy at the first time of diagnosis or in the category of the high malignancy group revealed significantly bleaker survival rates than those without.
抄録全体を表示PDF形式でダウンロード (545K) -
久保田 万理恵, 中条 恭子, 安松 隆治2013 年 106 巻 2 号 p. 131-137
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありIgG4-related disease (Mikulicz disease) was first reported by Mikulicz in 1892 in a case of a man with bilateral swelling of the lachrymal, parotid, and submandibular glands. However, since Morgan and Castleman examined the pathological features of what they called Mikulicz disease in the 1950s, Mikulicz disease’s been considered as a part of Sjögren’s syndrome. In 2000, Tsubota et al. reported the difference in salivary gland destruction patterns between Mikulicz disease and Sjögren’s syndrome, and explained the clinical differences of each disease. In 2004, Yamamoto et al. reported that the serum IgG4 level is extremely elevated in Mikulicz disease patients. The concept of a systemic IgG4-related syndrome came with the recognition of autoimmune pancreatitis, in which Hamano et al. reported in 2001 that the serum IgG4 level was elevated. Since that time, Mikulicz disease has been considered as a part of a systemic IgG4-related syndrome.
We report herein on the case of a man who came to our institute in 2001 with bilateral swelling of the submandibular glands. We initially suspected malignant lymphoma and some other diseases, but during the long course of more investigations and follow-up, we finally diagnosed the condition as IgG4-related disease (Mikulicz disease).
抄録全体を表示PDF形式でダウンロード (1392K) -
中田 吉彦, 石島 健, 佐藤 宏昭2013 年 106 巻 2 号 p. 139-142
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありLigature of the external carotid artery (LECA) is a very effective method of choice in patients with excessive post-tonsillectomy hemorrhage. We report herein on the case of a 25-year-old man who underwent LECA for an excessive post-tonsillectomy hemorrhage. His tonsillectomy had been performed under general anesthesia for habitual angina seven days previously. One morning abrupt and excessive bleeding occurred and the patient went into shock. Immediate LECA was performed under general anesthesia. The bleeding was stopped rapidly and a blood transfusion was performed. The patient was discharged 16 days after the LECA without any severe complications.
抄録全体を表示PDF形式でダウンロード (345K) -
滝口 修平, 櫛橋 幸民, 許 芳行, 山田 良宣, 篠 美紀, 門倉 義幸, 洲崎 春海2013 年 106 巻 2 号 p. 143-147
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありMarfan’s syndrome is a genetic disorder of the connective tissue. One of the most serious complications associated with Marfan’s syndrome is aortic dissection, which is often fatal, even when rapidly treated. We report a case of Marfan’s syndrome with acute aortic dissection presenting with pharyngeal pain.
The patient was a 41-year-old woman who presented with a one-week history of pharyngeal pain and slight fever. Although no abnormal findings were detected on physical examination of the pharyngolarynx, contrast-enhanced CT revealed acute aortic dissection and a funnel chest. Subsequently, we diagnosed the patient as a case of Marfan’s syndrome with acute aortic dissection.
Unexplained pharyngeal pain could be referred pain associated with cardiovascular disease.
抄録全体を表示PDF形式でダウンロード (927K) -
吉福 孝介, 大堀 純一郎, 宮下 圭一, 黒野 祐一2013 年 106 巻 2 号 p. 149-153
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありAcute epiglottitis is a life-threatening infectious disease. Severe swelling of the epiglottis, arytenoids, or aryepiglottic fold is known to cause dyspnea and unless adequate treatment is delivered rapidly, the patient may suffocate. Therefore, early diagnosis and treatment are mandatory. We investigated the clinical features of patients with acute epiglottitis treated in our department and discussed the indications for airway management in such patients. In total 144 patients (90 males and 54 females ranging in age from 16-85 years) with acute epiglottitis were enrolled in the study. All patients were treated at Kagoshima University Hospital between October, 1999 and March, 2012. Airway management was required in 19 patients (13.2%) and the clinical characteristics of those subjects were compared with patients in whom airway management was not performed. Those findings suggest that when abnormal findings of the glottis were observed or the glottis findings could not be observed, airway management should be considered. Our results indicated that patients who needed airway management had severe dyspnea, more rapid and progressive aggravation of clinical findings and more severe swelling of the aryepiglottic folds compared to patients who did not require airway management.
抄録全体を表示PDF形式でダウンロード (542K) -
十名 理紗, 篠原 尚吾, 菊地 正弘, 藤原 敬三, 山崎 博司, 岸本 逸平, 原田 博之, 内藤 泰2013 年 106 巻 2 号 p. 155-160
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありIn the period from April, 2004 to March, 2010, we retrospectively reviewed 286 patients who were newly-diagnosed as squamous cell carcinoma of the head and neck (HNSCC), in order to investigate the incidence of multiple primary malignancies and the overall survival rate of such patients, and the therapeutic strategy to deal with them.
In 83 patients (29%) other primary malignancies were revealed, 35 patients (12%) synchronously and 48 patients (17%) metachronously. The 5-year overall survival rates shown with the Kaplan-Meier method were 74% for single primary malignancy, and 49% and 70% for synchronous and metachronous multiple malignancies, respectively. The overall survival of patients with synchronous multiple malignancies was significantly worse than those with single primary malignancy, while the difference between single and metachronous cases was not significant. The therapeutic strategies for synchronous multiple malignancies were decided according to the following policies. 1) Treatment of more advanced cancer went ahead when simultaneous treatments of both malignancies were difficult. 2) As simultaneous operation for both lesions was considered if safely possible. 3) An endoscopic resection for the other gastrointestinal tract malignancy could be performed at a convenient time for HNSCC treatment. 4) The choice of synchronous or metachronous radiation for multiple lesions depended on the total range of radiation fields and the purpose of treatment. Upper gastrointestinal endoscopy and FDG-PET are recommended in patients with untreated HNSCC, because the ratio of synchronous primary malignancy was as high as 12%. Although synchronous multiple malignancies including HNSCC should be considered according to the stage and the location of each lesion, we discuss the relevant therapeutic strategies.
抄録全体を表示PDF形式でダウンロード (488K) -
竹林 慎治, 三好 拓志, 鈴木 千晶, 樋渡 直, 池田 浩己, 三浦 誠2013 年 106 巻 2 号 p. 161-165
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありFormation of thyroid nodules is a common clinical problem. Fine-needle aspiration biopsy (FNAB) is the most useful examination to triage patients for surgical treatment. On the other hand, Hashimoto′s thyroiditis is often associated with thyroid nodules and presence of autoantibodies against the thyroid gland. The present study examined whether autoantibodies against the thyroid could affect the distribution of the FNAB diagnosis. We retrospectively studied 817 patients who underwent FNAB and measurement of serum antibodies against thyroglobulin (Tg) and thyroid peroxidase (TPO) between July 2008 and December 2011. Statistical analysis was performed to determine the relationship between FNAB results and the presence of autoimmune antibodies against thyroid. FNAB results were classified into 4 categories: unsatisfactory material, benign, indeterminate and malignant cytology. The rate of unsatisfactory material was less from the patients with either Tg or TPO antibodies than from those without Tg and TPO antibodies. There was no statistical difference in the rate of indeterminate or malignant cytology between the patients with and without these autoantibodies. Moreover, although no significant difference in the frequency of papillary carcinoma was found between with and without autoantibodies against the thyroid, malignant lymphoma was found only in the patients with these autoantibodies. In conclusion, although autoimmune antibodies against Tg or TPO decreased the rate of unsatisfactory material during FNAB diagnosis, they did not affect the rate of indeterminate or malignant cytology.
抄録全体を表示PDF形式でダウンロード (322K) -
影山 桃子, 瀧澤 義徳, 杉山 健一, 高橋 吾郎, 三澤 清, 大和谷 崇, 細川 誠二, 峯田 周幸2013 年 106 巻 2 号 p. 167-171
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありMost cases of deep neck infection are due to oral and pharyngolaryngeal inflammation. Descending necrotizing mediastinitis (DNM) can be occasionally caused by deep neck infection and has a high mortality rate, so rapid diagnosis and treatment are essential. We experienced a case of DNM. The patient was a 76-year-old male with sore throat. CT imaging revealed a neck abscess, so we started antibiotic administration. Despite improvement in the patient’s general condition and inflammatory response, he had difficulty in swallowing during the course of the treatment and we performed CT imaging again. An abscess was confirmed in the mediastinum, but a neck abscess was not found at the time. Thoracotomic drainage was performed with antibiotic treatment, and the patient recovered. This case suggests that we should take note of swallowing disturbance as the sign of a potential abscess. CT imaging is very useful for determining whether to perform surgery, including transcervical, mediastinal, or thoracotomic drainage.
抄録全体を表示PDF形式でダウンロード (1765K) -
丹家 佐和子, 太田 有美, 長谷川 太郎, 宇野 敦彦, 今井 貴夫, 森鼻 哲生, 猪原 秀典2013 年 106 巻 2 号 p. 173-177
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありWe report herein on a 6-year-old girl with atlanto-axial rotatory fixation (AARF) which occurred after cochlear implantation under general anesthesia. The cochlear implantation procedure appeared normal, and took 3 hours and 50 minutes. On the 1st postoperative day, the patient complained of neck and shoulder pain but she could rotate her head. On the 4th postoperative day, she had torticollis without any neurologic damage and neither active nor passive rotation of the head could be achieved. She was diagnosed as having AARF on the basis of the computed tomographic findings. She was treated with Glisson’s traction for 4 days to correct the deformity.
AARF is a rare disorder and its diagnosis is often difficult and delayed. CT scans, especially 3-D reconstruction, are useful to diagnose AARF. It is suggested that AARF can occur after a cervical injury or an upper respiratory tract infection. AARF is also occasionally caused after head and neck surgical procedures such as pharyngeal flap plasty, ear surgery, and plastic surgery for microtia. It is important to be aware of the possible occurrence AARF and to start appropriate treatment as soon as possible.
抄録全体を表示PDF形式でダウンロード (1050K) -
橋田 光一, 池嵜 祥司, 武永 芙美子, 三箇 敏昭, 小泉 弘樹, 加藤 明子, 寳地 信介, 鈴木 秀明2013 年 106 巻 2 号 p. 179-182
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありThe extracranial carotid artery pseudoaneurysm is a rare vascular lesion. We report herein on such a case caused by bacterial infection. A 70-year-old man presented with a 2-week history of left-sided painful cervical swelling. Enhanced CT and ultrasonography examinations revealed a low density and hypoechoic lesion with ring enhancement surrounding the left carotid artery bifurcation. A deep neck abscess was suspected, and the patient received antimicrobial chemotherapy. The mass decreased in size, but did not disappear. Ultrasonography was then performed again, and a blood stream flowing into the mass was identified. Considering the results of serological tests and other imaging findings, the lesion was finally diagnosed as an extracranial carotid artery pseudoaneurysm. The patient underwent carotid artery stenting, and is currently free from disease 7 months after treatment. The clinical characteristics, diagnosis and management of carotid artery pseudoaneurysm were bibliographically reviewed.
抄録全体を表示PDF形式でダウンロード (849K)
研修ノート
-
近松 一朗2013 年 106 巻 2 号 p. 184-185
発行日: 2013年
公開日: 2013/02/01
ジャーナル 認証ありPDF形式でダウンロード (1227K)
- |<
- <
- 1
- >
- >|