耳鼻と臨床
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
15 巻, 4 号
選択された号の論文の8件中1~8を表示しています
  • 河田 政一
    1970 年 15 巻 4 号 p. 261-273
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    Résumé
    I advocated the appropriateness of the term of “movability” or “movableness” of the eardrum 15 years ago.It is very interesting and important to observe the physiological and patho-physiological finding of auditory organ through the reactive changes of the movability of the tympanic membrane.The main object of the present publication lies in it that the patho-physiological nature of eardrum retraction should exist apart from usual inflammatory or barometric origin.
    1) A method to indicate the retraction grades of the tympanic membrane was devised, through it we can suitably observe the movability of the tympanic membrane.
    2) The tympanic membrane retraction originated from acoustic trauma is due to the contracture of the tympanic muscles.
    3) Many cases of Ménière's disease have retracted tympanic membranes, 44.6° on the average.
    4) We measured the threshold of the acoustic reflex of the middle ear muscles by means of direct observation of the eardrum movability.Getting the threshold differences between the middle ear muscle reflex and minimal audibility, we can estimate recruitment phenomenon.
    5) The acoustic reflex of the tympanic muscles in normal persons was classified by means of the micromanometric procedure of the external auditory canal as follows:Retraction modus from tensor tympani muscle; 54.9%, Bulging modus from stapedius muscle; 38.7%, and mixed modus; 6.4%.
    6) We devised a recording method of the movability of the tympanic membrane by use of a small phototransistor inserted tube into the auditory canal, being not in contact with the canal wall.
  • 放射線療法
    梅垣 洋一郎
    1970 年 15 巻 4 号 p. 274-283
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    The author discussed radiation therapy for head and neck malignancies at National Cancer Center. 147 cases of head and neck malignancies were first treated with radiation and their 5-year survival ratio was 61%. In the cases which survived for 5 years, most of the patients were treated with Telecobalt or Ra-needle insertion but recently Lineac and Betatron are chiefly employed, especially in treatment of cancer of the tongue.To improve the method of intracavitary radiation in maxillary cancer after-loading applicator is adopted and the author maintained that computer should be employed for accurate calcuration of radiation dosis.
  • 広戸 幾一郎, 末吉 楠雄, 三橋 重信, 市川 昭則, 黒川 博愛
    1970 年 15 巻 4 号 p. 284-289
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    The continuous intra-arterial infusion of anticancer drugs combined with radiation therapy is very useful and effective for some head-and-neck carcinomas such as maxillary or lingual one; however, it is hardly available for laryngeal carcinoma. It is very difficult in the larynx to infuse chemotherapeutics by retrograde catheterization through superficial temporal artery, because there are various types in the division of superior thyroid artery, i. e. a division from external carotic artery, from carotic bifurcation and from common carotic artery. The infusion of the agent is possible under direct insertion of the catheter into superior thyroid artery after skin incision. This procedure is emphasized during surgery of the larynx, especially in some cases of partial laryngectomy.
    Out of 122 cases of laryngeal carcinoma 5 cases died of carcinoma in the lung, 10 cases of the recurrence in the cervical lymph nodes and only 2 cases of the recurrence in the base of tongue and the thyroid gland. As to the survival ratio of the partial laryngectomy, local recurrence in the laryngeal cavity was noticed in 4 of 14 cases without radiation therapy, 2 of 4 cases with preoperative radiation and 3 of 10 cases with postoperative radiation; all the cases were controlled by the followed total laryngectomy. It means that the carcinoma in the laryngeal cavity can be well controlled by the total laryngectomy, and that the presurgical intra-arterial infusion method of chemotherapy as well as the preoperative radiation therapy are not necessary in the laryngeal carcinoma.
    The local recurrence of carcinoma was noticed in 5 of 23 cases which were initially treated by radiation and in 2 of 6 cases of partial laryngectomy when the involved vocal cord was movable (T1, T2). When the carcinoma extended to the other region (T3) or the affected vocal cord was immovable, the local recurrence was found in 3 of 5 cases of radiation but in none of 7 cases of partial laryngectomy. These results indicate that 1) radiation therapy should be preferred to surgery in cases of glottic carcinoma when both vocal cords are movable, 2) partial laryngectomy, especially the hemilaryngectomy is chosen in cases when the carcinoma extends to the supraglottic region or the vocal cord is immovable in the involved side, 3) in more extended cases, total laryngectomy is the safest.
  • 佐々木 寛, 涌谷 忠雄, 織田 鹿之, 山崎 靖夫
    1970 年 15 巻 4 号 p. 290-296
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    Hydrogen peroxide and Mitomycin C infusion was employed in 38 cases of maxillary cancer for the purpose to increase the effect of anticancer agent. 4mg of MMC was injected in one shot after the infusion of Nyclin (40mg) and 0.12% H2O2. This procedure was continued for 10 days and partial resection of maxilla was made one week after the infusion. In the case of single infusion of MMC changes were seen in one week and in the case of hydrogen peroxide infusion in 3 to 4 days. Histological investigation revealed that degeneration was seen in tissue stroma in the case of one shot infusion and considerable degeneration was seen in all of the tumor tissue in the case of hydrogen peroxide infusion. These findings suggest that the hydrogen peroxide infusion intensify the effect of MMC. In this series injected hydrogen peroxide did not show any side reaction.
  • 河辺 義孝, 北川 俊夫
    1970 年 15 巻 4 号 p. 297-305
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    The forty untreated cases of cancer of the tongue in Aichi Cancer Center Hospital are presented, and the outline of these cases concerning the combined therapy and its indication is discussed.
    The clinical factors influencing on prognosis of patients with cancer of the tongue are the size as well as the spread of the primary tumor and the presence of cervical metastasis.By pathomorphological observation it -is turned out that the mononuclear round cell infiltration such as lymphocytes and plasma cells against tumor growth plays an important role during the course of the spread of the primary tumors.
    The choice of treatment is irradiation for primary lesion, and is radical neck dissection for cervical lymphadenopathy.
    Interstitial radium therapy is still essential to early primary lesion, particulary to that of the cases of T1. In the cases of T2, external irradiation is a suitable treatment and the residual tumors can be followed by small source irradiation.
    Futhermore a prophylactic neck dissection should be also performed after irradiation. In the advanced cases such as T3 and T4, the simultaneous irradiation including both the primary and cervical metastatic lesions should be considered as a first therapeutic plan and then radical neck dissection should be carried out as fast as possible. If the primary tumor still remains after irradiation, the combined operation is necessary to the primary and metastatic lesion.
    It is stressed that the combination of irradiation with the surgery of infusion chemotherapy is important.
  • 特に喉頭部分切除術の場合
    北村 武, 金子 敏郎, 海野 徳二, 神田 敬, 橘 昌孝, 陳 端和
    1970 年 15 巻 4 号 p. 306-311
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    1. Combined use of radiation and surgery: Sufficient amount of radiation to completely destoroy the tumor cells is approximately 10,000 rads. Partial laryngectomy following such amount of radiative dosis can not be performed, because of the markedly delayed wound healing. No disturbance as to wound healing has been observed in patients with preoperative irradiation amounting to 4,000 to 5,000 rads. Survived tumor cells, however, are sometimes recognized in the subepithelial scar tissue of the specimen in spite of the macroscopic cure of the epithelium.
    2. Combined use of chemotherapy and surgery: The arterial structure of the larynx and the cellular character of the laryngeal cancer had been obstacles against chemotherapy before Bleomycin was discovered. The electronmicroscopic findings show the direct effect of Bleomycin to the tumor cells themselves. Delayed wound healing has not been observed in patients treated by preoperative administration of Bleomycin without radiotherapy. Increased effect of Bleomycin was observed in some patients used in the hyperbaric oxygen tank. The influence of oxygen on the distribution of injected Bleomycin was also studied by animal experiments in the oxgen tank and with H2O2.
  • 佐藤 靖雄
    1970 年 15 巻 4 号 p. 312-323
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
    Since 1963, the simultaneous combined therapy of (1) surgery,(2) radiothe- rapy and (3) regional chemotherapy has been practised in malignant neoplasms of the nose and paranasal sinuses. By combining the merits of the three me- thods, we examined whether the curtailment in the total dose of radiotherapy was possible or not, and whether these malignant tumors could be treated with- out total resection of the maxilla.
    In our series we used 5-Fluorouracil (5-FU) alone or together with 5-Bro- modeoxyuridine (BUDR) as radiation-sensitizing agents. In order to eradicate of as much as 10, 000 rads must be administered. However, when 5-FU and BUDR are infused simultaneously with telecobalt therapy, and the necrotic tumor mass in the antrum is sucked out every day, the eradication of the tumor mass is achieved within the total dose of 4, 000 rads.
    In treating the tumors which had extended to the ethmoid sinuses, this combined therapy was rather insufficient in the rate of tumor disappearance. In order to compensate the insufficient drug concentration in these regions, the cleaning of the ethmoid sinuses was done from the antrum and in some cases mixed gas of 5% CO2 and 95% O2 was inhaled during radiotherapy to increase radiation effects.
    Even if the tumor still existed after the combined therapy, the partial resection of the maxilla or the intracavitary irradiation of Cesium-137 tubes was enough to eradicate the residue of the tumor.
    Thus, this method of treatment showed the definite improvement in saving the extent of surgery. No total resection of the maxilla has been required in the last four years. Consequently, a great number of patients were enabled to return to their former work soon after the completion of the therapy.
  • 高原 滋夫
    1970 年 15 巻 4 号 p. 324-344
    発行日: 1970/06/20
    公開日: 2013/05/10
    ジャーナル フリー
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