Die histologischen Bilder der Nasentumoren sind im allgemeinen sehr mannigfaltig. Manchmal ist es schwierig, die aus den Nasennebenhöhlen gewachsenen Tumoren von den der eigentlichen Nasenhohle klinisch zu unterscheiden. Wir Verfasser haben im Zeitraum vom Marz 1956 bis zum Februar 1968 14 Fälle der Malignome der eigentlichen Nasenhohle behandelt. Histologisch bestanden die Tumoren aus malignen Granulomen Karzinomen (3 Fälle) Retikulosarkomen (4 Fälle), Neuroblastomen (2 Fälle) und malignem Nasentumor (1 Fall). Auch bei unseren Fällen sind die histologischen Bilder, wie oben erwahnt, mannigfaltig.
Als Initialsymptome wurden uber Nasenverstopfung ( 9 Fälle), Augenbeschwerden wie Exophthalmus und TranenausfluB (2 Fälle), Nasenblutung (2 Fälle) und Zahnschmerzen (1 Fall) geklagt. Bei 8 Fällen ist spater eine Nasenblutu ng eingetreten.
Samtliche Fälle wurden hauptsachlich mit Strahlen behandelt. AuBerdem vervollstandigten die Verfasser die Behandlung mit Zytostatika und Operation. Bei Fällen der Malignome der NasenhOhle kann man auch sagen, daß die Malignität, die Ausgangsstelle und die Verbreitung der Tumoren, wie bei anderen Malignomen im Kopf-und Halsbereich, stark von der Behandlung abhangen.

抄録全体を表示

Seventy-nine cases of the carcinoma of the hypopharynx and cervical esophagus were treated surgically from 1950 to 1969 at Kurume University Hospital. Clinico-pathological studies were done with these cases on the view point of surgical treatment, and the following conclusions were obtained.
1) Three year cure ratio was 37% and five year cure ratio was 30%. The lower the tumor was located, the worse the prognosis was.
2) Three year cure ratio was 35% and five year cure ratio was 29% in cases of pharyngolaryngectomy or pharyngolaryngoesophagectomy, whereas in cases functional surgery preserving the larynx, both three year cure ratio and five year cure ratio were 50%. The cases preserving the phonatory function have been increased, 1 presenting more favorable prognosis.
3) Thirty-four cases of 79 developed recurrenc e of the carcinoma. The recurrence rate was 43%. 95% of the recurred cases could not be controlled by any other treatment, and were dead of tumor.
4) Regarding the site of recurrence of tumors after surgery, it should be emphasized that the recurrence in the mesopharynx was found more frequently than in the cervical esophagus. In our histological investigation, submucous expansion of the carcinoma cells was more extensive at the upper margin of the tumor than at the lower: it was measured 11 mm upward on average and 5 mm downward. Therefore, dissection must be done 2 or 2.5 cm above, and 1 or 1.5 cm below the visible tumor.
5) Among the various sites of the r ecurrence in the cervical lymph nodes, the paratracheal chain and the region of the mandibular angle were most concerned with the prognosis.
6) The recurrenc e ratio of the cervical lymphnode could be reduced to one-quarter by complete and careful neck-dissection with consideration of clinico-pathological findings mentioned above.

抄録全体を表示

A girl, aged 14, was admitted to E. N. T. clinic of K yushu University complaining of dysphagia and dysphonia which occurred rapidly as initial symptoms.
2 days later, the muscles of the upper and lower limbs as well as the neck and shoulder became weak and powerless. Tendon reflexes were diminished, but there was no disturbance of cutaneous reflexes or sensation.
In laboratory tests, increase of erythrocyte sedi mentation rate, ASLO-titer, and leucocytosis were noticed.
However no patholog ic changes were verified in the cerebrospinal fluid.
As respiratory muscles also became weak, tracheotomy was perfo rmed to secure the air way.
Steroid horm one, ATP, Vitamin B, and antibiotics were administered. 2 weaks later, recovery occurred rapidly and all neurological findings had completely disappeared.

抄録全体を表示

A case of hypopharyngeal diverticulum was reported. This patient has had repeated surgical treatinents for recurrent fistula developed after total laryngectomy with radical neck dissection.
The diverticulum was removed surgically. Histological examination revealed that the inner wall was lined with pharyngeal mucosa.
It seemed reasonable to conclude that pseudod iverticulum in the early stage was developed gradually to the genuine one due to mucosal preparation to the skin.

抄録全体を表示

The patient was 10-year-old boy with a teratoma arising in the pineal body. The tumor was surgically removed. Postoperatively he developed signs of severe meningial irritation which lasted for two weeks. A divergence nystagmus appeared during this period and was still observed four weeks after the operation, and the electronystagmography CENG) indicated the eye movements as follows:
1. Upon forward and upward gaze, a rhythmic nystagmus appeared. This nystagmus peculiarly comprised the diverging quick phase and converging slow phase.
2. Upon gaze vacant or through Frenzel's glasses, the eyeballs moved symmetrically but not rhythmically, thus in fashion not to be called a nystagmus, although the divergent movement was evident.
3. Nystagmus to the right was observed on gaze to the right, and vice versa.
4. Typical opto-kinetic nystagmus, either to the right or left, was not induced, and an opto-kinetic inversion appeared on some occasions.
In order to explain the divergence nystagmus, the following mechanism may be assumed.
Physi ologically the bilateral eyeballs move conjunctly. In order to make such a conjunct movement possible, there must be neural connections between the muscles of the two eyeballs. A muscle of one eyeball must have a reciprocal innervanation with the corresponding muscle of the other eye and an identical innervation with its antagonist.
Let us suppose fo ur different locations of lesion as shown in Fig. 4. In case of lesion A, even if the right eyeball moves to the right, the left cannot move to the right conjunctly. However, the innervation for the lateral movement of the left eyeball remains intact, and the left eyeball moves to the left when the right eyeball moves to the left. If the right eyeball moves slightly to the left before moving to the right, the left eyeball moves to the left conjunctly and stays as it was. This is the way, in our opinion, how the divergent nystagmus occurs.
In cases of lesions B, C and D, no possibility is thought to exist for the divergence nystagmus to occur. The site of lesion A should be presumed to be in the region of the abducens nucleus, and such a lesion in association with mesencephalic involvement should be an extremely rare occurence.
Only two cases of divergent nystagmus have been rep orted in the literature before this present case.

抄録全体を表示

Many authors have reported on the correlation between horizontal optokinetic nystagmus and the vestibular system, but investigations of caloric nystagmus connected with vertical optokinetic stimulation are few.
Five normal subjects were examined by using 30°C?water (H al1pike's 40 sec. irrigation methode) and a vertical optokinetic cylinder. The cylinder has 50 cm diameter and 40 cm length, and it was rotated vertically in a velocity of 60°/sec. Seven stripes were painted on the white surface of the cylinder at equal distance. The induced vertical and horizontal nystagmus were simultaneously recorded with electronystagmograph (time constant 0.03, 2.0).
Fig. 2 to 5 were recorded in same subject. The subjects were always stimulated by water in their left ears and a cylinder rotated downward (Fig. 1).
The results were as follows:
1) Caloric nystagmus with the vertical optokinetic stimulation was much longer than that with visual fixation in same surrounding illumination (Fig. 2, 4).
2) The rhythm of caloric nystag'mus was controled by that of vertical optokinetic nystagmus. After the irrigation, in the initial stage the frequency of caloric nystagmus was higher than that of the vertical optokinetic nystagmus and in the middle stage nystagmus of these two types were synchronous. Finally horizontal nystagmus gradually disappeared, although the vertical optokinetic nystagmus were still induced.(Fig. 4, 5, 6).
3) In this course, the quick phase of the nystagmus of lower frequencies always corresponded to that of another nystagmus of higher frequencies. Therefore the quick components of vertical optokinetic nystagmus and caloric nystagmus seems to be controled from a common region in central nervous system (Fig. 5, 6).
4) The slow components of the vertical optokinetic nystagmus also werechanged by the simultaneous caloric stimulation.
5) After the irrigation the one s ubject complained of a confusion in vision. At this time, the horizontal nystagmus showed apparent change and his eyes repeatedly moved to the right and left directions according with the rhythm of the previous caloric nystagmus. His vertical optokinetic nystagmus slightly chaged in eye-speed of the slow phase. CF ig. 7).
6) It may be concluded that there is an interactive mechanism between the vestibular system and vertical optokinetic system in normal subjects.

抄録全体を表示

With his recent experiences on the closure of antroalveolar fistula the author concludes as follows:
(1) In the case of small f istula Sasaki's method is the most available. The method is that after the completion of Caldwell-Luc procedure the mucous membrane of lateral wall of the inferior nasal duct is, as a flap, laterally turned towards the floor of the antrum in order to cover the fistula.
(2) The management of larger fistulae is complicated. After the completion of Caldwell-Luc procedure it is considered to be a successful method in perfect closure to superpose palatal flap containing a palatina major on the reversed gingival flap.

抄録全体を表示

The authors reported a case of 45-year-old housewife. She had had extractions several times in those 23 years under diagnosis of chondroma of the Ala nasi. The 6th extraction was performed at our clinic and the specimens showed chondrosarcoma histopathologically. Furthermore, we discussed about operatingtechnique, treatment and nature of this tumor.

抄録全体を表示

The purpose of this research is to study the vitamin B 1 metabolism biochemically after the exposure to intense white noise.
Materials and Methods:
Fifty one adult guinea-pig s having the normal reaction of Preyer's reflex and adult twenty five rabbits were used.
They were under controlled feeding for two weeks.
Guinea-pigs were divided into controls and two groups, and exposed to white noise for 12 or 24 hours, respectively. Rabbits were exposed to white noise for 20 hours. The intensity of the exposed white noise was 100 phon. Immediately after the cease of exposure they were decapitated. The Vitamin B 1 concentrations of guinea-pigs in perilymph, blood, whole cochlea removed perilymph, liver, kidney masseter, and brain were estimated according to the modified Sarett's method developed by MaciasR. On the other hand, the thiamine concentrations of rabbits in middle ear tympanic muscles, masseter and heart muscle were estimated.
Results:
1. The n ormal thiamine concentrations of guinea-pigs were as follows ; 12.7±3.74γ/100g in perilymph (10 cases), 36.1±10.4γ/100g in whole cochlea removed perilymph (10 cases), 35.9±8.36γ/dl in blood (20 cases), 279±83γ/100g in brain (2 0 cases), 877±203γ/100g in kidney (20 cases), 540±199γ/100g in liver (20 case s), 527±133γ/100g in masseter (20 cases), On the other hand, the normal thiam ine concentrations of rabbits were as follows;
73.8±35.4γ/100g in tensor tympani muscle (17 cases), 202±72.4γ/100g in stapedius muscle (8 cases), 358±84γ/100g in masseter C6 cases), 791±204γ/100g in heart muscle (7 cases),. 2. The thiamine concentrations in peri lymph, blood, and kidney tended to decrease with the exposure to white noise for 12 hours. But they were not changed in brain, liver, and masseter. on the other hand, the thiamine concentration in blood for 24 hours exposure tended to decrease more strongly than the exposure to white noise for 12 hours. The thiamine concentrations decreased in perilymph, whole cochlea removed perilymph, brain, and kidney. But they were not changed in masseter and liver. The vitamin B 1 concentrations of rabbits were not changed in middle ear muscles and masseter with the exposure to white noise for 20 hours.
They tended to decr ease in heart muscle for 20 hours exposure.

抄録全体を表示