耳鼻と臨床
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
19 巻, 2 号
選択された号の論文の19件中1~19を表示しています
  • 広戸 幾一郎
    1973 年 19 巻 2 号 p. 99-100
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
  • 沢木 修二, 山口 宏也, 松井 道夫
    1973 年 19 巻 2 号 p. 101-108
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    Eight cases of pseudo-otosclerosis were confirmed by exploratory tympanotomy. Originally, this disease entity was advocated by Goodhill.
    From the point of pathological findings, cases were classified as follows; tympanosclerosis 2 cases traumatic dislocation of the incus 1 case incus atrophy 1 case anomalies of ossicles and windows 4 cases
    A case of tympanosclersis, considered to be caused dualistically by both of inflammation and trauma, was reported.
    Immediately after the pathological findings ware confirmed, the tympanoplasty was performed on five cases. And the hearing of four cases of them were improved.
    The clinical evaluation of the exploratory tympanotomy was discussed. The advantage of this operation should be emphasized not only on the diagnostic but also therapeutic procedure.
  • 田中 博之
    1973 年 19 巻 2 号 p. 109-112
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
  • 松井 道夫, 佐竹 虔介, 北村 馨, 桔梗 辰三
    1973 年 19 巻 2 号 p. 113-120
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    A case of carcinosarcoma of the maxillary sinus, treated by irradiation and surgery and termnating in death, is presented. The patient is a 69-year-old female with complaints of swelling of the left cheek and bloody rhinorrhea. The x-ray examinations show destruction of bony wall of the sinus. The detailed histopathological examinations (the cytological examination by chymotrypsin lavage, biopsies and microscopic research of the maxillectomized tumor and the recurrent tumors) reveal that the tumor consists of two quite distinct elements-one squamous cell carcinoma and the other osteogenic osteosarcoma.
    This lesion shows the following characteristics,(1) Malignant epithelial and stromal elements are simultaneously present.(2) No transitional forms are noted between both elements despite intimate intermixture.(3) No additional tissue elements are present suggestive of a teratoma.(4) Metastasis of osteosarcoma to the bilateral lungs and pleural wall is proved by the autopsy.
    Finally this case is diagnosed “true carcinosarcoma” by above mentioned features and the clinical course.
  • 佐竹 虔介
    1973 年 19 巻 2 号 p. 121-126
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    89 cases of maxillary cancer were treated in this clinic 1966 to 1971.32 cases of them were treated by combined therapy of surgery, irradiation and 5 FU intra-arterial infusion. Others of them were treated without chemotherapy by surgery and irradiation.
    In this report the auther compared the result with chemotherapy and without chemotherapy. 5 FU increases irradiation effect which is very important in the treatment of maxillary cancer, so that 5 FU was adopted as chemotherapeutical agent. 250mg of 5 FU a day were infused almost by one shot.
    Results were as follows:
    1) 3 years survival rate was 48% with chemotherapy and 28% without chemothrapy.
    2) Histological effects were seen distinctly in cases with 5 FU. There were a few cases in which living cancer cells were not seen. This fact indicated that radical operation is not always necessary in some cases with chemotherapy.
    3) The most effective preoperative treatment for maxillary cancer was 3000 to 5000 mg 5 FU infusion with 3000 to 5000 rads irradiation.
    4) There was no serious secondary effect except one facial nerve palsy in this combined therapy.
  • 北村 馨, 朝比奈 久雄, 石川 岩男, 松井 道夫, 原田 重俊, 沢木 修二
    1973 年 19 巻 2 号 p. 127-131
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    A case of ameloblastoma which was found in 26-year-old female as maxillary tumor was reported. No recurrent evidence had not been observed for six years after the initial operation. Again she suffered from the gradual swelling of the cheek. The recurrent tumor was removed radically, and its histologic findings revealed the slight malignancy.
    Clinical features of ameloblastoma, especially factor influencing the prognosis, and histologic classifications were discussed. It was concluded that the radical operation should be rather preferred to the conservative one in order to avoid the recurrence of this lesion.
  • ハルジオン花粉症例
    清水 章治, 石橋 康, 高木 美佐江
    1973 年 19 巻 2 号 p. 132-136
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    A case of hay fever caused by Fleabane pollen, which is distributed widely in kanto district of Japan, was reported. The pollination of the Fleabane, one of the Comporsitae, occurs from May to June in Yokohama City area.
    A 14-year-old boy complained of seasonal nasal attack in early summer. He also complained of slight eye itching during these seasons. The patient showed positive reaction to the skin test with the Fleabane pollen extract, and the wheal-and-flare reaction was observed. Ophthalmic provocation test using 1:100 solution was positive and the threshold of positive reaction was 10-6. PK titer was 47 and serum IgE level was 0.034mg/dl. Three Fleabane pollens (3-colporate types) were found from the patient's nasal discharge. Among 60 cases who recently visted our clinic, 12 cases (20%) showed positive reaction to the skin test with the Fleabane pollen extract.
    From the above mentioned results the Fleabane pollen is considered as one of the antigens which cause hay fever in early summer in Japan
  • 沢木 修二
    1973 年 19 巻 2 号 p. 137-142
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    The statistical observations were tried on the nasal signs and symptoms in the cases of the nasopharyngeal malignant tumors. Cases are consisted of 532 cases of the cancer, 114 of malignant lymphoma and 12 of sarcoma. Their nasal signs were complained in 33.5%, 44.7% and 58%, respectively.
    The frequencies of the nasal obstruction were more in the lymphoma cases than in the carcinoma. On the other hand, the nasal bleeding were detetected more frequently in the carcinoma cases at the first visit time to the clinic. However the difference in these two lesions was disappeared during their clinical courses.
    Nasal obstructions were noticed more frequently in the cases, those tumors locate on the inferior-anterior margin of the nasopharngeal space. However symptoms are not influenced by the histopathological classification of the carcinoma. The lesions of the olfactory nerve with the tumor were found in two cases of the carcinoma.
    Nasal symptom is not always the first one of the nasopharyngeal malignant tumors. Therefore it is not useful for the early diagnosis of these tumors. On the other hand, this symptom is most important in order to understand the clincial features of these tumors, because of its highest frequency, comparing the other symptoms.
  • 沢木 修二, 北村 馨, 清水 章治, 石橋 康
    1973 年 19 巻 2 号 p. 143-148
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    One hundred and seventy-eight autopsy cases, cited from the Japan Autopsy Records for past twelve years, were statistically examined.
    Distant metastases were calculated to 65.7% of cases, and lymphnodes were to 58.4%. liver, lung and bone were the main organs, to which the metastases spreaded. And the vast majority of lymphnodes metastases appeared in the cervical nodes. Differences in sex and age groups were not observed respectively.
    According to the histopathological classification, distant metastases surpassed in the undifferentiated squamous cell carcinoma type, and lymphnode in the differentiated.
    From the standpoint of the above mentioned; findings, the prophylactic policies of the metastases in the clinical cases of the nasopharyngeal cancer were discussed. And it was concluded that the anti-EBV-antibody titlation might be useful to detect the early stage of the metastases.
  • 石橋 康, 高橋 誠
    1973 年 19 巻 2 号 p. 149-154
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    A case, 44-year-old female, of von Recklinghausen disease with large tumor of the soft palate was reported. She complained of the swallowing disturbance and articulation disorder. The nodules of the subcutaneous tissues were palpable. The round large tumor of the mediastinum was found in X-ray films. The tumor of the palate was removed. The complaints were disappered after operation. Histologically the tumor was diagnosed the neurofibroma.
    Neurogenic tumors are not so frequently observed in the head and neck region, except acoustic tumor. The von Recklinghausen disease, considered the systemic disease of the neurofibroma, are especially rare in ENT region.
    This case is the first report in which those local finding of the von Recklinghausen disease was observed on the palate.
  • 佐藤 靖, 高木 美佐江
    1973 年 19 巻 2 号 p. 155-158
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    Two cases of the rare salivary gland diseases were reported.
    Case 1: 52-years-old female suffered from the swelling of the submandibular region. The tumor was the child's fist size, and elastic hard. It was removed surgically, and was diagnosed as the typical mixed tumor of the submandibular gland.
    The mixed tumor of the submandibular gland is very rare, comparing those of the parotis.
    Case 2: 28-years-old male visited our clinic with the complaint of the swelling of the right parotid region and high fever. The tumor was incised, and the abundant pus protruded. The abscess was cured completely.
    The case was retarded mentally. Therefore first he refused the treatment. And the abscess was aggreavated gradually till the incision.
  • 鮑 健生
    1973 年 19 巻 2 号 p. 159-160
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
  • 大石 公直, 沢木 修二
    1973 年 19 巻 2 号 p. 161-165
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    Two hundred and three cases of the esophageal foreign bodies were observed statisticaly. The cases correspond to 0.7% of the out patients of our clinic for past five years (1967-71), and consist of 117 males and 86 females.
    Half of the cases were ranged to the single age. Male surpassed, and its sex ratio was 1.5. But only in second decade, female exceeded.
    The kinds of the foreign bodies were divided into coins (58 cases), fish bones (40), dentures (26) and other solid metal such as nails. Foreign bodies were removed through esophagoscope in almost half cases. But in the other half cases, the medical procedures were not necessary, because of their natural exclusion.
    Forty-one cases (21%) were recommended to visit our clinic by medical practioners, such as an otolaryngist and pediatrician. And 19 cases (10%) were forwarded by the doctors of other hospital. The other 143 cases (69%) prefered our clinic of their own will. Generally speaking, the vast majority of the cases of the esophageal foreign bodies should de treated at so called emergency clinic. For this status, we specialists have to build up the ideal medical system, as soon as possible.
  • 吉村 醇, 北村 馨, 山口 宏也, 沢木 修二
    1973 年 19 巻 2 号 p. 166-171
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    Three cases, previously treated with X-ray irradiation for the cervical tuberculous lymphadenitis, were diagnosed as the radiation cancer. Tumor located in the neck, hypopharynx and larynx, respectively. The severe radiation damage on the skin or subcutaneous tissues of the neck were observed in all cases.
    Generally speaking, it takes the considerable longer latent interval that the cancer develops after irradiation. The latent period of our cases ranged from 28 to 37 years.
    The etiology of the irradiation cancer were diagnosed. Conclusively to say, the prophylaxis of the irradiation cancer should be emphasized.
  • 真鍋 敏毅
    1973 年 19 巻 2 号 p. 172-180
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    In order to confirm the difference of the auditory evoked responses between in normal hearing and in perceptive deafness, eight patients with unilateral deafness (mostly cochlear type) were tested by ERA during sleep. If the ear is stimulated alternately, not only individual but also trial variability can be excluded in these cases. Prior to ERA, all cases were administered 50mg per kg of monosodium trichlorethyl phosphate per orally. Then auditory evoked responses were recorded in every sleep stage i. e. awake, light sleep, moderately deep sleep and low voltage stage before awaken. Tone stimuli were given to the ear alternately at the level of 30, 20, 10 and 0 dBSL.
    The thresholds of ERA in normal ears were higher than in affected ears in every sleep stage. The average difference between above mentioned two ears were about 10 dB. In the stage of moderately deep sleep the thresholds of ERA were most sensitive, 14.3 dBSL in normal and 4.3 dBSL in affected ears.
    The most of all evoked responses were detectable in the same trial at 30 dBSL. As soon as the tone pressure was reduced, the responses were disappeared in the normal ears. However, in the affected ears, the responses were not disappeared till the tone pressure was more reduced. The percentage of detectable responses in the affected ears were higher than in the normal.
    It is concluded that the auditory evoked responses in the affected ears were more sensitive in the threshold and more detectable than in the normal ears. And it is considered that these results are due to the recruitment phenomenon. The clinical use of ERA during sleep should be more evaluated.
  • 石川 岩男
    1973 年 19 巻 2 号 p. 181-195
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    The masking effects were observed in normal individuals, persons with conductive deafness and persons with sensory neural deafness by auditory stimulus. In the present experiments, two stimuli were used to mask pure tones. One masking stimulus was a white noise, and that of the second was a pure tone of 800 Hz. All measurements were monaural. The relation between the amount of masking at a certain frequency and intensity of the masking stimulus was statistically discussed. The obtained results and conclusions were as follows:
    1) At the amount of masking of pure tones by white noise, there was no difference between cases with conductive deafness and cases with sensory neural deafness.
    2) In the masking by white noise, statistically, there was a little discrepancy of amount of masking between normal individuals and persons with sensory neural deafness, but similar difference between normal individuals and cases with conductive deafness was observed. Therefore no peculiar masking effects in patients with sensory neural deafness was considerable.
    3) The masking effects of pure tones by pure tone of 800Hz had the same influences for cases with hard of hearing as for normal persons, when the intensity of the masking tone was the same relation to the level at the threshold of hearing corrected air-bone gap.
    4) By method of measurements of the masking effects, it is difficult to distinguish between inner ear disturbances and ganglion or auditory nerve impairments.
  • 小林 詢弥
    1973 年 19 巻 2 号 p. 196-219
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    On the basis of the records compiled from January 1961 to May 1971 at Department of Otolaryngology, Kurume University, statistical observations of the results of tympanoplasty in relation to various preoperative and surgical parameters were made with 456 cases of chronic otitis media.
    Postoperative perforation of the new drum was found more frequently for free skin graft than for fascia graft. Open cavity techniques were associated with more frequent postoperative perforation than techniques in which the external meatus had been preserved. In the cases of Wullstein's type I and II, less perforations were developed postoperatively for preoperative dry ears than ears with discharge.
    In terms of hearing acuity, the results for type I and II were relatively satisfactory whereas they were poor for type BI and IV. The technique with preservation of the external meatus and with fascia resulted in greater rate of success related to hearing than the other techniques.
    Follow-up studies were made in 143 cases. Their results also indicated that preservation of the meatus and usage of fascia should be the basic technique for tympanoplasty except for unusual cases. Indication for mastoidectomy was discussed on the basis of X-ray findings and postoperative results.
  • 松元 一郎
    1973 年 19 巻 2 号 p. 220-236
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
    Potassium bromate and sodium bromate are generally used as the neutralizing mediums in the cold wave permanent process. Poisoning due to the ingestion of these substances, by children accidentally or by adults for suicide, is not rarely encountered and up to date twenty-seven case reports have come to the author's attention. The ingestion of bromate causes the gastrointestinal irritability, renal damage with uremia and severe hearing loss.
    Case Report
    Two patients who had history of bromate ingestion visited our clinic complaining hearing loss. Hearing test of the first patient revealed a total deafness, and the second case revealed a severe perceptive deafness with recruitment phenomenon. The disorders of the vestibular function were not found in both patients. From the clinical findings of the patients it was suspected that hearing loss due to bromate poisoning is caused by the lesion in the auditory part of the labyrinth.
    Experimental Studies
    In order to clarify the mechanism of the hearing loss in bromate poisoning, the electro-physiological and histochemical studies were performed in guinea pigs.
    Methods: Cochlear microphonics (CM) were recorded with differential electrode technique. Endocochlear DC potential (EP) and negative DC potential of Corti's organ were measured with a glass pipette microelectrode via the round window membrane. The changes of potentials were observed for several hours after subcutaneous injection of sodium bromate. After the recording of CM or EP and negative DC potential of Corti's organ was finished, the succinic dehydrogenase staining was performed in vivo and the surface specimens of the cochlea were prepared. The kidneys of the animal were removed and stained with hematoxylin and eosin for microscopic examination.
    Results: A-group receiving 100mg/kg of sodium bromate. Twenty-four hours after the injection, four animals out of twenty lost Preyer's reflex. In these animals CM could not be evoked even with intense sound and EP showed 0mV. In the histochemical observation of these animals, a marked decrease of enzymatic activity and cellular destruction of the outer hair cells were found, but the inner hair cells were still observed with a slight decrease of enzymatic activity. Histological examination of the kidneys revealed hyaline droplet degeneration, cloudy swelling and necrosis of the epithelial cells in renal tubules, especially in proximal convoluted tubules, but the glomeruli remained unchanged.
    B-group receiving 200mg/kg of sodium bromate. CM began to decrease about one hour after the injection and reached to noise level within four hours. EP showed a reduction almost similar to that of CM and reached to 0mV within three hours. Negative DC potential of the Corti's organ showed frequently a tendency to decrease near 0mV. Histochemically no changes were found in the surface specimens within three hours after the injection, although a slight decrease of enzymatic activity and swelling of cells were observed later in the outer hair cells. A remarkable decrease of enzymatic activity and the severe destruction of the outer hair cells were observed six hours after the injection. The histological findings of the kidneys were similar to that of animals received 100mg/kg of sodium bromate.
    Conclusions
    1. The ingestion of a large quantity of bromates causes severe hearing loss with positive recruitment phenomenon.
    2. The vestibular function is not injured by bromate.
    3. Cochlear microphonics, endocochlear DC potential and negative DC potential of Corti's organ decreased equally after the injection of bromate. Histochemical examination of the cochlea revealed the degenerative changes of the outer hair cells.
    4. Hearing loss in bromate poisoning is attended by the lesions of renal tubules, especially prominent in proximal convoluted tubules.
    5. Hearing loss in bromate poisoning is caused by the lesions of the stria vascularis and the outer hair cells.
  • 北村 武
    1973 年 19 巻 2 号 p. 237-245
    発行日: 1973年
    公開日: 2013/05/10
    ジャーナル フリー
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