jibi to rinsho
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
Volume 24, Issue 5
Displaying 1-16 of 16 articles from this issue
  • Yasuo SATO, Kenbun INOUYE, Masaaki YAMANE, Eishi YAMAMOTO
    1978 Volume 24 Issue 5 Pages 757-768
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    We have studied the change of combined therapy, and the duration of hospitalization on 1100 cases of head and neck cancer treated in our hospital since 1965. Treatment for tumor of aged patients suggests the way the therapy for head and neck cancer should be. Limited hospital stay and long term follow-up makes it possible for us to help patients return to the society. And it will turn out to be so-called “Primary Care” that is to keep patients under medical and social care all the time. The basic point of this “Multipledisciplinary Treatment” is the thorough examination and treatment considering the relation among the Organism, the cancer (local findings) and the therapy in each case. And the process of the treatment would be more and more simplified.
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  • [in Japanese]
    1978 Volume 24 Issue 5 Pages 769-777
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
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  • Yasuo HARADA, Yoshiro SUGIMOTO, Mamoru SUZUKI, Yoshinori KIKUYA, Seiic ...
    1978 Volume 24 Issue 5 Pages 778-786
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Statistical analysis of 934 patients complaining of vertigo was made in reference to clinical manifestations and the results of the vestibular tests. A high incidence of the cases was in the age ranged 40 to 50. Vertigo due to circulatory disorder tended to involve the elderly patients, while the cases of epilepsy, psychogenic disorder and normal clinical findings involved mainly the young patients. Clinical manifestations in the peripheral disorder and the central lesions were characterized by recurrent vertigo and persistent dizziness, or ataxia, respectively. Among the vestibular tests, the incidence of abnormal findings was highest in the spontaneous nystagmus test (62.3%). Among the cases of vertigo, the most common abnormal findimgs tended to be central disorders. 539 cases (57.7%) were referred from other clinical departments or private clinics, showing the importance of mutual consultations among clinics.
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  • -A study on recurrent cases-
    Akira OGAWA, Isamu WATANABE, Koichi YAMASHITA, Kunihiko Tsutsumiuchi
    1978 Volume 24 Issue 5 Pages 787-790
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    The clinical courses of 22 patients with malignant tumors of the nasopharynx, treated at Tokyo Medical and Dental University Hospital, were investigated. Nine of them developed local recurrence and three of them showed metastasis to the cervical lymphnodes after the initial irradiation therapy. When the local recurrence was appeared, re-irradiation only was not so effective. Combination of treatment such as the local injection of oil-suspended bleomycin, radon-seeds implantation or cryosurgery was more effective. Fenestration into the palate is necessary to perform those kinds of treatment by observing the nasopharyngeal lesion directly.
    Five cases out of nine recurrent cases were effectively treated. Two of them were intensively treated by the combination of local treatments mentioned above. One of them survived more than 8.5 years, the other died of distant metastasis after 3.5 years.
    As a result of these observations, the authors considered it very difficult to control the local recurrence of nasopharyngeal carcinoma, however, intensive therapy by the combination of several local managements might have the effect to prolong the survival period of these areas.
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  • Takao SHIMOYAMA, Rokuro KAWANO, Makoto ODA, Naoki TASHIRO, Makito OKAM ...
    1978 Volume 24 Issue 5 Pages 791-795
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    In the past five years, from July 1971 to July 1976, total 872 ears had the ear surgery in Kitasato University Hospital. The most of all were the patient of the second and the third decades of the age. In the cases under 9 years old, there were a large number of male patient and most of these boys suffered from the cholesteatoma. Out of 872 ears, 25% were the cases with the cholesteatoma.
    In regard to the result of the surgery, the cases with simple otitis media had the most excellent result. 75% of them had a desirable hearing improvement. Both the re-operation cases and the cholesteatoma cases showed the improvement in 52% of the cases. The result of the surgery in the cases with the adhesion of ear-drum was 26%.
    The re-perforation of the ear-drum was observed in 7% of the all operated ear and 0.9% of the all complained the sensorineural hearing loss after surgery. A temporary facial paresis after surgery was observed in 0.7% of the cases.
    Finally, some considerations on the operation techniques for middle ear surgery were discussed.
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  • Takao SHIMOYAMA, Tetsuya SHITARA
    1978 Volume 24 Issue 5 Pages 796-799
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    From July 1971 to July 1976, 872 ears of the chronic otitis media which included 149 re-operation cases had the ear surgery in our Kitasato University Hospital. Fifty two percent of the re-operation cases had a fruitful result. The success rate of the re-operation cases was almost the same with that of the cholesteatoma or tympanosclerosis, however as compared with that of the simple suppurative otitis media it was worse. The success rate of the reoperation to the ear which previously had the radical operation was 54%. About half of the cases which had postoperative cholesteatoma had reoperation within 5 years after the primary operation and the other half was within 35 years after the first 5 years. The cases with disruption of the ossiclar chain had a better result among the cases which had reoperation only for the purpose of hearing improvement.
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  • Yoshikazu YOSHIDA, Tadahiko MATSUMOTO
    1978 Volume 24 Issue 5 Pages 800-805
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    A case of Candida esophagitis which was reconstituted the cellular immune deficiency with the transfer factor is reported. This case was diagnosed as chronic mucocutaneous candidiasis with esophageal involvement by various clinical and laboratory examinations. The lesion was circumuscribed mainly in esophageal mucosa, and no definite cause such as improper use of steroids or antibiotics was suggested. Agglutinating antibody titer against C. albicans was extremely higher than those of normal controls and localized superficial candidiasis patients. On the other hand, delayed hypersensitivity reactions to the Candida antigen and also to PPD were im- paired. Neither endocrine abnomalities, hypovitaminosis A nor abnormal iron metabolism have been recognized.
    Satisfactory result was obtained by the treatment with clotrimazole and transfer factor. Cellular immune state was successfully reconstituted. Clinical and immunological observations and sustaining administration of transfer factor have been continued.
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  • Yasuo HARADA, Yoshiaro SUGIMOTO, Nobuharu TAGASHIRA, Mamoru SUZUKI, Ma ...
    1978 Volume 24 Issue 5 Pages 806-811
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Clinical observation of 126 cases of the postoperative maxillary cyst was reported. The results were almost the same as those which have been reported, in terms of sex, age and clinical symptoms. In more than half of the cases, symptoms developed between 10 and 20 years after the initial sinectomy. In 70% of the cases, bony, or mucous closure of the antral window was observed. In 40% of the cases, bone defects were found in the orbital floor and these patients frequently showed ocular symptoms.
    In order to prevent the development of postoperative maxillary cyst, a complete removal of the maxillary and ethmoidal mucosa as well as a wide nasoantral window should be made in the initial sinectomy.
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  • Masakazu OHNO, Takuo NOBORI, Ikuo OHNO, Makoto YAMAMOTO
    1978 Volume 24 Issue 5 Pages 812-818
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Following other primary treatments, oral 5-Fluorouracil dry syrup was administrated to 22 cases of head and neck cancer for more than 12 weeks. The dose of the drug used was 200-300mg/day. The following results were obtained after evaluating of the effects of other primary treatments.
    1) The drug appeared to be effective in 7cases (38.6% of evaluative 19 cases). Of these, three patients were markedly effective, one moderately effective, three slightly effective.
    2) The regrowth of the tumor was observed more than 10 weeks later in the patients receiving this drug as compared with the control.
    3) This oral chemotherapy seemed to be also effective in the treatment combined with irradiation and vitamin A.
    4) The histological findings of the tumor proliferating for all the administration of the drug was revealed to be changed to more, poor maturation type.
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  • Susumu SHIDA, Noboru ABE
    1978 Volume 24 Issue 5 Pages 819-825
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Some types of the sudden deafness which shows the spontaneous recovery is a most typical one of the sensorineural deafness the hearing level of which shifts remarkedly. In this case, because of the presence of hearing recovery, the cause of deafness should be attributed to rather something else than the organic changes of the receptor organs, such as the degeneration of hair cells and the nerve fibers.
    Depending on the present knowledge in the electrophysiological territory of the inner ear, the reduction or disappearance of EP, the origin of which must lie somewhere in the stria vascularis, seems to be the most conceivable factor to induce this type of deafness. This study was undertaken to determine whether or not such consideration is right.
    In order to induce the reduction of DC potential gradient at the reticular layer, Furosemide which is a salturetic drug and is already wellknown to bring about the marked reduction of EP was used in this experiment.
    Throughout the experiment, CM and EP were recorded by an ordinary glass-micro-electrode from the scala media of the basal turn of the cochlea in guinea pigs, while the K+ ion concentration in endolymph was measured simultanously by using a specific K+ ion sensitive microelectrode.
    After the intravenous injection of furosemide, EP and CM declined rapidly. After reaching their lowest levels within 1 minute, EP and CM began to recover immediately. The recovery of CM was much more rapid than EP, and the remarkable over-shoot of the amplitude of CM was already observed even when the EP still stayed at a lower level of voltage. This experimental fact indicates that the high voltage of EP is not always needed to produce CM.
    In order to clarify the cause of early recovery of CM which seemed to be inreasonable in relation to the magnitude of EP voltage, the K+ ion concentration in endolymph was observed after furosemide injection. Because it has been generally agreed that the high K+ ion concentration in endolymph must be most important chemical component for maintaining the CM sensitivity. The V ion concentration in endolymph did not alter at all at every stage of the reduction and recovery of EP and CM after furosemide injection. From this result, it can be concluded that the remarkable recovery of CM does not come from the sudden increase of K+ ion concentration in endolymph. For greater clarification about the inadequate relationship between the magnitude of CM and EP, which observed at the recovery stage after furosemide injection, it should be necessary to investigate not only the relation between V ion concentration in endolymph and cochlear potentials but also that between Na+ and Cl-ion concentration in endolymph and cochlear potentials.
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  • Tsunehiko NAKASHIMA, Masahiro ITO
    1978 Volume 24 Issue 5 Pages 826-830
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Endocochlear DC potential (EP) and intracellular negative potential of the organ of Corti (INP) are depressed after small amount of Furosemide (a potent diuretic) is injected into the facial nerve of the guinea pig via stylomastoid foramen. The same amount of saline injection does not induce the change of EP and INP.
    Furosemide is thought to reach the organ of Corti through anastomosis with the cochlear nerve in the internal auditory canal, and then, to reach the stria vascularis through endolymph, or perilymph. The difference of the change in EP between Kana-mycin-poisoned guinea pig and normal guinea pig is obseved after Furosemide injection. The mechanism of maintenance system of EP is discussed in view of the integrity of the organ of Corti.
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  • An ultra-high-speed cinematographic investigation
    Senkichi KOBAYASHI
    1978 Volume 24 Issue 5 Pages 831-849
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Glottal vibration of four cases which had received glottal reconstruction by Hirano's technique was investigated with the use of ultra-high-speed photography. Twenty successive cycles was studied with frame-by-frame analysis. The results are as follows:
    1. The fundamental period varied to a great extent. Its cycle-to-cycle variation, however, did not markedly differ from the normal.
    2. Variation in the amplitude of glottal area curve was greater than that of normal subjects.
    3. OQ and SI did not differ from those of normal subject. Their variation was in normal range.
    4. The amplitude of horizontal excursion of the unaffected vocal fold was normal. Its variation, however, was much greater than the normal.
    5. The speed of lateral excursion of the unaffected vocal fold was in normal range, but that of medical excursion was faster than the normal in some subjects. Variation of the speed was greater than the normal.
    6. The bulge which had been constructed surgically showed very small and irregular vibrations.
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  • Ikuichiro HIROTO, Hiroshi WATANABE, Sohtaro KOMIYAMA
    1978 Volume 24 Issue 5 Pages 850-860
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Slow motion films of the vibration of the vocal cords were analized in 12 cases of unilateral recurrent laryngeal nerve paralysis. The vibratory pattern of vocal cords in unilateral laryngeal paralysis was classified into three groups. Bilateral vocal cords vibrate regularly and symmetrically in the first group which may be called the paretic type. It is considered in this type that the electromyography of the intrinsic laryngeal muscles shows normal discharge and their muscle atrophy is scarcelyo bserved. In the second group, the vibration of bilateral vocal cords is irregular and asymmetrical, especially different in both phases with little variation of the amplitude. Pathologic discharge such as fibrillation voltage is observed. The atrophy of the muscles may be increasing or recovering in this type. In the third group, the vibration of the vocal cord on the paretic side is remarkably irregular and little in its amplitude. This type may be named the paralytic type, and the muscles are extremely atrophic and electromyographically silent.
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  • [in Japanese], [in Japanese]
    1978 Volume 24 Issue 5 Pages 861-862
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1978 Volume 24 Issue 5 Pages 863-871
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1978 Volume 24 Issue 5 Pages 872-877
    Published: 1978
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
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