耳鼻と臨床
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
27 巻, 3 号
選択された号の論文の11件中1~11を表示しています
  • 井上 憲文
    1981 年 27 巻 3 号 p. 483-491
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    We have treated and studied on 171 cases of nasopharyngeal cancer during 17 years, from 1962 to 1978. Among the subjects, 145 cases of carcinomata (85 %), 65 of lymphoepithelioma, 58 of squamous cell carcinoma, 18 of reticulum cell sarcoma and 10 of anaplastic carcinoma were included. The subiects in the upper 4 groups were radiosensitive. In the carcinomata, 63 % of the subjects were found to be in N3 stages.
    Radiotherapy was performed on the primary and metastatic carcinoma, and surgery and/or regional chemotherapy were applied to the less radiologically reactive cases concomittantly.
    Initial dose of radiation to the primary focus was 6,000 rad in average in 1960's, but it was minimized to as low as 2,700 rad after 1977. Surgery and/or regional chemotherapy were given concomittantly only when indicated.
    The overall crude 5 year-survival ratio was 59 %. There was little difference between histopathological classification and T-classification, but they were found to be worse in the subjects of N3 stage (5 year-survival ratio, 48 %) than in NO, N1 and N2 stages (76 %). The death cause of the subjects having squamous cell carcinoma was due to progressed primary focus, but that of the subjects having lymphoepithelioma was due to distant metastasis.
  • 中野 雄一, 岩崎 恵美子
    1981 年 27 巻 3 号 p. 492-495
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    mesotympanum were reported. All these ears had erosion of the long process of the incus and of the stapes superstructure.
    In two of these five patients with intact tympanic membrane the appearance of a white mass was noted behind a translucent drum at diagnosis.
    Of these cholesteatomas, four were in children whose ages ranged from five to nine years, and one was twenty years. The parents of all patients denied any previous history of aural infections.
    The etiology of the presented cases is discussed on the basis of the congenital origin.
  • 松元 一郎, 井手 稔, 江夏 国寿, 森満 保
    1981 年 27 巻 3 号 p. 496-499
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    Malformation of the middle ear ossicles is frequently observed during microsurgery of the patients with congenital conductive deafness. The authers encountered the 21 years old female with a conductive deafness since her childhood.
    Exploratory of her left ear revealed the remnant of the manubrium of the malleus and long crus of the incus or the stapes. The head and body of the malleus and the head, body and short crus of the incus were not found in the tympanic cavity. Consequently we suspected these findings agree with the theory of HANSON et at advocating the manubrium of the malleus and long crus of the incus develope from the second visseral arch.
    Reconstruction of the ossicles was made in replacing a Teflon-strut between tympanic membrane and the footplate. For avoiding the extrusion of the Teflon-strut, homograft ossicle was inserted in the space of the tympanic membrane and Teflon-strut.
    Postoperatively hearing progressed 25 dB in air conduction and air-bone gap closed in 10 dB.
  • 小林 英人, 加藤 功, 青柳 優, 木村 洋, 鈴木 八郎, 小池 吉郎
    1981 年 27 巻 3 号 p. 500-504
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    For the past three years, we have treated seven cases of congenital cervical cysts. Four cases were median cervical cysts, and one case of lateral cervical cyst, dermoid cyst, and thyroid cyst.
    We performed clinical study and different diagnosis on these diseases, and reported two cases, which were important in different diagnosis.
  • 浅井 昌夫, 川端 五十鈴
    1981 年 27 巻 3 号 p. 505-509
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    A case of exostosis of the external auditory canal was reported.
    A 17-year-old boy, complaining of hearing loss and sensation of obstruction in his right ear, visited to our clinic. Examination revealed a complete occulusion of external auditory canal by a mass of bone-like tissue. The mass was surgically removed and was found to be originating from the tympanic bone. Histopathological examination of surgical specimens showed an exostosis from external auditory canal. After surgical removal of the exostosis, his hearing acuity regained to a satisfactory extent.
  • 調 賢哉
    1981 年 27 巻 3 号 p. 510-517
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    1) The author described 5 cases of accidental swallowing of PTP piece treated in his clinic. In 4 cases the pieces were staying in the esophagus and in the remaining 1 case the piece was staying in the air passage. 3 patients of them were over 70 years of age. The PTP pieces were removed under esophagoscopy except for 1 case in whom the piece passed down into the stomach.
    2) The characteristics of the foreign body of PTP piece staying in the esophagus were discussed as follows from the present cases along with 48 cases which were reported in literature:
    a) In the case of unconscious misswallowing of PTP piece it is extremely difficult to make accurate diagnosis.
    b) Since PTP piece is as sharp-edged as a fish-bone or a chicken-bone, it is liable to become a foreign body if it is small enough to be swallowed.
    c) The sharp edge may easily cause perforation on the esophagus wall and often develop mediastinitis in the result.
    3) The author had reported 7 cases of PTP pieces stayed in the air passage. A PTP piece is thin and light, and tends to fly off. Therefore careful observation should be kept on the foreign body of PTP piece that happens to stay in the larynx and the trachea as well as in the esophagus.
    4) The author discussed the importance of early diagnosis and of the precaution of the increasing incidence of PTP piece accident, and hoped to propose that pharmaceutical companies cease to make perforated lines on PTP plates which allow a cutt-off piece to become a foreign body.
    5) As for the precaution against the occurrence of PTP piece accident, a more adequate formula should be devised for easy oral administration for aged patients in whom PTP piece accident is comparatively apt to happen and the treatment is also rather difficult.
  • 安田 宏一
    1981 年 27 巻 3 号 p. 518-521
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    Sometimes patient complains of noises in the head. These headnoises have been considered identical with tinnitus aurium by some, while others are inclined to assume that they arise from such pathological conditions as disordered cerebral circulation and neurosis, being distinct from tinnitus.
    The author experienced 9 cases of tinnitus cerebri during the 5-month period from April through August, 1980. The patients were predominantly female (with a male-tofemale ratio of 2: 7) and ranged in age from 43 to 78 years with an average of 58. The primary disease was Meniere's disease in all cases.
    The tone of the headnoises reportedly varied from case to case.
    The subjective sensation of noise was perceived over the entire head in 5 cases, was localized at the center of head in 2 cases and in the occipital region in 2 cases. Characteristically, any of these locations were not grossly one-sided.
    In all cases there was a slight to severe hearing loss, moderate in most instances and showed high and low tone loss type audiogram. Most characteristic of these 9 cases was that all of them showed symmetrical type of audiogram.
    These results warrant us to assume that by analogy with the hypothesis that the source of noises in tinnitus is sensori-neural hearing loss per se, tinnitus cerebri might be explained as representing a stereo-effect of sounds of the same type and intensity produced in both ears.
  • 竹田 和夫, 中島 格, 広戸 幾一郎
    1981 年 27 巻 3 号 p. 522-529
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    A vocal cord polyp (1 mm in diameter) was obtained from a 56 years old man who died of cardiovascular disease. The specimen was extracted at the time of autopsy 3 hours after death and prepared for examination.
    Routine histopathological study revealed the hyaline deposition and submucosal hemorrhage. When consecutive sections were studied, it became evident that the basal layer of the stratified epithelium was broken and connective tissues appeared intradermally. Immunoenzymatic and immunofluorecent examination revealed the presence of IgA, IgG and other immunoglobulins in the polyp.
    Fluolescence for fibrin corresponded the distribution of hyaline deposition. Fluorescence for IgA and IgG was also found throughout the submucosal stroma beneath the stratified epithelium. Immunological survey of the vocal cord polyp is now underway
  • 王丸 光一
    1981 年 27 巻 3 号 p. 530-554
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    The mechanical properties of vocal fold were measured, taking its functional layer structure into consideration. The mechanical properties examined were (1) the YOUNG'S modulus,(2) the differential YOUNG'S modulus, and (3) the shear modulus and viscosity. Excised canine larynges were subjected to the present investigation.
    (1) YOUNG'S modulus
    The YOUNG'S modulus in the longitudinal direction was estimated to be in the order of 106-107 dyn/cm2 for the epithelium, in the order of 105-106 for the lamina propria and in the order of 104-105 for the resting muscle. This indicates that the tensile stiffness becomes smaller in the following order: the epithelium, the lamina propria, and the resting muscle.
    (2) Differential YOUNG'S modulus
    The ranges of the value of the differential YOUNG'S modulus became smaller in the order of the epithelium, the superficial layer of the lamina propria, the entire lamina propria, and the muscle. All the tissues showed a saturation effect at the elongation of 30 to 70 per cent. The value of the differential YOUNG'S modulus increased according to the increase in elongation. When the elongation was 0 per cent that is at the original length of the specimen, the differential YOUNG'S modulus was in the order of 105 for the epithelium, the superficial layer of the lamina propria and the entire lamina propria, whereas the modulus was in the order of 104 for the muscle. In the saturation renge, the differential YOUNG'S modulus of the epithelium and that of the superficial layer of the lamina propria were in the order of 108, the modulus of the entire lamina propria in the order of 107, and that of the muscle in the order of 106.
    For the entire lamina propria, the differential YOUNG'S modulus in the transverse direction was estimated to be in the order of 104, when the elongation was 0%. When a transverse tension was given to the lamina propria, the tissue was torn off at 200 to 300 per cent of the original length without showing a saturation effect. Just before being torn off the differential YOUNG'S modulus was estimated to be in the order of 106.
    (3) Shear modulus and shear viscosity
    The elastic and viscous shear properties were measured at very low frequencies, i. e. approximately 0.1 Hz. In the present experimental conditions, the elongation of the muscule was approximately 60% and that of the lamina propria approximately 30%.
    The value of the shear modulus of the muscle and that of the lamina propria were almost the same, being approximately (2-3) X105. The differential YOUNG'S modulus for those tissues at the same elongation was approximately five times as large as the shear modulus.
    The value of the shear viscosity of the muscle was twice or three times as large as that of the lamina propria. For both tissues, the value was in the order of 104 P (Cpoise=dyn·s/cm2).
    Generally, the visco-elastic properties of the high polymer depend on frequency and temparature. The viscosity decreases as the frequency increases. Therefore, during vibration in vivo condition, the viscosity of the vocal fold, especially that of the lamina propria, is assumed to become very low.
  • 永井 政男, 朴沢 二郎, 鎌田 重輝, 袴田 勝, 鈴木 史人, 袴田 真理子
    1981 年 27 巻 3 号 p. 555-558
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    Effects of Methycobal® (CH3-B12) were evaluated for the following 30 cases: nine cases of sensorineural hearingloss, 7 cases of facial paralysis, 4 cases of MENIERE'S disease, 2 cases of peripheral vestibular disorder, 3 cases of recurrent nerve paralysis, 2 cases of sudden deafness and 3 cases of tinnitus with unknown etiology.
    This drug was given p. o. six capsules (1500 μg) a day, and the administration was continued for 4 weeks.
    Methycobal was non effective for sensorineural hearingloss, but effective for facial paralysis and recurrent nerve paralysis. On the other hand, effects for tinnitus and vertigo were limitted.
    Side effect was not found with the exception of a case complaining of nausea.
  • 臨床蝸電図による治療効果判定
    山崎 勤, 林 奈美江, 渡辺 幸枝, 小崎 秀夫, 阿部 隆夫
    1981 年 27 巻 3 号 p. 559-569
    発行日: 1981/05/20
    公開日: 2013/05/10
    ジャーナル フリー
    For the purpose of improving the repeated attacks of vertigo, Isosorbide as an oral hyperosmotic diuretic was first administered to 14 patients with MENIERE's disease from November 1979 to December 1980 for reducing endolymphatic hydrops. The electrocochleographic examinations were also carried out on these patients.
    In 10 patients who experienced relief, attack of vertigo did not occur in 8 (57 %) and vertigo was relieved in 2 (14 %). Among 4 patients who experienced hearing improvement, 2 patients with long term administration showed hearing impreovement during the period of treatment and electrocochleographic examinations showed a decrease in the SP/AP wave form. In 2 patients with short administration, hearing loss was temporarily observed in low and middle frequencies; the hearing loss later improved more than before treatment, but the SP/AP wave abnormality was observed even after treatment in these patients. In only 1 patient, aggravation of hearing was observed after administration, although it has to be decided in the future whether it was a side effect. The observation period of these results was 6.7 months on the average.
    The results of Isosorbide therapy in patients with MENIERE's disease seemed epochmaking. In future, this therapy might replace sacculus surgery.
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