耳鼻と臨床
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
33 巻, 2 号
選択された号の論文の18件中1~18を表示しています
  • -自験例6例の報告と文献的考察-
    田中 寿一, 犬山 征夫, 藤井 正人, 高岡 哲郎, 細田 兵之助
    1987 年 33 巻 2 号 p. 219-228
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Six cases of neurogenous sarcoma (NS) arising from the paranasal sinuses were re viewed. Four patients were females and two were males. Four tumors arose from the maxillary sinus, one from the ethmoid sinus and one from the pterygopalatine fossa. NS is difficult to be diagnosed in its early stage. Diagnosis of benign neurinoma or other sarcoma was made in four of six cases after the first operation or biopsy. Final diagnosis of NS was made when tumors recurred after the first treatment. The prognosis of NS of the paranasal sinuses is poor. Five patients died of recurrence of the disease despite sur gery and/or radiation. The one living patient has unexpectedly responded to chemotherapy. Since NS is difficult to diagnose, recurrence is frequent, and resistive to radiation, careful radical surgery should be done to avoid recurrence.
  • 森田 恵司, 武藤 二郎
    1987 年 33 巻 2 号 p. 229-232
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Congenital fistula in the external meatus is often adhered to the auricular cartilage. Adhesion was observed in all the cases with a past history of suppuration. Histologic studies on the adhered region showed that the fistula wall and cartilage, were tightly connected to each other by inflammatory connective tissue, the distance between the two being 50-100μ. There were also some cases in which the fistula wall intruded into the cartilage. Where there is adhesion, the adhered region including the cartilage needs to be removed by resection for prevention of recurrence. We were able to do follow-up exams in 38 of the 50 surgically treated ears done in the past 5 years. None of these cases showed signs of recurrence.
  • -その文献的考察と自験例-
    竹山 勇, 大竹 英夫, 五島 可喜, 羽馬 晃
    1987 年 33 巻 2 号 p. 233-245
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Nonepithelial tumors of the larynx, especially sarcoma of this structure is rarely ob served. This study is based on unusual laryngeal neoplasma reported in the international literature from 1928 until 1985. In this literature, we found 53 cases of rhabdomyosasrcoma of the larynx. The incidence, distribuion by sex and age, and clincopathological manifes tations are tabulated. Rhabdomyosarcoma of the larynx generally requires treatment by a combination of extensive surgery and chemotherapy, and a long period of post-operative observations. We report our own experience in the management of a 57-year-old male pa tient suffering from a rhabdomyosarcoma who was treated by total laryngectomy. Neither recurrence nor distant metastasis has been observed in the past 3 years.
  • 花田 武浩, 内薗 明裕, 坂本 邦彦, 昇 卓夫
    1987 年 33 巻 2 号 p. 246-248
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Two rare cases with singular form of laryngeal fungal infection were reported. The first case was a 33-year-old woman with a chief complaint of hoarseness, who had been received steroid treatment for ulcerative colitis since 1982. She had an aerosol treatment of Amphotericin B for 11 weeks which proved ineffective, so that treatment using a con tact Nd-YAG LASER was initiated. Local findings and symptoms of this case have im proved. The second case was a 51-year-old woman who had been treated by steroid for rheumatoid arthritis (RA) since 1981. She was admitted to our out-patient clinic complaining of hoarseness in March, 1985, and a laryngeal polyp was diagnosed. Polypectomy was per formed, but the resected specimen was revealed histopathologically to be a fungal infection. Both cases have showed no local recurrence of fungus.
  • 永井 みどり
    1987 年 33 巻 2 号 p. 249-254
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    The outer surface view of the nasal gland and the cavernous sinus in human inferior turbinates were observed under the scanning electron microscope using HCl digestion me thod. The nasal gland is composed of a short duct with a cylindrical or spherical terminal portion. Myoepithelial cells, which are ocasionally observed, have thin processes covering a small area of the surface of the terminal portion. The wall of cavernous sinus is com posed of a thick layer of smooth muscle cells with much connective tissue in intracellular spaces. From the SEM findings, it is suggested that the constriction of the cavernous sinus is passively controlled by the decrease of blood flow into the cavernous sinus rather than active contriction of the smooth muscles.
  • -D13前庭神経節の変化-
    工田 昌也, 田頭 宣治, 世良 公志, 原田 康夫
    1987 年 33 巻 2 号 p. 255-260
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Morphological changes in the mouse vestibular ganglion cells after inoculation of Mycobacterium fortuitum were studied using scanning electron microscopy. Various stages of change of the ganglion cells were observed. Pathology of the ganglion cells was first observed one week after inoculation of Mycobacterium fortuitum. The degeneration process began as the swelling of mitochondria and the destruction of the mitochondrial cristae in the ganglion and Schwann cells. The next stage involved the Golgi apparatus and the endoplasmic reticulum. The rapid process of degeneration suggests a direct influence of bacterial toxic substance of Mycobacterium fortuitum on the ganglion cells.
  • 金子 まどか, 柊 光一, 古川 政樹, 久保田 彰, 持松 いつみ, 佃 守, 大石 公直, 澤木 修二
    1987 年 33 巻 2 号 p. 261-268
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Forty four cases with parotid gland tumors, treated during the past ten years in our clinic, were reported. They were reviewed according to sex and age distributions, clinical history, symptoms, diagnostic procedures, therapeutic methods, and prognosis. Among the 44 cases, 31 were benign and 13 malignant. Eighty percent of the benign tumors were the pleomorphic adenoma (25 cases). The vast majority of them were the female patients. Parotid gland tumors can be classified into the various types besides benign or malignant. Spontaneous pain, tenderness and facial palsy were found to accompany only malignant tumor, and therefore are very useful in preoperative diagnosis for malignancy. Sialo graphy, scintigraphy, computed tomography and ultrasonics are also useful for preoper ative diagnosis. Combined treatment with surgery, radiotherapy, chemotherapy and im munotherapy was indispensable to the management of malignant tumors.
  • 高岡 基雄
    1987 年 33 巻 2 号 p. 269-284
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    The concentration of pear pollen in the atmosphere was measured in the flowering season of pear trees, and pear pollinosis (PPS) in farmers who had been engaged in pear cultivation were studied between 1982 and 1984. A modified tube coating radioimmunoassay (TCR) was applied in detecting the serum-specific IgE antibody to pear pollen. Pear pollen concentration in the atomosphere was small in the pear-flowering season, except on days of pollination work. One or more allergic symptoms during the pollination work occured in 585/1723 (34.0%) of the subjects. Of 97 allergic subjects from the 585, 14 (14.4%) were diagnosed as with PPS. The age of the 14 averaged 38.4 years (mean time of pear cultivation work, 17.4 years), and all had symptoms of rhinitis. The serum-specific IgE antibody to pear pollen was positive in 11 (78.6%) of the 14 with PPS. A good correlation between TCR and skin/provocation tests was found.
  • その1:計測法について
    竹田 泰三, 竹内 俊二, 岸本 誠司, 齋藤 春雄
    1987 年 33 巻 2 号 p. 285-291
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Although there has accumulated considerable evidence that nerve compression may be one of the most important factors of facial palsy, measurement of nerve pressure within the fallopian canal has not been previously accomplished, because of technical difficulty of measuring the soft tissue pressure. The methods of measuring soft tissue pressure were surveyed in the litarature, and the possibility of measuring the pressure of the facial nerve using a servonulling system was investigated. The results were as follow: 1. The interstitial fluid pressure of the extirpated medulla oblongata was measurable with a servonulling system. The pressure was confirmed to be proportional to the applied water pressure of the surrounding tissue block. 2. In 8 out of 10 guinea pigs the facial nerve pressure within the fallopian canal was successfully recorded. In 6 of these, the nerve pressure was recordable for over 1 hour. 3. In 6 out of 8 guinea pigs with satisfactory measurment of the facial nerve pressure, fluctuations corresponded to the heart beat and respiration were observed. In the remaining two guinea pigs, the facial nerve pressure showed fluctuation coincident with only heart beat or respiration.
  • その2:脳脊髄液圧との関連
    竹内 俊二, 竹田 泰三, 岸本 誠司, 斎藤 春雄
    1987 年 33 巻 2 号 p. 292-295
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Adequate pressure measurement of the facial nerve within the epineural sheath has not previously been achieved because of technical difficulties. The aim of this report is to show that a servo-nulling system is an acurate measurement method within the interstitial fluid space of the nerve and to demonstrate that the interstitial fluid pressure in the fa cial nerve depends on the cerebrospinalfluid (CSF) pressure. A servo-nulling system (WPI micropressure system Model 900) was used to measure the interstitial fluid pressure of guinea pigs. Pressure in the facial nerve changed as the CSF pressure did, simultaneous with respiration and vascular pulsation. The respiratory changes disappeared during ar rest-periods of the respirator. Compression of the CSF resulted in a pressure increase in the facial nerve. This is the first report that has succeeded in establishing the direct evidence of pressure communication between the CSF and interstitial fluid space in the facial nerve. The authors concluded that pressure changes in the CSF are transmitted to the facial nerve via a fluid system connecting the CSF with the neural space.
  • 林 正彦, 山本 悦生, 本庄 巖
    1987 年 33 巻 2 号 p. 296-298
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    The relationship of pre-operative eustachian tube function to the postoperative course of tympanoplasty was investigated in 37 cases with chronic otitis media. Both ventilatory and clearance functions were tested pre-operatively. In half of cases operated on with poor grades of both functions the postoperaative course was poor. However, only 4 % of cases operated on with good and moderate grades of both functions failed. From these results we concluded that pre-operative tubal function is important in the postoperative course of the tympanoplasty.
  • 笠野 藤彦, 安達 裕一郎, 柊山 幹子, 森満 保, 星 博昭, 渡辺 克司
    1987 年 33 巻 2 号 p. 299-304
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Three cases operated on by ligation of the common carotid artery and 4 cases by reconstruction for radical neck dissection were reported. Four cases were examined with 133Xe cerebral blood flow scintigraphy. The first case, operated on by ligation, was examined on the 18 th postoperative month. Scintigraphy showed normal regional cerebral blood flow (rCBF). The second case, operated on by reconstruction with Gore-Tex, showed normal rCBF preoperatively and on the 15 th postoperative day, and showed abnormal rCBF in left frontal lobe on the 35 th postoperative day which was on the 5 th day after an occurrence of a cerebral infarction. The third case in which hemorrhage occurred a month after reconstruction of the saphenous vein, and the last case operated on by ligation showed normal rCBF preoperatively. Postoperatively, the third case on the 28 th day and the last case on the 10 th day had low rCBF in temporal lobe. These findings were not detected by X-ray CT performed at nearly the same time. The last case was examined again on the 3 rd postoperative month and showed normal rCBF.
  • 杉野 式康
    1987 年 33 巻 2 号 p. 305-311
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    The auditory brain stem response can be used not only as a diagnostic tool in audiological disorders but also as a functional test of brain activity in comatose patients, where a variety of pathological and physiological conditions is found. In the present paper, the effects of blood pressure, blood respiratory gas level and rectal temperature on auditory brainstem response in guinea pig were investigated. When the mean blood pressure dropped 32.9% from the value of control, there were no change in the ABR. The ABR was not affected by a high oxygen partial pressure in the artery in any case of normothermic, hypothermic and after rewarming condition. Systemic cooling, induced with chlorpromazine and an ice bag, prolonged the latencies and reduced the amplitude of waves I to IV. The rectal temperature was manipulated from 37° to 27°. The data indicated that a reduction of 1° in rectal temperature was associated with an increase of 5.9% in the interval between waves I to IV. Body temperature should be controlled in interpreting both experimental and clinical ABR recordings.
  • 馬場 駿吉, 木下 治二, 森 慶人, 鈴木 賢二, 島田 純一郎, 河村 正三, 板橋 隆嗣, 渡辺 洋, 藤巻 豊, 堀川 治久, 渋井 ...
    1987 年 33 巻 2 号 p. 312-336
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    The clinical efficacy, safety and utility of Ciproflxacin (CPFX) in the treatment of the patients with acute lacunar tonsillitis were compared with those of Norfloxacin (NFLX) in a double-blind study. Patients over 15 years old with acute lacunar tonsillitis were orally administered either 600mg of CPFX or NFLX for 7 days. The following results were obtained: 1. The clinical efficacy rate according to the doctors in charge was 86.5% (111/129) in the CPFX group and 85.5% (112/131) in the NFLX group. The difference between the two groups was not significant. 2. On the basis of committee judgement, the clinical efficacy rate was 75.2% (97/129) in the CPFX group and 74.8% (98/131) in the NFLX group. The difference was not significant. In the patient population with moderate infection, there was a tendency of better results with the CPFX group than the NFLX group (P<0.10). In the patient population with severe infection, the NFLX group has significantly better results than the CPFX group (P<0.05). 3. The bacteriological eradication rates were very high in both the CPFX group 97.6% (82/84) and the NFLX group 95.8% (91/95). 4. Side effects were noted in 3 out of 135 patients (2.2%) given CPFX and in 4 out of 135 patients (3.0%) given NFLX. Abnormal changes in laboratory findings were noted in 1 patient on CPFX and in 3 on NFLX. Neither serious side effects nor abnormal laboratory findings, were noted. 5. The utility rates according to the attending doctors were satisfactory in both the CPFX group 86.8% (112/129) and the NFLX group 87.8% (115/131). These results suggest that in treatment for acute lacunar tonsillitis; the clinical efficacy, safety and utility of CPFX are as high as those of NFLX at the same daily dose of 600mg.
  • 馬場 駿吉, 木下 治二, 森 慶人, 鈴木 賢二, 島田 純一郎, 河村 正三, 板橋 隆嗣, 藤巻 豊, 渡辺 洋, 堀川 治久, 丸尾 ...
    1987 年 33 巻 2 号 p. 337-354
    発行日: 1987年
    公開日: 2013/05/10
    ジャーナル フリー
    The clinical effectiveness, safety and utility of Ciprofloxacin (CPFX, BAY o 9867) was studied in the treatment of paranasal sinusitis. CPFX was given orally to 62 patients with paranasal sinusitis at a daily dose of 300-600mg for 7-14days. Two patients were excluded from evaluation of clinical effectiveness; therefore, 35 patients with acute sinusitis, and 25 patients with acute exacerbation of chronic sinusitis were evaluated. The clinical efficacy rate according to the doctor in charge was 73.3% (44/60), and that by the committee criteria was 80.0% (48/60). The utility rate according to the doctor in charge was 76.7%. The bacteriological eradication rate was 89.5% (17/19) in patients with gram positive bacteria infections and 100% (2/2) in patients with gram negative bacterial infections. Diarrhea and abdominal pain were observed in 1 patient. A slight elevation of s-GOT was noted in 1 patient. From the above results, CPFX was considered to be a very useful drug in the treatment of paranasal sinusitis.
  • 佐藤 喜一, 吉江 忠正, 佐々木 周興, 山下 公一
    1987 年 33 巻 2 号 p. 355-358
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    LZ-G is a new gargling solution consisting of lysozyme, cetyl pyridinium chloride and sorbitol. It has a slight bacteriolytic activity. The clinical effectiveness and safety of LZ-G for abnormal sensation, is evavluated. Twenty seven patients who were suffering from a sore throat, dry feeling, foreign body sensation and/or itching in pharynx were studied. The effective rate including “remarkable effective” and “effective” was 77.8%. The clinical judgement by the chief physician of LZ-G usage was 92.6%. No side effects were observed.
  • 大西 信治郎, 上田 良穂, 小林 恵子, 伊藤 依子, 田中 洋二
    1987 年 33 巻 2 号 p. 359-365
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    A clinical evaluation of LZ-G, a gargle containing lysozyme chloride and cetylpyridinium chloride, was conducted in 57 patients with inflammatory disease in the otorhinolaryngological field (pharyngitis, tonsillitis, stomatitis, etc.). Five to 10 ml of LZ-G was diluted 10-fold and the patients were instructed to gargle with the dilution four times daily for 3-35 days. The results of the clinical evaluation were as follows. 1. The clinical efficacy was rated excellent in 4 cases (7.7%), good in 30 (57.7%), fair in 11 (21.2%) and poor in 7 (13.5%) among 52 patients. 2. There was not a single case with side-effect. 3. The above results suggested that gargling with LZ-G was a useful therapeutic approach to pharyngitis, tonsillitis, stomatitis, etc.
  • 富山 道夫, 田中 久夫, 今井 昭雄, 井口 正男
    1987 年 33 巻 2 号 p. 366-369
    発行日: 1987/03/20
    公開日: 2013/05/10
    ジャーナル フリー
    Chronic otitis media with effusion (OME) has generally been charactarized as an otitis media without bacterial infection. A recent study has shown that bacteria (especialy H. influenzae and S. pneumoniae) are of major importance in the pathogenesis of chronic OME. We examined antimicrobial therapy in the treatment of OME. The penetration of Cefamandole (CMD) into Middle ear effusion (MEE) was studied and compared with serum levels. Patients with chronic OME aged 4 to 8 years received a single dose of 1000mg CMD by the venous route 15 minutes to 70 minutes before the removal of MEE and insertion of tympanostomy tubes. The penetration and elimination of CMD into MEE was very rapid and paralleled the serum levels.
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