耳鼻と臨床
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
34 巻, 6 号
選択された号の論文の19件中1~19を表示しています
  • 牧嶋 和見, 脇園 茂樹, 石井 喬志, 山岸 豪敏, 酒井 美香, 野口 敦子
    1988 年 34 巻 6 号 p. 1417-1420
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Recent advances in hearing aid technology have encouraged persons with impaired hearing. Many hearing aid users and candidates, however, have often experienced various annoyances associated with hearing aids obtained through unscrupulous hearing aid sales people. The clinic for potential hearing aid candidates of Kyushu University Hospital have afforded them counsel and the opportunity of fitting the hearing aid. For reasons of patient protection, we stressed here that hearing aid fitting and despensing should be done under the consultation of the otorhinolaryngologist.
  • 内藤 好宏, 増田 游, 小倉 義郎
    1988 年 34 巻 6 号 p. 1421-1425
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Three cases of pendulous tonsils where the patient complained of foreign body sensations in the throat were reported. They included the right tonsil of a 57-year-old female, bilateral tonsils of a 64-year-old female, and the left tonsil of a 35-year-old male. Microscopically, the pendulous portions of the tonsils showed the same findings as in simple tonsillitis. All cases had past histories of chronic tonsillitis. The authors considered the etiology of pendulous tonsils to be mainly related to chronic irritation of the local region of the tonsil.
  • 山下 弘之, 工藤 庄治, 松村 祐二郎, 古澤 元之助
    1988 年 34 巻 6 号 p. 1426-1430
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Two cases of carcinoma of the esophagus developing at the site of corrosions caused by ingestion of sodium hydroxide and sulfuric acid are presented. A curative operation was performed in case 1 after admmistering 30 Gy radiation. However, the patient died of lymph nodes metastasis two years after surgery. On the contrary, gastrostomy only was performed in case 2 since the patient was already in an advanced stage, He survived eight months after operation. Histopathological examination revealed squamous cell carcinoma in both cases. Incidence of carcinoma of esophagus due to corrosion is very low in Japan and few reports have been noted. Esophagectomy for benign corrosive stenosis has been increasing recently since the prognosis of corrosion carcinoma of esophagus is very poor. Early and late treatment of esophageal corrosion was also discussed.
  • 片岡 真吾, 卜部 晋平, 小林 仁和, 涌谷 忠雄
    1988 年 34 巻 6 号 p. 1431-1437
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    A 69-year-old woman who had lingual carcinoma (T3N1M0, Stage III), was admitted to our clinic. She was treated with radiotherapy consisting of 50.4 Gy and with chemotherapy, Two months later, a left hemiglossectomy and left radical and right functional neck dissection were performed. The defect in the oral cavity was reconstructed primarily with a latissimus dorsi myocutaneous island flap, and simultaneously the left carotid artery was covered with the pedicle of the flap. After the operation, there was minor necrosis of the reconstructed lingual flap, and two months later, due to much bleeding from the carotid artery, an emergency operation was performed. Bleeding occured due to the rupture of a false aneurysm originating from the left common carotid artery. The false aneurysm was resected and a 6 mm Gore Tex graft was interposed between the internal and common carotid arteries. She died due to the recurrence of cervical metastasis and cerebral infarction.
  • 加藤 太二, 小林 仁和, 涌谷 忠雄
    1988 年 34 巻 6 号 p. 1438-1442
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    A 36-year-old female was admitted to our clinic, complaining of a left submandibular tumor which had existed for 4 years. On April 20 1983, an operation was performed under general anesthesia. The tumor was 4.4×3.2×2.0cm in size and 16.4g in weight. The histological examination revealed paraganglioma. Left recurrent laryngeal nerve and hypoglossal nerve palsy appeared after the operation, but no other remarkable neurological deficits were present on the following day. The patient was discharged on July 4 1983, and no metastasis or recurrence have been observed thus far.
  • 飯田 直美, 三谷 芳美, 駒崎 陽子, 荒牧 元
    1988 年 34 巻 6 号 p. 1443-1447
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    We encountered a case of mediastinal teratoma which was enlarged to the anterior region of the neck. The patient was a 16-year-old female. She came to the hospital with complaints of anterior neck swelling, odynophagia, and dysphagia. CT scan and MRI were examined and showed a mass occupying the area of the low neck to the upper anterior mediastinum. One month after first examination, the anterior neck tumor was not palpable. It had been spontaneously absorbed. An operation revealed the mediastinal tumor which was 10×6×4.5cm in the diameter. The histopathological diagnosis indicated a mature teratoma comprised of three germlayers and thymic tissue. No malignant elements were present.
  • 許 家豪, 小宮山 荘太郎, 笠 誠一
    1988 年 34 巻 6 号 p. 1448-1452
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    As most specialists know, one of the most important factors for professional singers is the ability to master correct breathing. It has been observed that the breathing pattern used when yawning is very similar to the breathing pattern used while singing the Italian Bel Canto. The authors treated 91 cases suffering from singers nodules, recurrent nerve paralysis and glottal chink. Patients were given clinical voice training utilizing the “yawning” breathing pattern. In judging the results, objective standards were designed for evaluation of phono-exams. The effects have been analysed statistically. They showed that the therapy using the yawning-like breathing pattern is effective for those dysphonic symptoms.
  • 吉川 茂樹, 上村 卓也, 中島 格, 増田 玄彦, 山田 猛
    1988 年 34 巻 6 号 p. 1453-1457
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    It has been reported frequently that the contralateral reinnervation of the facial nerve from the healthy side of the face following resection of the facial nerve produces spontaneous recovery. There is a crossing innervation of the facial nerve of the midline of the face. Such innervation may be noted on the orbicularis oris and is up to 2.0cm on the contralateral side. We reported a case of cholesteatoma otitis media with complete facial palsy. After operative resection of the facial nerve, evoked muscle action potential was recorded at the same-side corner of the mouth (4.0cm from the midline). We concluded that this finding indicates that the contralateral reinnervation has ocurred from the healthy side of the face.
  • 外耳道電気刺激誘発法とその診断, 治療上の意義についての一考察
    増田 芳子
    1988 年 34 巻 6 号 p. 1458-1481
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    We studied electrically induced stapedial reflex (ESR) in cases of Meniere's disease and its influence on equilibratory and acoustic functions. 1. The electrical stimulus applied to the external auditory canal was a 0.01 msec width pulse discharged at the rate of 25Hz, with the electric current being between 60-90V. No significant difference was found in the positive rate of ESR between cases with Meniere's disease and the normal control group. 2. Concerning the equilibratory function, 26 normal subjects and 43 subjects with Meniere's disease were examined while standing upright on a forceplate. The lateral body sway during and after electrical stimulation for five seconds was summated ten times with a signal processor. Remarkable shift or increase in body sway (positive reaction) was observed during the electrical stimulation in 57.6% of the Meniere's cases, while in the normal group, positive reaction was observed in 26.9%. 3. Intermittent electrical stimulation was applied to six cases with advanced Meniere's disease. The manipulations were repeated once a week for more than 10 weeks. As a result, a slight improvement in hearing in four cases, and improvement in tinnitus in three cases was found, without any problems. According to the results mentioned above, the author discussed diagnostic and therapeutic significance of nonacoustical stapedial reflex in Meniere's disease.
  • 原田 好雄
    1988 年 34 巻 6 号 p. 1482-1487
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Sixteen cases of perennial allergic rhinitis patients were treated with AA-673 (Amlexanox) tablets. The patients were given one tablet of AA-673 (each tablet contains 50mg of Amlexanox) three times a day, for up to eight weeks. Final global improvement rating showed moderate or better improvement in 70% of the cases. Side effects were not observed in any cases. In most, cases, improvement appeared four weeks after the start of the administration. The author concluded that AA-673 tablet is a considerably useful medicine for the treatment of perennial allergic rhinitis.
  • 減量・中止について
    石川 哮, 茂木 五郎, 大山 勝, 宗 信夫, 上村 卓也, 家守 千鶴子, 曽田 豊二, 浜之上 隆史, 岡本 健, 知念 信雄, 平野 ...
    1988 年 34 巻 6 号 p. 1488-1500
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Tranilast, inhibitor of mediator release, was administered to 163 cases of whole year nasal allergy for more than 8 weeks to examine its effectiveness and safety. From the 8th week on, dose reduction and withdrawal of Tranilast were under taken. Observations of exacerbation and/or relapse then continued for 13 weeks to find the optimum dose reduction and withdrawal procedures. On the basis of “Patients' impressions” 8 weeks after administration, dose reduction and withdrawal were set up. A part of “Very well”, administration was withdrawn. The other part of “Very well”, was reduced 3 to 1 capsule.“Well” or “Slightly well”, was reduced 3 to 2 capsules. Withdraw or reduce 3 to 1 capsule was determined randomly. The results of the overall estimation revealed a rate of effectiveness of 62.2 and 90.0% after 4 and 8 weeks, respectively. A rate of relapse following dose reduction and withdrawal was 25.0-33.3% without a difference in the rate of relapse according to dose reduction procedures. This suggests the necessary selection of a dose reduction procedure according to the degree of effectiveness of Tranilast.
  • 西山 勉, 朴沢 二郎, 石川 馨
    1988 年 34 巻 6 号 p. 1501-1505
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Fifty two patients with peripheral vestibular disorder were treated with the administration of 15mg per day of Vinpocetine for 4 weeks. This drug was effective for subjective symptoms such as vertigo, faintness and stiffness of the shoulder, etc. However, a correlation between the degree of canal paresis and the improvement of subjective symptoms was not found. In the vestibular testing, positional nystagmus disappeared in 63% of cases after the treatment. The improving courses of three effective cases were demonstrated by the results of the computerized rotatory chair system.
  • 小田 恂, 谷野 徹, 水野 正浩, 原田 勇彦, 喜多村 健, 山口 宏也, 佐藤 恒正, 杉本 正弘, 鈴木 康司, 宮川 晃一, 竹森 ...
    1988 年 34 巻 6 号 p. 1506-1510
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Dilazep hydrochloride tablets were p. o. administered to 130 patients with a chief complaint of tinnitus, and changes in subjective symptoms and objective findings (loudness of tinnitus) were examined. As a result, the subjective improvement rate of tinnitus was heigtened as the number of administration days increased, and the improvement in tinnitus was shown in 39.8% of cases by assessment of the treating physician and in 56.5% of cases by score rating at week 8. Improvements were more marked in tinnitus without deafness more than in tinnitus accompanying deafness. Effectiveness was observed in cases with tinnitus accompanying deafness, which had head trauma, Ménière's disease, sudden deafness, or other acute deafness. Also, in view of the duration of illness, the use of Dilazep hydrochloride was effective in a great number of cases with an onset within one month. Am adverse reaction, transient gastrointestinal symptom, was observed in 3 cases (2.3%).
  • 犬山 征夫, 戸川 清, 高坂 知節, 大谷 厳, 森田 守, 竹生田 勝次, 金子 敏郎, 武宮 三三, 小野 勇, 野村 恭也, 奥田 ...
    1988 年 34 巻 6 号 p. 1511-1519
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    Patients (pts) from 35 institutions, with untreated squamous cell carcinoma of the head and neck at Stage III or IV were treated in this trial between December, 1986 and September, 1987. All pts were centrally randomized to receive either carboplatin (JM-8) 400mg/m2 i. v. on day 1 (arm A) or cisplatin (CDDP) 50mg/m2 on day 1 (arm B), together with peplomycin (PEP) 5mg/day i. m. on days 2-6. In principle, 2 courses of either regimen were given to each pt. Out of 91 pts registered, 83 pts (91%) were evaluable for response and toxicity. All pts required hydration in arm B, compared to 7 pts in arm A. In arm A, no pts obtained a complete response (CR) and 15 obtained a partial response (PR) with a response rate of 33%, while in arm B, 1 pt obtained a CR and 12 obtained a PR with a response rate of 34%. The response rates between the 2 regimens were not statistically different. The incidence of nausea and vomiting was significantly higher (p<0.01) in arm B than in arm A. Leukopenia and thrombocytopenia occurred in 22% and 31% of the arm A pts versus 13% and 18% in arm B patients. Renal toxicity, observed as decreased creatinine clearance, occurred in 19% of the arm A pts versus 33% of arm B patients. However, the above toxicities are generally mild and transient. It was concluded that JM-8+PEP suggested activity similar to CDDP+PEP, and also could be safely used at an outpatient level.
  • 馬場 駿吉, 島田 純一郎, 征矢野 薫, 小林 武弘, 鈴木 賢二, 岩田 重信, 高須 昭彦, 八井田 昌志, 横井 昌哉, 桜井 一生 ...
    1988 年 34 巻 6 号 p. 1520-1534
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    For objective evaluation of clinical efficacy and safety in lacunar tonsillitis, peritonsillitis and peritonsillar abscess, ceftazidime (CAZ) was examined for distribution of sensitivity of clinical strains, tonsillar tissue transfer, and also its clinical usefulness was examined in a multicentre clinical study using the same protocol. 1. CAZ completely inhibited growth of 53 clinical strains of gram-positive bacteria (27 of which were S. pyogenes) and 21 of gram-negative bacteria (14 were B. catarrhalis) isolated from patients with tonsillitis, at the concentrations not higher than 3.13μg/ml and 0.78μg/ml, respectively. 2. Following the intravenous administration of 1g CAZ, the mean tonsillar tissue level was 17.3μg/g (2.6-36.3μg/g, n=19) at 15-240 minutes. The mean ratio of tissue level to serum level was 40.8% (33.8-61.5%). The tissue level reached its peak at 15-22 minutes after administration and then gradually decreased. At 240 minutes after administration, however, the level was still 2.6μg/g. 3. In the clinical evaluation, 83 patients received CAZ. Clinical effectiveness and usefulness were evaluated in 78 patients, and safety in 80. The dose of CAZ was 1g twice daily in most of the 80 patients in the safety evaluation (65, 81.3%), and the duration of administration was 3 to 5 days in 43 patients, 53.8%. 4. Clinical efficacy rate (‘Excellent’ and ‘Good’) assessed by the Efficacy Assessment Committee was 94.9% (74/78) and that by the doctors in charge was 100%. The percentage of ‘Excellent’ cases was 61.5% in the assessment by the Committee and 67.9% in the doctors' assessment. As for bacteriological response, all the strains isolated before CAZ administration were eliminated, except for those from 3 patients whose response was unknown. 5. No clinical adverse event was observed in any of the 80 cases evaluated. Elevation of serum transaminases (4 cases), increase in eosinophil count (2 cases) and increase in platelet count (1 case) were observed in the laboratory tests, but none of them were serious. In conclusion, CAZ is considered to be highly useful in the treatment of tonsillitis.
  • 佐々木 亨, 杉森 久一, 佐々木 幸弘, 小崎 秀夫, 中江 政美, 三ケ田 昭是, 斉藤 滋, 坂本 毅, 原田 千洋, 一林 正剛, ...
    1988 年 34 巻 6 号 p. 1535-1553
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    TE-031 is a new macrolide antibiotic derived from erythromycin. It is highly stable to acid and shows excellent antibacterial activities against Gram-positive and some Gram-negative bacteria. Clinical efficacy of TE-031 in otorhinolaryngological infections was evaluated in 52 cases. TE-031 was administered orally 200mg b. i. d. The efficacy rates were 90.5% for otitis media, 95.7% for tonsillitis and 100% for sinusitis as judged by treating doctors, and 90.5% for otitis media, 91.3% for tonsillitis and 100% for sinusitis as judged by the committee. Side effects were observed in 3 cases (5.8%) but the symtoms disappeared after the use of TE-031 was discontinued. Clinical usefulness was judged by treating doctors to be 90.5% for otitis media, 91.3% for tonsillitis and 80.0% for sinusitis, and by the committee to be 90.5% for otitis media, 91.3% for tonsillitis and 80.0% for sinusitis. TE-031 appears to be a useful drug for the treatment of otorhinolaryngological infections.
  • 細川 晋一
    1988 年 34 巻 6 号 p. 1555-1559
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
  • 藤井 俊志
    1988 年 34 巻 6 号 p. 1560-1567
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
    The recently developed antidepressants are equal to the commonly used tricyclic antidepressants in clinical efficacy and are superior to them on safety. The mechanism of its action is generally believed to involve a change of monoamine-receptor sensitivity, caused by the effect to monoamine re-uptake at nerve terminals. It has been suggested that the role of monoamine such as Serotonin (5-HT) and Norepinephrine in clinical effects may contribute to mood-elevating and activity-improvement effects, respectively. The optimal choice of an antidepressant may be not difficult to determine according to above therapeutic response, in addition to sedative and anticholinergic ones. As an antidepressant is sometimes given to patients over a long time, less serious side effects such as anticholinergic reactions, cardiac toxicity and seizure-inducing effects should be desired. Furthermore, as the half life of most antidepressants is long, clinical effect will be achieved by medicating once a day. A rapid appearence of clinical effect, less side effects, reduction in sensitivity of serotonergic receptors and increasing catecholamine contents will be needed for the development of new antidepressants in the future.
  • 永松 啓爾
    1988 年 34 巻 6 号 p. 1568-1574
    発行日: 1988/11/20
    公開日: 2013/05/10
    ジャーナル フリー
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