日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
68 巻, 11 号
選択された号の論文の9件中1~9を表示しています
  • 特にその発現機構に就いて
    渡辺 昭夫
    1965 年 68 巻 11 号 p. 1391-1403
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    This study was undertaken in order to know what are indispensable for understanding theoretically the mechanism of recruitment phenomenon.
    The following results were obtained:
    (1) In human subjects.
    By determinating auditory loudness levels, the auther examined whether 20 ears with acoustic trauma have recruitment phenomenon or not, and obtained the fact that recruitment phenomenon was clearly noticed in the all ears.
    (2) In animals(guinea pigs).
    The auther has observed the changes of the intensity function of cochlear microphonics(CM) and whole nerve action potential(N1) of acoustic nerves of the animals, which had been exposed to intense sound.The remarkable recruiting slopes were observed in the N1, and they were similar to the recruiting slopes noticed in pathological human audition.On the other hand, in the function curves of CM the recruiting slopes were found only at non-linear portion of the curves.
    With these results, the auther has discussed a hypothesis on the mechanism of recruitment phenomenon.
  • 藤崎 隆三
    1965 年 68 巻 11 号 p. 1404-1415
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    A new conditioning technique was presented here for the achievement of objective audiometry using galvanic skin response.Galvanic skin response(GSR) audiometry with eletcric shock stimuli is usually accompanied by uncomfortable pain or anxiety of the patient, and may be an unpleasant experience for the child.As practical solution of such problemes, jet-air conditioning was devised. And it was studied experimentally and clinically.
    The conditioning schedule was set up as 60% partial reinforcement, i, e., the patient was irregu- lary given fifteen tone stimuli between 15 and 45 seconds, of which nine were combined stimuli of tone and jet-air.The jet-air pressure was about 30mmHg and was puffed out to the external canthus of the patient from a distance of about 20 centimeters, and was presented immediately after the, presentation of pure tone of 1, 000cps for 2 to 3 seconds at a level of 40db above the presupposed threshold.
    Some basic experiments and investigations in jet-air conditioning were carried out in 110 subjects from 4 to 43 years of age.And it was promised that jet-air conditioning might be succeeded above at the rate of 80% of subjects.
    Clinical application was carried out in 57 children from 2 to 12 years of age and in 20 adults. The threshold determination was performed at each frequency of 1, 000, 2000, 4, 000 and 500cps after conditioning by the reinforcement schedule.We could succeed to get the thresholds in 52 cases out of 57 children(91.2%) and 16 cases out of 20 adults(80.0%).
    Comparison of thresholds measured by using this method with those measured by subjective audiometry was studied.In children, both thresholds agreed at a level of ± 10db in each frequency as follows:97.3%in 1, 000cps, 91.9% in 2, 000cps, 85.9% in 4, 000cps and 89.5% in 500cps;and equally in adults.
    GSR audiometry by means of jet-air conditio- ning was proved one of the useful and excellent objective audiometries, particularly for children.
  • 中村 四郎, 山藤 勇
    1965 年 68 巻 11 号 p. 1416-1422
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    Three cases of congenital absence of both the stapes and the oval window, of which two cases were accompanied by absence of the round window, were presented and compared with 9 cases reported by others in the literature.
    Embryological relationship between absence of the oval window and anomaly of the structures in the middle ear including the ossicles were discussed.
    In addition, it was found that the audiograms were characterized by moderate hearing loss by air conduction with positive slow curve rather than flat curve, and normal or slight hearing loss by bone conduction in the case of absence of the oval window, or both oval and round windows.
  • 藤井 興年
    1965 年 68 巻 11 号 p. 1423-1451
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    1) Amoung the earlier studies on the directional hearing, there have been few on the discrimination ability of the sound from front and rear sources(DFR).Foundamental study on this ability was performed to establish the test method, and various kinds of hearing disorders were tested.
    2) The method was as follows:
    Two loudspeakers were set in front of and in the back of the subject at the same distance.
    Pure tone, white noise and bandpass-noise of the same loudness were given from the two speakers.The subjects were told to answer where the sounds came from.
    3) When a subject kept his head still.
    i) The wider the frequency range of the testnoise, the better the DFR.
    ii) To elicit good DFR, the duration and the intensity of the testnoise should be more than 0.25sec and 40db(SL) respectively. DFR was not significantly influenced by the rise and decay time of the testnoise.
    iii) Concerning the azimuth of the sound sources, the best DFR was obtained when the sources was 30° to 45° apart from the median sagittal plane.
    iv) When earplugs were inserted in the both earcanals, DFR was disturbed, but the effect of auditory fatigue was not so remarkable as earplugs.
    4) When the head of subject was moving, narrow bandpassnoise was also well discriminated as whhite noise.
    5) DFR of the subjects with hard deafness was oor in proportion to the degree of hearing loss.
    6) DFR was poor in the presence of central disorders, even when the hearing was normal. The last result indicates the possible usefulness of he test as a diagnostic aid of central disorders.
  • 山下 隆章, 原田 康夫, 上田 直昭, 田代 貴士, 金林 秀明
    1965 年 68 巻 11 号 p. 1452-1459
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    Nine cases of vocal cord paralysis following the endotracheal anesthesia for cases of abdominal operation were reported.
    Results of the electromyographic examination of the intrinsic laryngeal muscles and free movability of the cricoarytenoid joints assured by manipulating laryngeal spatula (5cases out of the nine) revealed that injury of the recurrent laryngeal nerve was responsible for the disturbance of movement of the vocal cord.
    Statistical observation of the reported cases of recurrent laryngeal nerve paralysis associated with endotracheal anesthesia in our country, including author's, revealed :(a) paralysis occured more frequently in the cases above 40 years old, (b) the paralysed vocal cords were often fixed in the intermediate position at the first inspection, (c) many cases had no laryngitis, (d) the prognosis was relatively good and healed within 3 months after operation.
    Some factors of nerve injury such as overextension of the neck during intubation and operation, pressure on the nerve by unsuitable endotracheal tube and cuff that was over-expanded, decrease in elasticity of the trachea and surrounding tissues, vulnerability and anatomy of the nerve, influence of muscle relaxants were deemed to be possible causes, and authors considered the interaction by their combination responsible for the nerve injury.
    For the purpose of investigation of vocal cord paralysis complicated with endotracheal anesthesia, the necessity of the examination at the early stadium after operation and each professional reseach were emphasized.
  • 特に本症に対する気管開窓術の意義
    広戸 幾一郎
    1965 年 68 巻 11 号 p. 1460-1465
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    The methods of surgical treatment of bilateral posticus paralysis are classified into 2 groups;1) tracheotomy with permanent metal cannula, 2) intralaryngeal or extralayngeal laterofixation of the vocal cord with or without aryectomy.The laterofixation of the vocal cord is very useful operative procedure to alleviate the dyspnea and to sustain the serviceable voice;however, in order to restore the laryngeal airway, some impairment of the phonatory function is always seen.After the tracheotomy patients' respiration is free and their voice is clear, however, a tracheotomy tube is considerably troublesome because of the annoying cough, granulation at the tracheal stoma, bleeding and pain caused by the cannula.
    The tracheal fenestration is a permanent airtight, leakproof, skinlined tracheocutaneous communication that was deviced by Rockey 1956.The external opening of this skin tube is guarded by two door-like valves which normally are in apposition and prevent the leakage of air or liquid.These valves may be mannually opened, occasionally by retroflexion of the head or by insertion of the small tube into the stoma at will.The tracheal fenestration does not have such disadvantages as conventional tracheotomy with metal canuula has, and the patients' voice is not impaired.
    The author reported two cases of bilateral posticus sralysis treated by the tracheal fenestration opera*ion.The first case can respirate through the tracheal opening as well as the glottis.He can normally phonate and cough in the prone position of the head.The second case uses a small tube at night;however, she does without cannula by day and her voice is not impaired.
  • (結紮時における脳循環血のPo2,PCO2, pHの変動について)
    柳野 権次郎, 高須賀 信夫, 江口 実美, 福崎 隆
    1965 年 68 巻 11 号 p. 1466-1471
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    Observations were made on the changes of the cerebral blood flow caused by the ligation of the common carotid artery in 5 clinical cases and 10 dogs.
    In the clinical cases, the fact was revealed that Po2 of jugular venous blood after 5 min.of ligation normal jugular venous blood, and Po2 of jugular venous blood, and Po2of jugular venous blood after 1min.and 30sec.of ligation of the common carotid
    It is considered from this fact that if the ma- ximum duration of ligation of the common carotid artery is 3 min., Po2 of the carotid artery blood surgery.
    In the cases of dogs, transition of Po2 and pH of blood presented the same trend as that of the clinical cases, but the degrees were smaller.
  • 服部 政夫
    1965 年 68 巻 11 号 p. 1472-1489
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    In order to make clear the effects of fine manipulation of experimental tympanoplasty, on the iuner ear the anther investigated the post operative histopathological changes in the inner ears of rabbits.
    The results of the investigations were as follows :
    1) Penicillin, when it has bas given into the tympanic cavity, causes no inner ear damage, but DHSM causes degeneration of the supporting cells of the organ of Corti firstly.
    2) Fine manipulation of the stapes may produce reactions of the inner ear similar to those caused by acoustic traum, hydrops, and sero-fibrinous labyrinthitis.
    3) Also, curettaging the mucosa from the promontory area and excessive suction at the oval window area, ought to be avoided.
  • ラツト自然発生慢性中耳炎
    吉田 一彦
    1965 年 68 巻 11 号 p. 1490-1509
    発行日: 1965年
    公開日: 2008/03/19
    ジャーナル フリー
    A histopathological and histochemical study of the osseous and soft tissues in chronic otitis media occuring spontaneously in Wistar rats was made.
    Histochemical study was confined to localization of enzymatic activities and polysaccharides in the inflammatory lesions.
    The results obtained were as follows:
    1) Histopathology of the chronic otitis media in rats was characterized by marked thickning of the subepithelial layer of the tympanic cavity, in which granulomatous inflammation with infiltration of lymphocytes, plasma cells and pseudoeosinophils was seen, as well as formation of cysts.
    In the affected bone disappearance of the osteocytes and dilated Haversian canals were found. Although coexistence of osteoblasts and osteoclasts were found in some areas, in general, absorption and degeneration of the bone tissue were predominated.
    2) The histochemical distribution of the vari ous enzyme systems in chronic otitis media of rats was investigated.Activities of alkaline phosphatase, ATPase, 5' nucleotidase, lactic dehydrogenase and cytochrome oxidase were demonstrated in the capillaries within the inflammatory granulation tissues of the subepithelial layer of the tympanic cavity.
    In pseudoeosinophils in the granulation tissue, activities of alkaline phosphatase, ATPase and 5' nueleotidase were noted.
    Of interest was that epithelium of the cysts, one of the most pronounced findings in chronic otitis media of rats, posessed many enzyme activities including acid phosphatase, ATPase, 5' nucleotidase, succinic dehydrogenase, lactic dehydrogenase, diaphorase, cytochrome oxidase, non-specific esterasecharides were demonstrable.
    In the periostium, activities of alkaline phosphatase, acid phosphatase, 5' nucleotidase, lactic dehydrogenase, diaphorase and cytochrome oxidase were seen.
    Although any of the examinated enzyme was not reacted in the bone matrix, the dilated Haversian canals showed the following enzyme activities:Alkaline phosphatase, acid phosphatase, 5' nucleotidase, lactic dehydrogenase, diaphorase, cytochrome oxidase and non-specific esterase.
    3) Decalcification by cold 10% solution of EDTA, adjusted to pH 7, 0 with IN NaOH solution after cold aceton fixation of the tissue specimen was recommended for preservation of enzyme activity and polysaccharides in the tissues.
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