日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
70 巻, 11 号
選択された号の論文の8件中1~8を表示しています
  • 佐藤 武男, 内海 重光, 梶川 宏造, 池田 恢
    1967 年 70 巻 11 号 p. 1773-1778
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    1) A 46-year-old man who had worked during 1941-1945 in a former Japanese army poison gas (chemical weapon) manufacturing factory mainly produced mustard gas, complained of sore throat, swelling of the neck and otalgia since 1962, and was diagnosed as having supraglottic cancer (T4N3M0).
    Biopsy showed squamous cell carcinoma. The latent period of carcinoma induction was about 21 years.2) The tumor of this case already extended from the left ventricular fold through the left side of epiglottis and aryepiglottic fold to the extrinsic laryngeal muscles. Metastasis was found in the left deep cervical lymph nodes without metastastic markings of the lung. He was treated in 1962 with total larygectomy with left radical neck dissection followed by 6000R. Co60 irradiation.
    No cervical or distant metastasis has been recognized in 1967.
    3) This factory was located on the Island of OKU-NO-JIMA, a small island in the Inland sea, Japan. Among these workers, frequent occurrences of laryngeal and bronchogenic cancer were reported by A. YAMADA.
    4) The carcinogenecity of mustard gas including itsderivatives has been clinically and experimentally confirmed. Accordinng to YAMADA's investigation, 32 consecutive cases were reported-18 cases of bronchogenic cancer, 7 cases of laryngeal cancer, 3 cases of pharyngeal cancer, 3 cases of cancer of the spheniod sinus and one case of cancer of the tongue.
    5) Eight cases of cancer of the larynx were reported. All cases were male of the average age of 54 year-old, which was younger than that of usual laryngeal cancer. They suffered from excessive cough and expectoration since their engagement in prodution of the mustard gas.
    The average latent period for carcinoma induction was 19 years and our case was 21 years. The histological type was squamous cell carcinoma.
    Concerning the sites of the cancer, the site of predilection was the supraglottic region, while only one case was in the subglottic region. In eight cases the glottic cancer was not encountered.
    6) The incidence of the occupational cancer of the larynx has been very rarely reported. But we believe that these laryngeal cancers observed in the workers having engaged in the production of the mustard gas. are one of the occupational cancer.
  • 附本邦最近11年間の文献的統計的観察
    来間 数雄, 桜井 栄, 中川 透, 佐々木 順一
    1967 年 70 巻 11 号 p. 1779-1807
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    A case of progressive gangrenous rhinitis was reported. The patient was a 54-year-old male who unfortunately expired of intestinal bleeding and of liver damage. Initial symptoms were remittent fever with 38-39ª, fowel smelling rhinorrhea and obstruction of the nasal cavity. Partial resection of the right maxilla was performed and Endoxan (3800mg), Ra radiation (3880mgh), steroid hormone and antibiotics were ad-ministered. Owing to such treatment, the patient came to a state of lull. Duration of disease was 2 months.
    Pathological finding: nasal tissue showed diffuse granulomatous degeneration with marked necrosis and proliferation of a typical reticulum cell, and also, soft palate, tongue, tonsils, liver and spleen revealed similary finding. Moreover, we total protein fraction, immuno-electrophoresis of serum and plasmin were ex-amined.
    In resent 11 years, 172 cases of progressive gangreneous rhinitis were reported in Japan. One hundred forty-four cases of these reported in literatures of this country. We reviewed & discussed those cases included 103 males and 41 females cases. The youngest patient was 11 years old, the oldest one was 77 years old. Most patients being affected by the disease were from 20 to 40 years old. Fourteen cases out of 144 (15%) were proven to have contributory factors. The majority of those were rhinological operation; polysinectomy, polypotomy and conchotomy, etc. Initial region of this disease was in the nasal cavity, external nose and palate, etc. The nasal cavity corresponded with 50% of all initial region. In 95 cases an initial region spread to the other regions; Increasing odor in the nasal cavity, palate, neck, pharynx and submandibular region.
    In 60 autopsies, 29 cases showed inflamatory finding and 31 cases showed tumorous finding, In the cases diagnosed as tumor microscopically, 11 cases of reticulosarcoma, 10 cases of sarcoma and 8 cases of granulomatosis were recongnized. Eighty-five patients died. Lethality rate was 80%. Duration of the disease in deceased cases was within a year.
  • 安野 友博, 伊藤 治夫, 大久保 英子, 井端 幸子, 河井 紀子
    1967 年 70 巻 11 号 p. 1808-1817
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    A considerable number of publications have appeared in recent years, but little is known about embryopathia rubeolosa (Gregg's syndrome). So far as we know, a few has been found in Japanese literature dealing with this syndrome.
    The special clinic of speech and hearing disorders in our department was established in 1961. Seven cases of deaf-children following maternal rabella were observed in our clinic. Those maternal rubella seemed to appear before 5th month in pregnancy period. They were, in this paper, detected to have no malformation in their eyes or heart.
    In past five years, statistical observations showed that 1.5% of children of hearing difficulty were due to maternal rubella while 24% of prenatal causes in deafchildren were due to rubella.
    In this embryopathia rubeolosa, the relationship between pregnancy period and malformation types and its incidence were discussed. Furthermore, the types of hearing disorder and dysfunctioned portions of the ear were embryologically investigated considering the following facts; (1) the inner ear originates from mesoderum and ectoderum. (2) its growth terminat by 20th or 21th weeks of pregnancy period, (3) organic differentiation is over by 8th week. In the case of rubella affected before 8th week of pregnancy, both the hearing and vestibular function may be impaired. However, the impairment of one of their functions may appear in the case affected after 8th week pregnancy. The cases reported here revealed to have no impairment of vestibule, and to have cochlear disorder. Kelemen investigated histologically that the inner ear of embryo affected in 7th week was found to have impaired organ of Corti. Moreover, most of the clinical cases showed only hearing disorder. The above mentioned findings suggest that rubella virus which has probably an affinity for cochlea is a possible cause of cochlear disorder. In the present cases, audiogramotric data lacked specific sign of hearing due to rubella.
  • 中村 廉
    1967 年 70 巻 11 号 p. 1818-1827
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    Using histochemical technique, changes of nucleic acid activity in the cochlea resulting from white noise exposure were investigated. Forty-eight guinea pigs were used for this experiment. The results obtained were as follows:
    1. The first sign of pathological changes in the organ of Corti due to exposure to white noise occurred in the outer hair cells. Temporary high metabolic rates of DNA were observed in the nuclei of the outer hair cells immediately after exposure to white noise at 110db sound-pressure level for 10 minutes. The nuclei of the outer hair cells appeared pyknositic in most cases. Chromatin granules were not always clear. DNA activities had low rates between 3 days and 7 days after exposure. However, they recovered completely from low rates on 14th day after exposure.
    2. DNA activities in the cuter hair cells immediately after exposure to white noise at 120db for 5 minutes increased temporarily, while they had low rates. The activities recovered on 21st day after exposure.
    3. Pyknosis and decreased clearness of chromatin granules in the nuclei of the outer hair cells appeared in all cases after exposure to white noise at 120db for 10 minutes. At that time, DNA activities increased temporarily, then they had also low rates. Only the half of the animals were allowed to recover for 21 days after exposure.
    4. Recovery pattern of DNA activities in the outer hair cells exposed to white noise at 130db for 3 minutes was almost the same as that in the outer hair cells exposed to noise at 120db fon 10 minutes.
    5. From the results above mentioned, it was evident that DNA activities in the organ of Corti immediately after noise exposure increased temporarily, thereafter they had low rates up to 14 days or so, then the activities recovered to normal. According to the findings of histochemical and morphological changes of nuclei of the hair cells, it was concluded that the limit of reversible changes in acoustic trauma resulting from white noise exposure was presumed to be at 120db fot 10 mingtes or at 130db for 3 minutes.
  • 森 三樹也
    1967 年 70 巻 11 号 p. 1829-1846
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    As a matter of fact, the calculated hearing lossthrough audiometry shows a great variation, besidetechnical errors and various conditions at each test.
    In order to know the real state of the auditorysense of the human beings and also to find the realhearing acuity of a person, the various range of thehearing acuity of normal ear, conductive and perceptivehearing test and speech hearing test were performedcontinuously.
    In order to decide the standard for testing hearingacuity on the basis of the results from the above mentionedtests, how the values tested during the firstthree days should be handled statistically to obtain theapproximate value of the real hearing acuity wasstudied.
    A. Pure tone audiometry hearing test.
    1) The variation of the hearing acuity in a prolongedperiod of time was larger than that in a day.
    The range of the critical limits of the calculatedhearing loss for a long period was as much as±14-25dB in normal ears and showed the largervalues in conductive and perceptive deafness.
    2) As to the closest value to the real hearing acuity ofnormal ears and each deafness obtained from thecalculated hearing loss tested on the first, secondand third day, the mean value of ones tested on thesecond and third day was the closest to the realhearing acuity and the critical limits of each cycleand of a+2b+c/4 value were ±10dB and ±7dB.The real hearing acuity in conductive and perceptivedeafness tested at 8000cps could not be obtain.ed as the variation of the calculated hearing loss atthat cycle was very large.
    B. Speech perception test.
    As to speech reception threshold, the mean valueof ones tested on the second and third day was theclosest to the real hearing acuity and its' critical limitwas ±3dB.
    As to speech discrimination score, almost no differenceamong each deafness was observed. In casethe discrimination score was classified into four groupsof 0-25, 26-50, 51-75 and 76-100%, their critical limitsof the mean value of ones obtained on the second andthird day were ±11, 11, 12 and 13% and the differencesamong each group were very small.
    C. The standard to know the variation of thehearing acuity.
    Above all, the method to know the variation ofthe hearing acuity is to perform above mentionedhearing tests for 3 days before treating the ears and tofind the mean value of ones tested on the second andthird day.
    Improvement of aggravation of the hearing acuitycan be decided when the value is larger than 15dB at500, 1000 and 2000cps and also larger than 10dB ata+2b+c/4value in conducthievaer ing test and whenthe degree of speech perception threshold is classifiedinto four groups of 0-25, 26-50, 51-75 and 76-100%and the differences between each group are larger than22, 22, 24 and 26% in speech hearing test.
  • -加速度記録図法の臨床的応用-
    西村 充
    1967 年 70 巻 11 号 p. 1847-1893
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    In 1965, O. Tsuiikawa of our department has already described the human equilibrium in normal subiects recorded by acceleration registogram.
    In this paper the clinical report of the acceleration registogram for recording the vestibulo-spinal responses on 86 patients was presented.
    All 86 patients tested were devided into the following groups. Namely cases of circumscribed labyrinthitis, 13 of Ménière's disease, 8 of headtrauma, 28 of congenital deafmute, 2 of sudden deafness, 3 of ototoxity due to streptomycin, 2 of labyrinthine syphilis, 3 of cervical vertigo, 1 of spinal ataxia, 5 of epilepsy, 5 of congenital nystagmus and 9 of cardiovascular disease.
    The accelerometer (120-ID) was placed on the head of the subiect wearing the helmet as the effective plane of the accelerometer was right angle with thefrontooccipatal axis of the head.
    Each subiect was tested by normal standing position, Mann's position and goniometer (Honjo).
    In the cases of unilateral labyrinthine lesion, like circumscrided labyrinthitis and or Ménière's disease.
    The acceleration registogram of the mann's position and goniometer test recording revealed clearly disturbed labyrinth in either side.
    In the cases of headtrauma, the curves of acceleration registogram showed different pattern from normal. There were three types in curves of acceleration registogram in the cases of deafmute, which were, 1) The same to normal subiects, 2) Moderate deviation and 3) Severe deviation.
    In the cases of cardiovascular diseases we were able to find no direction of deviation in the curves of acceleration registogram.
  • 栃木 照子
    1967 年 70 巻 11 号 p. 1894-1925
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    Statistical observations based on 752 tomographies of the living subjects including 327 infants and 425 adults were carried out with regard to their sphenoidal sinus development. The results were summarized in the following:
    In sagittal tomogram, regarding the appearance of the shenoidal sinus, the formation of the sinus was found in 8% of the age group of one year; in 90% of those between 3 to 8 years old group; and in 100% of those over 9 years. For those cases showing the definite appearance of the sphenoid sinus by the sagittal tomogram, the frontal tomogram was also taken. In 36% of 4 year-group proved to have the sphenoidal sinus, and in most of the cases over 5 years old, the sinus could be identified bilaterally.
    As to study the sphenoidal sinus development chronologically, the roentgenograms of the antero-posterior, vertical and lateral diameters, and also the space-area of the sphenoidal sinus were comparatively studied. The developmental stages of the sinus in the body of the sphenoid bone were also studied. As their increasement of ages, both antero-posterior and lateral diameters of the sinus were increased accordingly, whereas the gradual increase of the vertical diameter could only be seen during the period of childhood and no noticeable developmental increase could be seen be-yond that period. As to the space-area of the sinus, significant developmental increase was noticed between the ages of 3 and 29 years. Among those subjects the individualities were marked, however, the significance of those individual differences was found to be marked in the order of the space-area of the sinus; antero-posterior and lateral diameters; and the vertical diameters.
    Based on the statistical observations of each agegroups, the various modes of development of the sinus were defined. There upon the fundamental morphological classifications of the development status were attempted. Primarily concerning their shape and the direction of the development, the developmental stages were classified into 10 types (from A to J type) by the sagittal tomogram, and into 6 types (from a to f type) by the frontal tomogram. Thus the schemata were constructed with those two modes of the sinus development.
    Moreover, an observation was made as to the asymmetry of the shape of the sinus, the rate of occurrence of the asymmetry was observed in the order of the space-area of the sinus, lateral diameter, and vertial diameter.
    With regard to the positional deviation of the inter-sinus septum, the septum was rarely situated at the median position and was found to be in either on right or on left side of the midline in most of the cases.
    The positional relationships between the sphenoid sinus and posterior ethmoid cell and the correlationships between the sphenoidal sinus development and the other paranasal sinuses development were also investigated.
  • 坂本 毅
    1967 年 70 巻 11 号 p. 1926-1931
    発行日: 1967年
    公開日: 2008/03/19
    ジャーナル フリー
    Cholesterine granuloma obtained from the mastoid cavities of ten operated patients aged from 12 to 56 years was fixed by Millonig's 1% osmic solution, immediately after removal, embedded in Epon 812, stained by uranyl acetate solution and electron-microscopically observed in order to study the origin of cholesterine crystal which is recognized as cholesterine cleft within the granuloma.
    Results obtained were as follows:
    1. Small cholesterine clefts (possibly in early stage of development) were seen to be surrounded by numerous degenerated erythrocytes, D-Cell (see below) and phagocytes being in a close contact with each other (Fig. 6, 7).
    Several phagocytes in which phagosome, residual bodies and myelin figures indicated their active function, including the small cleft also (Fig. 6, 7).
    2. Foam cells contain various sized and forms of vacuoles and granules were often seen around the clefts. Some of the cells contained small cholesterine clefts or phagosomes in the cytoplasma. These cells were therefore, supposed to belong to phagocytes (Fig. 1, 2).
    3. Erythrocytes and degenerated cells were always found to be in a close contact with cholesterine cleft at its surface. The former degenerated frequently. The size of the latter was equal to that of the former. It had a cell membrane, but lacked nucleus. The cytoplasma consisted of diffusely scattered fine granules of low electron density.
    The feature of the cell suggested that the degenerated blood cell was its origin. Thus the cell was called D-cell by the author.
    4. Vascular lesions, such as stasis and thrombosis were frequently observed in the vicinity of the clefts (Fig. 4).
    5. These findings strongly suggested that the chole-sterine crystal derived from blood-element which had emigrated from disturbed blood vessels and could develop within extracellular spaces and that it could grow within phagocytes.
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