日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
78 巻, 2 号
選択された号の論文の7件中1~7を表示しています
  • 竹森 節子
    1975 年 78 巻 2 号 p. 93-101
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
    Vestibulo-oculomotor functions were studied before and after the flocculus in rhesus monkeys was extirpated under the operating microscope by a sub-occipital approach in 28 cases. Eye movements and eye speed were recorded by needle electrodes on electronystagmography. In 10 cases, the flocculus were stereotaxically extirpated. In all cases, neither spontaneous nor positional nystagmus were markedly provoked. Optokinetic nystagmus (OKN) was not makedly changed in the cases with unilateral lesion. The slow phase velocity of OKN increased up to 50'/sec even in the cases with bilateral lesion. Caloric response in the cases with unilateral lesion initially showed mild DP to the ipsilateral side. The duration and the maximum slow phase velocity of caloric nystagmus were within normal limits in the cases with bilateral lesion. Visual suppression of nystagmus at maximum amplitude was studied in the animals which were exposed to light for 10 sec in darkness during the maximum caloric test. Visual suppression of nystagmus in normal animals was about 50 %. Visual suppression of nystagmus to the ipsilateral side was reduced or lost in the cases with unilateral lesions and visual suppression to both sides were reduced or lost in the cases with bilateral lesions. The flocculus appeared to be essential for maintaining the visual suppression of vestibular nystagmus.
  • 平野 実
    1975 年 78 巻 2 号 p. 102-107
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to obtain a good phonatory function after glottic reconstruction following vertical partial laryngectomy, the following basic principles should be taken into consideration.
    1. An adequate glottic closure should occur during phonation.
    2. The top of the bulge constructed on the affected side should be located at the level of the vocal cord during phonation in order to prevent false cord vibration.
    3. The surface of the bulge should be smooth.
    A New surgical technique has been developed so as to meet the conditions described above. The present paper describes the details of the technique.
    The stemohyoid muscle on the affected side is dissected 5 cm below the middle level of the thyroid cartilage. The upper part of the muscle is elevated together with the overlying fascia carefully so that the vessels and the nerve branches are preserved as much as possible. Thus a single pedicle muscle flap is constructed. The thyrohyoid muscle is detached at its origin on the thyroid cartilage and is elevated. After removal of the cancerous lesion (usually by the extended frontolateral laryngectomy or its modifications), the muscle flap is bent 90 degrees at the level of the superior margin of the cricoid cartilage and placed on the wound. The tip of the muscle flap is sutured to the posterior wall of the larynx, and the bend is sutured to the sternothyroid and the cricothyroid muscles to assure the appropriate location. The top of the muscular bulge should be located at a level slightly lower than the vocal cord on the non-affected side, because the level of the vocal cord during phonation is slightly lower than that during respiration. The wound in the larynx is then covered with a pedicle mucosal flap taken from the hypopharynx or a free mucosal graft from the lower lip.
    The voice after the surgery usually sounds excellent. In some cases it sounds almost normal. The details of the phonatory function will be reported elsewhere.
  • 久松 建一
    1975 年 78 巻 2 号 p. 108-126
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
    Studies on histamine release from target cells of reaginic antibodies were markedly advanced by discoveries of IgE and cyclic AMP, while histamine metabolism in allergic patients was little known. The inactivation of histamine released from mast cells, basophils and platelets is very important in allergic patients with histamine hypersensitivity. Bernauer and coworkers (1964) discovered that heparin liberate histaminase in guinea pig. It is suggested that histaminase might be liberated by heparin from target cells on allergic reaction.
    In present study histamine contents of nasal washings, nasal mucous membranes and plasma from allergic and non-allergic subjects were measured using fluorometric assay. Plasma histamine level was elevated in allergic patients and more rised (56.6%±23.3 SD) within 5 minutes after nasal provocation by allergen. The histamine content of nasal washings was less in allergic (0.069 μg/total volume±0.032 SD) than non-allergic subjects (0.673μg/total volume±0.470 SD).
    The histamine content of nasal washings increased after nasal provocation by allergen and the same result was obtained by acetylcholine in allergic and vidian neurectomized patients. No increase in histamine contents was noted in nasal washings and plasma from healthy subjects following nasal provocation.
    The histamine contents of nasal mucous membranes were less in most allergic (0.218μg/mg protein ±0.135 SD) than non-allergic (0.397μg/mg protein ±0.176 SD), but high histamine contents were observed in some allergic patients.
    Histaminase (diamine oxidase) activity in nasal mucous membrane and plasma histaminase activity (PHNA) were determined by o-dianisidine-peroxidase method, which was rapid, sensitive and simple as described by Aarsen & Kemp in 1964. The histaminase activity in nasal mucous membrane was increased in allergic patients (0.031mμM/mg protein/min±0.022SD).
    PHNA was increased in 113 allergic and 20 asthmatic patients (2.49mμM/ml/min±1.17SD) and reduced to normal level (1.50mμM/ml/min ± 0.07 SD) by hyposensitisation or Histaglobin injections.
    PHNA was increased after nasal provocation by allergen. The level of PHNA and scores of nasal symptom such as sneezing and watery rhinorrhea were correlated (p<0.01).
    These results suggested that the histamine metabolism was enhanced in allergic patients.
  • 中島 恒彦, 山太 哲生
    1975 年 78 巻 2 号 p. 127-132
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
    The negative DC resting potential inside the organ of Corti of the guinea pig with normal hearing and the kanamycin-poisoned guinea pig was measured. The level of the potential was about -80 mV both in normal and kanamycin-poisoned guinea pig.
    In the normal guinea pig, the potential decreased gradually when the tip of electrode was attached to the fixed point of the organ of Corti for several minutes, and the potential of similar level was derived again when electrode was pushed slightly deeper. This indicates that the electrode records the intracellular potential, and then damages the cell so that its negativity is decreased. When the electrode is pushed slightly deeper, the electrode enters another cell and records the potential again.
    In the kanamycin-poisoned guinea pig, the potential decreased gradually when the tip of electrode was attached to the fixed point of the organ of Corti for several minutes, but the potential was not recorded again although electrode was pushed deeper. The histological examination of the cochlea of the kanamycin-poisoned guinea pig after this experiment revealed that the electrode penetrated the extracellular space in the organ of Corti where no cellular elements were recognized due to the degeneration of the outer hair cells.
    It is generally accepted that, in normal condition, the negativity inside the organ of Corti is intracellular in origin, and the hypothesis that this negativity is recorded from the fluid surrounding the hair cells seems to be denied by many investigators. However, the possibility that this fluid of the kanamycin-poisoned guiaea pig is negatively polarized because of the electrical leakage from the degenerated outer hair cells and thus the dendrites of the 8th nerve which pass through the fluid are depolarized could be considered from the observations of this experiment. This will explain the origin of the deafness induced by kanamycin-poisoning.
  • 定量的解析と経時的所見について
    高橋 正紘
    1975 年 78 巻 2 号 p. 133-153
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
    The author has studied the characteristics of induced nystagmus in damped pendular rotation test (DPRT) in peripheral vestibular lesions. This test, applied in clinical use by Greiner and Conraux, has been used as one of the routine vestibular examinations in the department of oto-laryngology of Keio University School of Medicine since 1971. During the test procedure, the velocity and acceleration of the chair decrese gradually until the chair stops, eliciting nystagmus in either direction. The diagnostic significance of nystagmus rhythm in this test has been studied in the author's clinic and it has been proved that valuable information could be obtained from this test in the diagnosis of brainstem lesions (Kanzaki, Sakagami, Takahashi 1973) as Greiner had already suggested from their clinical experiences.
    In this report, the author studied the characteristics of nystagmus response in DPRT and the compensation processes in 102 peripheral vestibular lesion.
    The results were as follows:
    1) The number of nystagmus in DPRT was linearly related to the logarithm of the maximum accerelation of the chair. 2) This relationship was well demonstrated in the vestbhulogram, in which the threshold of the induced nystagmus and its deviation in threshold level were quantitatively tabulated. 3) In irreversible peripheral vestibular lesions, the difference in the number of nystagmus in each direction, that is, the slope of the vestibulogram, became smaller as the time elapsed (compensation). In reversible disorders, especially in some type of Meniere's disease and Lermoyez's syndrome, recruitmentlike finding were noted in which the differences in induced nytagmus in each direction were greater in weaker stimulations than in stronger stimulations.4) Common mechanism among nystagmus elicited by DPRT, the one elicited by caloric test, and spontaneous nystagmus in peripheral vestibular lesions was speculated from the relationship between frequency of nystagmus and maximum slow phase velocity.
  • 今野 昭義, 戸川 清, 東 紘一郎, 打越 進, 小杉 忠
    1975 年 78 巻 2 号 p. 154-173
    発行日: 1975/01/20
    公開日: 2008/07/31
    ジャーナル フリー
    Several surgical techniques to reconstruct the oral cavity after extirpation of the malignant tumor of the mandible and the oral floor were evaluated as to their indication in individual cases.
    The reconstruction was performed with forehead flap, D-Pflap and D-P flap combined with cervical flap.
    The reconstruction with forehead flap was the best procedures especially in dderlyI male patients, in whom the reconstruction could be complyed by two stages wlthshortest hospital stay without fixation of the neck.But this was not suitable forthefemale or young patients due to the scar formation on the forehead.
    D-P flap could be used in the following three ways.
    1.The defect of the oral floor and the cheek is covered by theflap directly.The pedicle of the flap comes out in the submental area leaving small fistula antero-medial to the pedicle with the submandibular skin incision closed primarily.
    The procedure is completed in two stages with satisfactory cosmetic results but this is safely used only in cases with apparently good blood flow of the flap.
    2. Skin incision is made in the upper neck to make hinged cervical flap.
    After hemimandibulectomy with dissection of the oral floor and the infratemporal fossa, the cheek and the infratemporal fossa are covered by the turned-in hinged cervical flap.
    Secondary defect of the upper neck and the medial portion of the oral floor is covered by the D-P flap, leaving large fistula in the submandibular area to be closed secondarily.
    This procedure can be safely combined with radical neck dissection and is suited to the male patients.
    3.Skin incision is made along the submandibular natural skin crease and the D-P flap is transfered to cover the defect of the cheek and the infratemporal fossa primarily, where scar contracture causes the most apparent facial distortion.
    Medial portion of the oraldefect is covered by direct approximation of the tongue and the cervical skin edge with additional skin graft, which leaves large submandibular fistulae.
    The tongue is released and the oral floor is reconstructed with pedicle of the flap secondarily. This is suited to the young female, especially in cases with large defect of the cheek but can not be combined safely with primary radical neck dissection.
    In either methods, to prevent shifting of the remaining mandible after hemimandibulectomy, wearing of some kinds of sprint or Kirchner wire fixation are necessary for some postoperative period.
  • 石井 哲夫
    1975 年 78 巻 2 号 p. 197-200
    発行日: 1975/01/20
    公開日: 2008/03/19
    ジャーナル フリー
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