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87 巻, 11 号
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大山 和一郎1984 年 87 巻 11 号 p. 1483-1493
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリー昭和40年から56年の17年間に国立がんセンター頭頸科で加療した舌癌症例531例中外科療法を主体に行った扁平上皮癌新鮮例で,術前治療のないもの,または術前治療による影響を認めない40例を腫瘍の占居部位によって7群に分類し,その検討から以下の結論を得た.
1. 腫瘍の臨床的な進展部位と病理組織学的な進展部位はほぼ一致していた.術前の十分な触診は手術範囲の決定,予後推定に重要である.
2. 原発巣の切除について
1) 切除断端と腫瘍の距離が近い程,その部での再発の可能性が高い.
2) 術前腫瘍が口腔底に進展している例,あるいは接している例でも頸部皮膚直下での再発の可能性が高く,このような症例での底部の切除は顎舌骨筋は勿論のこと,舌骨上組織の全切除が必要で,舌骨の切除も考慮すべきである.
3) 腫瘍が前口蓋弓に進展している例では軟口蓋断端での再発の可能性が高く,このような症例では扁桃窩を含めて軟口蓋半側切除が必要と考えた.
4) 腫瘍が下顎骨に進展している例は別として,下顎骨切除の有無での局所再発率に差はなかった.下顎骨と腫瘍との距離が取れる場合には下顎骨は保存され得ると考える.
3. 頸部リンパ節転移について
1) 腫瘍の占居部位により分類した7群のいずれにも転移が認められた部位は,同側顎下部,上深顎部だった.次いで同側中深頸部に多かった.
2) 腫瘍が口腔底に進展した例では頸部リンパ節転移の出現は高率となり,転移の出現部位も対側下深顎部まで広範な領域に及んだ.
3) 初診時No症例に対する頸部郭清術は,今回の検討からは口腔底進展例等頸部リンパ節転移の出現頻度の高いもの,あるいは原発巣を外科療法で治療する場合には予防郭清術をその他のものでは原発巣の治療がRa針等であれば転移が出現してから郭清するという方針で良い.抄録全体を表示PDF形式でダウンロード (1136K) -
放射線誘発癌症例の分析市川 恭介1984 年 87 巻 11 号 p. 1494-1502
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーIn the decade spanning 1946 to 1955, 487 patients were irradiated for benign head and neck diseases. 292 of the 487 patients were followed and ten of 292 patients developed head and neck cancer in the irradiated areas. The incidence rate was estimated 3.4%. In the same period, 134 patients who had benign head and neck disease without irradiation therapy were observed. No head and neck cancer developed in these patients. Statistical analysis of these two patients groups was performed using the person-years method and the difference was statistically significant.抄録全体を表示PDF形式でダウンロード (584K) -
進 武幹, 松尾 浩一, 富田 まり子, 深浦 順一, 織田 正道1984 年 87 巻 11 号 p. 1503-1510
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーThe pectoralis major myocutaneous flap has been used for the reconstruction of defects incidental to resection of tumors in the oral cavity in five patients.
The thoracoacromial artery runs just lateral to the mid portion between the sternoclavicular joint and the acromion after originating from the axillary artery. Although arteriographic visualization of the entire muscle arborization is not possible, arteriography is required before surgery for identification of the major blood supply to the muscle.
The result of postoperative X-ray cinematographic analysis of the tongue movement is closer to normal as compared to that of simple removal. Likewise postoperative speech was also closer to normal compared with that of simple removal.抄録全体を表示PDF形式でダウンロード (1490K) -
大橋 淑宏, 中井 義明, 丸岡 健一, 池岡 博之, 井元 俊夫, 高野 啓江, 木原 匠子1984 年 87 巻 11 号 p. 1511-1518
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーThe main pathogenesis of nasal allergy lies in the immunological response of allergens and specific IgE antibodies. However, non-specific pathology of nasal mucous membrane induced by recurrence of type I allergy on the nasal mucous membrane might exert various influence on the nasal allergy.
Such being the case, in order to examine the pathophysiology of nasal allergy mucosa, the ciliary activity of the inferior turbinate mucosa of 35 patients with nasal allergy and 4 normal persons were investigated by the photo-electric method in the present work. From the present study, the following results were obtained.
1. The mean value of ciliary beating frequency on the inferior turbinate mucona in normal persons was 753±46.
2. In 32 of 35 cases with nasal allergy, ciliary activity of the nasal mucosa was observed, and the mean value of the ciliary beating frequency was 544±128.
3. From a multivariate analysis of the present data, the ciliary activity of nasal allergy mucosa had a close correlation with how long the patients have been suffered from nasal allergy and what type of nasal allergy they are.
It has been suggested from the present work that ciliary activity of patients with nasal allergy is declined and the reduced ciliary activity of nasal mucosa may complicate the pathology of nasal allergy. Therefore, the significance of possible consideration of the pathophysiology of nasal mucosa in the treatment of nasal allergy has been strongly suggested.抄録全体を表示PDF形式でダウンロード (501K) -
山際 幹和, 福生 治城, 西岡 博之, 坂倉 康夫, 三吉 康郎1984 年 87 巻 11 号 p. 1519-1526
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーIn order to examine the hypothesis that the sensation of a lump in the throat is mainly caused by local inflammatory changes and consequently elicits emotional or psychological disturbances, a statistical survey was conducted on 1000 of elder subjects than 60 years of age. The results obtained are as follows:
1. Of the 1000 subjects, 137 (13.7%) experienced the sensation of a lump in the throat in the past.
2. There was no significant correlation between the history of any specific disease and the experience of the sensation of lump in the throat, except that female subjects with respiratory tract diseases experienced the sensation with significantly (p<0.05) higher rate (31.3%) than those without the disease (16.5%).
3. According to the result of self-evaluation, 46.7% of the 137 subjects appreciated themselves as nervous. The rate was higher than that (38.7%) obtained from the subjects without the experience but the difference is statistically insignificant.
4. Among the 137 subjects, 38 (27.7%) had a history of habitual tonsillitits in their childhood and 69 (50.9%) reported to have recurrent pharyngoaryngitis. Both rates were significantly higher (p<0.005) than those obtained from the subjects with no experience of the sensation of a lump in the throat.
The results of the present survey seem to suggest that the sensation of the lump in the throat is caused by local inflammatory changes. As the sensation progresses, apprehension and subsequent cancerphobia may develop.抄録全体を表示PDF形式でダウンロード (615K) -
過去51年間の統計的観察鶴田 至宏, 佐野 光仁, 松永 亨, 松永 喬1984 年 87 巻 11 号 p. 1527-1537
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーStatistical study on the case of foreign bodies treated in the department of Otolaryngology, Osaka University, during the period from 1932 to 1982 was reported.
The results were as follows;
1. Total 4914 cases of foreign bodies treated in our clinic during last 51 years. The locations of the foreign bodies were as follows; 2760 cases in the esophagus (56% of all foreign bodies), 708 cases in the oral cavity and pharynx (15%), 498 cases in the gastrointestinal tracts (10%), 392 cases in the larynx, trachea and bronchus (8%), 290 cases in the nose (6%) and 260 cases in the ear. (5%).
2. The incidence of foreign bodies in the airway was not remarkably changed, and was about 10 cases annually. 55% of foreign bodies occurred in children under five years of age, half of them were beans in the airway. The right bronchus was obstructed more frequently than the other location. The removal of foreign bodies is recently performed under general anesthesia, since it is safe and sure.
3. The incidence of foreign bodies in the esophagus has changed as same as that of all foreign bodies. There were about 150 cases before the 2nd World War, and during the War they decreased to about 100 cases. Then they gradually decreased and now about 20 cases annually. In 37% of the foreign bodies were coins and more than half of their cases accurred in children under five years of age. Fish bones were main foreign bodies in adult, and pieces of meat were found frequently in the aged people. 45% of the foreign bodies in the esophagus were lodged at the 1st narrowing portion of the esophagus, and coin was mostly lodged there. The problems of P. T. P. package of medicine in the esophagus recently increasing in adults, were also discussed.
4. The foreign bodies in the ear and the nose were mostly toys and a part of toys frequently found in children under 9 years of age.抄録全体を表示PDF形式でダウンロード (739K) -
音圧•位相計測による計量診断法とその評価熊川 孝三1984 年 87 巻 11 号 p. 1538-1548
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーThe diagnosis of the ossicular condition, fixation or interruption, is often not achieved by the routine tympanometry. A new tympanometric system has been developed in order to improve the diagnostic value. This produces a sweep-frequency probe tone of 200 to 2000Hz and measures the sound pressure difference and the phase difference between the output and the input.
An experimental study was performed using eight fresh human temporal bones. Sound pressure curves and phase angle curves were figurized against the probe tone frequency in three conditions of the ossicular chain: normal, fixation glued by dental cement, and interruption made by mechanical separation. In addition, static compliance was also obtained by the conventional tympanometry. A multivariate analysis was performed to obtain the effective variables which would be a good indicator for the change in transmission characteristics of the ossicular chain. The results showed static compliance was less valuable than other variables of the sound pressure curve and the phase angle curve. Among these variables, four were selected as the most valuable ones from the result of a discriminant analysis.
These four variables were clinically applied to differentiate three groups of the ossicular pathology: staps fixation, malleus or incus fixation and incudostapedial disconnection. The internal and external check using the discriminant function were performed in forty ears, in which ossicular lesions were surgically confirmed. This resulted in a high ratio of differentiation. Thus, this system can be of great value in the diagnosis of ossicular abnormalities.抄録全体を表示PDF形式でダウンロード (1235K) -
細村 弓子1984 年 87 巻 11 号 p. 1549-1555
発行日: 1984/11/20
公開日: 2008/03/19
ジャーナル フリーAmong patients suffering from taste disorders, there are cases of abnormalities of the "umami" taste. To investigate this abnormality, panoral clinical examination was conducted and it results studied as follows:
1) Eighty six medical and nursing students were employed as the control group. Four hundred and three outpatients suffering from taste disorders were employed as the experimental group, "Haimi" seasoning was used for the taste examination.
2) Recognized levels of Haimi seasoning taste were recorded for the control and experimental groups. There was only a slight difference in concentration between the middle values for both groups. Minimal differences were obtained through the panoral method.
3) Four basic filter-paper discs were used for the determination of recognized levels of taste disorders. Recognized level of "umami" taste for 42 patients who recovered from taste disorders were examined. There was improvement seen in recognized levels for the filterpaper disc method and umami taste. However no relation was observed between the two.
4) It may be strongly suggested to consider the "umami" taste as an individual taste, different from the four basic tastes, in further examination of such taste disorders.抄録全体を表示PDF形式でダウンロード (446K)
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