日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
88 巻, 12 号
選択された号の論文の9件中1~9を表示しています
  • 西岡 出雄, 柳原 尚明, 丘村 煕, 佐藤 英光
    1985 年 88 巻 12 号 p. 1647-1651
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    According to the diagnostic criteria of mumps deafness presented by the research team on acute profound sensory neural hearing loss sponsored by the Ministry of Welfare, Japan, we investigated two subjects on mumps deafness; 1) the incidence of the mumps deafness in 1982, in which there was a big epidemic of mumps in Ehime Prefecture, Japan, and 2) clinical features of the mumps deafness based on the analysis of the 40 patients with sudden hearing
    loss associated with mumps. The incidence of the deafness caused by mumps viral infection was found to be 1 per 18000 patients with mumps (0.0056%). Among the 40 patients whom we experienced for the past seven years, 12 were confirmed and 28 were suspicious to be suffered from mumps deafness according to the diagnostic criteria.
    Unilateral total hearing loss of sudden onset was characteristic. The complication occurred within 25 days at the latest after the initial swelling of the parotid gland. Although hearing loss and tinnitus were irreversible, decreased caloric response normalized in a year.
  • FACSによる解析
    武田 哲男, 古内 一郎, 馬場 廣太郎, 日野 原正, 平林 秀樹, 越井 健二
    1985 年 88 巻 12 号 p. 1652-1658
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    Peripheral blood lymphocytes (PBL) on T lymphocyte subsets and NK cells in 46 patients with head and neck malignant tumors were examined. These PBL were determined in Fluores-cence Activated Cell Sorter (FACS) using fluorescein-conjugated monoclonal antibodies (anti-Leu 2a, anti-Leu 3a, anti-Leu 11a). Granulocytes, which are also known to be Leu 11a positive, were preeliminated by 90-size scattering procedure.
    The results obtained. were as follow:
    1. Leu 3a/Leu 2a ratio in patients with head and neck malignant tumor wass significantly reduced compared with healthy controls. (p<0.005)
    2. Patient in the stage differences(UICC), Leu 3a/Leu 2a ratio in stage III, IV groups was also reduced compared with stage I, II groups, (P<0.05)
    3. Leu 3a/Leu 2a ratio in chemotheraphy patients was also reduced compared with radiation theraphy patients. (p<0.05) The ratio of about 50% chemotheraphy patients were lower than one.
    4. Leu 11a positive cells in patients was markedly increased than healthy controls. (p<0.005)
  • 斎藤 裕夫, 小野 勇, 海老 原敏, 吉積 隆
    1985 年 88 巻 12 号 p. 1659-1665
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    During the period through 1962 to 1977, 55 previously untreated cases of squamous cell carcinoma of the floor of the mouth were seen at the National Cancer Center Hospital, Tokyo. Of these 55 cases, 52(95%) were male. Eight patients were treated only by external irradia-tion and 17 by a combination of external and interstitial irradiation. Five-year survival rates of those 2 groups were 25% and 53% respectively. The only two five-year survivors of the farmer group were surgically salvaged after the initial therapy. On the other hand, 32 patients were surgically treated and 21 of them were treated also by irradiation therapy. Five-year survival rate of this group was 73%. The prognosis of surgically treated group seemed better than that of irradiated groups, but the differences was not statistically significant. Along with poor prognosis, the irradiated cased frequently developed radiation injuries for a long period after the the treatment. For this reason, surgical resection has become the treatment of choice for squamous cell carcinoma of the floor of the mouth in our clinic. The functional deficits and deformities after the resection were problematic, but improved by recent advances of reconstruc-tive technique.
  • 宮嶋 佳世子, 石田 正人, 野末 道彦
    1985 年 88 巻 12 号 p. 1666-1672
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    Auditory brain stem responses were recorded in 114 ears of 63 high risk infants in NICU. The responses were evoked by 4kHz logon in 90dB.
    The mean values and standard deviations of wave 1 latencies were calculated in every con-ceptional age. The mean values of the latencies and the conceptional age showed a linear relationship, which was roughly indicated by the following formula; "the latency of 1 wave"="conceptional age" X (-0.07)+4.13.
    Delay of wave 1 peak were found in the cases of acute otitis media and Treacher Collins syndrome.
    Absence of wave 1 peak were found in the cases of congenital rubella syndrome and kernicterus.
    The measurement wave 1 latency, which was elicited by intense tone such as used in the present study, seemed to be useful to distinguish cochlear deafness from conductive deafness.
  • 治療成績および予後について
    井上 健造, 藤谷 哲造, 高原 哲夫, 納 一功, 服部 浩, 溝尻 源太郎
    1985 年 88 巻 12 号 p. 1673-1677
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    Eighty-four previously untreated patients with carcinoma of the floor of mouth were studied retrospectively. Patients with small lesions involving no regional lymphnodes were treated by radiation alone, while those with small lesions involving regional lymplinodes and those with large lesions were treated by radiation and/or surgery.
    In stage I, II patients treated by radiation alone, five-year survival rate was 100%, 80%, respectively. The five-year survival rate for stage III was 46% and 16.5% for stage IV. In stage III, IV patients, five year survival rate was 26.7% treated by radiation alone, 32, 7% by surgery alone, 44.7% by combined therapy.
    In early stage (Stage I, II), the tumor was successfully controlled by radiation alone. How-ever, in advanced stage, especially in stage IV, it was difficult to control the initial tumor. The additional therapy such as chemotherapy or immunotherapy might be required for these cases.
  • アドレナリン収縮試験を中心に
    石塚 洋一, 前田 秀彦
    1985 年 88 巻 12 号 p. 1678-1683
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    In 33 patients who visited us with a complaint of nasal obstruction, rhinomanometry was performed before and after reconstructive operation septoplasty and conchotomy of the nose. In particular, rhinomanometry was conducted before and after application of adrenaline to the nasal cavity (adrenaline contraction test). The respiratory sesistance through both nostrils was 6.7±2.7cmH2O/L/sec, before operation, 4.1±0.8cmH2O/L/sec after application of adrenaline, and 3.8±0.9cmH2O/L/sec after operation. The corresponding figures for the respiratory resis-tance through the right nostril were 11.6±5.7, 6.5±3.4 and 6.0±2.2, respectively.Similary, the corresponding figures for the respiratory resistance through the left nostril were 9.9±5.2, 6.6±2.0 and 6.4±2.5cmH2O/L/sec, respectively. At all of these determinations, the values obtained after application of adrenaline were the same as those after operation, corresponding to the results obtained in normal subjects. From these results, it was shown that preoperative adrenaline contraction test can be applied for determination of indication of reconstructive opera-tion of the nose and assessment of improvement rate of nasal obstruction after the operation.
  • 長谷川 賢一, 岡本 途也
    1985 年 88 巻 12 号 p. 1684-1693
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    The auditory function of patients with hemispheric damage due to cerebrovascular accident was evaluated by measuring auditory reaction times.

    The tests were performed on simple reaction, discrimination reaction, binaural discrimination reaction, and tapping.
    The results of the tests were considered assuming that the tests are able to evaluate the processes of recognition, discrimination, binaural discrimination, and performance reaction to
    stimulated sounds.
    Results are. as follows; 1) Tapping time of younger snbjects was significantly faster than that of older onees. The trapping time of hemiplegic groups had no difference between right and left hands and it was the same as that of normal aged group.
    2) Although simple reaction time of normal group did not show prolonged time among different aged groups, discrimination time was prolonged.
    3) There was a significant laterality between tight and left ears in hoth simple and discrimina-tion reaction times of hemiplegic groups and the prolonged time was remarkable in affected side.
    4) Prolonged time of simple reaction of hemiplegic groups was recognized in the ears of both affected and sound sides, compared with that of normal aged group. Prolonged time of dis-crimination reaction was recognized only in the ear of affected side and almost the same reaction time in the car of sound side was recognized in the normal aged group.
    5) Binaural discrimination time of normal group was prolonged with the age increased. Right hemiplegic groups had almost the same reaction time as the normal group. On the other hand, left hemiplegic group had a remarkable prolonged time,
    6) There was a tendency that hemiplegic groups had more errors in binaural discrimination reaction test when they heard the stimulation which should be selected to the ears of sound side.
    As indicated above, the auditory function of hemiplegic groups tend to listen to sounds dominantly with the ears of sound side and it is possible to infer "lowering of hearing" recognized in hemispheric damage by prolongation of reaction time, lateralitv, and errors of discrimination.
  • 分析アルゴリズム
    中村 正
    1985 年 88 巻 12 号 p. 1694-1704
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    A computer program was developed for on-line analysis of nystagmus parameters using a microcomputer (SORD M243EX). This computer has a Z80A microprocessor with a 320-kbyte random access memory, and includes two floppy disks with 2 megabytes of volume capable of storing application programs and analyzed data, as well as a graphic display and intelligent printer capable of displaying the results of analyzed data.
    In this system the programs consisted of two subprograms, "ADCON", designed for analog-digital conversion and "NYSANA" for analysis of nystagmus. These subprograms were written in both BASIC and assembler language. When "ADCON" was run, the analog data of the eye positions obtained from electronystagmography were digitized at a rate of 100 samples/sec through the multi-channel of a 12-bit analog-digital converter, Digitized data were simultaneously monitored on the graphic display and stored in the main memory of the computer. Based on digitized data, quantitative analysis of each nystagmus parameter was achieved. The initial step in this algorithm was identification of the beginning and end points of the fast and slow phases of nystagmus. The velocity, amplitude and duration of the fast and slow phases of nystagmus were subsequently established.
    Thereafter, to distinguish differences between nystagmus and artifacts, such as eye blinks, three conditions were established as follows.
    1) The direction of induced fast phase of nystagmus must coincide with what is expected.
    2) The value of nystagmus parameter had to be within critical values which were based on the parameters of optokinetic nystagmus of 5 normal subjects and 5 patients with central nereous system disorders.
    3) The slopes of the fast and slow phases of nystagmus had to be regular enough to compute. Under these conditions, 98%, of nystagmus were identified precisely by the computer, and the reliability of this algorithm proved highly significant. From these results, the computer system in the present experiment was judged to be practical in routine clinical tests.
  • 臨床的応用
    中村 正
    1985 年 88 巻 12 号 p. 1705-1713
    発行日: 1985/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    This paper containg the results of a quantitative analysis of optokinetic nystagmus (OKN), using a microcomputer, in 20 normal subjects and 49 patients who had discrete lesions in the thalamus, midbrain, pons, medulla oblongata, cerebellum and cerebellopontine angle (CPA). It was observed that the slow-phase OKN velocity in normal subjects increased in proportion to the stimulus velocity applied. Therefore, in order to evaluate the relationship between slow-phase OKN velocity and stimulus velocity, the gain (slow-phase OKN velocity/stimulus velocity) was measured for each 5 deg/sec of stimulus velocity. As a result, the gain was found to be greater than 0.8 at stimulus velocities of less than 60 deg/sec, whereas it decreased markedly at stimulus velocities greater than 60 deg/sec. Consequently, the maximum stimulus velocity during which time the gain was more than 0.8, was called the optokinetic adaptation limit (OAL), and used as an index for evaluation of OKN.
    All patients in the present study showed a remarkable decrease in OAL. The differences in OAL among these patients at each level of lesion site, however, proved to be statistically insignificant. Thereafter, the relationship between the direction of OKN limitation and the lesion side was investigated. In comparison with each value of OAL during clockwise and counter-clockwise optokinetic stimulation, the direction of OKN limitation was demonstrated in only 26 out of 49 patients. Therefore, another index, i. e., the sum of the gain for every 5 deg/sec stimulus velocity was calculated for both clock- and counter-clockwise OKN velocity. Using both OAL and the sum of the gain as measures, an asymmetry between right- and leftward OKN velocity was shown in all but 3 patients. In all patients who had lesions on the thalamus, midbrain and cerebellum, OKN limitation was observed toward the lesion side. OKN limitation, however, was seen toward the intact site in 7 of 11 patients with edullary lesions and in 2 of 11 patients with CPA tumors. In particular, 3 patients with lesions in the tegmentum of the pontine base showed OKN limitation toward the lesion side, whereas 2 patients with lesions in the dorsal tegmentum of the ponss howed OKN limitation toward the intact side. Hence, the following conclusions can be drawn 1)OKN is a useful diagnostic tool for the assessment of infratentrial lesions. 2) OKN tract may decussate at the level of pons. 3) Computer analysis of OKN may clinically useful.
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