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88 巻, 3 号
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外来統計と当科受診の背景市野 幸則, 石川 哮1985 年 88 巻 3 号 p. 253-260
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーWe analysed 2, 521 outpatients who had visited our clinic in Kumamoto University Hospital between January 1 and December 31, 1983. The number of patients with swelling of the neck was 173 (6.9%). In the 30- to 49-year-old group, females were more numerous than males, while males exceeded females between 50 and 69 years old. Benign diseases accounted for 94 cases (54.3%) and malignant diseases 61 cases (35.2%). Malignant diseases increased in patients over 40 years old, and exceeded the number of benign diseases in those over 50 years old. Patients with metastatic cervical tumors comprises the largest group (39 cases, 22.5%), followed by those with thyroid tumors (33 cases, 19.1 %), parotitis (23 cases, 13.3%) and parotid tumors (15 cases, 8.7%). Among metastatic cervical tumors, there were 13 cases of oral cancer and 10 of mesopharyngeal cancer. Metastatic cervical tumors were frequently found in the lateral neck. The eighty-eight percent of the patients (152 out of 173 cases) with neck swelling were referred to our clinic by other institutes or departments. Fifty-nine patients (34.1%) visited our clinic within 1 month and over half the number visited within 3 months after noticing the first symptom. Patients with benign diseases were mainly referred by oto-laryngologists, internists, and radiologist, while those with malignant diseases were mainly referred by otolaryngologists, surgeons, and dentists. Patients with metastatic cervical tumor were frequently referred by otolaryngologists and dentists, while those with thyroid tumors were referred more frequently by surgeons than by otolaryngologist.抄録全体を表示PDF形式でダウンロード (514K) -
染川 幸裕, 小林 一豊, 山口 龍二, 下田 和夫, 鈴木 敏夫, 形浦 昭克1985 年 88 巻 3 号 p. 261-266
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリー4-year retrospective study was performed in 152 children (279 ears) with secretory otitis media (SOM) in order to evaluate the long-term result with grommets. In 158 ears which were well controlled by grommets, the mean duration of treatment was 13.8 months. The tube four times or more in 10 (6%). Otoscopic changes of the eardrum were observed in 23% of the ears during the treatment. On the other hand, 11 of 30 abnormal eardrums which showed
tympanosclerosis, atrophy, or atelectasis at the first visit, were improved after the treatment with grommets. The incidence of abnormal eardrum were markedly increased in cases which were treated with more than two times insertion of grommets and also in cases treated in long period, i, e., more than ten months. Conductive hearing loss (10-20dB) was observed in 5 ears with grommets which were complicated with atelectasis and diffuse atrophy. From the result discribed above, the tube might successfully improve many SOM. However, considering those long-term results, much attention must be paid for the indication of grommets.抄録全体を表示PDF形式でダウンロード (433K) -
起立台上下移動装置による観察高橋 正紘, 緑川 周子, 辻田 直美, 星川 治子1985 年 88 巻 3 号 p. 267-272
発行日: 1985/03/20
公開日: 2008/12/15
ジャーナル フリーTo reproduce vertical body oscillations during walking and running, we constructed a vertical oscillating motor-driven platform with a wide range of amplitude (1-10cm) and fre-quency (0-5Hz). In this study, head movements and eye movements during vertical body oscillations (1-10cm, 1-3Hz) were investigated in normal adults with the subject visually focussing on a target on the wall. The following results were obtained.
1) The amplitude of the pitching motion of the head, which was in proportion to the vertical head displacement, increased at a geometric rate with the increase in the frequency of plat-form oscillation. The result indicates that walking is an excellent locomotion for maintain-ing spatial stabilization of the head, and that this is sacrificed to attaining a high speed of locomotion during running.
2) The amplitude of vertical eye movement exceeded the head rotation amplitude when the latter was less than 4°, however, it came to resemble the latter when the amplitude ex-ceeded 4°. Therefore, vertical eye movements may be produced as the compensation to the pitching motion of the head, although they are predominantly affected by visual fixation at low frequencies.抄録全体を表示PDF形式でダウンロード (1092K) -
その臨床的観察桜井 時雄, 小林 俊光, 武山 実, 鈴木 守, 馬場 重仁1985 年 88 巻 3 号 p. 273-278
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーEustachian tubal function in patients with otitis media with effusion (OME) was qualitatively evaluated. Following observation of middle ear pressure, draining function of the Eustachian tube was tested by introduction of specially prepared dye into the middle ear and subsequent inspection of the nasopharyngeal opening of the tube for dye during application of swallowing.
Obtained were followings:1. In cases of children, Eustachian tube may be reversibly functioned by equalizing the negative middle ear pressure to the ambient pressure. Draining function was considerably improved
in 82.9% of cases. On the contrary, equalization of pressure difference may not provide the improvement of the Eustachian tubal function in cases of adults. Improvement in draining function was achieved only in two cases out of 34. These suggest that tubal dys-function is usually constituted by temporary functional disturbance of tubal opening and closing mechanism caused by persistent middle ear negative pressure in children, whereas Eustachian tube muscles are mainly involved in adults.
2. Application of swallowing induced two different types of pressure change in the middle ear;
(1) the positive pressure change followed by negative change (observed in 25% of cases), (2) just the negative pressure change (75%). Negative pressure dominant change may be considered to mainly contribute to the development of OME抄録全体を表示PDF形式でダウンロード (518K) -
高戸 毅, 小野 勇, 海老 原敏, 斉藤 裕夫, 波利井 清紀1985 年 88 巻 3 号 p. 279-289
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーBetween October 1962 and February 1983, we had achieved 237 hemiglossectomy, subtotal glossectomy and total glossectomy for patients with head and neck cancers in National Cancer In the 1970's, deltopectoral and forehead flap had been used for reconstruction of the defect of tongue. These flaps frequently required surgery in stages and delay and fixation for long periods. Furthermore, conspicuous scars remained on donor sites. The recent progress in myocutaneous and free flaps has made it possible to close primarily the defects resulting from ablative operation of head and neck cancers. The pectoralis major, latissimus dorsi, forearm and other flaps have been available for reconstruction of the defects of tongue. On each method, complications (orocutane ous fistulae, flap necrosis etc.), speech, function of deglutition are re-viewed and advantages and drawbacks are discussed. And several representative cases are presented.抄録全体を表示PDF形式でダウンロード (3533K) -
14年間にわたり再発を繰り返した1例保喜 克文, 三部 重雄, 朝倉 光司, 形浦 昭克1985 年 88 巻 3 号 p. 290-294
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーMalignant melanoma of the nasal cavity is relatively rare, and has poor prognosis. Accord-ing to Gallagher, its mean survival years is 2.6 years. But, the cases with relatively long survival years were also reported. In the present report, a case of malignant melanoma is reported with three recurrences in fourteen years. Cryosurgery to the small local recurrence was performed with effect. Treatment policy for malignant melanoma is not established as yet,
but cryosurgery proved itself to be effective to limited local recurrence.抄録全体を表示PDF形式でダウンロード (1031K) -
湊川 徹, 雲井 健雄, 入谷 寛, 吉村 史郎, 森 裕司, 涌谷 治夫, 兵 典子, 藤木 宏也, 梅谷 芳雄, 稲守 徹, 谷口 郷美 ...1985 年 88 巻 3 号 p. 295-303
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーA study of tympanoplasties using allograft tympanic membrane with or without ossicles for 33 patients with conductive deafness during the period of 1980. 10 through 1984. 8 is presented with respect to primary take rate, type of allograft used and postoperative hearing changes. Out of 33 cases, 5 fell into necrosis and 6 perforation, allograft take rate being 84% (completely 67%). But those 5 cases of necrosis are included among initial 17 cases and no more necrosis occurred among another 16 cases, in which combination use of temporal fascia or pedicled epi-thelial flap were used. For 29 cases tympanoplasty using allograft ear drum attached with or without ossicles have been done and for another 4 cases only transplantation of ear drum attached with malleus have been done as first step of staged operation. Type of allograft trans-plantations grouped into 3 according to the number of ossicles attached to the tympanic membrane;
Group A: Tympanic membrane only. Group B: Tympanic membrane attached with malleus. Group C: Tympanic membrane attached with malleus and incus.
In group A (4 cases), small ossicles or PORP were placed between allograft drum and recipients stapes.
In group B of 17 cases, various management for ossicular continuity were made. i. e. con-nection between allograft malleus and (i) stapes footplate of a recipients with tragal cartilage (2 cases). (ii) head of the stapes with notched incus (9 cases). In one case allograft drum necrotized and two cases provided successful results in rest of 6. (iii) recipient's retracted malleus in 3 cases, two of which resulted in necrosis. (iv) recipient's deformed incus or stapes (2 cases). Both cases were congenital aural atresi and provided good hearing gain of 27dB and 42dB respectively.
In group C (8 cases), 2 cases necrotized and one perforated. Final results provided 6 successful hearing results.抄録全体を表示PDF形式でダウンロード (634K) -
藤田 寛1985 年 88 巻 3 号 p. 304-318
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーBy compressing the extratemporal facial nerve of guinea pigs, the author succeeded in pro-ducing the reversible palsy of the facial nerve.
The process and recovery of the palsy were assessed by evoked electromyogram of the orbicularis oculi muscle, and by blink reflex elicited by air puff. Nerve specimens obtained from the compressed site were examined under light microscope. In this experiment, the com-pression force was 1.6 kgW and the width of compressed area was 1.0mm. The duration of compression varied from one to 30 seconds.
In the first experiment, the author produced the palsy of a relatively short duration. The palsy was not induced by the compression of less than 5 seconds. After the compression from 5 to 15 seconds conductivity of the nerve remained for 24 hours, and then it was lost in 27 guinea pigs among 30. Three different types of the electromyographic response were observed
during 24 hours after the compression. However, no significant histological difference in the findings of myelin was found among these three types. The compression for 5 seconds resulted in the palsy for average 16 days in 15 guinea pigs without exception.
In the second experiment, the therapeutic effect of steroid hormone was investigated using 20 guinea pigs in which the nerve was compressed for 5 seconds. In 10 guinea pigs, methyl-
prednisolone acetate was injected 20mg/kg intramuscularly immediately after the compression and once every week. In 10 control guinea pigs, the same amount of physiological saline was injected in the same manner. In the steroid group, the blink reflex was restored significantly earlier than in control. The evoked electromyographic response in the steroid group appeared about one week earlier than in control. Histologically, the remyelinative process progressed earlier in the steroid group than in control.
Based on both experimental studies, it can be concluded that the compression for 5 seconds
is thought to be appropriate to investigate the therapeutic effect of different modality of treat-ment. Injection of steroid hormone accelerates repair of mechanical injury of the nerve.抄録全体を表示PDF形式でダウンロード (4062K) -
斎藤 武久1985 年 88 巻 3 号 p. 319-329
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーSome clinical datum concerning the relationship between hyperlipoproteinemia and sensori-neural hearing loss have been reported. However, definite histopathological evidence causing hearing loss has not yet been clarified.
Using 80 guinea pigs administrated hyperlipid diet (cholesterol 2.5%, bile acid 0.25%, cattle fat 7.5%) for 3 months, auditory dysfunction and histopathological changes in the coch-leae were studied. The results obtained were as follows:1. Biochemical findings of the sera showed hyperlipoproteinemia and liver dysfunction (fatty liver). Diabetes and renal dysfunction were not observed. Phenotype of hyperlipoproteinemia was Type IIa or Type IIb in all the animals examined. This hyperlipoproteinemic condition returned to a normal level after 3 months of breeding with a normal standard diet.
2. Auditory dysfunction, the threthold change of auditory brainstem response (ABR), was mild. Forty per cent of the experimental animals showed increased threthold of ABR from 10 to 20 dB.
3. Phospholipid staining by snake venom hospholipase digestive method revealed deposits of phospholipid in Corti's organ and the stria vascularis. They were especially intensive along the each cell membrane of the outer hair cells, of Hensen's cells, and of the inner piller cells, and in the marginal cells of the vascular stria. poradic losses of the outer hair cells were observed by succinic dehydrogenase staining. Electron microscopically, there were many protrusions toward the endolymphatic space on the surface of Corti's organ and on the marginal cells of the stria vascularis. Furthermore, vacuolar degeneration was observed in the basement membrane of the capillary of the stria vascularis. These morphological changes seemed to begin initially from the stria vascularis.
In conclusion, mild auditory dysfunction associated with hyperlipoproteinemia was proved by the experimental animals breeded with hyperlipid diet. It is necessary, however, for getting more severe auditory damage to impose other factors besides hyperlipoproteinemia.抄録全体を表示PDF形式でダウンロード (4623K) -
感覚上皮の分化と神経支配の影響について園部 紀子1985 年 88 巻 3 号 p. 330-337
発行日: 1985/03/20
公開日: 2008/03/19
ジャーナル フリーA histological study was carried out to clarify the early morphogenesis of the human membranous labyrinth with special reference to the relation between innervation and differenti-ation of the sensory epithelium. As the material, 20 embryos and 2 fetuses (6.0 to 51.0mm in CR length) were used and examined by H.E. and silver stains. The results and conclusion obtained from this study are as follows;1) In the embryonic developmental 14th stage, the statoacoustic ganglionic primordium has already existed and has shown apparent connection by nerve fibers to the rhomboencephalon. This fact may not support the postulation that the primordium originates from the otocystic wall.
2) The epithelium of the otic vesicle, which has received the nerve supply, begins upon the sensory epithelial differentiation. In the vestibular portion the differentiation arises at embryonic developmental 15th stage, and in the cochlear portion this occurs at the 19th stage.
3) Up to the embryonic developmental 23rd stage, the vestibular epithelium differentiates pro-gressively into the sensory and supporting cells and also receives rich nerve supply. It has completed a fundamental structure of the macula and crista.
4) The two and half turns of the cochlea have been completed at the fetal 8th week. At the 9th week, the sensory epithelial differentiation arises in the basal turn and the tectorial membrane primordium also develops after the penetration of the nerve fibers.
5) It is considered from the results of the study that the innervation to sensory areas plays an important role in the sufficient sensory epithelium development and differentiation of the membranous labyrinth.抄録全体を表示PDF形式でダウンロード (2142K)
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