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, 8 号
選択された号の論文の10件中1~10を表示しています
  • 藤原 文明
    1985 年 88 巻 8 号 p. 999-1009
    発行日: 1985/08/20
    公開日: 2008/12/15
    ジャーナル フリー
    Trapezoid acceleration tests(±2, 4, 8 and 10°/sec2, 10")using the Contraves'computerized rotary chair system were performed for 60 normal persons and 129 patients with aural vertigo. Maximum value of slow phase velocity (SPV) and duration of perrotatory nystagmus were investigated as diagnostic parameters.
    In normal subjects, the value of SPV as well as nystagmus-duration showed few differences between accelerative stimulation and decelerative stimulation. So-called "Response Decline Phenomenon" by repeating the test was not detected and the testing results showed good reproducibilities. On the other hand, testing results of patients with aural vertigo were variable in a close relationship with the state of vertigo. This relation was more closely observed than that of the positional nystagmus test.
    The pattern of testing results was divided into the normal type (Type I) and the abnormal types (Type II, III, IV). Type I showed "Vestibular Symmetry" which was observed in the normal persons. Type II (Parallel Type) and Type III (Divergence Type) were originated from "Directional Preponderance", and Type IV (Convergence Type) was caused by "Vestibular Recruitment or Decruitment".
    Testing results before the attack of Meniere's disease showed the ipsilateral directional preponderance which changed to the contralateral direction after the attack and disappeared in line with improvement of vertigo.
    From observations of numerous testing results, this testing system was thought to be very suitable for the inspection of vertiginous course.
  • 飯沼 壽孝, 大澤 博之, 広田 佳治, 清水 弥生
    1985 年 88 巻 8 号 p. 1010-1017
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    An experience over the twenty six cases of sphenoidal mucoceles was reported. Surgical approaches were analized as to the age of onset, gender, number of the cysts, location and distribution of the cysts, and previous sinus surgery, if any. The surgical approach among twenty six cases comprises, 18 endonasal surgeries, 6 transantral surgeries, and 2 extranasal surgeries. The surgical approach was not related to, age, gender, and sides. Mucoceles of monocystic type were 22 cases or 85%. 19 cases or 73% showed a limited distribution to the sphenoidal sinus and the posterior ethmoidal cells. Postoperative cases were 21 cases or 81%, and 19 cases among them had Caldwell-Luc operations. The proper approach to the sphenoidal mucocele is determined by such factors as the location and distribution of mucoceles, number of cysts, method of the initial sinusectomy, and the location of the optic canal. In the majority of cases, these factors are satisfied by the endonasal approach which provides superior command over the direct observation for the optic canal.
  • 咽頭形成術による改善例
    羽石 芳子, 渡辺 繁, 小林 武夫, 栗山 純一
    1985 年 88 巻 8 号 p. 1018-1026
    発行日: 1985/08/20
    公開日: 2008/12/15
    ジャーナル フリー
    We have evaluated and surgically treated three patients of sleep apnea syndrome. One was cured by tonsillectomy only and the others cured by UPPP (uvulo-palato-pharyngo-plasty). Early diagnosis followed by treatment including surgery is able to avert pulmonary hypertention, cor pulmonale, or other serious complications that threaten the life. We otolaryngologists must pay more heed to patients who complain of chronic hypersomnia associated with periodic breathing accompanied by loud snoring. Once the diagnosis of obstructive sleep apnea is established, treatment of choice is correcting the airway obstruction.
  • 田中 信三, 田辺 正博, 本庄 巖
    1985 年 88 巻 8 号 p. 1027-1031
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    Fifteen patients with apparent hypertrophy of unilateral false vocal cord were investigated with computered tomography (CT). In all the patients, marked concavity of unilateral thyroid ala was revealed in CT scan at the level of the false vocal cord, and this deformity of the thyroid cartilage seemed to cause a protrusion of unilateral false cord which was taken as hypertrophy in laryngoscopic view.
    Morphological comparisons of the thyroid cartilage were performed between these 15 patients and 10 normals by the use of CT scan. All the normals showed almost straight and symmetrical thyroid alae at the level of the false cord, whereas all the patients had remarkable concavity of unilateral thyroid ala. The angle between bilateral thyroid alae was statistically smaller in the patients than in the normals. There were no statistical differences between the two groups in both angles of rotation and inclination of the thyroid cartilage.
  • 杉田 公一, 洲崎 春海, 杉本 正弘, 野村 恭也, 岩森 正男, 永井 克孝
    1985 年 88 巻 8 号 p. 1032-1039
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    Mucin-type glycoprotein of nasal secretion was isolated by solubilization with EDTA-containing phosphate buffered saline, followed by gel filtrations (Sepharose CL-4B and CL-2B). After the purification, it was completely free from the molecules with up to 105 daltons molecular weight and contained carbohydrates in a high concentration. The purified mucin thus obtained and the nasal secretion, which was dialyzed against distilled water and lyophilized, were administered for immunization to rabbits with Freund's complete adjuvant. Antibody titer of the antisera were examined by ELISA with the purified, and the chemically and enzymatically modified mucins as the antigens. The antibody directed to the mucin was found to be effectively elicited in rabbits immunized with both the purified mucin and the nasal secretion. Titers of the antisera reached the plateau level 4 weeks after the immunization and were found to be 1:104-1:105. Treatment of mucin with either alkaliborohydride or NaIO4 resulted in the marked reduction of antibody binding activity, suggesting that the O-glycosidic carbohydrate residues of mucin are responsible for the antigenic determinants. Moreover, the antisera were used to localize the antigen in the mucous membrane of the maxillary sinus of the patients suffered from the chronic sinusitis, according to the indirect immunofluorescence technique using FITC-conjugated anti-rabbit IgG goat antiserum as a second antibody. The nasal glands, the mucous epithelial cells, the intercellular spaces of them and the surface mucus, but not the infiltrated cells in the submucous layer were stained with the anti-purified mucin antiserum. This observation was in contrast to the staining pattern with the anti-human IgA antiserum, which well stained the infiltrative cells in the submucous layers.
  • 大平 真司, 有賀 秀治, 石田 稔, 家根 且有, 兵 行和
    1985 年 88 巻 8 号 p. 1040-1044
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    Computed tomographic images of 49 cases of unilateral sinus lesions were examined, and 4 findings were obtained as follows;
    1) On the C. T. images of malignant tumors, detection of bone destruction was easy, but its early erosion was difficult.
    2) Fungus infections and papilloma of paranasal sinuses demonstrated bone thickness as well as destruction, and this finding would serve as a differential point from malignant diseases.
    3) From the C. T. values of soft tissue shadows in the maxillary sinus, it was impossible to differentiate malignant from benign lesions. However, a calcified or non-homogenous soft tissue shadow was seen only in cases of fungus infections and maxillary adenocarcinoma in malignant tumors, and it would be clinically a very important differential point.
    4) Many of the unilateral sinus lesions will prove to be indications for surgery, except acute and allergic sinusitis. The paranasal C. T. examinations should be performed if the case does not respond to a conservative therapy over a month, and a case showing bone destruction by the C. T. images would require an exploratory Caldwell-Luc operation.
  • 矢野 純, 船井 洋光, 牛嶋 達次郎, 飯沼 壽孝
    1985 年 88 巻 8 号 p. 1045-1050
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    The personality characteristics of the patients with tinnitus were surveyed in order to evaluate the psycological factors in tinnitus. The Japanese version of Maudsley Personality Inventory (MPI) and Manifest Anxiety Scale (MAS) were given to the patients with otological symptoms.
    While the personality test scores showed no difference between the patients with tinnitus and those without it, the distribution of the audiological test results significantly differentiated the two groups. The sensorineural hearing impairment were found more in the former group than in the latter one.
    The relationship between personality and annoyance of tinnitus were evaluated comparing the test scores among three subgroups devided according to subjective ranking of annoyance. The subgroup composed of the patients whose tinnitus were annoying tended to have significantly higher N (neuroticism) scores and lower E (extroversion-introversion) scores of MPI, and higher MAS scores than the subgroup of the patients who were aware of tinnitus and bothered by it somewhat. It was confirmed that the results were not related to the difference of age and sex distributions between the two subgroups, by comparison of matched pairs selected according to age and sex. The test scores of the patients who were aware of tinnitus but were not bothered by it showed no significant difference in comparison with the other subgroups, probably because of its relatively small numbers.
    It was suggested that the patients' personality was not a contributory factor in the genesis of tinnitus, but played an important role in subjective annoyance of tinnitus.
  • 大橋 淑宏, 中井 義明, 池岡 博之, 古下 博之, 木原 匠子, 丸岡 健一, 高木 皓一
    1985 年 88 巻 8 号 p. 1051-1055
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    In the present paper, the ciliary activity and the fine structure of the pathological middle ear lining of rabbits induced by the exposure to 20 ppm SO2, 4 hours a day, 7 days/week for 4 consecutive weeks, were studied. In addition, carbocysteine, 200mg/kg, was given orally at different times during the experiment to 18 rabbits, and its effects on the middle ear lining were also studied.
    The following results were obtained;
    1) Otitis media with effusion including serous exudate in the tympanic cavity was produced by exposure to SO2. Such pathology was more remarkable 2 weeks after the completion of exposure than immediately after that.
    2) It was disclosed that the ciliary activity and the morphology of the middle ear lining was affected by the exposure to SO2. The affected ciliary activity and morphology of the middle ear lining remained for a considerably long period of time even after cessation of the exposure.
    3) Carbocysteine given either previously or concomitantly with SO2 exposure had a mild effects on the S02-induced middle ear mucosal disorder, however, it revealed significant effects on accerelating the repair of the middle ear lining.
    The conclusions were as follows;
    1) SO2 exposure may be one of the promising methods to elucidate the pathogenesis and pathology of the otitis media with effusion.
    2) Air polluting substance such as SO2 may be associated with an increase of the otitis media with effusion.
    3) Carbocysteine that promotes repair of the affected middle ear lining could be useful for the medical treatment of otitis media with effusion
  • 大橋 淑宏, 中井 義明, 古下 博之, 池岡 博之, 丸岡 健一, 高木 皓一
    1985 年 88 巻 8 号 p. 1056-1060
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    The effects of SO2, one of main factors of air polution, on the nasal mucosa and tracheobronchial mucosa have been relatively well studied, but those on paranasal sinus have been little elucidated. In the present study, the pathology of the sinus mucosa induced in rabbits by exposure to 10 ppm of SO2, 4 hours a day for 4 successive weeks was studied from both functional and morphological point of view. In addition, the effects of carbocysteine given orally on the SO2-induced sinus mucosal disorder was studied.
    The following results were obtained from the present observations;
    1) 24 hours after the final exposure to SO2, the sinus mucosa showed advanced disorder such as formation of compound cilia, vacuolation of epithelial cells, and partial fall-off of epithelial cells.
    2) The mean ciliary activity at the sinus mucosa 24 hours after the withdrawal of exposure was about 390 beats/min, declined moderately.
    3) Even 2 weeks after the withdrawal of the exposure, the ciliary activity was declined with a value of 570 beats/min, and epithelial cells showed morphological disorder.
    4) The ciliary activity and the morphology of the sinus mucosa in rabbits given 200 mg/kg of carbocysteine during or after the exposure to SO2 were almost normal.
    The results suggested that 1) The exposure to 10 ppm SO2 for 4 hours a day, 7 days a week, for 4 weeks in rabbits induces the pathological sinus mucosa similar to that of human chronic sinusitis; 2) SO2-induced sinus mucosal disorder is a useful model to preclinically study the effects of medical agents for treatment of chronic sinusitis, because being hardly recovered;
    3) Carbocisteine could be useful as a drug to treat chronic sinusitis.
  • 藤崎 茂巳, 藤崎 恭大, 吉田 淳一, 中村 正彦, 三谷 満昭
    1985 年 88 巻 8 号 p. 1061-1066
    発行日: 1985/08/20
    公開日: 2008/03/19
    ジャーナル フリー
    About twenty years have passed since we first used oral administration of pronase on human chronic paranasal sinusitis with a so-called enzyme therapy. We have been engaged in biochemical studies on chronic inflammation with special reference to the anti-inflammatory effect of protease administration. We gave pronase, an excellent proteolytic enzyme natually produced from Streptomyces, to experimental animals, and found informations on the intestinal absorption, the form of complex in the blood streams and the fate of the complex on inflammatory tissues.
    We obtained the following results:
    1) The intestinal absorption continued for about 60 minutes after administration of the radiolabeled protease, and 2 to 3 per cent of the radioactivity was generally detected in the blood.
    2) Most of the protease was tightly associated with α2-macroglobulin in serum.
    3) The complex with α2-macroglobulin in serum disappeared in the blood rapidly 4) When the distribution of the complex was measured in the skin of rat with artificially introduced inflammation, the complex was found to be accumulated in the exudates to higher extent than a control.
    5) The complex was converted to small fragments in the exudates.
    From these observations we speculate on that administered pronase and their inhibitors play important roles in the process of inflammation.
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