日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
91 巻, 7 号
選択された号の論文の12件中1~12を表示しています
  • 石田 春彦, 藤谷 哲造
    1988 年 91 巻 7 号 p. 991-1001
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    Some tumor cell lines and fresh tumor cells are killed by natural killer cell (NK cell), and NK cell is said to play an important role in antitumor immune defense mechanism.
    This study was conducted in order to gain information about the cytotoxic activity of peripheral blood lymphocyte (PBL) and white blood cell (WBC) in patients with head and neck malignant tumor, and the change of that cytotoxic activity after therapy.
    PBL and WBC were obtained from patients with malignant lymphoma and carcinoma in head and neck region before the beginning of therapy, and 2 weeks, 1 month, 3 months, and 6 months after the end of therapy. NK cell activity of these effector cells against K562 cells was tested by the method of 4-hour 51Cr-release assay. Autologous lymphocyte cytotoxicity (ALC) against biopsied lymphoma cells was also tested in patients with malignant lymphoma.
    In the untreated patients, NK cell activity and ALC were reduced, and there was no significant difference between the cytotoxicity of PBL and that of WBC. It seemed that macrophages and granulocytes did not affect the cytotoxicity of PBL in vitro. Though no change of NK cell activity was noted in the posttreated period up to 6 months, increased ALC was observed, and furthermore the cytotoxicity of PBL against hot K562 cells was inhibited by cold autologous lymphoma cells in the cold target inhibition test. The incubation of PBL and WBC with OK432 for 20 hours in vitro resulted in the augmentation of NK cell activity and ALC. On the other hand, the incubation of those with mitomycin C (MMC) neither show the augmentation nor the reduction of the cytotoxic activity. No correlation was observed between the cytotoxic activity and the extent of the disease or immunological parameters (peripheral lymphocyte count, lmphocyte subset, lymphocyte blast formation test by PHA).
    NK cell activity and ALC were reduced in the patients with malignant tumor, and the cytotoxic activity abainst autologous tumor cells was recovred in the posttreated patients. These results suggest that the recongtion of PBL to autologous tumor cells was augmented in the posttreated period.
  • 中村 美弥子
    1988 年 91 巻 7 号 p. 1002-1011
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    High resolution CT axial scans were made at the three levels of the temoral bone 91 cases. These cases consisted of 109 sides of normal pneumatization (NR group) and 73 of poor pneumatization resulted by chronic otitis (OM group). NR group included sensorineural hearing loss cases and/or sudden deafness on the side. Three levels of continous slicing were chosen at the internal auditory meatus, the vestibular and the cochlear aqueduct, respectively.
    In each slice two sagittal and two horizontal measurements were done on the outer contour of the temporal bone. At the proper level, diameter as well as length of the internal acoustic meatus, the vestibular or the cochlear aqueduct were measured.
    Measurements of the temporal bone showed statistically significant difference between NR and OM groups. Correlation of both diameter and length of the internal auditory meatus to the temporal bone measurements were statistically significant. Neither of measurements on the vestibular or the cochlear aqueduct showed any significant correlation to that of the temporal bone.
  • 小林 英人
    1988 年 91 巻 7 号 p. 1012-1022
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    In order to evalute the interation of visual with vestibular systems in 131 patients with peripheral vestibular disorders, the vestibulo-ocular reflex (VOR) gain and the visual-vestibuloocular reflex (VVOR) gain were analyzed by a mini-computer (PDP 11/34). Pendular harmonic sinusoidal rotation and optokinetic stationary stimuli were used. The patients were rotated sinusoidally in an illuminated OK drum at an amplitude of 120°and a frequency of 0.1Hz (maximum velocity 75.4°/s), both with eyes closed (VOR) and open (VVOR).
    The results obtained were as follows.
    1. VVOR responses in peripheral patients were usually normal, whereas a VOR-DP with normal VVOR gain was more frequently observed in patients with definite Meniere's disease and in those with sudden deafness accompanied by vertigo or dizziness.
    2. VOR-DP was highly correlated with caloric CP and DP, and tended to be associated with the intact vestibular side.
    3. In most peripheral patients, spontaneous nystagmus and VOR-DP showed the same direction and this fact can be useful in differential diagnosis with reference to CNS disorders.
    4. The rate of decreased VOR-gain paralleled the decline of the patient's condition. The VOR and VVOR test battery constitutes an effective method in the evaluation of vestibular compensation.
  • 泰地 秀信, 神崎 仁
    1988 年 91 巻 7 号 p. 1023-1030
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    1) 突発性難聴における聴力回復の指標として,改善率(聴力の改善度/患側と健側との聴力の差)という概念を導入し検討した.この値は量的であり,従来の判定法と比べ統計解析が行いやすいという利点をもつ.
    2) 低年齢•発症後早期•めまい(-)•初診時聴力良好•低音障害型のものほど改善率は高かった.
    3) 偏相関係数の大きさは,めまいの有無,高-低音差,初診時聴力,来院までの日数,治療法,年齢の順であった.
    4) 重回帰分析の結果では,年齢•来院までの日数•初診時聴力•高-低音差で改善率は26%予測可能である.
    5) 改善率と高-低音差の相関図をみると,2つのクラスターに分かれるようであった.この意味は今後検討の予定である.
  • トリクロール酢酸の応用
    八尾 和雄, 設楽 哲也, 高橋 廣臣, 屋宜 晃
    1988 年 91 巻 7 号 p. 1031-1041
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    1. 80W/V%トリクロール酢酸による鼻閉の治療は,安全で副作用,中毒作用なく,耳鼻咽喉科医独自の治療手段で,86%の改善率を得た.
    2. 通年性アレルギー性鼻炎のくしゃみ症状,水様性鼻汁症状の改善も可能と考えた.
    3. 鼻閉改善の第一の理由は,本剤の影響した範囲での凝固壊死後の組織脱落による絶対的体積の減少にあると思われた.
    4. 再生したと考えられた上皮は重層扁平化していて,その直下には好酸球の浸潤はなく,この部分でアレルギー性反応は生じていないと思われる所見が得られた.
    5. 重層扁平化した上皮の部分の粘膜固有層の腺組織は機能低下を示している可能性が示唆された.
    6. トリクロール酢酸による影響を受けた神経線維はその成分であるNeurofilament Proteinが蛋白変性することから,神経線維に対する免疫染色法では抗原性の低下,すなわち染色性低下といった所見を認めた.この点は特にアレルギー性鼻炎の神経を介する症状に影響したと思われた.
  • 塩野 博己, 北原 伸郎, 飯沼 壽孝
    1988 年 91 巻 7 号 p. 1042-1048
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    1) 副鼻腔嚢胞疾患のA,B-モード法による超音波像とX像,CT像とを比較した.
    2) 術後性上顎嚢胞の超音波画像の特徴は(1) 上顎洞前壁の不連続または欠損像,(2) 嚢胞像は類円形,(3) 内部エコーは無~低エコーで均一,(4) 嚢胞底面,後壁は皮膚より3~4cmのところにある,などである.診断率は約80%である.
    3) 前頭洞嚢胞の超音波画像では術後性で前壁骨欠損があるものでは術後性上顎嚢胞像と同様であり皮膚より3cm以内に嚢胞底面,後壁像がある.
    4) 篩骨および蝶形骨洞嚢胞の超音波画像では,嚢胞内側は空気のため描写されないが外側は嚢胞の眼窩内圧排による眼窩内エコーの部分的欠損所見をみる.深部の嚢胞は描写されにくいため経眼窩的なスキャンがよい.
    5) 超音波検査は副鼻腔嚢胞性疾患の補助的診断法として有用である.
  • 白崎 英明, 小島 正, 朝倉 光司, 形浦 昭克
    1988 年 91 巻 7 号 p. 1049-1053
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    For the purpose of clarifying the pathophysiological role of chemical mediators on allergic rhinitis, we measured levels of kinins, leukotriene (LT) and histamine in the nasal lavage of ovalbumin (OA) sensitized guinea pigs after topical antigenic challenge. In these animals, exudative reactions were also studied by measuring the amounts of dye excreted into the nasal cavity. Kinins, LT and histamine concentrations were measured by radioimmunoassay.
    The following results were obtained: 1) Excretions of dye into the nasal lavage were recognized soon after antigenic stimulation and continued over 90 minutes. 2) Increased concentrations of kinins and immunoreactive LTC4 in the nasal lavage were recognized not only soon after antigenic stimulation, but also between 60 and 90 minutes after antigenic stimulation. 3) Increased concentrations of histamine in the nasal lavage were only recognized soon after antigenic stimulation.
    These results suggested that leukotrienes and kinins might be related to the onset of allergic rhinitis like other chemical mediators and the pathways of leukotrienes and kinins release might be different from the pathway of histamine release.
  • 唾液腺造影検査,口唇腺病理組織検査および眼科的検査との対比
    安藤 真姿子
    1988 年 91 巻 7 号 p. 1054-1065
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    シェーグレン病および各種膠原病症例145例について,RIシアロシンチグラフィ,シアログラフィ,口唇腺病理組織検査の耳鼻科的諸検査および眼科的にKCSの有無を診断し,それぞれの結果を比較検討して次の結果を得た.
    (1) 唾液腺機能を知る検査法としてRIシァロシンチグラフィが有用で,パラメーターとして用いた99m Tc-O4投与5分後の摂取係数(Sl5),15分後の刺激分泌により排泄率(Ex),集積最高値における摂取率(Up)はいずれも診断上有用であることが判明した.特に摂取率はシアログラフィおよび口唇腺病理組織所見の程度とよく対応する.
    (2) SjS病診断において,RIシアロシンチグラフィの摂取率は病変の推移を知る上で,繰り返しできる検査として,苦痛を伴いがちなシアログラフィに代用できうるものである.
    (3) シアログラフィの程度分類で,明らかな導管拡張にまで至らない軽度な異常陰影群を一つのグループとして(±)群として取り扱うこととしたが,これは膠原病などのSjS病周辺疾患で出現頻度が高かった.
    (4) シェーグレン病の診断ではKCS検索と耳鼻科的検索では異なる傾向があり,一つの検査のみ陽性の場合には,シアログラフィや口唇腺病理組織での軽度な変化についてより厳密に検索していくことが必要であると同時に,RIシアロシンチグラフィでのパラメーター,特に摂取率が重要なきめてになるものと考えられた.
  • 川上 理郎, 牧本 一男, 福瀬 信也, 野井 理, 中島 徹, 高橋 宏明
    1988 年 91 巻 7 号 p. 1066-1071
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    内耳循環動態を解明する研究の一環として,レーザードップラー血流計を用いてモルモットの蝸牛血流を測定した.本法による血流測定はすでに皮膚血流の領域でその有用性の評価が確立されているが,蝸牛血流を対象とした場合にも,安定性のある優れた感度をもつ測定法であると考えられた.Asphyxia負荷,Angiotensin II投与に対する蝸牛血流の反応は収縮期血圧のそれと強い相関をもつ動態を示した.Angiotensin IIによる蝸牛血流の増加は,昇圧作用による二次的効果と考えられ,その血流増加にはある範囲で投与
    量依存性が認められた.Angiotensin IIに対する皮膚血流の反応を耳珠皮膚で観察したところ,その反応には収縮期血圧の反応との相関はみられず,投与量を増量すると皮膚血流は低下する傾向もみられた.したがって蝸牛血流はAngiotensin IIに対する反応において,皮膚血流とは異なる血流動態の特性を有することが考えられた.蝸牛血流がAsphyxia負荷,Angiotensin II投与により収縮期血圧に追随する反応を示したことは蝸牛血管系が機能的には受動的である側面を有することを示唆するものである.今後,内耳循環動態を理解するには,諸種の実験条件によって内耳血管系にある特有の機能的側面を探っていく必要があると考える.
  • 井上 都子, 井上 美知子, 安部 治彦
    1988 年 91 巻 7 号 p. 1072-1077
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    頭部外傷による伝音難聴19例に早期の手術を行った.
    1. その結果,最も外傷を受けやすい耳小骨はツチ骨で,次いでキヌタ骨,アブミ骨の順であった.関節の障害はツチ•キヌタ関節の方がキヌタ•アブミ関節より多かった.
    2. その成因について,骨折線の歪みが外力として上鼓室に作用し,ツチ•キヌタ関節の障害を起こし,一方では鼓膜に加わった衝撃がツチ骨に伝達されたためと推定した.
    3. ツチ•キヌタ関節の傷害は自然回復が起こりやすいが,キヌタ•アブミ関節では自然回復が困難であるため,従来の報告と異なった結果となったと考えられる.
  • 皮内反応と髄液検査の意義
    奥野 仁
    1988 年 91 巻 7 号 p. 1078-1084
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    In the early stage of acute facial paralysis, proving the presence of a viral infection has important therapeutic as well as prognostic implications.
    We have already known that a significant increase of serum complement fixation (CF) antibody titer of the varicella-zoster virus (VZV) appears in 20 to 30% of Bell's palsy cases. However, it is difficult to say that the most common method of diagnosing a viral infection, by measuring the amount of serum CF antibody titer, is rapid, bacause it takes more than 2 or 3 weeks to reach a final conclusion. Recently, Takahashi6) reported a new procedure for diagnosing VZZ infection by using a skin test with VZV antigen. This procedure may permit us to succeed in the early diagnosis of a VZV infection. On the other hand, we know that Hunt's syndrome has some influence on the cerebrospinal fluid (CSF), especially in the early stage of the disease. We studied
    100 patients with acute peripheral facial paralysis by using both the VZV antigen skin test and the examination of the CSF, within 2 weeks after onset of paralysis. The purpose of this roport is to show the results of these two procedures and to point out their usefulness in the early diagnosis of VZV infection in patients with acute peripheral facial paralysis. The results obtained were as follows.
    1) By using VZV antigen skin test, the ratios of early diagnosis of VZV infection were shown in each diseases, as 85.4% in Hunt's syndrome, 58.3% in zoster sine herpete and 72.3% in Bell's palsy. It was indicated that this procedure is valuable for early diagnosis of VZV infection in these patients.
    2) In 73.2% of the patients with Hunt's syndrome and 66.7% of with zoster sine herpete, it was possible to detect increased cell counts (mainly monocyte) in the CSF. This is in marked contrast to Bell's palsy, as only 8.5% of these subjects were noted to have increased cell counts (mainly monocyte). By examining cell counts of CSF, it is possible to diagnose a high incidence of viral infections among facial nerve paralysis.
    3) By carrying out both of skin test with VZV antigen and CSF examinations, 12 out of 59 patients who had been diagnosed as Bell's palsy in their early stage of paralysis were diagnosed to have VZV infection before significant increase of anti-VZV CF antibody titer were detected in the sera.
  • 伊東 一則
    1988 年 91 巻 7 号 p. 1085-1095
    発行日: 1988年
    公開日: 2008/03/19
    ジャーナル フリー
    Angiogenesis, the induction of formation of blood vessels, is critical to the development, proliferation and the metastasis of tumors. Several angiogenic factors, derived from human or mammalian tumors, have already been isolated or purified and will be closely related to both the therapeutic and diagnostic modalities of cancer.
    In the present study, the endothelial cell growth factors, isolated from the human thyroid anaplastic cell carcinoma, were carried on nude mice to partially characterize. The activities of growth promotion were monitored by 3H-thymidine incorporation DNA using cultured human umbilical vein endothelial cells.
    The crude extracts from the thyroid anaplastic tumors with 0.1M Tris-HCI, pH7.2, were subjected to fractionation with 35%, 50% and 100% ammonium sulfate, respectively. The precipitates of 35% to 50% showed prominent growth promotion activities and were further analyzed by Bio-Rex 70 cation exchange chromatography and heparin sepharose affinity chromatography. From the results of these chromatography, it was proved that these growth factors possesed cationic property and had affinity for heparin, thus showing differencies from normal tissue growth factors. The molecular weight determinations of these factors by HPLC gel chromatography showed approximately 41, 000 and 19, 000 daltons.
    These results suggested that the endothelial cell growth factors of thyroid anaplastic cell carcinoma tissues were mainly derived from the tumor cells. Analysis of these endothelial cell growth factors will be expected to establish methods for new laboratory examinations as well as new therapeutics in oncology.
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