日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
92 巻, 4 号
選択された号の論文の13件中1~13を表示しています
  • 臨床効果と組織効果
    佐藤 公則, 粟田 茂二朗, 大久保 洋, 川口 寿郎, 松岡 秀隆, 平野 実
    1989 年 92 巻 4 号 p. 535-541
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Clinical and histological effects of cis-platinum-peplomycin chemotherapy for metastatic lymphnodes were studied in 35 head and neck carcinomas. The results were as follows ;
    1. As the clinical effects, 4 cases revealed CR, 17 cases PR, and 16 cases NC. The response rate was 57%.
    2. Histologically, 7 cases were classified as Grade III change, 1 case as Grade IIb change and 13 cases as Grade IIa change according to Ohboshi-Shimozato classification.
    3. The clinical effects for the metastatic lymphnodes almost agreed to that for the primary lesion.
    4. The histological effects for the metastatic lymphnodes almost agreed to that for the primary lesion.
    5. The clinical effects for the metastatic lymphnodes did not always agree to the histological effects for it.
    6. It was impossible to do radical treatment of metastatic lymphnodes with cis-platinumpeplomycin chemotherapy. In some cases, chemotherapy made it easy to do radical neck dissection.
  • の工夫その手術手技と術後経過
    小笠原 寛, 雲井 健雄, 吉村 史郎
    1989 年 92 巻 4 号 p. 542-547
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    With increase of cases with mild chronic sinusitis, especially the cases combined with nasal allergy, endonasal sinus surgery has been substituted for Caldwell-Luc or some other modified sinussurgery in recent years. The classical inferior meatal antrostomy for maxillary sinusitis is one of the treatments of choice, though this opening is easily closed and is somewhat different from normal sinus physiology. In the middle meatal antrostomy, the opening was made via the inferior turbinate or the middle meatal wall perforated with nasal forceps. Reported here is a new technique for middle meatal antrostomy which can be easily and safely performed. At the beginning, mucosal incision is made from the agger nasi to the anterior of the inferior turbinate, dividing the mucous membrane inferomedially. Then the mucous membrane of the inferior turbinate is cut along the upper margin of it and reflected downwards. With this procedure, the frontal process of the maxilla, lacrimal bone and inferior turbinate are well exposed and well oriented in the surgical field. The pars membranacea is then cut from anterior to inferior, and removed with the uncinate process, thus entering the maxillary antrum. The antrostomy opening is made at least ' 1 by 1. 5cm wide. Then, the intranasal ethomoidectomy is usually done and the reflected mucous membrane of the inferior turbinate returned to its normal position, This surgery was applied to 34 patients (7 children, 27 adults), (2 antrochoanal polyps, 5 optic neuritis, 3 maxillary sinusitis, 17 pansinusitis, and 7 pansinusitis associated with nasal allergy). We have not experienced surgical complications and none of them also had closure of the antrostomy opening. Most of the nasal synptoms in operated patients have been improved, except 4 cases.
  • 和田 仁, 小林 俊光, 宋武 光子, 新川 秀一
    1989 年 92 巻 4 号 p. 548-555
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    A tympanometer is well known to be a valuable apparatus for the diagnosis of secretory otitis media (SOM). However, it is insufficient for the diagnosis of ossicular chain disorders.Therefore, an attempt was made to develop a new measuring apparatus, which had a function of sweeping both frequency and pressure and was measurable the absolute sound pressure variations at the external auditory canal, owing to the carefully designed probe. In the previous papers, the middle ear dynamical characteristics of normal subjects were measured by this apparatus, and the measurement results were compared with the theoretical analysis. In this paper, the middle ear dynamical characteristics of patients were measured, and the effects of various kinds of middle ear diseases upon its dynamical characteristics were examined.
    The measurement results of the patients with ossicular chain separation, ossicular chain ixation, SOM and tympanic membrane perforation had their own distinctive patterns, and were also clearly different from those of normal subjects. Therefore, this apparatus seems to have a high degree of the clinical applicability to the diagnosis of these diseases.
  • 広田 佳治, 北原 伸郎, 高砂 江佐央, 水野 弥生, 飯沼 壽孝
    1989 年 92 巻 4 号 p. 556-565
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    A total of ten cases of blow-out fractures of the orbit was investigated as to the signs and symptoms, image findings of conventional views of Caldwell and Waters' and of coronal CT. According to the locations of fractures, medial, floor and medial-floor types were classified. Fractured bone tips were classified to depressive and trapdoor types. Fractures often occur posterior to the eyeball, the inferior rectus muscle showed dislocation and cylinder-like hypertrophy. Contrary to the reports in the past, the inferior rectus muscle did not show entrapment in the herniated portion. Caldwell view is superior to Waters' view in demonstrating fractures at the medial orbital wall. As to the choice of treatment in the majority of cases, conservative methods are indicated. Images by CT are used in determining surgical methods, the depressive type without clinical improvement after two weeks is the indication for the surgical treatments.
  • 山中 栄三, 暁 清文, 佐伯 忠彦, 柳原 尚明
    1989 年 92 巻 4 号 p. 566-573
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    One hundreds and forty-nine patients (221 ears) suffering from tinnitus were treated by an intravenous administration of Xylocaine (R) . Xylocaine(R), lmg per kg, was administered once a week. The immediate effect of Xylocaine(R) on tinnitus was evaluated subjectively for all the patients. The long term effect in 57 patients who received Xylocaine(R) administration more than 12 times was also analyzed.
  • 村田 清高, 西本 力, 玉木 克彦, 太田 文彦
    1989 年 92 巻 4 号 p. 574-578
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Existing studies on sudden deafness and Bell's palsy have shown no statistically significant differences in the numbers of patients by the times of the onsets, namely, days of the week, weeks of the month, months of the year and seasons of the year. However, accumulation of collective data in various areas and years may produce averaged data. Correlation between the occurrence of sudden deafness and that of Bell's palsy has not been studied so far.
  • 波多野 篤
    1989 年 92 巻 4 号 p. 579-587
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Intranasal inoculation of mice with herpes simplex virus (HSV) provides a model of human herpetic infection through a natural route of inoculation. Five-week-old male ICR mice were infected intranasally with various strains of herpes simplex virus type 1 (HSV-1), and the fundamental aspects of the pathogenicity of this virus were studied.
    Six virus strains examined showed variance in their virulence determined by lethal dose 50 (LDSO) for mice. Four of the strains were revealed to be virulent, and two were shown to be attenuated. The relative degree of virulence among these strains corresponded well to that shown by intraperitoneal inoculation.
    When mice were inoculated with a virulent virus strain (F), virus multiplication was shown clearly in several organs tested, such as the lung, brain, olfactory bulb, trigeminal ganglion, spinal cord and adrenal gland. Viremia was also demonstrated. On the other hand, in mice inoculated with an attenuated virus strain (-GCr), virus was recovered only from the lung and adrenal gland and in much less amount than in the respective organs of mice infected with the virulent strain. No viremia was demonstrated. These data strongly suggest that the lethal effect of IISV-1 on mice is dependent upon whether or not significant virus multiplication occurs in the central nervous system, which is the critical target organ of HSV.
    Preinoculation of mice with an attenuated strain via the intranasal route suppressed the lethal effect of subsequent infection with any of the virulent strains by the same route of inoculation, althogh this protection phenomenon was not so pronounced when the virulent UNO-1A strain was used.
    To test a plausible mechanism responsible for this protection phenomenon, the anti-viral effect of recombinant mouse interferon-/3 (rMuIFN-R) on HSV-1 infection in intranasally infected mice was examined. Intranasal administration of rMuIFN-J3 suppressed lethal infection with a virulent strain.
  • 斎藤 匡人, 嶽 良博, 垣 内弘, 加藤 寛, 九鬼 清典, 林 泰弘, 横田 昌也, 木下 和也, 九鬼 佐世子, 木村 貴昭, 藤原 ...
    1989 年 92 巻 4 号 p. 588-596
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    It is reported that the levels of serum IAP and IS are useful parameters to evaluate the prognosis along with the clinical course of tumor bearing patients. Serum IAP and IS were examined in 149 patients with head and neck cancer. The level of serum IAP and IS increased in patients with not only advanced stages, but also poor prognosis. In general, the patients with death or recurrence had higher levels of serum IAP and IS than those with good prognosis. It is concluded that serum IAP and IS well reflect the immunological condition and clinical course of patients with cancer and may be one of the useful parameter for them.
  • 加齢と血清総IgE値,スギRASTスコア,スギ特異IgG抗体,IgGsubclass抗体量の関係について
    榎本 雅夫, 横山 道明, 中西 弘, 寒川 高男
    1989 年 92 巻 4 号 p. 597-601
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Japanese cedar pollinosis occurs most frequently in the twenties and thirties. To understand this phenomenon, total serum IgE, frequency of positive RAST reactions to Japanese cedar and Japanese cedar-specific IgG antibody were examined in serum samples from a general population consisted of 1, 491 subjects and their age-related changes were investigated. The difference of mean value of total serum IgE was not significant between age groups. Positive RAST's to Japanese cedar were found in 13. 9% of cases. The frequency of positive RAST reactions showed a peak in the twenties and decreased thereafter with aging. The amount of Japanese cedarspecific IgG antibodies was 244.7-373.2 GRU/ml (mean-S.D.) and there was no significant difference between males and females. There was no difference in the amount of specific IgG antibodies among the subjects giving RAST scores of 0-3, whereas those giving RAST scores of 4 had lower specific IgG antibodies. The amount of Japanese cedar-specific IgG antibodies increased from the fifties. Specific antibody of IgG1 subclass to Japanese cedar increased with age, whereas IgG4 antibody increased slightly without statististically significant difference.Based on the above result, we discussed why Japanese cedar pollinosis occurs most frequently in the twenties and thirties.
  • 蘇 萬全
    1989 年 92 巻 4 号 p. 602-607
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    The autonomic and the peptidergic nerve fibers which control the blood flow and gland secretion in the nasal mucosa of the guinea pig were studied using histochemical and immunohistochemical techniques. There was a dense distribution of adrenergic nerve fibers (Adn) around the blood vessels, especially the vein, but a very sparse distribution in the glandular tissue. There was a dense distribution of cholinergic nerve fibers (Chn) both around the blood vessels and in the glandular tissue. The distribution of fibers containing vasoactive intestinal polypeptide (VIP) was dense in the glandular tissue but sparse around blood vessels and very sparse in the subepithelial layer. Fibers containing calcitonin gene-related peptide (CGRP) were densely distributed around blood vessels, glandular tissue and the subepithelial layer. A moderate number of CGRP containing fibers were observed in the intraepithelial layer. Fibers containing substance P (SP) and neurokinin A (NKA) were sparsely distributed around blood vessels, glandular tissue and the subepithelial layer.
    Radioimmunoassay for NKA and SP in the nasal mucosa revealed a greater content both of NKA and SP in the nasal concha than in the nasal septum. There was a greater content of NKA than SP in both the nasal septum and the nasal concha, with a higher SP/NKA ratio in the nasal concha than in the nasal septum.
  • 山積 博彦
    1989 年 92 巻 4 号 p. 608-618
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    The mode of the transportation of India ink to the nasal cavity was studied when it was given to the subarachnoid space chiefly through facial nerve sheath and partly by cisterna magna injection. From subarachnoid space India ink infiltrated through perineurium, epineurium and perineural space of the fila olfactoria and of olfactory nerve fibers to lamina propria of the olfactory mucosa and spread also to the respiratory mucosa. It was further taken into lymphatic vessels and accumulated in bilateral cervical lymph nodes. In normal rabbits, India ink didn't penetrate the basement membrane into the epithelial layer at all, but in rabbits with chronic rhinitis showing edema, degeneration and destruction of mucosa, India ink was found to pass easily through the basement membrane into the epithelial layer and further to leak into the nasal cavity in all cases. It was a new finding that in cases with rhinitis large particles like India ink could infiltrate from the subarachnoid space to the nasal cavity passing through the nasal mucosa, and was considered to be a possible cause of idiopathic cerebrospinal fluid rhinorrhea.
  • 松崎 勉
    1989 年 92 巻 4 号 p. 617-628
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    The collagenase produced by mesenchymal cells has been thought to have a great importance in the pathophysiology of connective tissue metabolism and prolongation of chronic inflammation. The factors, such as IL-1 and PMN factor, released by inflammatory cells have been known to induce mesenchymal cells to produce collagenase.
    In the present study, the collagenase activity of the nasal secretions were estimated using FITC -labelled collagens as substrates. The factor, enhancing the fibroblasts to produce collagenase, was also isolated from nasal secretions and partially characterized. The fibroblasts used in the present study were cultured with explant of the sections of nasal polyp obtained from a patient with chronic sinusitis. The collagenase activity in nasal secretions from patients with chronic sinusitis was high, whereas that of allergic nasal secretions was extremely low. Furthermore, the collagenase productions of nasal polyp-derived fibroblasts were enhanced by the extracts of nasal secretions from patients with chronic sinusitis. Crude extracts of nasal secretions were fractionat ed by ammonium sulfate precipitation. The active materials precipitated by 50% to 80% ammo nium sulfate were further purified by Sephadex G-75 gel chromatography. The molecular weight determination of the active fraction checked by HPLC utilizing for TSK 2, 000 SW gel column indicates 20, 000 daltons for the active materials. However, the collagenase production of human microvascular endothelial cells derived from nasal mucosa was not enhanced by this factor. Although either the origin or the nature was not confirmed, the factor was considered to relate to the prolongation of chronic inflammation in the nasal and paranasal sinus pathology. Analysis of these factors will expected to establish methods for new therapeutics in chronic inflammation.
  • (鼻性T細胞型リンパ腫としての考え方)
    形浦 昭克
    1989 年 92 巻 4 号 p. 670-673
    発行日: 1989/04/20
    公開日: 2008/03/19
    ジャーナル フリー
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