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, 5 号
選択された号の論文の14件中1~14を表示しています
  • 小笠原 真弓, 草野 英昭, 村上 裕, 樋口 明文, 村井 和夫, 立木 孝
    1989 年 92 巻 5 号 p. 687-693
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The audiological study for ears with aural stenosis and atresia was performed. The hearing level of ears with three types of ear plugs (with the hole of 1, 1mm, with the hole of q63mm and without the hole) was tested experimentaly by 10 normal hearing subjects in pure tone audiometry, and the audiograms of congenital and acquired aural stenosis and atresia were investigated statisti- cally. And then following results were obtained.
    1) The air conduction levels were higher, as the diameter of ear plug's hole got shorter in normal hearing subjects. And the shape of their audiograms was gradual sloping type.
    2) The air conduction levels of ears with congenital aural stenosis and atresia were almost from 60 to 70 dB, and the levels were almost same throughout 7 frequencies. But the audiograms of ears with acquired aural stenosis and atresia showed conductive and gradual sloping type.
    3) From the results mentioned above, the reason why the hearing loss of ears with aural stenosis and atresia showed conductive hearing loss limitted to low and middle frequencies was considered to depend on the abnormality of the middle ear.
    4) An average value of hearing threshold level in bone conduction among normal hearing subjects with three types of ear plugs was almost -7.8dB. There was no relation between the size of ear plug's hole and the shift of bone conduction level.
  • ステロイド大量点滴静注
    木西 實, 細見 英男, 天津 睦郎
    1989 年 92 巻 5 号 p. 694-702
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The etiology of Bell's palsy has not been as yet completely elucidated and the treatment is empirical and controversial. The two most common forms of treatment are steroid therapy and surgery. On the basis of the pathophysiology of Bell's palsy that edema as well as primary or secondary ischemia lead to both compression and hypoxia, Stennert employed high doses of cortison for a strong antiphlogistic and antiedematous effect, and dextran in combination with pentoxifilline to increase peripheral nerve perfusion and reported high recovery rate.
    Since the past 3 years, we have been treating patients with Bell's palsy with a high dose of steroid plus low-molecular dextran (SD therapy). Hydrocortisone was added directly to 500ml of dextran solution with ATP and vitamins, starting with 500mg and finally down with 100mg during 7 days.
    Before we had adopted this regimen, the patients with Bell's palsy were treated with orally- administrated steroid. A half dose of steroid was administrated in the latter regimen.
    SD therapy was employed in 120 cases of Bell's palsy, and its results were compared with those of 82 cases with orally-administrated steroid.
    In a total of 67 cases with incomplete palsy, all cases obtained complete recovery within one month after the onset regardless of the mode of treatment. Each patients with complete palsy was examined with a nerve exitability test (NET) at the first visit and one week later. According to the response of NET, the patients with complete palsy were divided into the following three groups ; " good ", " poor " and " absent "
    . In " good " group, all cases with SD therapy had complete recovery, while the recovery rate of 31 cases with orally-administrated steroid therapy was 90%. This difference was statistically significant (p<0.05).
    In " poor " group, the recovery rates were 88% and 53% in SD group and oral administration group, respectively. This difference was statistically significant (p<0.05).
    All cases in " absent " group remained incomplete recovery regardless of the mode of treatment. However, the final scores of facial movement were 82.1- 12. 2 and 49.2-8.7 in SD group and oral administration group, respectively. This difference was statistically significant (p<0.05). These results indicate that SD therapy to the complete palsy surpass the orally-administrated steroid therapy, while all patients with incomplete palsy recover completely within one month after the onset regardless of the mode of treatment. The following conclusions were induced.
    In case of incomplete palsy, the orally-administrated steroid therapy is useful unless incomplete palsy progresses in complete palsy.
    In case of complete palsy, however, SD therapy should be started immediately.
  • 藤森 功, 内田 實, 後藤 領, 大石 雄一郎, 村上 嘉彦, 山田 俊彦
    1989 年 92 巻 5 号 p. 703-708
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Several investigations have been reported on the interactive relation between the normal flora and the pathogenic micro-organisms in the human upper respiratory tracts (Thompson, Sanders, etc). It has also been known that some a-streptococci have inhibitory effect on the growth of group A 3-hemolytic streptococci.
    A study upon the role of a-streptococci in the throat (tonsil and pharynx) was performed using 73 culture specimens (throat swabs) obtained from 42 patients. Forty-four specimens were taken from the patients who received tonsillectomy, pre- and postoperatively, and 29 were from the patients who did not receive the operation. In the group of patients who received tonsillectomy, a-streptococci with inhibitory effect on the growth of group A, 8-streptococci were detected less frequently preoperatively, when compared with the patients without tonsillectomy. On the other hand, postoperatively, marked increase of a-streptococci of these types was found in the normal flora of the throat.
    However, further detailed study on this subject is necessary because of the exceptional results in our observations.
  • レクチンによる電顕組織化学
    金 春順, 鵜飼 幸太郎, 坂倉 康夫, 山田 弘之, 増田 佐和子
    1989 年 92 巻 5 号 p. 709-715
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Glycoconjugates in glandular and goblet cells of nasal mucosa were compared between normal and nasal allergy by using various horseradish peroxidase (HRP) -conjugated lectins ; WGA, PNA, UEA-I and RCA-I. Specific sugar residues of glycoconjugates could be identified under electron microscope. Golgi's complex of the serous secretory cells in nasal allergic mucosa had positive staining in UEA-I. Goblet cells of nasal allergic mucosa were stained strongly in PNA, compared to normal mucosa, however, they were stained weakly in WGA. In conclusion, glycoconjugates in glandular and goblet cells seem to be changed in nasal allergy.
  • 電顕,レクチンによる電顕組織化学
    金 春順, 鵜飼 幸太郎, 坂倉 康夫
    1989 年 92 巻 5 号 p. 716-721
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    To explain of the mechanism of the enhanced nasal epithelial permeability to HRP in patients with nasal allergy, the inferior turbinate mucosa was removed from 6 normal adults and 7 adults with nasal allergy. Difference of the fine structure of the intercellular junction was compared between normal mucosa and mucosa of nasal allergy by electron microscope. Staining pattern of four kinds of HRP-conjugated lectin (HRP-WGA, PNA, UEA-I and RCA-I) was also studied by electron microscope. There was no significant difference in the intercellular space of the mucosa between the normal mucosa and mucosa of nasal allergy. In the epithelial cell membrane, pattern of HRP-lectin staining was almost similar in both groups. In normal nasal epithelium, the intercellular junction consisted of junctional complex ; adherent junction, desmosome and gap junction. The intercellular space was approximately 150_??_250 A in width. The tight junction was located beneath the luminal surface of the epithelium, and belt-like continuation connecting the adjacent cells. It was concluded that enhanced permeability to HRP in nasal allergy was not morphologic changes of the intercellular junction and component and distribution of the glycocon-jugates in epithelial cellular membrane, but this may be based on functional changes.
  • 古川 仭, 上出 文博, 加藤 千維子, 坂下 英雄, 竹下 元, 梅田 良三
    1989 年 92 巻 5 号 p. 722-725
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Superinfection of Raji cells with Epstein-Barr virus (EBV) derived from P3HR-1 (P3H-EBV) leads to syncytium formation. Studies using inhibitors of DNA and protein synthesis suggest that the fusion-inducing factor belongs to the early antigen of virus-specified proteins. Induction of early antigen (EA) in Raji cells by using various chemicals also leads to syncytium formation. However, A2L/AH hybrid cells, which were prepared by fusion between epithelial cells of adenoid origin and lymphocytes transformed by B95-8 virus, could not be superinfected with P3H-EBV. But, the scyncytium formation was observed when EBV-EA was induced by chemicals in A2L/AH cells. It was considered that the synthesis of viral protein in superinfected Raji cells is essential for fusion and that the viral genes, inducible in Raji and A2L/AH cells by treatment with chemicals code for the necessary functions that lead to syncytia formation.
  • 乳突洞口断面積の影響について
    石原 基正
    1989 年 92 巻 5 号 p. 726-735
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    To aid in the establishment of optimum conditions for postoperative function of the tympanic membrane, a model of the middle ear was experimentally prepared, the cross-sectioned area of aditus ad antrum was altered and the effects on the tympanic membrane vibrational characteristics were observed using the holographic interference method. The following results were obtained.
    1) At the low frequencies below 2 kHz, the vibration mode of tympanic membrane was concentric on the whole, but the vibration pattern became fractionated at 4 kHz and above. The frequency of onset of the fractionated vibration pattern was changed only by the conditions of the membrane itself and was not affected much by the sound pressure, the volume of the middle ear cavity and the cross-sectioned area of aditus ad antrum.
    2) There were resonance and anti-resonance points in the tympanic vibration pattern. These resonance and anti-resonance frequencies became higher as the diameter of aditus increased until eventually a constant value was reached. At diameters in excess of this constant value, the resonance frequency tended to fall and the anti-resonance frequency tended to rise.
    3) The tympanic vibration in the middle ear cavity was not influenced very much by the diameter of aditus at 250Hz. Vibration decreased when aditus was blocked at 500Hz and the opening diameter had a major influence at 1kHz. Vibration was maximum at a diameter of about 2mm and a minimum when aditus was blocked. At 2 to 3kHz, the effects on vibration increased when aditus was blocked.
    4) When aditus ad antrum was blocked, the vibration frequency characteristics of tympanic membrane deteriorated at under 1kHz and improved at 2 to 3kHz. When a comparison was made between the case with opened aditus, (which was considered to be equivalent to the closed method of tympano - plasty), and the case with closed aditus, (considered to be equivalent to the open method), the vibration frequency characteristics of the tympanic membrane improved in the low sound region up to 2kHz when the diameter was 4mm.
  • 前山 拓夫, KARL-HEINZ PLATTIG
    1989 年 92 巻 5 号 p. 736-740
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Taste is an indispensable sense as well as olfaction to spend a tasteful life. The objective method of examining taste has not yet been established. Previous attempts to get gustatory evoked potentials (GEPs) in men and animals failed by contamining artifacts. Solving this problem, the following developments were done.
    1) Avoiding tactile artifacts, the tongue was rinsed constantly with distilled water.
    2) By recording and averaging the galvanic skin response (GSR) at the same time, its influence on GEPs was compensated.
    3) For proper averaging by computer, conditions of precise onset, duaration of stimulus, the shortest stimulus rise and fall times were fulfilled by magnetic valve system.
    The new gustometer is expected to be one of the standard objective methods of examining taste in clinical practice.
  • 登上線維投射
    神田 憲一
    1989 年 92 巻 5 号 p. 741-750
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The inferior olive afferents to the cerebellar uvula were studied by means of retrograde axonal transport of horseradish peroxidase (HRP) in the cat. Following large and small injections of HRP into the uvula, the distributions of labeled cells in the inferior olive were investigated.
    As to the climbing fiber projection, it is revealed that there are six longitudinal parasagittal zone extending throughout the dorsal and ventral uvula. That is, the caudal aspect of the nucleus beta projects to a most medially oriented zone (caudal beta zone), the rostral aspect of the nucleus beta projects to a zone (rostral beta zone) oriented lateral to the caudal beta zone, the caudal aspect of the medial accessory olive (MAO) projects to a zone oriented lateral to the rostral beta zone, the dorsomedial cell column projects to a zone (dorsomedial cell column zone) oriented in the interme- diate part of the uvula, the ventral lamella of the principal olive (v1PO) projects to a more lateral zone (v1PO zone), and the rostral aspect of the MAO projects to the most lateral zone (rostral MAO zone).
  • 苔状線維投射
    神田 憲一
    1989 年 92 巻 5 号 p. 751-763
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The mossy fiber projections to the uvula of the cerebellum were studied by means of retrograde axonal transport of horseradish peroxidase (HRP) in the cat. Following large and small injec- tions into the uvula, distribution of the labeled cells in the brainstem nuclei was investigated.
    The results showed different afferent projections between the dorsal and ventral uvula. Major sources projecting to the dorsal uvula were the peduncular, paramedian, and lateral nuclei of the pontine nuclei. Labeled cells found in the pontine nuclei amounted to 81. 6% of the total number of labeled cells in cat 1. On the other hand, major sources projecting to the ventral uvula were the caudal aspect of the medial and inferior vestibular nuclei, the x- and f-groups of the vestibular nuclei, the dorsal and central aspect of the superior vestibular nucleus, the rostral dorsomedial aspect of the paramedian nucleus of the pontine nuclei, the caudal aspect of the prepositus hypoglos- sal nucleus, and the infratrigeminal nucleus. Labeled cells in the vestibular nuclei amounted to 72. 1% of the total number of the labeled cells in the cat 40. It was revealed that the lateral aspect of the ventral uvula receives inputs from the pontine nuclei, whereas the medial part of the ventral uvula receives inputs from the vestibular nuclei. Mediolateral differences were not found in the dorsal uvula. These mossy fiber zones were mediolaterally wide, and the dorsal uvula was different from the ventral uvula with regard to mossy fiber projection.
  • その心理状態と経過について
    横山 晴樹
    1989 年 92 巻 5 号 p. 764-771
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    A questionnaire was mailed to 120 vertiginous patients who had taken either the CMI or the Y-G psychological test over one year ago. Of the 120 patients, 106 answered the questionnaire. They were classified into two groups of emotional instability, group A and group B, according to the results of the test.
    The subjective improvement rate of group A was 71. 9 percent, worse than that of group B. This shows that the patients in group A displayed a tendency to continuously being receive stronger treatment than those in group B.
    The subjective improvement rate of group B was 90. 5 percent, and better than that of group A. But the patients in group B showed no tendency toward vertigo attacks that were milder than those of the patients in group A. Therefore the patients in group B were satisfied by the decrease of the frequency of vertigo attacks.
    The results suggest that it is highly important to consider the psychological aspects of the patients in group A.
  • 黒野 祐一, 金田 則嗣, 茂木 五郎
    1989 年 92 巻 5 号 p. 772-776
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to evaluate the accuracy and clinical availability of MicroTymp (Welch Allyn) which was new, portable, cordless, and hand-held impedance audiometer, 64 normal subjects and 52 patients with otitis media with effusion were examined by use of MicroTymp and Amplaid 702 (Dana Japan). The types of tympanogram were agreed with each other in 87% of ears. Six cases of type C tympanograms in MicroTymp were shown to be type A by Amplaid 702, and the average of peak pressure of MicroTymp was more negative than Amplaid 702. The difference of peak pressure seemed to be influenced by the speed of ear canal pressure change, because the speed of MicroTymp was considerably higher than Amplaid 702; -200mmH2O/sec in MicroTymp, and - 50mmH2O/sec in Amplaid 702. In the experimental study on 7 normal ears, negative shift of peak pressure was observed by increasing the rate of ear canal pressure change from -25mmH2O/sec to -50mmH2O/sec in Amplaid 702. These findings suggest that one should note in the judgment of type C tympanogram in MicroTymp having the peak pressure close to -100mmH2O.
  • 内田 豊
    1989 年 92 巻 5 号 p. 804-807
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 村上 嘉彦
    1989 年 92 巻 5 号 p. 808-809
    発行日: 1989/05/20
    公開日: 2008/03/19
    ジャーナル フリー
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