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, 6 号
選択された号の論文の12件中1~12を表示しています
  • 変性及び再生
    野本 実
    1989 年 92 巻 6 号 p. 864-874
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    Morphological changes of the neuromuscular junctions induced by denervation and reinnervation have been investigated electronmicroscopically using cat intrinsic laryngeal muscles. Two experiments were performed : 1. simple transection of the unilateral recurrent laryngeal nerve at the level of the second tracheal ring ; 2. neurorrhaphy immediately after the transection at the same level.
    1. All the ipsilateral intrinsic laryngeal muscles except for the cricothyroid muscle were denervated 48 hours after the transection of the recurrent laryngeal nerve. In the denervated neuromuscular junctions some primary synaptic clefts were narrowed and others were flattened, while the secondary synaptic clefts were structurally preserved.
    2. Some of the regenerating axons returned to the neuromuscular junctions 3 weeks after neurorrhaphy, and all the muscle fibres were reinnervated after 6 weeks. The structural features of the reinnervated neuromuscular junctions were as follows ; 1) synaptic vesicles of the nerve terminals were more densely observed, 2) the original postsynaptic membranes were only partially in contact with the regenerated nerve terminals. These conditions persisted until 22 weeks after neurorrhaphy, when the appearance of remyelination was found in the vicinity of the neuromuscular junctions.
    Using an evoked electromyogram, the presence of neuromuscular transmission was observed 3 weeks after neurorrhaphy, indicating that the structural maturation of the neuromuscular junction was not necessary for neuromuscular transmission.
  • 自律神経によるシナプス形成
    野本 実
    1989 年 92 巻 6 号 p. 875-885
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    The purpose of this study is to identify the origin of the nerve terminals of unknown origin observed at the previously denervated neuromuscular junctions in the cat intrinsic laryngeal muscles. The results were as follows :
    1. Until 3 weeks after the transection of the recurrent laryngeal nerve, no nerve terminals were found at the neuromuscular junctions of the intrinsic laryngeal muscles except for the cricothyroid muscle, and no nerve fibres were detected in the Schwann tubes formed by Schwann cells and perineural cells. In addition, autonomic nerves around the vessels in the muscles were markedly decreased.
    2. At 6 weeks, accompanied by an increase of autonomic nerves around the vessels, nerve fibres and nerve varicosities containing a number of large granular vesicles were observed in the Schwann tubes.
    3. From 9 to 30 weeks, nerve terminals containing large granular vesicles were found at the neuromuscular junctions in all cases, even though the superior laryngeal nerve or the vagal nerve was transected on the ipsilateral side.
    4. A spontaneous discharge was recognized in 6/8 cases after 6 weeks, but an evoked electromyogram could not be recognized.
    5. The synaptic vesicles of the nerve terminals were labelled by 5-hydroxydopamine (5-OHDA), which was used as a marker for the sympathetic nerve.
    From these results, it was indicated that if the transected recurrent laryngeal nerve was prevented from regenerating, the autonomic nerves around the vessels entered into the Schwann tubes and reached the denervated neuromuscular junctions, instead of the motor nerve.
    The effect of the autonomic nerves on muscle fibres was discussed.
  • 唾液腺造影像との関係について
    加藤 洋子
    1989 年 92 巻 6 号 p. 886-892
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    Although the etiology of Sjögren's syndrome (SJS) remains unknown, Sjögren's syndrome can be diagnosed by means of clinical features and sialographic and histopathological examinations. In this study of 35 patients with primary SJS and 21 with secondary SJS, two parameters, (the findings of sialography of parotid gland and the histopathology of labial minor salivary gland), were evaluated. Then it was conculuded that grade of lesion in sialography was parallel to infiltrative grade of round cells around labial salivary gland in primary SJS but not in secondary SJS. Using monoclonal antibodies to cell surface antigens, lymphocyte subsets in 16 patients with primary SJS and 4 patients with secondary SJS were studied. A predominance of T cells was found and there was no definite chracteryzation of lymphocyte subset infiltration, between CD4 positive cell and CD8 positive cell. This result was different from the previous reports, and needs further studies.
  • 青木 和博, 江崎 史朗, 森川 清見, 菊池 康隆, 本多 芳男
    1989 年 92 巻 6 号 p. 893-898
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    It is generally believed that a cause and effect relationship exists between chronic middle ear inflammatory conditions and suppressed growth of the pneumatized cellulae. We already demonstrated the normal process of pneumatization and the suppressive process of pneumatization in experimental studies using pigs. In that study, the process of suppression of the pneumatization was caused by the continuous inflammatory changes of the epithelium of the middle ear cavity, and the degree of the suppression of the pneumatization was caused by the degree and duration of the air cavity's inflammatory condition at the growing stage of the mastoid process. We also carried out the histological study of the normal process of pneumatization using 100 sides of human fetuses between 16th and 36th week of pregnancy. In these studies the bone metabolisms which were found in the normal processes of pneumatization in pigs and human fetuses were same, and the normal pneumatization occurred at the growing stage of the mastoid process. This growing period of the mastoid is from 0 to 6 months after birth in pigs, and 0 to 15 years in humans. So in humans, we can infer that the suppression of the growth of the cellulae is closely related to a persistent state of otitic inflammation like an otitis media with effusion in the early stages of growth. From these studies, in children who have otitis media with effusion, it will be possible to realize the previous middle ear pathology by the degree of the suppression of pneumatization on x-ray film. According to this theory, two hundred forty-six children who had otitis media with effusion from the age of 3 years to the age of 15 years were separated to two groups by the degree of pneumatization on x-ray film, one group which had a large mastoid air cell system was treated with only a conservative treatment and the other group which had a small air cell system was operated mainly by insertion of a ventilation tube. After the start of this treatment, only twelve cases which were conservative treatment group's cases were changed to the operative treatment because of their difficulty to treat by conservative treatment. So it is clear that a large air cell system's group is basically good enough to treat only by conservative treatment, because the degree of pneumatization results from previous middle ear pathology.
  • 重心動揺からみた年齢変化
    八木 一記
    1989 年 92 巻 6 号 p. 899-908
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    Posturography is not a clearly defined examination. Recently a number of parameters can be obtained in stabilometry by means of computers. To evaluate each parameter and to decide its normal range, subject's age must be considered. The age-related factors found in stabilometry were studied in terms of both multiple regression analysis and cluster analysis. The parameters used in this study were as follows : the area of an ellipse for rejection and of the figure displayed on an X-Y recorder, the maximum width on both the X axis (left and right direction) and the Y axis (anterior and posterior direction), the total length and the sum of excursion in each direction, the root mean square, the velocity, the accerelation, and the averaged frequency of body sway in both X and Y directions.
    One hundred normal subjects, aged from the second to sixth decade, including 10 males and 10 females in each decade, were tested. Each subject was asked to stand on a platform in Romberg's position for 60 seconds with both eyes open and closed. The significant parameters to predict age, which were determined by multiple regression analysis, were as follows (P<0.05) : the averaged frequency in the Y direction with eyes closed, the maximum width in the X direction with eyes open, the area of the ellipse for rejection and of the figure with eyes closed, the maximum width in the Y direction and the area of the ellipse and the velocity in the X direction with eyes open. All test subjects were successfully classified into two groups by cluster analysis. One was the younger group aged less than 40 years and the other was the older group not younger than 40-year-old. However, the difference between with eyes open and with eyes closed was not significant (P<0.01) as regards the parameters of root mean square and averaged frequency in both sexes and at every decade. The difference between both sexes was supposed to be significant in the Y direction in the younger group and in the X direction in the older one.
  • 重心動揺のパターン認識
    八木 一記
    1989 年 92 巻 6 号 p. 909-922
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    A pattern of a figure which is displayed by an X-Y recorder or by a polygraph in stabilometry may present several qualitative facts about the standing ability of a test-subject. The purpose of this study was to make a quantitative evaluation of the body stability in both normal and ataxic patients who were standing erect. The technique utilised was pattern-recognition, composed of prinpal component analysis and discriminant analysis.
    Stabilometrical examinations were carried out in 20 normal subjects, 39 with peripheral vestibular disturbance and 11 with disturbance of the central origin. Each examinee was ordered to keep an upright posture for 60 seconds both with the eyes open and with the eyes closed. The following parameters were used : the area of the ellipse for rejection by a statokinesigram, the maximum width and the total length of body excursion, the root mean square, the velocity, the acceleration and the average frequency in the horizontal plane. These were the same parameters that were used in the first report.
    Each component predicting a specific character in stabilometry was identified by this study of principal component analysis. The relationship between the components in order and its prediction were as follows : the first component predicted the size of the body movement, the second the force, the third the density, the fourth the difference between body movement with the eyes open and with the eyes closed and the fifth the direction of body sway. Furthermore, the principal components were successfully utilized to allow the classification of the test subjects into three groups : those who were normal, those with peripheral vestibular disturbance and those with disturbance of the central origin. Discriminant functions were also used to classify the above mentioned three groups and another five groups, namely : those who were normal, those with vestibular neuronitis, those with positional vertigo of the benign paroxysmal type, those with Meniere's disease and those with cerebellar ataxia. In classification of the three groups, the significant parameters used for discrimination were as follows (P<0.05) : the root mean square with the eyes open, the distance and the maximum width of body excursion in the Y direction with the eyes open, the area of the ellipse for rejection both with the eyes open and with the eyes closed, the maximum width and the average frequency in the X direction with the eyes closed. On the contrary, the significant parameters used to classify the other five groups were as follows (P<0.05) : the length of excursion, the acceleration and the average frequency in the Y direction with the eyes open, the maximum width in the X direction with the eyes open, the root mean square in both the X and Y direction and the root mean square with the eyes closed. These discriminant functions may be available in differential diagnosis since they had a specificity and sensitivity of sufficiently high grade to classify both the three groups and the five groups, mentioned above.
    In conclusion, stabilograms were successfully classified into either three or five groups and they were discriminated quantitatively against each other by using discriminant functions.
  • 周波数音圧曲線,周波数位相差曲線のパラメータ主成分分析による診断法
    寺田 俊昌
    1989 年 92 巻 6 号 p. 923-930
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    A sweep-frequency tympanometer has been developed to diagnose auditory ossicular lesions more precisely. This device measures acoustic middle ear features by changing the probe tone frequency continuously. The oscillator sweeps frequency of the probe tone from 200 to 2, 500Hz in 1.5 seconds. A microphone picks up the changes in the acoustic pressure and the phase in the external auditory meatus during the frequency change of the probe tone. These measurements are performed under pressures at -200 and 0 dapa, and differences of both the acoustic pressure and the phase between these two pressures are graphically displayed using a microcomputer. This device can also measure and digitally display the frequency (BHz) and the sound pressure (BdB) at the minimum point (B) of the sound pressure curve, the frequency (ZHz) at 0 crossing point (Z) of the sound pressure curve, and the frequency (PHz) and the phase difference (Pdeg) at the maximum point (P) of the phase curve.
    Normal ranges of these five values were obtained to establish diagnostic criteria from 200 normal ears. The normal values were as follows : BHz, 480 to 1, 070Hz ; BdB, -6.0 to -1.8dB ; ZHz, 1, 100 to 1, 860Hz ; PHz, 910 to 1, 820Hz ; and Pdeg, 16.3 to 47.9°. Eight cases of ossicular dislocation and 14 cases of ossicular fixation, all of which had normal external auditory meati and tympanic membrance, were evaluated based on these values. All the cases with ossicular dislocation and 12 cases out of 14 with ossicular fixation were correctly diagnosed.
    Principal component analysis was performed on the data from 200 normal ears to calculate the primary principal component (PCA 1) and secondary principal component (PCA 2) in order to display these data on a two dimensional figure. Then this analysis was also performed on pathological ears. The results showed that the normal cases concentrated in the cross of the coordinate and abscissa, and cases of dislocation and of fixation were plotted on the right side and left upper side, respectively. As a conclusion, the sweep-frequency tympanometry is useful for the diagnosis of auditory ossicular lesions, and the numerical and two dimensional expression of the test result is a practical way as the diagnosis could be done based on the location of points in a PCA 1(X)-PCA 2(Y) figure.
  • 水上 千佳司, 山本 悦生, 大村 正樹, 磯野 道夫, 広野 喜信, 竹林 恵子, 森 一功
    1989 年 92 巻 6 号 p. 931-935
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    Recently, we had opportunity to use an oxygen saturation pulse oxymeter (minolta pulsox-7) which is a compact, light-weight device and allows continuous, percutaneous easy determination of arterial blood oxygen saturation.
    We obtained the following results from clinical application of this device in the field of otorhinolarygology.
    1. There was a high coefficient of correlation (0.899) between the values of oxygen saturation determined with a Minolta Pulsox-7 and an arterial blood gas analyzer.
    2. This instrument was simple to handle and was clinically applicable, and seems to be highly useful for a) timing of tracheostomy, b) objective evaluation of dypnea, c) moniter of nasal surgery under local anesthesia.
  • 堀 文彦, 川内 秀之, 茂木 五郎
    1989 年 92 巻 6 号 p. 936-942
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
    This study was designed to investigate the therapeutic efficacy of Cepharanthine for OME. Cepharanthine is a biscoclaurin type alkaroid, crude drug, and its main efficacy is to stabilize cell membranes. Experimental OME was induced in chinchillas by immunization with Keyhole Limpet Hemocyanin (KLH) into the right tympanic cavity following systemic sensitization. Forty-five chinchillas, weighing 350-600g, were used in this study. The animals were divided into 5 groups. Group A (N = 5), Group B (N = 5) and Group C (N = 5) were intraperitoneally given 1mg/kg, 2mg/kg or 5mg/kg dose of cepharanthine respectively, daily, after the induction of OME ; Group D (N = 5) received no medicine as a control group ; Group E (N = 17) received intraperitoneal administration of 2mg/kg of cepharanthine daily, for 7 days before the local antigenic challenge. The presence of middle ear effusion (MEE) was monitored daily by tympanometry and fiberscopic observation of the eardrum. At four days after experimental OME occurred, MEEs were aspirated aseptically through the eardrum and processed to biochemical analysis. The animals were then killed for the observation with autoradiography used by 3H-cepharanthine.
    Results demonstrated that the dose of 2mg/kg cepharanthine is more effective, compared with that of lmg/kg or 5mg/kg of cepharanthine. It was clear that this drug was immediately transferred to the middle ear following intraperitoneal administration and diffusely distributed in the middle ear mucosa.
    Findings of this study suggest the efficacy of cepharanthine is prophylactic and restorative against experimental OME.
  • 中島 務, 柳田 則之
    1989 年 92 巻 6 号 p. 986-989
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 第18回日本小児耳鼻咽喉科研究会
    平野 実
    1989 年 92 巻 6 号 p. 990
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 大国 真彦
    1989 年 92 巻 6 号 p. 991
    発行日: 1989/06/20
    公開日: 2008/03/19
    ジャーナル フリー
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