日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
93 巻, 2 号
選択された号の論文の14件中1~14を表示しています
  • 飯田 祐起子
    1990 年 93 巻 2 号 p. 157-164
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Stellate ganglion block (SGB) is clinically used for the treatments of various lesions diseases. SGB gives rise to nasal obstruction of transient duration. It is also suggested that derangement of the autonomic nervous system underlies nasal allergy. In order to study the hemodynamics of the nasal mucosa after SGB, two groups of the subjects, i. e. healthy volunteers and patients with nasal allergy, were included for evaluation of the partial pressure of oxygen of nasal mucosa (PtsO2) after SGB. Simultaneous evaluations were done to assess the nasal patency in the normal group and the temperature at the anterior tip of the inferior nasal turbinate in the nasal allergy group. The results thus obtained are summarized as follows:
    1) In the normal group, SGB was resulted in a reduction in nasal patency on the blocked side and a significant increase in PtsO2 when compared with the non-blocked side. The PtsO2 remained higher than normal after although nasal patency was restored.
    2) The PtsO2 at rest was lower in the nasal allergy group than in the normal group.
    3) Changes in PtsO2 following SGB were similar in the two groups.
    4) A parallelism was noted between changes in the temperature at the tip of inferior nasal turbinate and those in PtsO2 during SGB.
    These results suggest that SGB augments the arterial blood flow in the nasal mucosa. The compromized nasal mucosa of nasal allergy patients is in a state of hypoxia but showed virtually the similar improvement in circulation after SGB as noted in the nasal mucosa of normal subjects.
  • 木村 恭之, 上出 文博, 古川 仭, 三輪 高喜, 作本 真, 梅田 良三
    1990 年 93 巻 2 号 p. 165-170
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Among nerve cells of vertebrates, the olfactory elements are uncommon in their capacity to turnover and to be replaced after injury. An autoradiographical and morphological observation has shown that degenerated olfactory nerve cells are reconstituted by a new population of neurons which originate from basal cells. However, an autoradiographic method requires a special isotope institute and it takes a long time for the final specimen to observe. Recently, a rapid technique without the radioisotope has been alternatively developed in which a thymidine analogue, 5-bromo -2'-deoxyuridine (BrdU), is incorporated into replicating DNA and subsequently localized using a specific monoclonal antibody. In the present study, cell dynamics of olfactory mucosa in mice were investigated by means of immunohistological technique.
    The results were as follows.
    1. The labelled elements were concentrated at the basal layer of the epithelium, which were observed 5hrs after the first injection of BrdU.
    2. At 15 days after administration of BrdU, the labelled elements were located in the midlayer of the epithelium, where can be recognized as the compartment of nerve cells.
    3. After 30 days, the labelled cells disappeared from the epithelium. It indicates that the period of turnover in the olfactory epithelium of mice is within 30 days.
    4. Fifteen days after axotomy of the olfactory nerves, two stained patterns which were neumerously or sparsely labelled regions were observed. The former is considered that immature neurons predominantly exist, and the latter is the area which mature neurons abundantly locate.
    It is considered that this immunohistological approach is useful for the observation of the
    turnover of the olfactory epithelium.
  • 佐竹 充章, 柴原 義博, 石垣 元章, 高坂 知節
    1990 年 93 巻 2 号 p. 171-176
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    The forecast of daily Japanese cedar (Cryptomeria japonica) pollen counts was performed in Sendai in 1987, 1988 and 1989. The expected daily maximum temperature was used as a main determinative factor, and the term "pollen index", which is a ratio of a daily pollen count to the rest of the total seasonal pollen count, was devised and proved to be closely related to the daily maximum temperature.
    In 1987 and 1989, the total seasonal pollen count was very low, and daily pollen counts were in the lowest of three grades, except for a few days of the middle grade. In 1988, a fairly large number of pollen grains were observed, and forecasts of low grade were made for 28 days, middle grade for 25 days and high grade for 10 days, respectively. On the other hand, the actual daily pollen counts of low grade were 36 days, middle grade, 15 days, and high grade, 12 days, respectively. The accuracy of the forecast was 67% in 1988. The reasons for errors and the assignments for the forecast were discussed.
  • Ad, As型の新しい判定基準の提案
    熊川 孝三
    1990 年 93 巻 2 号 p. 177-182
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    The diagnosis of the ossicular condition, fixation or interruption, is often not achieved by the tympanometry, because the overlap of the distribution of the static compliance (SC) is so great with the normal group in these two groups. Therefore, it has been said that SC, by itself, has little diagnostic value for differentiating the ossicular lesion.
    The overlap of the distribution of SC, however, was much smaller between the group with ossicular fixation and the one with ossicular discontinuity. So, apart from deviation from the normal range of SC, the limiting value of SC for discriminating the two groups was determined in ears with conductive hearing loss. The subjects were fifty-one ears with ossicular fixation and seventeen ears with ossicular discontinuity, in which ossicular lesions were surgically confirmed. All ears showed intact tympanic membrane.
    The limiting value of SC was 0.9cc. The internal check using this discriminant value showed high ratio of discrimination, i.e. 94.1% in the fixation group and 64.7% in the discontinuity one were diagnosed correctly. Therefore the author proposed this value as the new criteria to differentiate type As ("s" means sclerosis) tympanogram from type Ad ("d" means discontinuity) one. In addition, the comparison of SC with the normal side in twenty-five unilaterally affected ears showed smaller SC in 75% of the fixation group and larger SC in 92.3% of the discontinuity one than the normal side.
    Thus, it can be said that SC have useful value in separating ossicular fixation from ossicular discontinuity, if one compares ears with both the intact tympanic membrane and conductive hearing loss.
  • 兼竹 博之, 山口 幹夫, 山下 利幸, 武田 直也, 小池 靖夫
    1990 年 93 巻 2 号 p. 183-189
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    To the best of our knowledge little if any information is available concerning human laryngeal mucosal blood volume presumably because the larynx is an anatomical position which renders the measurement of blood flow there difficult. With the advent of a reflectance spectrophotometer, however, studies of tissue blood flow have been facilitated to a great extent. As a result, attempts have been made to determine mucosal blood volume in various organs and tissues including the gastric mucosa.
    Recently, an ultra-thin fiber probe (1.8m min diameter) for measurement of tissue blood volume has been developed. Using a laryngeal flexible fiberscope attached with this newly developed probe in the opening for the forceps, an attempt was made to measure laryngeal mucosal blood volume by the method of reflectance spectrophotometry, determining IHb and ISO2 the former of which is a parameter of hemoglobin in the tissue blood vessels and the latter, a parameter of hemoglobin oxygen saturation in the tissue blood vessels.
    IHb of the vocal folds is significantly low, about half those of the false folds and arytenoid region, whereas ISO2 is significantly higher in the false folds and arytenoid region than in the vocal folds. The hemodynamics in the vocal folds as a high-speed vibrator are specific, unlike in other laryngeal regions.
    We have plans to determine laryngeal tissue blood volume at more sites so as to investigate the laryngeal tissue distribution of blood volume in greater detail. Furthermore, tissue blood volume in morbid conditions will also be determined for information which will be of value in clinical applications.
  • 金 春順
    1990 年 93 巻 2 号 p. 190-198
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to clarify possible alterations of membrane-, and cytoplasma-glycoconjugates of laryngeal cancer cells in metastatic process, a histochemical study was performed on laryngeal squamous carcinoma, using seven lectins conjugated with horseradish peroxidase (HRP); PNA, UEA-I, WGA, RCA-I, DBA, SBA and MPA. The author studied 32 primary tumors and 32 corresponding metastatic tumors obtained from 32 patients and primary tumors from 8 patients
    without histological evidence of lymph node metastasis. None of the patients underwent irradiation or chemotherapy before operation. The specimens were provided for routine lectin histochemistry. The present study revealed some significant differences in lectin-binding as follows.
    Primary tumor vs. metastatic tumor: There was a significant difference in lectin-binding between primary and metastatic cancer cells. 29 (90.0%) of 32 primary tumors were positive for MPA-staining. On the other hand, 21 (65.6%) of 32 metastatic tumors were positive for MPA-staining. There was a statistically significant (p<0.05) difference between primary and metastatic tumors with regard to MPA-binding. Primary tumor cells tended to more bind with lectins than with metastatic tumor cells.
    Well-differenciated primary tumor vs. moderately differenciated primary tumor: There was a significant difference in lectin-binding between these two types of tumors. Of 15 well-differenciated primary tumors, 13 (86.7%) showed SBA binding. The percentage of SBA-binding was significantly higher in well-differentiated tumor than in moderately differenciated primary tumors (50%, 8/16).
    Keratinization vs. non-keratinization: There was a significant difference in lectin-binding between keratinized and non-keratinized tumor cells in both primary and metastatic lesions. Keratinized metastatic tumor cells had significantly higher affinity to UEA-I, SBA and RCA-I than non-keratinized metastatic tumor cells. The percentages of SBA-, RCA-I- and UEA-I-stainings were 100%, 91.7% and 50%, respectively, for keratinized metastasis (n=12), and 70%, 30% and 5% for non-keratinized one (n=20).
    Primary tumor associated with cervical lymph node metastasis vs. primary tumor without cervical lymph node metastasis: 22 (68.8%) of 32 primary tumors associated with cervical lymph node involvement were positive for DBA-staining, whereas 8 primary tumors non-associated with this involvement were all negative. There was a significant difference between these two types of primary tumors with regard to DBA-staining. The above findings strongly suggest that glycoconjugates in cytoplasma and plasma membrane of cancer cells are altered in the process of metastasis, and closely related with metastatic potential and progression of laryngeal carcinoma.
  • 重野 浩一郎, 隈上 秀伯, 野田 哲哉, 江上 徹也, 中島 成人
    1990 年 93 巻 2 号 p. 199-206
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Experimental positional nystagmus (EPN) similar to benign paroxysmal positional nystagmus (BPPN) was induced in 8 of 20 rabbits by argon laser irradiation to the footplate. The power of the argon beam used was 2.0 watts and irradiation time was 1 or 2 sec.
    EPN and BPPN showed the following similarities maintained (1) When the head was maintained in the affected ear down position and the head positioned from the sitting to the supine position nystagmus directed to the affected ear or vertical nystagmus corresponding to rotatory nystagmus in man were provoked. (2) Delayed onset for provocation of nystagmus. (3) Limited duration. (4) Fatigability. (5) The direction of nystagmus was reversed when the head returned to the initial position (in two rabbits).
    Histological examination of the temporal bones showed separation of otoconia from the otolithic membrane of the saccule and bleeding in the saccule in both conditions. No lesions in the utricle and semicircular canals were evident. It was assumed that ablation of otoconia of the saccule causes this experimental positional nystagmus.
  • TSUYAKO FUKUYAMA, KOICHI MATSUO, TADATSUGU MAEYAMA, TAKEMOTO SHIN
    1990 年 93 巻 2 号 p. 207-218
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Recently, the Nd-YAG laser has been widely applied for head and neck surgery. This medical instrument provides several advantages, including hemostatic efficacy and cutting capability which are dependent on manipulation. The purpose of this study is to discuss the clinical application of Nd-YAG laser in the field of oropharyngeal surgery. For this reason, the canine tongue is used in this study. After irradiation by Nd-YAG laser, observations were performed on histological findings, measurement of tissue temperature and changes in blood vessels. The results obtained are as follows;
    1) Irreversible tissue changes were found in the center of the irradiated area, with other tissue degeneration occurring in the surrounding areas.
    2) Within the coagulated degenerative area, blood vessels were completely embolized.
    3) Temperature measurements revealed that there were minimal effects on the surrounding tissues.
    4) The coagulated degenerative area was replaced by granulation tissue subsequently occurring after wound healing.
    5) The Nd-YAG laser was useful for oral and paranasal surgery, because these diseases are localized in the cavity.
    6) Non-contact type Nd-YAG laser was indicated for vaporization of the lesions and was particularly useful for vaporizing superficial benign lesions. In this case, close range, low power vaporization is recommended. Conversely, vaporization for hemangioma and/or malignant lesions were most effective with high power irradiation.
    7) Contact type Nd-YAG laser might be suitable for cutting and excision of lesions, but careful attention must be given determining the safety margin for application in malignant lesions, because tissue degeneration when using contact type Nd-YAG laser is less reactive than in noncontact type.
  • 山岨 達也, 菅沢 正, 八木 昌人, 原田 勇彦, 二木 隆
    1990 年 93 巻 2 号 p. 219-228
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Acute low-tone sensorineural hearing loss (ALHL) has the following three criteria; obscure origin, acute onset and sensorineural hearing loss limited to low frequencies. Sixteen cases of ALHL which were considered as cochlear hydrops using glycerol test and electrocochleogram were studied. All patients visited our department within two weeks after onset and were followed up for one year or more after initial examination. The subjective symptoms, the character of vestibular and hearing impairment and prognosis of 16 cases with ALHL were also investigated.
    The results were as follows.
    1. Patients complained of ear fullness rather than hearing impairment. Four patients were unaware of hearing loss.
    2. Recruitment phenomenon was found in all of 15 cases examined. Vestibular findings were mostly normal, except that spontaneous nystagmus was found in two cases and head-shaking nystagmus in one.
    3. Recurrence and fluctuation of hearing impariment occurred in 14 cases. Three cases had an attack of rotatory vertigo once and two has diagnosed as Meniere's disease later.
    4. During three months prior to last examination, hearing was stabilized in nine cases and continued to fluctuate in seven cases. In the former, hearing was improved in four cases, unchanged in three, and worsened in two.
    5. Two patients underwent an endolymphatic sac operation and have had a good prognosis.
    6. The authors suggest that most of ALHL should be considered as transient cochler hydrops because the subjective symptom and audiological and vestibular findings of our cases are similar to those of cases which were reported as ALHL by other investigators. According to the findings of glycerol test and electrocochleogram, endolymphatic hydrops in ALHL is considered to exist in all turns of cochlea.
  • 膨大部神経電位に及ぼす影響
    平川 治男
    1990 年 93 巻 2 号 p. 229-243
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    The inhibitory response of the posterior semicircular canal (p.s.c.) ampullary nerve was studied in comparison with the excitatory response. The isolated p.s.c. of the bull frog was stimulated by the mechanical endolymphatic flow toward either the ampullofugal (AF, excitatory) or the ampullopetal (AP, inhibitory) direction. Three experiments were performed.
    1) Experiment I: The influence of the endolymphatic K+ concentration.
    In both the high (50mM) and the low (2.5mM) K+ environment, the inhibitory response was smaller than the excitatory response. This was more pronounced in the low K+ environment.
    2) Experiment II: The influence of the initial position of the cupula.
    The magnitudes of the responses when the cupula was moved from various positions were compared. When the same amount of stimulus was given in the same direction, the responses were equal regardless of the initial position of the cupula. The inhibitory response yielded a time constant approximately 2-3 times as long as the excitatory response.
    3) Experiment III: The interaction of the AF and the AP stimulus.
    The influence of the inhibitory response upon the following excitatory response and vice versa, were studied by changing the timing of the stimulus onset. Both the action potential and the DC potential were recorded for comparison. The AP stimulus which immediately followed the AF stimulus suppressed the action potential and the negative DC potential was observed. On the other hand the AF stimulus which immediately followed the AP stimulus gave rise to the distinct positive DC potential but the action potential could hardly be evoked. That AF stimulus resulted in different responses between the action potential and the DC potential indicates that the DC potential recorded in this study is possibly a generator potential.
  • 高橋 宏幸
    1990 年 93 巻 2 号 p. 244-255
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Mycobacterium chelonae has a pathogenicity for mouse inner ear, resulting in "spinning disease". The mice were subjected to intravenous injection of 1-1.2×107 organisms of strain ATCC19977 of M. chelonae subspecies abscessus. Morphological changes in the inner ear were investigated together with changes in behavior and auditory brainstem response (ABR). Three days after injection, the threshold of ABR rose in high frequency and the latency of the fifth wave prolonged. The behaviors of the mice such as "grooming" or "sniffing" were suppressed day by day. Fourteen days after injection, 35% of mice showed abnormal behavior, such as "spinning disease". The damage in the cochlear and vestibular sensory cells were observed using scanning electron microscopy and light microscopy. The inner ear showed serous or purulent labyrinthitis after injection. The most specific change found in purulent labyrinthitis was massive abscess of the cochlea with necrosis. Serous labyrinthitis which might have been induced by bacterial toxins was characterized by homogeneous and eosinophlic precipitates and slight cellular infiltrations in the perilymphatic and endolymphatic spaces. In the organ of Corti, the inner and outer hair cell cilia had degenerated and disappeared. In the vestibular end organs, the sensory cilia were fused, lost and sustained ballooning. The cross links and rough nature of the sensory hair membrane had disappeared in the early stage of serous labyrinthitis.
  • 立本 圭吾
    1990 年 93 巻 2 号 p. 256-267
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Anticonvulsant drugs like Carbamazepin and Phenytoin natrium (PHT) have been used for suppressing the tinnitus.
    In this paper, a clinical experience was reported, in that 100 patients with tinnitus were treated with intravenous administration of PHT, and the influence of PHT on auditory systems in the guinea pig investigated in ditail electrophysiological examinations was also reported.
    The results are summarised as follows:
    1. Clinical evaluation in the treatment of tinnitus
    (1) Of the 100 patients, more than 70% were well responded.
    (2) Pith match, loudness balance test correlated closely with the suppression of tinnitus.
    (3) Side effects were found in 5%, but there were all mild enough to be well tolerated.
    2. Experimental evaluation in the guinea pig
    (1) In intravenous administration of PHT, latency and amplitude of each waveform peak in ABR were prolonged and decreased. As for the latency, waves III and IV were most prominently affected. The results may indicated that PHT works in the upper brain stem predominantly and effects also to the cochlear nucleus and cochlear nerve.
    (2) The amplitude of N1 in AP was depressed and its latency was slightly prolonged. These phonomena related closely with change of wave I in ABR. This may indicate that PHT can directly suppress the cochlear nerve.
    (3) Even at the dose that apparently influenced ABR and N1 in AP, no obvious change was observed on amplitudes in CM and EP, that may indicate PHT cannot affect on hair cells at this dose or it cannot proceed to the cochlea.
    (4) These changes were considered to be direct effect of PHT on auditory systems, since they were not correlated with change in the circulatory system.
    (5) In the perilymphatic perfusion of PHT, amplitudes in EP and CM were depressed slightly at the beginning of the perfusion. Changes in EP preceded those in CM. The results may indicate that PHT effects directly on the stria vascularis and secondarily on CM.
    (6) In this perfusin, no obvious change was found in AP. Nevertheless, the amplitude of N1 in AP increased over the initial level after the perfusion corresponding to the recovery of EP in some animals. The results may indicate that PHT cannot work directly on hair cells nor cochlear nerve and that the suppression of efferent inhibitory neurons can increase AP potentials.
    (7) PHT works on the large part of auditory pathway without cochlea, as a role of inhibitor. Considering antitinnitic effect of PHT, tinnitus bases on unusual excitements of the auditory pathway.
  • 加藤 寛
    1990 年 93 巻 2 号 p. 268-281
    発行日: 1990/02/20
    公開日: 2008/12/15
    ジャーナル フリー
    The auditory responses of infants until 3 months after birth were examined using the doll "Nenkororin" which contains a tape recorder of the intrauterine sound (IUS). The purpose of this study was to assess the applicability of these responses to screening of infants with severe hearing impairment. The results are summarized as follows.
    1. The IUS with 1/3-octaval audiofrequency of 400Hz-4kHz was presented to 152 neonates. Positive responses showing alert inactivity were obtained in 148 infants, but negative responses in 2 neonates. 2 infants were undetermined. The neonates showed negative responses had severe hearing impairment with comparison of ABR. ABR was also carried out in 69 of the 152 infants. The results of ABR well agreed with those of the IUS test.
    2. A typical reaction of neonates who stopped crying and assumed a state of alert inactivity in responses to the IUS was demonstrated until approximately one month after birth. At the end of the first month after birth, the threshold of this reaction grew smaller than that of the one-week period after birth. The latent time of this reaction also tended to become shorter.
    3. The infants mostly failed to respond to the 1/3-octaval noise consisting of 0.5, 1.0, 2.0, 4.0kHz extracted from the IUS. From the experiment using high and low pass noise components extracted from the IUS. High response were obtained at low frequencyy band components below 1kHz.
    4. Public health nurses without experience of auditory test were requested to compare the reaction by the IUS test and an auditory reflex test using tongue-clicking, whistling and papercrumpling sounds. The IUS test was found to be easier for evaluation of the reactions than the other method of test.
    From the above results it is concluded that the auditory response to the IUS was useful for screening of severe hearing impairment in neonates until one after birth.
  • 新井 景子
    1990 年 93 巻 2 号 p. 282-289
    発行日: 1990/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Standard Language Test of Aphasia (SLTA) may not represent sufficiently about communication ability of aphasic patients. Therefore authors studied factors affecting the communication ability of aphasic patients. Subjects were 66 aphasic patients treated in the Department of Communication Clinic, Atami General Hospital. These patients were divided into 2 groups; good communication (41 cases) and bad communication groups (25 cases) according to the result of communication ability test. Factors affecting the communication ability are then examined by quantitative analysic class 2. Nine factors, severity of aphasia, self-modification in speech, memorization disorder, disturbance of volition ability, the time elapsed since onset, disturbance of concentration and continuation ability, depressive state, shyness, positiveness are revealed to be greatly affecting the communication ability of aphasic patients.
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