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93 巻, 9 号
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池野 敬一1990 年 93 巻 9 号 p. 1307-1313
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーCharastaristic nystagmus simular to the Menieres' attack could be observed after introducing KCI solusion into the tympanic cavity of guinea pigs. To confirm the fact that this nystagmus was provoked by the high perilymphatic potassium ion concentration, the K+ activity of perilymph was recorded serially through the K' specific microelectrode inserted into the scala tympani. The rapid increment of K+ activity reached maximum at 120 minutes after introducing KCI solusion, and then it decreased gradually to a half of the maximum activity. However, such change of perilymphatic potassium ion concentration was not observed by introducing sucrose solution as control.抄録全体を表示PDF形式でダウンロード (1245K) -
暁清 文, 西原 信成, 佐藤 英光, 柳原 尚明1990 年 93 巻 9 号 p. 1314-1319
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーRecurrence of the perilymphatic fistula is not rare and may be a tough problem for surgical treatment. This is because a graft is usually applied on the ruptured window(s)from the middle ear and therefore the perilymphatic pressure directly acts on the graft. The recurrence may be caused by a technical failure, use of an unsuitable graft material, poor postoperative bedrest, trauma, increased inner ear pressure, etc. In our clinic, the recurrence occurred in 70f 48 cases surgically treated. Vertigo accompanied with spontaneous or positional nystagmus was seen in all 7recurrent cases, while only 20f them complained of worsening of the existing hearing loss. Reoperation was carried out in two patients. In the first case, closure of the round window by the previous operation was found incomplete, and the perilymph leaked through the gap around the graft. In the second case, closure of the round window was complete, but perilymph leaked from the oval window. In order to prevent the recurrence, the operation should be carefully performed by using strong and adhesive tissue as a graft material, applying a glue between the graft and the inner ear window(s), and keeping strict postoperative bedrest.抄録全体を表示PDF形式でダウンロード (979K) -
鼓室内貯留液細胞診の有用性間口 四郎, 田渕 伴秀, 熊谷 雅彦, 石川 和郎, 千田 英二, 田中 克彦1990 年 93 巻 9 号 p. 1320-1327
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーAlthough otologic involvement by leukemic infiltration was supposed to be unusual, increasing number of cases have been reported in recent years, probably due to the advance of chemotherapy, improved remission rate and longer survival of leukemic patients. Two cases of myelogenous leukemia with infiltration of mastoid bone were reported. One is 15-year-old girl with acute myelogenous leukemia, which had been well controlled for 1 year, developed a sudden onset of facial nerve palsy. The other is 30-year-old female with chronic myelogenous leukemia and blastic crisis, complained hearing loss. As both cases had exudate in the tympanic cavity, the punctures were carried out through the eardrum, The pathological study of these exudate cells revealed the involvement of mastoid bone by leukemia.
The cytologic examination of exudate in the tympanic cavity is simple, time-sparing and of little burden to the patient. This technique is very useful and supposed to take the place of the exploratory surgery of mastoid cavity which is previously considered necessary for the correct diagnosis.抄録全体を表示PDF形式でダウンロード (2486K) -
武井 泰彦, 行本 英生1990 年 93 巻 9 号 p. 1328-1334
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーCT scanning has made significant contributions to the diagnostic, therapeutic and prognostic aspects for the managements of the lesions in the paranasal sinuses and the orbit. The current' availability of 3-D imaging reformatted from CT scans has added a new dimension to anatomic investigations and pre- and postoperative evaluations of the skull base structures.
Twenty-five craniomaxillofacial 3-D CT examinations were performed during the year of the 1989 for the purpose of the diagnosis of the pathology, surgical planning and postoperative evaluation in reconstructive surgery of the skull base.
Results : 1. The use of 3-D CT improves the display of the location and volume of thepathology and affords the accurate therapeutic and surgical planning.
2.Preoperative 3-D CT imagings are useful for the display of the bony erosion of the skull base. Stereotaxic 3-D CT imagings are particulary appreciated in the diagnostic aspects of the management of the pathology.
3.In the reconstructive surgery of the skull base, an accurate prefabricated model of the bony defect can be made to aid the surgery.
4.A major limitation of 3-D CT is its inability to reconstruct the pathology of soft tissues with the same fidelity afforded bony structures.抄録全体を表示PDF形式でダウンロード (2523K) -
小笠原 真弓, 村上 裕, 後藤 昌代, 立木 孝, 村井 盛子1990 年 93 巻 9 号 p. 1335-1346
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーFifty-eight children (from 4 to 19 years of age) with bilateral, symmetrical, sensorineural hearing loss, who had used a hearing aid in only one ear for 1 to 19 years were investigated to study the influence of hearing-aid upon the residual hearing between the used and no used ears.
The results were as follows,
1)The average hearing level for the used ear at seven frequencies was 49. 5dB of prehearingaid usage and was 53.8dB of posthearing-aid usage. The discrepancy of audiograms between the aided and unaided ear was not remarkable.
2)The hearings for both the aided and the unaided ears in Audiograms was progressive for a long time. But no significance relation was observed between changes in used-ear hearing of the aided and unaided ears.
3)When the hearing levels of the children were scrutinised on an individual basis, it was found that 9 cases (15. 5%) in both ears, 2 cases (3. 4%) in only used ear and 1 case (1. 7%) in only no used ear out of 58 cases showed deterioration of hearing.
4)These data did not lead us to the conclusion that hearing-aid usage was detrimental on the residual hearing of children with sensorineural hearing loss.抄録全体を表示PDF形式でダウンロード (990K) -
末武 光子, 小林 俊光, 高坂 知節, 新川 秀一1990 年 93 巻 9 号 p. 1347-1353
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーNinety ears (52 patients, aged 3-11 years) affected by secretory otitis media (SOM) were treated by insertion of ventilation tubes (VT). Following insertion of the VT, middle ear air volume of these ears was estimated using an impedance audiometer, at 1, 3, and 6 months postoperatively, and every 3 months thereafter. The middle ear air volume, expressed as the compliance value, increased rapidly for the first 3 months followed by a gradual increase thereafter. A great difference among the compliance values of ears was observed, values ranging from over l0cc to below 1. 5cc at 6 months, postoperatively. Twelve percent of the ears had compliance values of less than 1. 5cc, and in this group, CT showed opacified and poorly developed mastoid cells.
Although the association of upper respiratory disorders such as chronic sinusitis, nasal allergies and cleft palates were found to be more frequent in cases of ears with smaller compliance values, this was not statistically significant. Small compliance values (middle ear air volume) were correlated with the early onset of acute or secretory otitis media, repeated otorrhea after VT insertion and high recurrence rates after the extrusion of the VT.抄録全体を表示PDF形式でダウンロード (547K) -
山口 幹夫, 阿河 邦治, 兼竹 博之, 小池 靖夫, 加島 健司1990 年 93 巻 9 号 p. 1354-1362
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーThe purpose of this study is to evaluate the blood volume and blood flow in human tympanic membrane.
Hemoglobin concentration (IHb) and oxygen saturation of hemoglobin (ISO2) were measured in 71 ears by using a tissue spectrum analyzer. Blood flow (Flow level) was measured in 40 ears by using a laser speckle flow meter. By using two fiber optic probes, these three parameters were measured in the tense part of the tympanic membrane.
A comparison was made between the measurements made with fiber probe touching the tympanic membrane and the measurements not touching it. Between two measuring patterns, there was no significant differentiation in three parameters, so we took non-touching tequnique.
IHb and Flow level had reproducibility between the first and second recordings. But ISO2 did not have clear reproducibility.
In normal tympanic membrane, IHb and Flow level were not significantly correlated (r=0.52).
IHb was 16±1.3 (Mean±SEM) in nomal cases, 17±4.6 in otitis media with effusion and 104±22.8 in acute otitis media. Flow level was 0.7±0.07 in nomal cases, 0.6±0.07 in otitis media with effusion and 2. 2±0.37 in acute otitis media.
It is considered that the measurement of hemoglobin concentration by using tissue spectrum analyzer and the measurement of blood flow by using laser speckle flow meter are useful in the studies of the pathophysiology of human tympanic membrane. tympanic membrane, blood flow,
Key words : otitis media with effusion, tissue spectrum analyzer, laser speckle flow meter抄録全体を表示PDF形式でダウンロード (1210K) -
IEC373に対する批判竹内 義夫1990 年 93 巻 9 号 p. 1363-1371
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーMechanical impedances of human mastoids and foreheads were measured on frequencies from 250 to 6300Hz for 80 young adults by means of B&K impedance head (# 8000) and shaker (# 4810) as main parts of the measuring setup. The measurements revealed the following problems in the IEC373 (1971/1981) which had defined the mechanical impedance characteristics of the mechanical coupler for calibration of bone vibrators in audiometric use. The average impedance levels of the mastoids differ significantly from those of the foreheads in middle and high frequencies. The impedance levels of the IEC373 mechanical coupler are higher than those of the present measurements of the mastoids and the foreheads. The differences exceed the tolerance limits of IEC373 (1981) in every frequency. These findings strongly suggest that the coupler is neither the artificial mastoid nor the artificial forehead but a coupler having a spedified impedance, therefore, disregard for effect of the type of bone vibrator on the Reference Equivalent Threshold Force Level, as seen in IS07566, should be revised and that the RETFL should be determined for an each type of bone vibrator.抄録全体を表示PDF形式でダウンロード (702K) -
免疫組織学的検討高橋 光明, 富山 俊一1990 年 93 巻 9 号 p. 1372-1378
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーSecondary endolymphatic sac (ES) immune response against keyhole limpet hemocyanin (KLH) were immunohistochemically investigated in guinea pigs by analysing the distribution of IgG and C3 complement in the inner ear over a 4-week period. After systemic sensitization with KLH and Freund's adjuvant, KLH was inoculated into the right ES by trans-cranial approach. KLH was found in the ES immediately after KLH challenge and then disappeared on the 7th day. On the 2nd and 3rd day moderate endolymphatic hydrops and a massive cell infiltrations within the
ES were observed, and they gradually decreased their severity with time. Diffuse stainings with IgG and C3 were found in the ES, the epithelial and subepithelial regions of the vestibule. Similar findings were obtained in the spiral ligament and the hair cells after antigen challenge. IgG bearing cells were detected within the endolymphatic sac alone. Our results suggested that endolymphatic hydrops may be produced by the imbalance of in-out flow of the endolymph and the immunologically mediated inflammation through IgG-complement system.抄録全体を表示PDF形式でダウンロード (2517K) -
関眞 規子, 市川 銀一郎, 小端 哲二, 奥村 康1990 年 93 巻 9 号 p. 1379-1387
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーDepartment of Immunology, Juntendo University, School of Medicine, Tokyo
The killer cell characteristics of γ δTCR-bearing T cells induced from human tonsil by streptococcus pyogenes stimulation were examined. Immunohistologic staining of tonsil showed that γ δTCR-bearing T cells were mainly located in the interfollicular area connected with stratified squamous epithelium. Streptococcus pyogenes could induce the proliferation of γ δTCR- bearing
T cells from tonsil in the presence of low-dose of IL-2. This streptococcus pyogenes-induced γ δTCR-bearing T cell proliferation was likely to be independent on the IL-2/IL-2R system since an obvious inhibition was not observed with anti-IL2 and anti-IL-2R mAbs. More importantly, these γ δTCR-bearing T cells exhibited cell-mediated cytotoxic activity in a 4hr 51 Cr-release assay. In addition, immunocytochemical staining revealed that these cells contained a killer protein perforin. These results demonstrate that y6TCRbearing T cells from tonsil exhibit typical killer cell characteristics. These data also suggest that γ δTCR-bearing T cells in human tonsil may play a cytotoxic role in protecting the integrity of tonsil from infection抄録全体を表示PDF形式でダウンロード (1641K) -
古川 政樹, 山下 耕太郎, 金子 まどか, 大石 公直, 澤木 修二, 柊 光一, 猪狩 秀則1990 年 93 巻 9 号 p. 1388-1396
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーOne of the most important problems in dealing with vocal cord paralysis is to clarify the cause of paralysis. In those case where the definite cause is unknown, it is possible that an occult type of malignant tumors exists along the course of the vagus or recurrent laryngeal nerves.
For the past 16 years, 62 out of 560 cases with vocal cord paralysis were diagnosed to have malignant tumors first manifested by paralysis of vocal cord. They consisted of 25 cases of thyroid carcinoma, 18 lung carcinoma, 13 esophageal carcinoma, 3 mediastinal tumors and 3 tumors of miscellaneous origin. Among these, 36 were male and 26 were female and the mean age was 63 years old. In 40 cases, paralysis was found on the left side, in 18 on the right and bilaterally in the remaining 4. There was a marked sexual difference in the origin of malignant tumors, i. e. the incidence of lung carcinoma was higher in male with paralysis on the left side, while that of thyroid carcinoma was higher in female. In some cases with throid carcinoma, vocal cord paralysis wasnoted more than a year before the detection of the tumor.
Ultrasonography of the neck, chest x-ray, CT scan of the chest, fluoroscopy of the pharyngoesophagus should be performed for the detection of malignant tumors in cases with left vocal cord paralysis, while ultrasonography of the neck and chest x -ray should be sufficient in right paralysis, although additional fluoroscopy of the pharyngo -esophagus seemed preferable in male. vocal cord paralysis, malignant tumors, diagnostic抄録全体を表示PDF形式でダウンロード (1258K) -
長谷川 寿珠1990 年 93 巻 9 号 p. 1397-1409
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリー102 children (mean age-7 years 9 mo.) with mild and moderate perceptive hearing impairment who had neither any auditory training nor had used a hearing aid were studied. Mean hearing level was 51.9dB. Our findings :
(1) Speech discrimination score (SDS) correlated with the hearing level at 2, 4 and 1kHz, in that order. In all patients, SDS gradually worsened to 60dB before registering a sharp decline ; SDS was better than in patients who had acute unilateral hearing impairment and similar audiogram patterns, especially in vowels.
(2) Correlation existed between the rate of accurate articulation and hearing levels at 2 and 4kHz ; it improved with age but plateaued at around 8 years. In children with a high tone loss, distortion and confusion of fricatives, plosives, unvoiced affricates and postconsonantal vowel /i/ were marked besides articulation errors commonly attributable to normal speech development.
(3) On the WISC and WISC-R intelligence scale, verbal intelligence score had little correlation with performance intelligence and was influenced by hearing levels at 2, 4 and 1kHz, in that order. When the mean hearing level was over 40dB, verbal intelligence was frequently below par. Performance intellgence grew worse with age.
(4) Children with a mild hearing loss exhibited a slight delay in vocalizing the 1st word and combining 2 words together while in those with a moderate loss, the delay in combining 2 words was pronounced. In both mild and moderate hearing loss, verbal intelligence was low when there was a delay in the ability to vocalize two words together.抄録全体を表示PDF形式でダウンロード (951K) -
神崎 仁1990 年 93 巻 9 号 p. 1446-1447
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (108K) -
柳原 尚明1990 年 93 巻 9 号 p. 1448-1449
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (99K) -
第52回耳鼻咽喉科臨床学会平野 実1990 年 93 巻 9 号 p. 1450-1451
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (156K) -
森田 守1990 年 93 巻 9 号 p. 1452-1453
発行日: 1990/09/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (222K)
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