巻号一覧
後続誌
前身誌
94 巻, 11 号
選択された号の論文の14件中1～14を表示しています
- |<
- <
- 1
- >
- >|
-
石尾 健一郎, 山根 雅昭, 飯沼 壽孝, 広田 佳治, 鈴木 光也, 小山 和行1991 年 94 巻 11 号 p. 1665-1672
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーA 57 year-old Japanese male was seen with the chief complaints of left parotid gland swelling, pain, trismus.
At the initial visit, a subcutaneous mass, measuring 50 x 70mm, was seen in the left parotid region. The mass was moderately tender and the consistency was soft anteriorly and elastic firm posteriorly. The mobility was restricted with no change in the skin covering the mass. The saliva from the left parotid gland was normal in colour and contents. Various imaging modalities were done preoperatively including CT, MRI, ultrasonography and aspiration biopsy under the ultrasono-graphic guide. None was thus conclusive for the differential diagnosis and our tentative diagnosis was a cystic lesion in the parotid gland.
A partial parotidectomy was performed under general anesthesia and the cystic lesion, measuring 20mm in diameter, was found in the deep lobe. The cyst showed no connection to the external ear canal, and tracts and fistulae were absent.
Histopathological report lead to the definite diagnosis of lymphoepithelial cyst. A mild and incomplete facial palsy on the left had been noted for more than 10 years and this, however, improved after the surgery.抄録全体を表示PDF形式でダウンロード (2535K) -
荒尾 はるみ, 丹羽 英人1991 年 94 巻 11 号 p. 1673-1682
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーAuditory brain-stem responses (ABR) to click stimuli were recorded from 81 children and 20 young adults of Down's syndrome with normal hearing. Comparisons were made to groups of normal control subjects matched by age and sex. I - V interpeak interval in infants younger than 18 months was significantly shorter, while that in children over 18 months and young adults with Down's syndrome was not shortened, compared with that of each control group.
Previous studies have emphasised that, regardless of age, the I - V interpeak interval in Down's syndrome is significantly shorter than in the control group. However our study suggests that cases of Down's syndrome with normal hearing have normal central conduction times after CNS maturation. And the shortened central conduction times in infants of Down's syndrome were not lesser than that of normal adults. Our results suggest that the shortened central conduction time in Down-syndrome infants is associated with earlier neurological maturation in Down's syndrome.抄録全体を表示PDF形式でダウンロード (663K) -
高橋 光明, 上戸 敏彦, 畑山 尚生, 篠原 宏, 茗荷 秀昭, 荻野 武, 海野 徳二1991 年 94 巻 11 号 p. 1683-1688
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーEight cases were treated by lateral skull base surgery. Three benign tumors (2: paraganglioma, 1 : neurinoma) originated from parapharyngeal space and infiltrated into jugular foramen, and five malignant tumors (3: squamous cell carcinoma, 1 : adenoid cystic carcinoma, 1 : rhabdomyosar coma) involved the skull base.
Preoperative magnetic resonance imaging gives information as to whether tumors invaded to cranial bone or not, and also permits deciding surgical procedures.
Surgical management of mandibular bone was performed in five cases for complete tumor resection and sufficient surgical view ; hemimandibulectomy was carried out in four malignant cases, who simultaneously underwent radical neck dissection, and one benign case underwent mandiblotomy. Ligation of sigmoid sinus was carried out in four cases (1 ; benign, 3 ; malignant) to control bleeding from large vessels. The skull base was reconstracted with myocutaneous flaps which were fixed by fibrin tissue adhesive. No significant surgical complications were not noted.
There were no recurrence of benign tumor during 8-13 years follow up period. Malignant tumors, except one (rhabdomyosarcoma), had no local recurrence during follow up period (4 months-2 years) .
We emphasize that the progress in preoperative assessment, as well as in reconstructive surgical techniques, will assure more adequate indication of lateral skull surgery for malignant tumors.抄録全体を表示PDF形式でダウンロード (975K) -
千葉 恭久, 古屋 信彦1991 年 94 巻 11 号 p. 1689-1693
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーThe optokinetic pattern test for optokinetic nystagmus is performed to diagnose equilibrium disorders on clinical examination. We constructed computer assisted instruction (CAI) algorithm based on knowledge of expert for optokinetic pattern (OKP) diagnosis theoretically based Fuzzy reasoning derived from Fuzzy theory to ascertain the possibe application of CAI to OKP and to develop a useful diagnostic tool.
The algorithm was constructed by rules of fuzzy reasoning using analysed data of diagnostic modes of one expert, consisting of six variables, and of 30 normal and 22 abnormal patterns of optokinetic nystagmus which were diagnosed by the expert. The results derived from the fuzzy reasoning and those obtained by expert agreed with 96% in this test battery. In addition, a consistency of 87.3% was obtained after comparison with another 251 OKP patterns which diagnosed by the same expert and estimated by this algorithm. This algorithm incorporating fuzzy theory is concluded to be useful in obtaining results of the same as those of an expert for diagnosing the equiliblium disorders. Furthermore, CAI using Fuzzy theory is confirmed to have good potential as a diagnostic tools.抄録全体を表示PDF形式でダウンロード (451K) -
西井 さつき, 間島 雄一, 野々山 勉, 岡田 英作, 高橋 志光, 湯田 厚司, 坂倉 康夫1991 年 94 巻 11 号 p. 1699-1706
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーEighty cases of pediatric sinusitis (4 to 15 years old, averaged 8 years old) were treated with frequent antral irrigations. Antral puncture was made through the inferior meatus with a Kyoto University needle under topical or general anesthesia. Then a plastic tube of 14G Medicut 19 intravenous canula was left in place to serve as an indwelling catheter. Antral lavages were performed through this tube 3 times daily for 7 to 10 days.
The opacity of the maxillaly sinus at post-treatment was improved significantly compared with that at pre-treatment in Waters view. This improvement was continued even at about 5.7 months after treatment. The opacity of the ethmoid sinus was also improved significantly after the treatment in occipito-frontal view. Our results suggest that the frequent antral lavage is an useful therapeutic modality for pediatric sinusitis.抄録全体を表示PDF形式でダウンロード (2274K) -
佐野 肇, 高橋 廣臣, 岡本 牧人, 八尾 和雄, 稲木 勝英1991 年 94 巻 11 号 p. 1702-1709
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーIn 106 autopsies of patients in Kitasato University Hospital from 1974 to 1989, who had died of malignant tumor in the head and neck, the relationship between the clinical diagnosis and its autoptic finding was retrospectively investigated.
The result was summarized as follows.
1. Characteristics in 98 cases other than malignant lymphoma :
1) Local recurrence was detected by autopsy in 60 cases (61%) among 98.Discrepancy between clinical diagnosis and autoptic findings was recognized in 10 cases (10%), in whom 4 false positive cases by clinical diagnosis were included and it was considered that the rate was relatively high.
2) The metastatic lymphnodes were demonstrated by autopsy in 50 cases (51%). Discrep- ancy between clinical diagnosis and autoptic findings was found in 37 (38%), 35 of them were clinically diagnosed to be negative. However, in 35 of them it was considered that the discrepancy had not influenced their fatal courses.
3) Metastases to distant organs were demonstrated by autopsy in 49 (50%). Discrepancy between clinical diagnosis and autoptic findings was found in 39 (40%). 33 of them were clinically diagnosed to be negative. The discrepancy concerned with the causes of death was shown in 5 cases.
2. Characteristics in 8 cases of malignant lymphoma :
Discrepancy between clinical diagnosis and autoptic findings of distant metastases was fre- quently observed but the discrepancy concerned with the causes of death was not shown. There were 2 cases in which side effect of chemotherapy may cause poor prognosis.抄録全体を表示PDF形式でダウンロード (744K) -
熊谷 雅彦, 松島 純一, 原田 千洋, 犬山 征夫1991 年 94 巻 11 号 p. 1710-1715
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーThis study was aimed to elucidate the effects of salicylate on the cochlear nerve by recording the spontaneous activity in guinea pigs. After guinea pigs were given salicylate (200mg/kg) intravenously, the transient reduction in cochlear spontaneous activity and the elevation over the subsequent 10-20 minutes were observed in three of four fibers recorded for more than 30 minutes. The mean spontaneous discharge rate of 102 fibers after administration of salicylate (200mg/kg) was not significantly higher than the control values from 30 to 120 minutes after salicylate adminis-tration, while that rate of 112 fibers after administration of salicylate (400mg/kg) was significantly higher. The observed changes in spontaneous activity due to salicylate administration may represent the evidence of a tinnituslike phenomenon in guinea pigs.抄録全体を表示PDF形式でダウンロード (462K) -
吉尾 知, 徳増 厚二, 藤野 明人, 長沼 英明, 野口 浩男, 新田 健太郎, 星野 功1991 年 94 巻 11 号 p. 1716-1726
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーIt seems acceptable that pathological brain stem lesions exist in the patient with Neuro-Behcet disease (NB). However, only few reports have been published in this field.
We report the neuro-otological findings in 33 patients who fulfilled the diagnostic criteria of Behcet disease completely or uncompletely. The patients were classified into 2 groups : one is group of NB and the other is a group of Behcet disease without NB (non-NB). Furthermore, the latter was devided into 2 subgroups of patients with dysequilibrium and patients with normal equilibrium. They underwent equiliblium function tests, such as body balance test, gaze test, spontaneous and positional nystagmus test, eye tracking test (ETT) and optokinetic pattern test (OKP) by using electro-nystagmography (ENG).
The following results were obtained.
1. Cerebellar and brain stem lesions were confirmed in all cases of NB group.
2. Most cases (6 of 8 cases) in the subgroup of dysequilibrium of the non-NB group showed peripheral vestibular disturbance. The other two patients were diagnosed to be vertebro-basilar insufficiency (VBI) and vascular Behcet disease with CNS disorder, respectively.
3. Nine of 13 patients in the normal equilibrium subgroup of the non-NB group were diagnosed to be neurotologically normal. However, we found two patients with peripheral vestibular disturbance and CNS disorder associated with hearing disturbance of the retrocochlear origin, respectively.
4. The neuro-otological examination is assumed to be useful to diagnose neuro-Behcet disease, to reveal the lesion site and the state of dysequilibrium in patients with Behcet disease.抄録全体を表示PDF形式でダウンロード (3721K) -
前腕皮弁を用いた症例について黒田 浩之, 田原 真也, 天津 睦郎1991 年 94 巻 11 号 p. 1727-1732
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーSoft palate and tonsil (mesopharynx) play an important role on articulation and swallowing. We must take care not to restrict these physiological function when we reconstruct the mesopharyn-geal defect after cancer ablation. In order not to restrict the postoperative function of mesophar-ynx, we take it the more important to preserve the function of the residual tissue rather than to rebuild the lost function. We took notice of pliable nature of the radial forearm flap and tried to reconstruct mesopharyngeal defect in five cases with this flap.
We analyzed articulatory function and velopharyngeal closure in these cases, postoperatively. Articulatorty function was assessed on the results of intelligibility test with 100 Japanese monosylla-bles. In four cases out of five, about 70% of syllables were accurately heard. According to the Hirose's standard of speech function after the operation of oral and/or oropharyngeal cancer, those four cases were evaluated also to be excellent. Whether the resection was done beyond the uvula or not, proved not to have anything to do with the postoperative speech intelligibility. Although speech intelligibility once went down immediately after the operation, it improved around six months later. The improvement might be due to the following facts ; The forearm flap was cicatrized postoperatively, disturbing the mobility. After the softening of the cicatrix began, the flap gradually recovered flexibility, which enabled surrounding structure to move more smoothly.
Articulatory dysfunction was characterized as plosives tend to be misunderstood as nasals or affricates. Concerning nasality, the velopharyngeal closure was examined by fiberscope. Perfect closure was seen in two cases, near-perfect in two cases, and insufficient in one case. In the near -perfect cases a small space was observed in the side where the forearm flap was transplanted.
Previous reports depict that the patients who obtained the score more than 70% in speech intelligibility test can go back to their casual life. Actually, even our patients without perfect velopharyngeal closure did not have any trouble in conversation with their family or on phonecall.抄録全体を表示PDF形式でダウンロード (1459K) -
岡本 美孝, 白鳥 浩二, 工藤 和夫, 伊藤 永子, 戸川 清1991 年 94 巻 11 号 p. 1733-1737
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーThe role of respiratory syncytial virus (RS virus) in otitis media with effusion was studied. Reverse transcriptase-polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (Nested PCR) were used to provide accurate methods for detection of RS viral sequences in the otitis media effusion from children. We could find RS viral sequences in 10/12 samples tested which had been collected during and even after natural outbreak of RSV in the community. These observations suggest RS virus as an important factor in the pathogenesis of otitis media with effusion. The disturbance of the local humoral and cell-mediated immune response in the middle ear accompanied with RS virus infection may lead to the development of infection-induced inflammation and ventilatory compromise, development of suppurative and effusion, multiplication of low virulence pathogens and subsequent development of mucosal damage.抄録全体を表示PDF形式でダウンロード (942K) -
川島 悦子1991 年 94 巻 11 号 p. 1738-1747
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーAttic retraction was also observed in 4. 5% of cases without inflammation, but its severity was mild. The incidence of attic retraction in cases of adhesive otitis media was 42. 7% in mild adhesive otitis media (adhesive grade I) and 60. 8% in severe adhesive otitis media (adhesive grade II), both incidences were significantly higher than the incidence of 23.8% in cases of otitis media with effusion. Thus, the incidence of attic retraction increased as the grade of adhesion became severer. In cases of otitis media with effusion, the incidence was significantly higher in the adult group (32.3%) than in the child group (17.4%).
In many of the ears with otitis media with effusion, adhesive grade I and chronic otitis media, the severity of attic retraction was mild. There were more cases of milder retraction in the child group than in the adult group.
Attic retraction underwent change with time in 2. 8% of cases, and cholesteatoma occurred in 1. 8% of cases. No improvement in attic retraction was achieved by insertion of a ventilation tube.
Bilateral attic retraction was observed in 56. 9% of the child group and 30. 2% of the adult group, and the difference was statistically significant.
Ear X-ray findings by SchUller's method revealed many ears with poorly developed mastoid cells and poor pneumatization. Good pneumatization was seen in many cases of mild attic retraction.
On CT, 18.3% of the cases of attic retraction had no shadow in the middle ear cavity. In all other cases, a shadow was observed in some part of the middle ear cavity.
In the operative cases, the presence or absence of attic block coincided with the presence or absence of shadow in the middle ear cavity as shown by CT.抄録全体を表示PDF形式でダウンロード (1301K) -
野中 学, 富山 俊一1991 年 94 巻 11 号 p. 1748-1755
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーWe examined vestibular dysfunction and histological damage caused by direct antigen chal-lenge to the endolymphatic sac in guinea pigs. We observed spontaneous nystagmus every eight hours and performed caloric testing every week following endolymphatic sac secondary KLH challenge. Spontaneous nystagmus was seen in 12 of 18 animals, and nystagmus in all directed toward the unchallenged ear (paralytic). The caloric response time courses were classified into two types, which were irreversible type and reversible type after endolymphatic sac KLH challenge. The immune injury of animals with irreversible type was thought to be stronger than that of these with reversible type. The spontaneous nystagmus of irreversible type animals was longer than that of reversible type animals. The temporary vestibular dysfunction was thought to be similar to that observed in Meniere's disease.抄録全体を表示PDF形式でダウンロード (2679K) -
喉頭の血管神経支配岩田 重信1991 年 94 巻 11 号 p. 1794-1797
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (214K) -
第4回日本口腔•咽頭科学会本庄 巖1991 年 94 巻 11 号 p. 1798-1799
発行日: 1991/11/20
公開日: 2008/03/19
ジャーナル フリーPDF形式でダウンロード (143K)
- |<
- <
- 1
- >
- >|