日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
94 巻, 3 号
選択された号の論文の14件中1~14を表示しています
  • 沖田 渉, 市村 恵一, 田中 利善, 飯沼 壽孝
    1991 年 94 巻 3 号 p. 291-299
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    Endothelin (ET), a novel endothelium-derived vasoconstrictor peptide with 21 amino acid residues, has recently been isolated from the supernatant of cultured porcine aortic endothelial cells.Several authors reported preliminary results demonstrating that ET has a potent contractile action in vascular smooth muscles, but its effect is slightly different in each target tissue. In the present study, we have examined the vasoactivity of ET in human and canine nasal mucosa with in vitro bioassay. The results are as follows.
    1) ET induced a slow, and very sustained contraction from 10-9M. This response is stronger than that of noradrenaline (NA) and continued for 6-12 hours.
    2) Under the sustained contraction by the adminstration of a, adrenoceptor agonist (methoxamine), ET induced an additional contractile response.
    3) The response of ET depended on the concentration of Ca'-`
    4) ET did not affect the contraction of vascular smooth muscle which was caused by the electrical stimulation.
    5) ET increased the contraction of vascular smooth muscle which was caused by the administration of NA into the bath solution.
  • 西園 浩文, 森山 一郎, 小川 和昭, PHAKDEE SANNIKORN, 大山 勝
    1991 年 94 巻 3 号 p. 300-306
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    Laser is useful for surgery to cut, coagulate, vaporize and weld the tissue. Recently, low power laser was utilized for the treatment of ulcer, pain and vascular anastomosis. We applied low power Nd : YAG laser irradiation for skin approximation. An experimental study was carried out by using the Nd : YAG laser in approximating the surgically cut skin wound of guinea pigs.Healing of the wound was observed on post operative days of 3, 7 and 21, respectively. Laser approximation for the incised skin showed less scaring and faster healing than conventional suture technique. This laser technique will be beneficial as one of the new procedures of skin suture in clinical practice. The results were discussed from either technical or cosmetic standpoint.
  • 飯沼 壽孝, 池田 利昭, 加瀬 康弘, 粟山 純一, 市村 恵一, 山根 雅昭
    1991 年 94 巻 3 号 p. 307-315
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    Morphological relation between the sphenoidal sinus and the petrous apex cell was studied using HRCT images obtained by 339 adults and 43 infants. The adults were classified into normal group(without chronic otitis media or its surgery)237 cases, and otitis group(chronic otitis media or its post. op.), 102 cases, The posterior extent of the sphenoidal sinus was evaluated in reference to the carotid canal, and the petrous apex cells were evaluated by their mode of distribution in the apex.
    In the normal adults, no evident relation was seen between the posterior extent and the mode of distribution. Although adult normal female showed statistically significant better development of the posterior extent, sinus-cell relation was similar between both sexes. The adult. normal group and otitis group behave similarly by sinus-cell relation, i.e., no evident relation, although inhibited mode of distribution was seen by otitis group. When the adult and infant were compared, the sinus-cell relation was similar and the posterior extent suffered underdevelopment by infant.
    The distance, between the posterior extension of the sphenoidal sinus and the apex cell at the medial-anterior tip of the petrous bone, is between 8…16mm and the contact of the both separated by thin bony wall(less than 0.5mm)was seen in 3 adult cases(0.9%).
    Both the sphenoidal sinus and the petrous apex cells are under genetic influence of variable degree, separate genes seem to be at work, thus effecting no evident relation between the two.part from the internal or genetic influence, environmental or outer influence also affectsthe jevelopment of the two, less than the genetic. And the common factor as the inflammation might Wing about adverse effects upon the development of the two, as both the sinus and cells often suffer common underdevelopments.
    The trans-sphenoidal approach to the petrous apex ls lndicated when the apex is already expanded and in contact with the sinus wall. Rare cystic lesions and primary cholesteatoma are reported as operated upon by this approach.
  • 藤本 政明
    1991 年 94 巻 3 号 p. 316-324
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    The vestibular aqueduct (VA) and paravestibular canaliculus (PVC) were reconstructed using a computer-aided three-dimentional reconstruction system (SERSERS) from five series of the serial, histopathological sections of the human tempolar bones without alignment markers. In order to align the serial sections, more than ten sectional tissue structure images on a section such as the cochlea, VA, PVC, semicircular canals, ossicles and facial canal were compared with those on the consecutive section and the position was determined where the deviation of each sectional image pair would be the minimum in every direction. Repeating this procedure throughout the series of the sections, we could perform the overall alignment of the sections. As the standard viewing axis of reconstruction, we used the modiolus and constructed a triplet of images ; posteromedial view image viewing from posterior surface side of the pyramis parallel to the modiolus, superior view image viewing from anterior surface side of the pyramis perpendicularly to the modiolus, anteromedial view image viewing from the internal carotid artery side perpendiculaly to the modiolus. The triplet images of the cochlea, VA and PVC presented us their three-dimentional configuration and the spatial relationship among them. Superior view showed that the angle between the plane of the proximal portion of the VA and that of the basal turn of cochlea varied in a wide range from 53 degrees to 68 degrees. Anteromedial view showed that the angle between the plane of the distal portion of the VA and that of the posterior semicircular canal also varied in a wide range from 22 degrees to 49 degrees. In comparison with a medial view graphic reconstruction method developed by Egami and Sando (1984), computer-aided three-dimentional reconstruction gives us more precise configurations of the VA and PVC and their spatial relationships to the posterior semicircular canal.
  • 安部 治彦, 井上 都子
    1991 年 94 巻 3 号 p. 325-332
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    Bilateral tumors of the same histotype occur rarely in opposite organs. These include hereditary diseases such as retinoblastoma and Wilm's tumor. Bilateral tumors of the same histotype also occur in the parotid glands. A study was performed to determine if there is a possibility that hereditary tumors are included in such cases.
    Two cases of bilateral parotid tumors, one of pleomorphic adenoma and one of adenolymphoma were reported, and 59 cases reported between 1942 and 1990 with clear times of onset which underwent histological examinations were analyzed.
    The main histotypes were adenolymphoma in 50.8% (30 cases), pleomorphic adenoma in 27. 1% (16 cases), acinic cell tumor in 13. 6% (8 cases). Onset of the tumors was simultaneous in 43% of the adenolymphomas. The sex and age at onset showed the same trends as in unilateral cases for each histotype. Among parotid tumors, the percentage of bilateral onset is 1_??_2%, and when adenolymphomas which show the highest incidence among such tumors were considered from the standpoints of multiplicity, simultaneous onset and the fact that they are benign, the possibility that hereditary diseases are included in the aforementioned 43% was suggested.
  • I:短期観察
    富山 俊一, 野中 学, 八木 聰明, 後藤 裕一, 池園 哲郎
    1991 年 94 巻 3 号 p. 333-342
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    The development of endolymphatic hydrops (e. hydrops) following secondary e. sac immune response was investigated in Hartley guinea pigs, for a period of 5 weeks. E. hydrops immediately developed to a maximum from day 2 to day 7 and then gradually reduced in the next 4 weeks. In the e. sac, numerous inflammatory cellular infiltrates, mainly polymorphonuclear cells and macrophages, were seen from day 1 to day 2. Lymphocytes and plasma cells appeared from day 3 and increased to a maximum by day 7 and then gradually decreased in the next 4 weeks. Neither primary e. sac KLH challenge nor e. sac PBS inoculation could derive e. hydrops. Development of e. hydrop was considerably parallel to the grade of immune reaction within the e. sac, suggesting that immuno-pathological reaction of the e. sac has an important effect on regulation of the endolymph volume.
  • 平野 実, 佐藤 公則, 田中 信三, 田井 良明, 井上 要二郎, 清川 兼輔, 重森 稔
    1991 年 94 巻 3 号 p. 343-350
    発行日: 1991/03/20
    公開日: 2008/07/30
    ジャーナル フリー
    A total of seven patients with head and neck tumors underwent a surgery of the anterior skull base in combination with an extracranial approach. Two patients had squamous cell carcinoma of the frontal sinus ; one, undifferentiated carcinoma of the ethmoid sinus ; two, squamous cell carcinoma of the ethmoid sinus ; one, olfactory neuroblastoma ; and one, recurrent squamous cell carcinoma of the nasopharynx. Two patients, one with frontal sinus carcinoma and one with undifferentiated carcinoma, developed recurrence. The former was treated with a salvage operation and the latter, with radiotherapy and chemotherapy. Six patients are alive disease free (4, 5, 6, 8, 27 and 73 months) whereas the other is alive with disease (8 months). One patient developed partial necrosis of the reconstructed bony skull base and another developed enophthalmus and temporary diplopia postoperatively. No serious complications, however, were noted in any cases.
  • 小川 浩司, 橋口 一弘, 和山 行正, 増田 はつみ, 山崎 嘉司
    1991 年 94 巻 3 号 p. 351-356
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    A newly recognized chlamydial species, Chlamydia pneumoniae causes acute respiratory infections including pneumonia, bronchitis and pharyngitis. In this paper, eight cases of bronchitis and tonsillitis associated with C. pneumoniae are presented.
    Three cases came to the clinic because of persistent cough and productive sputum. C. pneumoniae was isolated from sputum of a patient and cultured in HeLa 229 cells. Other two patients were diagnosed serologically ; Antibodies were measured by microimmunofluorescence using formalized elementary bodies of C. pneumoniae. A titer of 512 in the IgG class was detected.
    Four patients had sore throat. C. pneumoniae was isolated and cultured from tonsillar swabs in all of them.
    A patient with sore throat and cough diagnosed as pharyngolaryngitis was sero-positive.Antibodies to C. pneumoniae in IgG and IgM class were 128 and 32, respectively.
    All the patients were treated with macrolide antibiotics (erythromycin and rokitamycin), and clinical symptoms subsided. In five patients from whom the organism was isolated, the agents were eradicated by the treatment. However, clinical courses of those patients revealed that patient takes a long time to recover from the illness, if diagnosis and first choice of antimicrobial agent are not appropriate.
  • 酒井 仁
    1991 年 94 巻 3 号 p. 357-365
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to apply the phase spectral analysis of auditory brainstem response (ABR) to the clinical diagnostic test, the following studies in cats were performed. At first, the phase spectra of normal ABRs were investigated under adequate stimulus intensities. In addition the component synchrony measures (CSM) of ABRs were calculated at each stimulus level. Moreover the waveforms and phase spectra of ABRs were investigated before and after the destructions of cochlear nerve and brainstem auditory pathways in cats.
    The results were as follows;
    (1) In normal ABRs, the phase spectra were mainly composed of three frequency components at 0-300Hz (component A), 300-900Hz (component B) and 900-1500Hz (component C). The CSMs of component A represented the degree of synchrony for a slow component of the ABR and the CSMs of components B and C represented the degree of synchrony for a fast component.
    (2) A decrease in stimulus intensity resulted in a decrease in each average of the CSMs of the three components.
    (3) A greater decrease of the CSM occured if ipsilateral destruction was performed in a peripheral lesion. Lesions of the auditory pathway were followed by a decrease of the CSM of component C to contralateral stimulation.
    These results suggest that the phase spectral analysis of ABRs has significant clinical value in the detection of brainstem lesions.
  • (第二報)二相性反応の鼻汁中ヒスタミン.ロイコトリエン,キニンに関する検討
    小島 正, 朝倉 光司
    1991 年 94 巻 3 号 p. 366-376
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to clarify the details of a late phase response (LPR) in allergic rhinitis, serial changes of nasal symptoms and concentration of chemical mediators (histamine, leukotriene (LT) C, and kinins) in nasal lavage fluid were investigated after the nasal antigen challenge in ten patients with perennial allergic rhinitis with a positive intradermal skin reaction to mite extract. Samples were collected periodically for 8 hours following the challenge. Nasal airway resistance (NAR) and clinical symptoms were also recorded serially. Three out of ten patients showed only early phase response (EPR) and the other seven patients showed both early and late phase response after the challenge. The chief nasal symptom in LPR was nasal obstruction. In EPR, concentrations of chemical mediators in the nasal lavage fluid always increased. In dual (early and late) phase responders, increases of chemical mediators in nasal lavage fluids were notable during both early and late phase responses. In EPR, there was a significant correlation between severity of sneezing attack and concentration of histamine. In LPR, increase of LTC, level was significantly correlated with the increase of NAR. RAST score and daily nasal symptoms tended to be higher and more sever in dual phase responders compaired with early phase responders. We suggest that the amounts of released chemical mediators during allergic reaction denoted the LPR in allergic rhinitis patients.
  • 小出 千秋
    1991 年 94 巻 3 号 p. 377-385
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    It is well known that inverted caloric nystagmus is seen during air caloric testing in cases of chronic otitis media. The mechanism of inversion and its clinical significance are discussed here.
    Temperature changes in the tympanic cavity and external ear canal were measured with a microthermister and a digital tester in seventeen ears with tympanic membrane perforation, during bithermal air caloric testing. The tympanic cavity mucosa was cooled by hot stimulation because of the evaporation of heat. When the perforation was closed or humidified air was used, the tympanic cavity mucosa was not cooled by hot stimulation and the inverted caloric nystagmus changed to a normal response.
    Inverted caloric nystagmus occurred in 30. 4% of 335 ears affected by chronic otitis media with perforation. Inverted caloric nystagmus occurred in 90 ears with hot stimulation and in 12 ears with cold stimulation. Inverted caloric nystagmus turned to normal response after myringoplasty in all of 10 ears. The cooling effect caused by evaporation of water from the moist middle ear mucosa during dry air blowing and direct thermal conduction to the vestibulum through a perforation of the ear drum and inversion of the endolymphatic convection seemed to cause the inversion.
  • 外有毛細胞障害蝸牛における支持細胞の核DNA合成から
    村上 匡孝
    1991 年 94 巻 3 号 p. 386-395
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
    3H-thymidine autoradiography in vivo was carried out on normal mature mice, whose organs of Corti were securely damaged by Nitrogen Mustard-N-oxide (nitromin). The cell kinetics of supporting cells of the organ of Corti were examined and relation between these changes and mechanism of supporting cells to maintain the organ of Corti was discussed in this paper.
    A few grains in various kinds of supporting cells in S stage, which were not found in control mice without nitromin injection, were discovered. Those were detected in Hensen′s cell, Deiters′ cell, Claudius′ cells, and inner phalangeal cell. Mitosis was seen in one Claudius′ cell in addition. Therefore some supporting cells seem to be able to synthesize DNA and proliferate in the acutely damaged organ of Corti even in mature cochlea and those in G0 stage begin to go around cell cycle as occasion demands.
    Although labelled supporting cells decreased over time, the portion of supporting cell is likely to change in proportion as the extension of damage in the organ of Corti. If this new dynamic change of cell kinetics in the acutely damaged organ of Corti means the reaction to repair the organ of Corti, the supporting cells seem to have a reasonable role to maintain the organ of Corti including repairment of reticular lamina.
  • 内田 豊
    1991 年 94 巻 3 号 p. 428-429
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 渡部 泰夫
    1991 年 94 巻 3 号 p. 430-431
    発行日: 1991/03/20
    公開日: 2008/03/19
    ジャーナル フリー
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