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, 4 号
選択された号の論文の14件中1~14を表示しています
  • 高橋 光明, 熊井 恵美, 上戸 敏彦, 植原 元晴, 海野 徳二
    1991 年 94 巻 4 号 p. 489-494
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    We analyzed the clinical courses and pathological findings of six recurrent benign pleomorphic adenomas of the parotid gland, compared with fifty-nine primary pleomorphic tumors.Primary cases were treated with extirpation of a tumor nodule with a surrounding area of parotid tissue with preservation of the facial nerve.Of the 59 patients, 42 who had follow-up information have had no recurrent tumors during a average 6.6 years follow up period.On the other hand, all six recurrent cases had received surgical enucleation or excisions elsewhere.To avoid the recurrence of the primary pleomorphic adenoma it was considered to be very important to remove a tumor completely without damaging the tumor capsule.
    CT scan is very useful to know the relationship between the recurrent tumor and the surround- ing important organs.In order to determine the surgical approach and procedures for those cases, it is important to obtain the information of the previous pathological diagnosis or surgical proce- dures.For the recurrent tumor, complete extirpation of the tumor and surrounding operative scar was necessary for the management of the tumor.When the tumor was tightly adhesive with the facial nerve, sacrifice of the nerve and immediate nerve transplantation might be required.
  • 八田 千広, 佐藤 武男, 吉野 邦俊, 馬谷 克則, 藤井 隆, 沢田 達
    1991 年 94 巻 4 号 p. 495-499
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    We had 31 patients(8 males and 23 femals)with postcricoid carcinoma in the period from 1978 to 1988.This number of patients correspond to about 15.3% of patient with hypopharyngeal carcinoma we encounterd in this period.There were 4 patients in the condition Stage I, 8 in Stage II, 7 in Stage III and 12 in Stage IV.Most of these patients underwent radical surgery.5-year cumulative survival rate was 46.8%(Kaplan-Meier).The cause of death was neck metastasis in 75% of patients who died of postcricoid carcinoma.There was a significant difference in survival curve between patients with neck metastasis and patients free from it(5-year cumulative survival rate was 68.0% and 16.7%, respectively;p<0.01).Neck metastasis was noted in the paratra- cheal region in 29.0% of patients.In patients with primary tumor of not larger 2.5cm(n=7), nometastasis was noted, nor recurrence in this series of patients.
  • 軸位断CT像における計測
    市村 恵一, 加瀬 康弘, 飯沼 壽孝
    1991 年 94 巻 4 号 p. 500-505
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Parapharyngeal space can be defined as a potential space surrounded by deglutitional and masticator muscles and their covering, superficial and middle layer of deep cervical fascia.It is easily recognized in images provided by modern scanning devices, such as CT and MRI.Paraphar- yngeal space has traditionally been devided by styloid process and fascia of tensor veli palatini muscle(nasopharyngeal level)or fascia of stylopharyngeus muscle(oropharyngeal level)into two compartments, prestyloid and poststyloid spaces.The latter is often called as carotid space.
    Prestyloid portion exclusively contains fat tissue, which yields hypoabsorption area in CT films and high density area in MRI.In most of papers in radiological journals, the term of parapharyngeal space is regarded as its prestyloid portion which is clearly identified.
    Axial CT images of 144 patients without any naso- or oropharyngeal lesions were analyzed. Two reference levels of nasopharynx were adopted for the study.The upper level passes through the plane of fossa of Rosenmuller, and the lower reference level transects soft palate.The following parameters of the space were measured;
    Length and width of the whole space, length and width of prestyloid fatty space, and further- more, width of pre- and poststyloid space, that were devided by a imaginary line pararell to the axis of the whole space(the upper level);Length and width of the whole space, length of base and height of a triangle of the prestyloid part(the lower level).
    While parapharyngeal space was symmmetrical in the upper level, the rate of asymmetry amounted to a fourth in the lower level.Prestyloid space was broader than poststyloid one in the upper level.Men were dominant in length of the space in both the upper and the lower level and in length of the base of fatty space in the lower level.There was no difference between any age groups other than in fatty area in the lower level.Teens tended to be narrow, while 60's and older were wide.
  • 杉浦 欣一, 大橋 淑宏, 江崎 裕介, 古谷 博之, 大野 義春, 中井 義明
    1991 年 94 巻 4 号 p. 506-515
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    There is amount of epidemiologic, clinical and laboratory evidence to document that viral infection is involved in otitis media with effusion(OME).However, few studies have demonstrat- ed the direct influence of viruses on the tubotympanum.The purpose of this study is to establish the effect of influenza A virus invaded in the tubotympanum, in an attempt to elucidate the possible mechanism by which the virus contributes to the pathogenesis of OME.80 guinea pigs with normal otoscopic findings were inoculated with 0.2m1 suspension of influenza A(3.3 x 108PFU/ml)into their tympanic cavities through their tympanic membranes.To serve as controls, the same number of guinea pigs were injected with 0.2ml of physiologic saline solution into their tympanic cavities.At 3, 7, 14, and 28 days postinoculation, they were used for examination of the mucociliary function.
    Middle ear effusions were observed only in the animals inoculated with the virus.Mucociliary dysfunction was observed only in the animals inoculated with the virus.The ciliary activity in the bulla was declined at any time examined.On the other hand, the ciliary activity in the eustachian tube and the tympanic orifice was slightly lowered between 7 and 14 days, but the level was not different from that of the control.However, the number of active ciliated cells(showing more than 500 beats/min)was significantly smaller than that of the control.The mucociliary clearance time of the tubotympanum was more prolonged than that of the control at 3, 7, and 14 days, and returned to the control level at 28 days.
    A variety of morphologic changes were observed in the tubotympanum treated with the virus. Major pathologies observed included a general inflammatory cell infiltration, vacuolation and other degeneration of ciliated cells, and vascular damage and increased vascular permeability.Regener- ation of cilia or ciliated cells followed the degeneration, which included an increased number of basal cells and new formed centrioles.However, the viral infection had an influence on the epithelial cells with new centrioles.
    Our study has demonstrated that viral infection could evoke mucociliary dysfunction of the tubotympanum and create an increased susceptibility to bacteria.Therefore, viral infection could enhance bacterial infectious process in the tubotympanum.Through the failure viruses could contribute to the occurrence of OME.
  • 第1報 脂質成分
    矢部 利江
    1991 年 94 巻 4 号 p. 516-524
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Middle ear effusions(MEEs)from adult were usually serous in nature, but those from child were mucous.MEEs contain the substances secreted by the epithelial cells of the middle ear and Eustachian tube to regulate surface tensions as well as those produced as the result of inflammation, but the biochemical bases of serous and mucous MEEs have not been clearly established.
    To clarify the biochemical differences giving rise to the characteristic physicochemical prop- erties of MEE from children and from adults, all lipid components of MEEs from 7 children and 7 adults by thin-layer and gas-liquid chromatographies were analyzed, and also they were compared with those from sera.Although no significant difference in lipid composition was observed between adult and pediatric sera, the amounts of phosphatidyl ethanolamine(PE)and phosphatidyl serine(PS)in pediatric MEE were higher than those in adult MEE.The relative concentration of PE in the total phospholipids of pediatric MEE was 26.5%, significantly higher than that in adult MEE(9.2%), and pediatric(6.1%)and adult(3.1%)sera.A similar high concentration of PS was also observed in pediatric MEE.Since phospholipids were the major components of sur- factunts secreted from the epithelial cells of the middle ear, significantly high concentrations of the charged phospholipids, PE and PS, might be responsible in part for the characteristics of pediatric MEE.
    To compare physical properties in different phospholipid compositions between pediatric and adult MEEs, polarization value was measured with liposomes in each phospholipid compositions. The polarization value in pediatric phospholipid composition liposomes was higher than in adult. It seemed that the microviscosity in pediatric MEE was lower than in adult.
  • 第2報蛋白質成分
    矢部 利江
    1991 年 94 巻 4 号 p. 525-533
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    To clarify the biochemical differences between pediatric and adult middle ear effusions(MEEs) in secretory otitis media with effusion(OME), we analyzed the protein components from MEEs of 3 children and 3 adults by electrophoresis.High molecular protein components(280 and 265 kDa proteins), which contained in sera in the concentrations less than 2.5%, were not detected in MEEs even in trace amounts.The protein components which molecular weights were less than 260 kDa are transferred from sera into MEEs in a same proportion as in sera.
    Mucin type glycoprotein was comprised about 30% of the total protein in pediatric mucous MEEs and the weight ratio of mucin to albumin in pediatric mucous MEEs was 2.69, but serous MEEs from adult patients did not contain mucin.
    Immunoglobulin(IgA, IgG and IgM) concentrations in pediatric mucous MEEs were same as in adult serous MEEs.The concentrations of IgA and IgM in MEEs were higher than in sera. Lysozyme concentration in MEEs was also higher than in sera, and that in pediatric mucous MEEs was nearly 2 times higher than serous MEEs from adult patients.
  • 湯本 英二, 小澤 哲夫, 柳原 尚明, 青木 太三郎, 浅野 尚, 荒木 元秋, 大島 弘至, 田口 喜一郎, 月山 昌夫, 西田 之昭, ...
    1991 年 94 巻 4 号 p. 534-540
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    The authors investigated the influence of faucial tonsillar hypertrophy to physical growth, and diseases of the nose and the ear for 7190 pupils of elementary schools in nine different areas in Japan.Tonsillar hypertrophy seemed to prevent physical growth of pupils of lower grades.In pupils without tonsillar hypertrophy, the number of pupils suffering from rhinitis gradually de- creased from 16.9% in the first grade to 8% in the sixth degree.On the other hand, the number of pupils suffering from rhinitis remained to be large, ranging between 20.5% and 29.7% in the group of tonsillar hypertrophy.The number of pupils with hearing loss were much more in the group of tonsillar hypertrophy.Since an only available diagnostic mean of ear disease was an otoscopic examination, a significant number of pupils with serous otitis media may be labeled as hearing loss.For this reason, tonsillar hypertrophy possibly affected the number of pupils with hearing loss.There were no apparent relations between tonsillar hypertrophy and allergic rhinitis, chronic paranasal sinusitis and chronic otitis media.
  • 加齢変化を中心に
    中山 明仁
    1991 年 94 巻 4 号 p. 541-555
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Dryness of the mouth, taste disturbance or misswallowing may appear due to physiological changes of tongue especially in old aged person.The purpose of this study is to investigate histological changes related to aging in the human tongue, qualitatively and quantitatively.
    The samples were collected from 100 autopsy-cases without any pathological changes consist- ing of 50 males and 50 females aged between 5 and 82.
    Five specimens(I-V) were obtained from each tongue by frontal section.
    Specimen I(anterior part of tongue), III(central part), V(posterior part) were studied.
    Each specimen with thickness of 4, um were stained with Hematoxylin-Eosin and Alucian-Blue.
    Tongue mucosa, glands such as Blandin-Nuhn gland, von Ebner gland and those glands distributed in the root of tongue, and M.longitudinalis superior were observed histologically.
    The study was done quantitatively by I-BAS one picture analyzer manufactured by Zeiss Co. The results of this study are as following:
    1) The epithelium of lingual mucosa The thickness of epithelium decreased with aging, rather prominent on dorsal part than the lateral.
    2) lingual glands Acinar atorophy increased with aging, especially quickly in females. The atorophy of the acinus started from 40 years old in Blandin-nuhn gland and 30 in von Ebner gland.However, tongue root glandular atorophy was milder in comparison with the other two glands.
    3) Lingual muscles Decrease in muscle fiber diameter with aging is also observed.
  • 増子 正敏
    1991 年 94 巻 4 号 p. 556-560
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    The structure of the opening of the Eustachian tube of 702 cases were obserbed with fiberoptic endoscope, and the relationship between the difficulty in ear douche by Eustachian tube catheteriza- tion and the shape of the orifice was discussed.
    The shape of pharyngeal orifice of the tube was classified into two types.The one which is well-known as ordinary shaped was named as type I, while the other which has an arched upper edge by torus tubarius was termed as type II.
    Type II orifices were found more frequently(54.3%) than type I.Insertion of a catheter was difficult in type II ones because the tip of catheters was apt to slip down from the tubal elevation.
    Moreover, anatomical irregularities in the nasopharynx, which is observed quite often, seem to be a factor of difficulties in douching the tube.In case of a failure in ear douches, it is necessary for us to detect its cause, and in case of type II orifice, the way of probing the orifice should be changed. I have treated some patients who were suffered from tubal obstruction with an injection of remedies into the auditory tubes, observing with remodelled Olympus NPF-S3 fiberscope, and have got a good result.
  • 悪性度評価と鼻副鼻腔腫瘍における癌化過程の検討
    鶴田 至宏
    1991 年 94 巻 4 号 p. 561-576
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Flow cytometric analysis of DNA content from paraffin-embedded material has become an important diagnostic and prognostic method in clinical pathology and investigative oncology.We analyzed nuclear DNA content in order to detect possible alternations in DNA histogram as an indicator of malignant potential and carcinogenic process of head and neck tumor.DNA histo- grams were evaluated by three parameters;DNA aneuploidy, S+G2M%:rate of S and G2+M phase cells as a parameter for growth kinetics, and polyploid%:rate of more than tetraploid cells as a parameter of nuclear atypia.
    We took a simple method for the selection of tumor area in paraffin blocks using a consecutive section stained with hematoxylin-eosin as a diagnostic guideline.This technique can be used either to enrich the sample to be analyzed with aimed area or to analyze histopathologically different compartments of the tumor.
    We compared the result of fresh and fixed specimens in 20 materials.DNA aneuploidy was found in both specimens of the same two carcinomas and there was a close relationship between them in S+G2M%(p<0.01) and polyploid%(p<0.05).
    We studied two cases of maxillary carcinoma with coexisting inverted papilloma as precancer- ous lesion.In one case S+G2M% and polyploid% were 16%, 1.15% in nasoparanasal papilloma, 20.5%, 4.0% in papilloma with atypia, and 33%, 8.25% in carcinoma, respectively.In the other case those were 3%, 0.1% in transitional papilloma, 8%, 0.9% in inverted papilloma, and 13%, 4.0% in carcinoma, respectively.There was positive correlation between these two parameters and histopathological grade.
    Finally we analyzed nuclear DNA content from fixed specimens in three groups;33 papillomas, 15 maxillary carcinomas and 23 normal epithelia.Mean values of S+G2M% and polyploid% were as follows:2.1%, 2.6% in normal epithelia, 19.6%, 8.9% in papillomas, and 34.8%, 18.1% in carcinomas.There was statistical significance between three groups(p<0.01).DNA aneu- ploidy was only found in 6 of 15 carcinomas(40%).
    The results demonstrated that S+G2M% and polyploid% were significantly compared with the histopathological grade of atypia and DNA aneuploidy was a marker of carcinoma.We suggest that DNA histogram is a good indicator for biological activity and that the increased S+G2M% and polyploid% may indicate carcinogenic process.We also suggest that tumor progression may lead to acquired genetic variability and DNA aneuploidy.
  • 超音波断層法とX線CTの比較
    古川 政樹, 金子 まどか, 持松 いづみ, 澤木 修二, 猪狩 秀則, 佃 守
    1991 年 94 巻 4 号 p. 577-586
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Correct assessment of lymph node metastasis in the head-neck region is very important for management of head and neck cancer. 233 lymph nodes were removed by radical neck dissection from 12 cases with cancer in the head and neck region, who did not undergo any preoperative treatment, and the materials were histopath- ologically examined.The histopathological findings were compared with preoperative US and CT findings.
    Histopathologically, 26 lymph nodes were found positive for metastasis and the remaining 207 lymph nodes, negative.
    US detected 45(19%) of 233 lymph nodes before operation, and 40 of the 45 lymph nodes(89% 40/45) were qualitatively correctly diagnosed. CT detected 21 lymph nodes(19%), 16 of which were qualitatively correctly diagnosed(76% 16/21).
    Of 26 lymph nodes which were histopathologically involved, 19 lymph nodes were correctly diagnosed by US and 11 by CT.Possible reasons explaining the superiority of US to CT in terms of diagnostic reliability are the following:
    1) US demonstrates more clearly the existence of lymph nodes than CT.
    2) US is more reliable for measuring sizes of lymph nodes than CT...
    In literature, CT has been often reported to be useful to diagnose cervical lymph node involve- ment in individual cases.However, we insist that it is necessary to diagnose individual lymph nodes strictly for correct assessment of the reliability of image diagnosis.
  • (第三報)in vitroにおける鼻粘膜よりのヒスタミンおよびロイコトリエンの遊離について
    小島 正, 朝倉 光司
    1991 年 94 巻 4 号 p. 587-593
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
    Responses to mite antigen and nonimmunological stimuli, substance P, of chopped fragments of nasal mucosae were studied from eleven patients with perennial allergic rhinitis who were sensitive to mite antigen.Amount of released histamine significantly increased by either stimulation.
    However, the release of leukotrienes(LTs) increased only by the stimulation of mite antigen, which correlated with that of histamine.By either stimulation, amount of histamine release tended to be higher in patients with severe nasal symptoms than in those with moderate nasal symptoms.Only by mite antigen stimulation, amount of the release of peptide LTs and LTB4 tended to be higher in patients with severe nasal symptoms.We concluded that the amounts of histamine and LTs released from nasal mucosa in allergic reaction were closely related with the severity of nasal symptoms in patients with allergic rhinitis.
  • 市村 恵一
    1991 年 94 巻 4 号 p. 622-625
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 第1回日本頭頸部外科学会
    三宅 浩郷
    1991 年 94 巻 4 号 p. 626-627
    発行日: 1991/04/20
    公開日: 2008/03/19
    ジャーナル フリー
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