日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
97 巻, 2 号
選択された号の論文の12件中1~12を表示しています
  • 田中 利善, 沖田 渉, 加瀬 康弘, 飯沼 壽孝
    1994 年 97 巻 2 号 p. 207-212
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Acoustic rhinometry is a new method of evaluating the geometrical distributions of the crosssction and volume of the nasal cavity. Its characteristics are that of a nontraumatic procedure requiring minimal time for measurements.
    Eight males (27-39 years old) without nasal lesions were investigated with acoustic rhinometry before and after unilateral administrations of decongestants. Conventional nasal decongestants such as naphazolin nitrate 0.1% (Privina) and tetrahydrozoline hydrochloride 0.1%, as well as prednisolone 0.02% (Cor-tyzine), were used in solutions diluted 10 or 100 times.
    As to the method of decongestant application, we adopted the head tilt method, in the successive order of backward, lateral (toward the non-application side) tilt and backward. Each position was maintained for 30 seconds.
    Minimal cross sectional area of the nasal cavity, and nasal volume were evaluated with acoustic rhinometry.
    After the application of nasal drops, the minimal cross sectional area increased within 10 minutes, followed by a plateau level for one hour. With the application of nasal decongestants, an I-notch, corresponding to the nasal valve, was unchanged, whereas the C-notch, corresponding to the anterior and of the inferior turbinate, often shifted upwards. Thus, the minimal cross sectional area changed from an I-notch to a C-notch location.
    The volume of the nasal cavity increased within 10 minutes, and maintained a plateau level for one hour which was similar to that of the minimal cross sectional area.
    Changes in the ratio of the minimal cross sectional area were greater for less diluted solutions.
    Changes in the ratio of the nasal cavity were similar to those of the minimal cross sectional area.
  • Tリンパ球とEG2陽性細胞を中心に
    高崎 賢治, 吉見 龍一郎, 高村 博光, 隈上 秀伯
    1994 年 97 巻 2 号 p. 213-217
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    We studied the distribution of T lymphocyte subpopulations and EG2 positive cells in the inferior turbinates of subjects with latent nasal allergy by use of an immunohistochemical procedure. Five patients who had a positive skin test for house dustand one who had a positive skin test for Japanese cedar were studied. The specimens were frozen at-70°C and sliced at 4um with a cryostat. The peroxidaseantiperoxidase method with monoclonal antibodies (CD4, CD8, EG2) was used to detect T lymphocyte subpopulations and activated eosinophils. Finally, the specimens were counterstained with Mayer's Hematoxylin.
    CD4 positive cells and CD8 positive cells were found mainly in the superficiallayer of the lamina propria. In every subject, the number of CD4 positive cells dominated that of CD8 positive cells in the lamina propria. The ratio of CD4 positive cells to CD8 positive cells was 1.93, On average. This ratio was lower than the ratio typical of nasal allergy, but higher than the ratio of non-allergic normal controls.
    Though the number of EG2 positive cells was lower than the number typical of nasal allergy, EG2 positive cells were observed in every case.
    We speculate that latent nasal allergic reactions may develop in the inferior turbinates.
  • 横田 雅子, 家根 旦有, 田中 治, 宮原 裕, 松永 喬
    1994 年 97 巻 2 号 p. 218-225
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    An immunohistochemical study was perfomed to observe the aberrant expression of bloodrelated group antigens in squamous cell carcinomas of the tongue from 10 patients and 13 normal tongue tissues using seven monoclonal antibodies, A, B, H, X001, H001, Lea and Leb, and four lectins, PNA, VVA-B4, UEA-1 and LTA.
    In SCC, Leb antigens were expressed in all cases examined (10 cases). T and Tn antigens which were examined with PNA and VVA-B4 stains, were expressed in seven out of 10 and six out of 10 cases, respectively, while these two antigens were not found in normal tissues.
    A, B and H antigens were expressed in most normal tongue epithelial cells, strictly dependent on the patient blood type. But in SCC, A and B antigens were not detected in five out of seven cancer cells from blood group A, B and AB individuals, whereas H antigen was expressed in 5 out of 7 cancer cells from blood group A, B and AB individuals.
    These results suggest that the expression of blood group-related antigens is suppressed to that of more immature carbohydrate chains in the setting of tongue cancer.
  • 北南 和彦, 高橋 光明, 富山 俊一
    1994 年 97 巻 2 号 p. 226-232
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Alterations in the distributions of type IV collagen (C-IV), laminin (La), and fibronectin (Fib), which are important components of the basement membrane, in the inner ear following secondary endolymphatic sac immune response were studied immunohistologically using control animals for comparison.
    Endolymphatic hydrops developed following direct secondary keyhole limpet hemocyanin (KLH) challenge to the endolymphatic sac in systemically presensitized animals. In the endolymphatic sacs of control animals, C-IV and La were localized continuously just under epithelial cells whereas Fib was present intermittently in subepithelial connective tissue. In the endolymphatic sac, following secondary KLH challenge, linear subepithelial localizations of C-IV and La were interrupted, thinner and more losely aggregated with numerous inflammatory cellular infiltrates on days 2-4. Following these changes, endolymphatic hydrops in the cochlea developed and peaked on days 4-7. On days 1-7, Fib was strongly but sporadically localized in subepithelial cells. These results suggest that C-IV and La may play important roles in the regulation of endolymph whereas Fib may be related to the restoration of injured endolymphatic sac tissue in animals exposed to a secondary challenge.
  • 川端 五十鈴, 八木 昌人, 川島 貴之, 本間 利生, 高橋 伸明
    1994 年 97 巻 2 号 p. 233-239
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    We investigated the clinical features of 64 cases of sudden deafness in patients more than 60 years of age. Forty-eight cases (75%) had profound deafness, 13 moderate and three mild deafness. The audiograms of 25 cases showed a flat pattern, 13 a gradually descending curve, and 13 total deafness.
    In 60 cases, the unaffected ear also had hearing impairment of variable severity. Fifty-one of these 60 cases demonstrated a physiological hearing threshold shift termed presbycusis in the unaffected ear.
    Hearing impairment in 35 cases (55%) was cured or improved by medical treatment including steroids. But in the majority of cases, the hearing threshold level of the affected ear did not improve above that of the unaffected ear when the unaffected ear had a hearing impairment. In particular, hearing impairment in five cases with total deafness in the unaffected ear did not improve.
    The elderly often had various systemic complications, including nine cases of diabetes and seven of hypertension. We treated patients with diabetes using steroids under the consultation of diabetic specialists. As a result, there was no case of complications induced by steroids.
    We consider the effects of treatment of sudden deafness in the elderly to be best judged in comparison with the hearing threshold level of the unaffected ear, since the elderly commonly have various degrees of hearing impairment in the unaffected ear.
  • 化生扁平上皮および扁平上皮癌における分布
    川原 孝文, 宮口 衛, 酒井 俊一, 宇多 弘次, 桑原 宏子, 阪本 晴彦
    1994 年 97 巻 2 号 p. 240-246
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Dendritic cells, macrophages and lymphocytes infiltrating the epithelia of sino-nasal lesions were investigated immunohistochemically using antibody S-100 protein for dendritic cells, Ki-M1P for macrophages, MT1 for T-cells and L26 for B-cells, respectively. Seventy-five specimens of sino-nasal mucosae involving 51 cases of metaplastic squamous epithelium (MSE), 12 of inverted papilloma, 1 of atypical hyperplasia and 11 of squamous cell carcinoma (SCC) were studied.
    Dendritic cells were observed in 12 cases of MSE (23.5%), in 4 of inverted papilloma (33.3%), and in 6 of SCC (54.5%). More dendritic cells were found infiltrating MSE of the infective and fibrotic types than of the mild and edematous types, histopathologically. Furthermore, infiltration correlated with the degree of squamous differentiation in MSE, but not in SCC.
    The number of macrophages was significantly smaller in MSE than in columnar ciliated epithelium, while that in SCC was significantly greater than that in MSE. With dendritic cell infiltration macrophages in MSE as well as SCC and T-cells in and around the carcinoma were often increased.
    These findings suggest that dendritic cells may be attracted to maturative squamous epithelium, and may play an important role in the immunologic defence mechanisms of MSE. Dendritic cells, in contrast, may play a role in the cellular immune response of T-cells against the carcinoma.
  • 益田 慎, 小寺 一興, 飯野 ゆき子, 設楽 仁一
    1994 年 97 巻 2 号 p. 247-253
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    The efficacy of computed tomography (CT) of the temporal bone was studied in 45 ears with a middle ear anomaly but whose tympanic membranes were normal. The plane of the film was 30 degrees oblique to the orbito-meatal line.
    Four otorhinolaryngologists made radiological diagnoses of the CT film without having any information about the patients. CT films of 40 normal ears were also evaluated and served as controls. The incudo-stapedial joint (I-S jont) and the stapes were visualized in all control group subjects. The percentage of correct diagnoses was 77.8% for separation of the I-S joint, and 75.6% for fixation of the stapes. The monopedal stapes was not visualized. Fixation of the malleus and the incus could not be diagnosed correctly. Abnormalities in the location of the facial nerve were visualized in a few ears. CT of the temporal bone was clinically useful for differentiating I-S joint separation and fixation of the stapes.
  • 新井 泰弘, 榎本 浩幸, 伊藤 恵子, 古川 まどか, 久保 田彰, 佃 守
    1994 年 97 巻 2 号 p. 254-259
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    The DNA ploidy of fresh frozen tissues from head and neck squamous cell carcinomas was determined by flow cytometry, with the aim of investigating whether DNA ploidy correlates with various clinical and pathological parameters. The subjects were 51 patients who had undergone radical surgery in our department.
    The DNA ploidy pattern was classified into three types, diploid, single aneuploid and multiploid, according to the DNA index and the DNA histogram. This is our original classification. No particular correlation could be detected between the DNA ploidy pattern and sex, age, primary tumor site or disease stage. The degree of tissue differentiation tended to be poorer in aneuploid than in diploid tissues. The efficacy of chemotherapy was higher in aneuploid than in diploid cases. The reccurence rate was significantly lower in diploid than in multiploid cases.
    When disease stage, degree of histological differentiation, the efficacy of chemotherapy and the DNA ploidy pattern were subjected to multivariate analysis for correlation with prognosis, the DNA ploidy pattern showed the highest correlation. Our results suggest that the DNA ploidy, as analyzed by flow cytometry, can serve as useful prognostic factor.
  • 植原 元晴, 片桐 一
    1994 年 97 巻 2 号 p. 260-267
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Allergic rhinitis caused by birch pollen is common in parts of Northern Europe, North America and the northern Japanese island of Hokkaido. The major antigenic fragment of European birch (Betula verrucosa) pollen allergen with a M.W. of 17k dalton was isolated and termed Bet vI. The amino acid sequence of Bet vI has already been identified.
    We have attempted to identify an antigenic peptide of Japanese birch (Betula platyphylla var. Japonica) pollen allergen. Seventeen Kd fragments separated from pollen allergen by SDS-PAGE were shown to bind with IgE in the pooled sera of pollinosis patients. The fragment was digested with trypsin and fractionated by reverse phase HPLC. Five fractions were identified to have in vitro activities, such as the lymphocyte proliferative response, in pollinosis patients. Amino acid sequences of peptides in the fractions were determined. The sequence of a 12-mer peptide was shown to correspond to that of No22-33 of Bet vI, except for the amino acid at the 31st position, phenylalanine, which was instead isoleucine. Synthetic peptides based on this sequencing were shown to cause proliferation of lymphocytes, derived from pollinosis patients, which was blocked by monoclonal antibodies to HLA-DR molecules.
  • 田原 哲也
    1994 年 97 巻 2 号 p. 268-273
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Hindlimb unweighting in the rat may serve as an experimental model simulating muscle atrophy under weightlessness. As a preventive measure, retroauricular galvanic stimulation was delivered to the unweighted rat hindlimb and the weights of the bilateral soleus and gastrocnemius muscles were compared.
    Wistar rats, with unweighted hindlimbs, were divided into two groups; the control group which received no galvanic stimulation and a galvanically stimulated group which received galvanic stimulation (bipolar biauricular, 1mA in intensity, 500msec in duration, 1Hz in frequency) for one hour twice a day for 7 days using an electronic stimulator made by NIHON-KODEN (MODEL SEN -1101). The weights of the soleus and gastrocnemius muscles on both sides were measured in each group using a balance (METTLER AT201).
    The results were as follows:
    1. Muscle weights in the galvanically stimulated group were greater than those in the control group.
    2. A statistically significant difference between right and left soleus muscle weights was obtained in the galvanically stimulated group (P<0.01).
    3. We found no significant difference between the two sides in the weights of gastrocnemius muscles.
    It is presumed that retroauricular galvanic stimulation exerts some influence, not only on vestibular organs, but also on hindlimb muscles through the lateral vestibulo-spinal tract and, in addition, through the spinal motor neuron.
    Therefore, we speculate that galvanic stimulation might prevent atrophy of the unweighted hindlimb muscle.
  • 竹越 哲男
    1994 年 97 巻 2 号 p. 274-283
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    A quantitative analysis of horizontal head-shaking nystagmus (HSN) was made on 48 patients with unilateral peripheral vestibular disorders in conjunction with stimulus intensity (the number of head-shakes). Each patient underwent three head-shaking tests with 10, 30 and 50 horizontal headshakes, with a rapidity of about 2Hz, in random order. HSN was recorded by ENG with the eyes open in a completely dark room, and various components of nystagmus were measured manually.
    1. HSN appeared in a biphasic or monophasic pattern. In some patients with biphasic HSN, the 2nd phase disappeared as the stimulus intensity diminished.
    2. The maximal slow-phase eye velocity (MSV) of the 1st phase of biphasic HSN was significantly greater than that of monophasic HSN. The tendency to increase in proportion to stimulus intensity was also greater in biphasic than in monophasic HSN. The MSV values of the 2nd phase of biphasic HSN were smaller than in the 1st phase (less than one-third) at all stimulus intensities.
    3. The duration and total number of HSN beats were greater in the 2nd phase of biphasic HSN and increased markedly in proportion to stimulus intensity. In contrast, in the 1st phase of biphasic HSN and in monophasic HSN, the values of these nystagmus components were smaller, there was no clear relationship with stimulus intensity, and when the stimulus intensity was high, they were instead significantly smaller in the 1st phase of biphasic HSN than in monophasic nystagmus.
    4. As the stimulus intensity rose to a high level, the interval between the 1st and 2nd phases of biphasic HSN (2nd phase latency) shortened, and the 2nd phase tended to appear more quickly after head-shaking.
    5. The time constant of the decline in slow-phase eye velocity was nearly constant in both the 1st phase of biphasic HSN and monophasic HSN, regardless of stimulus intensity.
    It was especially noteworthy that in response to an increase in stimulus intensity, both the MSV in the 1st phase and the duration of the 2nd phase of biphasic HSN increased, while the duration of the 1st phase of biphasic HSN was inversely suppressed by the 2nd phase.
  • 経鼻的内視鏡下昼間薬物睡眠検査の有用性について
    貞岡 達也
    1994 年 97 巻 2 号 p. 284-295
    発行日: 1994/02/20
    公開日: 2008/03/19
    ジャーナル フリー
    Twenty two patients with obstructive sleep apnea syndrome were examined by nocturnal polysomnography (n-PSG), and the obstructive sites in the upper airway were observed by nasendoscopic diurnal polysomnography using diazepam (n-d-PSGD). The types of apnea were divided into three groups according to the obstructive sites in the upper airway: soft palate apnea, tongue base apnea, and combined type apnea. Among the 22 patients, there were 17 soft palate apneas, 3 tongue base apneas and 2 combined type apneas. All patients underwent uvulopalatopharyngoplasty (UPPP).
    Preoperative values of AI, AR, DI and mean sleep SaO2 were 37.2, 24.5%, 31.4 and 92.5%, and the postoperative values were 10.4, 7.3%, 6.8 and 94.8%, respectively. Criteria were established to define UPPP responders, as follows: 50% or more reduction in AI and postoperative AI less than 20. The overall improvement rate was 81.0%. The improvement rates for soft palate apnea, combined type apnea and tongue base apnea were 93.8%, 50.0%, and 0%, respectively.
    In 15 of the 22 patients, measurements of mesopharyngeal and esophageal pressures were performed simultaneously with n-d-PSGD. In these 15 patients, 12 soft palate apneas, 2 combined type apneas and 3 tongue base apneas were observed with n-d-PSGD, while 7 soft palate apneas, 3 combined type apneas and 5 tongue base apneas were detected by measuring the pressures. The results of these two methods concurred in only nine of fifteen patients. It was suspected that the obstructive sites in the upper airway were identfied by tissues with n-d-PSGD, but by region with the pressure measuring method.
    It was suggested that UPPP is the most suitable treatment for patients with soft palate type apnea, without pathologic obesity.
    In conclusion: n-d-PSGD is a useful method of evaluating respiratory status during sleep, can be performed in a few hours, and can simultaneously identify the obstructive site in the upper airway, so as to allow treatment planning.
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