巻号一覧
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101 巻, 10 号
選択された号の論文の15件中1～15を表示しています
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先進医療としての「先天性難聴の遺伝子診断」をふまえて宇佐美 真一2008 年 101 巻 10 号 p. 727-738
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーCongenital deafness is a very common sensory disorder (occurring in 1-2per 1, 000 children) that can interfere extensively in the development of speech and language, and comprises a heterogeneous group of disorders. Based on several etiological studies, at least 50% of childhood hearing loss has been estimated to be of a genetic etiology. Therefore, genetic testing has become increasingly important for a more accurate diagnosis, prediction of the severity of future hearing loss, estimation of associated abnormalities, selection of appropriate habilitation options, prevention of hearing loss, and improved genetic counseling. In genetic testing, the human rights of the person must be protected, and proper and appropriate genetic testing should be promoted. Certified clinical genetic experts and ENT specialists should provide counseling before and after a genetic diagnosis. Geneticists should explain genetics in general as well as the genetic risks involved in hearing. ENT specialists who are experts on hearing and therapeutic options are the most appropriate to accompany the geneticists. Easily understandable language should be used when explaining the genetic testing and results to patients.抄録全体を表示PDF形式でダウンロード (1992K) -
三輪 高喜, 達富 真司2008 年 101 巻 10 号 p. 740-741
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (1621K) -
伊藤 まり, 相馬 啓子, 安藤 麗子2008 年 101 巻 10 号 p. 743-748
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーOne hundred thirty-two patients complaining of acute hearing loss or tinnitus were seen at the Department of Otolaryngology in Nippon Koukan Hospital and Koukan Clinic during the one-year period from April 2006 to March 2007. We investigated oxidative stress in 13 of 60 cases of acute sensorineural hearing loss (Group AHL) and 21 of 53 cases of chronic hearing loss, or tinnitus (Group CT). Free Radical Analytical System 4 (diacron-reactive oxygen metabolites) was used to investigate the level of free radical oxidative stress. We compared the d-ROM level between 13 Group AHL patients and 21 Group CT. The d-ROM levels were higher in Group AHL than in Group CT. We compared the d-ROM levels before treatment and after administration of glucocorticoids. After treatment, d-ROM levels decreased in Group AHL and hearing levels also improved. Some patients in Group CT underwent tinnitus retraining therapy (TRT) with a tinnitus control instrument (TCI) and were followed up. We conducted a survey to evaluate patients using the tinnitus handicap inventory (THI) score. Patients who underwent TRT were normal before therapy, but d-ROM levels did not indicate any change between before and after treatment although the THI scores improved significantly. Our findings suggest that acute Sensorineural hearing loss is related to oxidative stress at the onset of acute sensorineural hearing loss, such as sudden deafness.抄録全体を表示PDF形式でダウンロード (843K) -
1次, 2次治療別検討三浦 誠, 坂本 達則, 平海 晴一, 金丸 眞一, 伊藤 壽一2008 年 101 巻 10 号 p. 749-757
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーThis retrospective study included 256 cases with sudden hearing loss treated by hyperbaric oxygen therapy (HBO) in our hospital from 2000 to 2006 (57 primary cases with intravenous steroid administrations, and 199 secondary cases after insufficient effects of initial steroid therapy). Hearing thresholds were ascertained at frequencies of 250, 500, 1000, 2000, and 4000Hz using pure-tone audiometry. To establish the indication of secondary HBO therapy for the treatment of sudden hearing loss, several prognostic factors including initial average hearing thresholds, age, intervals between the onset and beginning of HBO treatment, and the presence or absence of vertigo at onset were evaluated between primary and secondary cases. Although the HBO effects in the secondary were poorer than those in primary cases, one third of the secondary cases indicated hearing threshold gains of over 10dB. Regardless of an age over 60 years, the presence of vertigo, and/or poor initial average hearing levels, HBO is considered to be an effective choice for secondary therapy of sudden hearing loss in patients within 8 weeks after onset.抄録全体を表示PDF形式でダウンロード (1441K) -
平井 美紗都, 折田 頼尚, 菅谷 明子, 妹尾 一範, 結縁 晃冶2008 年 101 巻 10 号 p. 759-764
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーWe report a 21-year-old female who complained of dizziness with cerebellar arteriovenous malformation (AVM). At her first visit, she complained only of dizziness and did not show any other cranial nerve symptoms. She was therefore diagnosed with peripheral vertigo and started treatments. Two weeks after the first examination, she was examined by electronystagmograph (ENG) because her dizziness had not improved. The ENG result suggested that the dizziness was caused by a central lesion disorder and a MRI scan revealed a large AVM in the cerebellum and brainstem. Although AVM commonly shows cerebral hemorrhage or convulsion as the first symptom, we experienced a case of AVM with only mild symptoms of dizziness and headache.抄録全体を表示PDF形式でダウンロード (2031K) -
高林 宏輔, 片田 彰博, 長門 利純, 岸部 幹, 片山 昭公, 坂東 伸幸, 林 達哉, 原渕 保明2008 年 101 巻 10 号 p. 765-769
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーMeningioma is a common intracranial tumor, accounting for 13-18% of all intracranial tumors, however, extracranial meningioma is very rare, especially with extension into the temporal bone. A 49-year-old female had complained of left hearing loss for several years. A granuloma-like mass was seen through the left tympanic membrane, and a pure tone audiogram showed left combined hearing loss. We performed left tympanoplasty with mastoidectomy. At the time of operation, the granuloma-like mass was seen in the mastoid and tympanic cavities, postoperative pathological study revealed it to be a meningioma. After the operation, CT and MRI scans showed a large mass in the C-P angle. We conclude that CT and MRI examinations are valuable when there is the possibility of a tumor.抄録全体を表示PDF形式でダウンロード (4020K) -
福嶋 宗久, 宮口 衛, 神原 留美, 佐々木 崇博2008 年 101 巻 10 号 p. 771-775
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of unilateral recurrent facial paralysis caused by cavernous hemangioma of the pons. The patient was a 38-year-old woman suffering from mild right facial paralysis. Initially, she was diagnosed as having Bell's paralysis, treated with peroral steroids, and it improved. After half a year, right facial palsy appeared again, and the patient presented with acute hearing loss of the right ear after several days. Furthermore, MRI identified hemangioma of the pons in the region of the right facial nerve nucleus. We concluded that this recurrent facial nerve paralysis was caused by repeat hemorrhage from the hemangioma. It is concluded that central impairment should be a criterion when diagnosing unilateral recurrent facial paralysis.抄録全体を表示PDF形式でダウンロード (5235K) -
根本 祥子, 荒木 進, 永井 賀子, 本橋 玲, 飯村 陽一, 鈴木 衞2008 年 101 巻 10 号 p. 777-780
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーRenal cell carcinoma tends to present multiple hematogenous metastases. But metastasis to the paranasal sinuses is rare. We encountered metastasis of renal cell carcinoma to the ethmoidal and sphenoidal sinuses. Because of extensive lesion, we selected debulking surgery. The residual tumor was treated with radiation combined with Docetaxel. This treatment controlled progression of the tumor and contributed to the quality of life of the patient.抄録全体を表示PDF形式でダウンロード (5842K) -
物部 寛子, 籠谷 領二, 戸島 均2008 年 101 巻 10 号 p. 781-784
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーA case of non-clostridial gas gangrene in the Infratemporal fossa with sepsis is described. A 49-year-old woman with no history of diabetes presented with persistent fever, left facial puffiness, and trismus. Her physical examination and laboratory tests indicated that she had SIRS (systemic inflammatory response syndrome). CT (computed tomography) scan demonstrated a gas-forming abscess in the left infratemporal fossa that was attributable to a caries tooth in the mandible. Surgical drainage was performed via the subtemporal-preauricular approach combined with the intraoral approach, and antibiotics TAZ 2g/day, CLDM 1.8g/day and γ-globulin 5g/day were given. Thirteen days post operatively, the inflammatory response subsided and she was discharged. Bacterial culture isolated Streptococcus constellatus, Peptostreptococcus micros, and Prevotella intermedia.
Gas gangrene in head and neck lesions is usually caused by a non-clostridial organism, and most lesions are not due to a traumatic wound but to infections such as periodontitis, peritonsillitis, and pharingitis. For abscess formation, surgical drainage in the early stage is needed, and for Infratemporal fossa lesions, the subtemporal-preauricular approach, intraoral approach and transmaxillary approach have been reported. In this case, surgery was successful via the subtemporal-preauricular approach combined with the intraoral approach.
Infratemporal fossa gangrene is a potentially dangerous complication of odontogenic infection, and knowledge of the relevant anatomy and pathway of the spread will facilitate effective diagnosis and treatment of these infections.抄録全体を表示PDF形式でダウンロード (4235K) -
齊藤 祐毅, 木下 淳, 遠藤 麻世, 北野 睦三, 壁谷 雅之2008 年 101 巻 10 号 p. 785-789
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーWe present five cases showing lower cranial nerve palsy. All patients complained of dysphagia due to bilateral IX and X cranial nerve palsy. Serum antibodies to HSV and VZV suggested viral neuropathy. One patient, a 62-year-old man, underwent rehabilitation of swallowing for 1.5 months in order to resume oral intake. Four patients, a 29-year-old woman, 71-year-old woman, 38-year-old-woman and 69-year-old woman, underwent steroid and anti-viral therapy based on the regimen for Ramsay-Hunt syndrome. All patients showed remarkable improvement in oral intake ability. In cases showing acute onset of unilateral cranial nerve palsy, steroid therapy and anti-viral therapy should be considered.抄録全体を表示PDF形式でダウンロード (675K) -
本多 啓吾, 土師 知行, 佐藤 進一, 田村 哲也, 本吉 和美, 小澤 一之, 山口 浩志, 辻村 隆司, 山田 光一郎2008 年 101 巻 10 号 p. 791-794
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーReinke's edema is a condition characterized by diffuse polypoid changes in the subepithelial superficial lamina propria of the vocal cords, which is usually treated using the minimally invasive microflap technique. However, in patients with dyspnea, the epithelium has often undergone pathological changes due to repeat infection and hemorrhage. During the resection of such bulky, inflamed lesions, the operative field is compromised by bleeding, which can result in complications. We report two patients with severe Reinke's edema who presented with a chief complaint of dyspnea. In both patients, emergency tracheostomy was performed immediately before the curative resection of the lesion with the laryngeal microdebrider. The procedures were promptly completed with good visualization. No complication occurred and the patients were satisfied with the vocal outcome one month after the treatment. Although few reports are available on the use of the microdebrider in inflammatory lesions of the vocal cords, our experience showed its usefulness in selected cases of Reinke's edema.抄録全体を表示PDF形式でダウンロード (4457K) -
峰晴 昭仁, 東川 雅彦, 田中 朝子2008 年 101 巻 10 号 p. 795-801
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーA 65-year-old woman presented with a 3-month history of an enlarged cervical mass. Ultrasonography and CT scan of the neck showed tumors of the thyroid and its lateral neck. The lateral tumor appeared to be compressing the internal jugular vein. Fine needle aspiration cytology of the thyroid revealed atypical cells. Perioperatively, we recognized that the neck tumor had embolized into the internal jugular vein. A total thyroidectomy with modified radical neck dissection, combined with resection of the left internal jugular vein was performed. All tumors including the thrombus were macroscopically removed. Only a few cases of differentiated thyroid carcinoma showing such massive invasion into a great vein have been reported, but they generally had a poor prognosis. This patient has been followed up for 24 months with neither recurrence nor metastasis.抄録全体を表示PDF形式でダウンロード (6188K) -
小林 政美, 保富 宗城, 島田 純, 藤原 啓次, 山中 昇2008 年 101 巻 10 号 p. 803-809
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーSome antimicrobial agents have been reported to have immunomodulatory effects and to show synergy in their anti-inflammatory effects. To study the immunomodulatory effect of gatifloxacin (GFLX), a fluoroquinolone, we investigated its influence on the production of cytokines in human tonsillar lymphocytes. Erythromycin (EM) was employed as a positive control, having previously been reported as having immunomodulatory effects. Palatine tonsils were obtained from 21 patients, including 9 patients in recurrent tonsillitis (5 males and 4 females, mean 26.7 y. o.), 5 patients with hypertrophic tonsils (3 males and 2 females, mean 6.5 y. o.), and 7 patients with focal tonsillar disorders (1 male and 6 females, mean 42.6 y. o.). Informed consent was obtained from all patients to use their tonsils for this study. The tonsillar lymphocytes were stimulated by Staphylococcal enterotoxin B (SEB, 100ng/ml) and were incubated with GFLX (2, 4, 10, or 20μg/ml) or EM (0.5, 1, 5μg/ml) for 24 hours. Cytokine production (IL-8 and TNF-α) in the supernatant was measured by solid-phase ELISA. IL-8 production of tonsillar lymphocytes was significantly suppressed by EM in three groups and by GFLX in recurrent tonsillitis groups. TNF-α production of tonsillar lymphocytes was enhanced in the tonsillar hypertrophy group and focal tonsillar disorders group by GFLX; however, no significant influence was shown in tonsillar lymphocytes by EM. In conclusion, GFLX has immunomodulatory effects on tonsillar lymphocytes through the suppression of IL-8 production; in particular, the recurrent tonsillitis group may have shown synergistic anti-inflammatory effect with its anti-bacterial properties.抄録全体を表示PDF形式でダウンロード (1106K) -
白馬 伸洋2008 年 101 巻 10 号 p. 810-811
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (420K) -
梶川 泰2008 年 101 巻 10 号 p. 812-813
発行日: 2008/10/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (2644K)
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