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101 巻, 2 号
選択された号の論文の14件中1～14を表示しています
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氷見 徹夫, 金泉 悦子, 小笠原 徳子, 山本 元久, 高橋 裕樹2008 年 101 巻 2 号 p. 73-82
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーThe newly established concepts of Mikulicz's disease and Kuttner's tumor (chronic sialadenitis) are discussed. Mikulicz's disease has been included within the diagnosis of primary Sjogren's syndrome, but it represents a unique condition involving persistent enlargement of the lacrimal and salivary glands. Recently, elevated IgG4 concentration in serum and prominent infiltration by plasmacytes expressing IgG4 in the salivary glands was demonstrated in Mikulicz's disease. Mikulicz's disease differs from Sjogren's syndrome, and may be a systemic IgG4-related plasmacytic disease. Kuttner's tumor is a chronic sclerosing sialadenitis that presents with asymmetrical firm swelling of the submandibular glands. The histological characteristics of Kuttner's tumor are severe fibrosis, atrophic acinus, and mononuclear cell infiltration. Immunohistochemical evaluation demonstrated that the proportion of IgG4-positive plasmacytes was elevated in Kuttner's tumor similar to that in Mikulicz's disease. Therefore, it is possible that both Mikulicz's disease and Kuttner's tumor may involve a similar pathogenesis of IgG4-related disease as a form of autoimmune pancreatitis.抄録全体を表示PDF形式でダウンロード (6646K) -
高林 宏輔, 坂東 伸幸, 高原 幹, 野村 研一郎, 原渕 保明, 山田 有則2008 年 101 巻 2 号 p. 84-85
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (1776K) -
小泉 敏三, 上條 朋之, 家根 旦有, 細井 裕司2008 年 101 巻 2 号 p. 87-93
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーIn an immuno-compromised host with systematically disordered immuno-function, a mild infectious disease of the head and neck occasionally becomes severe, developing to cervical necrotizing fasciitis (CNF). We reported a case of CNF in a 74-year-old woman with chronic nephritis, who had been taking adrenocorticosteroids for about 20 years. Conservative therapy using intravenous antibiotic agents, based on the initial diagnoses of buccal cellulitis and acute tonsillitis, was ineffective for cheek and tonsil symptoms. Consequently, a large clot originating from tonsillar hemorrhage led to respiratory arrest after 6 days in hospital. Intensive medical care in the ICU improved her respiration and consciousness level. However, the progressive lesion of the cheek and tonsil, which was finally diagnosed as CNF and treated by surgical debridement, formed a large pharyngocutaneous fistula after 9 days in hospital. The pathogenic bacteria were Streptococcus milleni, Prevotella oris and Pseudomonas aeruginosa. Two weeks later, the pharyngocutaneous fistula was closed by reconstructive surgery using a pectoralis major myocutaneous (PMMC) flap, indicating that this flap is appropriate to reconstruct a large pharyngeal and cervical defect with a poor environment for wound healing because of the rich muscle volume and stability of local blood flow.抄録全体を表示PDF形式でダウンロード (5840K) -
大田 重人, 武藤 俊彦, 三代 康雄, 阪上 雅史2008 年 101 巻 2 号 p. 95-100
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーPneumocephalus is defined as the presence of air or gas in the cranial cavity. Typical causes include trauma, neoplasm, infection and surgical intervention, but some cases are idiopathic. However, idiopathic pneumocephalus is rare.
We present a very rare case of idiopathic pneumocephalus with a widely pneumatized mastoid. The patient was a 20-year-old man who complained of right orbital pain but there were no other specific neurological symptoms. Initially, he was treated by neurosurgery to close a bone defect only. However, right orbital pain recurred after one and a half months after surgery. Otolaryngological findings (pure tone audiometry, tympanometry, and measurement of eustachian tube function) were normal. Hyperpneumatized mastoid air cells and a bone defect of the posterior cranial fossa were detected on computed tomography scan. We performed second surgery, mastoidectomy, obliteration of the mastoid and bone defect, and blockade aditus using free fascia from the abdomen, bone powder and abdominal fatty tissue. Follow-up CT 9 month after surgery demonstrated that there was no recurrence of pneumocephalus. To cure it, it is important to identify the route of air invasion and block it. We thought that the mechanism of pneumocephalus in our case involved the presence of “a check valve effect” formed in the widely pneumatized mastoid.抄録全体を表示PDF形式でダウンロード (5906K) -
寺岡 正人, 中村 光士郎, 小林 泰輔, 岡田 昌浩2008 年 101 巻 2 号 p. 101-105
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーHeadache is a common complaint in sinus diseases. Especially in cases of acute sinusitis, headache is often associated with congestion and purulent discharge, which facilitates the diagnosis. However, cases of chronic sinusitis that involve persistent headache as a chief complaint may often cause difficulty in selecting the surgical method such as endoscopic sinus surgery (ESS). This study investigated the relationship between headache site and CT findings and evaluated the postoperative results of patients with sinus headache after ESS. Thirty-eight patients with headache underwent surgery between 2000 and 2005. The etiology of headache was chronic sinusitis in 31, fungal sinusitis in 4 and sinus cyst in 3. Twenty-seven patients complained of frontal and/or occipital headache and 3 complained of temporal headache.
On CT findings, the site demonstrating clouded sinus almost corresponded to the lesion causing headache and lesion of the ostiomeatal complex seemed to be causative in frontal headache. As a result thirty-seven of 38 patients had no further headache after surgery during an average postoperative followup of 7.1 months.抄録全体を表示PDF形式でダウンロード (645K) -
井上 庸夫, 江口 智徳, 山口 晋太郎, 徳丸 晶子, 大出 茂典, 渡辺 建介2008 年 101 巻 2 号 p. 107-113
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーBetween 1995 and 2005, 198 cases of major salivary gland tumors underwent surgery in our department, including 158 parotid gland tumors, 38 submandibular gland tumors and 2 sublingual gland tumors.
The number of parotid tumors increased annually, although submandibular gland tumors did not demonstrate any increasing trend.
The ratio of malignant tumors among submandibular gland tumors was 24%, which was higher than among parotid tumors (11%). In addition, the ratio of the malignant tumors among submandibular gland tumors in males (42%) was significantly higher than that in females (5%).
Fine needle aspiration biopsy was the most useful for diagnosis of the malignant tumors on preoperative examinations.
Permanent paralysis of the facial nerve after resection of parotid tumor was 29% in malignant tumors, 6% in benign tumors and 8% among parotid tumors overall. Frey's syndrome was occurred in 12%.抄録全体を表示PDF形式でダウンロード (931K) -
吉福 孝介, 永野 広海, 黒野 祐一2008 年 101 巻 2 号 p. 115-120
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of Behçet disease. A 68-year-old female complicated with diabetes mellitus consulted our hospital complaining of intractable oral ulcers that had continued to expand despite treatment with antibiotics and topical steroid at another hospital.
Since she complained of severe oral pain and pain upon swallowing, she received oral cavity care and gargled with azulene sodium sulfate and amphotericin B following admission.
Three days after admission, the patient's complaints decreased. Six days after admission, she complained of oral pain because a vesicle had erupted in the oral cavity. Therefore, we considered herpes stomatitis and treated her with a virucide, but there was no improvement. Since erythema nodosum had erupted on the anterior surface of her leg, the patient was referred to a dermatologist and Behçet disease was suspected even though there were no eye lesions or genital ulcers. Based on the diagnosis, oral steroids and colchicine were administered. Further, hypodermic injection of insulin was administered to control the blood glucose. These treatments were effective and local findings improved day by day. After oral administration of steroids for 2 weeks, she was discharged and there has not been any recurrence to date.抄録全体を表示PDF形式でダウンロード (3904K) -
内田 真哉, 足立 直子, 西村 泰彦, 牛嶋 千久, 出島 健司2008 年 101 巻 2 号 p. 121-126
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーMany patients with severe dysphagia are male, the larynx has often dropped, and even tracheostomy is sometimes difficult. During surgery to prevent aspiration in such patients, techniques that can be performed even in the presence of a dropped larynx are necessary. In addition, since complications are generally present in such patients, minimally invasive surgical techniques are desirable. Therefore, we developed a laryngeal closure method in the subglottic area that prevents postoperative suture failure and can also be performed in patients with a dropped larynx. This surgical technique was performed in patients with severe dysphagia.
The subjects comprised 5 patients who had undergone this procedure more than 6 months previously. All were males aged ≥70 years and had demonstrated repeated episodes of pneumonia.
In this surgical technique, laryngeal closure is performed in the subglottic area, and the dead space formed in the suture area is filled with an anterior cervical muscle flap. The status of ingestion before and after surgery and the course were observed and evaluated.
There were severe complications in any patients. In all patients, the prevention of aspiration was achieved, and the status of ingestion improved.
This surgical procedure may be an accurate aspiration-preventive technique that is minimally invasive and infrequently induces suture failure.抄録全体を表示PDF形式でダウンロード (3760K) -
海山 智九, 西屋 圭子, 奥野 敬一郎2008 年 101 巻 2 号 p. 127-130
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーThis study was investigated the epidemiologic features of epiglottitis and considered the risk factors contributing to the need for airway management. We retrospectively reviewed the medical records of all patients with a diagnosis of epiglottitis who had been discharged from Ebara Hospital. The 11 years period between May 1995 and July 2005 was chosen for this review. Age, gender, chief complaint, appearance of symptoms at consultation, laboratory features, and the presence or absence of airway management were reviewed. There were four patients that required airway management (8%). Tracheostomy was performed in all four patients. There were no deaths.
Four patients who underwent tracheostomy had been seen by a physician within the previos 24 hours. White blood cell cout was greater than 14, 000 (mean, 12, 174). In all four cases, highly swollon epiglottises were observed by direct laryngoscopy with dyspnea. It was difficult to predict patients that would require airway management. More data must be accumulated for statical analysis to clarify risk factors for airway management.抄録全体を表示PDF形式でダウンロード (629K) -
中尾 芳雄, 中下 陽介, 谷光 徳晃, 田頭 宣治2008 年 101 巻 2 号 p. 131-136
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーParaganglioma of the larynx is an uncommon lesion. To our knowledge, only 12 cases have been reported, in Japan.
We treated a 33-year-old female with a paraganglioma on the larynx. She was complaining of hoarseness for six months. Indirect laryngoscopic examination demonstrated a large submucosal tumor on the right arytenoid. After CT, MRI, angiography and embolization, we resected the tumor by an external approach with tracheotomy under general anesthesia. Paralysis of the right vocal cord occurred post-operatively, but improved after two months. Histological examination demonstrated that the paraganglioma arose from the laryngeal nerve. There has not been any recurrence for 19 months.抄録全体を表示PDF形式でダウンロード (9272K) -
上田 征吾, 齋藤 滋, 原渕 保明2008 年 101 巻 2 号 p. 137-141
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーWe report two cases of spontaneous mediastinal emphysema. In the first case, a 23-year-old female complained of dysesthesia in the pharynx. Cervical X-ray and CT scan demonstrated mediastinal and cervical subcutaneous emphysema. In the second case, a 26-year-old male complained of cervical pain. CT scan demonstrated mediastinal and cervical subcutaneous emphysema. Both patients were treated conservatively.抄録全体を表示PDF形式でダウンロード (3379K) -
櫟原 健吾, 李 昊哲, 河田 了, 東野 正明, 辻 雄一郎, 竹中 洋, 栗栖 義賢, 辻 求2008 年 101 巻 2 号 p. 143-146
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーOmohyoid muscle syndrome was first reported in 1969. Only two cases of this disease were reported in Japan. The patient was a 27-year-old woman, who had been complaining of so-called globus sensation during swallowing for several years. She also had slight foreign body sensation in the right neck. Right lateral mass during swallowing was detected in correspondence with the omohyoid muscle by ultrasonography. Surgery was carried out under general anesthesia. The muscle was excised at the central tendon. The patient immediately became free from globus sensation during swallowing. Pathological examination did not demonstrate any specific change in the muscle specimen except for hypertrophy.抄録全体を表示PDF形式でダウンロード (3995K) -
三上 慎司, 上條 朋之, 小泉 敏三, 福田 多介彦, 家根 旦有, 細井 裕司2008 年 101 巻 2 号 p. 147-151
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーWhite lesions in the larynx, pharynx, and oral regions, which are called leukoplakias clinically, show a variety of histopathological features, including hyperplasia, dysplasia and cancer. Therefore, they should be treated carefully as precancerous lesions. Eighty-one patients with leukoplakia of the larynx, pharynx and oral tissue were treated between 1996 and 2005.
The majority of these patients with leukoplakia in the larynx were heavy smokers.
In the 11 cases of leukoplakia in the larynx, the white lesions were resolved by conservative treatment. Based on the findings above, it is important for heavy smokers to stop smoking completely. In leukoplakia of the larynx, squamous cell carcinoma was detected in 15 cases (26.8%).
In leukoplakia of the oral tissue and pharynx, squamous cell carcinoma was detected in 2 (8.0%).
Among the 81 cases in this series, squamous cell carcinoma was detected in 6 laryngeal lesions and 1 oral and pharyngeal lesions. Histological findings of these lesions were all dysplasia, initially. Therefore, long term follow-up is recommended if the histologoical findings of leukoplakia initially demonstrate dysplasia.抄録全体を表示PDF形式でダウンロード (3566K) -
門倉 義幸2008 年 101 巻 2 号 p. 152-153
発行日: 2008/02/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (290K)
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