巻号一覧
前身誌
103 巻, 8 号
選択された号の論文の16件中1～16を表示しています
- |<
- <
- 1
- >
- >|
論説
-
大久保 公裕原稿種別: 論 説
2010 年 103 巻 8 号 p. 695-700
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありThe evidence of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) is introduced. SCIT and SLIT is an allergen immunotherapy used internationally now. In Japan, SCIT is still the only immunotherapy. There are no evidence-based protocols for SCIT but the effect is reliable with high level evidences including the meta-analysis. Although the effect of SCIT is large, the social problems around the medical system in Japan prevent SCIT from general usage. SLIT is another immunotherapy that is internationally evaluated as an effective therapy. SLIT is handier to perform and is gathering attention. Some double-dummy tests reported that SLIT was as effective as SCIT, but the effectiveness of SLIT compared to that of SCIT is still controversial. Many doctors and patients are longing for SLIT to be available in Japan. We are aiming to put SLIT to pollinosis caused by Japanese cedar pollen in practical use at 2014.
抄録全体を表示PDF形式でダウンロード (383K)
カラー図説
-
水田 邦博, 中西 啓原稿種別: カラー図説
2010 年 103 巻 8 号 p. 702-703
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありPDF形式でダウンロード (503K)
臨床
-
―6例の検討と適応について―児玉 悟, 平野 隆, 鈴木 正志原稿種別: 臨 床
2010 年 103 巻 8 号 p. 705-711
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありEndoscopic nasal and paranasal sinus surgery (ESS) provides superior magnification, illumination, and angled visualization enabling a tumor base to be isolated and the disease extent accurately defined. Extended endoscopic frontal sinus surgery, including Draf type I-III, is effective in treating extensive frontal sinus lesions, but endoscopic endonasal management of inverted papilloma (IP) involving frontal sinus and drainage remains controversial. We analyzed six cases of IP involving the frontal recess and sinus and their clinical outcomes treated from 2005 to 2008. ESS by an experienced surgeon under general anesthesia involved four frontal recess tumors without frontal sinus attachment undergoing Draf type IIa procedures and 2 with frontal recess and infundibulum attachment undergoing Draf type IIb procedures. All were successfully, with an uneventful postoperative course and no recurrence observed in follow-up examination. We concluded that ESS achieves complete IP removal, plus the advantages of no external incision, decreased blood loss, low morbidity, and short hospitalization.
抄録全体を表示PDF形式でダウンロード (1568K) -
―CT所見の検討―立山 香織, 児玉 悟, 前田 一彦, 安倍 伸幸, 能美 希, 鈴木 正志2010 年 103 巻 8 号 p. 713-720
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありWegener’s granulomatosis (WG) is a systemic vasculitis that can affect any organ. It is often difficult to diagnose at an early stage. Chronic sinusitis is a well-known clinical feature of the disease. We reviewed computed tomography (CT) findings in three cases of WG with sinonasal symptoms.
Case 1: A 33-year-old woman presented with choanal flow and recurrent epistaxis. CT findings revealed a ring-like calcification mimicking a fungus ball, in the right maxillary sinus. PR3-ANCA was positive. Biopsy was performed for the granulation in the right nasal cavity, and she was diagnosed as having WG.
Case 2: A 79-year-old woman who presented with right cheek pain. CT findings showed bone destruction of ethmoidal cells and bony thickening of the right maxillary sinus. Malignancy was ruled out histopathologically in endoscopic sinus surgery, but the pathology could not confirm the diagnosis of WG. Cheek pain and general fatigue persisted. Laboratory data showed elevated CRP and normal concentrations of PR3-ANCA. We clinically suspected WG and started steroid therapy. Symptoms immediately improved.
Case 3: A 59-year-old woman with acute right visual loss and exophthalmos. She had saddle nose deformity, and anterior rhinoscopy revealed the absence of both the middle and inferior turbinates and nasal septum. CT showed a soft tissue mass in the right orbit and new bone formation in the right maxillary sinus.
WG is difficult to diagnose at an early stage and when limited to the head and neck region. In our cases, CT in our cases showed mucosal changes, bone destruction and sclerosis, and an orbital mass. These CT findings may aid diagnosis at an early stage when clinical suspicion is high.
抄録全体を表示PDF形式でダウンロード (931K) -
力丸 文秀, 松尾 美央子, 檜垣 雄一郎, 冨田 吉信2010 年 103 巻 8 号 p. 721-724
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありIn treatment of squamous cell carcinoma of the mouth floor, we reviewed 26 cases-25 men and one woman from 38 to 83 years old-treated from January 1997 to January 2006 in our institution. Three-year survival rate was 88% in all cases, 100% in stages I and II, and 67% in stages III and IV. Overall sites recurrence was 38%, 17% in primary recurrence, 13% in cervical recurrence, and 8% in distant metastasis. Primary recurrence was salvaged 25% of patients and cervical recurrence, 67%, respectively. In non-operative cases for the neck, cervical recurrence was 8% and salvaged by neck dissection, so we concluded that elective neck dissection was not necessary.
抄録全体を表示PDF形式でダウンロード (337K) -
弘中 志央, 渡邉 大樹, 中井 茂, 久 育男, 吉松 政喜2010 年 103 巻 8 号 p. 725-728
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありWe report a case of osseous choristoma on the tongue radix. A 25-year-old woman with Turner syndrome was seen for a 10-year-old asymptomatic tongue tumor. Assuming it to be benign, we totally resected the tumor through an oral approach under general anesthesia. The pathological diagnosis was osteoma of the tongue, called osseous choristoma. She had undergone estrogen and progestogen treatment for Turner syndrome. We concluded that estrogen treatmenat triggered osseous choristoma due to accelerated new bone formation.
抄録全体を表示PDF形式でダウンロード (539K) -
廣瀬 由紀, 田渕 経司, 大久保 英樹, 中山 雅博, 林 健太郎, 菅野 雅人, 長田 道夫, 原 晃2010 年 103 巻 8 号 p. 729-735
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありSmall-cell parotid gland carcinoma is rare, and it had been considered that the prognosis in small-cell salivary gland carcinoma was better than in other parts of the head and neck. We report a case of small-cell parotid gland carcinoma. An 81-years-old man with a right parotid gland mass and partial facial palsy visited our hospital. Imaging studies showed a parotid tumor 36 mm in diameter. Fine-needle aspiration cytology suggested poorly differentiated carcinoma. The man also had a gluteal basal cell carcinoma and upper right lung squamous cell carcinoma. Pathological diagnosis following total right parotidectomy was small-cell carcinoma lesions recurred in cervical and mediastinal lymph nodes and liver caused. His general condition gradually deteriorate, and he died 6 months after the operation. The tumor in our case was extremely aggressive and highly and swiftly metastatic, emphasizing the need for early diagnosis and adequate therapy in managing small-cell parotid gland carcinoma.
抄録全体を表示PDF形式でダウンロード (1378K) -
本多 伸光, 小林 泰輔, 澤井 尚樹, 菰渕 勇人, 中村 光士郎2010 年 103 巻 8 号 p. 737-742
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありCarcinoma ex pleomorphic adenoma (CEPA), a rare, aggressive malignant secondary carcinoma developing in pre-existing pleomorphic adenoma usually occurs in the salivary glands. Capsular invasion has an oppressive prognosis. We report a rare case of CEPA of the palate originating in a minor salivary gland with cervical lymph node metastasis. A 63-year-old woman with a 6-month history of several enlarging cervical masses had a painless non-growing palate mass for the last 20 years. Preoperative histological findings partially supported malignancy and histological lymph node diagnosis indicated adenocarcinoma motastatis necessitating complete oral tumor resection and modified radical neck dissection. Histological findings of oral tumor carcinoma were scattered through the pathologically benign pleomorphic adenoma tumor. Despite the absence of capsular invasion, this case featured high-grade malignancy with multiple cervical lymph node metastases. Histological and clinical discrepancies made it difficult to diagnose preoperatively.
抄録全体を表示PDF形式でダウンロード (1064K) -
計良 宗, 朝倉 光司, 本間 朝, 氷見 徹夫2010 年 103 巻 8 号 p. 743-746
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありRanulas are conventionally treated by total resection, marsupialization or intracystic OK-432 injection. We clinically studied 16 such cases from 2000 to 2008—15 sublingual and 1 mixed. The ranula was excised in 7 cases with recurrence in 42.9%, marsupialized in 3 with 100% recurrence, the sublingual gland totally resected in 4 with no recurrence, and OK-432 injected intracystically in 2 with 50% recurrence. Our results thus suggest that total sublingual gland resection is an effective method for the treatment of ranula.
抄録全体を表示PDF形式でダウンロード (298K) -
倉上 和也, 太田 伸男, 阿部 靖弘, 渡辺 知緒, 伊藤 吏, 尾上 義浩, 石田 晃弘, 稲村 和俊, 和氣 貴祥, 鈴木 祐輔, 青 ...2010 年 103 巻 8 号 p. 747-754
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありWe report to cases of systemic IgG4-related sclerosing disease involving the dissemination of CD4- or CD8-positive T lymphocytes and IgG4-positive plasma cells in numerous internal organs. The pancreas, bile duct, salivary glands, thyroid gland, and retroperitoneum are often permeated by IgG4-positive plasma cells, suggesting that sclerosing salivary glanditis as Mikulicz’s disease and Küttner’s tumor, autoimmune pancreatitis, sclerosing cholangitis, and retroperitoneal fibrosis are IgG4-related sclerosing phenotypes. The paucity of cases has prevented development of a conclusive treatment regimen, although oral steroid is have proven effective.
抄録全体を表示PDF形式でダウンロード (1056K) -
田中 秀峰, 村下 秀和, 米納 昌恵, 田渕 経司, 原 晃2010 年 103 巻 8 号 p. 755-762
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありWe retrospectively reviewed medical records of all those admitted and diagnosed with acute epiglottitis from 2006 to 2009. Of these 43—26 men and 17 women—9 underwent tracheotomy. Epiglottal and arytenoidal swelling severity were classified based on the classification of Katori et al. Focusing on epiglottal swelling seen under flexible laryngoscopy, we divided subject types into abscess and edema, and studied how these classifications and tracheotomy indications were related. The percentage of tracheotomy was 42.9% for severe epiglottal swelling, 7.7% for moderate swelling and 12.5% for mild swelling. Tracheostomy was also done in 36.8% with arytenoidal swelling and 8.3% with non arytenoidal swelling, 36.8% with epiglottic abscess and 8.3% without abscess. Epiglottal abscess formation was thus a risk factor strongly associated with airway intervention as well as severe epiglottal and arytenoidal swelling.
抄録全体を表示PDF形式でダウンロード (635K) -
鈴木 千晶, 平野 滋, 渡邉 佳紀, 岸本 曜, 楯谷 一郎, 三浦 誠, 伊藤 壽一2010 年 103 巻 8 号 p. 763-767
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありLocalized laryngotracheal amyloidosis is rare, and therapeutic strategy yet to be determined. We report a case of localized laryngotracheal amyloidosis as an intraluminal tracheal mass compromising respiration. A 53-year-old woman was seen for severe dyspnea. Flexible laryngoscopy indicated subglottic stenosis, with computed tomography and magnetic resonance imaging showing a large mass lesion in the tracheal membrane. After tracheotomy, laryngotracheofissure was done for biopsy and to reduce the mass at the trachea and subglottic region, preserving as much mucosa as possible. Postoperative pathology was amyloidosis. Due to the limited effect of surgical reduction, another laryngotracheal fissure was done to completely remove the tracheal mass. The raw postresection surface was covered by atelocollagen sheet, with posterior cricoid split added to enlarge the subglottic area. The Postoperative airway was sufficient and the tracheostoma closed. No recurrence has been found 6 months after final surgery. Complete resection using laryngotracheal fissure and simultaneous laryngotracheal reconstruction with atelocollagen sheet is thus effective in treating of laryngotrahceal amyloidosis and resolving airway stenosis.
抄録全体を表示PDF形式でダウンロード (773K) -
牧瀬 高穂, 福岩 達哉, 大堀 純一郎, 吉福 孝介, 黒野 祐一2010 年 103 巻 8 号 p. 769-773
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありBasaloid squamous cell carcinoma (BSCC), a rare head and neck neoplasm, is differentiated clearly from conventional squamous cell carcinoma morphologically and biologically. Only one case of laryngeal BSCC has been reported in Japan, vs. over 60 in the international literature. We present a second such case. An 83-year-old man admitted for slight hoarseness and a large mass on the right arytenoid had no palpable cervical lymph nodes. Biopsy under a fiberscope showed poorly differentiated squamous cell carcinoma, T1N0M0, necessitating CO2 laser laryngomicrosurgery. Pathological studies showed BSCC positive in the margins, further necesstating 70 Gy of radiotherapy and consecutive chemotherapy with TS-1. The man remains alive and disease-free three years after surgery.
抄録全体を表示PDF形式でダウンロード (505K) -
東谷 敏孝, 片田 彰博, 荻野 武, 岸部 幹, 片山 昭公, 高原 幹, 国部 勇, 坂東 伸幸, 今田 正信, 林 達哉, 野中 聡, ...2010 年 103 巻 8 号 p. 775-779
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありWe report a rare case of papillary thyroid carcinoma with pathological fracture. A 69-year-old male reporting left femoral pain was found in pathological orthopedic examination to have papillary thyroid carcinoma metastasis to the left femur but no apparent distant metastasis, necessitating total thyroidectomy and radioiodine therapy twice, but thyroglobulin remained elevated. To preserve all possible quality of life, we continued radiation therapy as the thyroid cancer spread to multiple bones and liver sites.
抄録全体を表示PDF形式でダウンロード (1614K)
研究
-
森 智昭, 江川 峻哉, 小野 智裕, 鎌数 清朗, 小林 斉, 嶋根 俊和, 寺尾 元, 三邉 武幸, 洲崎 春海原稿種別: 研 究
2010 年 103 巻 8 号 p. 781-785
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありBackground
IgA nephropathy treatment is usually planned and conducted based on pathological renal biopsy findings, laboratory data, and clinical symptoms. This involves improving the physical condition, diet therapy, and pharmacotherapy. Steroid pulse therapy following tonsillectomy is reported to be effective intending IgA nephropathy.
Methods
24 patients that diagnosed with IgA nephropathy in renal biopsy underwent tonsillectomy. We them analyzed of the relationship between pathological renal biopsy findings and the tonsils of those with IgA nephropathy.
Results
No relationship was seen between the severity in pathological renal biopsy findings and the tonsils, thus showing typical morphological IgA nephrophath features.
Conclusions
Our study indicated no relationship between pathological renal biopsy findings and tonsils, suggesting that histological tonsils findings play no role in IgA nephrophath status and prognosis, Histological tonsils findings in IgA nephropathy differ from those in chronic tonsillitis, and the tonsils appear to be a unique organ causing initial and/or progressive events generating glomerular IgA deposits.
抄録全体を表示PDF形式でダウンロード (673K)
研修ノート
-
林 達哉原稿種別: 研修ノート
2010 年 103 巻 8 号 p. 786-787
発行日: 2010年
公開日: 2010/08/01
ジャーナル 認証ありPDF形式でダウンロード (667K)
- |<
- <
- 1
- >
- >|