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前身誌
105 巻, 7 号
選択された号の論文の16件中1～16を表示しています
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論説
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橋本 誠, 山下 裕司2012 年 105 巻 7 号 p. 603-612
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありIt is essential to use an infrared CCD camera in clinical examination of the vestibular system. Devices are currently available that can quite accurately record human eye movements, based on the principle of video-oculography (VOG). We devised an original video-oculography (HI-VOG) system using a commercialized infrared CCD camera, a personal computer and public domain software program (ImageJ) for the data analysis. The video image from the infrared CCD camera was captured at 30 frames per second at a resolution of 640*480 pl.. For analysis of the horizontal and vertical components, the X-Y center of the pupil was calculated using the original macro. For analysis of torsional components, the whole iris pattern, which was rotated by 0.1 degree, was overlaid with the same area of the next iris pattern, and the angle at which both iris patterns showed the greatest match was calculated. For quantitative analysis, the slow phase velocity of each occurrence of nystagmus, the average value of the slow phase velocity and the visual suppression value, were analyzed automatically. Analyses of the eye tracking test, as well as the test for optokinetic nystagmus were also applied in this system. Using the HI-VOG system, it was possible to inexpensively perform nystagmus analysis from video images recorded with an infrared CCD camera.
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カラー図説
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竹村 景史, 中山 明峰, 村上 信五2012 年 105 巻 7 号 p. 614-615
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありPDF形式でダウンロード (653K)
臨床
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亀井 昌代, 佐藤 宏昭, 小田島 葉子2012 年 105 巻 7 号 p. 617-622
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありThe aim of this study was to examine the monosyllable intelligibility test and subjective evaluation of the reading voice. This study involved 5 hearing-impaired subjects using 5 hearing aids (Behind The Ear). Hearing aids with the directional microphone and noise reduction system showed a higher speech discrimination score under noise than the others. In general, on hearing aids selection, the requirements are better speech intelligibility and natural sounds. No significant correlation was observed between the speech discrimination score and the sound quality evaluation results of reading speech under condition of noise. Thus, even if hearing aids provide high speech intelligibility, the sound quality does not always suit a subject’s preference. Therefore, both speech intelligibility and subjective evaluation should be tested.
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辻川 覚志, 辻川 敬裕2012 年 105 巻 7 号 p. 623-629
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありThe purpose of this study is to investigate the effect of viewing television and playing video games upon children with chronic otitis media with effusion (OME). Forty-nine patients (31 males and 18 females) from 1-11 years old (mean: 4.5 y.o.) were assessed for OME outcomes under media restriction. The presence of OME was evaluated with otoscopic findings. Media restriction achievement and sleep habits were examined through the use of retrospective survey questionnaires. The group of patients in whom media restriction was well-enforced (n = 43) showed a significant amelioration of OME compared with the poorly restricted group (n = 6) [p < 0.05]. A positive correlation was found between the degree of media restriction achievement and the score of sleep habits improvement [p < 0.05], and the group in whom sleep habits improved well (n = 29) showed better OME outcomes than the unchanged group (n = 20) [p < 0.05]. These findings suggest that viewing television and playing video games are both associated with subsequent deterioration of OME through sleep disturbance.
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牧原 靖一郎, 岡野 光博, 折田 頼尚, 小野田 友男, 假谷 伸, 津村 宗近, 西﨑 和則2012 年 105 巻 7 号 p. 631-636
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありWe report on the case of an epidermoid cyst of the pterygopalatine fossa, which we operated on via the endoscopic transnasal approach, only the second one in the world to the best of our knowledge. A 67-year-old woman had discomfort in her left jaw when biting. MRI findings taken two years after the first medical examination showed that the cyst had gradually grown larger. In addition she started to show a symptoms of ipsilateral otitis media with effusion (OME). After the surgery the OME improved. There is a possibility that the OME had something to do with the compression of the cyst. The endoscopic transnasal approach is a safe, effective and less invasive therapeutic modality for treatment of cysts in the pterygopalatine fossa.
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田口 大藏, 福島 慶, 竹内 裕美, 神部 敦司, 黒崎 雅道, 渡辺 高志, 北野 博也2012 年 105 巻 7 号 p. 637-640
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありWe report on the case of a 51-year-old male with a brain abscess secondary to chronic sinusitis. In this patient, intracranial extension developed via the direct route through the bone defect in the posterior wall of the left frontal sinus. We successfully performed synergic operations of endoscopic sinus surgery and neurosurgical operation for the abscesses in the left frontal lobe and frontal sinus. At present, about 10 months after the treatment, the patient has no recurrence of the brain abscess. Onset of headache and fever associated with central nervous symptoms may indicate intracranial complication of sinusitis, and early image diagnosis and treatment are very important.
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深瀬 滋2012 年 105 巻 7 号 p. 641-646
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありI experienced two complicated cases of ranula. The first case was a 9 years old girl. She had suffered from ranula for 3 years. At first, her ranulas were the bilateral oral type. After two surgeries via the oral approach, her ranulas changed into the plunging type. Thereafter, surgery was performed via the neck, but her ranula recurred immediately. After that, she got OK-432 intracystic injection therapy. However, following increased swelling after OK-432 therapy, dehiscence occurred at her operation wound and it became a salivary fistula.
The second case was an 8 years old girl. She had suffered from ranula for 2 years. At first, her ranula was the small oral type. She had a marsupialization operation but her ranula recurred as a very big plunging ranula. She then received three OK-432 therapy sessions, but they were not effective because of the dehiscence of the oral operation scar.
I treated theses cases with OK-432 after waiting for a long time till their wound became tight. The first case was cured with only one OK-432 injection. Case 2 needed 4 OK-432 injections to be cured because of the wound dehiscence.
The reason why these cases became complicated was the surgical procedure. We must be aware that marsupializaion and an excision operation for oral ranulas can sometimes cause a plunging ranula. A ranula is a mucocele through which saliva leaks from the sublingual gland. The strategy for treating ranulas must therefore be to stop leakage. The easiest method to stop saliva leakage is OK-432 and the most certain method is excision of the sublingual gland. Considering the fact that the efficacy of OK-432 therapy after surgery is low comparing to that of an unoperated case and OK-432 therapy does not increase the difficulty and risk of any subsequent operation, I believe that OK-432 therapy should be performed as a first choice. If the OK-432 regimen is not effective, transoral excision of the sublingual gland should be considered.
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戸田 京子, 渡邊 雄介, 駒澤 大吾, 竹腰 英樹2012 年 105 巻 7 号 p. 647-652
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありLingual osseous choristoma is an extremely rare condition, of which only 73 cases have been reported. Monserrat in 1913 was the first to report this bony lesion on the dorsum of the tongue and it was labelled as a lingual osteoma, the term that normally describes neoplastic pathology. Krolls et al. changed this term later to osseous choristoma, which means normal tissue in an abnormal location. The aetiology and pathogenesis of lingual osseous choristoma remain debatable. We report on a case of osseous choristoma on the dorsum of the tongue. A 20-year-old woman was referred to our hospital for a polypous tumor on the posterior part of the dorsum of the tongue. The patient has had no recurrence for 6 months after surgery. We discuss the clinical features, diagnosis and treatment and provide a review of the literature.
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乾 智一, 比嘉 輝之, 比嘉 麻乃, 真栄田 裕行, 喜友名 朝則, 鈴木 幹男2012 年 105 巻 7 号 p. 653-659
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありPalmoplantar pustulosis (PPP) is a relapsing vesiculopustular eruption of the palms and soles, with onset usually occurring in middle aged adults. To clarify the long term prognosis of PPP after tonsillectomy, multi-choice questionnaires were mailed to 331 patients, i.e. 61 with tonsillectomy (tonsillectomy group) and 270 without tonsillectomy (non-tonsillectomy group). These patients were diagnosed as having PPP between 1988 and 2008 by dermatologists at the Ryukyu University Hospital and followed up by them at least for one year. Patients had tonsillectomies for intractable PPP compared with the usual dermatologic treatments.
The response rate to the written questionnaire was 36.8% (122/331), comprising 30 in the tonsillectomy group and 92 in the group without tonsillectomy. The improvement rates of pustules with skin redness and pruritis-associated pain were 83.3% and 76.7% in the tonsillectomy group, and 84.7% and 73.9% the non-tonsillectomy group, respectively. The relapse rate of skin eruptions after tonsillectomy was 23.3% with an improvement of skin eruptions after relapse of 71.4%. The complete disappearance rate of skin symptoms in the tonsillectomy group was 63.3%, which was significantly higher than that (26.1%) in the non-tonsillectomy group. As the most effective treatment against PPP, 66.7% of patients selected tonsillectomy in the tonsillectomy group. Satisfaction rates for treatment were 70.0% in the tonsillectomy group and 33.7% in the non-tonsillectomy group, respectively. The satisfaction rate in the tonsillectomy group was significantly higher than that in the non-tonsillectomy group.
The present study clearly indicated that a favorable treatment outcome for PPP was obtained by tonsillectomy even in intractable cases and lasted considerably longer. As the satisfaction rate for tonsillectomy was also high in the tonsillectomy group, otolaryngologists should be involved in PPP treatment in cooperation with dermatologists.
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山田 雅人, 西尾 綾子, 桑波田 悠子, 角 卓郎2012 年 105 巻 7 号 p. 661-666
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありWe present a rare case of a hypopharyngeal perforation after concurrent chemoradiotherapy (CCRT). A 69-year-old man with schizophrenia received CCRT with Docetaxel, Cisplatin, and 5-FU following a diagnosis of hypopharyngeal squamous cell carcinoma (T3N2bM0). Complete remission was achieved with CCRT, but four months later, he forcibly swallowed a meat bun (Chinese manju) which led to the perforation of his hypopharynx. He was treated with conservative therapy (intravenous antibiotic, fasting and tube feeding). The swelling gradually subsided and the patient was able to consume food naturally after the 13th day of hospitalization. We considered the composite factors had contributed to the pathogenesis of this case: anatomical weakness, pathological weakness after chemoradiotherapy, physical pressure to the hypopharynx due to the metastasis of the cervical spine, and the powerful deglutition pressure caused by his forcible swallowing of the bun. The possibility that such a serious complication might be caused by CCRT was suggested, and we believe that clinicians should have recognition and understanding of how to treat it because of its severe morbidity.
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渡邉 佳紀, 辻 純, 安里 亮, 神田 智子, 本多 啓吾, 森 祐輔, 辻村 隆司, 牛呂 幸司2012 年 105 巻 7 号 p. 667-674
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありKimura’s disease is a chronic inflammatory disease of uncertain cause. It occurs mainly as a head and neck lesion, especially as parotid, submandibular and buccal lesions. We report herein on a very rare case of Kimura’s disease which occured on the epiglottis. The patient had some respiratory discomfort, so surgical treatment was effective to secure a clear airway.
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鈴木 良, 楯谷 一郎, 椛 慎治, 荻野 枝里子, 平野 滋, 北村 守正, 嘉田 真平, 伊藤 壽一2012 年 105 巻 7 号 p. 675-679
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありA 79-year old woman visited Kyoto University Hospital with stridor and dyspnea. She had a history of lung adenocarcinoma and had undergone a partial lung resection. Endoscopic, CT and MRI findings revealed a subglottic tumor and a tracheostomy was performed. Histologic examination of a specimen from the subglottic tumor proved it was a metastatic lung adenocarcinoma. Subglottic tumor resection was performed under direct laryngoscopy and external beam radiation therapy (3 Gy×10) was added postoperatively. The patient remained recurrence-free for over half a year till she died of carcinomatous pleurisy.
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本田 圭司, 鎌田 知子, 田崎 彰久, 畑中 章生2012 年 105 巻 7 号 p. 681-685
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありWe report a case of burns of the larynx caused by hot food in which emergency airway management was required.
A 36-year old male came to the hospital with a sore throat 14 hours after ingesting hot food (takoyaki, a Japanese dumpling containing octopus). Fiberscopic examination revealed mild edema of the aryepiglotic fold. The patient refused hospitalization against medical advice and went home after a corticosteroid injection, but returned to the hospital by ambulance with severe dyspnea the next day (44 hours after the injury). A considerably swollen epiglottis were seen on fiberscopy. Since endotracheal intubation was expected to be difficult, surgical cricothyroidotomy was performed for the relief of the airway obstruction. If a laryngeal burn is suspected, the patient should be hospitalized and observed carefully for 24-48 hours.
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薬物
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山中 昇, 末武 光子, 冨山 道夫, 杉田 麟也, 松原 茂規, 澤田 正一, 宇野 芳史, 兼定 啓子, 内薗 明裕2012 年 105 巻 7 号 p. 687-698
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありIn recent years, the increasing incidence of drug-resistant strains such as penicillin-resistant Streptococcus pneumoniae (PRSP) and β-lactamase-non-producing ampicillin-resistant Haemophilus influenzae (BLNAR) have been identified as causative pathogens in acute otitis media (AOM) and this fact is considered to be an important cause of intractable cases. In the present study, we evaluated the efficacy of tebipenem-pivoxil (TBPM-PI) in moderate to severe AOM cases including recurrent/persistent cases and discussed the clinical positioning of TBPM-PI. Ninety-six cases of AOM in childhood (65 simple acute cases and 31 recurrent/persistent cases) were evaluated. The incidence of recurrent/persistent cases was significantly high in the under 2-year-old age group (p=0.0426). S. pneumoniae and H. influenzae were isolated as the major causative pathogens; specifically, S. pneumoniae was isolated in 63% of the uncomplicated acute cases, H. influenzae was isolated in 71% of the recurrent/persistent cases, and resistant strains were isolated at a high rate for both of the bacterial species. TBPM-PI showed favorable antibacterial activities against these isolated pathoegns. Regarding the curative effect, the cure rate determined by the primary physicians was as high as 90% in the moderate to severe cases including recurrent/persistent cases and the cases resistant to prior therapy. This result suggested that TBPM-PI is useful in children with AOM, especially in recurrent/persistent cases and cases resistant to prior therapy.
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短報
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―診療所での治療経験―正木 義男2012 年 105 巻 7 号 p. 700-701
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありI report herein on a case of nasal septum neurinoma. A 67-year-old female patient presented with right nasal obstruction. A tumor was detected in her right nasal septum. The tumor was completely removed with endscopic sinus surgery. The histopathological diagnosis was Antoni A type neurinoma. The post operative course was uneventful without any signs of recurrence for 15 months after surgery.
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研修ノート
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野中 学, 田中 友佳子2012 年 105 巻 7 号 p. 702-703
発行日: 2012年
公開日: 2012/07/01
ジャーナル 認証ありPDF形式でダウンロード (521K)
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