The five-year survival rate for carcinoma of the tongue usually ranges from 40 to 60 percent. Recently, it was reported that an excellent result was obtained with intra-tissue radium needle therapy, as conducted at the National Cancer Center in Tokyo. With this therapy the five-year survival rate was 60 percent. Because of the minimum disturbance in function, this therapeutic approach is probably the best available. It requires, however, special facilities which many hospitals do not have. The present paper is a discussion of treatments for carcinoma of the tongue in the absence of the facility for intra-tissue radium needle therapy.
For the 34 patients treated at our hospital between 1960 and 1970, different approaches were applied on a patient to patient basis. The five year survival rate was 44 percent. The cause of death in 19 was local recurrence in 11 and cervical metastasis in 6. Thus, there was a necessity for improvement in managing the primary lesion and the cervical lymph nodes.
Since 1971 we have been using a program which includes preoperative radiation and local infusion chemotherapy followed by extensive removal of the primary lesion and radical neck dissection. In some patients, the basic program was modified according to their condition. The five-year survival rate for 40 patients was 65 percent. Only one patient died of local recurrence and three died of cervical metastasis.
A retrospective study and histological examination of the neck specimens appears to justify the following conclusion:
(1) For T1 and T2 lesions limited within one half side of the tongue body, radiation and local infusion chemotherapy without surgical removal is frequently successful. Neck dissection in an attempt at prevention is not required.
(2) For a T2 lesion extending beyond one half side of the tongue body, and the T3 lesion, treatments should include preoperative radiation and local chemotherapy followed by extensive surgical removal and radical neck dissection. Reconstructive procedures are required to minimize functional disorders.

抄録全体を表示

迷路破壊術後の閉眼, 暗所開眼時の眼球偏位の経時的変化を追跡した.
i) 眼球偏位量は閉眼, 暗所開眼の両記録間で強い相関を示しながら減衰し, 1ヵ月内に正常人の90%許容限界内に収束する.
ii) 眼球偏位方向は, 眼球偏位量の徴小な場合を除き, 終始一定し患側に向い, 前庭脊髄反射のように代償, 過代償を繰り返す事はなかった.
iii) 眼球偏位 pattern は眼球偏位量の減少とともに, Type II, IIIの不安定な眼位より Type I の安定した眼位に収束した.
iv) 眼球偏位と眼振の代償過程は必ずしも相関しなかった.

抄録全体を表示

昭和47年より昭和52年の間の当科メマイ外来受診者の統計的観察を行ない次の結果を得た.
(1) 年間のメマイ検査数は外来総患者数の4～6%であるが, 外来総患者数が他大学に比較して多いので, メマイ検査数も極めて多い.
(2) メマイ患者の男女差はほとんどなく, 年令的に40才代が一番多く以下30才代, 50才代, 20才代と続く.
(3) 受診状況では約70%近くが紹介患者であり, その紹介も院外では耳鼻科医からの紹介が, 院内では整形外科, 内科, 脳外科からの紹介が多い.
(4) 疾患統計ではメニエル病はメマイ患者の約10%内外, 外来患者総数の約0.5%である. いわゆる脳循環不全症か頭頸部外傷患者が極めて多い.
(5) 検査結果では立ち直り反射異常に非常に高い異常発現率がみられる.
(6) 素因の検査では血圧異常を示すものが, 約50%近くあるが, 血清脂質異常, 梅毒反応陽性者は約6～7%である.
(7) CMIでIII, IV領域に入るものは約60%近くある.

抄録全体を表示

Viral titer was investigated in 159 cases of 296 Bell's palsy and in 44 cases of 66 Ramsay-Hunt's syndrome. Diagnostic titer of viruses was observed in 55 cases of 159 Bells palsy (35%) including 21 cases of herpes zoster virus (13%). These 21 cases are regarded as ‘Zoster sine herpete (ZSH)’ because they have peripheral facial paralysis with a diagnostic titer of herpes zoster virus but without herpes oticus.
Cases of ZSH generally had a lower titer of herpes zoster virus than cases of Ramsay-Hunt's syndrome. Those with ZSH showed a more severe degree of facial paralysis than did those with Bell's palsy and a negative titer of viruses. Furthermore, those with ZSH showed a negative stapedial reflex in 3 cases out of 4 and suggested a more likely possibility of supra-stapedial lesion in ZSH. As for the clinical course, those with ZSH showed a tendency toward a longer period for complete recovery than did any of the others with Bell's palsy, but no definite statistical differences among Ramsay-Hunt's syndrome, ZSH, and Bell's palsy with negative titer of viruses were noted. In addition, those with ZSH revealed intermediate features between those with Ramsay-Hunt's syndrome and Bell's palsy with regard to distribution. There were no particular findings concerning vestibular involvement.

抄録全体を表示

慢性中耳炎760耳を対象に嫌気性菌の検出率, 嫌気性菌と病巣との関係などについて検討した.
1) 760耳中62耳から9種, 81株の嫌気性菌を分離した.
2) 主な嫌気性菌の検出率は Peptococcus 40%, Bacteroides 22%, Peptostreptococcus 8%, Fusobacterium 7%, Veillonella 7%などであった.
3) 無芽胞嫌気性菌が97.5%を占めた.
4) 嫌気性菌1菌種検出は62例中74%, 2菌種19%, 3菌種3%, 4菌種3%であった.
5) 62耳中56耳から21種, 128株の好気性菌を分離した. 主な菌の検出率は黄色ブ菌6%, 表皮ブ菌18%, Corynebacterium 20%, 緑膿菌8%, Proteus mirabilis 17%などであった. 好気性菌のみを検出した中耳炎と比較すると黄色ブ菌の検出率が低く, 逆 P. mirabilis, Corynebacterium, 表皮ブ菌の検出率が高いのが特徴的であった.
6) 中耳腔に真珠腫や肉芽が充満している中耳炎および術後再感染+肉芽増生の症例で嫌気性菌を検出することが多かった.
7) 真珠腫, 肉芽の増生で中耳腔と外界との交通路が遮断され, 病巣の酸素分圧が低下するため嫌気性菌が増殖すると考えた.

抄録全体を表示

(1) 視束管骨折で, 外傷後34時間という早期に視束管開放術を施行し, 術前視力全盲から術後視力0.2という良好な成績を得ることができた症例を報告した.
(2) 術前視力0のものでは, 術後成績は悲観的であるというのが, 視束管開放術の成績に関する一般的見解であるが, 本症例のように, 可及的早期に開放術を行えば, 術前全盲であっても, 十分な視力回復が望めることを強調し, 2, 3の反省点を述べた.

抄録全体を表示

Fifty-five patients with cancer of the head and neck were treated in the Oto-rhinolaryngology Department of Keio University in the period between Oct., 1974 and Dec., 1977. These patients were divided into the immunotherapy group, where immune activators (OK-432, PS-K, SSM) were long administered after radical treatment of cancer, and the control group, and immunotherapy was analyzed in the light of clinical progresses and immunologic parameters. Findings that served as immunologic parameters were CH₅₀, PPD response and peripheral blood lymphocyte count. Administration of immunologic activators was aimed at reduction in size of tumor or arrest of its growth in the non-radical therapy group, and prevention of recurrence and metastasis in the radical therapy group.
The results were as follows:
1. OK-432, PS-K or SSM had no tumor-reducing effect in the non-radical therapy group (cancer-bearing patients).
2. Immunologic findings suggest that OK-432, PS-K and SSM have prophylactic effects against recurrence and metastasis.
3. The immunologic response of cancer in vivo is not always advantageous to the body. Administration of immune activators may not, therefore, be indicated in some cases. Further studies are necessary in this respect.
4. To enhance the effect for tumor shrinkage and prevention of recurrence or metastasis, immunochemotherapy requires further study.

抄録全体を表示

甲状腺機能亢進症患者15名に対し, 抗甲状腺剤 methimazole とβ遮断剤 bupranolol の併用療法を行い, 次の成績を得た.
1. 自覚症状とくに動悸, 発汗過多, 易疲労性等の著明な改善をみた.
2. 他覚的所見として頻脈, 手指振せん等の改善をみとめた.
3. この併用療法が, 甲状腺機能亢進症に対する有用な治療法であると結論された.

抄録全体を表示

新半合成 Penicillin 剤 Apalcillin に関して, その試験管内抗菌力, 水溶液の安定性および化膿性中耳炎に対して本点耳液の局所的応用を検討した結果, つぎのとおりの結論がえられた.
1) 試験管内抗菌力: Apalcillin は, 各標準菌株のグラム陽性, 陰性菌のいずれにも抗菌力を示し Broad spectrum であった. 耳漏分離の Coagulase 陽性ブドウ球菌60株は, 0.78～50μg/mlに感受性分布がみられ, 3.13μg/mlにMICの Peak が認められた. 病巣分離の Proteus mirabilis, Escherichia coli は0.78～25μg/mlの範囲内にMICが分布し, Klebsiella pneumoniaem は6.25～≧100μg/mlとMICが高かった. Pseudomonas aeruginosa は, 0.78～50μg/mlで3.13μg/mlにMICの Peak が認められた.
2) Apalcillin 水溶液の安定性: Apalcillin 20mg/ml 水溶液を5℃, 37℃保存で14日間にわたり安定性を検討した結果, その外観, 色調およびpHには変化なく, また抗菌力価は5℃は10日後, 37℃は8日後より低下が認められた.
3) 臨床治療効果: Apalcillin 20mg/ml 点耳液を急性および慢性化膿性中耳炎30例に対して点耳耳浴療法を行なった結果, 有効22例, やや有効6例および無効2例となり, その有効率は有効, やや有効例を合算すると28例93%の好成績がえられた.
4) 副作用: Apalcillin 20mg/ml 点耳液使用にさいして, とくに臨床的に副作用と考えられる症状の発現はまったく認められなかった.

抄録全体を表示

Patients with otorhinolaryngological related infections were treated with 750mg of ABPC given in three divided doses, either alone or with 3 capsules of Dogmatyl, for 4 or more days. The patients were observed for development of gastrointestinal disorders including loss of appetite, nausea, vomiting, gastric distress, heartburn, belching, loose stool, and sensation of fullness in the abdomen.
The overall incidence of these disorders was considerably lower in patients who were concomitantly given Dogmatyl (15%, i. e. 8 in 52) than in patients given ABPC alone (27%, i. e. 14 in 52).
As for the incidence of loose stool, the difference between the two groups was even greater: 10% (5 in 52) and 21% (11 in 52), respectively.

抄録全体を表示

We devised a new animal box with which the caloric test can be easily performed in the awake cat.
The animal box has the following advantages:
1) This device is suitable for all adult cats of various sizes in which a steel bar could be passed through both the canines.
2) With the animal box standing upright, the horizontal semicircular canal lay in an optimal position, and the caloric test could be easily performed in the awake cat.
3) This device is suitable for the positional test. Any desired position is feasible.
4) It was also advantageous for the optokinetic test, because bars or clamps do not interfere with movements of the cat.

抄録全体を表示