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73 巻, 2special 号
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久保 武1980 年 73 巻 2special 号 p. 245-250
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーStabilization of the retinal image during head movements could be performed by reflex oculomotor control by the visual, vestibular and neck proprioceptive systems. It has been known that the visual-oculomotor system primarily acts to maintain gaze when the frequencies of head movements are low (i. e. slow head movements), however, during high frequency head movements the vestibulo- and neck-oculomotor systems have a dominant role. Since the gain of neck-oculomotor reflex is low, the gaze performances during saccades are controlled mostly by way of the vestibulo-ocular reflex (Morasso et al., 1973). Bilateral labyrinthectomy in rheusus monkeys caused a gaze over-shoot up to 4-6 weeks after the operation (Dichgans et al., 1973). Author and others have reported that squirrel monkeys show an over-shoot of gaze during optokinetic stimulation at 3-4 weeks after bilateral lateral semicircular canal block. The over-shoot of gaze was subsided with similar time course in both of these experiments. Compensatory mechanisms underlying the recovery of the gaze, which occurred in CNS after the interference of vestibulo-ocular reflex, were discussed.抄録全体を表示PDF形式でダウンロード (2820K) -
宮本 浩明1980 年 73 巻 2special 号 p. 251-258
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーIn 1965, Kimura and Schuknecht showed that blockade of endolymphatic sac and duct in the guinea pig produces on endolymphatic hydrops. Since this time, underabsorption of endolymph by the endolymphatic sac has been implicated as a cause of Meniere's disease.
But analysis of inner ear fluids taken from experimental hydrops or Meniere's patients show no significant changes in ion activities or protein contents.
From this results, it seemes to be necessary to research the functions of endolymphatic sac still more.
In this paper, biochemical and physiological research were made about the fluids of the endolymphatic sac.
K+ activity of endolymphatic sac fluid was 9 times lower than in the cochlear part of endolymph.
After injection of Thorotrast in the endolymphatic sac, this particle could be found in the cochlear endolymph 2 days later. Ethacrynic acid injected into the peritoneal space (60mg/kg) shows a decrease of K+ activity in the cochlear endolymph but an increase in the endolymphatic sac. This effect was controlled by light and electron microscopic pictures.
Pratein content in the endolymphatic sac was about 14 times higher than in the cochlear endolymph.
But this differences of protein contents between endolymphatic sac and cochlear endolymph seemes to be difficult to induce the endolymphatic hydrops from the point of view of osmotic pressure.抄録全体を表示PDF形式でダウンロード (2825K) -
中心および偏心振子様回転検査による奥村 新一, 松永 喬, 松永 亨, 内藤 儁1980 年 73 巻 2special 号 p. 259-263
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe applied the furosemide test using centric & eccentric pendular rotation stimuli to the patients with Ménière's disease for the purpose of diagnosis of endolymphatic hydrops. In patients with probable Ménière's disease, after the administration of furosemide in doses of 20mg intravenously, the difference of the directional preponderance index of the centric & eccentric pendular rotation test improved to within normal ranges, as a result of prompt diuretic activity.
In this report, we evaluated 60 patients with Ménière's disease and 25 patients with vertigo due to peripheral labyrinthine origin except Ménière's disease or central origin for the control.
Twenty seven of 60 patients with Ménière's disease (45%) were positive in the furosemide test. In these patients, positive test results were seen in 25 of 39 patients (64%) in the attack stage, but in the period of remission were seen in 2 of 21 patients (10%).
None of 25 patients with vertigo except Ménière's disease showed a positive furosemide test.
Hearing improvements after furosemide administration were seen in about a half of affected ears of patients with Ménière's disease in the ranges of 1 to 10dB in the average of hearing threshold levels from 250, 500 and 1000Hz.
Changes of subjective symptoms, particularly dizziness and tinnitus, after furosemide injection, were hardly seen in the patients with Ménière's disease or non-Ménière's disease.抄録全体を表示PDF形式でダウンロード (2013K) -
昭和52, 53年度を中心として佐野 光仁, 津田 守, 後藤 和彦, 松永 亨, 松永 喬1980 年 73 巻 2special 号 p. 264-269
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe investigated the patients who complained of vertigo, dizziness in our clinic from 1977 to 1978.
The number of vertigenous patients has been increasing step by step and especially the old patients of them have been increasing. There were 547 (male 281, female 266), 569 (male 312, female 257) patients in 1977, 1978 respectively and they occupied 6.4%, 6.5% in total outpatients.
The causes of vertigo or dizziness were inflammation (chronic otitis media, cholesteatoma), intoxication (streptomycin, kanamycin), cerebral circulatory disturbance (vertebrobasilar insufficiency, hypertention, hypotention), congenital or degenerated disease (congenital nystagmus, multiple sclerosis), tumor (CP angle tumor, cerebral tumor), trauma (whiplash injury, head trauma) and unknown. The group of unknown causes contained Meniere's disease, sudden deafness, benign paroxymal positional vertigo and unknown causes, origin disturbances.
The vertigo or dizziness due to unknown origin and unknown causes were the most numerous of all and tended to increase, but Meniere's disease has been decreasing.抄録全体を表示PDF形式でダウンロード (556K) -
血液学的検査と血圧測定松永 喬, 柿内 寿美, 和久田 幸之助, 奥村 新一, 森 望, 佐伯 和夫, 松岡 洋一, 岡本 康幸1980 年 73 巻 2special 号 p. 270-281
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーVertigo is closely related not only with central nerve disorders but with peripheral, circulatory and autonomous nerve disorders and such general disorders. We, therefore, conducted hematological examinations and hemadynamometric measurement at the time of change of bodily position on patients of vertigo in order to see if the hematological and hemadynamometric factors can be predispositions for vertigo. The subjects were the patients with established diagnosis of Meniere's disease, or suspected of Meniere's disease, or had vertigo accompanying cerebro-circulatory disturbances, or of vertigo unknown origin who visited Nara Prefectural Medical College's Otolaryngological Department in the period covering April 1978 through October 1979. For control, normal individuals and patients of sensorineural deafness were selected. The results of the above tests were compared between the group of vertigo and the group of having no vertigo, and the possible predispositions were compared between the time having vertigo and the time not having vertigo in order to determine if those could be factors for causing the disease. The results were as follows.
1. Of all the items of hematological examination, total cholesterol, neutral fats, free fatty acids could be considered as predispositions for vertigo particularly in the cases of cerebro-circulatory disturbances. It was also considered that total cholesterol, free fatty acids, HDL and blood platelet aggregation were possibly the factors to cause vertigo.
2. In hemadynamometry, the fluctuations of the mean arterial pressure and of the pulse pressure at change of bodily position were great in the cases of Meniere's disease while those in the cases of cerebro-circulatory disorders were small. Also in the patients having vertigo, decline of pulse pressure and differences of mean arterial blood pressure and pulse pressure between the right and left were observed. However, the hemadynamometric examination of this time did not differentiate critical factors of vertigo from predispositions.抄録全体を表示PDF形式でダウンロード (1063K) -
津田 守, 松永 亨, 佐野 光仁, 後藤 和彦1980 年 73 巻 2special 号 p. 282-289
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーThe effects of the stellate ganglion block were investigated in 10 patients with sudden deafness, recording the blood flow pattern of the common carotid and the vertebral arteries by ultrasonic doppler method. Increased blood flow of the common carotid and vertebral arteries on the diseased side was demonstrated after the block of the diseased side.
The effects of intravenous administration were investigated in 5 healthy persons by the same method. The velocity of the common carotid artery was increased after bolus injection of ATP, whereas both the velocities of blood flow of the common carotid and the vertebral arteries were increased after drip infusion of ATP.抄録全体を表示PDF形式でダウンロード (728K) -
めまいの発症因子および発症機序より松永 亨1980 年 73 巻 2special 号 p. 290-304
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーPathological factors contributing to the development of vertigo and dizziness, according to the authors' clinical survey, have proven to include abnomalities in Schellong's test, disturbed vertebral blood flow in Doppler's test, high serum cholesterol values, positive Wassermann's reaction, irregular menstruation, glycosuria, hyper- and hypo-tension, psychogenic stress, and anemia. Any one of factors may trigger the functional or organic impairment of circulation to the brain stem and inner ear.
We have also experimentally confirmed the existence of critical levels of blood supply to the brain stem and inner ear, which are affected mainly by disturbance of baroreceptor reflexes and by impaired blood flow in the vertebral arteries. Finally, we are convinced that the treatment of choice for vertigo and dizziness consists of causative therapy for correcting pathological factors, symptomatic therapy for suppressing vertigo itself. essential therapy for improving impaired circulation, and physical therapy.抄録全体を表示PDF形式でダウンロード (1749K) -
森 望, 松永 喬, 浅井 英世1980 年 73 巻 2special 号 p. 305-311
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーElectrocochleographic changes accompanying fluctuations in hearing loss on 4 patients with Meniere's disease were reported. Extratympanic electrocochleography (ECochG) was performed again after the audiogram had changed at one or more frequencies. The intervals between these ECochGs ranged from 1 month to 2 years. In two patients whose audiogram had changed only at one frequency, no significant change in ECochG was found. In two patients whose audiogram had changed at three frequencies, changes in action potential (AP) thresholds corresponded to changes in the audiograms. Negative summating potential (-SP) detection thresholds and -SP amplitudes remained unchanged, but -SP/AP ratios were significantly changed. In one of two patients with significant changes in ECochG N1 latency was prolonged accompanying progression of the hearing loss. The mechanism causing changes in ECochG accompanying fluctuations in hearing loss was discussed.抄録全体を表示PDF形式でダウンロード (636K) -
水津 百合子, 浅井 英世, 森 望, 松永 喬1980 年 73 巻 2special 号 p. 312-318
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー22 patients presenting unmistakable symptoms of Ménière's disease including two bilateral cases, among whom a glycerol test and an electrocochleography were carried out on 24 ears. 13 out of 24 cases, i. e. 54%, turned out positive to the glycerol test, and 17 out of 24 cases, i. e. 71%, gave 0.5 or more in the electrocochleography's -SP/AP. Among those who were tested in a period close to a vertigo attack, the positive ratio was slightly higher in both tests: the former being 60% and the latter 84%. However, no correlation was observed between the results.
When positive and negative groups are compared in the glycerol test results, in the positive group the majority showed large values in the -SP/AP in the vicinity of 1.0; while in the negative group, many showed fairly small values contained between 0.5 and 0.8.
Based upon these results, we presume that an active endolymphatic hydrops is reflected by large -SP/AP in the vicinity of 1.0, and the increase of these specially large -SP/AP may turn out to be as significant as the positive group in the glycerol test.抄録全体を表示PDF形式でダウンロード (665K) -
三好 敏之, 松永 亨1980 年 73 巻 2special 号 p. 319-325
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー難聴疾患を主とする68症例に, ECB検査 (臨界帯域幅の測定) とMLD検査 (マスキング・レベル・ディファレンスの計測) を行い, このうち58症例にはABR検査 (聴性脳幹反応の記録) を施行した.
内耳末梢性病変と考えられる症例では, SmNm値の異常症例が少なかった.
補充現象を有する症例では, SmNo値, MLD値の両耳聴検査で異常となる割合が多く, 部位診断については注意が必要である.
年代別に見た場合, 20才代以下ではECB値, MLD値の異常を示す頻度は小さいが, 30才代以上で異常の割合が急増する. しかし, 年令が高い程, 異常発現率が大きくなるような傾向は見られなかった.
ABRの第I波と第V波の間隔を測定し, 各耳についての値を, ECB検査異常耳群と健康成人群との各々の平均値で比較した所, 異常値群に潜時の延長を認めたが, 統計学的検定では健康成人群との間に明瞭な有意差はなかった. この点に関してはABRでのピーク潜時の測定上のバラつきを小さくする為, いくつかの問題点を克服して, 更に検討すべきであると考えられた.抄録全体を表示PDF形式でダウンロード (741K) -
須沢 八千代1980 年 73 巻 2special 号 p. 326-331
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーAn auditory screening test was done at one of the Health Center in Osaka to find infants of hearing loss from rubella by means of Neometer and opinionaire.
The results were as follow;
(1) There was not a infant of hearing loss from rubella.
(2) The screening using opinionaire was useful.
(3) 4 months infants were most suitable for the auditory screening test at Health Center.抄録全体を表示PDF形式でダウンロード (475K) -
酒井 國男, 中村 賢二1980 年 73 巻 2special 号 p. 332-338
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーThere are several methods such as Pure Tone Audiometry and Speech Discrimination Tests, to examine auditory function of the patients with hearing loss. These tests do not necessarily measure auditory faculty of the patients with hearing loss in daily life.
Recently we have contrived “speech comprehension test” which examines how those with hearing loss can understand what other people say. Voices other than as noises to the test.
The results are as follows:
1) Some differences in degrees of effectiveness of hearing aid were recognized. The differences cannot be distinguished by the ordinary speech-discrimination test through 67 AB List.
2) High level of effectiveness was attained when a person suffering from conductive deafness, used the bone-conductive hearing aid.
3) The patients with hearing loss who showed little differences in understanding human speeches in the conventional tests, indicated larger differences in this test.
4) In the large S/N field, the patients with hearing aids have great difficulty in hearing in comparison with the normal persons.抄録全体を表示PDF形式でダウンロード (1747K) -
聴力回復パターンを中心として杉山 茂夫1980 年 73 巻 2special 号 p. 339-345
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーIn our procedure of stapedectomy, a superstructure of the stapes is removed and replaced mainly an artificial material such as a steel piston, but a polyethylene tube, a teflon piston or a gelform wire is occasionally employed as the substitute.
The surgical outcomes were classified into four types according to the hearing acuity attained finally as well as the pattern of its recovery. Successful cases, in whom an air-bone gap disappeared was 36 out of 47 cases operated. In most of these cases, the closure of the air-bone gap was demonstrated within a month following the operation. However, ones whose air-bone gap remained for longer than a month, were often complicated by a sensory deafness as well though the cases of this complication were unknown. Even in the cases who had troubles during the operation, e. g. leakage of a large amount of perilymph and/or bleeding into perilymph, their surgical results were not always poor but occasionally fruitful. However, since the unsuccesful cases were more frequently encountered in the cases having had the troubles during the operation, the suction of perilymph and contamination of blood in it should be avoided to the best of one's ability.
We had six cases whose hearing acuity got worse suddenly though their dysacusis had been improved by the operation. In four among these cases causes of their hearing deterioration were known and loss of hearing could be amoliorated by a reoperation in one case. The remaining two cases experienced the dysacusis just like a sudden deafness around one year after the operation. No apparent causal factor for their dysacusis was found in their surgical procedure, postoperative course or living conditions just before getting worse. It might be a so called postoperative sudden deafness, for which etiological mechanism is, however, obsqure.抄録全体を表示PDF形式でダウンロード (706K) -
玉置 弘光, 陌間 啓芳, 野村 侃, 古川 裕, 上塚 弘, 荻野 敏, 野村 功, 古川 喜英, 原 万里子, 伊吹 薫, 浜村 康司1980 年 73 巻 2special 号 p. 346-352
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーIn the entity of the peripheral facial palsies, there are idiopathic, otitic, traumatic palsy, Ramsay Hunt's syndrome, and others. The causes of the facial palsies were due to the disturbance of microcirculation and the bleeding in Fallopian canal, infection of bacteria and virus, the direct damage of the facial nerve and etc..
Some of them occur accompanying with the systemic disease. We reported 8 cases of the facial palsies which were accompanied with the systemic disease. These systemic disease were diabetes mellitus, sarcoidosis, aseptic and carcinomatous meningitis, systemic lupus erythematosus, aplastic anemia, and pregnancy. The facial palsies accompanied with diabetes mellitus and pregnancy are due to the disturbance of microcirculation (anoxia, ischemia, microembolism). As sarcoidosis sometimes involves in degeneration of myelin, and aseptic meningitis and infectious mononucleosis are viral infection of seventh nerve, these cause probably a neuritis or a ganglionitis. The palsy of carcinomatous meningitis is rare, but if initial symptom is only facial palsy, this palsy should be differentiated from idiopathic facial palsy (Bell's palsy).
As aplastic anemia causes the tendency of bleeding, this palsy occurs from the bleeding in Fallopian canal. One case of the facial palsy accompanying the aplasic anemia revealed the bleeding in Fallopian canal by autopsy. The importance of systemic disease as a possible cause of idiopathic facial palsy was emphasized.抄録全体を表示PDF形式でダウンロード (4083K) -
川本 浩康, 斉藤 博宣, 佐野 由紀子, 玉置 弘光1980 年 73 巻 2special 号 p. 353-357
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe tried a new therapic method, microwave irradiation, for the treatment of the patients with Bell's palsy expecting the improvement of circulatory metabolism in peripheral facial nerve regions by heating at deeper tissues. A patient was irradiated with 26 watts microwave apparatus at frequency of 2450MHz from side civix on the affected side toward vertebral artery and external carotid artery for 15 minutes, once or twice a day. This practice was continued over 10 days. Microwave irradiation was considered to improve blood flow in such arteries as vertebral, external carotid and those related arteriolas and veins.
In the treatment, combined microwave and drug therapy of Bell's palsy initiated within 3 weeks after onset, cure was found in 35 cases (92%). No side effects were encountered with microwave treatment. Microwave treatment produced excellent effects when care was taken to prevent overheating. Simpleness of this method, a lower fee for such treatment and comfortable feeling for the patients during manipulation are definite merits.抄録全体を表示PDF形式でダウンロード (546K) -
荻野 敏, 玉置 弘光, 古川 裕1980 年 73 巻 2special 号 p. 358-362
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーFacial paralysis caused by chickinpox are rare. Two cases of facial paralysis associated with varicella were described.
First case, a 5-year-old girl, complained of immobility of right facial muscle on Feb. 6, 1979. Three days later, she developed typical varicella. Laboratory studies revealed no abnormalities except for an elevated anti varicella-zoster virus (VZV) antibody levels in the serum. Anti VZV antibody titers were measured by immune adherence hemagglutination test (IAHA). The serum IAHA titers for VZV were 1:128 (Feb. 14) and 1:128 (March 5). Complete recovery occured five weeks after the onset.
Second case, a 5-year-old boy, had a skin rash and diagnosed as varicella on April 5, 1979. On May 17, he noticed a weakness of the right facial muscle. No other neurological abnormalities were observed. About two weeks later, mumps occured. The serum IAHA titers for VZV were 1:64 (May 23) and 1:128 (June 18) and the mumps virus antibody titers were 1:<2 (May 23) and 1:64 (June 18). The facial palsy completely recovered after six weeks.抄録全体を表示PDF形式でダウンロード (542K) -
肋軟骨フレーム法松永 喬, 奥村 新一, 柿内 寿美, 須沢 八千代, 内藤 儁, 中島 礼士1980 年 73 巻 2special 号 p. 363-371
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーThe authors have experiences of surgical auricle formation for microtia by costocartilage frame method on 22 cases in the period covering 1968 to 1979, which we are reporting hereunder.
The operation was done in Fukuda's procedure, which is presently done in three stages. The first stage operation consists of downward turning of the existing portion of lobule, formation of a subcutaneous pocket in the location for the auricle formation, removing of autocostocartilage from the patient's chest for transplant-use, formation of an auricle with the costocartilage and transplantation of the costocartilage auricle frame into the subcutaneous pocket, and thus the present operation method includes the external auditory meatus formation. The second stage operation consists of decollement of the lower two thirds of the transplanted costocartilage frame to raise it, the process of so-called “ear raising”, as well as the full thickness skin grafting to cover the exposed raw surface. The third stage operation consists of decollement and fixing of the upper one third of the costocartilage frame and the full thickness skin grafting to cover the exposed raw surface.
Besides the above, two or three times of trimming of various parts of the auricle are done.
The above-method operation was completed on 17 cases. Both the patients and the surgeons were more than satisfied in 6 cases; the surgeons were extremely satisfied while the patients were fairly satisfied in 5 cases; both the patients and the surgeons were not quite satisfied in 2 cases, and both the surgeons and the patients were unsatisfied in 4 cases.
Retrospectively from these experiences, we conclude that this operation method should be applied starting at the patient's age of 8 to 9 years; that the frame work should be done excellently, that decollement of the subcutaneal tissues should be sufficiently done; that subcutaneal tissue steel should be formed; that the frame should be covered with subcutaneal tissues; that the mattress suture should be relaxed; that the method of raising the auricle be improved, etc. in order to perform better and more satisfactory auricle formation.抄録全体を表示PDF形式でダウンロード (6336K) -
松永 喬, 奥村 新一, 柿内 寿美, 水津 百合子, 須沢 八千代1980 年 73 巻 2special 号 p. 372-380
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe reported our experiences of surgical auricle formation for microtia using silicone rubber, produced by Ko-Ken, on 15 cases in the period covering the years 1975 to 1979.
The operation was done in the same procedure for the costocartilage frame method.
The whole operation procedure consists of three stages, the first stage being the posterior and downward turning of the existing lobule of the ear, formation of a subcutaneal pocket, inserting of the silicone rubber frame into the subcutaneal pocket, and thus the present method performs the external auditory meatus simultaneously. The second stage operation consists of decollement of the lower half of the inserted silicone rubber frame from the pars temporalis and raise it in the so-called manner of “raising the ear” and skin grafting all over the raw surfaces. The third stage operation consists of decollement of the remaining upper half of the silicone rubber frame to fix it upward, and the full thickness skin grafting on the exposed raw surface. Besides the above, a few times of trimming of various parts of auricle are done.
Operations of the above method have been completed on 12 cases. Both the surgeons and the patients are particularly satisfied in 4 cases. The surgeons are sufficiently satisfied while patients are fairly satisfied in another 4 cases, and both the surgeons and the patients are not quite satisfied in 2 cases, and both the surgeons and patients are utterly unsatisfied in 2 other cases.
In view of the experiences of the above operations, we conclude that this operation method is relatively simple to perform and the lobule thus formed has soft texture just like natural one while it has disadvantages such as exposition to secondary infections or external injuries or perfrigeration which require exquisite precautions. However, these difficulties can be conquored with sufficient caution, and we are in favor of this method if this is to be employed side by side with the costocartilage frame method in the future.抄録全体を表示PDF形式でダウンロード (8403K) -
限局型 Wegener 肉芽腫を含めた Wegener 肉芽腫の新しい criteria の提案渡部 泰夫1980 年 73 巻 2special 号 p. 381-394
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWegener's granulomatosis is characterized by a necrotic and granulomatous changes of the upper or lower respiratory tract and glomerulonephritis and disseminated small vessel vasculitis.
In the field of otolaryngology, there are not a few cases with lesions in the upper respiratory tract, similar to those in Wegener's granulomatosis, although they do not fully coincide with the definition established by Godman in 1954. These conditions are named as localized Wegener's granulomatosis by Carrington et al.
Clinical pictures of 15 cases of generalized or localized Wegener's granulomatosis (8 generalized and 7 localized) were presented.
The localized form of the disease spares the kidney. Male to female ratio is 4:11. Age distribution is 16 to 63 years (mean age is 31 years). The most comman symptoms are the necrotic and granulomatous changes of the upper respiratory tract. Histologically, vasculitis is not comman in the lesion but giant cell granuloma is usually seen. The most remarkable laboratory findings are the elevated BSR, positive CRP and RA, increased serum complement level (CH50) and serum fibrinogen level, and increased Ig level and decreased A/G ratio.
The polymorphonuclear leukocytes from the patients showed remarkable decrease in their chemotactic activity.
The other characteristic clinical findings are follows: the saddle nose, laryngeal stenosis, ulceration of the skin and pulmonary involvement respond to corticostedroi herapy.抄録全体を表示PDF形式でダウンロード (8562K) -
原田 保, 石田 稔1980 年 73 巻 2special 号 p. 395-398
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーPostoperative maxillary cysts occurring in 74 patients who received the paranasal sinusitis operation from October 1972 to August 1979, were studied.
Average lapse of time after operation was 16 years. The importance of complete removal of the pathological mucous membrane and that of drainage were emphasized.抄録全体を表示PDF形式でダウンロード (476K) -
岡田 益明, 野村 功, 玉置 弘光, 浜村 康司1980 年 73 巻 2special 号 p. 399-403
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe reported 3 cases of the postoperative maxillary cyst and the radicular cyst which occured after the radical operation.
Case 1. A 36 year old male was received the radical operation of maxillary sinuses 22 years ago. The patient complained of swelling and pain of the right cheek. Postoperative maxillary cyst and atypical radicular cyst were found at the reoperation of maxillary sinus.
Case 2. A 23 year old male was operated for chronic maxillary sinusitis 11 years ago. The patient complained of the swelling and pain of the right cheek. The Reoperation revealed the radicular cyst. He was operated by Neumann's method. The teeth from 4 to 7 was extracted with extirpation of the cyst. The cyst wall was squamous cell with granulation pathologically. In granulation, cholesteatoma and macrophage were observed.
Case 3. A 29 year old male was operated for the diagnosis of maxillary blood boil 13 years ago. During the treatment of the caries of the teeth, the swelling of the left cheek occurred. X-ray finding (pantomography) showed the destruction of the left lateral portion of the maxillary sinus and the periodontitis from 5 to 8. and the fistula between the 6th tooth and the maxillary sinus was found. This case was the 2nd operation showed the postoperative maxillary cyst with odontogenic inflammation.
The following results were obtained from these 3 cases;
1) The cyst which should be differentiated as the postoperative radicular cyst could occur after the radical operation of maxillary sinus.
2) The postoperative radicular cyst may be caused by the disturbance of the dental roots which have been exposed into the sinus at 1st operation.
3) Pantomography of the teeth is useful for the differential diagnosis between the postoperative maxillary cyst and the radicular cyst.抄録全体を表示PDF形式でダウンロード (2135K) -
第三編JJC案とAJC案の比較酒井 俊一1980 年 73 巻 2special 号 p. 404-414
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー1. 上顎洞癌のTNM分類についてJJC案 (日本案) とAJC案 (アメリカ案) とを紹介した. JJC案は1977年に日本TNM分類委員会からUICCに案提されたもので, 近い将来, 臨床の場において, その正当性を立証して行かねばならない.
2. 昭和32年から昭和52年までに新鮮症例として治療された上顎洞癌718症例をJJC案とAJC案によって分類した. T1, T2, T3, T4に所属する症例はJJC案では 2%, 25%, 48% 25%に分布し, AJC案では0%, 8%, 45%, 47%に分かれた. JJC案による症例構成は適当な配分になっている.
3. JJC案とAJC案の各TNM分類別に見た5年累積生存率を求めた. T2N0M0, T3N0M0, T4N0M0について, 生存率をJJC案で見ると39%, 32%, 13%となり, AJC案で見ると52%, 35%, 21%となった. JJC案ではT分類別生存率に差がみられ, とくにT4N0M0のそれは予後不良であるてとを示した.
4. JJC案の Stage 分類を提案し, その5年累積生存率を見ると, Stage I, II, III, IV と進むにしたがい, 41%, 32%, 16%, 4%となり, 各病期別に予後がよく分離されている.
5. 3年以上観察のN0M0例573例についてJJC案とAJC案のT分類別マトリックスを作り, 3年粗生存率について両案を比較した. AJC案のT3はJJC案ではT2とT3に分かれ, 生存率は43%と35%と差を示した. またAJC案のT4はJJC案ではT3とT4に分かれ, 生存率はそれぞれ34%と16%となり, JJC案が予後に大きく関係していることを示した.
6. JJC案のT分類別に腫瘍進展方向を検討し, 同一T分類中では進展方向が異っても, ほぼ同一の予後を示すてとを明らかにした.
7. JJC案のT分類は治療方針にも関連して意義があるてとを明らかにした.抄録全体を表示PDF形式でダウンロード (1143K) -
第1編: 根治的治療後の suppressive 効果についての randomized control study伊東 真人, 酒井 俊一, 村田 雅美, 佐々木 良二1980 年 73 巻 2special 号 p. 415-421
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーNocardia-CWS (N-CWS) was examined for adjuvant-immunotherapeutic effectiveness in patients with head and neck malignancies whose tumour mass has diminished after radical operation and/or radical irradiation.
The evaluation of effect of N-CWS was done with comparing between the nonrecurrent rate of patients who had been injected N-CWS and that of patients who had not injected under randomized control study.
The subjects comprised 36 patients who were given N-CWS injections. They completed both their therapeutic courses and subsequent 6-month or more observation periods in or before April, 1979. The control patients numbered 35 and matched for disease and severity.
The rate of sufficient control, as difined by the rate of no local recurrence of tumour mass or metastasis after radical treatment in the subjects and control patients, was 75% (27/36) 71% (25/35), respectively, at 6 months; 61% (17/28) and 41% (9/22) at 12 months; and 50% (11/20) and 25% (3/12) at 18 months.
The patients on N-CWS were better controlled than the reference patients by ca 20%, and these findings clearly showed the excellent immunotherapeutic effectiveness of the agent.抄録全体を表示PDF形式でダウンロード (645K) -
第2編 regressive 効果の検討と悪性黒色腫に対する使用経験佐々木 良二, 酒井 俊一, 村田 雅美, 伊東 真人1980 年 73 巻 2special 号 p. 422-429
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー14例の頭頸部再発癌患者と5例の鼻腔, 口蓋または上咽頭の悪性黒色腫例を対象として, 腫瘍の退縮または生存期間の延長を期待してN-CWSによる免疫療法を行った.
1) N-CWSを悪性黒色腫患者に投与し, 2例の鼻腔原発症例で腫瘍の退縮が認められ, 1例の鼻腔原発症例で腫瘍の増大抑制が認められた.
2) N-CWSを再発癌患者に用い, 腫瘍の退縮および生存期間の延長は認められなかった.
3) N-CWS投与後, 遅延型皮膚反応の成績は再発癌患者では悪化傾向を示したが, 悪性黒色腫患者では不変またはやや上昇傾向を示した.抄録全体を表示PDF形式でダウンロード (782K) -
村田 雅美, 古川 喜英, 渡部 泰夫1980 年 73 巻 2special 号 p. 430-437
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー462人の嗅覚障害者に, 旧基準10臭による嗅覚検査 (におい紙法) を行い, 各嗅素の残存率及び回復パターンを分析した. その結果10臭を次の3群に分類した. 1型: 残存率が低く, 治療により中等度の回復を示すが, 一旦 Scale out になると回復が困難な群. 2型: 残存率が高く, 治療によく反応し, Scale out になっても比較的容易に回復する群. 3型: 残存率が非常に高く, 治療によく反応するが, 一旦 Scale out になると正常に復しにくい群である. 各々, 1型:β-PEA, CAM, EXA, 2型: OYC, VAL, UND, SCA, 3型: DIA, ACEが含まれる. この3群の異いは, 主嗅覚神経・副嗅覚伸経の関与の程度によるものであると考察した.抄録全体を表示PDF形式でダウンロード (670K) -
12例の治療経験より尾崎 正義, 中尾 雄三1980 年 73 巻 2special 号 p. 438-445
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー1. 12例の小児の Blowout fracture につき経上顎洞的, 経眼窩的に治療を施行し, 満足すべき結果を得た.
2. 全例 pure type の骨折であり, pure type の骨折は殆ど小児に生じ, 成人では impure type の骨折となることを強調した.
3. 穿孔は全例下眼窩神経孔に一致した場所であり, その大きさは平均7～8mmであった.
4. 骨欠損部の補填に厚さ1mmの軟性シリコン・シートを眼窩骨膜下に挿入した.
5. Blowout fracture は耳鼻科, 眼科が協力して診断, 治療するのが望ましい.抄録全体を表示PDF形式でダウンロード (4268K) -
原田 保, 松永 亨1980 年 73 巻 2special 号 p. 446-449
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーA case of emphysema of the orbit, a rare opthalmic disease is reported. The patient is a 19-years-old male who had coryza a short time before and developed left exophthalmus on blowing the nose. Radiological examination showed that exophthalmus was due to orbital emphysema which, in turn, proved to have arisen from an invisible bony defect on the medial orbital wall. Both emphysema and exophthalmus disappeared after Killian's operation.抄録全体を表示PDF形式でダウンロード (3906K) -
吉野 邦俊, 吉田 淳一, 石田 稔, 酒井 俊一, 宮田 俶明1980 年 73 巻 2special 号 p. 450-462
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー1965年1月～1978年12月までに, 大阪大学医学部耳鼻咽喉科, 大阪回生病院耳鼻咽喉科および大阪大学医学部放射線科で治療された上咽頭悪性腫瘍患者107例 (癌腫88例, 肉腫19例) につき, その臨床統計を行った.
1. 性・年令は癌腫では男性60例, 女性28例と男性が多く, 40～50才代にピークがあり, 肉腫では男性8例, 女性11例とやや女性に多く, 各年代に分布していた.
2. 初発症状は癌腫では鼻症状53.4%, 耳症状47.7%, 頸部腫瘤37.5%, 脳神経症状15.9%であり, 肉腫では耳症状47.4%, 頸部腫瘤36.8%, 鼻症状31.6%, 脳神経症状15.8%であった.
3. 脳神経症状 (初診時): 癌腫ではV (18例) VI・XI (各9例) IX (8例) の順であり, 肉腫ではVI (4例) II・IV・V (各2例) であった. Iは1例もなかった.
4. 原発部位は癌腫では後上壁43.2%, 右側壁29.5%, 左側壁27.3%であり, 肉腫では後上壁63.2%, 左側壁21.1%, 右側壁10.5%で, 肉腫の方が後上壁に多発する傾向がみられた. 下壁のものはみられなかった.
5. 病理組織像は癌腫では扁平上皮癌 (リンパ上皮腫・移行上皮癌を含む) が64.8%を占め, 未分化～低分化型のものが61.4%と過半数を占めていた. 肉腫は全例が悪性リンパ腫の範疇に属するものであった.
6. 治療は主として放射線治療を行った.
7. 癌腫・肉腫の5年粗生存率は各々37.7%, 27.3%で癌腫の方が良かった.
8. 癌腫についてUICCとHoの二つの病期分類による予後の比較では, あまり明確な差は認められなかったが, Hoの分類で Stage I+II, Stage III+IV, Stage V にわけると, その5年粗生存率は各々45.0%, 33.3%, 0%となり, この分類において, 多少とも Stage が予後と関係していた.
9. 癌腫の組織別では, リンパ上皮腫の5年粗生存率が66.7%ともっとも良かった. 組織の分化度と予後は平行していなかった.
10. 肉腫では, 5年粗生存率は Stage I 50.0%, Stage II 28.6%, Stage III 0%であった.
11. 死因は遠隔転移死が49.1%と半数近くを占め, 原発巣死は16.4%であった.抄録全体を表示PDF形式でダウンロード (1270K) -
里見 真美子1980 年 73 巻 2special 号 p. 463-467
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーWe treated 82 patients complaining of abnormal sensation of the pharyngolaryngeal region. Otorhinolaryngological examination, roentgenogram of hypopharynx, esophagus, cervical spine and paranasal cavity and blood examination. Cornell Medical Index, and Yatabe Guilford personality test were also examined.
The results were as follows;
1) The complaint of abnormal sensation of the pharyngo-laryngeal region appeared to be more prevalent among female who in their age-group of fourties.
2) III area of C. M. I. was most as 38% and IV area was 21%. This suggested that these patients of abnormal sensation had tendency of neurosis. On Y. G. test, A and D type was prevalent.
3) Most of these cases were treated by administration of minor tranquilizers, antiinflammatory and antidepressant drugs and psychotherapy. These treatments were effective.抄録全体を表示PDF形式でダウンロード (443K) -
森山 憲, 玉置 弘光, 松永 亨1980 年 73 巻 2special 号 p. 468-472
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーA 48-year-old man with glossopharyngeal neuralgia admitted to Osaka University Hospital was first treated with Tegretol (carbamazepine) and nerve blockage for 28 days. He obtained only a slight relief and soon began to suffer increased pain from this day on. He was therefore subjected to peronal neurectomy and withheld from Tegretol. The pain was refractory to pen-oral neurectomy, and became much more intensive than before, but completely abated when Tegretol was began after 4 days, withdrawal.
The slight degeneration of the axon of the glossopharyngeal nerve, which was confirmed histopathologically, and the thrapeutic effect of Tegretol have suggested that the onset of his neuralgia is due to disturbed central nervous functions as well as to the wellestablished peripheral nerve impairment.抄録全体を表示PDF形式でダウンロード (2368K) -
佐藤 武男, 前田 和雄, 宮原 裕, 里見 真美子, 平木 さとし1980 年 73 巻 2special 号 p. 473-479
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーThe TNM system for the classification of cancer of the larynx proposed by three booklets, the Livre de Poche, published in 1968, in 1974 and in 1978 was discussed in this paper.
From the analysis of 1261 cases of laryngeal cancer treated in our hospital, cancer of the larynx was classified in six regions and eight sites. The division of the regions of the larynx are Epipharynx, Supraglottis, Transglottis, Glottis, Subglottis and Multicentric.抄録全体を表示PDF形式でダウンロード (692K) -
矢田部・ギルフォード性格検査を用いて前田 和雄, 佐藤 武男, 奥田 純一郎1980 年 73 巻 2special 号 p. 480-485
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリー喉頭癌患者115名にY-G検査を施行した結果,
1) 類型別では, D類 (情緒安定適応積極型) が全体の43.5%を占め最も多く, ついでA類 (平均型), B類 (不安定不適応積極型), C類 (安定適応消極型), E類 (不安定不適応消極型) の順であり, E類はきわめて少数であった.
2) 男性の平均プロフィールはAD型を, 女性の平均プロフィールはD型を示した. 特に女性では66.7%がD類を示し, 外向的, 男性的性格をもつものが多かった.
3) 個人的特徴を含めて因子別出現頻度をみると, 抑うつ性と劣等感の小さいこと, 活動性ならびに支配性が大きい傾向がみられた.抄録全体を表示PDF形式でダウンロード (603K) -
主として臓器染色標本石田 稔1980 年 73 巻 2special 号 p. 486-490
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーDescribes a morphological study of the laryngeal epithelium from which cancer arose. The larynges used were isolated from 55 patients who had suffer from various causes: 30 from laryngeal cancer, 10 from non-laryngeal, upper respiratory tract cancer, and 15 from non-malignant disease. The larynges were dipped in pyronine or phyloxine/alcian blue solution for 4 minutes (Stell's method) to distinguish the squamous epithelium from ciliated columnar epithelium.抄録全体を表示PDF形式でダウンロード (4224K) -
主に大型切片標本の所見について石田 稔1980 年 73 巻 2special 号 p. 491-497
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーA histopathological study of the laryngeal epithelium from which laryngeal cancer arises revealed.
1) Metaplasia of the epithelium and mucous gland duct was frequently detected in the larynges from patients with laryngeal cancer.
2) The laryngeal epithelium surrounding tumor masses was frequently atypical.
3) In general, supraglottic cancer was extensively invasive below the epithelium, which glottic cancer was not invasive.
These histopathological findings suggest that extreme caution should be observed in epithelial metaplasia, atypical epithelium, and metaplasia of the mucous gland duct in the management of laryngeal cancer.抄録全体を表示PDF形式でダウンロード (4146K) -
基底膜の存在意義を中心に宮原 裕, 佐藤 武男1980 年 73 巻 2special 号 p. 498-508
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーIn recent years, we observed systematically the specimens of the head and neck tumors including both benign and malignant tumors.
These were tumors arising from the squamous epithelium, salivary glands, neurogenic tumors, malignant lymphoma and malignant melanoma etc.
Electron microscopical basal lamina (basement membrane) was observed in detail. As a result, the continuity of basal lamina could be devided into the four types. Type one is clear and continuous basal lamina. In ca. in situ, basal lamina would be continuous. Type four is complete defect of basal lamina. This type was observed only in the case of poorly differentiated carcinoma.
It will be provable that the continuity of electron microscopical basal lamina relates to pathohistological malignancy. In some tumors, basal lamina is useful for recognizing their origin.
Therefore, the electron microscopical observations for the head and neck tumors are proved to be a valuable diagnostic tool in surgical pathology.抄録全体を表示PDF形式でダウンロード (14796K) -
後藤 和彦, 大矢 良人, 酒井 国男, 宮本 浩明, 松永 亨1980 年 73 巻 2special 号 p. 509-514
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーTwo decannulated cases after tracheostomy following endotracheal intubation were reported. Both cases showed the subglottic stenosis with circular diaphragma. After the circular scar formation were resected under laryngomicrosurgery, they could be free from cannulated condition. Author concluded that this technique is available as one of the surgical treatments for such cases.抄録全体を表示PDF形式でダウンロード (2762K) -
吉田 淳一, 吉野 邦俊, 松永 亨, 古川 裕, 田上 悦子1980 年 73 巻 2special 号 p. 515-522
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーストレスの交感神経系に対する反応をみるため, 血中NEを指標として種々のストレス負荷による血中NEの変動を観察した.
手術侵襲による血中NEの上昇は最も大きく, 手術翌朝まで持続していた. 起立負荷では50%の有意の血中NEの上昇がみられ, 血圧, 脈拍とも有意に増加した. 寒冷負荷では起立負荷に比し, より強い血中NEの上昇がみられ (約90%), 有意の血圧の上昇がみられた. いっぽうα交感神経系刺激剤フェニレフリンの静注では, 血圧は有意に上昇したが, 血中NEは有意の減少を示した.抄録全体を表示PDF形式でダウンロード (706K) -
向井 貞三, 大川 内一郎, 西岡 敏之, 鵜山 昭雄1980 年 73 巻 2special 号 p. 523-526
発行日: 1980年
公開日: 2011/11/04
ジャーナル フリーA considerable amount of reseach has been reported on the colour designation of roentgenograms and the stereoradiography. We have already discussed the significance of these method. The purpose of the present paper is to demonstrate our collection.
In cobaltgram of tongue cancer, the back are designated in blue and radiated distribution, reached to film, are indicated in chiaroscuro of red.
Tone is emphasized necessary part and canceled unnecessary on by the maskes process. The objects designed in distinct colour, then the readings of film are facilitated judgement and improved its precision.抄録全体を表示PDF形式でダウンロード (2841K)
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