耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
74 巻, 10special 号
選択された号の論文の18件中1~18を表示しています
  • 北嶋 和智, 北原 正章
    1981 年 74 巻 10special 号 p. 2321-2328
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    嗄声を有する各種喉頭疾患について, 持続発声時の平均呼気流率 (DC) とAC/DC% (声の能率, 一色) の2のパラメーターを測定し, 疾患別に比較検討した.
    声帯麻痺例ではDCとAC/DC%の間には逆の相関があるが, 喉頭炎や sulcus vocalis ではAC/DC%が低くてもDCは正常範囲にとどまる. 前者は声門閉鎖不全が後者は声帯の物性の変化が嗄声の主因と考えられるが, この違いが2つのパラメーターの上に反映されたものと考えられる.
  • 腫瘍例
    齋藤 春雄, 北原 正章, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 仁, 北野 眞由美, 北野 博也
    1981 年 74 巻 10special 号 p. 2329-2333
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    内耳道から膝状神経節までの顔面神経錐体部が神経に圧迫が加わり易い部位であることを示した.
    反復性顔面神経麻痺の中に悪性腫瘍による麻痺も含まれていることを乳癌側頭骨転移位で示した. 同時に, 麻痺反復の原因が, ホルモンに依存性腫瘍がホルモン量の変化により大きさの変化を生じ, 顔面神経に加わる圧変化をもたらして麻痺が回復した実例として示した.
  • 自験例と本邦35例に対する文献的考察
    北野 博也, 斎藤 春雄, 北野 眞由美, 北原 正章
    1981 年 74 巻 10special 号 p. 2334-2340
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    A case of a facial nerve neuroma, originated from its horizontal segment, was reported.
    The tumor full-filled the hole mastoid air cell system and extended to the middle and posterior cranial fossa, and anteriorly to the tubar area. The mass was well encapsulated, and had not infiltrated into the surrounding structures.
    A review of Japanese literature revealed 35 cases of the facial nerve neuroma since 1937. Although the tumor originates from the facial nerve, paralysis of the nerve is not a common sign. A visible mass through an otoscope, hearing loss, vestibular hypofunction and abnormal findings in x-ray films are the major contributors for the diagnosis.
    We stressed that the tumor was not so much a rare entity as commonly believed.
  • 齋藤 春雄, 北原 正章, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 仁, 北野 眞由美, 北野 博也
    1981 年 74 巻 10special 号 p. 2341-2345
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    鼻性髄膜炎で激烈な経過をとって死亡した症例の側頭骨病理を示した.
    頭蓋内の炎症は主として蝸牛導水管を通って蝸牛基底回転の鼓室階に波及する.
    内耳道より神経周囲組織, 血管周囲組織を通って内耳に達する経路も存在する. この場合, 頂回転側より基底回転側の浸潤が強い.
    蝸牛導水管, 蝸牛軸, いずれの経路をとっても浸潤は基底回転に強く, 高音障害型の難聴を起してもよい所見である.
    急性中耳炎の組織像は正円窓窩のみに限局しており, また, 正円窓膜に内耳側から連続的に多核白血球浸潤がみられるので, 内耳から中耳へ炎症が波及するときも正円窓膜を介して行われることを不している.
  • 齋藤 春雄, 北原 正章, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 仁, 北野 眞由美, 北野 博也, 児玉 章, ...
    1981 年 74 巻 10special 号 p. 2346-2352
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    The analysis of physiological data on patients in the ward is essential for the study of their normal and pathological basis. Linked by cable to recording device, the patients are very limited in their movements. The telemetry method permits the study of the subject in real time and recording from unrestrained, behaving patients.
    Features of the telemetry system in our ENT-ward were described with some typical examples of the use. This technique, easy to use at night, offers a considerable progress in otolaryngologic clinic and research.
  • 北野 眞由美
    1981 年 74 巻 10special 号 p. 2353-2361
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    Three major tinnitus identification tests, i. e., beat method, balance method and masking method, are reviewed literary. The new tinnitus identification test was devised and reported. Not only the central frequency and its loudness of tinnitus but also the pattern of frequency curve could be indicated by the new method. New method was applied to the tinnitus of Meniere's disease and the objective changing pattern was obtained.
  • 北嶋 和智, 斎藤 春雄, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 仁, 北野 眞由美, 北野 博也, 北原 正章
    1981 年 74 巻 10special 号 p. 2362-2369
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    Aiming to perform an audiometry by a fully-automatic method, an audiometer which was controlled by a micro-computer was developed.
    This audiometer can follow automatically the testing procedures regulated by the Japan Audiological Society. The SISI test can also be made automatically. This equipment has a correcting program by manual procedure. The frequency in which this program was used was 5.1%, which was believed not to deteriorate the usefulness in the clinical practice. The time required for each subject was 8 minutes in mean. The subject's age and degree of hearing loss did not impose any limit upon the daily use, compared with the ordinary audiometer. This audiometer does not only save time and energy of the audiologist but also can evaluate the objective change of hearing level in the same subject.
  • 北野 仁, 斎藤 春雄, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 眞由美, 北野 博也, 児玉 章, 水上 千佳司
    1981 年 74 巻 10special 号 p. 2370-2378
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    Meniere's disease is represented by episodic vertigo (vestibular symptom), tinnitis and hearing loss (cochlear symptom). It is possible to devide patients with Meniere's disease into three groups; those with cochlear and vestibular symptoms starting at the same time, and those with the vestibular symptoms starting before or after cochlear symptoms: In this presentation, we studied the clinical differences of these three groups. The following results were obtained.
    1. In the case of cochlear Meniere's disease, the cochlear symptom is slight and it is easy to acquire the vestibular symptom. The cause of cochlear Meniere's disease was considered to be the existence of endolymphatic hydrops. Compared with frequency of bilateral Meniere's disease, bilateral cochlear Meniere's disease was more found.
    2. In the case of vestibular Meniere's disease, the vestibular symptom is slight and it is difficult to acquire the cochlear symptom. The cause of vestibular Meniere's disease, in all cases was not considered to be the existence of endolymphatic hydrops.
    3. In the case of Meniere's disease with vestibular symptoms starting after the cochlear symptoms, both the vestibular symptoms and cochlear symptoms are heavy. In the case of Meniere's disease with vestibular symptoms starting before the cochlear symptoms, both symptoms are slight.
  • 北野 仁, 斎藤 春雄, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 眞由美, 北野 博也, 水上 千佳司, 児玉 章
    1981 年 74 巻 10special 号 p. 2379-2384
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    Meniere's disease and vestibular Meniere's disease have episodic vertigo followed by remission in which the patients feel perfectly well. Recurrences may come at intervals varying from a few days to several years. The duration of attacks showed an irregular pattern producing both a longest period without a vertigo attack and a shortest period without a vertigo attack. In this presentation, clinical characteristics between Meniere's disease and vestibular Meniere's disease were studied by using the maximum and minimum intervals. The following results were obtained.
    1. Most patients with a 1-2 year history of Meniere's disease were found to have a maximum attack-free interval of within 6 months. Patients with a history of 2-5 years and 5-10 years were found to have maximum attack-free intervals of 2-5 years.
    2. The minimum attack-free interval of Meniere's disease was not influenced by the duration of the disease.
    3. The minimum attack-free interval of Meniere's disease was observed most often within 7 days. The minimum attack-free interval of vestibular Meniere's disease was observed most often over 7 days.
    4. Regarding bilaterality, sex and age of onset, there was no significant difference in patient with a history of over 2 years in maximum and minimum attack-free intervals of Meniere's disease.
    5. Patients with Meniere's disease can be divided into 3 groups; those with cochlear and vestibular symptoms starting at the same time, and those with the vestibular symptoms starting before or after cochlear symptoms: All 3 groups had the same tendency in terms of maximum and minimum attack-free intervals.
    6. For the prognosis of Meniere's disease, it is convinient to use the accumulated frequency of maximum intervals.
  • 北野 仁
    1981 年 74 巻 10special 号 p. 2385-2395
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    The medical history of a patient plays an important role in diagnosing Meniere's disease. However, as the patient's history is usually restricted to what he can remember, it is often difficult to obtain a reliable picture of the first vertigeous attack and those that follow. Therefore, in order to determine the accurate course of Meniere's disease, we had the patient keep a diary after the first visit. From the comparison between the subjective symptoms found by using the diary and objective findings obtained by using the audiometer, vestibular function test, etc, we could check whether the patient's determination of symptoms was accurate or not. The following results were obtained.
    1. The memory of the accurate vertigeous date with Meniere's disease was influenced by how long ago the attack occurred.
    2. As to the history of Meniere's disease, not only the history based on the patient's memory but also the subjective symptoms recorded in the diary were unreliable.
  • 北嶋 和智, 斉藤 春雄, 北野 仁, 北原 正章
    1981 年 74 巻 10special 号 p. 2396-2405
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    メニエール病の具体的な治療方法に関して, 1970年と1980年に, 同じ内容のアンケート調査を行った. 対象は日本耳鼻咽喉科学会会員である. その結果この10年間の治療動向を知ることが出来た. 結果を以下に示す. 発作の頻発する急性期には, 7%重曹水の注射がより多く使われる様になった. 数は少ないが利尿剤やステロイド剤も増加を示している. 間歇期には, 末梢血管拡張剤, 精神安定剤, β-ヒスチンの3者がよく使用されるのであるが, 1970年では, 3者とも同じ頻度であった. 1980年においては, 3者のうち, 末梢血管拡張剤が著明に増加した.
    保存的治療が無効と考えられると, 次にとられる治療法は, 処法の変更, 専門医への紹介, 手術治療の3者である. 1970年と1980年を比較すると, 専門医への紹介が増加しているのが特徴的であった. 初期治療が無効であると判定される時期は1980年では2週間であり, 1970年の4週間と比較すると, この判定がより早くなっている. メニエール病の最終治療として, 1970年, 1980年の双方とも保存的治療, 手術的治療の2者があげられており, 10年間での変動はない. このことは最終治療法の選択のむずかしさをそのまま反映している. 但し手術治療の内容に関しては, 1980年に内リンパ嚢手術が増加し, 1970年に多かった, 迷路破壊手術, 鼓索神経切断術は著明に減少を示している.
    メニエール病の治療法はなお多彩ではあるが, この10年間に一つの傾向をみることが出来た.
  • 北野 博也, 斎藤 春雄, 北嶋 和智
    1981 年 74 巻 10special 号 p. 2406-2412
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    The medical decompression therapy for Meniere's disease with osmotic diuretics was literally reviewed.
    At first, we discussed the usefulness of glycerol, urea, furosemide, and other diuretics for Meniere's disease.
    Second, a study was made of 52 cases who had suffered from Meniere's disease and the patients had been given medical care with osmotic diuretics, Isosorbide. Isosorbide was especially effective for several symptoms of Meniere's disease, i. e., tinnitis, headache, and dizziness.
  • 齋藤 春雄, 北原 正章, 北嶋 和智, 竹田 泰三, 矢沢 代四郎, 松原 秀春, 北野 仁
    1981 年 74 巻 10special 号 p. 2413-2417
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    中耳炎の所見のある側頭骨標本を調べ, いづれか1つの回転にでもライスネルに膜の伸展があるものを「伸展あり」として判定したところ, 急性中耳炎の42.9%, 慢性中耳炎の44.4%, 粘膜に炎症性変化が乏しいが中耳腔に白血球浸潤のある例の50%に伸展の所見があり, 全体として44.8%を占めた. 中耳炎の組織所見がない例には15.9%にしか伸展がないので, 危険率10%のレベルではあるが両者の間に有意の差を認めた.
  • 松原 秀春
    1981 年 74 巻 10special 号 p. 2418-2449
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    In order to reveal the mechanism of attacks of Meniere's disease, endolymphatic pressure and concentration of electrolyte in perilymphatic fluid were measured using normal, under absorption and over production models of guinea pigs.
    The following results were obtained,
    1) In normal guinea pigs, the pressure of scala tympani was 26.1±10.5mmH2O (n=9), the pressure of scala media was 29.0±6.6mmH2O (n=7) and the pressure of CSF was 36.6±5.9mmH2O (n=5).
    2) In normal guinea pigs, the concentration of potassium and sodium ions were 3.4±0.5mEq/l (n=15) and 159.9±9.0mEq/l (n=15) respectively in scala tympani, 9.6±0.5mEq/l (n=15) and 148.8±12.9mEq/l (n=15) respectively in scala vestibuli.
    3) There was no difference in labyrinthine pressure between guinea pigs with hydrops caused causarization of endolymphatic sac and normals. No difference was observed between endolymphatic and perilymphatic pressure in guinea pigs with hydrops.
    4) In guinea pigs with hydrops caused causarization of the endolymphatic sac, the concentration of electrolytes in perilymphatic fluids was within normal range.
    5) Endolymphatic hydrops due to under absorption of sac was considered to be a model of the remissiona.l stage of Meniere's disease.
    6) A remarkable increase in the concentration of potassium ions in the perilymphatic space was observed in cases with the application of 10cmH2O pressure into the scala media.
    7) It was suspected that a variation of symptoms of Meniere's disease would be caused by the perforation site of Reissner's membrane.
    8) It was suspected that attacks of Meniere's disease would be caused by the increasing of endolymphatic pressure and potassium concentration in the perilymphatic space, especially the latter,
    9) Administration of Glycerol and Isosorbide reduced endolymphatic pressure of guinea pigs with hydrops.
    10) The epidural opening of the endolymphatic sac is effective for moderating the increase of endolymphatic pressure.
  • 矢沢 代四郎
    1981 年 74 巻 10special 号 p. 2450-2506
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    内リンパ水腫剖検例の文献的考察, また内リンパ嚢腐蝕法による実験的内リンパ水腫の発生, さらに, これら実験的内リンパ水腫を用いて脱水剤の負荷や内リンパ嚢開放による組織変化を検討し, 日常臨床で行なわれている Glycerol test, Furosemide test, Iso-Sorbide の内服, また内リンパ嚢手術の基礎的問題を検討した. 一方内リンパ液産生過剰による水腫モデルを作製し, 組織学的に検討した. 以下これらの研究から得られた結果を列記する.
    (1) メニエール病70剖検例 (1938-1980) 中4例を除く66例 (94%) にライスネル膜の伸展を認めた. これはメニエール病を特発性内リンパ水腫の臨床診断名と規定しても良いとする根拠の一つである.
    (2) これらメニエール病剖検70例中, 31例において内リンパ嚢に関する記載があり, そのうちの約半数15例に fibrosis 所見を認めた. 内リンパ水腫発生の原因の1つと考えられる.
    (3) モルモット内リンパ嚢を腐蝕することで内リンパ嚢組織は線維化し, これにより内リンパ水腫が形成される. とりわけ10%硝酸銀液をガラスキャピラリーで微量注入する方法で60例中その88%に水腫を認めた.
    4) 内リンパ嚢腐蝕法による内リンパ水腫モルモットの内耳組織変化を検討すると, コルチ器の変性は5~10%に認め, 血管条の萎縮は41%に認め, さらに水腫高度例では球形嚢の感覚細胞の萎縮を認めた. また内リンパ嚢の線維化の強い例では水腫も高度である傾向が強い.
    5) Glycerol, Furosemide, Iso-Sorbide の脱水剤を実験的水腫モルモットに負荷すると, 伸展していたライスネル膜が収縮して folding 皺襞形成を認めた. その程度は Glycerol が最も著明で, 次いで Iso-Sorbide, Furosemide の順序であった. 極端な collapse を認める例もあったが対照側と比較検討してみると, むしろ例外的であり, artifact の可能性もある.
    6) 実験的内リンパ嚢を骨内部まで開放すると基底回転側に内リンパ圧の低下を示唆するライスネル膜の folding を認めた. 但し開放部分を吸引すると, ライスネル膜は collapse を起こしやすい.
    7) 内リンパ液産生過剰のモデル実験として微小ガラスキャピラリーを蝸牛管に刺入し, 内リンパの等価液で加圧すると次のような変化がおきた.
    (i) 50mmH2O圧: ライスネル膜が波打っている所見を認めるが水腫は認めない. 但し約80分を要してゆっくり徐々に加圧すると水腫を認めることがあった.
    (ii) 100mmH2O圧: ライスネル膜はほぼ (+)~(廾) まで伸展し, 一部ライスネル膜に断裂を認めることもあった.
    (iii) 300mmH2O圧: ライスネル膜は伸展して完全に断裂していた.
    以上 (i), (ii), (iii) の所見は, ガラスキャピラリーの刺入部位周辺に限局し, それ以上の上方回転では変化はほとんど認めない. 但し300mm H2O圧の場合, 上方回転では collapse 傾向を認めた.
  • 竹田 泰三
    1981 年 74 巻 10special 号 p. 2507-2561
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    The characteristic hearing loss of Meniere's disease is both diagnostically and therapeutically important symptom. According to the cause of this hearing loss, there were built up many hypothese. This pathogenesis, however, remains obscure. In order to elucidate the cause of this hearing loss, and to establish the ground of the medical and surgical decompression of endolymph which is the chief therapy of Meniere's disease, an electrophysiologic study was conducted.
    The results were as follows: 1) The anoxia of inner ear was not thought to cause the hearing loss of Meniere's disease. 2) Experimentally induced retension hydrops caused hearing loss in proportion to the grade of the hydrops. This hearing loss resembles that in the remission phase of Meniere's disease. 3) The increase of endolymph pressure caused the hearing loss associated with an enhanced negative summating potentials. Also, the potassium elevation in scala tympani caused the same hearing loss. Therefore, the increase of endolymph pressure and/or potassium concentration in scala tympani is thought to be the cause of the active phase in Meniere's disease. 4) The hearing loss of hydrops animals was improved by intravenous injection of glycerol. Thus, the endolymphatic hydrops was proved electrophysiologically to be detected by glycerol test. 5) Within a limit, the opening of the endolymphatic sac reduced the hearing loss induced by hypertension of endolymph.
  • 貝塚 〓
    1981 年 74 巻 10special 号 p. 2562-2592
    発行日: 1981/10/25
    公開日: 2011/11/04
    ジャーナル フリー
    Otorhinolaryngological special treatment in Shiga Prefecture began in 1912 almost same time at Otsu Red Cross Hospital by Dr. Kiyoshi Oosugi and Hikone Official Hospital by Dr. Shinichiro Miura. Auther described this 70 years medical history of otorhinolaryngology in Shiga Prefecture with 2 Parts.
    1st Part: Topics of this history and changing otorhinolaryngological disease.
    2nd Part: Chronological table of otorhinolaryngology in Shiga Prefecture and another related Japan, since 1868.
  • 宿題報告「メニエール病の基礎と臨床」に対する特別発言
    内藤 儁
    1981 年 74 巻 10special 号 p. 2593-2596
    発行日: 1981年
    公開日: 2011/11/04
    ジャーナル フリー
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