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75 巻, 2special 号
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金川 清人, 時本 孝行1982 年 75 巻 2special 号 p. 455-463
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーUntil now, it has been more difficult to maintain satisfactorily permanent electrodes for cochlear microphonic (CM) measurements in guinea pigs than in cats or rabbits. We implanted Teflon-coated electrodes on the round window of the cochlea in 40 guinea pigs, and also implanted electrodes for the recording of brain stem responses in their skulls. Using these, we recorded the auditory brain stem response (ABR) and CM potentials daily for about three months. The recorded amplitudes of the ABR and CM potentials dropped suddenly about a day after the operation, but returned to their original levels in about two weeks, and remained stable thereafter.
During this initial two-week period, CM potentials and ABR were also measured by bone conduction. These ABR values remained steady, and the CM amplitudes were reduced but were larger than those measured by air conduction. These results suggest that postoperative serous exudate caused a decrease in the CM amplitudes to be measured.
We found permanent electrodes for CM measurements in guinea pigs to be reliable and useful for many auditory experiments.抄録全体を表示PDF形式でダウンロード (2524K) -
金川 清人, 時本 孝行1982 年 75 巻 2special 号 p. 464-475
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーUsing permanent electrodes for measuring the auditory brain stem response (ABR) and cochlear microphonics (CM), we carried out basic experiments in 31 guinea pigs to determine optimal techniques and conditions for bone conduction stimulation.
The best position for stimulation was found to be the intersection of the median line and the interaural line. The most appropriate force and tip size of the probe of the bone receiver were determined to be about 300g and 2mm2, respectively.
Furthermore, we made experimental hearing damage in the conductive systems of the external, middle and inner ear and created sensori-neural hearing loss with kanamycin (KM). We obtained input-output relation curves of ABR and CM by air and bone conductions in these animals, respectively and observed the change in hearing threshold in each operation.
We also studied the hearing of the animals showing the symptoms of otitis media and tympanosclerosis in comparison with the above-mentioned results.
The availability and significance of measuring bone conduction hearing in experimental animals is discussed.抄録全体を表示PDF形式でダウンロード (2421K) -
西尾 正寿1982 年 75 巻 2special 号 p. 476-500
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーA new operative procedure for the radical treatment of maxillary sinusitis was first tried in the Department of Otolaryngology, Kobe University School of Medicine in May 1967, in which the maxillary sinus ostium was enlarged and the middle meatus opened, instead of establishing a counter opening in the inferior meatus. Since then, 5 patients were similarly treated in the Department. Furthermore, 108 cases in which the same operative procedure was applied, were experienced during 7 years in the Department of Otolaryngology, Osaka Dental University.
One hundred and thirteen patients were similarly treated in the last 9 years. The present report describes the clinical significance of the procedure, and discusses it based on an experimental nasal-maxillary model.
1) Operative procedure: In the radical operation of maxillary sinusitis, after complete removal of the mucous membrane of the maxillary sinus, (a) the bone wall of the inferior meatus, (b) the bone of the inferior concha of the hiatus sinus maxillaris, i. e. Crista conchae, (c) the membranous part of the hiatus sinus maxillaris, and (d) mucus membrane of the middle meatus side of the inferior concha, are removed in that order. At the completion of the operation, it is confirmed that the free edge of the middle concha and the nasal septum can be seen from the maxillary sinus side.
Namely, the hiatus sinus maxillaris is anatomically opened.
2) The post-operative regeneration tissue in the sinus develops from the lateral inferior side, and is eventually replaced by connective tissue in 3 months to 3 years. The regenerated maxillary sinus can be roentogenographically seen as an excavation connected with the middle meatus.
3) According to questionnaires, our patients are progressing favofably.
4) In an experimental model with an enlarged sinus ostium, ventilation within the maxillary sinus is well done on expiration.
5) No later complication such as postoperative maxillary cyst is noted.抄録全体を表示PDF形式でダウンロード (10422K) -
深澤 高士1982 年 75 巻 2special 号 p. 501-515
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー1. 14年間に放射線治療を行った舌癌144例中118例 (82%) は腫瘍消失したが, その118例中42例 (37%) は再発をきたした.
2. 5年粗生存は, 腫瘍消失群81%, 再発群48%, 腫瘍残存群43%であった.
3. 再発群の再発の要因は臨床統計的には解明できなかった.
4. ラジウム針組織内照射治療後再発例ではコンピューターによる線量分布曲線により, 原発巣の中心部や舌根部に線量不均衡を生じていることが判明した.
5. ベータートロン電子線腔内照射治療後再発例では, 摘出標本により, 原発巣の前方深部～後部に再発する例を確認した.
6. 82例に対し Willén の方法に従って腫瘍細胞, 宿主双方から見た悪性度と放射線治療効果を比較検討すると, 腫瘍消失群では腫瘍細胞の悪性度は低く, 宿主の抵抗性は高かった.
7. 癌細胞巣内および周辺に浸潤するリンパ球は, ほとんどT細胞であった.抄録全体を表示PDF形式でダウンロード (12188K) -
臨床的並びに病理組織学的研究牧 孝1982 年 75 巻 2special 号 p. 516-529
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーFour hundred and fifty-three cases of squamous cell carcinoma of the larynx were treated during the period from 1969 to 1978 at the Department of Otolaryngology, Kobe University Hospital. Two hundred and flinty-cases were treated by irradiation therapy and one hundred and five cases developed local recurrence following initial irradiation. In 17 cases radical reirradiation was performed for local recurrence. Seven cases were successful and ten unsuccessful. Eight of the latter received total laryngectomy with good results.
In all of the unsuccessful reirradiation cases, the involvement of the anterior commissure was macroscopically evident before the initial irradiation and the reirradiation, and in the removed specimen observed microscopically following the failure of reirradiation. In the successful reirradiation cases on the other hand, the anterior commissure was not involved on clinical examination. Based on the above-mentioned fact, the choice of reirradiation for the relapsed laryngeal carcinoma should be confined to those in whom the involvement of the anterior commissure is completely deniable.
On histopathological study, the effect of irradiation is different in each specimen examined regardless of the similarity in type and amount of irradiation. A centripetal shrinkage of the tumor was not seen in any microscopically examined specimens, but islands of the tumor left in the primarily involved area was the marked finding which was obtained.抄録全体を表示PDF形式でダウンロード (5244K) -
小笠原 寛, 木村 純平, 久門 正義, 雲井 健雄1982 年 75 巻 2special 号 p. 530-535
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThe effect of specific immunotherapy on the lymphocyte response was investigated in 18 untreated and 16 treated patients with house dust nasal allergy, and 5 non-atopic control subjects. The suppressor factor was induced with Dermatophagoides farinae (D. farinae) and the suppression of lymphocyte proliferative response (LPR) and the secretion of anti-D. farinae IgE antibody were measured.
The percentages of suppression in the treated and control group were higher than in the untreated group. The suppressor factor reduced the LPR to D. farinae and the secretion of IgE antibody. In a previous study, the LPR to non-specific pokeweed mitogen and phytohemagglutinin were equal in three groups (allergic untreated and treated, and controls). The suppressor factor may be specific for D. farinae. In patients with high IgE antibody, even though immunotherapy was also used, the percentage of suppression was not increased satisfactorily.抄録全体を表示PDF形式でダウンロード (559K) -
毛利 学, 西尾 正寿, 島津 薫, 吉松 政喜, 藤本 一弘, 田幡 徹, 田幡 純, 毛利 純, 福武 洋二1982 年 75 巻 2special 号 p. 536-542
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーAntral secretions from 67 patients with dental sinusitis were examined bacteriologically. The results were summerized as follows:
1) From the 67 patients, 22 species and 113 strains were isolated.
2) Mixed infections with two, three and four species were found in 33 of the total cases. Fourteen of them were a mixture of Staphylococcus aureus and Esherichia coli. Twelve showed a mixture of aerobic and anaerobic bacteria.
3) Aerobic bacteria were isolated with higher incidence than anaerobic bacteria. Aerobic bacteria were isolated and composed of 17 species and 94 strains. Staphylococcus aureus was the most frequent species, followed by α-Streptococcus, Esherichia coli and Pseudomonas aeruginosa. In anaerobic bacteria, 5 species and 19 strains were isolated in descending order of Peptococcus, Veillonella and Peptostreptococcus.
4) From 49 patients in the acute stage, 19 species and 87 strains were isolated, Staphylococcus aureus was the most frequent species. From 18 patients in the chronic stage, 15 species and 26 strains were isolated, Pseudomonas aeruginosa was the most frequent species and Staphylococcus aureus had a low incidence.
5) No difference was found between bacteriological findings in dental sinusitis and nasal sinusitis. In other words, the bacteria participating in this disease are approximately similar to those in nasal sinusitis. No special bacteria are present in this disease.抄録全体を表示PDF形式でダウンロード (907K) -
田渕 哲, 谷口 郷美, 天津 睦郎, 箱崎 聖史1982 年 75 巻 2special 号 p. 543-549
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーEarly diagnosis of acoustic tumors plays an important role in minimizing the disorder caused by operation and in the aspect of rehabilitation. It can be said that the otorhinolaryngologists' mission is to make an early diagnosis of acoustic tumors. A present, however, unfortunately, acoustic tumors are only rarely detected at the stage where the affected area is confined to the internal auditory meatus, i. e, so-called “ear tumor”. In many cases of early acoustic tumors, there are no abnormal objective findings except perceptive deafness and a reduced or extinct response on caloric nystagmus examination. On many occasions, neuro-otolbgical examination does not lead to a definite diagnosis of acoustic tumor but only suggests its presence. Therefore, we cannot but resort to diagnostic imaging in order to confirm the presence or absence of a tumor. As a next step, CT is performed following plain roentogenography, pluridirectional tomography, etc. Conventional CT where the limits of the detectable image in the diameter of the tumor have been considered to be 1.5-2cm is, however, not helpful for early diagnosis. For this reason, we have been troubled with a gap between what the functional test results indicate and CT-findings. We are now equipped with CT (from the Review of metrizamide cisternograms produced by GE CT/T) which seems to adequately fill such a gap and be useful for early diagnosis of acoustic tumors. We believe that CT-scan will reveal a greater number of cases of “ear tumor”.抄録全体を表示PDF形式でダウンロード (2350K) -
外傷性頭蓋底骨折から長い経過をたどった前頭葉膿瘍湊川 徹, 雲井 健雄, 池田 公行, 森村 達夫1982 年 75 巻 2special 号 p. 550-556
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーA 17-year-old boy was referred to our hospital because of multiple maxillofacial skeletal fractures, visual loss in his left eye and a lacerated wound of the left upper eyelid sustained ten days previously when he ran into a pavement tree while riding his motorbicycle. Open reduction of the fractures and endonasal surgery for the fracture of the optic bony canal on the left were performed. Almost a month postoperatively, the patient returned with fever and swelling of his left upper eyelid and this abscess formation at the site of the lacerated wound in his left upper eyelid recurred many times during the following period of one year. Brain abscess in the left frontal lobe communicating with the upper eyelid was finally found and this was excised by frontal craniotomy.抄録全体を表示PDF形式でダウンロード (5077K) -
保存的治療及び減荷術施行40例に関して箱崎 聖史, 天津 睦郎, 松居 敏夫, 細見 英男1982 年 75 巻 2special 号 p. 557-566
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー過去11年間で, 外傷性顔面神経麻痺患者56例を取扱い, このうち経過の明らかな40例に対して検討した.
1) 麻痺は30～40才台の男性に多くみられた.
2) 意識障害を伴なわない症例の麻痺回復の程度は良好で, 意識消失時間の長い症例ほど回復不良な傾向がみられた.
3) 全症例の完全回復率は58%であった.
4) 保存的治療で経過観察した26例では, 不全麻痺は全例完全回復し, 完全麻痺でもNE正常例はほぼ完全回復したが, NE低下例では, 受傷後25日以内に回復徴候を呈した症例は全例完全回復し, 2ヶ月以後に回復徴候を呈した症例の回復程度はきわめて不良であった.
5) 手術例14例では, NE消失例でも回復良好な症例が多くみられ, かつ回復が遅れた症例でも回復良好な症例がみられた. 受傷後1ヶ月以内に手術を施行した症例は回復が良好であるが, 3ヶ月以後に手術をした症例は回復不良であった.
6) 以上よりNE消失例は, 直ちに手術の適応となり, NEが消失していない症例でも受傷後1ヶ月を過ぎてもなお回復徴候のない症例では1～2ヶ月の間に手術を考慮するべきであると考える.
7) 小児の回復程度は成人に比べて良好な傾向がみられた.抄録全体を表示PDF形式でダウンロード (1176K) -
入谷 寛, 木西 實, 箱崎 聖史, 松居 敏夫, 古閑 次夫, 細見 英男1982 年 75 巻 2special 号 p. 567-571
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー発症2週以内にステロイドを投与したベル麻痺とハント症候群の完全麻痺例の経過を, 従来の保存療法による経過と比較した. 又, ステロイド治療開始時期の相違による経過を検討し, 次のような結果を得た.
i) ベル麻痺について
(1) ステロイド投与群の完全回復率は49%, 非投与群は37%であった. (危険率≒9%)
(2) 発症より1週以内にステロイドを投与した例の完全回復率が高かった. (危険率≒1.6%)
(3) ステロイド投与群のNET陰性率は29%, 非投与群は55%であり, 有意差を認めた. (危険率≒0.26%)
(4) 発症1週以内にステロイドを投与し得た症例で, 神経変性の予防率が高かった. (危険率≒1.1%)
ii) ハント症候群について
(1) ステロイド投与群の完全回復率は17%, 非投与群は38%であった. (有意差なし)
(2) ステロイド投与群では, 不全回復例中, 回復良好群の占める割合が高かった. (危険率≒1.2%)抄録全体を表示PDF形式でダウンロード (530K) -
松居 敏夫, 天津 睦郎1982 年 75 巻 2special 号 p. 572-574
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーA case of bilateral facial palsy and rhinolalia aperta in a thirty-one-year old female is reported.
The patient had been unable to close her eyes for 4 years prior to consultation and subsequently complained of hypernasality of voice 2 years thereafter with a problem of aspiration occurring 6 months prior to consultation. On physical examination, bilateral facial palsy was observed as evidenced by the patient's inability to crease her forehead, wrinkle her nose, or close and blink her eyes. The rest of the physical examination revealed normal findings. Facial nerve testing, Schirmer's test and electrogustometry were normal but no stapedial reflex was elicited on either side. Blood chemistry, brain CT-scan, EEG and ophthalmological examination revealed no significant abnormalities.
The difficulty in establishing the diagnosis was discussed. Electromyography and Tensilon test results documented the diagnosis of myasthenia gravis.抄録全体を表示PDF形式でダウンロード (2963K) -
谷口 郷美, 鈴木 茂身, 松山 文彦, 堀井 勝, 柴 裕子1982 年 75 巻 2special 号 p. 575-581
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー59耳に骨弁を作成し病変清掃を行った.
1) 再手術は19耳に行い, 骨弁が陥没した3耳では骨萎縮・変形がみられた. 又骨弁の位置が若干ズレているものも, 骨萎縮の傾向がみられた.
2) residual cholesteatoma は2耳, iatrogenic chole. は1耳にみられた.
3) retraction は17耳にみられ, その原因として露出された骨壁からの肉芽形成 -線維化- 閉塞の機転を重視した.
4) 骨弁の作成・整復時の注意点を述べた.抄録全体を表示PDF形式でダウンロード (4005K) -
雲井 健雄, 小笠原 寛, 梅谷 芳雄, 永本 浩1982 年 75 巻 2special 号 p. 582-587
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー兵庫イアーバンクから入手した allograft human stapes を, 既に中耳根治手術をうけた open mastoid cavity に応用し, mastoid cavity は側頭筋で充填した上で患者の卵円窓窩に固定して鼓室形成術を行った症例を報告すると共に, 鐙骨消失例に対する聴力改善手術についての若干の考察を行った.
故人の遣志によって死後自己の遺体側頭骨を提供された人々及び兵庫イアーバンクの“Gift of Life”(allograft) に深甚の謝意を表します.抄録全体を表示PDF形式でダウンロード (663K) -
松居 敏夫, 天津 睦郎1982 年 75 巻 2special 号 p. 588-592
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー1. 50才女性の Van der Hoeve 症候群の両鐙骨手術例を報告した.
2. 術前検査で右耳は鐙骨脚の離断, 左耳は鐙骨底の固着が予想された.
3. 手術所見は術前の予想通り, 右耳は鐙骨後脚の骨折および底板の固着が, 左耳は底板の固着がみられた. 両耳とも stapedectomy を行い wire fascia で連鎖を再建した.
4. 術後聴力は会話音域平均右45dB, 左10dBの改善をみた.抄録全体を表示PDF形式でダウンロード (3599K) -
森本 大和, 井上 健造1982 年 75 巻 2special 号 p. 593-597
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThree high school students, 16 years of age, experienced sudden explosion while experimenting with gun powder. The major damage was burn on their faces and bilateral rupture of the tympanic membranes. The perforations were repaired surgically and conservatively.抄録全体を表示PDF形式でダウンロード (2219K) -
後迷路性難聴の診断服部 浩1982 年 75 巻 2special 号 p. 598-604
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThe patient, a 27-year-old female, showed remarkable fluctuations in audiological findings during the period of 4 years of treatment, which included one V-P shunt operation and 3-time tumor exstirpation by suboccipital craniotomy. The threshold for continuous pure tones fluctuate from normal to complete loss, speech discriminations from 95% to 0%, the TTS from (-) to (+) and sometimes discrepancies between speech discrimination and TTS were found. Even when the patient showed a normal audiogram, very good discrimination and negative TTS, a decruitment phenomenon and loss of tonality was found in the lower frequency range. Some hazards of overlooking the presence of retrocochlear lesions were discussed.抄録全体を表示PDF形式でダウンロード (746K) -
山辺 けい子, 増田 基子, 法貴 昭1982 年 75 巻 2special 号 p. 605-609
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThe traditional radical operation for chronic sinusitis had occasionally a complication of post-operative maxillary cysts, and various methods to avoid this problem have been tried recently. Since 1975, 12 patients with chronic sinusitis have been treated at the Cryosurgical Clinic of Kobe University Hospital. The cryosurgical unit was devised to freeze the abnormal mucous membrane of the maxillary sinus. At first a small hole was made at the lateral wall of the meatus nasi inferior or the fossa canina, and next a special probe was inserted through this hole to freeze the maxillary sinus with liquid nitrogen. Before and after the treatment, we evaluated the effectiveness using morphological and functional tests. In nine cases, the treatment was evaluated to have been effective. These results suggest the usefulness of cryosurgery for chronic sinusitis. This is a preliminary report of our study.抄録全体を表示PDF形式でダウンロード (3676K) -
第1報 生存率及び初回治療法と予後溝尻 源太郎, 志水 雄輔, 箱崎 聖史1982 年 75 巻 2special 号 p. 610-615
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThe prognosis of maxillary sinus cancer in recent seven year period was discussed. The study of 107 patients of primary maxillary sinus cancer revealed that the five-year survival rate was 47%. The most common cause of death was local tumor and, therefore, sure treatment for local tumors is required. What is important is the selection of patients who do not need radical operations.抄録全体を表示PDF形式でダウンロード (672K) -
高原 哲夫, 牧 孝, 藤谷 哲造, 森本 木和1982 年 75 巻 2special 号 p. 616-619
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーA woman, aged 43, came to the out-patient department complaining of progressive right nasal obstruction and epistaxis. Nasal examination showed granulomas with crusts in the bilateral Kiesselbach areas and anterior end of the right inferior turbinate. We took this tissue for biopsy, and sections showed tuberculosis of the nasal mucosa.
She had no past history of pulmonary tuberculosis and X-rays of the chest and sinuses were reported normal. Whole-body examination showed no other suspected tuberculous focus. She was cured by general chemotherapy only using streptomycin, INAH and RFP. She has been followed up for the past two years and is symptom-free, with no local or general signs of recurrence.抄録全体を表示PDF形式でダウンロード (3742K) -
133例の経験から: 臥位施行一側隔時施行などについて細見 英男1982 年 75 巻 2special 号 p. 620-627
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー昭和53年1月から56年6月までの間の自験扁摘症例133例 (全麻例79例を含む) の手術施方法, 経過などにつき, できるだけ安全を期するという見地から検討を加えた. 特に注目したのは実際に施行するにあたっての取り扱い方法と術後の不良経過に対する配慮の二点である. 施行時実行すべき最も重要なところは局麻時でも手術は臥位で行うを常とし起立性低血圧の発来を除外すること, 術中心拍, 呼吸, 血圧の監視を確実に行うことと結論し得た. 臥位による技術上の困難はなかった. プラスチック静脈針による血管確保が種々の観点から不可欠である. 電気焼灼を主体とすると止血操作が容易かつ確実となり, また臥位施行をも容易にする. 術後経過の不良化に対処するには一側扁摘後一定期間 (5～7日の間隔) の後に他側を摘出することが一つのよい解決法と考え実行した. この実施法は特に高令者に適用すべきは明らかである. 小児の場合原則として両側同時施行して可であることは勿論である. いま一側摘出の適用年令を幾歳以上に置くべきかについての結論は今後の検討にまちたい.抄録全体を表示PDF形式でダウンロード (3077K) -
増田 基子, 法貴 昭, 山辺 けい子1982 年 75 巻 2special 号 p. 628-633
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー1) 210症例 (1974年12月～1981年10月, 男115例, 女95例, 年令分布4～72才) の習慣性扁桃炎, 慢性咽頭炎, ASLO高値, 病巣感染および疑い例, 慢性咽頭炎について検討した.
2) 肥大I度の扁桃は笑気ガスが, II度では液体窒素の使用が適当と考えられる.
3) 凍結治療は出血がなく, 操作が簡便で, くり返して行え, 咽頭も対象となるという利点がある.
4) 凍結治療では残存を生じる, 肥大の著しい扁桃は適応とならない, 術後一時発熱, 掌蹠膿疱症の悪化を生じるという欠点, 副作用がある.
5) 2次治療以上施行した症例が27.8%ある.
6) 2次治療は, 残存部位の再炎症, 初回治療後の代償的な扁桃炎, 咽頭炎に行った.
7) 発熱, 慢性炎症症状, ASLO高値, 微熱, 蛋白尿, 血尿の改善する症例は多いが, 腎炎, 掌蹠膿疱症等組織変化の大きい疾患の改善は前者に劣る.抄録全体を表示PDF形式でダウンロード (5065K) -
化学療法併用の有用性について高原 哲夫, 藤谷 哲造, 服部 浩, 今城 吉成, 小笠原 寛1982 年 75 巻 2special 号 p. 634-640
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー1. 口蓋扁桃悪性リンパ腫の放射線単独治療群の1年から4年までの生存率は, 64%, 47%, 36%, 34%であったが, 放射線化学療法併用群では82%, 66%, 60%, 49%と生存曲線は有意に上昇が認められた.
2. 実測生存率による0～1年, 2～3年で放化群の生存率が有意に高かった.
3. Stage I では放単群と放化群の生存率に有意差を認めなかった.
4. Stage II では0～1年, 2～3年の観察期間で放化群の生存率は放単群に比較して, 有意に高かった.
5. Stae III, IVでも放化群の生存期間の延長が認められた.
6. Lucus-Collins の分類では Non-T Non-B の生存率が最も良く B-cell lymphoma, T-cell lymphoma でも他領域の悪性リンパ腫に比較して予後は良好であった.抄録全体を表示PDF形式でダウンロード (747K) -
手術的治療を中心として天津 睦郎, 松居 敏夫, 牧 孝, 深沢 高士, 金川 清人, 牧野 邦彦, 木西 實, Joselito Centeno Jamir, ...1982 年 75 巻 2special 号 p. 641-650
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー下咽頭頸部食道癌138例につき検討した.
1. 発生部位別にみると梨状陥凹89例, 咽頭食道接合部37例, 咽頭後壁12例で, 男女比は87:51で男性に多く, 年令は60才台が最多であった.
2. 治療法は放射線単独71例, うち根治照射48例, 姑息照射23例, 手術単独17例, 放射線+手術41例, うち根治照射後の再発26例, 術前照射15例, 治療 (-) 9例であった.
3. 原発巣に対する手術的治療では58例中咽喉食摘26例, 咽喉摘27例と両者でその大半を占めた. 前者は咽頭食道接合部癌に後者は梨状陥凹癌に行われる頸度が高く, 夫々の基本術式であった.
4. 咽喉食摘の食道再建は昭和47年以前は種々の方法が採用されていたが, それ以降はDP-Fによる再建が主流を占めた.
5. 郭部頸清術は手術例58例中55例に行われ, 照射単独例では71例中11例に行われた. 手術例では一側37例, 両側18例で両側例の割合が高かった.
6. 全例の治療成績は5年生存が82例中21例 (26%) であった. 治療成績向上には放射線, 手術, 場合によって化学療法を組み合わせた, 総合的治療を有機的に行う必要があることを述べた.
7. 手術例の死因をみると局所再発, 頸部リンパ節転移, 遠隔転移といった原患癌に関連したものが90%以上を占めた.抄録全体を表示PDF形式でダウンロード (1095K) -
牧野 邦彦, 松居 敏夫, 牧 孝, 深沢 高士, 金川 清人, Joselito Centeno Jamir, 天津 睦郎, 坪井 慶孝1982 年 75 巻 2special 号 p. 651-658
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーTwo cases of double primary cancers involving the hypopharynx and larynx were observed at the Department of Otorhinolaryngology, Kobe University. The first case was a 64-year-old male with simultaneous hypopharyngeal and laryngeal cancers. The second case was a man, aged 63, who initially had laryngeal cancer and developed hypopharyngeal cancer seven years after the irradiation of the initial lesion.
Seven double primary cancers were found in 141 cases (5%) of hypopharyngeal cancers from January 1965 to March 1981. The hypopharynx and larynx were both involved in two cases. Only six cases, including our present report of double primary cancers involving the hypopharynx and larynx, have been reported in the Japanese literature. Three were double primary simultaneous cancers while three were metachronous.
In the three double primary simultaneous cancers, the hypopharyngeal cancers were asymptomatic, and in two, the hypopharyngeal lesions were not detectable on indirect laryngoscopy. The three cases of double primary metachronous cancers were hypopharyngeal cancers believed to be induced by the irradiation for primary laryngeal lesions.
Therefore, in hypopharyngeal cancer patients, the possibility of double primary cancers should be kept in mind. A thorough examination is mandatory before initiation of therapy. The same is true for laryngeal cancer patients. Furthermore, in irradiated laryngeal cancer patients, the physician must be vigilant for radiation-induced cancers especially those of the hypopharynx and cervical esophagus.抄録全体を表示PDF形式でダウンロード (5770K) -
口蓋形態と手術成績の比較木村 照1982 年 75 巻 2special 号 p. 659-664
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーI compared the 53 patients with congenital velopharyngeal insufficiency without cleft palate with the 29 patients with submucous cleft palate.
Velopharyngeall insufficiency without cleft palate (53 patients):
1) They were divided into two groups according to the characteristic shapes of their palates, that was non-cleft palate and pseudo cleft palate. In the non-cleft palate patient, the palate showed normal or broad uvula, normal looking soft palate, and flat edge of the hard palate. On the other hand, in the pseudo cleft palate patient, the palate showed bifid uvula, thin muscular layer on median raphe, and a slight notch in the hard palate.
2) In their history, birth asphyxia was found in 27 patients, congenital heart disease in 13 patients, convulsive seijure in ten, chronic otitis media in seven, and speech retardation in 48 patients.
3) Twenty-eight patients looked alike, and they were divided into two groups according to their characteristic facial signs, the humorous type and the nervous type.
4) Muscular atrophy of the soft palate was proved on pathological examination.
5) In a total of fifty patients repair was ultimately achieved by pharyngeal flap operation. It was concluded that the push-back operation was an ineffectual procedure in reducing velopharyngeal insufficiency, whereas the pharyngeal flap operation was an effective treatment.
6) There was a marked post-operative improvement in speech in 39 patients, fair improvement in 11 patients, no improvement in 3 patients.
Submucous cleft palate (29 patients):
1) The palate shows a bifid uvula, no muscular layer on median raphe, and a large defect in the hard palate.
2) In their history, asphyxia was found in 4 patients, speech retardation in 10 patients. Neither congenital heart disease nor convulsive seijure were found in any patients.
3) There was no facial resemblance.
4) Muscular atroply of the soft palate was not proved in these patients.
5) The push-back operation was effective in 17 patients.
6) There was a marked post-operative improvement in speech in 27 patients and fair improvement in two patients.抄録全体を表示PDF形式でダウンロード (2375K) -
木村 照1982 年 75 巻 2special 号 p. 665-671
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーI have found and treated 53 patients with congenital velopharyngeal incompetence without cleft palate from 1968 to 1981. There were 24 males and 29 females ranging in age from 2 to 15 years.
Their speech was nasal in quality and indistinct. Twenty-eight of the 53 patients looked alike, and they were divided into two groups according to the characteristics of their faces. I called one group (14 patients) the humorous type, and the other (14 patients) the nervous type. The faces of the humorous type were characterized by round eyes and retruded mandible. On the other hand, those of the nervous type were characterized by palpebral fissure with an upward obliquity and plump upper eyelids. Push-back operations were performed in six patients with no consequent improvement. For the repair of velopharyngeal incompetence, pharyngeal flap operations were performed successfully in a total of 50 patients. There was no difference in speech result, not only between the typical face group and the other, but also between the humorous group and the nervous group.抄録全体を表示PDF形式でダウンロード (4423K) -
藤谷 哲造, 箱崎 聖史, 西脇 至, 服部 浩, 今城 吉成, 今中 一文1982 年 75 巻 2special 号 p. 672-676
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーForty patients of Tx No squamous cell carcinoma of mobile tongue were treated at Kobe University, Departments of Otolaryngology and Radiology between November 1975 and October 1980. Twenty-three patients had preventive neck irradiation prior to the local treatment. Six of these patients subsequently developed a neck nodal metastasis. The primary lesion was uncontrolled in 4 of these 23 cases.
Eight of the 17 without neck irradiation subsequently developed a neck nodal metastasis within 1 year and the primary lesion was uncontrolled in 7 of these 17 cases. The rate of lymph node metastasis in T1 and T2 patients with neck irradiation was significantly lower than that in those without neck irradiation. Post-irradiation necrosis of the mandible occurred in 3 of the 23 patients with preventive irradiation. We consider that the preventive neck irradiation for the patients with T1 and T2, No tongue cancer is effective in destroying subclinical metastasis and the mandible should not be included in the irradiation field.抄録全体を表示PDF形式でダウンロード (533K) -
松山 文彦, 谷口 郷美, 堀井 勝, 鈴木 茂身, 柴 裕子, 宮本 武, 井上 佑一1982 年 75 巻 2special 号 p. 677-685
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー30例の耳下腺部及びその周辺に生じた腫瘤に対する術前のCTと, 手術所見, 病理診断とを比較検討し, 現時点でのCT検査の有用性について, 次のように結論した.
1. 単純CTだけでも耳下腺腫瘍の局在は診断可能であるが, contrast CT により腫瘍は増強され, より明確にその局在がわかる.
2. 側頸嚢腫は, contrast CT により嚢腫壁は増強されるが, 内部は増強されないことにより, 耳下腺腫瘍との鑑別は可能である.
3. 耳下腺腫瘍で, contrast CT で増強されても充実性腫瘍とは限らない.
4. CT値から, その腫瘤内容のわかる場合もある.
5. 副咽頭間隙への進展例は, CTが極めて有力である.
6. 単純CTから顔面神経と耳下腺腫瘍との関係を予測するのは困難である.抄録全体を表示PDF形式でダウンロード (8701K) -
谷 光毅, 山本 邦之, 天津 睦郎1982 年 75 巻 2special 号 p. 686-690
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー12才女児の耳下腺に発生した Mucoepidermoid tumor の1症例を報告し, 若干の文献的考察を加えた. 術前腫瘍が良性であるか悪性であるかを知る上で, 唾液腺造影, CTスキャン, RIシンチグラム, 超音波診断等の総合的な判断が有効であると思われた.抄録全体を表示PDF形式でダウンロード (4140K) -
高島 荘二, 高原 哲夫, 小笠原 寛, 法貴 昭1982 年 75 巻 2special 号 p. 691-699
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーSeven patients with juvenile laryngeal papillomatosis, treated at the Kobe University Hospital, Japan mainly using a combination therapy of microsurgical removal and cryosurgery from 1974 to 1981 were investigated.
The results are as follows.
1. Two adults who were diagnosed for the first time in adulthood as having juvenile laryngeal papillomatosis were cured.
2. One adult who suffered from papillomatosis in childhood and had a recurrence 17 years later is thought to be under control.
3. One young adult who suffered from papillomatosis and was treated by radiation therapy in childhood died of radiation-induced cancer.
4. Two children whoes papillomatosis were cured, but one has a vocal cord atresia after the treatment.
5. One child who has frequent recurrences is under treatment.
From the above results, the following conclusions were drawn.
1. There is no absolutely effective therapy for juvenile laryngeal papillomatosis and multidisciplinary treatment is considered to be the best method at present.
2. Irradiation for this disease especially for children must be avoided.
3. In order to avoid dissemination, silastic tracheostomy tubes should be used and unnecessary suctioning should be avoided during treatment.
4. Cryosurgery is superior to surgical resection in that the healing process of the treated area after cryosurgery is better than that after surgical resection. In our case, cryosurgery under local anesthesia was effective in the disseminated papillomatosis in the trachea. But care should be taken not to freeze too much tissue to avoid laryngeal adhesion and tracheal stenosis.
5. Attention should be given to recurrent nerve palsy and vocal cord atresia probably due to frequent and excessive surgical removal and cryosurgery.
In such cases, tracheostomy should be performed before operation.抄録全体を表示PDF形式でダウンロード (4201K) -
木西 實, 天津 睦郎1982 年 75 巻 2special 号 p. 700-704
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー喉摘後の音声の現況を知る目的で92例に対し調査を行なった.
1) 喉摘時年令は, 60才代が最多で全体として高令化の傾向にある.
2) 代用音声による会話を行なっている症例は82例で, T-Eシャント42例, 人工喉頭33例, 食道音声7例にわけられる. 代用音声を用いない症例は10例である.
3) T-Eシャント会話症例は全例良好な会話能力を有する.
4) 食道音声会話者は大半がT-Eシャント会話不成功例で, その会話明瞭度は良好である. すなわち, T-Eシャント手術は食道音声を容易に体得しうる前段階処置としても有用である.
5) 人工喉頭使用者は高令者に多く, 会話明瞭度は加令とともに悪化する傾向がうかがえる.抄録全体を表示PDF形式でダウンロード (483K) -
藤本 一弘, 天津 睦郎, 深澤 高士1982 年 75 巻 2special 号 p. 705-709
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーA 34-year-old man visited the ENT clinc of Kobe University Hospital with a complaint of 3 months' duration of recent enlargement of a painless mass 6×8cm in size at the right side of the neck.
Before the patient came to us, he had undergone an open biopsy at another clinic, and its histopathological examination revealed a malignant metastatic tumor. The primary lesion was not detected on the thorough examination not only of the head and neck area but also of the entire body.
Although the primary lesion was not found, as the tumor had a histopathological malignancy, a radical neck dissection of the right side under general anesthesia was performed. The well-capsulated tumor about 3×2cm in size was located beneath the sternocleidomastoid and separated from the carotid artery. The histopathological examination of the removed specimen at Kobe University Hospital revealed a chemodectoma of the neck.抄録全体を表示PDF形式でダウンロード (4168K) -
山形 健一, 松山 文彦, 堀井 勝, 谷口 郷美1982 年 75 巻 2special 号 p. 710-716
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーTwo cases of branchial cysts were reported.
Case 1. A 25-year-old female had been complaining of a tumor on the right side of the neck for 7 years.
Case 2. A 42-year-old male had been complaining of a tumor at the right side of the neck for 3 months.
These tumors were extirpated surgically. Histologically, a diagnosis of branchial cyst was made seven cases of branchial cysts were observed in the last 10 years (1971-1981) in the Department of Otolaryngology, Kobe Central Municipal Hospital. The literature on branchial cysts was reviewed.抄録全体を表示PDF形式でダウンロード (6080K) -
山形 健一, 松山 文彦, 堀井 勝, 谷口 俊夫1982 年 75 巻 2special 号 p. 717-721
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーThe patient was a 77-year-old woman who had complained of a giant tumor at the right lateral neck. The tumor was extirpated surgically. Histologically a diagnosis of cav nous hemangioma was made.
The literature on hemangioma is reviewed.抄録全体を表示PDF形式でダウンロード (4145K) -
鈴木 茂身, 谷口 郷美, 内田 博也1982 年 75 巻 2special 号 p. 722-727
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーCarcinoma arising in the thyroglossal duct remnant is rare. It is often diagnosed as a thyroglossal duct cyst. In our case, microscopic examination revealed follicular adenocarcinoma in association with ectopic thyroid rests.
The purpose of this paper is (1) to report one additional case, (2) to review the literature, and (3) to discuss differentiation between a carcinoma arising in the thyroglossal duct remnant and a metastatic carcinoma from the main thyroid gland.抄録全体を表示PDF形式でダウンロード (2454K) -
古閑 次夫, 山辺 けい子, 天津 睦郎, 岸原 道三1982 年 75 巻 2special 号 p. 728-732
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーWe treated a 42-year-old female with subacute thyroiditis. She suffered from swallowing pain, general fatigue and slight fever. Though an increase in the erythrocyte sediment ratio was noted, the diagnosis was difficult to obtain.
This short report describes the problem of the diagnosis of subacute thyroiditis and the rapid effect of corticosteroid hormone therapy. We believe that the history and the physical findings of the painful goiter as well as the inflammatory signs led us to the diagnosis of subacute thyroiditis.抄録全体を表示PDF形式でダウンロード (1698K) -
堀井 勝, 谷口 郷美, 鈴木 茂身, 松山 文彦, 山形 健一, 箱崎 聖史1982 年 75 巻 2special 号 p. 733-739
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリー胸鎖乳突筋皮弁, 大胸筋皮弁による頭頸部再建術を11例に行い, 8例は生着したが, 3例に壊死脱落を認めた. その内, 2例には高度の全身的な合併症が存在していた. 口腔底の再建に際しては, 下顎骨の正中截開, 辺縁切除を行って, 口腔内で筋皮弁と周囲との縫合を確実に行う事, 筋体を下顎骨にしっかりと固定する事, 死腔をつくらない様にする事が重要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 (6351K) -
法貴 昭, 増田 基子, 山辺 けい子, 貴島 哲香1982 年 75 巻 2special 号 p. 740-750
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーSince 1979, 120 patients suffering from head and neck malignant tumors have been treated by means of CO2 laser at the laser clinic of Kobe University Hospital. They were divided into two groups. One hundred and four patients were treated for radical treatment and 14 for palliation. Two patients were unknown cases. The equipment employed was a Medilaser S produced by Mochida Co. A special manipulator with 4 joints was manufactured and used as a trial. To utilize the laser as easily as possible, all patients except one were macrosurgically treated under local anesthesia. To exhaust the smoke resulting from laser irradiation, a big vacuum cleaner was used.
For the purpose of radical treatment, three methods were applied for fresh and recurrent cases: 1) laser only: All of 21 cases could be locally controlled after the primary therapy. Satisfactory results were obtained using the laser scalpel in tongue cancer. 2) a) combined therapy with cryosurgery: 14 of the 17 cases could be locally controlled after the primary therapy. b) combined therapy with radiotherapy: 9 of the 10 cases could be locally controlled after the primary therapy. This combined therapy was effective for those recurring after ordinary operations. 3) multidisciplinary treatment with radiotherapy, chemotherapy, hyperthermia and cryosurgery. This treatment was applied to the most advanced cases. Forty-one of the 49 cases could be locally controlled after the primary treatment (except the cases of under treatment). In this treatment antrostomy, vaporizing tumor tissues, enlargement of the fenestra, and excision of hard and soft palates invaded by tumor were easily performed by laser surgery. Satisfactory results were obtained in maxillary sinus carcinoma. Laser was effective for prolongation of life and reducing pain in palliative cases. The side effects were negligible.抄録全体を表示PDF形式でダウンロード (7126K) -
気は生体電流であるとみる仮説木村 照1982 年 75 巻 2special 号 p. 751-755
発行日: 1982年
公開日: 2011/11/04
ジャーナル フリーIn ancient India, Ki was considered Vayu, that was a strong corpuscle. In China, Ki was the source of energy. In our country, Ki was estimated to be spirit, mind, or electric energy. I consider that Ki is the action current, and is related to the blood circulation and autonomous nervous system.
Ki is moving but invisible. It exists only in the living body, not in the dead body. The blood cells move only in the living body, but stop in the dead body. The blood circulation in the body is controlled by the autonomous nervous system. Therefore I hypothesize Ki as the action current moving through the autonomous nervous system.抄録全体を表示PDF形式でダウンロード (529K)
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