Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 75, Issue 7
Displaying 1-12 of 12 articles from this issue
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  • The Auditory Brainstem Response Audiometry in Newborns and Infants
    Hidemichi Ashikawa, Osamu Yamada, Kazuoki Kodera
    1982 Volume 75 Issue 7 Pages 1479-1485
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1479
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    The reliability of the auditory brainstem response (ABR) audiometry in newborns and infants was studied. In the subjects consisting of 7 newborns and 15 infants, whose responses to conventional behavioral audiometry were obtained at intensities ranging from 40 to 70dB, the ABR thresholds evoked by both 1kHz tone-pips and clicks lay between 5 and 20dB. These were the same as those in adults with normal hearing. In the subjects consisting of 2 newborns and 7 infants who did not respond to conventional behavioral audiometry at the intensity of 70dB, the ABR thresholds for each auditory stimulus were elevated by 35 to 70dB and no responses were noted at 90dB. The results of the present study indicate that the ABR can be applied clinically as an objective method of audiometry for newborns and infants.
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  • Nystagmus Related to Vertiginous Attack in Ménière's Disease
    Hiroaki Hashimoto, Osamu Yamada, Jun-Ichi Suzuki
    1982 Volume 75 Issue 7 Pages 1487-1492
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1487
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    The spontaneous positional nystagmus during vertiginous attacks of Ménière's disease was observed in 15 patients using the Frenzel glasses. The direction-fixed positional nystagmus toward the affected side was observed in 13 patients, and toward the non-affected side in two. In nine of the fifteen, the course of the positional nystagmus was observed. In seven patients, the positional nystagmus frequently change both the direction of the quick phase and the plane of eye-ball rotation. There were great individual variations. At about 20 hours after the onset of the vertiginous attack, there was little vertigo but a weak nystagmus was still found beating to the non-affected side in most patients. In a specific indivisual, changing of the nystagmus was similar in each attack. In the same patient, pure-tone audiometry was performed during the acute stage in addition to the observation of the positional nystagmus. The results of the pure-tone audiometry showed that the pure-tone threshold was elevated only at low-frequency ranges before the onset and it elevated at both low and high frequencies just after the vertiginous onset. Two hours following the onset, pure-tone thresholds at lower frequencies recovered. Taking all the results in the present study together, it can be speculated that during the acute vertigo in Ménière's disease, the pathology may change on an hourly basis. This would affect a part or more of the labyrinth and result in hyper- and hypo-functions of each different endorgan, which would manifest themselves in changes in spontaneous positional nystagmus. From the results of one patient, it was also speculated that the cochlear-saccular hydrops appeared before the onset, and that the disease was recovered initially in part of the cochlea, and then in the vestibular organs.
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  • Considerations on Vector of Down Beat Nystagmus
    Hitoshi Sasaki, Jiro Hozawa, Shigeki Kamata, Isao Mori, Keiji Fukuoka
    1982 Volume 75 Issue 7 Pages 1493-1501
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1493
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    Down beat nystagmus was analysed by two channel electronystagmography and influences of the head and eye positions on the horizontal and vertical components of nystagmus were discussed. From the results of this investigation, down beat nystagmus was classified into two types: typical and atypical.
    In the typical type of down beat nystagmus, the vertical component always appeared simultaneously with the onset of the horizontal component, and the direction of nystagmus was shown as the vector of two components.
    Such simultaneity of the two components was not always observed in the atypical type of down beat nystagmus. When the vertical component did not correspond with the onset of the horizontal component, pure vertical nystagmus was observed. However, when the two components appeared at same time, the direction of nystagmus changed irregularly by the influence of the horizontal component. The typical type was observed in patients of syringobulbia and basilar impression. The atypical type was seen in those of spinocerebelar degeneration and subdural abscess.
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  • Five Cases of Alport's Syndrome in Three Families
    Izumi Harada, Yasuro Miyoshi, Yasuo Sakakura, Kotaro Ukai, Yoko Sugiya ...
    1982 Volume 75 Issue 7 Pages 1503-1512
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1503
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    Alport's syndrome is a condition in which there is dominant hereditary hearing loss with accompanying renal disease. In present study, we reported five cases in three families.
    Case 1 is a 27-year-old male and case 2 is his mother who is 59 years old. In these two cases, we found both hearing loss and renal disturbance. The hearing loss of case 1 is a 50dB loss on the right side and a 45dB loss on the left side. The hearing loss of case 2 is a 56dB loss on the right side and 63dB loss on the left side.
    Case 3 is a 24-year-old male who has renal disturbance and hearing loss. His hearing loss was a 36dB loss on the right side and a 28dB loss on the left side when he was 12 years old. The hearing loss was progressive and was a 57dB loss on the right side and a 50dB loss on the left side.
    Case 4 is a 12-year-old female and case 5 is her sister who is 9 years old. We found only renal disturbance in these two cases.
    Renal biopsy performed on cases 3 and 4 showed microscopically typical foam cells in the interstitial tissue.
    In all the cases, no other symptoms than hearing loss and renal disturbance were found.
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  • The Waiting Period for the Performance of Medial Shift of the Vocal Cord for Recurrent Nerve Paralysis
    Isei Satoh, Michihisa Yamada
    1982 Volume 75 Issue 7 Pages 1513-1516
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1513
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    This study was undertaken to clarify the length of time needed to follow up after onset of recurrent nerve paralysis for medial shift of the vocal cord.
    The following items were investigated:
    1) Possibility of recovery of vocal cord movements in the affected side.
    2) Looseness and atrophy of the intrinsic laryngeal muscles in the affected side following the onset of recurrent nerve paralysis.
    3) Compensatory overcrossing of the vocal cord in the normal side.
    For 1), the evoked EMG test is available, which can give information as to whether movements of the vocal cord recover or not. For 2), dogs with injured recurrent nerves were used for this study. The result showed that the atrophy of the intrinsic laryngeal muscle virtually never increases 2 months after nerve injury. For 3), compensatory overcrossing was observed only in 2.5 percent of the 436 patients with recurrent nerve paralysis. Alleviation of hoarseness is, therefore, not expected.
    As above, the author obtained a result that the medial shift of the vocal cord can be performed 2 months after the onset of recurrent nerve paralysis.
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  • Statistical Analysis of Childhood Malignant Neoplasmas of the Head and Neck
    Kazuo Uede, Seiichi Komiya, Fumiko Tanimura, Fumihiko Sato, Hitoshi Sa ...
    1982 Volume 75 Issue 7 Pages 1517-1524
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1517
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    Of a series of 15 patients with head and neck malignant neoplasmas under 15 years of age treated at our department from 1957 to February 1981, a statistical analysis was performed.
    Results obtained from the analysis were as follows:
    1. The primary sites of the origin of the tumors were the nasopharynx, tonsil, oral cavity, nasal cavity, paranasal sinus and parotid gland.
    2. Histopathologically these cases consisted of 9 cases of malignant lymphoma, 2 of fibrosarcoma, 2 of squamous cell carcinoma, one of malignant teratoma and one of rhinitis gangrenosa.
    3. The five-year survival rate for all the cases was 44%.
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  • Laser Surgery for Head and Neck Tumors
    Yuichi Kurono, Masaru Ohyama, Takuo Nobori, Shigeru Furuta, Ryuzi Kiyo ...
    1982 Volume 75 Issue 7 Pages 1525-1533
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1525
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    CO2 laser surgery was performed on 31 cases composed of head and neck malignancies, benign tumors, and other lesions with scar formation.
    In 17 of the 25 patients with head and neck cancer, good effects were seen, and 2 of the 3 patients with benign tumors were completely cured by only one-time laser surgery.
    Laryngeal cancer (T1, T2) could be almost completely vaporized without any bleeding and with little injury to the normal tissue under microscopic laser surgery.
    In these patients, thus, the total dose of radiation therapy and the period of hospitalization were reduced compared to patients without laser surgery.
    Laser surgery for children with oral benign lesions such as hemangioma and lymphangioma seemed to be beneficial, because postoperative care was quite easy as eating was possible immediately after operation and there was no need to take out stitches.
    On the basis of these, the advantages and disadvantages of laser surgery were discussed from a clinical viewpoint.
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  • Endolymphatic Hydrops Limited to the Apical Turn
    Toshio Yamashita
    1982 Volume 75 Issue 7 Pages 1535-1541
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1535
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    A study of human temporal bones revealed a considerable number of endolymphatic hydrops limited to the apical turn of the cochlea (apical hydrops). Apical Hydrops was found in 49 of a total of 322 temporal bones (15.2%). These 49 temporal bones included 17 from the 83 non-pathological cases (20.5%) and 32 from the 239 infection cases (13.4%).
    No causal relation has been established between apical hydrops and aging, strial atrophy and infections of the middle and/or inner ear. Therefore, apical hydrops is thought to be of no functional significance. The mechanism of the production of apical hydrops was also discussed.
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  • A Pharmacological Study of the Mechanism of Electroacupuncture Analgesia
    Toru Nakajima
    1982 Volume 75 Issue 7 Pages 1543-1569
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1543
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    Since 1976, more than 50 successful cases of electroacupuncture (EAP) analgesia have been performed in the treatment of post-operative pain in tonsillectomized patients. This clinical experience prompted the author to conduct a series of experimental studies for clarifying the mechanisms underlying the EAP-analgesia.
    Besides the well-established roles of the endogenous opioidal system in EAP-analgesia, serotonergic and catecholaminergic systems have been implicated to be involved in the mechanism. In the present report, noradrenergic blockers were employed to see how EAP-analgesia was influenced by these drugs. Experiments were conducted on Wistar rats. In almost of all the cases, radiant heat noxious stimulations were applied on the tail, and bilateral tsu-san-li points were selected for EAP stimulation. Stimulation parameters were as follows: frequency, 4Hz; intensity, non-noxious but enough to produce muscle contraction; duration, 30min in almost all the cases; and pulse pattern, biphasic pulses generated by a Chinese EAP stimulator. Under these experimental conditions, apparent and durable analgesia was observed in 23/28 rats which lasted for over 4 hours after cessation of EAP-stimulation. The analgesia was antagonized by pre-treatments with α2-blockers, yohimbine and tolazoline, but not with α1-blockers, phenoxybenzamine or chlorpromazine. The production of analgesia during EAP was confirmed by monitoring multiple unitary activities of the parafascicular and centrum medium nuclei of the thalamus. The analgesia during EAP was also suppressed by tolazoline but not by chlorpromazine or phenoxybenzamine.
    From these data, the authors presents a hypothesis that the α2-adrenergic system may play an important role in the production or the regulation of EAP-analgesia.
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  • Concentrations in Aural Discharge and Clinical Effect of Cephem Antibiotics
    Rinya Sugita, Shozo Kawamura, Yutaka Fujimaki, Hiroyuki Ohsawa, Koichi ...
    1982 Volume 75 Issue 7 Pages 1571-1584
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1571
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    The in vitro antibactrial activity against various isolates from otitis media, the serum and otorrheal levels and the clinical effects of cephem antibiotics were investigated to obtain data pertinent to the treatment of otitis media with systemic administration of the antibiotics.
    The in vitro antibacterial activity was determined by the re-revised MIC assay procedure of the Japanese Society of Chemotherapy. Antibiotic concentrations in the serum and aural discharges were measured by the thin agar layer-cup and sensitivity disc assay on specimens obtained from patients after an intravenous dose of 1-2g of cefinetazole (CMZ) or cefazolin (CEZ), using Micrococcus luteus ATCC 9341 and Bacillus subtils ATCC 6633, respectively, as test organisms.
    Therapeutic responses were assessed in patients receiving 1-2g b. i. d. of CMZ by i. v. drip or single shot, employing a set of criteria formulated in our department. Results:
    1) Sensitivity tests showed increased activity against Haemophilus influenzae and indol-positive Proteus.
    2) The level of cephem antibiotic in otorrhea were characterized by an approximately five-fold increase in acute otitis media as compared to that in chronic conditions and by greater and longer-sustained concentrations in cases of more pronounced inflammation. The level of CMZ in otorrhea was almost the same as that of CEZ, another cephem antibiotic used as a standard.
    3) CMZ therapy was effective in 100% of the acute otitis media cases and in 56% of the chronic cases. Although the efficacy of systemic CMZ administration in otitis media was remarkable, some of the chronic inflammation cases required additional local administration.
    4) Clinico-bacteriologically, CMZ proved effective against H. influenzae, Proteus spp. and Staphylococcus aureus as well, which was consistent with the results of bacteriological studies.
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  • A Clinical Study of Histaglobin Nebulizer Therapy for Nasal Allergy
    Hiroko Yonekawa, Yasuo Kitano, Yasuo Koike, Fumihiko Ohta
    1982 Volume 75 Issue 7 Pages 1585-1592
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1585
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    To evaluate the clinical effect and safety of Histaglobin nebulizer therapy, 18 patients suffering from house-dust nasal allergy were treated with this drug. These subjects were divided into two groups with nine subjects in each group. The patients of group A were given 1/4 vials three times per week for a total of 24 times. The subjects of group B were treated with 1/2 vials twice per week for a total of 12 times. All subjects in both groups received a total dosage of 6 vials. The effects on the subjects of the two groups were compared. The results obtained were as follows:
    1) The effective rate was 78% for group A and 56% for group B.
    2) The rate of improvement in nasal congestion was 89% for group A and 67% for group B. The decrease in rhinorrhea was 89% for group A and 56% for group B. The decrease in the number of sneezing attacks was 67% for group A and 44% for group B.
    3) From the laboratory findings, it was found that the serum level of IgE antibody fell after the treatment in three subjects. The histaminopexic power rose after the treatment in ten subjects.
    4) There was no side effect observed in any subject.
    Histaglobin nebulizer therapy was considered to be very effective and safe for the treatment of house-dust nasal allergy.
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  • A Fundamental and Clinical Study of Cefotiam in the Otorhinolaryngologic Field
    Takehiko Iwasawa
    1982 Volume 75 Issue 7 Pages 1593-1608
    Published: July 01, 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.1593
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    A fundamental and clinical investigation of cefotiam, a new cephalosporin derivative, was performed with the following conclusions:
    1) In vitro antibacterial activity: The minimum inhibitory concentration of cefotiam was tested by the agar plate dilution method. Cefotiam produced an excellent, broad spectrum antibacterial activity against standard strains of various bacteria. Cefotiam had same antibacterial spectrum as those of other cephalosporin antibiotics. The MIC against Staphylococcus aureus isolated from otorrhoea was distributed at arange from<0.2 to 3.13μg/ml (of Cefotiam) with its peak at 0.39μg/ml. Escherichia coli, proteus mirabilis and Klebsiella pneumoniae were inhibited by <0.2 to 3.13μg/ml of cefotiam. Cefotiam showed the MICs of > 100μg/ml against 60 strains of pathogenic Pseudomonas aeruginosa.
    2) Concentration in serum: The serum level of cefotiam in healthy adults given 250mg reached a maximum of 9.7μg/ml 30 minutes after intramuscular injection. Even 6 hours after intramuscular injection, the serum concentration of cefotiam was 0.1μg/ml.
    3) Concentration in tissues: Activity of cefotiam was demonstrable at the concentration of 1.2μg/g in palatine tonsilla and 0.8μg/g in the mucous membrane of the maxillary sinus one hour after intramuscular injection, when the serum concentration of cefotiam was 8.9μg/ml and 8.7μg/ml, respectively.
    4) Results of clinical treatment: When cefotiam was intravenously injected to 31 patients with representative infections in the otorhinolaryngologic field, clinical results were excellent in 25 patients, good in 5 and fair in 1. When the excellent and good cases were considered together, clinical response was obtained in 30 cases, 96.7 per cent. No side effect was found with intravenous injection of cefotiam.
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