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81 巻, 4 号
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大山 勝1988 年 81 巻 4 号 p. 481-489
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーArachidonic acids released from phospholipids in cellular membrane are converted to various leukotrienes (LTs) by lipoxygenase as well as being transformed into different kinds of prostaglandins (PGs) by cyclooxygenase. LTs and PGs are known to play an important role in allergy and inflammation.
Therefore the presence of LTs and PGs was examined in the retention fluids in maxillary cysts, the nasal secretion in nasal and paranasal mucosa and polyps obtained at the time of nasal and sinus operation.
The predominant arachidonic acid metabolites in both nasal secretion of nasal allergy and chronic sinusitis were LTD4, 12-HETE, PGE2 and 6-Keto PGF1α.
The levels of 5-HETE, 15-HETE and LTB4 were higher in nasal mucosa of hypertrophic rhinitis and sinus mucosa of chronic sinusitis than in nasal mucosa of allergic patients and nasal polyps.
The levels of PGE2, 6-Keto PGF1α and TXB2 in nasal mucosa of allergic subjects were higher than those in nasal or sinus mucosa in non-allergic subjects.
These results may help to understand the biochemical basis of the pathogenesis of chronic sinusitis and nasal polyps.抄録全体を表示PDF形式でダウンロード (963K) -
丹羽 英人, 柳田 則之1988 年 81 巻 4 号 p. 490-491
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1796K) -
馬場 完仁, 坂田 英治, 寺本 和弘, 村田 保博, 大都 京子, 井上 鐵三1988 年 81 巻 4 号 p. 493-504
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーA 45-year-old woman with a diagnosis of probable multiple sclerosis had various abnormal eye movements. Her initial rotatory nystagmus changed to down-beating nystagmus in the primary position of gaze and horizontal rebound nystagmus was observed. Impairment of nystagmus inhibition was found in OKN, OKAN, rotatory after nystagmus, head shaking after nystagmus and visual suppression test. Lesions in the right external medulla, cerebellar vermis, flocculi and fastigial nuclei were presumably responsible for these neurotological findings.抄録全体を表示PDF形式でダウンロード (982K) -
鈴木 幹男, 北野 博也, 北原 正章1988 年 81 巻 4 号 p. 505-508
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーThe number of pure tone audiometric (PTA) tests performed on 334 neurotological patients was investigated in relation to type of disorder, degree of hearing loss and whether hearing loss was unilateral or bilateral.
1) The frequency of PTA testing performed on the 334 patients in the survey ranged from 0.01 to 2.79 times per month.
2) Sudden deafness, bilateral Meniere's disease, and luetic hydrops necessitated particularity frequent PTA testing. In cases of dizziness and tinnitus without hearing loss, however, a small number of tests sufficed. Inpatients needed more frequent testing than outpatients.
3) The necessity for PTA testing increased greatly when the hearing loss was more than 30dB.
4) No significant difference was found between patients with unilateral and bilateral hearing loss except that. Bilateral Meniere's disease required more frequent testing than unilateral.抄録全体を表示PDF形式でダウンロード (482K) -
藤川 憲夫, 北野 博也1988 年 81 巻 4 号 p. 509-514
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーA 48-year-old female patient had sensorineural hearing loss accompanying a brain stem tumor. On her first visit she complained of hearing loss and tinnitus in her left ear. She subsequently developed dizziness, right facial palsy, dysphagia, and crossed sensory disturbance. A brain lesion was suspected, the most likely site being the right brain stem. A CT scan of this region was normal. MRI (Magnetic Resonance Imaging), however, showed a tumor in the suspected area of the right brain stem. This tumor was thought to press upon the patient's left acoustic nerve, causing her left cochlear symptoms. MRI was found to be very effective in the detection of posterior fossa lesions, as it is uninfluenced by bony structures.抄録全体を表示PDF形式でダウンロード (2662K) -
中西 弘, 榎本 雅夫, 寒川 高男1988 年 81 巻 4 号 p. 515-524
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーViral infection seems to be the most common cause of sudden deafness. In the context, thinking that an antiviral agent might be effective against sudden deafness of unknown etiology. We used an antiviral agent, acyclovir, in addition to conventional palliative therapy, to treat 89 patients with sudden deafness of unknown etiology. They were divided into 3 groups, Group A received steroids and acyclovir, Group B acyclovir only, and Group C steroid only. The nonspecific treatments were the same in all three groups. Outpatients received 250mg of acyclovir by i. v, infusion for one hour per day for 7 days, and inpatients received 250mg every 8 hours for 7 days.
Audiometric tests with standard pure sound were performed just before treatment and twice a week during treatment against Herpes simplex virus, Varicella zoster virus, Epstein-Barr virus, Cytomegalovirus and Mumps virus were determined.
The effectiveness of the treatment was evaluated by the following parameters: auditory capacity before treatment, difference of therapeutic effect between inpatients and outpatients, vestibular symptoms, age and sex of patients, tinnitus, and stellate ganglion block. No significant improvement of auditory capacity was found in any of these parameters. We conclude that acyclovir is ineffective against sudden deafness. It seems more important to try to save the damaged cells than to suppress the growth of the virus.抄録全体を表示PDF形式でダウンロード (925K) -
村上 泰, 野村 恭也1988 年 81 巻 4 号 p. 525-534
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーJugular bulb diverticulum which extends into the medial petrous bone is an extremely rare condition. As far as we know, only 8 cases have been reported in the world literature and this is the first report of jugular bulb diverticulum in Japan. Here we document a case of high jugular bulb with jugular bulb diverticulum and discuss the clinical difference between jugular bulb diverticulum and high jugular bulb.
A 58-year-old female first visited Tokyo University Hospital in August, 1986, with the chief complaint of pulsatile tinnitus in her left ear. Physical examination revealed a blue pulsating mass in the posteroinferior quadrant of her left middle ear behind an intact tympanic membrane. Left jugular vein compression markedly increased the blue mass. Polytomography, CT scanning and retrograde jugulography demonstrated a jugular bulb diverticulum behind the internal auditory canal with dehiscence of the posterior bony wall.
An exploratory tympanotomy under general anesthesia confirmed the presence of the high jugular bulb protruding into the tympanic cavity with bony dehiscence of the hypotympanic floor.
Postoperatively, pulsatile tinnitus continued.抄録全体を表示PDF形式でダウンロード (6094K) -
奥谷 文乃, 齋藤 春雄, 浜田 栄幹, 田中 信三, 八木 伸也, 上野 脩幸, 岸 茂, 園部 宏1988 年 81 巻 4 号 p. 535-538
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーAfter sinus surgery, a 34-year-old man was found to have two separate cysts, one in the maxillary sinus and one in the orbit. There was a new bone crest beneath the orbital cyst. The cyst was lined with stratified epithelium and ciliary epithelium. Histologic and operative findings suggested that the intraorbital cyst was a postoperative one sealed off from the postoperative maxillary cyst.抄録全体を表示PDF形式でダウンロード (4097K) -
石川 保之, 川野 通夫, 本庄 巖1988 年 81 巻 4 号 p. 539-543
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーIt has been reported that cleft palate patients often have sinusitis, but the details of their sinusitis are not known. We compared sinusitis in cleft palate patients with that in normal subjects, and we investigated the incidence of sinusitis in cleft palate patients in different age groups and the effect of medical treatment.
1) The incidence of sinusitis in cleft palate patients showed a peak at 3 to 5 years of age and then decreased gradually. After 12 to 14 years of age, the incidence of sinusitis remained constant at 36 to 39%.
2) According to Nakosi's clinical classification of sinusitis, “restricted infection” was more frequent in cleft palate patients than in normal subjects.
3) Twenty six cleft palate patients with sinusitis were followed for more than 6 months.
In the group of 15 treated conservatively, 11 (73.3%) showed improvement. On the other hand, only two (18.2%) of 11 untreated patients showed improvement.抄録全体を表示PDF形式でダウンロード (502K) -
末武 光子, 新川 秀一, 佐々木 豊, 高坂 知節, 沢井 高志1988 年 81 巻 4 号 p. 545-548
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーA 72-year-old-man had had total gastrectomy in 1983 for stage III gastric adenocarcinoma. In October, 1986 dull pain in the right parotid area and facial weakness were noted. Three months later, he was found to have a hard mass approximately 20mm in diameter in the parotid region. Partial parotidectomy was performed Febrary 16, 1987. Histological examination revealed a well-differentiated adenocarcinoma which was identical to the pattern of the gastric cancer.
The clinical features and differential diagnosis of metastatic lesions to the parotid gland are discussed with a review of the literature.抄録全体を表示PDF形式でダウンロード (2642K) -
宇野 欽哉, 小川 晃弘, 小池 聰之1988 年 81 巻 4 号 p. 549-552
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーA rare case of nasopharyngeal cancer associated with dermatomyositis was treated in our department. A 58-year-old woman was found to have a cervical mass, which proved to be a metastatic squamous cell carcinoma. The cervical mass was removed surgically although the primary site was unknown. Seven months later, a nasopharyngeal tumor was discovered to be the primary lesion. Although the radiotherapy and chemotherapy were administered, the patient died of metastases in the lung and liver. During the clinical course, dermatomyositis was diagnosed by an internist because of muscle weakness and skin pigmentation of the extremities. The problems of malignancy associated with dermatomyositis and therapy for cervical metastases from unknown primary cancers are discussed.抄録全体を表示PDF形式でダウンロード (1733K) -
木村 正, 岸本 誠司, 齋藤 春雄, 古川 昌幸1988 年 81 巻 4 号 p. 553-558
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーThis report calls attention to MEN IIB, with special reference to life threatening complications. MEN is classified into three subtypes; Type I, Type IIA, and Type IIB. Type IIB is the rarest, and the present case is the 15th to be reported in the Japanese literature. Thyroid carcinoma, pheochromocytoma, and neuroma are included in this syndrome. As MEN IIB is known to be a complication of medullary carcinoma of the thyroid and as the tumor tends to metastatize aggressively in its early stage, the early diagnosis of MEN JIB is essential. Oral neuroma is usually the initial sign of this type, as in the present case. The authors stress that early detection of oral neuroma and close follow-up by checking the serum calcitonin would save patients with this syndrome. This is the first case to be reported of MEN IIB with hemifacial hypertrophy.抄録全体を表示PDF形式でダウンロード (4044K) -
渋沢 三伸1988 年 81 巻 4 号 p. 559-561
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーAbnormal muscular contraction in the upper neck or pharynx was associated with a globus sensation in two patients. One patient was a 24-year-old male and the other was a 52-year-old female. EMG showed abnormal rhythmic contractions of the geniohyoid muscle in the former case and the cricopharyngeus muscle in the latter. The characteristics of the muscle contractions were similar to those of palatal myoclonus.抄録全体を表示PDF形式でダウンロード (387K) -
―最近の動向―立本 圭吾, 豊田 健司, 安田 範夫, 小宮 精一, 久 育男, 西村 秀夫, 橘 正芳, 水越 治1988 年 81 巻 4 号 p. 563-569
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーWe have recently experienced three cases of the laryngeal tuberculosis. These cases were reported with some discussion.
Case 1: 57-year-old female visited emergently our hospital with complaints of dyspnea, hoarseness and general malaise. In the larynx, large granulomatuos tumor involving superior surface of false vocal fold and epiglottis and adjacent ventricule were found. Dyspnea and general malaise were diagnosed to be caused by miliary tuberculosis. She died 5 days after by disseminated intravascular coagulation (DIC) before initiation of adequate chemotherapy.
Case 2: 56-year-old male presented with 3 month history of slight discomfort in the throat. The patient had been under the care of an interest for several month following an episode of common cold. In the larynx, granulations and ulcerative lesion were found in false vocal fold. These complaints and lesions were much improved by administration of antituberculous agents for about a month.
Case 3: 46-year-old male presented with 4 month history of hoarseness and pain on swallowing. There was no history of previous tuberculosis or contact with an active case of this disease. From epiglottis to aryepiglottic fold, edema and mucosal redness were visible, and granulomas in the false vocal fold and arytenoid were found. After the chemotherapy for tuberculosis, these lesions changed into perichondritis and thickening of mucosa in epiglottis and interarytenoid area with fixation of vocal fold.
From these three cases the following points could be summarized.
1) All cases were bronchogenic infection due to active pulmonary tuberculosis.
2) Although case No. 1 and 2 had been pointed out abnormality in previous chest X-ray, they left them as they were.
3) Granulomatous lesions of larynx responded well to antituberculous chemotherapy except case No. 1.
4) Perichondritic changes were the final findings of laryngeal tuberculosis in all cases.抄録全体を表示PDF形式でダウンロード (5521K) -
田林 徳昭, 八木 伸也, 田辺 正博1988 年 81 巻 4 号 p. 571-575
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーA 22-year-old man complained of pain in swallowing. He had been treated surgically with a colostomy, for Crohn's disease of the ileum and rectum about 18 months earlier. Examination of the histology of the granulation in the larynx demonstrated a giant cell and epitheloid granuloma. On the presumption of the Crohn's disease in the larynx, he was treated conservatively and the lesion almost disappeared on the hundredth day. Only a few reports have been published on Crohn's disease in the larynx. However, we think this disease should not be neglected in the differential diagnosis of laryngeal granulomatous disease.抄録全体を表示PDF形式でダウンロード (4273K) -
稲木 匠子, 丘村 煕, 近森 義則1988 年 81 巻 4 号 p. 577-580
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーUsing a lateral tongue flap, we reconstructed the mesopharynx after excising a tonsillar cancer in a 54-year-old male patient. Speech and deglutition were normal post-operatively. A tongue flap has the advantages of rich vascularity, good movability, excellent elasticity. Moreover, excision of the tumor and reconstruction of mesopharynx can be done in one stage in the same operative field. We emphasize that a tongue flap is one of the useful reconstructive materials in the mesopharyngeal area, especially for conservation of speech and deglutition.抄録全体を表示PDF形式でダウンロード (3801K) -
飯野 ゆき子, 石戸谷 淳一, 鳥山 稔, 菅原 勇, 森 茂郎1988 年 81 巻 4 号 p. 581-586
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーWe carried out immunohistochemical studies of granulation tissue adjacent to the Cholesteatoma sac using both polyclonal antibody against keratin and monoclonal antibodies against lymphocyte subsets. Keratin (debris) was frequently associated with giant cells, macrophages and lymphocytes infiltration, forming a so-called keratin granuloma. In patients with clinically active cholesteatoma, many such keratin granulomas were identified. The lymphocytes surrounding the keratin were mainly T lymphocytes, mostly cytotoxic/suppressor cells. These results suggest that immune responses against keratin (debris) play an important role in the pathogenesis of choles-teatoma and accompanying bone resorption.抄録全体を表示PDF形式でダウンロード (4442K) -
―第3報: in vitroにおけるcisplatin, peplomycin併用療法の作用機序の解析―和田 安弘, 岡 茂, 山下 敏夫, 熊沢 忠躬, 河本 圭司1988 年 81 巻 4 号 p. 587-597
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーThe results of chemotherapy for tumors of the head and neck have been markedly improved since cisplatin was introduced. The synergistic effect of cisplatin and peplomycin has been especially favorable therapeutically. Although clinical experience has favored the use of these two drugs together, basic research has been lacking in an attempt to establish an ideal protocol with cisplatin and peplomycin based on cell kinetics and pharmacokinetics, we investigated in detail the in vitro actions of these drugs, as described in our previous reports. We have here attempted to determine the best schedule of administering peplomycin and cisplatin on the basis of study of pharmacokinetics and survival, using bromodeoxyuridine and fluorescein diacetate techniques. We found that tumor cell survival was the lowest and cytocidal effects were the highest when peplomycin was administered 3 days after cisplatin. The cell kinetics showed an accumulation in the S and G2M stage.
Peplomycin appears to be the most effective when it is given 3 days after cisplatin.抄録全体を表示PDF形式でダウンロード (3635K) -
香取 早苗, 高安 劭次1988 年 81 巻 4 号 p. 599-606
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーWe evaluated the efficacy and safety of long-term administration (4 to 20 months) of Myonal, a muscle relaxant, in 20 patients with cervical vertigo. The efficacy of the agent was 85.0% based on pharmacotherapy standards, and 100% based on clinical findings of complete disappearance of cervical nystagmus (the main objective warning sign) during therapy in all patients. No serious adverse effects were observed during administration, and no recurrence was noted 18 months after cessation of medication. The doses were gradually decreased during the last one or two months of administration to preclude compulsive seizures that might have occurred following the abrupt termination of medication. These findings indicate that Myonal is effective for relieving cervical vertigo, which can become increasingly aggravated with age.抄録全体を表示PDF形式でダウンロード (2113K) -
時田 喬, 瀧本 勲, 梅田 良三, 山下 公一, 田口 喜一郎, 水越 鉄理, 柳田 則之, 馬場 駿吉, 野末 道彦, 斎藤 等, 岩田 ...1988 年 81 巻 4 号 p. 607-621
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーComelian (dilazep dihydrochloride) was used to treat 105 patients with central vertigo due to disturbed cerebral circulation. The dose was 300 mg/day for 8 weeks. These patients were examined before and after 4 and 8 weeks of treatment for subjective symptoms (including vertigo), complications, OD signs, equilibrium function, auditory function, Schellong's response and platelet function.
1. The overall improvement rate was relatively high: 77.3 % and 80.5% after 4 and 8 weeks of treatment, respectively.
2. Adverse reactions occurred in 4 patients: 3.81% aggravation of dizziness, nausea, numbness of hands and lower abdominal pain. However, these symptoms were mild.
3. The rate of efficacy was also high: 76.3% after 4 weeks and 79.3% after 8 weeks of treatment.
4. In 22 patients platelet function was determined, and a positive relationship was observed between suppressed platelet agglutination and clinical efficacy, suggesting that inhibition of platelet agglutination by Comelian may play a role in the improvement of vertigo due to cerebral circulatory failure.抄録全体を表示PDF形式でダウンロード (1472K) -
宮田 英雄, 森岡 保, 鈴木 智雄, 澤井 薫夫, 白戸 弘道, 佐久間 伸二1988 年 81 巻 4 号 p. 623-632
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーSixteen patients with perennial nasal allergy were treated with tranilast combined with histamine γ-globulin conjugate for more than 4 weeks. Improvement was observed in 75% of the patients for sneezing, 71.4% for nasal discharge, 80% for nasal obstruction, 73.3% for swelling of the inferior turbinate, and 80% for the amount of nasal discharge.
The global utility of this combination therapy was rated as “moderate to marked effectiveness” in 56.3% and as “slight to marked effectiveness” in 81.3%. Marked improvement of subjective symptoms was observed with this combination therapy, as compared with the tranilast treatment alone. Stomatitis was noted in 1 case but not severe enough to require discontinuation of the medication.
It was thus concluded that this combination therapy is useful for treatment of perennial nasal allergy.抄録全体を表示PDF形式でダウンロード (964K) -
太田 文彦1988 年 81 巻 4 号 p. 634-635
発行日: 1988/04/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (189K) -
1988 年 81 巻 4 号 p. e1
発行日: 1988年
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (17K)
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