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84 巻, 6 号
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―外耳道形成と聴力改善―増田 游, 渡邊 周一, 服部 謙志1991 年 84 巻 6 号 p. 721-727
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーThe Authors describe 8 years of experience with the surgical management of 31 ears with complete and 6 ears with incomplete congenital aural atresia.
Canaloplasty was performed in 18 ears and tympanoplasty in 19 ears. In this series there were 28 males and 6 females, aged 5 to 44 years at the time of surgery.
Surgical attempts to improve hearing were tried in all 37 ears but failed in 18 because of inability to reach the tympanic cavity by interruption of surgery due to profuse bleeding, leakage of liquor, damage to the capsule of the temporomandibular joint, etc.
The success rate was 27.8% with canaloplasty and 84.2% with tympanoplasty, based on postoperative average hearing levels of 35dB or less for 0.5, 1 and 2kHz. The final success rate with tympanoplasty was 63.2% based on the average hearing levels at the last examination. The average follow-up period was 2.5 years for tympanoplasty cases.
The results led to the following conclusions:
1. Stenosis of the reconstructed external auditory canal was prevented by creation of a canal with at least 1.5 times the normal diameter.
2. The presence of a mobile stapedial footplate results in satisfactory hearing improvement in most cases of middle ear anomaly, especially when tympanoplasty is performed.
3. Lateralization of the reconstructed tympanic membrane is the primary cause of hearing loss following initial improvement.抄録全体を表示PDF形式でダウンロード (3386K) -
隈上 秀伯, 佐々野 利春, 松村 高洋1991 年 84 巻 6 号 p. 728-729
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1676K) -
―側頭骨摘出標本の病理組織学的検討―大平 泰行, 児玉 章, 加我 君孝, 山根 仁1991 年 84 巻 6 号 p. 731-737
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA 48-year-old woman developed middle ear carcinoma after radical mastoidectomy. The left temporal bone was examined after 40Gy of irradiation.
A pathological study of the resected temporal bone revealed necrotic tissue and fibrous tissue in 80% of the middle ear. Carcinoma cells were observed in the tympanic sinus, round window niche, anterior wall of the external auditory meatus, and mastoid cells. Carcinoma was still present in the eustachian tube. Six months after surgery, the patient had a local recurrence. Ten months later, she died after cancer had invaded the brain.
Radiotherapy for middle ear carcinoma cannot be considered radical treatment. Multi-modal treatment, including subtotal temporal bone resection, is more effective than radiotherapy alone.抄録全体を表示PDF形式でダウンロード (5900K) -
―ペットブームへの警鐘―末武 光子, 湯浅 涼, 西條 茂, 欠畑 誠治, 香取 幸夫, 小泉 敦弘, 神谷 晴夫, 稲葉 孝志1991 年 84 巻 6 号 p. 739-742
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA female patient had been suffering from intermittent tinnitus for several days. An otomicroscopic examination revealed a small mite moving on the tympanic membrane. The tinnitus increased when the mite was moving around the pars tensa and disappeared when the mite was moving on the surface of the external ear canal. After removal of the mite, the tinnitus disappeared.
The mite was identified as Otodectes cynotis, which causes ear mange in dogs and cats. The patient had kept a dog and a cat inside her house for one year as pets. Examination of their ears revealed many Otodectes cynotis in the external ear canals. It was assumed that the patient was infected with Otodectes cynotis from those animals. As far as we know, this is the first case to be reported of a mite on the tympanic membrane. It is important to be concerned about parasite infestation from pet animals.抄録全体を表示PDF形式でダウンロード (3348K) -
石川 保之, 藤田 明彦, 本庄 巖1991 年 84 巻 6 号 p. 743-748
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーMucociliary function plays an important role in the defense mechanism of the upper respiratory tract including the middle ear and paranasal sinuses. It has been reported that impaired nasal mucociliary clearance of the nose and nasopharynx may increase the chance of infection through the Eustachian tube.
Nasal mucociliary function was assessed by the saccharin test in 163 patients with OME, otitis media purulenta chronica, otitis media cholesteatomatica, or adhesive otitis media to determine whether it plays any role in the development of chronic middle ear infection. The control group included 67 normal subjects with no history of nasal disease who were assessed as having no nasal disease by rhinoscopic examination.
Significant prolongation of saccharin time was noted in the patients regardless of age or nasal condition. Impaired nasal mucociliary clearance was thought to be due to inflammation of the nasal mucosa or a predisposition to nasal mucociliary dysfunction.抄録全体を表示PDF形式でダウンロード (568K) -
水上 千佳司, 山本 悦生, 大村 正樹, 磯野 道夫, 廣野 喜信1991 年 84 巻 6 号 p. 749-754
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーAmeloblastoma is a common epithelial tumor of dental tissue. Its incidence is high in the mandible and extremely low in the maxilla. A 43-year-old male noted a queer sensation in his left cheek three months prior to the first consultation at our hospital and his left maxilla swelled gradually.
Radiography showed a unilobular transparent bone image with a tooth-like shadow in the center. the tumor continued to grow, so an exploratory operation was performed. The pathological diagnosis of the excised tissue was follicular ameloblastoma. One year after surgery, no recurrence has been observed.
Ameloblastoma may recur, and the best therapy remains contraversial. Primary treatment should be conservative. The patient should be observed for a long time, and if there is any sign of recurrence, radical operation, i.e. maxillectomy, should be considered.抄録全体を表示PDF形式でダウンロード (3766K) -
―ハイドロキシアパタイトでの眼窩底再建―河村 裕二, 松本 康, 泉田 仁美, 城戸 通宗1991 年 84 巻 6 号 p. 755-761
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーTwo patients with broad orbital blowout fractures were treated surgically by the following method. After repair of the orbital floor fractures through a transmaxillary and an orbital approach under general anesthesia, a hydroxyapatite plate was inserted into the maxillary sinus and attached to the orbital floor with human fibrin glue. Furthermore, fixation of the plate was reinforced with a balloon inserted through the counter opening of the maxillary medial wall for about ten days. Satisfactory results were obtained in both cases.
Autogenous bone or alloplastic materials utilized as grafts for reconstruction of blowout fractures have been previously reported, and most of them were inserted into the orbit. It is possible that insertion of the plate into the orbit causes adhesion to intraorbital tissues or that the thickness of the plate results in disturbances of ocular movements. Therefore, the authors conclude that the method described in this paper is useful in the treatment of orbital floor fractures.抄録全体を表示PDF形式でダウンロード (4878K) -
関 敦郎, 岩崎 幸司, 木下 吉史, 武林 悟, 浅井 美洋1991 年 84 巻 6 号 p. 763-767
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA 55-year-old male with chronic sinusitis was treated with sinusectomy. Patient had MRSA infection at the site of operation, and lost the sight of his right eye. Endnasal decompression of the optic canal was performed, but his visual acuity did not show early recovery. Then, we opened both maxillary sinuses again and removed the coating, because fever, cheek pain and headache persisted. Culture of nasal discharge was negative eight weeks after the infection. Visual acuity recovered to 0.3.
We emphasize that careful attention to MRSA infection is important, and accurate curettage and irrigation are necessary to control the infection.抄録全体を表示PDF形式でダウンロード (1723K) -
朝倉 光司, 小島 正, 白崎 英明, 成田 慎一郎, 斉藤 博子, 形浦 昭克1991 年 84 巻 6 号 p. 769-774
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーWe examined immediate-type allergic skin reactions in 113 children with chronic maxillary sinusitis. In 82 children, skin reactions were positive. The profiles of positive antigens (HD 86.6%, Candida 36.6% and Broncasma Berna 26.8%) in children with chronic sinusitis were similar to those in children with simple allergic rhinitis. The group of children with sinusitis and allergy (SA) contained older children than the control group (S: sinusitis without allergy), although the peak age was the same in both groups (5-6 years). oentogenographic examination of maxillary sinuses showed more mucosal hypertrophy in SA patients than in S patients. The frequency of daily sneezing attacks tended to be higher in SA patients than in S patients.抄録全体を表示PDF形式でダウンロード (1896K) -
加藤 昭彦, 高橋 志光, 矢野原 邦生1991 年 84 巻 6 号 p. 775-780
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA 79-year-old male complained of a mass on the left side of his tongue.
A biopsy specimen was diagnosed as verrucous carcinoma, which was considered to be a sub-type of squamous cell carcinoma.
He was treated with preoperative irradiation (30Gy) and adequate surgical resection.
There was no recurrence or anaplastic transformation of the tumor 6 months after therapy.
Adequate surgical resection is recommended as the treatment of choice for verrucous carcinomas of the oral cavity.
For advanced tumors preoperative irradiation appears to be significantly effective.抄録全体を表示PDF形式でダウンロード (4069K) -
中村 雅一, 増田 成夫, 川端 五十鈴1991 年 84 巻 6 号 p. 781-786
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーFive patients were treated for pleomorphic adenoma of the submandibular gland: 2 males and 3 females, aged 24 to 53 years. The tumors were on the right side in 3 cases, on the left in 2. All 5 patients complained of a painless mass in the submandibular lesion. Ultrasound sonography and CT scan were useful in the diagnosis In 3 patients Ga scintigraphy showed abnormal accumulation although the histopathological diagnosis was benign tumor. It was presumed that the proliferating activity is higher in pleomorphic adenomas of the submandibular gland than in those of the parotid gland. All patients were treated surgically.抄録全体を表示PDF形式でダウンロード (2320K) -
大村 正樹, 山本 悦生, 水上 千佳司, 磯野 道夫, 廣野 喜信, 細谷 亮, 細谷 亮, 石川 稔晃, 鈴木 茂彦1991 年 84 巻 6 号 p. 787-792
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーIn a patient with cancer of the hypopharynx and cervical esophagus reconstruction was performed with a free Sigmoid colon autograft. The feeding vessels of this autograft were anastomosed by microvascular surgery. A reconstructed esophagus made from a free Sigmoid colon has less peristalsis than one from a free jejunum. Therefore, our patient did not have swallowing difficulties after the beginning of oral feeding 2 weeks after operation. From this aspect, Sigmoid colon autografts seem to be better than jejunum autografts in the reconstruction Qf the hypopharynx and cervical esophagus.抄録全体を表示PDF形式でダウンロード (4565K) -
林 秀俊, 山際 幹和, 坂倉 康夫, 川口 信也, 鈴村 栄久, 真弓 広子, 久保 将彦1991 年 84 巻 6 号 p. 793-801
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA clinical study was conducted on a consecutive series of 147 patients with laryngeal cancer treated at the Department of Otorhinolaryngology, Mie University Hospital, during the 9 years from 1981 to 1989.
1. There were 138 males and 9 females with a ratio of 15:1. Most of the patient (87.8%) were 50 to 70 years of age.
2. According to the TNM classification of malignant tumors proposed by the UICC (1987), there were 85 (57.8%) glottic tumors, 47 (32.0%) supraglottic, 5 (3.4%) subglottic and 10 (6.8%) without a distinguishable site of origin (transglottic).
3. The rates of recurrence after initial treatment were 10.9%, 20.9%, 31.0% and 27.3% for T1, T2, T3 and T4 patients, respectively.
4. The presence or absence of lymphnode metastasis during the period of initial treatment showed no correlation with either later recurrence or later distant metastasis.
5. Analysis by Kaplan-Meier's method showed 5-year survival retes of 80% for glottic, 55% for supraglottic, 69% for subglottic and 62% for transglottic tumors. The overall 5-year survival rate was 62%.抄録全体を表示PDF形式でダウンロード (885K) -
―第2報―緒方 洋一, 関谷 透, 野口 高昭, 増満 洋一, 下郡 博明, 岡崎 英紀1991 年 84 巻 6 号 p. 803-808
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーIn order to obtain ultrasonic clues for the differential diagnosis of tumors, we evaluated the internal echo histograms of 23 cases with head and neck tumors (14 malignant and 9 benign) with respect to standard deviation (SD) of the echo level and width of the histograms at 0%, 25%, 50%, 75% frequency.
1) The average SD of the echo level of the malignant tumors was 8.2, which was significantly greater than that of the benign tumors (p<0.01).
2) An analysis of the width of the histograms showed three patterns: bell type with wide base and sides for the malignant tumors, mountain type with a wide base for the benign tumors and mountain type with a narrow base for normal tissue.
It was concluded that we can obtain objectively significant ultrasonic information from the SD of echo levels and the width of histograms for the differential diagnosis between benign and malignant tumors of the head and neck.抄録全体を表示PDF形式でダウンロード (1540K) -
西川 益利, 西川 恵子1991 年 84 巻 6 号 p. 809-812
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーA 29-year-old man had myxofibromas of the hard palate, lips, axillas, thigh, scrotum and anus. The tumors of the hard palate, thigh and scrotum were large and pendulous. A search of the literature showed that no such extensive myxofibromas had ever been reported.抄録全体を表示PDF形式でダウンロード (2946K) -
竹内 和郎1991 年 84 巻 6 号 p. 813-823
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーRecently medial high jugular bulb, which is an anomaly of the jugular vein protruding into the posterior wall of the internal auditory canal, is believed to cause clinical symptoms, such as sensorineural hearing loss, tinnitus and Meniere's disease. Several articles have discussed this hypothesis on the basis of computed tomography findings. We used computed tomography to examine 188 patients and reviewed serial horizontal sections of 293 temporal bones from patients aged 3 to 85 years.
Medial high jugular bulbs were classified into 3 types according to the position: Type I (below the round window niche); Type II (between the round window niche and the floor of the internal auditory canal); Type III (above the floor of the internal auditory canal). Type II and Type III are considered to be clinical medial high jugular bulb.
The following analyses were performed: frequency, side (right or left), diameter of the internal auditory canal and vestibular aqueduct, degree of development of periaqueductal pneumatization. We also correlated medial high jugular bulb and clinical symptoms.
1) Medial high jugular bulb (Type II, Type III) was observed in 32.2% of CT scans and in 14.3% of temporal bones.
2) In temporal bones, Type II was more often seen on the right side and Type III on the left side, but in CT scans both types were more often seen on the right.
3) Among the three types, there was no significant difference in the diameter of the internal auditory canal and vestibular aqueduct.
4) The degree of development of the periaqueductal pneumatization seemed to correlate with the height of the medial high jugular bulb.
5) Stenosis of the internal auditory canal and bony dehiscence of the vestibular aqueduct were seen in some Type II as well as Type III patients.
6) There is a possibility that medial high jugular bulb causes some clinical otologic symptoms.抄録全体を表示PDF形式でダウンロード (6379K) -
―香川県多施設共同臨床研究成績―木村 守, 酒井 俊一, 渡辺 泰樹, 岸本 浩之, 渡邊 周一, 深沢 元晴, 藤沢 成人, 真鍋 敏毅, 金滝 育子1991 年 84 巻 6 号 p. 825-835
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーAzeptin® was administered to 48 patients with perennial allergic rhinitis for prolonged periods to determine its efficacy and safety.
1) The rate of improvement, as determined by a final general improvement rating, was 60.5% when “moderately improved” or better evaluations were included. The rate of usefulness was 66.0% when “moderately or more useful” evaluations were included.
2) The rate of improvement, as determined by a general improvement rating for subjective symptoms, was 61.4% when “moderately improved” or better evaluations were included. The rate of disappearance was high for sneezing (82.2%), nasal discharge (66.7%), and nasal obstruction (46.7%).
3) The rate of improvement, as determined by a general improvement rating for objective symptoms, was 56.8% when “moderately improved” or better evaluations were included.
4) The side effect elicited in this study was mild sleepiness which was experienced by one patient. This symptom disappeared without any particular procedure, although the drug was continued.
In conclusion, Azeptin®, even when administered for extended periods of time, can maintain its beneficial effect on perennial allergic rhinitis, with safety as evidenced by only mild side effects. It is concluded that Azeptin® is a very useful drug.抄録全体を表示PDF形式でダウンロード (1017K) -
山際 幹和, 原田 輝彦, 坂倉 康夫1991 年 84 巻 6 号 p. 837-851
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーWithout following the traditional diagnostic procedure based on oriental medicine, we administered an oral Kampo (traditional Chinese herbal) medicine, Tsumura Saiboku-to (7.5g/day), daily for 2 weeks to 108 patients with abnormal sensation in the throat, such as a lump or choking.
After excluding 8 patients, 4 with unpleasant side effects and 4 who discontinued the medication, we evaluated the efficacy at the end of the first and second week of administration and one week after the termination of treatment in 38 males and 62 females. The medicine was considered to be very effective when the abnormal sensation improved subjectively by 80% or more, moderately effective if improvement was 50% to 80%, slightly effective if it was 30% to 50% and not effective if less than 300.
The respective effectiveness rates were 22%, 32%, 11% and 35% at the end of the first week; and 35%, 33%, 12% and 20% at the end of the second weed; and 43%, 30%, 7% and 20% at the end of the third week. Further analysis of the data suggests that this medicine is more effective for females than males, for younger patients and those over 50, for non-drinking than habitually drinking patients, for those not previously treated, for those without cancer phobia, for those treated within one month after the start of abnormal sensation, for those with the sensation higher in the pharynx, and for those with lower neurotic scores on psychological tests.
Side effects were reported by 6 (6%), 4 of whom stopped the medication: 4 had gastrointestinal symptoms and 2 had dry mouth and/or throat.
From the point of view of western medicine, the effectiveness of Saiboku-to on abnormal sensation in the throat is good enough. It would probably be even better if administered after a selection based on diagnosis according to the concepts of oriental medicine.抄録全体を表示PDF形式でダウンロード (1704K) -
入船 盛弘, 荻野 仁, 松永 亨, 田矢 直三, 金 聖眞, 石田 稔, 藤井 隆, 馬谷 克則, 吉野 邦俊, 野入 輝久, 浅井 英世 ...1991 年 84 巻 6 号 p. 853-861
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーWe investigated cefepime, a newly developed parenteral cephem antibiotic, in the treatment of otorhinolaryngological infections. Cefepime was injected intravenously in a total of 26 patients, 1.0g-2.0g for 2-8 days. The infections were otitis media 4, paranasal sinusitis 6, tonsillitis 13, other infections 3.
The clinical response was excellent in 6, good in 14, fair in 5, no response in 1. The efficacy rate (excellent + good) was 80.0%. Especially in tonsillitis, the efficacy rate was very high (100%). The efficacy rate was higher for acute than for chronic infections.
Of a total of 29 cultured bacteria, 24 were eliminated. The eradication rate was 92.3% excluding 3 strains whose bacteriological response was unknown. The eradication rate was over 90% for gram positive and gram negative bacteria.
The tissue levels of cefepime were higher in the maxillary sinus mucosa than in the palatine tonsil.抄録全体を表示PDF形式でダウンロード (763K) -
野田 寛, 宇良 政治1991 年 84 巻 6 号 p. 862-863
発行日: 1991/06/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (319K) -
1991 年 84 巻 6 号 p. e1
発行日: 1991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 (30K)
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