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84 巻, 7 号
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―はじめに―戸川 清1991 年 84 巻 7 号 p. 865-866
発行日: 1991/07/01
公開日: 2011/11/04
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垣鍔 典也, 高橋 宏明1991 年 84 巻 7 号 p. 866-870
発行日: 1991/07/01
公開日: 2011/11/04
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山川 浩治, 宮崎 総一郎, 戸川 清1991 年 84 巻 7 号 p. 870-874
発行日: 1991/07/01
公開日: 2011/11/04
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石田 達也, 小池 靖夫1991 年 84 巻 7 号 p. 874-879
発行日: 1991/07/01
公開日: 2011/11/04
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朝倉 光司, 形浦 昭克1991 年 84 巻 7 号 p. 880-882
発行日: 1991/07/01
公開日: 2011/11/04
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舩坂 宗太郎1991 年 84 巻 7 号 p. 884-885
発行日: 1991/07/01
公開日: 2011/11/04
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一條 宏明, 朴沢 二郎, 新川 秀一, 富永 健1991 年 84 巻 7 号 p. 887-894
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーFive patients with typical manifestations of vestibular neuronitis were examined repeatedly for spontaneous nystagmus, positional nystagmus, caloric responses and Contraves rotation test results determined by electronystagmography.
1) Spontaneous nystagmus was observed for more than 2 months. The duration of spontaneous nystagmus in patients with vestibular neuronitis was longer than patients in those with other acute vestibular disorders.
2) No patient showed direction-changing positional nystagmus, but in 2 cases, nystagmus amplitude was increased in the supine healthy-ear-downn position.
3) Four of 5 patients showed no caloric reaction on the affected side in the early stage of the disease; however, at the follow-up examination after several months, all patients showed reappearance of the caloric responses.
4) In the rotation test, all patients showed directional preponderance to the healthy side, but the “recruitment type”, which is observed exclusively in disturbances of the vestibular organ, was not observed in any patient.
5) It was thought that vestibular neuronitis represented a neuropathy due to a viral infection, such as varicella zoster or herpes simplex.抄録全体を表示PDF形式でダウンロード (835K) -
鈴木 衛, 平田 思, 松島 隆浩, 小野 邦彦, 渡部 雄二, 平川 勝洋, 多田 渉, 西田 功, 佐藤 孝至, 原田 康夫1991 年 84 巻 7 号 p. 895-900
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーThe clinical features and postoperative course of 104 cases of cholesteatoma were analyzed statistically. Cholesteatoma was categorized as PF (pars flaccida), PSQ (posterosuperior quadrant) or central type. One stage surgery was performed on 44 ears (57.7%) of the PF type and on 16 ears of the PSQ type (61.5%). Canal wall-up operation was performed on 37 ears of the PF (48.7%) and 15 ears of the PSQ type (57.7%). Only 16 ears underwent canal down operations. Columella III type tympanoplasty was most frequently (37.5%) performed for ossicular chain reconstruction. The overall rate of improvement of hearing was 63.2%. Postoperatively 44.7% of the patients showed abnormal appearance of the ear drum, such as retraction pocket, adhesions or otorrhea. Recurrent cholesteatoma occurred in 17 ears of the PF type and in 2 ears of the PSQtype. Cholesteatomas extending from the aditus through the mastoid cavity showed a high rate of recurrence. Residual cholesteatoma was found in 21.4% of all ears. In general, ears without otorrhea.had better postoperative hearing than wet ears. The incidence of recurrence was especially high in wet ears of the PF type.抄録全体を表示PDF形式でダウンロード (686K) -
―術後1年目における検討―棉源 廉孝, 小林 謙, 佐久間 辛子, 石田 祐子, 浜田 慎二, 上村 敏夫, 神尾 友和1991 年 84 巻 7 号 p. 901-905
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーSpeech reception thresholds were analyzed in 71 patients with chronic otitis media one month before and after and one year after typmpanoplasty. Bone conduction thresholds of all the subjects were within the normal range.
In 19% of the subjects improvement in the reception threshold was observed one month and one year after the operation. The air conduction threshold was also markedly improved after both one month and one year.
In 12% of the subjects the speech reception threshold improved after on month, but one year later the threshold had reverted to the pre-operation level. The air conduction threshold was improved after one month, but after one year it was in the low frequency zone.
In 17% of the subjects the speech reception threshold remained the same after one month but had improved by one year after surgery. The air conduction threshold also showed no significant change after one month but was improved after one year.
In 33% of the subjects no significant change was noted in the speech reception threshold either one month or one year after the operation. The air conduction threshold the same.
The results suggest that it is too early to judge the improvement of the speech reception threshold one month after tympanoplasty. Therefore, speech audiometry should be carried out one year after tympanoplasty.
In several cases the changes in the air conduction threshold and those in the speech reception threshold were different. Accordingly, pure tone audiometry and speech audiometry are considered necessary to evaluate hearing after tympanoplasty.抄録全体を表示PDF形式でダウンロード (495K) -
屋鋪 豊, 岩永 迪孝, 酒井 豊彦, 玉木 久信, 森 弘1991 年 84 巻 7 号 p. 907-911
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーEighty-eight patients had type N tympanoplasty with ossicular reconstruction. The procedure was classified as successful when the postoperative hearing level met at least one of these three conditions: 1) a hearing level above 40 dB, 2) a gain of more than 15 dB, or 3) an air-bone gap of less than 20 dB.
Success was obtained in 55 (63%) of the 88 patients.
In 39, a cartilage plate was placed on the CORP head to prevent extrusion, and the success rate was 77% in these patients.
For staged operations to treat chronic otitis media with cholesteatoma, the success rate was 76%.抄録全体を表示PDF形式でダウンロード (560K) -
澤井 薫夫, 鈴木 智雄, 大野 通敏, 藤宮 大, 下川 邦泰1991 年 84 巻 7 号 p. 913-917
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーNon-ossifying fibroma is relatively common in long bones, but is very rare in the head and neck. The patient was a 52-year-old man who had had gradually increasing left hearing loss for several years. He consulted a doctor because of headache. CT scan revealed an abnormal shadow in the middle fossa of the brain. Curettage was performed by neurosurgeons through the middle cranial fossa. He was referred to our department because of left hearing loss. The left external auditory meatus was filled with tumor. A pure tone audiogram showed mixed-type hearing loss. Roentgenography showed a sharply delineated, radiolucent lesion with a sclerotic border. Curettage of the tumor which occupied the external canal was performed. The histopathologic diagnosis was non-ossifying fibroma of the temporal bone. Hearing improved by 20 dB postoperatively.抄録全体を表示PDF形式でダウンロード (3479K) -
―第18報: 鼻粘膜血行動態の検討―菊守 寛, 野瀬 道宏, 入船 盛弘, 荻野 敏1991 年 84 巻 7 号 p. 919-925
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーAlthough nasal mucosal hemodynamics in nasal allergy has been studied by various methods, it is still obscure. Using a tissue spectrum analyzer, we measured ISO2 and IHb in the nasal mucosa of patients with nasal allergy. ISO2 and IHbindicate O2 saturation in hemoglobin and tissue blood volume, respectively.
i) In general, little difference in ISO2 or IHb was found beween patients with symptoms and patients without symptoms.
ii) IHb in patients with perennial nasal allergy seemed to decrease when they had symptoms. On the other hand, IHb in patients with seasonal nasal allergy seemed to increase when they had symptoms.
iii) In three patients with Japanese cedar pollinosis, IHb was increased during the season and was decreased at other times.抄録全体を表示PDF形式でダウンロード (2437K) -
片桐 聡, 村上 匡孝, 松岡 秀樹, 日向 美知, 後藤 達也1991 年 84 巻 7 号 p. 927-933
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーA 76-year-old man with multiple metastases despite surgical treatment and chemotherapy with PAV and DAV was given HuINF-R by intravenous drip infusion, but the melanoma did not respond. A 56-year-old man who had been treated with combination therapy with surgery, chemotherapy (DAV) and HuINF-β, was given HuINF-β by local injection preoperatively and postoperatively. He has since been receiving injections as an outpatient, with no side effects. No recurrence has been noted ll months after surgery.抄録全体を表示PDF形式でダウンロード (4174K) -
河北 誠二, 稲木 匠子, 有友 宏, 柳原 尚明, 丘村 煕1991 年 84 巻 7 号 p. 935-944
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーA 60-year-old man with diabetes mellitus visited our clinic with complaints of lowgrade fever, headache, left cheek pain and left periorbital edema on September 13, 1988. Left paranasal sinusitis was found. Left peripheral facial palsy started on September 20. A left probe maxillotomy was performed on September 21. The specimen of maxillary mucosa was consistent with a diagnosis of mucormycosis. Sinusitis was temporarily improved by surgery and local irrigation with amphotericin B, but facial palsy persisted. Left mastoiditis was disclosed by high resolution CT on November 18. He received left frontal, ethmoidal and maxillary sinus debridement and left mastoidectomy on December 7. The vertical segment of the facial nerve was necrotic due to severe inflammation and was resected during the mastoidectomy. Hyphae of mucor were not found in the specimens of mastoid mucosa and facial nerve, but the severity of the inflammation seen in the operative and histological findings suggested that the mastoiditis and the facial neuritis might have been caused by mucormycosis. After the surgical debridement, left sinusitis and mastoiditis were controlled with 6 months of intravenous amphotericin B therapy combined with flucytosine. The authors discuss the management of peripheral facial palsy and em-phasize the importance of combined surgical treatment and antifungal chemotherapy.抄録全体を表示PDF形式でダウンロード (7102K) -
蔦 佳尚, 上川 保廣, 友田 幸一, 野添 恒幹, 古川 恵造1991 年 84 巻 7 号 p. 945-951
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーTwenty-four patients with paranasal cysts which accompanied by orbital complications were treated in our hospital from July 1986 to August 1990. A retrospective study of all 24 included the following items: sex, age, location of cyst, past history of paranasal operation, orbital complications, interval between last operation and appearance of orbital complications, accuracy of diagnosis by X-ray. A determined study was made of 7 patients with visual disturbances (6 lost their sight completely), and the relationship between the interval from the onset of the visual disorder and the operation and the outcome was studied. The time from the onset of visual disturbance to the operation and from the onset of blindness to the operation were 2.1 days and 16.7 hours respectively, in 3 patients with a good outcome, and 5.0 days and 62.7 hours, respectively, in 3 patients with a poor outcome. Thus, it is important to operate on cysts accompanied by visual disturbances as soon as they are diagnosed.抄録全体を表示PDF形式でダウンロード (805K) -
久保 武, 梅本 匡則, 坂田 義治, 川嵜 良明, 松永 亨1991 年 84 巻 7 号 p. 953-958
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーA 53-year-old woman, visited us complaining of unilateral visual disturbance (visual acuity was 0.06) and ocular motor palsy on the contralateral side. Numbness of the face, ocular pain and headache were her other major symptoms. CT and MRI showed mucosal thickening of the right sphenoidal sinus. Angiography revealed absence of contrast medium inside the left cavernous sinus. The sphenoid sinus was opened and inspected by endoscopic endonasal surgery. All ocular complications disappeared within 17 days after the operation. It was concluded that unilateral sphenoidal sinusitis caused ipsilateral optic neuritis and contralateral cavernous sinus symptoms presumably due to sinus thrombosis.抄録全体を表示PDF形式でダウンロード (2819K) -
坂本 守, 荒木 伸彦, 小川 明, 石川 義麿1991 年 84 巻 7 号 p. 959-962
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーA 63-year-old female complained of a painful parotid mass and facial palsy. Malignant parotid gland tumor was suspected, so a resection was performed. The histological diagnosis was tuberculosis.
Parotid tuberculosis with facial palsy is very rare, only two cases have been reported in Japan.抄録全体を表示PDF形式でダウンロード (2291K) -
森 繁人, 斎藤 等, 藤枝 重治, 野田 一郎, 山田 武千代, 吉田 幸夫1991 年 84 巻 7 号 p. 963-967
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーIt is known that lip cancer is rarer in the Japanese than in the Europeans and Americans. When we treat lip cancer surgically, it is important to reconstruct the lip preserving its function and appearance.
We recently treated an 82-year-old male with cancer of the lower lip (T2NOMO) and immediately reconstructed the defect by a modification of Bernard's method, obtaining good cosmetic and functional results. He is free of tumor 17 months postoperatively.抄録全体を表示PDF形式でダウンロード (2122K) -
酒巻 牧子, 安岡 義人, 吉見 富夫, 川島 理, 亀井 民雄, 中里 洋一1991 年 84 巻 7 号 p. 969-974
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーIn some patients with cleft palate (CP), velopharyngeal insufficiency persists after palatoplasty. In order to determine whether such insufficiency is due to the pathological changes of the levator veli palatini (LVP) muscle, we examined histologically the LVP muscles of 35 patients with CP and of six control patients with congenital microtia. Electromyographic records were obtained of the LVP muscles of 12 patients with CP after palatoplasty.
The muscle structures were well preserved in seven of 35 patients with CP. Among the other 28 patients, perimysial fibrosis was observed in 13, variations in fiber caliber in seven and internal nuclei in one, but these findings were also observed in the control group. The incidence of each finding was not significantly different between the two groups. Electromyography revealed the mean action potential during phonation of the sound “ah” to be 825 μV. Effective elevation of the soft palate was correlated with neither the histology nor the action potential of the LVP muscle.
Therefore velopharyngeal insufficiency persisting after palatoplasty is considered not to be due to pathological changes in the LVP muscle.抄録全体を表示PDF形式でダウンロード (3179K) -
八木 正人, 立本 圭吾, 安由 範夫, 村上 泰1991 年 84 巻 7 号 p. 975-980
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーLingual thyroids are fairly common among ectopic thyroids. However, carcinoma arising in a lingual thyroid appears to be extremely rare. In this paper, a case of follicular carcinoma of the lingual thyroid is reported, and the clinical and pathological features are reviewd.
34-year-old female, who had been treated for 3-years with gonadotropic hormone, developed bloody saliva and a mass at the base of the tongue.
Thyroid scintigraphy and histological examination led to a diagnosis of follicular carcinoma arising in a lingual thyroid. It was removed via lateral pharyngotomy. The patient continues to be well 2 years after operation.抄録全体を表示PDF形式でダウンロード (4893K) -
高橋 志光, 加藤 昭彦, 矢野原 邦生1991 年 84 巻 7 号 p. 981-986
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーA statistical investigation was carried out on 30 patients with throat paresthesia treated with surgical resection of thyroid tumor. There were 3 men and 27 women, most of them between 40 and 49 years of age, who complained of pain and constriction of the throat. The reduction of throat paresthesia was closely related to the interval since thyroid surgery but not to any other factors.抄録全体を表示PDF形式でダウンロード (541K) -
大村 正樹, 山本 悦生, 磯野 道夫, 廣野 喜信, 水上 千佳司, 稲田 由紀, 船曵 和雄, 田辺 牧人, 石原 隆, 服部 尚樹, ...1991 年 84 巻 7 号 p. 987-992
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーIn a series of 43 patients with differentiated carcinomas of the thyroid who were treated with total thyroidectomy during the past 2 years in Kobe City General Hospital, 5 with papillary carcinoma and 1 with follicular carcinoma had distant metastases. There was no particular relationship between the distant metastasis and the number of metastatic cervical lymph nodes. On the other hand, the number of metastases was high in the jugular chain in patients with distant metastases. Therefore, total thyroidectomy is recommended in patients with jugular chain metastases.抄録全体を表示PDF形式でダウンロード (1956K) -
河野 淳, 吉田 知之, 初鹿 信一, 寺田 俊昌, 渡部 一雄, 舩坂 宗太郎1991 年 84 巻 7 号 p. 993-999
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーWe treated a 21-year-old woman with malignant rhabdoid tumor on the left side of the neck.
Malignant rhabdoid tumors of the kidney are common in young children and are rarely seen in extrarenal regions. Histologically, the tumor cells have abundant acidophilic cytoplasm occasionally containing peculiar hyaline inclusion bodies. Ultrastructually, intracytoplasmic inclusion bodies were observed with whorls of interlacing bundles of
intermediate filaments.
The patient was treated with chemotherapy and radiation following surgery. However, several bilateral pulmonary metastases and pulmonary effusion appeared, and she died within 10 months after the first sympton: slight numbness of the left shoulder and arm.抄録全体を表示PDF形式でダウンロード (6817K) -
荻野 敏, 阿部 能之, 入船 盛弘, 原田 保, 松永 亨1991 年 84 巻 7 号 p. 1001-1007
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーThe etiology of nasal polyps is obscure. Many factors are involved, but it is thought that allergy and inflammation are the most important factors. Histamine (HA) is related not only to allergy but also to inflammation. Therefore, in this study we examined histamine metabolism in nasal polyps.
HA is synthesized from histidine by histidine decarboxylase (HDC), and is degraded by two enzymes: diamine oxydase (histaminase, DAO) and histamine-N-methyl transferase (HMT).
The HA content in AIP (aspirin-induced asthma with associated polyps) was significantly lower than in other polyps. In nasal polyps, HMT was the main enzyme causing degradation. HMT activity was 10 to 200 times higher than DAO activity. HDC activity was not significantly different in several nasal tissues. HMT activity was higher in AIP than in other polyps. These results suggest that histamine metabolism in AIP is more active than in other polyps and that histamine may be related to the pathogenesis of AIP.抄録全体を表示PDF形式でダウンロード (683K) -
豊嶋 勝, 小林 俊光, 高坂 知節, 末武 光子, 湯浅 涼, 荒井 英爾, 沖津 卓二, 遠藤 里見, 鈴木 茂1991 年 84 巻 7 号 p. 1009-1016
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーThe effectiveness of ofloxacin in the prevention of infection after middle ear surgery was studied in a series of patients treated in our clinics. This series consisted of 71 patients: 58 with simple chronic otitis media, 6 with cholesteatoma otitis media, 2 with adhesive otitis media, 1 with otoscleroris and 4 previously operated patients.
Ofloxacin was administered orally in a does of 600mg a day at least 3 days preoperatively and 7 days postoperatively.
1) The clinical efficacy rate was found to be as high as 91.5%, which is comparable to the rate obtained by intravenous antibiotics such as penicillins and cephems.
2) Three patients (4.2%) reported side effects (1 nausea, 1 diarrhea and 1 stomach discomfort), but these disappeared after cessation of the drug.
3) Oral administration of ofloxacin was welcomed by both patients and nurses because it is painless and inexpensive.
It was concluded that ofloxacin is useful in preventing postoperative infection in middle ear surgery.抄録全体を表示PDF形式でダウンロード (746K) -
由嬉 一郎, 石山 哲也, 後藤 昭信, 和田 清, 窪田 志功, 河原 由和夫, 谷内 山仁, 高木 範男, 武居 哲也, 奥平 信正1991 年 84 巻 7 号 p. 1017-1025
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーCefteram pivoxil was used to treat otorhinolaryngological infections, and the following results were obtained:
1) Clinical efficacy was excellent in 32 patients, good in 38, fair in 16 and poor in 6: 76.1% showed a good or excellent response.
2) Bacteriological examinations showed that 25 strains were eradicated, 1 was decreased in number, 1 was replaced by other species, 3 were not effected and 4 could not be identified. The final total eradication rate was 86.7%.
3) Adverse reactions: 1 patient had nausea and vomiting and 1 had a drug rash.
4) These results suggest that cefteram pivoxil is very useful in the treatment of otorhinolaryngological infections.抄録全体を表示PDF形式でダウンロード (799K) -
―ボツリヌストキシンによる治療―小林 武夫1991 年 84 巻 7 号 p. 1026-1027
発行日: 1991/07/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1821K)
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