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86 巻, 8 号
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市川 銀一郎1993 年 86 巻 8 号 p. 1077-1085
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーMany of components of the auditory evoked potentials (AEPs) recorded from the vertex have been described. AEPs have been subdivided into three responses according to their latency and partly to the generator: auditory brainstem responses, middle latency responses and slow vertex responses.
Conventionally, these three responses were recorded at different analysis times and recording parameters. Eventually, they were recorded separately with the use of linear time axis.
An attemt was made in this study to record these vertex-potentials on the same time axis simultaneously and successively with the use of a logarithmic time axis. The logarithmic transformation of the time axis makes it possible to identify the relationship of the three responses. This method of recording provides more detail and precise information concerning neurophysiological and neuroclinical events, including neural hearing impairment. In another experiments, keeping the initial 10 msec of the time axis linear made it possible to record the fast components of ABR without distortion.
The replacement of ABR to EcochG was attempted at the initial 2-3 msec from the onset of the time-sweep with the hope that more sophisticated recording methods can demonstrate electrophysiological events from the inner ear to the central auditory pathway.抄録全体を表示PDF形式でダウンロード (879K) -
森田 守1993 年 86 巻 8 号 p. 1086-1087
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1477K) -
宇野 研吾, 蓑田 涼生1993 年 86 巻 8 号 p. 1089-1093
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーA 61-year-old man with HTLV-1 associated myelopathy (HAM) complained of vertigo and unilateral hearing loss in the right ear.
On our first examination, the patient showed right sensorineural hearing loss and right canal paresis without nystagmus. Sensorineural hearing loss progressed slowly and eventually became bilateral, and various types of nystagmus developed. Direction-changing apogeotropic positional nystagmus and rebound positional nystagmus showed cerebellar involvement, and direction-fixed horizontal rotatory nystagmus and direction-changing rotatory positionl nystagmus showed peripheral vestibular involvement.
These findings suggested that HAM involved not only the spinal cord but also the cerebellum, as considered previously. We suspected that HAM had also damaged the peripheral vestibular organs.抄録全体を表示PDF形式でダウンロード (540K) -
小山内 龍一1993 年 86 巻 8 号 p. 1095-1100
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーA 31-year-old female with oculocutaneous albinism presented with congenital nystagmus and positional nystagmus of the benign paroxysmal type. The patient had had abnormal ocular movements since 4 years of age. She developed severe vertigo when she moved her head 7 days before she visited our hospital. Stenger's head positioning test elicited pure rotatory nystagmus accompanied by vertigo. A horizontal pendular eye movement of about 1° width and 4Hz frequency was observed continuously at any eye or head position; its width was smallest when she gazed up about 10° to the right electronystagmography (ENG) disclosed that this pendular eye movement was weaker with the eyes open in darkness and was absent with the eyes closed. ENG also disclosed saccadic pursuit, poor optokinetic nystagmus and very weak caloric nystagmus. The characteristics of the horizontal eye movements were compatible with congenital nystagmus. Neurological findings, other than eye movements, blood and urine analyses, auditory brainstem response, visually evoked potential and NMR-CT study of the brain were normal.
Congenital nystagmus is a very common symptom in patients with albinism and it usually is not accompanied by vertigo. The pure rotatory nystagmus observed on head positioning in this patient was thought to be “positional nystagmus of benign paroxysmal type” or positional nystagmus of peripheral vestibular origin. A pure tone audiogram showed about 20 to 30dB bilateral sensori-neural hearing loss at 4 and 8kHz. These findings could be due to fragility of the inner ear of albino patients.抄録全体を表示PDF形式でダウンロード (2053K) -
浅井 美洋, 梅村 和夫, 野末 道彦, 安原 秋夫, 関 敦郎, 岩渕 史郎1993 年 86 巻 8 号 p. 1101-1107
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーSubjective disability in activities of daily living was surveyed with a questionnaire to 59 patients with non-acute vertigo or imbalance (mean age, 60.0 years, vertigo group) and to 102 patients without vertigo problems (mean age, 67.7 years, control group), who visited the otolaryngology outpatient clinic.
1) Multivariate analysis showed that vertigo and advanced age were disadvantageous factors, which tended to worsen subjective disability in activities of daily living, while having a steady job was a positive factor, which tended to maintain the ability to perform activities of daily living.
2) The subjective disabilities in quick head positioning and walking on a rough road were statistically significant in the discriminant analysis between the vertigo group and the control group.
3) The subjective difficulty in going down stairs without touching rail or wall and walking on a rough road was greater in patients with vertigo of central origin. On the other hand, the difficulty of turning quickly while walking was greater in patients with vertigo of peripheral origin.
4) These results suggest that investigations of subjective disabilities in daily living might provide useful information for the diagnosis and therapy of balance disorders, and also help in determining safety factors for patients with vertigo.抄録全体を表示PDF形式でダウンロード (809K) -
平田 義成, 暁 清文1993 年 86 巻 8 号 p. 1109-1112
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーTympanograms of otosclerosis were studied in 27 patients in order to evaluate the pathognomonic reliability of the test. The results were analyzed according to Jerger's classification of tympanograms. Type As in which the compliance of the tympanogram was below 0.23ml was recognized in 11 ears (37%). Type Ad with compliance over 1.22ml was observed in 6 ears (20%) and type A with compliance between 0.23 and 1.22ml in 13 ears (43%).
The reason that the 63% of tympanograms in these patients were not type As is probably a thin tympanic membrane or a loose incudo-stapedial joint, presumably due partly to frequent air inflation therapy.抄録全体を表示PDF形式でダウンロード (509K) -
羽熊 直行, 田中 誠史1993 年 86 巻 8 号 p. 1113-1119
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーFour types of investigation of the causes of diffuse otitis externa revealed the following:
1) Bacteriological examinations of 54 patients (54 ears) with diffuse otitis externa with effusion showed 53 strains of bacteria in 47 ears: Staphylococcus aureus in 29 ears (62%), Pseudomonas aeruginosa in 8 ears (17%) and multiple drug resistant Staphylococcus aureus in 2 ears (4%).
These results confirmed the importance of bacteriological examinations.
2) Bacteriological examinations of 7 other patients with unilateral diffuse otitis externa revealed Staphylococcus epidermis in 4 of the 7 normal ears and in only one ear of the infected ears.
In general, Staphylococcus epidermis is thought to play a protective role. These results indicate that removal of Staphylococcus epidermis by excessive cleaning of the external ear canal is not recommended.
3) The incidence of diffuse otitis externa was high in summer and early fall: 46 cases in July, 76 in August, 62 in September and 48 in October.
It was found that scratching of the external ear canal after the onset of the disease may worsen the symptoms.
4) The anterior inferior meatal recess was proved to be deeper in patients with diffuse otitis externa with effusion than in those with simple chronic otitis media with effusion or with otitis externa without effusion.
These findings suggest that deposits of debris and effusion in this recess may be a causative factor in this disease.
It seems that in most cases several factors may be involved in the etiology of diffuse otitis externa, so in order to cure this disease several causative factors must be removed.抄録全体を表示PDF形式でダウンロード (740K) -
鈴木 元彦, 伊藤 博隆, 西村 穣, 佐藤 薫, 間宮 紳一郎, 馬場 駿吉, 大屋 靖彦, 伊藤 弘美, 横田 明, 杉山 和子, 木野 ...1993 年 86 巻 8 号 p. 1121-1127
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーIn an attempt to determine the usefulness of insect RAST, 267 patients with nasal allergy were tested with CAP-RAST: mite, candida, alternaria, cat dander, orchard grass, ragweed, mugwort, Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid midge, adult chironomid midge, and silkworm moth allergen supplied by Pharmacia AB. We also performed intradermal skin tests with extracts of 12 allergens: mite, house dust, cat dander, candida, alternaria, Japanese cedar, Japanese cypress, orchard grass, ragweed, mugwort, Japanese hops, and silk.
1) The highest rate of RAST in 267 patients was 73.8% for Japanese cedar, followed by 53.2% for mite, 50.6% for Japanese cypress, and 47.6% for orchard grass.
2) The positive response to insect RAST was also high: silkworm moth 32.1% and adult chironomid midge 19.4%. These results suggest that silkworm moth, chironomid, and silk are important allergens in nasal allergy.抄録全体を表示PDF形式でダウンロード (719K) -
―長期成績と難治例の解析―藤田 明彦, 高橋 晴雄, 倉田 響介, 本庄 巖1993 年 86 巻 8 号 p. 1129-1133
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーThe long-term (3 years) effect of adenoidectomy on chronic otitis media with effusion (OME) was analyzed in 130 children (244 ears) aged 4 to 8 years. Although the cure rates of OME in the first and second years after surgery were significantly better in the adenoidectomized group than in the non-adenoidectomized one, in the third year no significant difference was found between the two groups.
Among the treatment failures, poor pneumatization of the mastoid, abnormally low or high opening pressure of the eustachian tube, and/or paranasal sinusitis were their characteristic features. Adenoidectomy appears to shorten somewhat the time for cure of OME. However, children with poor mastoid pneumatization, or very abnormal eustachian tubes, and/or chronic recurrent upper respiratory infections (URI) since infancy were not likely to benefit from adenoidectomy.抄録全体を表示PDF形式でダウンロード (609K) -
宮田 耕志, 北村 淳之, 高北 晋一, 田渕 圭作1993 年 86 巻 8 号 p. 1135-1138
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーAmong the various benign tumors of the oral cavity, Lipoma is rare. A 52-year-old female complained of swelling of the left floor of the mouth. The swelling was the same color as the normal mucosa of the oral floor. This tumor was soft, and we diagnosed it as lipoma with the help of CT scanning. It was resected. The tumor was light yellow, and histopathological examination showed it to be a lipoma.抄録全体を表示PDF形式でダウンロード (3583K) -
細田 泰男, 山下 敏夫, 岩野 正, 熊澤 忠躬, 土井 秀明, 楠本 健司, 小川 豊, 坂井 信幸1993 年 86 巻 8 号 p. 1139-1145
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーAn arteriovenous malformation is defined as a congenital lesion of dysplastic vascular origin with large feeding arteries. Previously, attempts at treatment by complete excision of the vascular mass were complicated by severe hemorrhage. With the advantages of angiography, the arteriovenous anomaly can be defined more clearly, and preoperative embolization effectively reduces intraoperative blood loss.
This paper describes an extensive arteriovenous malformation supplied by the ipsilateral external carotid artery, internal carotid artery, and vertebral artery and the contralateral external carotid artery. This patient was treated successfully with radiologic microembolization followed by surgical extirpation with little blood loss.抄録全体を表示PDF形式でダウンロード (4903K) -
石島 健, 野々村 光栄, 福島 英行1993 年 86 巻 8 号 p. 1147-1150
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーA 39 year-old male had the swelling of the right parotid region for 3 years. Surgical resection of the cyst was difficult because it was very large, extended from the deep lobe into the superficial lobe and was firmly attached to the main trunk of the facial nerve.
The cyst was resected completely without facial paralysis, and there has been no sign of recurrence.抄録全体を表示PDF形式でダウンロード (1910K) -
武田 純治, 宮口 衛, 酒井 俊一1993 年 86 巻 8 号 p. 1151-1155
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーMany kinds of neoplasms of the parotid glands are recognized. They are classified chiefly by their histopathological type. Sometimes, however, it is very useful to classify them according to their location. This report describes such a case.
A 50-year-old man had a 1-month history of painless swelling in the left parotid region, On physical examination, there was a diffuse swelling in the left parotid region, but no facial palsy. Sialography and CT scan revealed a tumor in the left parotid gland. Operation was recommended, but the patient refused. Two years later, CT scan and MRI revealed slight growth of the tumor, so operation was recommended again. The patient finally agreed, and left parotidectomy with preservation of the facial nerve was performed. Histopathological examination revealed that the tumor was present only in the dilated excretory duct of parotid gland, and that it was a papillary adenocarcinoma. More than 20 months after the operation, ther is no evidence of recurrence.抄録全体を表示PDF形式でダウンロード (5128K) -
岡添 真介, 桜井 淳, 中川 雅文1993 年 86 巻 8 号 p. 1157-1163
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーTwo cases of acute lymphadenitis induced by antibiotic drugs are reported. Case 1 was a 40-year-old female with cholesteatoma, who was given antibiotics after the operation. Two weeks later she suffered from neck lymphadenopathy associated with fever.
Case 2 was a 44-year-old female with chronic otitis media, who was given antibiotics after the operation. She suffered from neck lymphadenopathy and a rash, followed by fever three weeks later.
Drug-induced hypersensitivity reaction was suspected and all drug administration was halted. Their symptoms and signs subsided rapidly.抄録全体を表示PDF形式でダウンロード (2953K) -
宮嶋 義巳, 佐藤 公則, 田中 信三, 平野 実1993 年 86 巻 8 号 p. 1165-1170
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーA rare case of metastasis of laryngeal carcinoma to the thyroid gland is reported. The patient was a 61-year-old male who had received laser surgery followed by radiotherapy for laryngeal carcinoma 29 months earlier. He complained of hoarseness since June 18, 1991. Thyroid tumor of the left lobe and ipsilateral recurrent laryngeal nerve palsy were observed. No cervical lymphnode swelling was palpated. On CT scan, tumor was detected in the left thyroid lobe. Hemithyroidectomy and paratracheal lymphnode dissection were performed on July 22. Histological examination revealed the same histological type as the previous laryngeal carcinoma, moderately differentiated squamous cell carcinoma, and intravascular invasion. Total thyroidectomy and left modified neck dissection followed by radiotherapy (30Gy) were performed. The patient has lived, without any evidence of disease, for 11 months after treatment.抄録全体を表示PDF形式でダウンロード (5598K) -
平田 晃一, 藤田 文香, 北嶋 和智1993 年 86 巻 8 号 p. 1171-1174
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーGilles de la Tourette's syndrome (GTS) was diagnosed in a 12 year-old male who complained of peculiar involuntary vocalization. Aerodynamic and sonographic examinations of involuntary speech were performed to clarify the mechanism of the disease. The results showed that words were produced with expiratory air flow. Otolaryngologists must know the symptoms of this disease, because GTS patients often consult otolaryngologists first because of involuntary vocalization.抄録全体を表示PDF形式でダウンロード (467K) -
―内視鏡所見を中心に―倉田 響介1993 年 86 巻 8 号 p. 1175-1185
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーUsing an endoscope, which is one of the most reliable techniques for examination of the nasopharynx, the relationship between pathological findings of the nasopharynx and symptoms was investigated. First, in 100 normal subjects with no symptoms in the nasopharynx, chronic inflammation, such as redness and/or edema of the nasopharyngeal mucosa was observed on the posterior wall of the nasopharynx in 58%. In 15 patients in whom endoscopy demonstrated redness and/or edema, pathologecal studies of biopsied specimens revealed a high incidence of inflammation. Second, 118 patients with nasopharyngitis were examined. They had one or more of the following complaints: nasopharyngeal pain, a sensation of foreign bodies, and nasal stuffiness. In more than 80% of patients, redness and/or edema was observed on the posterior wall and/or nasal side of the soft palate. These inflammatory changes were confirmed by pathological examination. The brush test, 4% lidocaine challenge test and the 2-point discrimination test revealed that nasopharyngeal symptoms were closely correlated with the conditions on the nasal side of the soft palate, and that sensitivity was highest in this area. Third, pathological examination of nasopharyngeal mucous membranes obtained from 10 autopsies of individuals between the ages of 50 to 70. In many cases, the epithelial mucosa of the posterior wall was lined with stratified squamous epithelium. On the other hand, ciliated columnar epithelium was well preserved on the nasal side of the soft palate.
From these results, it was concluded that the nasal side of the soft palate is the most sensitive area within the nasopharynx, and it seems to cause local symptoms more often than other areas. It is therefore recommended that when patients with nasal symptoms are examined, attention should be paid to the condition of the nasopharynx, especially the nasal side of the soft palate.抄録全体を表示PDF形式でダウンロード (9077K) -
羽柴 基之, 向井 研, 安井 桂子, 馬場 駿吉1993 年 86 巻 8 号 p. 1187-1194
発行日: 1993/08/01
公開日: 2011/12/12
ジャーナル フリーNicergoline is a synthetic alkaloid with many effects: suppression of platelet aggregation, increase of blood flow in the brain and improvement of metabolic changes in the brain after ischemia. To determine whether it is useful in patients with vertigo due to circulatory disorders in the peripheral or central vestibular system, we investigated its clinical effects in 47 patients (15 males and 32 females) with vertigo who were over 40 years of age and whose vertigo was considered to be caused by circulatory disturbance. A dose of 15mg/day was administrated for 4 or 8 weeks.
1. The overall rate of improvement was 75.0% after 4 weeks and 92.3% after 8 weeks of treatment.
2. Side effects were noted in two patients (4.3%).抄録全体を表示PDF形式でダウンロード (947K) -
―鼓膜切開との併用効果について―立花 文寿, 石谷 保夫, 石田 達也, 小池 靖夫, 岡田 修治, 山口 幹夫, 大津 信也, 高石 司, 平賀 智, 阿部 律子, 川田 ...1993 年 86 巻 8 号 p. 1195-1202
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーOxatomide was administered to 78 patients (total 86 ears) with otitis media with effusion for four weeks after myringotomy, and its effectiveness and safety were evaluated. The rate of clinical efficacy was 47.7% (marked effect, 15.1%; moderate effect, 23.3%; slight effect, 9.3%). The appearance of the tympanic membrane was improved in 40.7% of the ears. There was improvement in 34.2% of the ears on the pure tone audiogram and in 36.9% on the tympanogram. A side effect was observed in 1 patient (1.3%), but it was mild and no treatment was required. On the basis of these results, oxatomide was judged to be effective in the treatment of otitis media with effusion.抄録全体を表示PDF形式でダウンロード (853K) -
井上 敦子, 松永 喬, 宮原 裕, 田中 治, 北村 溥之, 田渕 圭作, 宮田 耕志, 金子 賢一, 安里 亮, 平野 滋, 和久田 幸 ...1993 年 86 巻 8 号 p. 1203-1213
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーThe efficacy of oxatomide (Celtect®), an antiallergic agent, in the treatment of Japanese cedar pollinosis was evaluated in this study of 138 patients, 90 of whom received it prophylactically and 48 therapeutically.
There were good clinical results in 51 of the former and in 21 of the latter. Thus, treatment with oxatomide, either prophylactically or therapeutically appears to be beneficial in the clinical control of pollinosis. The prophylactic and therapeutic effects could not be compared adequately, since the criteria for their evaluation differed. The prophylactic effectiveness was evident throughout the pollen season, while the therapeutic effectiveness was greatest during the middle and late periods of the season.抄録全体を表示PDF形式でダウンロード (1179K) -
高橋 廣臣1993 年 86 巻 8 号 p. 1214-1215
発行日: 1993/08/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (347K)
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