巻号一覧
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86 巻, 9 号
選択された号の論文の21件中1～21を表示しています
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―脳と側頭骨の病理組織学―加我 君孝1993 年 86 巻 9 号 p. 1217-1233
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーFor assessing brain dead patients, auditory brain stem response (ABR) has been used as an objective measure. However, pathological findings of the brain and temporal bone have rarely been studied. In this report, both the neuropathology of the brain and temporal bone pathology were studied to elucidate the pathophysiology of the disappearance of ABR in brain death. In temporal bone pathology, generally, the more prolonged the disappearance of ABR, the more severely the inner ear structure was destroyed. In brain pathology, the more prolonged the disappearance of ABR, the more severely the cerebrum, cerebellum and brain stem degenerated. In the inner ear, the inner and outer hair cells disappeared and the stria vascularis separated due to autolysis. In the brain, cell layers of the cerebral cortex, granular cells of the cerebrum and neuronal cells of the dorsal cochlear nucleus disappeared due to ischemic changes. These pathological findings suggest that vascular circulation in the brain stem could be damaged at the beginning of brain death and cause irreversible changes in the brain stem resulting in autolysis of inner ear structures since the inner ear is supplied by the anterior inferior cerebellar artery. However, more extensive study is needed because exceptional cases with unusual pathology of the inner ear and brain do exist.抄録全体を表示PDF形式でダウンロード (12419K) -
海野 徳二1993 年 86 巻 9 号 p. 1234-1235
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1566K) -
―LGOBテストによる検討―硲田 猛真, 間三 千夫, 横山 道明, 新井 宏紀, 榎本 雅夫1993 年 86 巻 9 号 p. 1237-1241
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーPatients with inner ear deafness (sudden deafness and acoustic trauma) and presbycusis were examined with the LGOB (loudness growth in 1/2-octave bands) test to evaluate inner ear damage.
In an analysis of the inclination of regression, the LGOB test was conducted with the Resound Digital Hearing System.
In cases of inner ear deafness, the test results showed a strong correlation between hearing loss and inclination as well as between inner ear damage and recruitment.
In senile deafness, the hearing level and the inclination were not as well correlated as in inner ear deafness, indicating that in senile deafness there are vareous degrees of inner ear damage.抄録全体を表示PDF形式でダウンロード (412K) -
韓 東一, 楊 偉炎, 張 素珍, 戴 朴1993 年 86 巻 9 号 p. 1243-1249
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーKlippel-Feil syndrome associated with bilateral cerebrospinal fluid (CSF) otorrhea was diagnosed in a 4-year-old girl. She had had CSF rhinorrhea from the right nostril since seven months of age and had had five episodes of meningitis in a three-year period. There was total bilateral hearing loss. A computed tomography scan demonstrated bilateral cystlike labyrinths. Exploratory tympanotomy revealed CSF leakage through bony defects of both stapedial footplates. The CSF leak was controlled by packing the vestibule with temporal muscle and fascia.抄録全体を表示PDF形式でダウンロード (3960K) -
―短期的聴力改善効果について―片岡 英幸, 竹田 泰三, 柿木 章伸, 齋藤 春雄1993 年 86 巻 9 号 p. 1251-1255
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーHearing change was studied in 130 ears (94 patients) with endolymphatic hydrops before and after an 8-week administration of isosorbide. Hearing was markedly improved in 50 (38.5%) of the ears. This hearing improvement showed a significant positive correlation with the glycerol test results. Therefore, the response to isosorbide therapy of hearing loss with the endolymphatic hydrops can be predicted by the results of the glycerol test.抄録全体を表示PDF形式でダウンロード (597K) -
小林 一豊, 橋場 功夫, 児玉 広幸, 形浦 昭克1993 年 86 巻 9 号 p. 1257-1264
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーRecurrent acute otitis media (rAOM) is one of the most common pediatric diseases. Klein reported that the criteria for rAOM are three or more documented episodes of AOM in 6 months or four episodes in 12 months. Freijd A et al have reported subtle immunologic defects, i. e., IgG2 subclass deficiency in rAOM. The pathogenesis of rAOM, however, is still poorly understood.
We examined 136 patients with rAOM aged 1 to 20 years who were attending our ENT clinic in Hokkaido. There was a higher incidence of rAOM in the younger children. Males had significantly more episodes than did females.
To clarify the pathogenesis of rAOM, both secretory IgA and surfactant were analyzed in the present study. Secretory IgA is related to decreased bacterial adherence. Surfactant is composed mainly of phospholipid, i. e., DSPC (disaturated phosphatidylcholine), and has the definite function of lowering surface tension. Middle ear effusion samples were obtained from patients with OME (otitis media with effusion). OME patients with four or more episodes of AOM during a 12-month period were defined as the (rAOM +OME) group, and OME patients without a previous episode of AOM were in the OME group.
Both secretory IgA and DSPC levels were lower in the (rAOM+OME) group than in the OME group. These results suggest that both immunologic disturbance and eustachian tube dysfunction play important roles in the pathogenesis of rAOM.抄録全体を表示PDF形式でダウンロード (831K) -
岩野 正, 土井 直, 細田 泰男, 牛呂 公一, 山下 敏夫1993 年 86 巻 9 号 p. 1265-1272
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThis paper investigated transmucosal gas exchange in middle ear (ME) pressure regulation mechanisms. In volunteers with normal ears, positive or negative pressure was applied by Valsalva's or Toynbee's maneuver and ME pressure change without transtubal pressure regulation was monitored for 30-40 minutes. ME pressure tends to return to atmospheric pressure independent of applied pressure indicating that transmucosal gas exchange is involved in ME pressure regulation, together with transtubal pressure regulation. Furthermore, we developed a test to evaluate the transmucosal gas exchange capacity and compared normal ears and ears with otitis media with effusion (OME). ME cavity was insufflated with various gases with different compositions (room air, 100% N2, 100% O2 mixed gas with 5% CO2 and 95% O2). The ME pressure changes due to gas diffusion into or out of the mucosa were measured using a pressure transducer connected to the ME cavity. When room air and 100% N2 were insuffiated into the ME cavity, positive pressure were observed in both normal and OME cases. However, insufflation with 100% O2 or a mixture of 5% CO2 and 95% O2 produced quite different results. In contrast to positive pressure by 100% O2 and no significant pressure change by mixed gas in normal cases, remarkable negative pressure changes were observed in OME ears. This result suggests that O2 absorption is accelerated in cases of OME compared to that in normal ears.
From our study, we conclude that the transmucosal gas diffusion in OME cases is quite different from that in the normal ears, and that increased 02 absorption in OME may also promote development of negative ME pressure which is thought to play an important role in the pathogenesis of OME.抄録全体を表示PDF形式でダウンロード (1019K) -
高橋 姿, 佐藤 弥生, 浦野 正美, 中野 雄一1993 年 86 巻 9 号 p. 1273-1278
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーCase 1: A 52-year-old woman was sent to our clinic for suspected malignant tumor of the right external canal. The canal was filled with granulation tissue and purulent otorrhea. The head of a toothpick and a small piece of cotton were found in the left ear canal, so the right external canal was investigated for foreign bodies. Pieces of a decayed cotton ball were discovered in the granulation deep in the right external ear canal. After removal of the cotton and the oral administration of antibiotics, the granulation decreased dramatically, the tympanic perforation closed and her hearing returned to normal.
Case 2: A 59-year-old woman, who was predisposed to allergic disease, complained of left tinnitus and hearing loss. Severe swelling of the left posterior external canal with purulent otorrhea was noted. A piece of cotton was seen in a smear of the pus. Removal of the cotton plug, local treatment and oral antibiotic administration relieved her symptoms immediately.
Many patients with foreign bodies in the external ear canal have subjective symptoms. In patients who are not aware of a foreign body in the external canal, the diagnosis is difficult, and treatment may be refused. On the other hand, even patients with severe pathological findings show good improvement after removal of the foreign body. It is important to examine local findings in detail, to consider the possible presence of foreign bodies and to discuss ear hygiene at the time of treatment of granulation external otitis. Many patients with this disease have chronic external otitis as an underlying disease.抄録全体を表示PDF形式でダウンロード (4062K) -
―咽頭側壁,軟口蓋の運動性との関係―石川 保之, 松本 晶子, 川野 通夫1993 年 86 巻 9 号 p. 1279-1282
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーEustachian tube (ET) function was examined by sonotubometry in 59 patients, aged 7 to 62 years, with cleft palate and A type tympanograms. Active ET opening function was determined to be good if 2 or more out of 4 saliva swallowings were positive by sonotubometry. The movements of the lateral pharyngeal wall and soft palate were also observed through a flexible fiberscope and graded as “good”, “moderate” or “poor”.
There were significant relationships between ET function as tested by sonotubometry and the movement of the lateral pharyngeal wall or soft palate. The levator veli palatini muscle was reported to be the main muscle involved in the movements of the lateral pharyngeal wall and soft palate. Therefore, it was assumed that good function of the levator veli palatini muscle is necessary for the active opening of the eustachian tube.抄録全体を表示PDF形式でダウンロード (425K) -
服部 雅彦, 浜口 幸吉, 林 秀俊, 坂倉 康夫1993 年 86 巻 9 号 p. 1283-1287
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーA 71-year-old female was admitted with a giant tumor of the left parotid gland that had grown to a weight of 1700 g within 40 years. The histological examination revealed a grade II mucoepidermoid tumor (according to Healey's classification). The tumor was removed surgically, and no evidence of recurrence has been observed to date.抄録全体を表示PDF形式でダウンロード (3561K) -
―Image analyzerを用いた咽頭腔の計測―松田 史明, 朝倉 光司, 中野 勇治, 新谷 朋子, 秋田 信人, 形浦 昭克1993 年 86 巻 9 号 p. 1289-1295
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThe obstructive sleep apnea syndrome (OSAS) is characterized by recurrent obstruction of the upper airway during sleep.
In this study, we performed CT scans in 20 adult OSAS patients and 6 control subjects, and measured the airspaces in the nasopharynx, mesopharynx and hypopharynx, using an image analyzer.
The airspaces were significantly smaller at all sites of the pharynx in OSAS patients than in the control subjects, but they did not show a positive correlation with the apnea index or the body mass index.
In good responders whose apnea indexes improved more than 50% after uvulo-palatopharyngoplasty (UPPP), the nasopharyngeal and mesopharyngeal airspaces were significantly smaller, and the hypopharyngeal space tended to be larger than in poor responders.
Our results suggest that CT scan is a helpful method for analyzing the area of the upper airway, especially in relation to the response to UPPP in adults with OSAS.抄録全体を表示PDF形式でダウンロード (2081K) -
菅野 澄雄, 中島 博昭, 岩武 博也, 竹山 勇, 田所 衛1993 年 86 巻 9 号 p. 1297-1302
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーAll four patients had neck swelling, but only one had a pulmonary lesion. It is now difficult to diagnose tuberculosis, because it has become rare, but it was never easy to diagnose tuberculous lymphadenitis.
Biopsy and histopathologic examination are useful in the diagnosis of tuberculous lymphadenitis.抄録全体を表示PDF形式でダウンロード (7288K) -
土師 知行, 片岡 和哉, 沢田 正一, 楯敬 蔵, 片岡 英幸1993 年 86 巻 9 号 p. 1303-1308
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーA new arytenoid adduction technique was devised for reduction of hoarseness in patients with unilateral recurrent laryngeal nerve paralysis. In our technique, the arytenoid cartilage is fixed in fully adducted position by suturing directly to the cricoid cartilage, instead of Isshiki's technique, in which the muscular process is pulled by nylon threads and fixed in the particular portion of the thyroid cartilage. Our technique has some advantages over Isshiki's; 1) easy to conduct, 2) easy to confirm proper adduction of the arytenoid under direct vision, 3) easy to combine with thyroplasty, 4) less possibility of loosening of sutures. Arytenoid adduction was performed with this technique in three patients, all of whom had excellent improvement of voice.抄録全体を表示PDF形式でダウンロード (5860K) -
佐藤 達明, 中山 明峰, 岩崎 博, 瀧本 勲1993 年 86 巻 9 号 p. 1309-1314
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーForty-eight hours after swallowing a foreign object, a male infant aged 1 year and 9 months was brought to our out-patientclinic. His father had noticed that a disc-type battery was lost. X-P during the initial examination revealed a round foreign body lodged about 3 cm beneath the entry to the child's esophagus. Esophagoscopy was performed under general anesthesia, and the object was removed. The foreign body was a battery. About 2 weeks later, esophagoscopy revealed a tracheal fistula where the battery had been. We performed conservative treatments such as intravenous antibiotics, N-G tube and intravenous hyperalimentation(IVH) for nourishment for about 3 months. Subsequent esophagoscoppy indicated the fistula had closed. The charge of a lithium battery is twice that of the conventional alkali manganese or mercury battery, therefore it is imperative that swift treatment be given when one is swallowed.抄録全体を表示PDF形式でダウンロード (4822K) -
鈴村 栄久, 山際 幹和, 浜口 幸吉, 坂倉 康夫1993 年 86 巻 9 号 p. 1315-1320
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThe incidence of deep neck infection has decreased since the development of antibiotic therapy. However, there are still some severe cases with serious complications, such as lethal necrotizing mediastinitis. A 51-year-old and a 54-year-old male patient with mediastinitis secondary to deep neck infection were treated in our department. They developed mediastinitis within a few days after the diagnosis of deep neck infection. They had no systemic disease, such as diabetes. They were treated successfully with early debridement and surgical drainage from both the neck and the mediastinum. When the diagnosis is established or suspected, prompt surgical drainage and washing with antibiotics are necessary in the management of deep neck infection.抄録全体を表示PDF形式でダウンロード (3533K) -
板橋 隆嗣, 中川 利香, 関真 規子, 榎本 冬樹, 岡添 真介, 佐藤 典史, 後藤 明美1993 年 86 巻 9 号 p. 1321-1327
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーIn 1991, we described a newly designed washer for flexible laryngeal fiberscopes which used running water.
In this study, disinfection of fiberscopes was tested with the combined method of dipping them in glutaral solution and then washing them with running water in the washer. The main part of the washer is a cloro-vinyl pipe 16 mm in diameter, into which the fiberscope is inserted, and fresh water is kept flowing for 3 minutes. Immediately after endoscopic examinations, an average of 1.65 strains of bacteria were cultured from the tip of the endoscope.
After the dipping endoscopes in the glutaral solution for 3 minutes, the washer was applied for 3 minutes. The incidence of the cases was 97.1%, which all strains of bacteria detected before the disinfection were disappeared, and the no effective cases were 2.9%.
All of the tips of the nasal endoscopes used in 15 patients with epistaxis had negative occult blood tests except 1 case, in the trial to apply just running water for 3 minutes without glutaral solution.
The combined method of disinfection of endoscopes by dipping in glutaral solution and applying the washer which uses running water was considered to be clinically effective for successive endoscopies.抄録全体を表示PDF形式でダウンロード (2487K) -
―文献的考察―高橋 晴雄, 本庄 巖1993 年 86 巻 9 号 p. 1329-1333
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーRecent trends in cochlear implants for children were discussed with a review of the literature. For prelingually-deaf children, cochlear implant seemed to be superior to any other method for communication. Factors affecting the postoperative performance in speech perception and/or production included methods for communication used by the child preoperatively, and the child's postoperative educational environment. Postoperative performance of postlingually-deaf children were not inferior to that of postlingually-deaf adults. In either pre- or post-lingually-deaf children, use of the cochlear implant as early as possible appeared to be desirable. The incidence of complications following cochlear implant surgery was not greater in children than in adults.抄録全体を表示PDF形式でダウンロード (633K) -
中村 英生, 藤原 満, 中野 雄一1993 年 86 巻 9 号 p. 1335-1339
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThe mechanism of Tegafur-induced olfactory disturbance was studied immunohistochemically in guinea pigs with the use of antisera to bromodeoxyuridine (BrdU) and to proliferating cell nuclear antigen (PCNA).
Tegafur was administered orally for 1.5 years.
Cells taking up BrdU and containing PCNA disappeared in the olfactory epithelium after long-term administration of Tegafur, and marked morphological changes, such as atrophy of the olfactory epithelium, a decrease in the number of mature and premature olfactory cells, and degeneration of olfactory vesicles or cilia were seen.
It is suspected that long-term administration caused continuing inhibition of the cell division in the olfactory epithelium, following the morphological changes mentioned above.
Olfactory disturbances in humans may be caused by the same mechanism.抄録全体を表示PDF形式でダウンロード (3849K) -
―塩酸ビフェメラン(セレポート®)の効果―喜多 村健, 神永 千織, 石田 孝, 伊藤 彰紀, 坂田 英治, 古屋 信彦, 八木 聰明, 加我 君孝, 水野 正浩, 二木 隆, 高橋 ...1993 年 86 巻 9 号 p. 1341-1350
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThe usefulness of bifemelane hydrochloride was evaluated in 99 patients with dysequilibrium. The severity of both subjective and objective vestibular findings were studied before and after the administration of bifemelane hydrochloride 150 mg/day for more than 4 weeks. Equilibrium grading by self-assessment was based on the handicap inventory of dysequilibrium composed of 11 daily activities. The degree of effectiveness evaluated by subjective and objective findings was 85.9%. Side effects were observed in 3 out of 121 patients (2.5%), but none were serious. Significant improvement of the handicap inventory of dysequilibrium scores was demonstrated after treatment with bifemelane hydrochloride.抄録全体を表示PDF形式でダウンロード (1025K) -
加納 有二, 角田 浩幸, 千葉 恭久, 橋本 循一1993 年 86 巻 9 号 p. 1351-1358
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーThe effect of the concurrent use of Sizofiran (SPG) and radiation therapy for head and neck cancers was evaluated by tests of cell-mediated immunity in the peripheral blood of patients. The administration of SPG was started at the beginning of radiation therapy. It was administered intramuscularly in a dose of 40 mg once a week during hospitalization and 40 mg once every 2 weeks during outpatient care. This regimen was continued for 1 year
after the completion of basic treatment. The subjects were 39 patients with stage III or stage N head and neck cancers treated at the Department of Otolaryngology, Teikyo University Hospital between May, 1988 and April, 1991. Twenty-four of these patients received SPG plus radiotherapy (SPG group), and the remaining 15, who received only radiotherapy, were considered to be controls. The subjects were allotted to the two groups by the envelope method. 1) Cell-mediated immunity was reduced by irradiation. 2) The reduction in cell-mediated immunity after irradiation was milder in the SPG group than in the control group. 3) The recovery of cell-mediated immunity was greater in the SPG group than in the control group 1 month after the completion of the basic treatment. These findings indicate that SPG prevents the suppression of cell-mediated immunity and promotes its recovery during radiation therapy for head and neck cancer.抄録全体を表示PDF形式でダウンロード (838K) -
折田 洋造1993 年 86 巻 9 号 p. 1360-1361
発行日: 1993/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (365K)
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