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88 巻, 9 号
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高橋 晴雄1995 年 88 巻 9 号 p. 1113-1119
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーTransmucosal gas exchange and aeration of the middle ear were examined in patients who had had middle ear surgery for otitis media.
1. Both the gas exchange function and aeration in the mastoid were lost after complete mastoidectomy.
2. When the posterior wall of the external auditory canal was reconstructed by soft tissue only such as a temporal fascia, it retracted in all the 8 mastoidectomized ears postoperatively but in only 1 of the 3 ears in which the mastoid mucosa was preserved totally or partially.
3. Whether aeration in the mastoid cavity recovered after middle ear surgery depended only on whether or not the mastoid mucosa was preserved even partially, and not on whether anterior or posterior tympanotomy was performed.
On the basis of these results, we make the following practical points necessary for middle ear surgery:
1. Preservation of the mastoid mucosa is most important for the recovery of the ventilation function and aeration of the mastoid cavity.
2. The canal-down technique is recommended when the mastoid mucosa cannot be preserved.
3. When the mastoid mucosa is preserved, especially if it is continuous with that in the epitympanum, but the bony ear canal cannot be preserved, the ear canal need not be reconstructed by solid tissue.抄録全体を表示PDF形式でダウンロード (3381K) -
吉野 邦俊, 上村 裕和1995 年 88 巻 9 号 p. 1120-1121
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1923K) -
―ステロイド非併用例の検討―金丸 眞一, 福島 英行, 中村 一, 玉木 久信, 福山 泰彦1995 年 88 巻 9 号 p. 1123-1127
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーThe severe type of idiopathic sudden sensor-ineural hearing loss (ISSHL) was treated with recombinant interferon alpha-2a (IFN-α) (3MU/day for 10 days) without steroids. Complete recovery was observed in nine out of eleven patients with severe ISSHL, and the hearing of the remaining two patients recovered ≥30dB.
Ototoxicity, including sensorineural hearing loss has been reported to be induced by IFN. Our results with IFN in ISSHL suggest that, although IFN can be ototoxic at high doses, low dose IFN may be effective in the treatment of ISSHL caused by inner ear damage.
Thus, IFN may actually be an effective substitute for steroids in ISSHL therapy.抄録全体を表示PDF形式でダウンロード (553K) -
澤田 正一, 竹田 泰三, 柿木 章伸, 齋藤 春雄1995 年 88 巻 9 号 p. 1129-1134
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーDelayed endolymphatic hydrops (DEH) is a disease entity that can be differentiated from Meniere's disease. This condition was first reported by Kamei, Nadol and Wolfson. Schuknecht classified DEH into three types, ipsilateral, contralateral and bilateral. We reported clinical features of 30 cases of DEH. Eleven cases were the ipsilateral type, 12 contralateral type and 7 bilateral type. In 12 cases, hearing loss was caused by sudden deafness. Other causes were juvenile unilateral hearing loss in 6 cases, mumpus in 3 cases, head trauma in 1 case and unknown in 8 cases. The most common clinical picture was fluctuating hearing loss (45% ipsilateral type, 100% contralateral type, 100% bilateral). The latency between early history and late history ranged from 3 months to 66 years and averaged 13.3 years. In the cases of sudden deafness, the latency was short (average 5.3 years), but in juvenile unilateral hearing loss, the latency was much longer (average 35.8 years).抄録全体を表示PDF形式でダウンロード (783K) -
鈴木 秀明, 中塚 滋, 千葉 敏彦, 高坂 知節1995 年 88 巻 9 号 p. 1135-1139
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーTwenty-three children with secretory otitis media, aged from 3 to 8 years, underwent tympanostomy tube insertion under general anesthesia in day surgery. The patients were anesthetized by inhalation of nitrous oxide and sevoflurane via face mask, and the surgery was done without hindrance in all the cases. Six patients manifested post-operative low grade fever, which was easily controlled with antifebrile medication. No major complications such as vomiting, aspiration, laryngospasm, pulmonary edema, atelectasis, prolonged apnea or delayed recovery were observed. We conclude that tympanostomy tube insertion under general anesthesia can be satisfactorily performed as day surgery. The advantages and disadvantages of day surgery in otolaryngology are discussed.抄録全体を表示PDF形式でダウンロード (535K) -
―ティンパノメトリーを用いた方法―千葉 恭久1995 年 88 巻 9 号 p. 1141-1146
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーMiddle ear pressure (MEP) changes induced by sniffing were measured directly through a perforation of the tympanic membrane caused by otitis media with effusion (OME). Indirect measurements of MEP changes due to sniffing using tympanometry were also performed with healthy ears. This indirect method is easy to carry out and is non-invasive. Using tympanometry, showed that MEP decrease was induced by sniffing. Improvement in middle ear pressure of OME patients was measured the same way. One hundred OME patients aged one to eleven years were examined and their MEP changes were measured by tympanometry before and after sniffing or sobbing, during crying, and after swallowing. By statistical analysis, it is estimated that sniffing ability starts at the age of two. The incidence of MEP decrease by sniffing was 27.5% in patients over two years old, and that by sobbing was 18.8% in patients under five years old. Decreased MEP was not improved by swallowing in 20%. The ability to correct MEP was, however, higher in older children than in younger. It was concluded that using tympanometry, 1) the detection rate of MEP decrease by sniffing is lower than that by direct measurement of MEP; 2) MEP decrease by sniffing or sobbing occurs more easily in OME patients than with normal ears ; and 3) OME may occur and continue due to dysfunction of the Eustachian tube ; tubal closing failure and/or mechanical incomplete obstruction of the tube.抄録全体を表示PDF形式でダウンロード (769K) -
藤田 友彦, 福山 智子, 高橋 志光, 伊藤 由紀子1995 年 88 巻 9 号 p. 1147-1150
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーWe reported a case of large radicular cyst considered to have developed from the left maxillary molar and extended into the maxillary sinus. Our patient was a 23-year-old female. She was referred to us on October 19, 1993, with a chief complaint of a swelling in the left cheek. She was diagnosed with radicular cyst by X-ray examination. Surgery was performed and good results were obtained.抄録全体を表示PDF形式でダウンロード (5558K) -
河野 聖美, 川島 悦子, 吉原 俊雄, 石井 哲夫1995 年 88 巻 9 号 p. 1151-1154
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーA case of a tooth erupting in the maxillary sinus is reported. A 15-year-old female was hospitalized bacause of diplopia and purulent left nasal discharge. She had a history of purulent sinusitis and Grave's disease. Ophthalmonogically, she also showed a upward deviation of the left eye. CT scan revealed left maxillary sinusitis with a tooth-like structure attached to the posterior wall of the sinus and a high density area at the innerside of the left orbit due to inflammatory change.
It was, therefore, considered that diplopia was caused by sinusitis due to the erupted tooth rather than hyperthyroidism.
Under general anesthesia, the erupted tooth was extracted by the Caldwell-Luc procedure.
There was no bony destruction of the orbit or the maxillary sinus, nor cyst formation.
Two months after surgery, diplopia and deviation of the left eye had completely disappeared. Reccurrence of maxillary sinusitis has not been observed to date.抄録全体を表示PDF形式でダウンロード (3689K) -
川本 亮, 田中 久哉, 箕山 学, 蔦 佳明, 村田 清高1995 年 88 巻 9 号 p. 1155-1160
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーHemangiomas involving the skeletal muscles are relatively uncommon and often difficult to diagnose. A 16-year-old male patient was referred to our department for treatment of erectile hemangioma in the masseter muscle. The erectile hemangioma was characterized by the swelling in the malar region during contraction of masseter muscle. Surgical removal of the tumor was performed by an extraoral approach. The postoperative course was uneventful and facial palsy did not occur. A case of erectile hemangioma in the masseter muscle is presented along with a review of the literature.抄録全体を表示PDF形式でダウンロード (5761K) -
盛川 宏, 佐藤 道哉, 田部 哲也, 中之 坊学, 北原 哲, 井上 鐵三1995 年 88 巻 9 号 p. 1161-1169
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーOne hundred twenty-three patients with laryngeal cancer treated in our department between 1983 and 1992, were studied clinically. Mean patient age was 62.2 years, and the male-female ratio was 10: 1. Histopathologically, squamous cell carcinoma was the most common malignant tumor constituting 97.6% of all cases. Four cases involved change from leukoplakia.
Eighty-five cases were glottic and thirty-eight cases were supraglottic, but none were subglottics.
In patients classified as T1 or T2 with the supraglottic type, the following treatment was recommended as a basic policy: radiotherapy as the initial treatment, if unsuccessful, secondary salvage surgery was performed.
In patients classified as T1 with the glottic type, laser surgery was performed as a basic policy.
In patients classified as T2 with the glottic type, the combination of laser and erradiation was performed as a basic policy.
In patients classified as T3 or T4 with either the glottic type or supraglottic type, total laryngectomy was performed.
The overall five-year survial rate was 74.6%.
The five-year survial rates of the glottic type and supraglottic type were 87.1% and 48.1%, respectively.抄録全体を表示PDF形式でダウンロード (1151K) -
森 茂樹, 岩田 重信, 高須 昭彦, 桜井 一生, 浦野 誠, 小森 克彦1995 年 88 巻 9 号 p. 1171-1176
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーSix patients (4 males and 2 females) with subglottic cancer were treated in our clinic between January 1974 and September 1994. Clinical and pathological studies were performed on these patients.
Patient ages ranged from 48 to 82 years old with an average of 62.7.
The ratio of subglottic cancer was 1.1% (6 cases) of all laryngeal cancer (518 cases) treated at our clinic. Of these cases, three were determined to be stage I and three were stage II.
The initial subjective complaint was a slightly husky voice in 5 cases and a cough in one case.
All cases revealed swelling in the subglottic space.
Five cases were treated by radical radiation therapy, but one patient showed recurrence of the primary lesion. This and one other case underwent by total laryngectomy.
All patients are currently alive without recurrence.抄録全体を表示PDF形式でダウンロード (1863K) -
瀬尾 達, 小笠原 寛, 森 裕司, 天野 吉晴, 伊達 和宏, 阪上 雅史1995 年 88 巻 9 号 p. 1177-1185
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーThe prognosis of malignant melanoma is very poor especially when it originates in the head and neck region such as the nasal, paranasal sinus, and oral mucosa. Although surgical therapy, radiotherapy, chemotherapy, immunotherapy, interferon therapy, and other therapies have been suggested for treatment of this malignant disease, there are still no therapies established as definitely effective. We attempted various types of therapies for our patients with primary nasal or paranasal malignant melanoma with unsatisfactory results. However, chemotherapy using anti-estrogen TAM (Tamoxifen®) has provided satisfactory results in 2 patients. The regimen of this chemohormonal therapy agreed with McClay's regimen. TAM is widely known as an anti-estrogen chemotherapeutic agent breast cancer and thought to exert anti-cancer effect by competing with estrogen for estrogen receptors in breast cancer tissues. The mechanism of the effect of TAM on malignant melanoma remains unknown. Although its anti-cancer mechanism must be further explored, we consider that this chemohormonal therapy will likely become very important in multidisciplinary therapy for malignant melanoma in the head and neck region.抄録全体を表示PDF形式でダウンロード (5839K) -
冨田 俊樹, 井上 貴博, 川崎 篤, 山崎 一人1995 年 88 巻 9 号 p. 1183-1187
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーA case of thyroid cyst that presented with a sudden onset of dyspnea is discussed. The patient was a 62-year-old female who had an anterior cervical tumor for several decades. She had had upper respiratory infection and had felt an enlargement of the tumor for a week before onset. A 60×70mm round, smooth, cystic mass was present on the right side of the anterior portion of her neck. X-ray films of the neck showed a remarkable stenosis and a deviation of the trachea to the left. CT scan of the neck revealed a large cystic mass in the right lobe of the thyroid gland. Dyspnea was improved after open biopsy of the mass in the right lobe of the thyroid. Histologic examination of the biopsy specimen showed thyroid cyst. Enucleation of the thyroid cyst was performed.
Dyspnea was precipitated by upper airway obstruction with rapid enlargement of the cyst and an increase of sputum due to upper respiratory infection.抄録全体を表示PDF形式でダウンロード (5469K) -
―輸血後肝炎について―加藤 尚美, 坂倉 淳, 岡本 茉莉子, 中井 健, 野井 理, 牧本 一男, 高橋 宏明1995 年 88 巻 9 号 p. 1189-1196
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーOf the 667 patients who underwent surgery under general anesthesia in our department from May 1991 to December 1993, 37 received intraoperative blood transfusions. In a study of hepatitis caused by intraoperative blood transfusion, we surveyed the results of serum examinations, including transaminase, in these 37 patients. In this comparison of data, studies were extended to patients who received intraoperative blood transfusion in 1989, the year before the introduction of routine screening of blood for HCV. There was no difference in the range of fluctuation of postoperative transaminase values between the 1991.1993 and the 1989 patients. According to the criteria for the clinical diagnosis of HCV, HCV was found in only one of 10 patients 1989 and in one of 37 patients in 1991 to 1993. The last mentioned patient had a negative routine serum test for HCV. An other postoperative unfavorable event due to intraoperative blood transfusion was toxoplasma infection. Although the incidence of post-transfusion hepatitis has become much lower, we should continue to strive to reduce it still further. As one effective measure, we are now using autologous blood transfusion in selected cases. This method is promising for the future and will be come routine in the clinical practice of surgery.抄録全体を表示PDF形式でダウンロード (856K) -
―文献的考察を中心に―藤木 暢也, 内藤 泰1995 年 88 巻 9 号 p. 1197-1204
発行日: 1995/09/01
公開日: 2011/12/12
ジャーナル フリーMagnetoencephalogram (MEG) is a noninvasive technique for the evaluation of cerebral cortical function. Neuromagnetic fields are very weak and detected with devices called neuromagnetometers. When a magnetic field links the coils in the dewar of the neuromagnetometer, an electrical current is generated. The current is directed toward a very sensitive detector called a superconducting quantum interference device (SQUID).
This paper reviews the literature on the auditory evoked field (AEF). Investigators have demonstrated tonotopicity, amplitopicity, and periodicity pitch representation in the auditory cortex. Differences of AEF between vowel and consonant-vowel have been reported in Finnish and Japanese. AEF was measured in patients with tinnitus and in patients during auditory hallucinations.
MEG is better than evoked potential in the estimation of auditory evoked response in the cerebral cortex.抄録全体を表示PDF形式でダウンロード (2281K) -
清水 啓成, 石戸谷 淳一, 小口 直彦, 太田 庸起子, 鳥山 稔1995 年 88 巻 9 号 p. 1205-1210
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーTo investigate the effects of nitrogen dioxide (NO2), which is a major component of air pollution, on the olfactory epithelium, we exposed 38 8-week-old Wistar rats to 10 ppm NO2 for 14 days in an inhalation chamber at the National Institute for Environmental Studies. We performed histological examinations, including immunohistochemistry (microtubule-associated protein 5, MAP5), and behavioral olfactometry to examine the effect of NO2 on the olfactory epithelium. MAP5 is present in the cell bodies of neurons and all along their dendrites and is believed to be involved in the early stage of active axonal outgrowth.
Irregular olfactory vesicles and olfactory cilia and increased numbers of Bowman's glands were observed immediately after NO2 exposure. Although the morphology of the olfactory epithelium was almost normal 14 days after exposure, behavioral olfactometry was still abnormal up to 30 days after the exposure. MAP5 was distributed diffusely in the dendrites of the olfactory epithelium in the control rats. In contract, MAP5 was dense in the upper regions of the olfactory epithelium from immediately until 30 days after the exposure. Thus, there was a discrepancy between the morphological changes and the behavioral olfactometry results, while immunoreactive test results with MAP5 were in accord with the behavioral olfactometry results. Our findings indicate that functional olfactory disturbances are not always in accord with morphological changes of the olfactory epithelium.抄録全体を表示PDF形式でダウンロード (6236K) -
川合 正和, 前山 裕之, 太田 伸男, 舟久保 辰男, 吉田 美加, 青柳 優1995 年 88 巻 9 号 p. 1211-1215
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーA wide area within the tympanic cavity, including regions which cannot be visualized by otomicroscopy, can be observed with a fine oblique rigid-type telescope in patients with tympanic perforation, but the images obtained with this telescope are too dark for permanent recording.
A new system was devised which can be used in routine examinations by combining a fine forward-oblique type telescope (2.7mm diameter) with a video system. The resulting apparatus is very simple to operate, provides clear images, and costs less than the conventional system because an industrial camera. It is thought that clinicians and researchers will find our new system to be very useful.抄録全体を表示PDF形式でダウンロード (4075K) -
―特に予防投与群と治療投与群での比較―田中 治, 松永 喬, 宮原 裕, 北奥 恵之, 吉川 恒男, 太田 和博, 秋岡 勝哉, 上田 和孝, 家根 旦有, 柏木 令子, 水上 ...1995 年 88 巻 9 号 p. 1217-1227
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーThe usefulness of ketotifen (Zaditen®) nasal solution for Japanese cedar pollinosis in a preventive administration group was compared with that in investigational administration group. This subjects consisted of 181 cases (66 in the preventive administration group and 115 in the investigational administration group). The drug was useful in 65.1% and slightly useful in 93.3% of the preventive administration group. It was useful in 45.1% and slightly useful in 87.3% of the investigational administration group. Both in the preventive and investigational groups, the drug was useful for the treatment of the three typical symptoms of nasal allergy; ptarmus, watery rhinorrhea and congested nose. No side effects were observed. Thus, the study showed that ketotifen nasal solution was useful for the treatment of Japanese cedar pollinosis and was very safe. In particular a prophylactic effect was noted.抄録全体を表示PDF形式でダウンロード (1025K) -
―上顎洞機能検査を用いた客観的評価―南 豊彦, 久保 伸夫, 熊沢 博文, 佐藤 一雄, 柿本 晋吾, 山下 敏夫1995 年 88 巻 9 号 p. 1229-1236
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーThe clinical usefulness of long-term low-dose roxythromycin (RXM) therapy was studied in 21 patients with chronic sinusitis with the use of the X-ray mucociliary function test. Half the usual daily dose (150mg/day) of RXM was administrated for six months or longer. The symptom efficacy rates for rhinorrhea, nasal obstruction, postnasal discharge and heaviness of the head were 73.7%, 66.7%, 68.8% and 70.6%, respectively. The X-ray mucociliary function test proved that mucociliary clearance function improved and/or mucosal edema in the maxilary sinuses decreased in more than 75% of the patients after RXM treatment. These results suggest that RXM relieves on chronic sinusitis even below the MIC level and that its efficacy may be due to improvement of the mucociliary clearance function.抄録全体を表示PDF形式でダウンロード (1945K) -
新川 秀一1995 年 88 巻 9 号 p. 1238-1239
発行日: 1995/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1862K)
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