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90 巻, 12 号
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川内 秀之, 片岡 眞吾, 佐野 啓介, 加藤 太二, 岩元 純一1997 年 90 巻 12 号 p. 1305-1314
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーThe availability of CYFRA21-1 levels as a tumor marker in patient sera, was examined in this study for the diagnosis and prognosis of malignant head and neck disease, and was compared with that of established squamous cell carcinoma (SCC) antigen. CYFRA21-1 was determined to be useful as a tumor marker, similar to SCC antigen, and CYFRA21-1 was superior to SCC antigen as a diagnostic factor in patients with even early stages of malignant disease. Serum levels of CYFRA21-1 appeared to accurately reflect the clinical course of head and neck cancer patients. However, our study is ongoing and a more extensive and precise evaluation of this important issue, is required.抄録全体を表示PDF形式でダウンロード (2726K) -
夜陣 紘治, 平田 したう, 長田 理加1997 年 90 巻 12 号 p. 1316-1317
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1784K) -
藤木 暢也, 内藤 泰, 田村 哲也1997 年 90 巻 12 号 p. 1319-1322
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーTo evaluate the effect of the hyperbaric oxygen (HBO) therapy for sudden deafness unsuccessfully treated with steroids, we investigated improvements in hearing threshold with this treatment. HBO therapy was used in 30 patients who were not cured by adrenocorticosteroid therapy between January 1992 and December 1996. HBO therapy in these patients was started between the 15th to 150th day after the onset of deafness. In this study, the overall efficacy rate of HBO therapy was 37 percent. There was no significant difference in the efficacy rate among three groups delineated according to the time after onset of the deafness. Hearing threshold before HBO therapy and age of the patients had no significant influence on the effect of HBO therapy. HBO therapy may be effective for unsuccessfully treated cases of sudden deafness.抄録全体を表示PDF形式でダウンロード (456K) -
加藤 朗夫, 河野 淳, 鈴木 衛1997 年 90 巻 12 号 p. 1323-1327
発行日: 1997/12/01
公開日: 2011/12/12
ジャーナル フリーSurgical complications were reviewed among a total of 106 Nucleus cochlear implant patients. Complications were classified as “major” when they required surgical intervention, and were classified as “minor” when they resolved with conservative treatment. As a result, 9 patients (8.5%) had major complications, involving flap necrosis, electrode slip-out, and otitis media. An additional 16 patients (15.1%) had minor complications. In two patients with flap necrosis surgical reconstruction was required, and in one patient the device had to be removed. The surgical prin-ciples for avoiding such complications were discussed.抄録全体を表示PDF形式でダウンロード (2399K) -
松岡 寿子, 西岡 慶子, 河北 賢哉, 多田羅 尚登1997 年 90 巻 12 号 p. 1329-1335
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーA 70-year-old male complaining of dizziness and hearing disturbances had sudden onset of meningitis and DIC. Target CT scans revealed latent petrositis with no clinical symptoms for six years. CT scans and MRI were found to be very useful in the early diagnosis of petrositis and the prediction of intracranial complications. This case suggested that asymptomatic petrositis with a high risk of intracranial complications is not rare in the recent antibiotic era. Twenty-three cases of petrositis reported in Japan from 1985 to 1995 were reviewed, and diagnostic and therapeutic problems were discussed.抄録全体を表示PDF形式でダウンロード (3959K) -
石島 健, 高橋 晴雄, 須藤 正治, 田辺 牧人, 本庄 巖1997 年 90 巻 12 号 p. 1337-1341
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーWe analyzed 14 cases of postoperative recurrent cholesteatoma based on the viewpoint of the ventilation of the middle ear using the CT images and findings during the revision surgeries. Aeration of the mastoid was not observed in any of 14 cases, whereas aeration of the tympanic cavity was observed in 10 out of 14 cases; this correlated well with tubal function. In 12 out of 14 cases, a mastoidectomy had been performed at the first operation. In the other 2 cases, the mastoid air cells had been partially resected. During the first operation, the posterior canal walls had been preserved in 12 out of 14 cases, and had been reconstructed in 12 cases. One case was reconstructed by the hard tissue, the other is only by the soft tissue. The eustachian tubes were obstructed in 3 out of 14 cases, but were not obstructed in the other 11. In 8 cases, the pathway through which the recurrent cholesteatoma had extended into the mastoid was the epitympanum and in another 5 cases it was through a small bony defect in the posterior canal. In the remaining one case, the recurrent cholesteatoma had entered into the mastoid through the osteo-cartilaginous junction of the posterior external auditory canal.
These results suggested that a decrease in the gas exchange function of the mastoid might disturb the postoperative recovery of aeration in the mastoid, and thus might have led to a recurrence of the cholesteatoma.抄録全体を表示PDF形式でダウンロード (4321K) -
花満 雅一, 児玉 章, 望月 隆, 田中 寛, 片岡 英幸, 北嶋 和智1997 年 90 巻 12 号 p. 1343-1350
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーMucormycosis usually occurs in patients with diabetic acidosis or in immunosuppressive conditions such as malignant disease, steroid therapy or cytotoxic therapy. This paper describes our experience with rhinocerebral mucormycosis (RCM) in an apparently normal host, and an accompanying literature survey. A 68-year-old man was admitted because of pain in the right buccal region. Computerized tomography and magnetic resonance imaging revealed a shadow in the right maxillary sinus, which was expanding into his right orbit, cavernous sinus and middle cranial f ossa, with signs of destruction of the ethmoidal and maxillary walls. His definite diagnosis was RCM, due to the detection of the genera Rhizopus by an open biopsy of his maxillary sinus. He was treated by debridement of the right pansinuses, and an intravascular administration of amphotericin B (AMPH). There was kidney dysfunction as a side effect of the AMPH, but a total dose of 899 mg of AMPH was administered by discontinuation for a month and alternate-day therapy. He did not undergo orbital exenteration; he had normal visual acuity and ocular movement. There was no recurrence 18 months after the treatment.
RCM is a fatal disease, and the mortality rate is 38% even given a correct diagnosis and treatment. About 4.5% to 18% of RCM cases have no predisposing factors according to the literature. RCM in normal hosts has a lower mortality rate than in patients with diabetes, but early diagnosis and treatment are still imperative.抄録全体を表示PDF形式でダウンロード (6933K) -
玉置 かおり, 寒川 高男, 山中 昇, 田中 智之, 木村 通郎1997 年 90 巻 12 号 p. 1351-1358
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーWe report a case of teratocarcinosarcoma involving the right nasal cavity. The patient was a 55-year-old male, whose chief complaints were right nasal obstruction and bleeding. Histological, immunohistochemical and electron microscopic findings of the biopsied nasal tumor revealed an epithelial component of squamous cell carcinoma and mesenchymal components of myofibrosarcoma, chondrosarcoma and undifferentiated sarcoma with small nuclei. The patient was treated with intensive irradiation and chemotherapy, and a total maxillectomy. He has had no recurrence to the present.
Teratocarcinosarcoma, consisting of a malignant epithelial element and two malignant mesenchymal components, is exceptionally rare in the sinonasal tract with only 28 reported cases, including the present patient. Rapid growth and extensive local destruction are prominent features of this type of tumor, emphasizing the need for early diagnosis and prompt introduction of aggressive therapy.抄録全体を表示PDF形式でダウンロード (9843K) -
平海 晴一, 平塚 康之, 佐藤 宏昭, 榊原 淳二1997 年 90 巻 12 号 p. 1359-1361
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーMaxillary sinus mucoceles without a history of previous surgery or trauma are extremely rare. If these mucoceles are accompanied by bony destruction, then the differential diagnosis includes tumorous lesions. We report here two such cases of maxillary sinus mucoceles. In both cases, a CT scan showed a homogeneous mass causing expansion of the maxillary sinuses and bony destruction. Aspiration from the affected maxillary sinuses showed a thick yellowish fluid, which suggested that they were mucoceles. The findings of the Caldwell-Luc operation with an antrostomy coincide with the diagnosis of mucoceles, and no further tumorous lesions were observed by histological examination.抄録全体を表示PDF形式でダウンロード (2257K) -
高野 信也, 荒牧 元, 上田 範子, 高松 真奈美, 岡村 由美子, 西田 素子1997 年 90 巻 12 号 p. 1363-1368
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーAmong the patients whose first visit with nasal complaints to the Tokyo Women's Medical College Daini Hospital occurred between January 1993 and December 1995, cysts were detected by CT in the postoperative paranasal sinuses of 95 patients.
These patients were compared to 42 patients without cysts in postoperative paranasal sinuses.
1) The presence of nasal discharge and ocular symptoms was of diagnostic value in cases of postoperative paranasal sinus cyst.
2) Nasal discharge was related primary to the presence of postoperative paranasal sinus cysts.
3) The presence of nasal polyps was not related to postoperative paranasal sinus cysts.
4) The presence of nasal polyps alone was of no diagnostic value in detecting postoperative paranasal sinus cyst, with the excepting of cysts located in the maxillary sinus.抄録全体を表示PDF形式でダウンロード (731K) -
篠原 尚吾, 田坂 康之, 山本 悦生, 奥村 智子, 板谷 隆義, 村井 紀彦, 坂本 達則, 金 泰秀, 高桑 由紀子1997 年 90 巻 12 号 p. 1369-1373
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーIn 1984, Shishiba et al described 4 cases with multiple cutaneous neurilemmomas as “neurilemmomatosis” which is a systemic disease distinct from neurofibromatosis. Since then, some reports have been published on multiple schwannomas as a systemic disease. In this paper, we report a case of multiple schwannomas with the initial symptoms of a parotid tumor.
A 64-year-old man visited our hospital complaining of swelling in the right inf raauricular region. Preoperative CT and MRI examinations revealed a 25×25 mm round tumor in the deep portion of the right parotid gland and two other tumors in the deep right upper neck. A malignant tumor in the parotid gland with lymph node metastasis was suspected. An operation revealed that these tumors originated from the facial nerve, a branch of the accessory nerve and the brachial plexus. There were two independent tumors in the facial nerve. The tumor in the accessory nerve was totally removed, but the others were treated conservatively in consideration of his quality of life. The tumors in the accesory and the facial nerves were examined histologically, and were diagnosed as a mixed type schwannoma.
The present case could not be considered to be neurofibromatosis, because the patient did not have dermatological findings, cafe au lait spots, neurofibromas, nor a familial history of neurofibromatosis.抄録全体を表示PDF形式でダウンロード (6003K) -
三保 木美子, 森 一功, 平野 実1997 年 90 巻 12 号 p. 1375-1380
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーMalignant fibrous histiocytoma (MFH) is one of the most common sarcomatous tumors, usually growing in soft tissues of the whole body, but with a predilection for the extremities. Occurrence in the head and neck is less frequent, and that in the mandible is extremely rare.
A 45-year-old male with primary MFH of the mandible is reported. His chief complaint was a tumor in the right preauricular region. Intra-arterial administration of cisplatin and adriamycin did not have any apparent effect. Extended surgical resection was then performed followed by reconstruction with the use of a rectus abdominis myocutaneous flap, subsequently resulting in a good clinical course. In the treatment of MFH of the head and neck neither chemotherapy nor radiotherapy have provided outstanding results in general. Therefore, when chemotherapy is not effective, as in the present case, extended surgical excision at an early stage, is necessary.抄録全体を表示PDF形式でダウンロード (6379K) -
假谷 伸, 青地 克也, 永井 陽介, 赤木 博文, 西崎 和則1997 年 90 巻 12 号 p. 1381-1386
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーPrimary leiomyosarcoma of the pharynx is extremely rare. A review of the literature revealed only 7 cases of pharyngeal leiomyosarcoma in Japan. We describe the case of a 72-year-old man with a leiomyosarcoma of the middle pharynx in this paper. Seven years ago, the patient had a malignant melanoma of the pharynx, and total extirpation of the tumor was performed with reconstruction of the pharynx using a pectoralis major myocutaneous flap, irradiation (20 Gy), and chemotherapy. In this case, leiomyosarcoma arising from the pharynx occurred in the irradiation field. Only 12 cases of radiation-induced leiomyosarcoma have been reported in the Japanese and foreign literature.抄録全体を表示PDF形式でダウンロード (6580K) -
秋定 健, 折田 洋造, 吉弘 剛, 竹本 琢司, 奥本 香苗, 東川 康彦, 日高 利美, 和田 秀穂1997 年 90 巻 12 号 p. 1387-1392
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーA 67-year-old man was admitted to our hospital because of general fatigue and pancytopenia. The patient had a past history of total laryngectomy for cancer of the larynx at age 64. Following that operation Tegaful 642.0g was administered for about three years. Hematological examinations revealed a hemoglobin of 7.6 g/dl, a white cell count of 2300/μl, and a platelet count of 34000/μl. A diagnosis of myelodysplastic syndrome (RAEB-t) was made from bone marrow, which contained myeloblasts and atypical cells, and peripheral blood cells (65%). A chromosomal banding study of the bone marrow cells was normal. We speculated that the preceding adjuvant chemotherapy was probably related to the occurrence of myelodysplastic syndrome.抄録全体を表示PDF形式でダウンロード (5964K) -
秋定 健, 折田 洋造, 吉弘 剛, 竹本 琢司, 奥本 香苗, 東川 康彦, 日高 利美, 和田 秀穂1997 年 90 巻 12 号 p. 1393-1397
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーA 67-year-old man was admitted to our hospital because of general fatigue and pancytopenia. The patient had a past history of total laryngectomy for cancer of the larynx at age 64. Following that operation Tegaful 642.0g was administered for about three years. Hematological examinations revealed a hemoglobin of 7.6 g/dl, a white cell count of 2300/μl, and a platelet count of 34000/μl. A diagnosis of myelodysplastic syndrome (RAEB-t) was made from bone marrow, which contained myeloblasts and atypical cells, and peripheral blood cells (65%). A chromosomal banding study of the bone marrow cells was normal. We speculated that the preceding adjuvant chemotherapy was probably related to the occurrence of myelodysplastic syndrome.抄録全体を表示PDF形式でダウンロード (3654K) -
水田 啓介, 伊藤 八次, 西田 基, 秋田 茂樹, 加藤 雅也, 小塩 勝博, 海田 健宏, 古田 充哉, 宮田 英雄, 柳田 正巳, 柴 ...1997 年 90 巻 12 号 p. 1399-1407
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーIPD® (supratast tosilate) was investigated for its prophylactic efficacy and therapeutic efficacy in the treatment of cedar pollinosis during the 1996 cedar pollen season. The subjects investigated were patients at the Gifu University School of Medicine and its affiliated hospitals, who had a history of cedar pollinosis. The patients were classified into two treatment groups: the prophylaxis group (70 patients), in whom IPD® administration began before the start of cedar pollen dispersion, and the treatment group (49 patients), who underwent IPD® treatment only after cedar pollen dispersion had begun and symptoms of pollinosis had manifested.
Results were as follows: (1) The nasal symptoms (sneezing, runny nose, nasal congestion) were milder in the prophylaxis group than in the treatment group throughout the cedar pollen season, with the difference being significant during the season's first 2 weeks. (2) In the prophylaxis group, IPD®'s inhibitory effect was rated as excellent in 18.6% of the patients, good in 45.7% and fair in 20.0%. In the treatment group, the improvement in the symptoms was rated as disappearance in 4.2%, excellent in 20.8% and good in 43.8%. (3) When symptom inhibition in the prophylaxis group was investigated as a function of the duration of IPD® administration prior to the start of pollen dispersion, the good + excellent inhibition rate was 57.7% in the subpopulation pretreated for <2 weeks (26 cases), 64.9% with 2 to <4 weeks' pretreatment (37 cases) and 85.7% with 4 to <6 weeks' pretreatment (7 cases). Thus, IPD®'s prophylactic inhibitory rate increased with the length of the pretreatment period. (4) In the prophylaxis groups, the CAP-RAST value was significantly reduced at the time of peak pollen level and at the end of the pollen season compared with the value before IPD® administration.抄録全体を表示PDF形式でダウンロード (1064K) -
清水 啓成, 高橋 明洋, 小口 直彦, 石戸谷 淳一1997 年 90 巻 12 号 p. 1409-1414
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーChronic paranasal sinusitis encompasses a variety of pathologies, and eosinophil infiltration of nasal polyps is characteristic of chronic sinusitis in which allergy is a strong etiologic factor (allergic paranasal sinusitis). Suplatast tosilate is an anti-allergy agent that suppresses production of IgE antibody and inhibits tissue infiltration by eosinophils. In the present study we assessed the efficacy of suplatast tosilate immunohistochemically in surgical specimens of nasal polyps before and after drug therapy to evaluate its efficacy in allergic sinusitis.
The subjects were 8 patients with allergic sinusitis associated with nasal polyps. These patients were treated with suplatast tosilate for about three months. Nasal polyps were collected before and after treatment, and 5-μm frozen serial sections were prepared and stained with HE and by immunochemical methods. The number of eosinophils and eosinophil activation were assessed by using EG2 antibody, which recognizes secretory type eosinophilic cationic protein (ECP) alone, as the primary antibody, to investigate eosinophil activation.
Infiltration by numerous eosinophils, predominantly in the superficial layer of the lamina propria, was observed in the nasal polyps of allergic rhinitis patients. Significant decreases in the number of eosinophils and the number of EG2-positive cells were observed in the nasal polyps after treatment with suplatast tosilate, and a significant decrease was also observed in the ratio of the number of EG2-positive cells to the number of eosinophils. Thus, suplatast tosilate was shown to have eosinophil tissue infiltration suppressing activity in human nasal polyps, and to also possess inhibitory activity against eosinophil degranulation. Based on these findings, suplatast tosilate suppresses allergic inflammation, which is predominantly manifested by eosinophil infiltration, and was found to be effective in the treatment of allergic paranasal sinusitis.抄録全体を表示PDF形式でダウンロード (850K) -
新川 敦1997 年 90 巻 12 号 p. 1416-1417
発行日: 1997/12/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (2481K)
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