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90 巻, 7 号
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大山 勝, 本庄 巖1997 年 90 巻 7 号 p. 733
発行日: 1997/07/01
公開日: 2011/11/04
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小林 俊光1997 年 90 巻 7 号 p. 734-738
発行日: 1997/07/01
公開日: 2011/11/04
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中島 務, 田中 宏明, 星野 通隆, 柳田 則之1997 年 90 巻 7 号 p. 738-741
発行日: 1997/07/01
公開日: 2011/11/04
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―可能性と限界―小宗 静男, 山本 智矢1997 年 90 巻 7 号 p. 741-744
発行日: 1997/07/01
公開日: 2011/11/04
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市村 恵一1997 年 90 巻 7 号 p. 745-748
発行日: 1997/07/01
公開日: 2011/11/04
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―咽頭―木田 亮紀1997 年 90 巻 7 号 p. 748-752
発行日: 1997/07/01
公開日: 2011/11/04
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岸本 誠司1997 年 90 巻 7 号 p. 752-755
発行日: 1997/07/01
公開日: 2011/11/04
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増田 游, 西崎 和則, 苅田 賢治1997 年 90 巻 7 号 p. 756-757
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1711K) -
山本 一博, 小川 克二, 井口 芳明, 加藤 幸子, 小野 雄一, 鐵田 晃久1997 年 90 巻 7 号 p. 759-764
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーThe case of a 34-year-old man with tuberculous otitis media is reported. He presented with a first chief complaint of deafness in the left ear. A simple central perforation without transdate and without granulation tissue was noted. A tympanoplasty was carried out under the diagnosis of simple otitis media, and it revealed that the cavity from the attic to the mastoid antrum was occupied by a mass of granulation tissue. Since this characteristic finding was found during surgery, tuberculous otitis media was strongly suspected. A tuberculin test, a smear test of the bacterial specimen of the ear transdate and a histopathological examination of the granulation tissue by Zeel-Neelsen stain yielded negative results. However acid fast bacilli were cultured from the sputa and aural discharge. Pulmonary tuberculosis with tuberculous otitis media was finally diagnosed and the patient was treated with adequate antituberculous medication. Most of the tuberculous examination showed negative results in the patient. The only one positive finding was the granulation tissue in the middle ear cavity, which was detected by surgery. It is necessary to repeated lyexamine the ear, and to keep in mind tuberculous otitis media if massive granulation tissue is detected in the middle ear cavity during surgery.抄録全体を表示PDF形式でダウンロード (4137K) -
藤尾 久美, 大村 文秀1997 年 90 巻 7 号 p. 765-769
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーChronic granulomatous disease (CGD) is one of the congenital immune deficiency diseases in which the bacteriocidal function of neutrophils is missing. Even though the prevalenecs of CGD is low among various hereditary diseases, it is the highest among phagocyte disorders. The pathognomonic symptoms of this disease include recurrent infection and the granulomatous infection foci which begin in infancy. Pneumonia is the most prevalent clinical symptom, while otorhinological diseases tend to berare. We examined a child who was referred to our hospital with left acute otitis media. Because the patient did not respond well to treatment, the patient was referred to the pediatrics department and was later diagnosed as having CGD. Oral administration of the ST mixture (sulfamethoxazol/trimethoprim), and tympanic caviy cleaning using steroids and OFLX (ofloxacin) cured the otitis media and improved the general state of the patient.抄録全体を表示PDF形式でダウンロード (1892K) -
北林 かおる, 佐藤 宏昭, 棚本 洋文, 村井 紀彦, 田渕 圭作1997 年 90 巻 7 号 p. 771-775
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーThe case of a fistula in the cartilaginous portion of the external auditory meatus (EAM) is reported. A 14-year-old girl who had complained of left hearing impairment and discharge had admitted to our clinic.
The orifice of a fistula was found in the posterosuperior wall of the EAM. Computed tomography showed superior extension of this fistula into the cartilaginous portion of the EAM. The fistula was removed surgically and was believed to be an anomaly of the cartilaginous portion of the EAM.
This is the first report of a fistula that originated from the EAM and extended superiorly into the EAM.抄録全体を表示PDF形式でダウンロード (4309K) -
小森 克彦, 岩田 重信, 高須 昭彦, 内藤 健晴, 森 茂樹, 岩田 義弘1997 年 90 巻 7 号 p. 777-780
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーSchwannoma originating from the external auditory canal (EAC) is reportedly very rare. Only seven cases have been documented in the literature.
A 57-year-old male visited us with a one-month history of hearing loss of the left ear. The EAC was occupied by a smooth-surfaced spherical tumor. On October 5, 1994, the tumor was excised under general anesthesia through an incision in the posterior auricular sulcus.
This excised tumor was smooth and soid, and was 15mm×10mm×10mm in size. The histopathological diagnosis was Antoni A and B mixed schwannoma. The tumor has not recurred during the two years since the operation.抄録全体を表示PDF形式でダウンロード (3919K) -
荒井 朱美子, 吉原 俊雄, 藤田 かおり, 高橋 裕子, 石井 哲夫1997 年 90 巻 7 号 p. 781-785
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーThree cases of osteoma of the temporal bone are reported. The patients include one male and two females. Osteomas of the temporal bone have been reported predominantly in females. In one case, the tumor appeared after a trauma, while the causes of the tumor in the other two cases remain unknown. There are several hypotheses concerning the etiologey of osteomas. The present cases were asymptomatic except for the present of swellings behind the ears which were hemispheric and hard. CT scans revealed that the density of the tumors was almost the same as that of the temporal bone, and the mastoid had not been invaded in any cases. Pathological examinations of the tumors revealed wide irregular lamellous bone tissue which lacked osteoblasts. To date, osteoma has not recurred in any of these cases.抄録全体を表示PDF形式でダウンロード (6424K) -
石川 忠孝, 原渕 保明, 若島 純一, 形浦 昭克1997 年 90 巻 7 号 p. 787-790
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーA 30-year-old female presented with a complaint of mucopurulent nasal discharge. A ball-like round mass of fungus with pus was found in the middle meatus of her left nasal cavity. A biopsy was performed, and actinomycosis was suspected by histopathological examination. A plain CT revealed mucosal hypertrophy in the left maxillary sinus. However, we believed that the actinomycosis was not the cause of the left nasal cavity mass. The mass in the left nasal cavity was resected by endonasal surgery, and an actinomycotic body was found following the histopathological examination. Cultures of the discharge were negative for bacteria. Hence, the histopathological examination was useful for making this diagnosis. She has been symptom-free for nine months since the operation.抄録全体を表示PDF形式でダウンロード (4774K) -
武田 広誠, 甲斐 智朗, 小川 明, 臼井 信郎1997 年 90 巻 7 号 p. 791-796
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーMidline laser glossectomy with UPPP was performed on 9 patients exhibiting sleep apnea syndrome with the site of obstruction at the base of the tongue. The sleep apnea was diagnosed by a sleep study using medications. Based on the apnea index, of 9 patients, 5 showed a marked improvement after treatment; 3 showed a slight improvement; and 1 showed no improvement. There were some complications as follows; bleeding 12 and 17 days postoperatively (n=2), an abnormal sensation in the throat (n=5), and a change in taste for more than 1 year (n=1). There were no major complications, and no persistent difficulties with speech or swallowing. Furthermore, no one required tracheostomy. These results demonstrate that midline laser glossectomy with UPPP is a useful treatment for the base of the tongue type obstructive sleep apnea.抄録全体を表示PDF形式でダウンロード (667K) -
山中 由美, 山本 昌彦, 折原 廣巳, 太田 豊, 小田 恂, 沢井 清1997 年 90 巻 7 号 p. 797-801
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーA 22-year-old male with a persistant sore throat and fever was admitted to our department of otolaryngology. Physical examination revealed an erythematous pharynx, swollen tonsils with exudate and multiple swollen lymphnodes with tenderness in the neck. Although he underwent medical treatment under a diagnosis of infectious mononucleosis, his fever persisted and the level of transaminases in his blood increased.
Futhermore he developed pancytopenia and a pre-DIC state with a bleeding tendency. A bone marrow puncture revealed the proliferation of monocytes and histiocytes and phagocytosis. These pathologic findings as well as a high serum ferrit in level, multiple organ failure and hepatosplenomegaly suggested the diagnosis of hemophagocytic syndrome (HPS).
Malignant histiocytosis (MH) and virus-associated hemophagocytic syndrome (VAHS) are classified as define HPS, a type of hemopathy. Abnormal poliferation and infiltration of monocytes and histiocytes with active phagocytosis are noted in various organs such as bone marrow, liver, spleen, lung and lymph nodes. Hemophagocytosis is induced by the excess production of cytokines by activated T-lymphocytes and macrophages. Although the patient underwent chemotherapy (CHOP, MEP) as well as treatment for DIC, hedied of gastrointestinal homorrhage and sepsis caused by methicillin-resistant Staphyjococcus aereus (MRSA) and Pseudomonas aeruginosa.抄録全体を表示PDF形式でダウンロード (2428K) -
村井 紀彦, 山本 悦生, 田坂 康之, 奥村 智子, 板谷 隆義, 篠原 尚吾, 坂本 達則, 高桑 由紀子, 小形 哲也1997 年 90 巻 7 号 p. 803-806
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーWe treated a case of a bleeding varix of the vallecula, which is a rare cause of massive hematemesis or hemoptysis.
A 60-year-old man visited our hospital because of hematemesis, hemoptysis and melena. Upper gastrointestinal fiberscopy, bronchofiberscopy and abdominal ultrasonography revealed no bleeding lesions. There was only a small, smooth, dark hematoma-like mass 7mm indiameter in the right side of the vallecula. Inspite of the size of this lesion, his hemoglobin ranged from 5.8 to 9.1g/dl, and the patient needed frequent transfusions. However, the symptoms disappeared after he underwent a resection of the mass in the vallecula with a KTP laser under direct laryngomicroscopy. The histopathological diagnosis of the mass was a varix.抄録全体を表示PDF形式でダウンロード (4368K) -
櫻井 弘徳, 花田 誠, 北嶋 和智, 村田 忠行1997 年 90 巻 7 号 p. 807-812
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーTwo cases with lateral cervical fistulae originating from the second branchial cleft are reported. Case 1, a 19-year-old female, presented with a complete fistula. Case 2, a 14-year-old male, showed an incomplete fistula. Both cases were treated by a total excision of the fistula under general anesthesia. We also discuss the embryological characteristics of the fistulae originating from the second branchial cleft on the basis of our histopathological observations.抄録全体を表示PDF形式でダウンロード (6509K) -
太田 一郎, 山中 敏彰, 田中 治, 宮原 裕, 松永 喬, 田中 真理子1997 年 90 巻 7 号 p. 813-819
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーThe incidence of deep neck infection has decreased with the development of antibiotics. However, treatment still requires careful consideration, since delays in treatment may cause severe complications, such as septic shock or DIC leading to death. Twenty-three cases of deep neck infection which occurred over a 13-year period were evaluated. Surgical treatment was applied in 11 of the 23 cases. A total of 10 cases (71.4%) out of the 14 cases of abscess which were incised resulted in good recovery. In 2 of the remaining 4 cases who underwent conservative treatments for deep neck abscess, both of which had gas formation, secondary mediastinitis, and systemic disease such as diabetes, ultimately contributed to death.
These results strongly support the conclusion that it is necessary to use appropriate surgical treatment in combination with antibiotic therapy to control systemic disease, but conservatlve therapy alone is in sufficient, in the management of severe deep neck abscess with gas formation, mediastinitis, and systemic disease such as diabetes.抄録全体を表示PDF形式でダウンロード (827K) -
村上 匡孝, 秋山 優子, 四ノ宮 隆, 丸山 晋1997 年 90 巻 7 号 p. 821-826
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーA case of severe neck edema arising from Virchow's lymphnode metastasis of gastric scirrhous carcinoma was reported. A 69-year-old man complained of dysphagia and aggressive neck swelling in addition to severe swelling of both legs. Radiographic examination showed difilse subcutaneous swelling surrounding the trachea and esophagus, which corresponded to cancerous lymphangitis, and a multiple mass lesion on the iliopsoas muscle (celiac lymphnode metastasis). Fine needle aspiration biopsy revealed adenocarcinoma, and immunohistological examination showed rich CEA in the cytoplasm, which characterizes gastric cancer. Gastrography and a gastrofiberscopiy biopsy revealed gastric scirrhous carcinoma. When supraclavicular lymphnode metastasis of adenocarcinoma is encountered, further examination of the abdominal organs is very important.抄録全体を表示PDF形式でダウンロード (6699K) -
仁保 正和1997 年 90 巻 7 号 p. 827-834
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーIn this paper, 8 case studies of patients with persistent fever are presented. Fever in 1 patient was caused by otitis media, in 3 by sinusitis, in 2 by odontogenic maxillary sinusitis, and in 2 by peritonsillar abscess.
The results of drainage, followed by medical treatment, are discussed. The patients, ranging in age from 8 months to 58 years, had temperatures of 37-39°C continuously for 3 days to 3.5 years despite medical treatment. Evidence of acute localized inflammation was only observed in one of the patients. A 7-year-old patient with aperitonsillar abscess had developed the complication of severe lymphadenitis in the neck. Temperatures dropped to a normal level 5 to 6 hours after drainage in the acute phase patients, 12-30 days later in the subacute/chronic phase patients, and 18 days later in the patient with lymphadenitis in the neck. Repeated antral lavage was administered to the patients with sinusitis or odontogenic maxillary sinusitis, and the removal of both the carious tooth and the carious bone around the apix of the dental root was also necessary in the patient with odontogenic maxillary sinusitis. The medical treatment induced nonpurulent changes in inflammation, which obscured the relationship between the disease and the fever. These results indicated that the drainage was effective not only in the alleviation of fever but also in the recovery of lesions.抄録全体を表示PDF形式でダウンロード (1167K) -
―文献的考察―内藤 健晴, 岩田 重信, 妹尾 淑郎, 井畑 克朗, 横山 尚樹, 馬場 錬, 宮田 昌1997 年 90 巻 7 号 p. 835-841
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーOtolaryngologists or allergologists, have only recently become familiar with the term laryngeal allergy or allergic laryngitis. However, laryngeal allergies have become increasingly noteworthy with increases in allergic diseases, such as nasal allergies, asthma and atopic dermatitis. Pollinosis patients allergic to Japanese cedar often complain of itching or the sensation of a foreign body in the larynx, in addition persistent coughing or soreness of the throat. The existence of laryngeal allergy was proven on the basis of study in rats sensitized with Japanese cedar pollen, in previous studies. In the present paper were view the nature, mechanisms, manifestations, differential diagnosis and treatment of laryngeal allergy, both fundamentally and clinically.抄録全体を表示PDF形式でダウンロード (2727K) -
山田 武千代, 斎藤 武久, 斎藤 等, 大坪 俊雄, 都築 秀明, 山本 健人, 成田 憲彦, 徳力 雅治, 山本 英之1997 年 90 巻 7 号 p. 843-847
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーThe rapeutic approaches in the treatment of sudden deafness patients unresponsive to steroid treatment remains controversial. Defibrinogenation therapy using batroxobin is thought to be useful, because vascular disorders are potentially involved in the etiology of sudden deafness. Batroxobin was administered to twelve patients showing little improvement after steroid treatment. The patients included three males and nine females, average age 48.0 years, with a mean heahng level of 85.0dB.
Following defibrinogenation therapy, eight of the twelve patients showed good recovery of hearing without any side effects. In this report, we summarize the results of defibrinogenation therapy and discuss the importance of these results.抄録全体を表示PDF形式でダウンロード (676K) -
暁 清文1997 年 90 巻 7 号 p. 848-849
発行日: 1997/07/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (336K)
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