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90 巻, 9 号
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加藤 功, 朝倉 美弥1997 年 90 巻 9 号 p. 975-980
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーPlatelet aggregability was investigated in 81 patients with vertigo and 12 patients with Menieres disease in which microcirculation can be impaired. Increased platelet aggregability was observed in about 75%. At the same time, their low density lipoproteinemia (LDL) were about 75% higher than
the norm.
In the present study, platelet aggregability responding to adenosine diphosphate (ADP) was analysed in relation to dose of ticlopidine and simvastatin from grading scores of disability based on equilibrium function. Treatment of both platelet hyperaggregability and hyperlipoprotenemia with ticlopidine and simvastatin, respectively, resulted in improved disability and equilibrium function.
Hence, increased platelet aggregability accompanied by hyperlipoproteinemia are suggested as factors influencing microcirculation in these patients.抄録全体を表示PDF形式でダウンロード (608K) -
市川 銀一郎, 桜井 淳1997 年 90 巻 9 号 p. 982-983
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (1599K) -
坂本 徹, 福田 諭, 柏村 正明, 犬山 征夫1997 年 90 巻 9 号 p. 985-992
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーWith the recent advances in MRI, which have facilitated easy detection of acoustic neuroma (AN), we have encounted many AN cases without typical symptoms or findings. We report the clinical findings in 11 cases of AN with atypical symptoms, and summarize the clinical course of these cases following treatment in our hospital.
Our findings suggest that it is very difficult to detect AN in patients with atypical symptoms and similarly difficult to evaluate clinical course of these patients, Accordingly, it is necessary the conduct further studies on the diagnosis of AN, with special attention directed toward atypical cases.抄録全体を表示PDF形式でダウンロード (7914K) -
前原 浩史, 野口 佳裕, 原口 秀俊, 堤 剛, 西田 裕明, 小松 崎篤1997 年 90 巻 9 号 p. 993-998
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA 79-year-old woman complained of right hearing loss, tinnitus and dizziness. CT, MRI and angiography demonstrated a large aneurysm of the right vertebral artery. On the pure-tone audiogram, there was a remarkable difference between the right and left ears. On the left side hearing was almost normal for her age, although on the right side hearing at the frequency above the 1kHz was severely affected. Electrocochleography was performed using the extratympanic approach. The detection thresholds of both cochlear microphonics and action potential were lower than the audiometric threshold. In spite of the difference in the audiometric threshold between the right and the left ears, the DP audiograms were similar. The auditory brainstem response was normal in the left ear, but only wave I was demonstrated in the right ear. It is thought that these neurotological examinations showed retrocochlear hearing loss.抄録全体を表示PDF形式でダウンロード (4332K) -
栗山 博道, 細田 泰男, 辻 裕之, 小田 恭弘, 友田 幸一, 山下 敏夫1997 年 90 巻 9 号 p. 999-1004
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA 60-year-old female had experienced facial palsy for 6 months and pulsation tinnitus for 9 months in the left ear without hearing loss. Physical examination revealed a vascular mass in the left hypotympanum and no cranial nerve deficits, except in the facial nerve (facial palsy score 27/40). MRI revealed a glomus jugulare tumor along the internal carotid artery. This tumor was classified as class C2 according to Fisch's classification.
An Inf ratemporal fossa approach was used, with preservation of middle ear structure and reconstruction of the external auditory canal. The tumor was extirpated with preservation of the cochlea, vestibule and facial nerve. After removal of the tumor, the external auditory canal was reconstructed using bone pate and the ossicular chain was reconstructed using a ceramic prosthesis.
Two years postoperatively, the patient has neither hearing problems nor tinnitus, and only mild facial palsy.抄録全体を表示PDF形式でダウンロード (7234K) -
藤田 修治, 長谷部 誠司, 伊藤 壽一, 大田 耕造, 田浦 晶子1997 年 90 巻 9 号 p. 1005-1008
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA 43-year-old woman with a left retroauricular tumor was diagnosed with fibrosarcoma following excisional biopsy. Wide local excision with an ample safety margin was performed following preoperative chemotherapy with cisplatin and doxorubicin. The skin-defected area was covered using a local skin flap. Problems with pathologic diagnosis and treatment of fibrosarcoma were reviewed.抄録全体を表示PDF形式でダウンロード (4484K) -
佐藤 公則1997 年 90 巻 9 号 p. 1009-1012
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーEndoscopic laser surgery was performed in 47 cases of perennial nasal allergy, in which conservative treatment had no effect. A thin rigid endoscope (2.7mm in diameter) and thin pipe guide handpieces (2mm in diameter, straight, 45°, 90°, 135° deflective tip) were used in the surgical procedure. The inferior turbinate was vaporized with a defocused carbon dioxide laser beam. The advantages of this method were as follows; 1) The posterior portion, in addition to the inferior and superior surfaces of the inferior turbinate (whole surface of the inferior turbinate) could be vaporized. 2) The inferior turbinate could be vaporized even though the nasal cavity was narrow. 3) Compact vaporization of the inferior turbinate could be performed. 4) Two months after laser surgery, 74% of the patients had excellent or good results, while 9% had no improvement.抄録全体を表示PDF形式でダウンロード (4146K) -
高野 信也, 荒牧 元, 北嶋 整, 岡村 由美子, 信貴 宏治, 稲見 親哉1997 年 90 巻 9 号 p. 1013-1017
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA total of 383 patients who had initial consultations at the Department of Otorhinolaryngology, Tokyo Women's Medical College Daini Hospital were diagnosed with nasal allergies. The following tendencies were recognized in these cases.
1) Most patients who complain of allergies throughout the year noticed the onset of this disease in their youth.
2) The positive rates and scores of CAP RAST decrease as the age of the nasal allergies increases.
3) Detecting antigens by CAP RAST alone is difficult in patients who develop nasal allergies at older ages.抄録全体を表示PDF形式でダウンロード (634K) -
小坂 道也, 菅田 研一, 苅田 賢治, 中田 道広, 瓦井 康之, 赤木 博文, 西崎 和則1997 年 90 巻 9 号 p. 1019-1023
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA thyroglossal duct cyst may occur anywhere between the foramen cecum area and the suprasternal notch, but only rarely does it occur in the intralingual area. A case of a thyroglossal duct cyst in the intralingual area is reported. The patient was a 19-year-old female who suffered from the sensation of a foreign body in the throat for a period of 1 month. Since a cystic mass was found at her tongue, she was referred to our department for further examination and management. MRI revealed the cystic mass to be in the left intralingual area. Suprahyoid pharyngotomy was performed to remove the cystic mass. The foramen cecum was also removed. However, the hyoid bone to which the cyst was not adherent was preserved. The resected cystic mass measured 57×30×18mm in size. Histopathologically, the cyst wall was comprised of a layer of fibrous connective tissue. No recurrence was noted within the 6 months' follow-up period.抄録全体を表示PDF形式でダウンロード (6168K) -
坂東 伸幸, 執行 寛, 北南 和彦, 吉田 真子, 伊藤 智雄, 高橋 光明1997 年 90 巻 9 号 p. 1025-1028
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA 49-year-old male complained of a swelling of the left submandibular region. Twenty years before he had received surgical enucleation of the left submandibular tumor and 5 years later he noticed a swelling in the same region. A CT-scan revealed multiple tumors both in the submandibular and the subcutaneous lesions. They were completely extirpated with surrounding operative scar and the remaining submandibular gland. The histopathlogical diagnosis was pleomorphic adenoma. There has been no recurrence for a year after surgery.抄録全体を表示PDF形式でダウンロード (2479K) -
小林 正明, 老木 浩之, 石川 雅洋, 村田 清高1997 年 90 巻 9 号 p. 1029-1034
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーWe report here a case of multiple oncocytomas that occured in the bilateral parotid glands. A 58-year-old female patient visited our hospital because of a mass that had existed for about 3 years in the left parotid region. Echography noted a hypoechoic lesion, CT scanning and MRI showed 3 masses in the left parotid gland, and 1 mass in the right parotid gland. There was a rapid and high accumulation of 99mTc in the tumor lesion by 99mTc-pertechnetate scintigraphy. A subtotal parotidectomy was performed on the left gland, and a partial parotidectomy of the superficial lobe was performed on the right gland. The histopathologic diagnosis was oncocytoma in the bilateral glands. Malignant oncocytoma that recur or metastasize have been previously reported. Oncocytoma is thought to be a difficult malignancy to diagnose, thus we needed to follow up carefully. To our knowledge, there have been no previous reports of multiple oncocytoma in the bilateral parotid glands. There has been no sign of recurrence or metastasis of the tumors. We also discuss the differential diagnosis, and the most appropriate treatment method.抄録全体を表示PDF形式でダウンロード (5783K) -
赤木 博文, 小坂 道也, 福島 邦博, 土井 彰, 佐藤 嘉余子, 西崎 和則, 増田 游1997 年 90 巻 9 号 p. 1035-1040
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーThe prognostic value of tonsillar provocation tests using direct irradiation with ultramicrowaves was evaluated in this study. The results of preoperative tonsillar provocation tests among 10 IgA nephropathy cases, in which tonsillectomy was considered to be effective after a 6 month follow-up period (effective-tonsillectomy cases), were compared retrospectively to results obtained from 10 healthy controls, as well as 5 IgA nephropathy cases which showed no significant improvement after tonsillectomy (ineffective-tonsillectomy cases). The average age was 34.7 years for the effective-tonsillectomy cases, 32.6 years for the healthy controls and 22.6 years for the ineffective-tonsillectomy cases, respectively.
Positive provocation results were obtained in 80% of the effective-tonsillectomy cases, 60% of the healthy controls and 80% of the ineffective-tonsillectomy cases. Changes in body temperature, erythrocyte sedimentation rate, and number of white blood cells showed no statistically significant differences among these three groups. Urinary findings after the provocation test were worsened in 40% of the effective-tonsillectomy cases (2 cases of proteinuria and 2 cases of hematuria), while none of the healthy controls and 20% of the ineffective-tonsillectomy cases (one case of proteinuria and no cases of hematuria) showed positive results after the provocation test. Hematuria seemed to have the best prognostic value as a tonsillar provocation test for tonsillectomy in patients with IgA nephropathy.抄録全体を表示PDF形式でダウンロード (797K) -
田渕 経司, 原 晃, 国広 美紀, 芹澤 富士子, 瀬成田 雅光, 草刈 潤, 荒木 眞裕, 原岡 誠司1997 年 90 巻 9 号 p. 1041-1045
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーWe report a case of a 72-year-old man with an atypical laryngeal carcinoid tumor. The patient first visited the University of Tsukuba Hospital in 1989 with complaints of a sore throat and hoarseness of 4 years' duration. A solid tumor with an intact mucosal lining was recognized in the right arytenoid. A biopsy was taken and the diagnosis was chronic inflammation. After several negative results in a number of subsequent examinations, the tumor was finally diagnosed as an undifferentiated carcinoma in 1995. Irradiative therapy of 50Gy was unsuccessful and the patient eventually underwent a total laryngectomy. Pathological examination of the resected specimen revealed that the tumor was an atypical carcinoid tumor and this diagnosis was confirmed by immunohistochemical studies.
An atypical carcinoid tumor is a rare neoplasm in the larynx and only 14 cases have been reported previously in Japan. The methods used in the diagnosis of this rare neoplasm are discussed in a review of available literature.抄録全体を表示PDF形式でダウンロード (4668K) -
篠原 孝之, 湯本 英二, 兵頭 政光1997 年 90 巻 9 号 p. 1047-1052
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーThis report describes a 20-year-old female with a giant neurilemmoma of cervical sympathetic nerve origin. The tumor arose in the parapharyngeal space, and extended inferiorly to the submandibular region and medially to the opposite side of the posterior pharyngeal wall. She did not show any symptoms suggesting cranial nerve palsy or Homer's trias. The tumor was completely excised using a submandibular approach and the tumor was found to have originated from the superior ganglion of the sympathetic nerve. Miosis and palpebroptosis appeared postoperatively, which confirmed that the tumor had originated from the cervical sympathetic nerve. Postoperative weakness in the left soft palate improved two weeks after surgery. Recovery has been uneventful without any evidence of cranial nerve deficits 16 months since the surgery.抄録全体を表示PDF形式でダウンロード (8764K) -
五十嵐 充, 金地 明星, 鈴木 慎二1997 年 90 巻 9 号 p. 1053-1058
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーWe treated a 51-year-old female with von Recklinghausen's disease with a large neurinoma of the cervical vagus nerve.
Her chief complaint was swelling of the right side of the neck. There were numerous cafe au lait spots and neurofibromas all over the body. CT and MRI imaging revealed a tumor that was so large that the common carotid artery was pushed aside towards the midline and the internal jugular vein could not be detected. Based on the diagnosis of a neurinoma or a neurofibroma of the cervical vagus nerve. Surgery was performed under general anesthesia. The tumor was found to originate from the vagus nerve. The tumor was resected together with the vagus nerve. The histopathological report was of a benign neurinoma. No adverse symptoms were observed postoperatively, except for hoarseness of the voice.
There have only been 3 cases of neurofibromas, and 1 case of a neurinoma originating from the cervical vagus nerve in Von Recklinghausen's disease reported in Japan. We also discuss the pathological differences between a neurinoma and a neurofibroma.抄録全体を表示PDF形式でダウンロード (5848K) -
松永 信也, 西園 浩文, 平瀬 博之, 岩下 睦郎1997 年 90 巻 9 号 p. 1059-1062
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーA 76-year-old female was admitted to Izumi City Hospital with otalgia, a sore throat, dysphagia and dyspnea. A physical examination revealed ear and pharyngo-laryngeal herpetic lesions and a IX, X cranial nerve disorder. The patient underwent a tracheostomy on the second day of hospitalization because of laryngeal stenosis. Palsy involving the VII cranial nerve and auricular herpetic vesicles were recognized on the third hospital day. Otalgia, the sore throat and dysphagia were improved rapidly after acyclovir treatment. The W and K cranial nerve palsy was improved gradually, but the X cranial nerve disorder remain. Accordingly, physicians should be alert to the possibility of air way stenosis in cases of laryngeal herpes zoster.抄録全体を表示PDF形式でダウンロード (2963K) -
三輪 高喜, 北 桂子, 田守 亜希子, 中橋 明子, 作本 真, 木村 恭之, 岡部 陽三, 長山 郁生, 古川 仭1997 年 90 巻 9 号 p. 1063-1069
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーCeftizoxime and ambroxol were administered in combination to patients with chronic sinusitis, who required surgical treatment. The transfer of ceftizoxime in combination with ambroxol into the ethmoid cell mucosa was compared to that of ceftizoxime alone. Ethmoid cell mucosal concentrations of ceftizoxime 90-120 minutes after intravenous administration of 1g of ceftizoxime alone ranged from 0.21 to 14.3μg/g. Plasma concentrations ranged from 9.51 to 31.6μg/ml, and the tissue distribution rate (ethmoid cell mucosal c./plasma c.) was 31%. When ambroxol was administered in combination with ceftizoxime, ethmoid cell mucosal concentrations of ceftizoxime ranged from 1.04 to 9.66μg/g. Plasma concentrations ranged from 6.7 to 33.5μg/ml, and the tissue distribution rate was 38%. In patients administered ceftizoxime alone, the tissue distribution rates of ceftizoxime were comparatively variable. The mean distribution rates however, were nearly the same in both groups. On the basis of these findings, it was concluded that the concentrations of ceftizoxime in the ethmoid cell mucosa and the plasma were scarcely affected even when ceftizoxime was administered in combination with ambroxol. Ethmoid cell mucosal concentrations and plasma concentrations of ceftizoxime are typically maintained at MIC80 values for period of 4 hours or more, in the treatment of various clinical isolates including organisms causing respiratory infection. This suggests that the therapeutic effects of ceftizoxime can be obtained clinically even when it is used alone. Concomitant use of ambroxol is however, considered to be useful supplemental therapy since the antibacterial activity of ceftizoxime is supported by the improvements in sinusitis induced by ambroxol.抄録全体を表示PDF形式でダウンロード (772K) -
北野 博也1997 年 90 巻 9 号 p. 1070-1071
発行日: 1997/09/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (254K)
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