巻号一覧
前身誌
97 巻, 9 号
選択された号の論文の15件中1～15を表示しています
- |<
- <
- 1
- >
- >|
-
藤枝 重治, 山田 武千代, 高橋 昇2004 年 97 巻 9 号 p. 757-765
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーAllergic rhinitis is a relatively common disorder in the general population. Especially, seasonal allergic rhinitis (Japanese cedar pollinosis) has become a serious social problem between February and April in Japan. The age-adjusted prevalence of Japanese cedar pollinosis in Japan in 2000 was 19.4% by a cross-sectional random sampling method.
Antihistamines, leukotriene modifiers and nasal steroids are now popular therapies for allergic rhinitis. Only antigen-specific immunotherapy has been accepted as an etiologic treatment available to patients with nasal allergy. Studies are ongoing to determine the efficacy of less invasive delivery routes for vaccination, including oral and sublingual vaccination. A surgical approach (submucous turbinectomy and neurectomy of posterior nasal nerve) has been demonstrated to be effective treatment for stuffy nose.
As new strategies for immunotherapy, peptide therapy, anti-IgE antibody (Omalizumab), a human immunoglobulin Feγ-Fcε chimeric protein and an allergen vaccine conjugated with CpG-DNA has have administered to allergic patients in clinical trials. Signal transduction by stimulation in human immunopotential cells has been investigated in terms of for cell-specific response. Ideally, these methods will eventually be replaced by strategies targeting the prevention of allergic responses.抄録全体を表示PDF形式でダウンロード (3177K) -
小室 哲2004 年 97 巻 9 号 p. 766-767
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (2445K) -
小林 大輔, 吉田 晋也, 小川 益, 児玉 ひとみ2004 年 97 巻 9 号 p. 769-774
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of Ramsay Hunt syndrome with involvement of the VI-X cranial nerves and meningitis. The patient was a 68-year-old woman with complaints of left hearing impairment, left facial palsy, dizziness, sore throat, hoarseness and double vision. Physical examination revealed left vocal cord paralysis. On examination of hearing and vestibular function, left sensorineural hearing total deafness and left canal palsy were found. OKP showed brain stem encephalitis. Cerebrospinal fluid examination revealed a remarkable increase in cell count, thus the patient was diagnosed with zoster virus meningitis. A steroid hormone and acyclovir were administered intravenously. Three months after the first examimation, disturbance of the VI and VII cranial nerves abated completely. The disturbance of the VIII and X cranial nerves, however, did not respond to the treatment at all.
It is important to consider the possibility of brain stem encephalitis in cranial polyneuropathy. We consider that cranial polyneuropathy may result from brain stem encephalitis, and brain stem encephalitis may result from meningitis.抄録全体を表示PDF形式でダウンロード (808K) -
山河 和博, 濱田 昌史, 竹田 泰三2004 年 97 巻 9 号 p. 775-779
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of Ramsay Hunt syndrome followed by cerebellar encephalitis. A 69-year-old man with concomitant presentation of right severe facial palsy, ipsilateral auricular vesicle and vertigo was referred to our hospital under a diagnosis of Ramsay Hunt syndrome. A high dose of steroid and a conventional dose of acyclovir were administered from the second day of the disease onset. He quickly recovered from the vertigo, but the facial palsy persisted. He also exhibited an ataxic gait several days after the primary treatment. An increase in cell count, protein and VZV Ig-G in the cerebrospinal fluid led to a diagnosis of VZV-associated cerebellitis, even though VZV DNA was negative on PCR. Twice the previous doses of steroid and acyclovir each was administered and thereafter his walking ability improved. Care for central nerve complication should be taken in cases with VZV reactivation.抄録全体を表示PDF形式でダウンロード (598K) -
一條 宏明2004 年 97 巻 9 号 p. 781-787
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーGeotropic direction-changing positional nystagmus is considered to be caused by canalolithiasis of the horizontal semicircular canal. However, horizontal nystagmus, which persists without decreasing over time, can not be explained by canalolithiasis. The behavior of nystagmus as a function of the head position in space was studied in four patients without any evidence of neurologic disease and with persistent geotropic direction-changing positional nystagmus. In the supine position, permanent horizontal nystagmus toward the intact side was observed. In neutral position 1, with the head turned 15 to 45 degrees to the affected side, the nystagmus decreased and eventually stopped. With greater head-turn, nystagmus toward the earth lasted for more than one minute. These phenomena were considered to indicate that the cupula was deflected by the buoyancy of attached light debris which is hypodense compared with the endolymph. In the prone position, persistent horizontal-torsional nystagmus to the affected side was detected. In neutral position 2, with the head turned 15 to 45 degrees to the affected side, the nystagmus stopped. On the basis of these findings, the pathophysiology of the persistent type of geotropic direction-changing positional nystagmus is considered to be a result of light debris cupulolithiasis of the horizontal semicircular canal.抄録全体を表示PDF形式でダウンロード (971K) -
田中 紀充, 福岩 達哉, 西園 浩文, 黒野 祐一2004 年 97 巻 9 号 p. 789-795
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーAlthough the incidence of otogenic intracranial complications is decreasing, these complications are still serious problems in the otological field. We experienced a case of otogenic intracranial complications due to a giant cholesteatoma in a 77-year-old female. When she was transported to our hospital, she was unconscious. Examination by CT and MRI showed extradural abscess, brain edema and the destruction of the temporal bone. The anatomy of the ossicles and mastoid antrum was not detected. Abscess drainage by a retroauricular incision and the removal of the cholesteatoma were performed immediately. The day after surgery, the patient regained consciousness. The reason she had not complained of severe symptoms before she fell into a coma was not clearly explained. Since the cholesteatoma progressed slowly, central compensation might have been obtained. The present case suggests that immediate treatment is necessary for intracranial complications with advanced cholesteatoma, even if the symptoms are not specific and severe.抄録全体を表示PDF形式でダウンロード (5924K) -
堀江 理恵, 松永 忠彦, 佐藤 進一2004 年 97 巻 9 号 p. 797-801
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe experienced a case of adult onset Still's disease in a 31-year-old man with a chief complaint of severe sore throat and fever. As we diagnosed him with an infectious disease at first, we gave antibiotics, but he did not recover. So, we suspected adult onset Still's disease after investigation, and the subsequent steroid therapy was effective. Adult onset Still's disease is a characterized rheumatic disorder of unknown origin, which affects multiple organs. We consider that severe sore throat is an important early symptom of adult onset Still's disease.抄録全体を表示PDF形式でダウンロード (577K) -
椿 恵樹, 石井 甲介, 安達 秀雄, 太田 康, 篠崎 剛, 山本 昌範2004 年 97 巻 9 号 p. 803-806
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーSubjects and Methods: The subjects were 9 patients who consulted our hospital for thoracic aortic aneurysm-related laryngeal paralysis, which was not associated with surgery, between April 1999 and March 2002. We investigated the findings on the initial consultation, aneurismal features, and prognosis of laryngeal paralysis in each patient.
Results: On the initial consultation, hoarseness was observed in all subjects, and aspiration was noted in 4 patients. There was no vocal motility in 8 patients (the accessory midline and intermediate position were fixed in 7 and 1 patients, respectively), whereas slight vocal motility was observed in 1 patient. No patient showed vocal atrophy. Concerning the aneurysmal features, the aneurysm diameter ranged from 55 to 75mm, and all lesions were present around the arch. In 5 patients, the course could be followed. Four of these patients subsequently underwent thoracic surgery. In Patients 3 and 9, there was no vocal motility after surgery, and atrophy occurred with the deterioration of the hoarseness and aspiration. In Patients 1 and 5, vocal motility appeared, and improvement in the hoarseness and aspiration was achieved. Patient 6 did not undergo thoracic surgery, and the symptoms deteriorated.
Conclusion: The size of the aneurysms that caused laryngeal paralysis was similar to that in other patients for whom thoracic surgery was indicated; laryngeal paralysis is an indication for thoracic surgery. In some patients, the symptoms deteriorated after thoracic surgery, whereas improvement in paralysis relieved the symptoms in other patients. Furthermore, improvement in laryngeal paralysis after surgery or improvement in the symptoms in the presence of persistent paralysis was achieved in some patients; therefore, patients should be instructed to start rehabilitation before surgery.抄録全体を表示PDF形式でダウンロード (489K) -
林 正樹, 國本 優, 山中 昇2004 年 97 巻 9 号 p. 807-811
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of relapsing polychondritis (RP) in a 32-year-old woman who first presented with a painful swelling of the right auricle. She also had arthritis of the elbows and a history of swelling in the apex nasi. Her auricular swelling was not improved by antibiotic therapy, however, injections of methyl-prednisolone significantly reduced her symptoms. Using Damiani's diagnostic criteria, we made an early diagnosis of this case. The auricular chondritis remarkably improved following the steroid therapy. The reduction of prednisolone brought about conjunctivitis in her bilateral eyes. Bilateral auricular chondritis is generally considered a major diagnostic sign of RP, however, we should remember that unilateral auricular chondritis can be an important sign of RP.抄録全体を表示PDF形式でダウンロード (3380K) -
丸子 文, 小川 洋, 野本 幸男, 渡邉 睦, 大森 孝一2004 年 97 巻 9 号 p. 813-817
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーPenetrating injuries of the oral cavity sometimes occur in children. In most cases, the injury is superficial; however, the foreign body sometimes penetrates deeply into the head and neck tissue and has to be removed surgically. We report a case of a foreign body stuck into the temporal muscle from the oral cavity.
A 2-year-old girl presented with a penetrating injury of the oral cavity by a chopstick. Computed tomography (CT) demonstrated a foreign body in the temporal muscle. Surgical procedure was performed immediately and the wooden fragment was removed. The postoperative course was uneventful. Penetrating injury in the temporal muscle has not been reported yet. It should be noted that if the tip of the foreign body is not found CT should be immediately performed.抄録全体を表示PDF形式でダウンロード (4837K) -
那須 隆, 小池 修治, 鈴木 豊, 伊藤 吏, 岡崎 慎一, 野田 大介, 青柳 優2004 年 97 巻 9 号 p. 819-824
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーA 1-year-and-1-month-old boy presented with a wooden foreign body in a right cervical lesion after falling down. The foreign body was the broken tip of a wooden chopstick which was penetrating into his neck. No foreign bodies were reliably detected by plain film. We then used helical CT for the diagnosis of the foreign body. A wooden foreign body, 2.2cm long and 2mm in diameter, like a rod, was shown embedded in his neck by reconstructing 3D images of helical CT. The wooden foreign body was removed through an incision of the neck under general anesthesia.
In this case, helical CT was helpful in the diagnosis of a radiolucent wooden foreign body in a cervical lesion.抄録全体を表示PDF形式でダウンロード (4369K) -
岸本 曜, 池上 聰, 庄司 和彦, 鈴木 慎二, 丸毛 みゆき, 児嶋 剛2004 年 97 巻 9 号 p. 825-828
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of first branchial cleft anomaly. A 16-year-old girl consulted our hospital, complaining of swelling at the angle of the mandible.
MRI imaging revealed the tract of the fistula. The tract extended from the angle of the mandible, through the parotid gland, to the intertragic notch.
We excised the fistula, utilizing superficial lobectomy to preserve the facial nerve. Facial palsy was not observed after surgery.
Microscopic examination of the fistula showed squamous epithelium and skin adnexa, and this lesion was diagnosed as first branchial cleft anomaly.抄録全体を表示PDF形式でダウンロード (4564K) -
小西 ひろみ, 小松 誠, 朝永 康徳, 平山 篤志, 坂口 喜清2004 年 97 巻 9 号 p. 829-832
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーWe report a case of acute myocardial infarction presenting as atypical throat pain. A 76-year-old man complaining of throat pain was admitted to the otorhinolaryngology division of Osaka Police Hospital. Physical examination and laryngoscopy did not detect any abnormality. Then we considered the possibility of referred pain due to coronary heart disease, and ordered electrocardiogram and serum troponin T, which showed acute coronary syndrome. Finally the patient was diagnosed as anterior acute myocardial infarction and underwent emergent treatment in the Cardiovascular Division. Unexplained throat pain can be referred pain due to ischemic heart disease.抄録全体を表示PDF形式でダウンロード (3861K) -
投与方法による臨床効果の差はあるか深澤 啓二郎, 高安 定, 橋本 喜輝, 藤井 恵美, 奥中 美恵子, 岩田 彩子, 阪上 雅史2004 年 97 巻 9 号 p. 833-838
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーAzithromycin hydrate (AZM) is a new macrolide antimicrobial. In this study, we evaluated the clinical efficacy of AZM for acute sinusitis. The patients were randomly divided into two groups. Twenty-five patients (Group A) were given a daily 500-mg oral dose of AZM for 3 days, and 26 patients (Group B) were given the same dose of AZM two times with a 1-week interval. The clinical efficacy rate was 85.2% in Group A and 88% in Group B, and there was no significant difference in the efficacy rates between these groups. These findings suggested that AZM was useful for the treatment of acute sinusitis and that a 500-mg oral dose of AZM for 3 days should be sufficient.抄録全体を表示PDF形式でダウンロード (1983K) -
清水 猛史2004 年 97 巻 9 号 p. 840-841
発行日: 2004/09/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (372K)
- |<
- <
- 1
- >
- >|