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99 巻, 12 号
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山下 裕司, 菅原 一真2006 年 99 巻 12 号 p. 981-987
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーIt is believed that the sensory cells are very fragile and that their function is difficult to recover after damage to the inner ear. Therefore, methods used for the protection of inner ear tissue against stress are important. We have studied the mechanism of hair cell protection. The review inculdes our recent studies on hair cell protection with clinical reagents. The effect of the free radical scavenger edaravone on acoustic trauma was investigated. Our results showed that edaravone could protect cochlear function against intense noise. The protective effects of the reagents tested were observed in the inner ear 9-21 hours after noise exposure. These results were supported by immunohistochemical analysis of 4-hydroxy-2-nonenal. An inducer of heat shock protein, teprenone, was used for cochlear protection. Western blot analysis showed that the expressions of Hsp70, 40, and 27 were increased 24-48 hours after the administration of a single dose of teprenone. In addition, daily administration of teprenone for 7 days could enhance Hsps expression more strongly than single dose administration. In test animals given teprenone before intense sound exposure, their ABR threshold elevations were lowered significantly. In addition, significantly fewer defects were observed in outer hair cells of the organ of Corti in animals treated with teprenone than in those of non-teprenone-treated animals.
These clinical reagents are candidates for cochlear protection therapy.抄録全体を表示PDF形式でダウンロード (4763K) -
津田 豪太2006 年 99 巻 12 号 p. 988-989
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (2424K) -
平松 隆2006 年 99 巻 12 号 p. 991-997
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーChronic otitis media with effusion may progress to atelectatic ear and further adhesive otitis media. Treatment of advanced adhesive otitis media is very difficult.
To assess the value of the ventilation tube in the treatment of atelectatic ear and early adhesive otitis media, 5 ears with atelectasis and 5 ears with early adhesive otitis media (total of 8 patients) treated with ventilation tube insertion were investigated.
Once the ventilation tube was inserted, retractions of the tympanic membrane rapidly resolved in all ears with atelectasis. Even in ears with adhesive otitis media without surgical separation, their adhesions were almost resolved, and the retractions of the tympanic membrane finally disappeared in all ears. In two ears with atelectasis and one ear with slight adhesive otitis media, the ventilation tubes were rejected, but they had normal function for over 15 months.
These results suggested that ventilation tube insertion for early adhesive otitis media, the same as that for atelectatic ear, can at least help to control deterioration. Ventilation tube insertion may be of significant therapeutic value in some ears with early adhesive otitis media because of there being no appropriate treatment at present.抄録全体を表示PDF形式でダウンロード (9198K) -
岩永 哲, 崎浜 教之, 田中 藤信, 木原 千春, 桂 資泰, 道津 充, 木下 直江, 林 徳眞吉, 高橋 晴雄2006 年 99 巻 12 号 p. 999-1003
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーEpithelial-myoepithelial carcinoma (EMC) accounts for approximately 1% of all salivary gland tumors. EMC mainly involves the major salivary glands, especially the parotid gland. We report a case of EMC arising from the nasopharyx. A 62-year-old woman complained of an unusual sensation in her throat. Fiberscopic examination revealed a yellowish smooth surface mass which originated from the right nasopharynx. Before surgery, we performed a biopsy and pathological diagnosis suggested the possibility of malignancy. We planned surgical resection through the nasal and oral cavity. Under general anesthesia, the tumor was resected using surgical instruments for endoscopic sinus surgery and tonsillectomy. The tumor was completely excised. Histopathological and immunohistochemical examination revealed that the inner cells differentiated to the ductal epithelium and outer cells to the myoepithelium. Consequently, we diagnosed epithelial-myoepithelial carcinoma. Six months after surgery, she is following an uneventful course.抄録全体を表示PDF形式でダウンロード (4902K) -
関根 基樹, 飯田 政弘, 浜野 巨秀, 大上 研二, 小田 真理2006 年 99 巻 12 号 p. 1005-1010
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーAlthough hemangioma is a benign tumor that is generally treated surgically, preoperative treatment is often required for hemangioma in the nasal cavity or paranasal sinuses because a good visual field is difficult to achieve with heavy blood flow, increasing the risk of massive hemorrhage. Super-selective embolization is widely accepted as the treatment of choice to control hemorrhage during surgery for vascular tumors.
A 43-year-old woman complained of unilateral nasal obstruction and nasal bleeding. A hemorrhagic tumor was found in the left nasal cavity. The pathologic diagnosis was capillary hemangioma. Embolization was performed prior to surgery to minimize bleeding. Selective catheter embolization was performed with NBCA (N-butyl-2-cyanoacrylate), which was introduced into the distal branch of the sphenopalatine artery.
Radical surgery was planned for a few days after embolization, but it was postponed because Moya-Moya disease was found during angiographic study. The tumor gradually decreased in size after angiography and selective embolization of the feeding arteries. We were able to resect the tumor by the transnasal route with endoscopy 69 days after embolization. Total blood loss during the operation was 10ml.
In general, radical surgery is performed within 1 week after preoperative embolization because a long waiting period after embolization increases the risk of recanalization and collateral vessel formation. When we use long-acting embolic material and embolize the distal branch of the feeding artery, we may be able to perform minimally invasive surgery by waiting for a longer period after embolization.抄録全体を表示PDF形式でダウンロード (10971K) -
中下 陽介, 中尾 芳雄, 谷光 徳晃, 田頭 宣治, 小林 優子2006 年 99 巻 12 号 p. 1011-1016
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーNasal septum perforation occurs via many causes such as during surgery head trauma or through systemic disease.
Crusting or hemorrhage occurs from the perforated region, and a lot of cases decrease the quality of life of patients remarkably.
In addition, a perforation choke operation is chosen for cases whereby control is poor only by conservative treatment such as a topical treatment or chemical administration as therapy. As for the perforation choke operation, various operation methods have been reported. Perforation cause, size, and perforation ambient histionic property vary among cases leading to difficulty in the choice of operation methods.
We report one example of nasal septum perforation that we were able to close by isolation via auricular cartilage transplant.
The case was a 64 year old woman. The chief complaint was recurrent epistaxis. We completely closed the nasal septum perforation by isolation auricular cartilage transplant and achieved symptomatic improvement.
As we were able to close the perforation good cartilaginous survival with the perichondrium was suggested.抄録全体を表示PDF形式でダウンロード (6686K) -
粟飯原 輝人, 平塚 純一, 森田 倫正, 西池 季隆, 宇野 雅子, 小野 公二, 熊田 博明, 原田 保2006 年 99 巻 12 号 p. 1017-1022
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーMalignant melanoma developing in the mucosa of the nasal cavity and paranasal sinuses is rare and has an unfavorable prognosis. We report the clinical course of the first case treated by boron neutron capture therapy (BNCT) for nasal malignant melanoma and discuss several advantages of BNCT. The patient was a 55-year-old man with nasal malignant melanoma complaining of right nasal bleeding. He underwent a pre-irradiation CT scan for treatment planning that was performed with the “JCDS” software program. The tumor was irradiated at the Japan Atomic Energy Agency Research Reactor No. 4 (JRR4) with epithermal neutrons at 3.5MW for 44 minutes. The tumor dose and normal tissue dose calculated ranged from 16.0 to 21.2Gy and from 6.8 to 9.5Gy, respectively. There has been continuous complete regression in the tumor and no acute and chronic complications for 8 months up to the present. Although only one patient has shown a complete regression and additional long-term follow-up should be performed to assess this treatment, we believe that nasal malignant melanoma is suitable for BNCT and that such excellent results will have a great impact on patients in the near future.抄録全体を表示PDF形式でダウンロード (7328K) -
吉福 孝介, 松根 彰志, 黒野 祐一2006 年 99 巻 12 号 p. 1023-1027
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーPatients with allergic rhinitis are frequently complicated with some abnormal findings in the paranasal sinuses by X-ray examination. Recently this disease is being diagnosed as allergic rhinosinusitis. In many allergic rhinosinusitis cases, antiallergic drugs such as antihistamines and topical steroids comprise effective medication, but additional macrolide therapy for sinusitis has been reported to be in effective and unnecessary. In this study, the relationship between the type of X-ray shadow of sinuses and the efficacy of macrolide with antiallergic therapy in allergic rhinosinusitis cases was studied as a retrospective therapy. Subjects were 44 allergic rhinosinusitis patients aged from 4 to 60 years old enrolled in the outpatient clinic of the Kagoshima University Hospital ENT clinic. All the allergic rhinosinusitis cases were classified into 3 groups based on the type of X-ray shadow in the sinuses; mucosal thickness, polypous, and diffuse patterns. The X-ray findings were compared between before and after antiallergic therapy with/without macrolide in children and adult cases. X-ray examination revealed that the diffuse type was found in 18 of 42 (42%) children and in 26 of 136 (19%) adults cases. In child cases the diffuse type X-ray shadow was seen more often and macrolide therapy was thought to be more effective in combination with antiallergic medication than in adult cases. This study suggests the efficacy of macrolide therapy in the field of pediatric allergic rhinosinusitis.抄録全体を表示PDF形式でダウンロード (757K) -
佐藤 公則2006 年 99 巻 12 号 p. 1029-1034
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーHow to manage teeth causing odontogenic maxillary sinusitis was investigated in 46 patients with surgery-requiring odontogenic maxillary sinusitis.
1) Seventy-one percent of the causative teeth leading to odontogenic maxillary sinusitis had apical lesions after root canal treatment. The root canals of most of these teeth were incompletely filled with the filling material. Apical lesions in incorrectly treated teeth caused odontogenic maxillary sinusitis. 2) If ventilation and drainage of the maxillary sinus is successful after surgery, 90% of the causative teeth (root canal-treated teeth with apical lesions) can be preserved only by treatment with antibiotics. 3) Thirteen percent of the causative teeth leading to odontogenic maxillary sinusitis had marginal periodontitis. 4) In the case of odontogenic maxillary sinusitis caused by teeth with marginal periodontitis, it was hard to preserve the causative teeth. The indication of extraction should be decided by the degree of teeth mobility and marginal periodontitis. 5) All cases of odontogenic maxillary sinusitis treated with endoscopic sinus surgery improved remarkably. Endoscopic sinus surgery is strongly indicated for odontogenic maxillary sinusitis. Treatment of the causative teeth should be performed based on the pathological condition of the teeth.抄録全体を表示PDF形式でダウンロード (4484K) -
清野 由輩, 中山 明仁, 竹田 昌彦, 橋本 大門, 宮本 俊輔, 八尾 和雄, 岡本 牧人2006 年 99 巻 12 号 p. 1035-1039
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーWe experienced a case of hepatocellular carcinoma metastasized to the palatine tonsil. The patient was a 55-year-old man. His chief complaint was pharyngeal discomfort. An exophytic tumorous mass was found occupying the left palatine tonsil. We conducted a biopsy. The pathology was not squamous cell carcinoma nor malignant lymphoma, therefore, we conducted various immunostainings. It was finally diagnosed as metastasis from hepatocellular carcinoma. Subsequent examinations identified that the tumor had invaded the entire liver. This tumor is likely to metastasize through the hematogenous pathway. In general, metastasis to the head and neck region from any systemic primary tumor indicates a poor prognosis. However, treatment options should not be excluded, especially if the QOL of the patient can be improved.抄録全体を表示PDF形式でダウンロード (8603K) -
堀 龍介, 田邉 牧人, 扇田 秀章2006 年 99 巻 12 号 p. 1041-1044
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーA 26-year-old man visited our hospital with right neck swelling, which was initially diagnosed as a lateral cervical cyst. After follow up for approximately 5.5 years, the right neck swelling was diagnosed as cervical lymph node metastasis of thyroid papillary carcinoma on extirpation of the cyst. An additional operation, right lobectomy of the thyroid grand with unilateral neck dissection, was performed, but pathologically, no carcinoma was detected in the specimen. It was suggested that the carcinoma was missed because it was present between sections of the specimen. Finally we diagnosed the case as occult thyroid carcinoma.
There was no evidence of recurrence a year after surgery. The case is being closely followed up.抄録全体を表示PDF形式でダウンロード (5441K) -
大野 覚, 三浦 誠, 市丸 和之, 藤野 清大2006 年 99 巻 12 号 p. 1045-1048
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーFibrous dysplasia is a benign proliferative bone disorder. We report a case of polyostotic fibrous dysplasia of the skull base. A 77 year-old man who presented with head discomfort visited our outpatient clinic. Computud tomography revealed and sclerotic changes of the sphenoid, ethmoid, and submandibular bones. Biopsy of the ethmoid bone was performed and histopathological examination confirmed a diagnosis of fibrous dysplasia. Because no dysfunction caused by this abnormal lesion was observed, surgical treatment was not performed. The patient was doing well without any sign of disease progression 12 months after the biopsy.抄録全体を表示PDF形式でダウンロード (4851K) -
高橋 淳人, 庄司 和彦, 河田 恭孝, 鈴木 慎二, 岸本 曜, 児嶋 剛, 伊木 健浩, 本庄 原, 池上 聰2006 年 99 巻 12 号 p. 1049-1053
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーMyopericytoma is a newly-defined benign soft tissue tumor showing perivascular myoid differentiation. This tumor usually arises from the extremities of the elderly, however its occurrence in head and neck is rare. A 67-year-old woman presented with a gradually growing painless mass of the lateral neck. The tumor, which was well circumscribed, measured 38×35mm. On CT and MRI study, the tumor was well enhanced by contrast medium. Preoperatively, we diagnosed the lesion as a neurogenic tumor like paraganglioma, because of its rich blood supply. The tumor was easiky excised under general anesthesia. The surgical specimen was histopathologically and immunohistochemically diagnosed as myopericytoma. The postoperative clinical course was uneventful, and she was discharged 11 days after surgery. Currently, she is making satisfactory progress without recurrence. We reported a case of myopericytoma of the neck and review the literature.抄録全体を表示PDF形式でダウンロード (8310K) -
稲垣 康治, 伊與田 貴之, 中島 淳治2006 年 99 巻 12 号 p. 1055-1058
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーAn 85-year-old male presented with a painful swelling in the right side of the neck. Contrastenhanced CT showed thrombosis of the right internal jugular vein and pulmonary artery. The patient was treated with thrombolytic and anticoagulant therapy. After the therapy, the thrombus disappeared; however, there was no blood flow in the right internal jugular vein.
The cause of vein thrombosis was suggested to involve three factors: blood stagnation, hemal damage and hypercoagulability. However, there was no predisposing factor in this case except advanced age.
We suggest that advanced age should be included in the causes of idiopathic vein thrombosis.抄録全体を表示PDF形式でダウンロード (3776K) -
福島 邦博2006 年 99 巻 12 号 p. 1060-1061
発行日: 2006/12/01
公開日: 2011/10/07
ジャーナル フリーPDF形式でダウンロード (370K)
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