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氷見 徹夫, 新谷 朋子, 山口 朝, 原渕 保明, 吉岡 巌, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
1-6
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
The Nucleus 22-channel cochlear implant was placed in 21 postlingual profoundly deaf patients. Speech perception, promontory stimulation test, psychophysical factors, surgical complications, clinical background and the utility of cochlear implant were estimated. In speech perception, correct responses without lipreading were 62% in the vowel test and 35% in the consonant test. Correct responses with lipreading and cochlear implant were 98% and 73%, respectively. Both the duration of profound deafness and patient's age at surgery were significantly correlated to the postoperative consonant recognition score. However, the promontory stimulation test or psychophysical factors were not related to the degree of the speech perception. Although minimal surgical complications (transient dizziness and facial palsy) were observed in 2 patients, the cochlear implant surgery was considered to be a safe surgery. Condition of the conversational communication was remarkably improved postoperatively in 90% of patients with cochlear implantation. Thus, the utility of cochlear implant surgery was recognized.
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当科小児中耳炎外来通院患児と耳鼻咽喉科検診児の比較から
原渕 保明, 光沢 博昭, 縫 郁美, 大黒 慎二, 高田 竜多, 横山 雄司, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
7-14
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
To determine risk factors for otitis media, retrospective study was performed by interview and otorhinolaryngeal screening examinations. Three groups of age-matched (mean±SD: 4.5±2.0years) Japanese children were examined; 130 children who have visited our clinic for treatment of recurrent (>3 episodes) acute otitis media (AOM) or persistent otitis media with effusion (OME),171 children who had 1-2 episodes of AOM or were diagnosed with OME by otological examinations, and 299 children who never had AOM or OME. There was no difference in the distribution of gender, birth weight, or being breast fed among the 3 groups. Children with a long duration of breast feeding, no episode of recent upper respiratory infection or sinusitis, and siblings without episode of otitis media were more frequently found in the group without otitis media than in the remaining 2 groups. The recurrence of AOM or persistence of middle ear effusion was associated with infantile onset of otitis media, tonsillar or adenoidal hypertrophies, frequent upper respiratory infection, history of sinusitis, allergic rhinitis, and atopic dermatitis, parental history of otitis media, and parental and sibling history of allergic rhinitis.
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小林 一豊, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
15-19
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
The cause of OME (otitis media with effusion) is not clearly known, but many studies indicate that dysfunction of the eustachian tube plays a role in its pathogenesis. The potential existence of a STLS (surface tension lowering substance) in the middle ear cavity which facilitates the opening of the eustachian tube was first postulated by Bauer in 1970.
Appreciable phospholipids were shown to be present in eustachian tube lavage fluid by many investigators. The major components of pulmonary surfactant are phospholipids, especially DSPC (dipalmitoyl phosphatidylcholine). We also detected the existence of DSPC in middle ear effusions.
Monoclonal antibodies against pulmonary surfactant protein were prepared by Kuroki et al. We found fine positive granules in the mucosal epithelial cells of the middle ear, while Lamellar bodies were found in the secretory cells of the middle ear by electromicroscopic examinations.
Yamanaka et al reported that the positivity of SAP (surfactant apoprotein) in middle ear effusions showed a good correlation with the clinical course of OME, and the period of observation of SAP-positive cases being significantly shorter than that of SAP-negative cases.
Some investigators have suggested the efficacy of treating OME with artificial pulmonary surfactant. Kobayashi et al reported that the use of artificial surfactant was effective for patients with OME.
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氷見 徹夫, 原渕 保明, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
20-24
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Preoperative diagnoses, operative findings and postoperative results are discussed for 45 ears of 43 patients suffering from ossicular abnormalities with intact tympanic membrane. The ossicular abnormalities in this study included 35 ears with congenital anomalies and 10 ears with traumatic ossicular dislocation. Reconstruction of the ossicular chain was fully successful for patients with traumatic disruption and surgical results were satisfactory. In the cases of congenital anomalies, the degree of hearing gain following reconstruction of the ossicular chain depended on the type of ossicular abnormality. The "disruptive type" of case showed successful surgical results more often than the "fixed type" of case. However, preoperative examination including an audiogram, impedance audiometry and a high resolution CT, was not able to be fully differentiate between the “di sruptive type” and “fixed type”.
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竹沢 裕之, 北秀 明
1995 年 1995 巻 Supplement84 号 p.
25-29
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
The Schellong test is one of the minor examinations for orthostatic dysregulation. As the Schellong test is a non-invasive examination, it is frequently performed to evaluate autonomic imbalance of patients with dizziness.
The results of the Schellong test were positive in 61 (51.3%) of 119 patients (male 30, female 89)and specificity for orthostatic dizziness and orthostatic dysregulation were noted.
Overall,64.4% of the patients with hypertension showed positive results on the Schellong test. Although, the rate of patients with hypertension increased with age, the results of the Schellong test were not dependent on age. The results of this study suggest that hypertension affects the results of the Schellong test.
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石井 歓, 竹沢 裕之, 小島 正, 児玉 広幸, 浜本 誠, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
30-35
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Thirty-two handicapped children with hearing impairment were fitted with hearing aids. Hearing aids were effective in 28 of these caces, but were effective for all children less than 1 year old. Hearing aids could not be fitted in 4 caces.
The results of this study showed the importance of early diagnosis of hearing impairment and early fitting of hearing aids in handicapped children.
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第一報:臨床所見
白崎 英明, 朝倉 光司, 成田 慎一郎, 齋藤 博子, 小笠原 英樹, 石井 歓, 渡辺 雅子, 東 英二, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
36-41
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
A clinical study of 437 patients with nasal allergy treated between January 1990 and July 1994was performed. The results showed that males developed nasal allergies at an earlier age than females. X-rays revealed that approximately 28% of patients were affected by paranasal sinusitis. Eosinophilia was found in nasal smears of 66.8% of patients, and peripheral blood eosinophilis (>6% eosinophils) were found in 47.0%. Sinusitis and eosinophilia in nasal smears and peripheral blood were more frequently observed in younger patients.
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第二報:原因抗原の検討
成田 慎一郎, 朝倉 光司, 白崎 英明, 齋藤 博子, 小笠原 英樹, 石井 歓, 渡辺 雅子, 東 英二, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
42-48
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Between 1990 and 1994,437 patients were treated for allergic rhinitis at Sapporo Medical University. Intracutaneous tests were positive in 75.1%,34.0% and 32.6% of the patients for house dust, orchard grass and white birch, respectively. RAST was positive in 64.6%,68.8%,34.4%,27.8%,19.5% of the patients for house dust, mite, orchard grass, white birch and mugwort. The total IgE level in serum was more than 160 IU/ml in 50.6% of the patients. The positive rates on intracutaneous tests and RAST to house dust and the level of total IgE in patients with asthma and/or atopic dermatitis were significantly higher than the positive rates and IgE level of patients without asthma or atopic dermatitis.
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森本 賢治, 小笠原 英樹, 朝倉 光司, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
49-54
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
This study investigated the relationship between nasal allergy and chronic sinusitis in children. We examined 231 children with nasal symptoms (nasal obstruction, sneezing and watery rhinorrhea)using allergy tests and radiological examination. We divided the subjects into a definite group (125children), a possible group (60 children) and a negative group (46 children) using allergy studies. Radiological examination showed the frequecy of maxillary sinus shadow in each of the above groups were 60%,73% and 89%, respectively.
The results suggested that nasal allergy does not increase the incidence of maxillary sinus shadow. Radiological examination of the adenoid showed that adenoidal hypertrophy influenced the incidence of chronic sinusitis and otitis media with effusion in definite group.
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山本 哲夫, 高田 竜多, 平尾 元康, 上村 正見, 齋藤 博子, 朝倉 光司, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
55-61
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
We evaluated pollinosis (seasonal nasal or ocular symptoms and CAP positive (score>1)) in 170patients in Sapporo in 1992.
One-hundred cases of birch pollinosis,66 cases of grass pollinosis and 36 cases of composite pollinosis were found in 1992. The number of patients with birch pollinosis in Sapporo was much higher than the number reported in past studies.
However, the number of birch trees in Ishikari has remained the same over the past 25 years.
However, the number of diesel powered cars in Sapporo has increased over the past 15 years.
The residential area of Sapporo has also expanded over the past 25 years.
The increase in the quantity of road dust generated by studded tires in Sapporo may also be a factor.
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北 秀明, 竹沢 裕之, 磯部 実, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
62-69
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Seventy-one patients with chronic sinusitis were treated with 600 mg erythromycin (EM) or 150 mg roxithromycin (RXM) daily for three months.
Significant improvement in subjective nasal symptoms was noted after three months in both the EM-treatment group and the RXM-treatment group, except for hyposmia. Objective findings improved significantly after three months with either EM or RXM treatment except for swelling of the nasal mucosa. Significant improvement in the X-ray appearance of the maxillary sinuses was observed with either EM or RXM. There was no significant difference between the efficacy of EM and that of RXM.
Long-term, low-dose EM therapy was effective even when EM-resistant bacteria were present in nasal cavity.
Therefore, this effect was not considered assosiated with its antibacterial activity but with some as yet unknown mechanism.
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習慣性扁桃炎を中心に
石川 忠孝, 原渕 保明, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
70-76
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
A total of 1,396 patients, who underwent tonsillectomy in our hospital over a period of 10 years, were retrospectively studied. The patients were divided into four illness groups; 535 patients with recurrent tonsillitis,160 with tonsil hypertrophy,54 with chronic tonsillitis, and 647 with focal tonsillitis. The study was focused mainly on the recurrent tousillitis group. A survey was conducted to study improvements in subjective symptoms for 320 patients in the recurrent tonsillitis group. We received answers to the questionnaire from 119 patients (37.2%). Improvements in subjective symptoms, such as recurrent fever and pharyngeal pain were observed in 116 of the 119 patients. One hundred and sixteen patients were satisfied with the results of tonsillectomies.
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村形 寿郎, 氷見 徹夫, 浜本 誠, 横山 雄司, 若島 純一, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
77-81
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Thirty patients diagnosed with focal tonsillitis accompanied by low-grade fever were treated by tonsillectomy. The symptoms were resolved postoperatively in 22 of the 30 cases (73%). The prognotic value of preoperative annulment tests of the tonsil was high.
However, the results of provocation tests of the tonsils did not correlate with the results of the tonsillectomies. A decline in fever was seen within 3 months after surgery. The results of the study suggest that tonsillectomy is an acceptable method of treating patients with low-grade fever, and annuration test results provide useful prognotic information.
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石川 忠孝, 久々湊 靖, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
82-86
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Tonsillectomy was performed on four patients with erythema exudativum multiforme (EEM)who were suspected of having tonsillar focal infection.
Antistreptolysin-O (ASO) was negative in all cases. However, an increase in skin lesions with tonsillitis were observed in 3 cases. A tonsil provocation test using ultra-short wave stimulation and a negation test using impletol injection were performed on all 4 patients. From the results of the provocation test, all cases were considered positive. However, the results of the negation test showed that only 3 cases were positive.
The following results were obtained from this study.
1) Tonsillectomy was shown to be effective in all cases.
2) We considered that the results of the negation test and the interval between the onset of EEM and tonsillectomy were related to the post operative prognosis.
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朝倉 光司, 氷見 徹夫, 原渕 保明, 久々湊 靖, 坪田 大, 浜本 誠, 形浦 昭克, 晴山 雅人, 森田 和夫
1995 年 1995 巻 Supplement84 号 p.
87-92
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
We performed a clinical analysis of 53 cases of maxillary cancer treated at Sapporo Medical University Hospital between 1982 and 1990. Patients were treated by a combination of radical surgery, pre-and post-operative irradiation (total,50-60 Gray) and regional chemotherapy by intraarterial infusion. The 5-year cumulative survival rates of squamous cell carcinoma were 83.3,63.3and 51.9% in T2, T3 and T4 cases, respectively. In cases with cervical lymphnode metastasis,74%were successfully treated, and 4 of 5 cases of neck failure had residual or recurrent tumor at the site of their original lesions. Ten of 17 DOD (dead of disease) cases also had distant metastasis. To improve the prognosis of maxillary cancer, efforts must be made to decrease the incidence of distant metastasis.
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坪田 大, 朝倉 光司, 氷見 徹夫, 原渕 保明, 浜本 誠, 大黒 慎二, 形浦 昭克, 大内 敦, 晴山 雅人, 森田 和夫
1995 年 1995 巻 Supplement84 号 p.
93-99
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
One hundred fifty-nine cases of laryngeal cancer that were diagnosed and treated between 1983and 1992 at the Department of Otolaryngology, Sapporo Medical University Hospital were evaluated. There were 101 glottic (66.0%),53 supraglottic (33.3%) and 5 subglottic (3.1%) tumors.
The overall five-year survival rate was 74.2%, while the ten-year survival rate was 62.7%. Regarding the primary site of the tumor, the glottic type was more curable than the supraglottic type and its five-year survival rate was 82.8%, while that of the supraglottic type was only 63.8%. There was no significant difference in the five-year survival rate of laryngeal cancer patients with and without lymph node metastasis.
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大黒 慎二, 朝倉 光司, 氷見 徹夫, 原渕 保明, 久々湊 靖, 坪田 大, 浜本 誠, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
100-105
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Ninety-five patients with thyroid tumor underwent surgery at our hospital between 1987 and 1994. There were forty benign tumors and fifty-five malignant tumors. The ratio of male/female for malignancies was higher than that for benign tumors. Twenty-two of ninety-five patients had no subjective symptoms before consulting the hospital. Ultra-sound sonography was a useful imaging technique for diagnosing malignancy. Most of the pathological diagnosis of benign tumors were follicular adenoma or adenomatous goiter. Pathological diagnosis of malignant tumors were papillary adenocarcinoma in fifty patients, follicular adenocarcinoma in four patients and anaplastic carcinoma in one patient. Only one patient who had anaplastic carcinoma died of disease. Permanent vocal cord palsy occurred in three patients with benign tumor and in five patients with malignant tumor. Permanent hypocalcemia occurred in six patients with benign tumor and eighteen patients with malignant tumor.
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新谷 朋子, 朝倉 光司, 形浦 昭克, 氷見 徹夫, 原渕 保明
1995 年 1995 巻 Supplement84 号 p.
106-111
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Eighty-six cases of parotid tumor were treated in our clinic between 1984 and 1993. The pathological diagnosis were made according to the classification of the World Health Organization (1991). Of the 86 tumors,60 were benign and 26 were malignant. In the benign tumors,63.3%were pleomorphic adenoma, and 21.7% were Warthin's tumor. The incidence of Warthin's tumor was increased. In the malignant tumors, squamous cell carcinoma were predominant and the incidence of malignant lymphoma was increased. Total parotidectomy was performed in 15 malignant tumors and radical neck dissection was performed in 10 cases. Radiotherapy was performed in 17 cases.
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小笠原 英樹, 朝倉 光司, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
112-117
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
We reviewed pathological findings of 134 patients with benign laryngeal tumors. The study population consisted of 103 males and 31 females who were treated at the Department of Otolaryngology, Sapporo Medical University between 1975 and 1993. Each case underwent biopsy and surgical treatment (endolaryngeal microsurgery) and pathological diagnoses included papilloma, leukoplakia, hyperkeratosis, hyperplasia and dysplasia of the larynx.
Patient ages in these 134 cases ranged from 4 to 87. The incidence was higher for males and peaked at approximately 50 to 60 years of age, as a number of investigators have reported previously. Smoking was suggested to be a risk factor for these disease.
Pathological findings revealed the dominance of white lesions of the larynx (leukoplakia, hyperkeratosis, hyperplasia and dysplasia). Fourteen of 134 cases developed carcinoma of the larynx after a period of more than six months. Progression to carcinoma occurred predominantly in white lesions and dysplastic lesions.
Therefore, careful follow-up of patient with these benign laryngeal tumors is required and we recommend that these lesions be considered premalignant.
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横山 雄司, 朝倉 光司, 形浦 昭克, 晴山 雅人, 森田 和夫
1995 年 1995 巻 Supplement84 号 p.
118-126
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Cervical nodal metastasis is not an unusual occurrence. The majority of patients with such metastasis had primary cancer of the head or neck. However, the primary cancer cannot be detected in some cases until treatment has begun. Eight patients with metastatic carcinoma to the cervical lymph nodes from unknown primary sites were treated between 1975 and 1993. Histopathological diagnosis of the cervical masses were as follows; five cases had squamous cell carcinoma, two had adenocarcinoma, and one had undifferentiated carcinoma. Treatment generally involved radical neck dissection followed by intensive radiation therapy extended from the base of the skull to the clavicle and medially to the midline, and occasionally, with chemotherapy for palliation. Primary lesions became evident in three patients after the initial therapy was concluded. The primary lesions were located in the kidney, the lung and oropharynx, and the patients died of uncontrolled distant metastasis. Of the remaining five patients who had no evidence of primary lesions, three survived while two died of kachexie due to the malignant tumor. Three patients with supraclavicular disease died of distant metastasis from the initial disease. Initial radical therapy was performed on five patients who had no distant metastasis and were in good general condition, and four of these patients survived for more than three years. This report was based on our experience in the management of cervical nodal metastasis and the survival characteristics of these patients.
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自験3症例の検討
小島 正, 石川 忠孝, 鈴木 敏夫, 若島 純一, 朝倉 光司
1995 年 1995 巻 Supplement84 号 p.
127-134
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Recent advance in reconstructive surgery have made it possible to reconstruct a mandibular defect remaining after surgical resection for cancer. However, there are still many difficulties concerning the recovery of oral function following mandibular reconstruction. We attempted a different mandibular reconstruction method in three patients. The first patient was a 66-year-old male with mesopharyngeal cancer. His mandibular defect was reconstructed by a free rib bone graft with a free rectus abdominis musculocutaneous flap. The second patient was a 55-year-old male with tongue cancer. His mandibular defect was reconstructed using a free vascularized osteocutaneous scapular flap. The third patient was a 65-year-old male with lower gingival cancer. His mandibular defect was reconstructed using a titanium mandibular reconstruction plate with a pedicled pectoris major musculocutaneous flap. All three patients were satisfied with their oral function following mandibular reconstruction. Thus, the mandibular reconstruction method should been selected with consideration of the patient's age and general condition.
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染川 幸裕, 浅野 勝士, 今井 良吉, 平 篤史
1995 年 1995 巻 Supplement84 号 p.
135-140
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
A clinical study was carried out of 11 patients treated for mucoepidermoid carcinoma between 1978 and 1994. Based on histological subtype, the tumors were classified as well differentiated (4cases), moderately differentiated (3 cases), and poorly differentiated (4 cases).
Six of the eleven patients (2 moderately and 4 poorly differantiated) were advanced cases with local invasion and cervical lymph node metastasis. Prognosis was correlated to the histological subtype of the tumor. Six of seven cases in the well and moderately differentiated groups survive with no signs of recurrence, while 1 patient in this group died of unrelated causes. However, all 4 patients in the poorly differentiated group died as a result of the disease.
The method of treatment was selected, based on histological examination. However, the results of the study suggest that wide bloc excision may be the most effective method of treatment for all tumor types. Post-operative radiation or chemotherapy may be required in poorly differentiated tumor cases.
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東 英二
1995 年 1995 巻 Supplement84 号 p.
141-143
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Benign osseous tumors of the paranasal sinus and external auditory canal are sometimes found in the head and neck region. Osteomas of the middle ear are extremely rare lesions.
Here, a case of a 6-year-old boy with osteoma arising from the middle ear is reported. A white mass was observed in the hypotympanum through the intact right ear drum of the patient. An exploratory myringotomy was performed, and palpation with a microinstrument showed that the mass which was covered with intact middle ear mucosa was a bony hard tumor. The osteoma was not removed since, it was the asymtomatic.
The osteoma has not changed in size during 6 years of observation.
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山田 恭子, 氷見 徹夫, 大黒 慎二, 鈴木 敏夫, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
144-147
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
A 45-year-old male with Van der Hoeve syndrome is reported. He showed a sudden onset of hearing loss on the right side at 32 years of age. Audiometric examination showed a mixed hearing loss (PTA; 69 dB) and dislocation of ossicular chain was suspected. At surgery, fracture of the stapedial crus was revealed. Mobility of the stapedial foot plate remained, thus tympanoplasty was performed. This fructure may have been caused by a mechanical shift of the tympanic membrane. The histological findings of the stapedial crus showed pathological changes not due to osteogenesis, but due to decrement of osteoblasts. Moreover, radiological findings revealed pathogical changes of the bony cochlea.
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川口 竜一, 朝倉 光司, 児玉 広幸, 齋藤 博子, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
148-152
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Intractable recurrent ulcers in the pharynx of unknown cause are resistant to treatment. A 34year-old man with a recurrent ulcer was treated at our hospital. Because of the association with inflammatory changes of the lingual tonsil, we vaporized the lingual tonsil using a CO
2 laser. After this procedure, his pharyngeal ulcer was cured and no recurrence of the disease has been noted for 2years. Focal infection may be one of the causes of this disease.
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村形 寿郎, 氷見 徹夫, 大黒 慎二, 吉岡 巌, 朝倉 光司, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
153-156
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Surgical treatment using Nd-YAG laser was performed on a 39-year-old man with sleep apnea syndrome (OSAS). According to the results of sleep study, the apnea index and the lowest Sa02 indicated severe OSAS. Radical examination, including MRI, showed that the obstructed region in the respiratory system was mainly in the nasopharynx, not the mesopharynx, and that a hypertrophic pharyngeal tonsil caused the obstruction in the nasopharynx. It is thought that the cases of OSAS involving nasopharyngeal obstruction due to a hypertrophic pharyngeal tonsil are common in children but rare in adults. Resection of the hypertrophic tissue was performed using an Nd-YAG laser at the midsection of the soft palate.
Tracheostomy was also performed. The symptoms and results of sleep study were remarkably improved post-operatively, and the decrement in the region of obstruction was confirmed by a radiological analysis. The results showed that surgical resection of the pharyngeal tonsil using a laser is an effective and safe methods of treating OSAS in adults.
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大黒 慎二, 朝倉 光司, 齋藤 博子, 渡辺 雅子, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
157-160
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
We present a patient with chronic stenosis of the larynx due to attempted suicide by hanging. A 32-year-old male with schizophrenia attempted to hang himself. He consulted our hospital with a complaint of difficulty in swallowing. Fiberscopic examination and CT findings revealed blunt damage between the hyoid bone and thyroid cartilage.
Resection of scar was done to maintain a sufficient lumen. After surgery, his swallowing improved.
It would be better to evaluate the larynx as soon as possible when examining a patient with neck
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児玉 広幸, 朝倉 光司, 小林 一豊, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
161-165
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Three pediatric cases of internal jugular phlebectasia which showed specific clinical features are described and a brief review of the literature is presented. Two of the cases were 5-year-old boys who were affected on the right sides of their necks, and one case was a 2-year-old girl with her left side affected. A soft swelling appeared in the neck during straining, forcible phonation, or holding the breath after deep inspiration, which increased intrathoracic pressure. When the patients relaxed, however, no swelling could be seen. CT and MRI images were obtained. Ultrasonic study of the neck revealed that the internal jugular vein became dilated in caliber when the patients exerted pressure.
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松井 利憲, 久々湊 靖, 新谷 朋子, 高田 竜多, 白崎 英明, 小笠原 英樹, 朝倉 光司, 形浦 昭克, 晴山 雅人, 森田 和夫
1995 年 1995 巻 Supplement84 号 p.
166-171
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
The incidence of Hodgkin's disease among all types of malignant lymphomas is a relatively low 10% in Japan. It is very rare, especially in Waldeyer's ring.
We report three cases of Hodgkin's disease in the head and neck region.
Two of these cases originated in Waldeyer's ring and the other in the nasopharynx. Case 1 was a 10-year-old male whose chief complaint was left neck masses. He was treated with chemotherapy using 6 cycles of MOPP/ABVD. Case 2 was a 45-year-old male. He complained of nasal obstruction, and his nasopharynx was swollen. He was treated with chemotherapy using 3 cycles of CMOPP and underwent radiotherapy as well. Case 3 was a 65-year-old male, who complained of swelling of the left faucial tonsil. He was treated with chemotherapy using 1 cycle of MOPP and underwent radiotherapy.
Survival in three cases ranged from 7 months to 4 years 10 months after treatment, without relapse.
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秦 正人, 原渕 保明, 浜本 誠, 山口 朝, 氷見 徹夫, 大黒 慎二, 齋藤 博子, 吉岡 巌, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
172-177
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Non-Hodgkin's lymphoma usually occurs in the head and neck regions. It is commonly known. that T cell lymphoma infiltrates the skin, while B cell lymphoma is rarely associated with skin infiltration. We report two cases of B cell lymphoma with skin infiltration. The first case was a 58-yearold female with swelling of the right tonsil. She was treated with chemotherapy (2 cycles VEPA)and radiotherapy.
The second case was an 82-year-old female with swelling of the left cheek, who was treated with radiotherapy.
Histopathological features of these two cases showed diffuse large cell types (LSG's classification).
Despite treatment, both patients died from B cell lymphoma infiltration of the skin.
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平尾 元康, 原渕 保明, 朝倉 光司, 形浦 昭克, 晴山 雅人, 森田 和夫
1995 年 1995 巻 Supplement84 号 p.
178-183
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Laryngoscopic examination revealed a subglottic mass with a smooth surface in a 15-year-old boy with a sore throat and dyspnea. Radiological examination showed that the mass involved not only the post-subglottic region but also the cervical-trachea. From specimens obtained by laryngomicrosurgery, the mass was immunohistochemically diagnosed as a B-cell non-Hodgkin's lymphoma (NHL), diffuse, large cell type (LSG classification). No other lesions were detected on systemic evalution. After three units of MACOP-P chemotherapy and regional irradiation, the tumor disappeared. There has been no evidence of recurrence was seen for 40 months since the treatment. The clinical and pathological characteristics, and the treatment of NHL of the larynx are discussed.
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山谷 浩信, 小林 一豊
1995 年 1995 巻 Supplement84 号 p.
184-188
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Malignant lymphoma in the parapharyngeal space is very rare in Japan.
A 68-year-old male with a malignant lymphoma in the parapharyngeal space is reported. In this case, preoperative diagnosis from fine needle aspiration and open biopsy was difficult.
The malignant lymphoma was discovered on postoperative histopathological examination.
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若島 純一, 小島 正, 鈴木 敏夫
1995 年 1995 巻 Supplement84 号 p.
189-193
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
An 89-year-old male complained of exophthalmus and diplopia. Image diagnosis including CT pointed to a tumor or mucocele in the left frontoethmoidal region. An extranasal incision was performed and the mass in the left frontal sinus was diagnosed as non-Hodgkin's lymphoma on frozen section report. He was treated with irradiation and Etoposide, but died 3 months later. Previous reports of frontal sinus lymphoma in Japan are reviewed and discussed.
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齋藤 博子, 朝倉 光司, 児玉 広幸, 形浦 昭克, 保喜 克文
1995 年 1995 巻 Supplement84 号 p.
194-198
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
We report a rare case of a metastatic parotid tumor of gastric origin. Previous reports have shown that the most primary lesions of metastatic parotid tumors are in the head and neck and there have been few cases which developed tumors in areas distant from the primary site. This is only the second reported case of gastric adenocarcinoma metastasizing to the parotid gland.
A 66-year-old male who complained of swelling in the right parotid gland and neck consulted our outpatient clinic. He had undergone total gastrectomy 5 years earlier. A total parotidectomy and radical neck dissection were performed on the right side, and postoperative irradiation therapy was planned. However,2 weeks after surgery, hepatic function deteriorated, and a recurrence of a gastric tumor was diagnosed as multiple abdominal lymphnodes and hepatic metastases. Clinical and histopathological examination showed that the parotid tumor had metastasized from gastric adenocarcinoma.
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齋藤 博子, 朝倉 光司, 保喜 克文, 児玉 広幸, 形浦 昭克
1995 年 1995 巻 Supplement84 号 p.
199-204
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
This report presents a 60-year-old male with primary rhabdomyosarcoma in the neck. Rhabdomyosarcoma is an uncommon neoplasm seen in the head and neck regions. In recent years, chemotherapy and irradiation have been more frequently used as adjuvant therapies in combination with total surgical excision.
In this case, for evaluation of tumor staging, we performed surgical excision followed by chemotherapy, CYVADIC and IMVP-16 therapy. The tumor was abnormally large, with a diameter of 33 cm, and is the biggest reported case so far.
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山岸 みどり, 志藤 文明, 岡田 勝也, 形浦 昭克, 竹内 薫
1995 年 1995 巻 Supplement84 号 p.
205-208
発行日: 1995/10/15
公開日: 2012/11/27
ジャーナル
フリー
Intrathyroid thymoma is a rare tumor. This report describes a 62-year-old woman with a solitary tumor in the lower pole of the right thyroid lobe. The tumor and regional lymph nodes were surgically resected. Histopathological examination revealed a thymoma located in the thyroid.
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