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術前診断,術後成績を中心に
渋谷 和郎, 岡部 陽三, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
1-8
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
It is difficult to diagnose conductive deafness with intact or unperforated eardrum. We analyzed the preoperative diagnoses and post-operative results in 24 ears of 21 patients with middle ear abnormalities included 11 ears with congenital anomalies,9 ears with otosclerosis,2 ears with tympanosclerosis with intact eardrum and 2 ears with congenital cholesteatoma.
For an operative diagnosis, it has been difficult to evaluate ossicular mobility from routine measurements. A new ossicular measuring system, the ossicular mobility analyzer, OMA, has been developed for the diagnosis of ossicular condition.
Reconstruction of the ossicular chain was performed by Wullstein III or IV for ossicular anomalies, tympanosclerosis or congenital cholesteatoma and by stapedotomy for otosclerosis. The improvement rate of the air bone gap was 74.7% in 20 evaluable cases.
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岡部 陽三, 渋谷 和郎, 三輪 高喜, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
9-12
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Although traumatic middle ear lesions are quite common, isolated fracture of the handle of the malleus is extremely rare.
A33-year-old woman presented with hearing loss in the left ear since she had accidentally stabbed herself in the ear with an earpick. Traumatic perforation of the ear drum closed spontaneously on the thirteenth day after onset, however, she complained of a sensation of ear fullness. Hearing test revealed a mild conductive hearing loss on the affected side. A high compliance at tympanometry and absence of stapedial reflex were also found on that side. CT scan showed a suspicious fracture of the handle of the malleus.
Under general anesthesia, exploration of the middle ear was performed. A fracture of the malleus was identified distal to the short process. A small tip of the tragus cartilage was inserted between the fractured handle of the malleus and the long process of the incus. The hearing normalized immediately after surgery.
We also report the usefulness of an ossicular mobility analyzer which was developed in our department to evaluate middle ear function.
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中村 保子, 嶋田 武文, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
13-16
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Spinal anaesthesia is a very common procedure, which technically is easy to perform and when correctly done generally has few and minor side effects. In this report, a case of bilateral hearing loss in the low-frequency range after lumbar anaesthesia is presented.
It is suggested that endolymphatic hydrops due to the loss of cerebrospinal fluid during the procedure played a role in the development of this complication.
Hearing loss may occur more often than it is generally assumed, though the symptom is often overlooked. Since not all of these hearing losses prove to be fully reversible, it is important to inform the patient concerning this complication.
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中川 圭, 吉崎 智一, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
17-20
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Several adverse effects of Interferon (IFN) have been recognized since IFN therapy for viral hepatitis started. Recently, ototoxicity of IFN was reported as one of the adverse effects.
Here, we reported a case of patient who suffered sudden sensorineural hearing loss from IFN which was administrated as therapeutic agent for viral hepatitis. Following discontinuation of IFN and administration of steroids, ATP and vitamins, the patient obtained partial recovery of low-tone hearing level though he could not achieve total recovery. Toxic effects of IFN on the microvascular environment was speculated as the mechanism of ototoxicty. The high incidence and reversibility of auditory disability following administration should be recognized. Moreover, monitoring of hearing level is essential for patients being treated with IFN.
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石丸 正, 作本 真
1995 年 1995 巻 Supplement85 号 p.
21-27
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
A 61-year old female patient with fibrous dysplasia of the temporal bone is reported. She consulted us for hearing loss in the left ear. Stenosis of the external auditory canal caused the conductive hearing loss. CT-scan and scintiscanning using
99mTc-MDP demonstrated fibrous dysplasic change in the left temporal bone. On MRI, a parotid tumor was discovered on the same side as the fibrous dysplasia of the temporal bone.
Surgery was performed on the external auditory canal and the parotid tumor. After creating a new auditory canal, her hearing loss was improved. Pathological diagnosis of a section of the temporal bone showed fibrous dysplasia.
Surgery of the parotid tumor was also performed. We diagnosed it as a neurinoma of the facial nerve by its surgical and pathological findings.
We review the combination of fibrous dysplasia and the neurinoma in the literature. There is a relationship between fibrous dysplasia and Albright's syndrome and Albright's syndrome has also a relationship to neurofibroma. Both neurinoma and neurofibroma are symptoms of Recklinghausen disease. Therefore, there seemed to be a common area among these diseases.
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菊地 さおり, 作本 真, 岡部 陽三, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
28-33
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Middle ear adenomas and adenocarcinomas are both rare lesions and the clinical and histopathological distinction between these lesions is difficult.
We report a 26-year-old man with a middle ear adenoma that originated from the right middle ear mucosa. The mass was found in the posterior tympanum. It surrounded intact ossicles and extended to the additus and mastoid antrum. The patient underwent tympanoplasty with mastoidectomy.
In this case, we diagnosed this lesion as middle ear adenoma from the absence of bone destruction, confinement to the middle ear cleft and lack of metastasis as Hyams & Michaels noted in 1976. The postoperative course has been uneventful for nearly 7 months.
The literature indicates that of there is no invasion, most of these tumors are benign and the prognosis is good, but a few recurrences are reported, so the careful follow-up is mandatory.
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浦本 直紀, 加勢 満, 渡辺 宏, 室野 重之, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
34-39
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
An analysis and an evaluation of the prognostic factors in peripheral facial nerve palsy were performed on 68 patients admitted to the Department of Otorhinolaryngology at Toyama Municipal Hospital between 1992 and 1994. The process of recovering from peripheral facial nerve palsy could be generally divided into two groups. The prognosis could be predicted by the outcome of salivary gland scintigraphy better than that of electrogustometry. Antibody titration against varicella-zoster virus was useful for predicting prognosis, even in the patients who were not clinically suspected varicella-zoster virus infection.
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能登谷 晶子, 岡部 陽三, 瀧口 哲也, 鈴木 重忠, 諏訪 美幸, 山崎 芳文, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
40-45
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Since 1991 we have performed 22 channel cochlear implants in 8 profoundly deaf patients. One patient also had severe visual impairment. Auditory training course and speech comprehension scores are reported for this 53-year-old woman who underwent 22-channel cochlear implant surgery. Using the cochlear implant alone, the open-set sentence scores achieved 80-84%, while vowel confusion study and consonants confusion study scored 85% and 37.5%, respectively. Vowel recoginition abilities and environmental sound recognition in daily life was sufficient with this implant, whereas, consonant recognition abilities were insufficient. Moreover, it took approximately 2years to reach the open-set level.
Accordingly, it is suggested that even auditory-visually impaired patients are indicated for cochlear implant.
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新家 恵子, 能登谷 晶子, 鈴木 重忠, 室野 亜希子, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
46-50
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Speech and language training for hearing-impaired children at our clinic is done by the Kanazawa Method which consists of reception and expression training in sign language as well as auditory/oral language and written language training. The present investigation was undertaken to explore long-term progress in reading abilities in 14 hearing-impaired children who had participated in the Kanazawa Method before entering elementary schools. Progress in reading ability was evaluated using the New Diagnostic Reading Ability Test of the Kyoken Method.
The results obtained were as follows:
1) The average score in reading ability just before entering elementary schools reached the second grade.
2) Ten children (71.4%) maintained a high score longitudinally.
3) There was a significant correlation between reading achievement level at 6 years of age and the later level (rs= 0.62).
4) The reading achievement level of our children was higher than that of those trained by the conventional method.
These results suggest that early instruction in written language is effective in the acquisition of reading ability which is especially difficult for the hearing-impaired.
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室野 亜希子, 能登谷 晶子, 鈴木 重忠, 新家 恵子, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
51-57
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
The recovery process in a case of transcortical motor aphasia is presented. The subject was a 73-year-old right-handed man. CT scan revealed a low-density area in the left internal capsule, atrophy in the left fronto-parietal lobe and an old low-density area in the right parieto-occipital lobe. The initial stage was characterized by severe disturbance in spontaneous speech, good repetition, poor oral and written comprehension, word finding difficulty. This stage showed the characteristic features of so-called transcortical mixed aphasia. Compared with the initial stage,3 months after the onset, the patient recovered naming, writing and oral and written comprehension. After 7 months, his correct naming score was more than 80/100 (80%). Disturbances in spontaneous speech and word fluency, however, remained almost unchanged. During the early stage, our case showed transcortical mixed aphasia, and then during the later stage his aphasic symptoms showed transcortical motor aphasia. However, writing errors by this patients were similar to hypergraphia which is sometimes observed in patients with right hemispheric damage. We referred his writing errors to the bilateral damage.
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嗅球除去に伴うNGF受容体の発現
堀川 勲, 三輪 高喜, 木村 恭之, 土定 建夫, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
58-64
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Topographical expression of nerve trophic factor receptors in the murine olfactory epithelium after bulbectomy was studied immunohistochemically using high-affinity binding of the trk group of tryosine protein kinases. We used three polyclonal antibodies against trk, trkB and trkC, which specifically recognize nerve growth factor (NGF) receptor, brain-derived neurotrophic factor (BDNF) receptor and neurotrophin-3 (NT-3) receptor, respectively. Among the three antibodies used, trk immunoreactivity was most prominent after bulbectomy. In this experiment, the possible regenerative or degenerative effects of bulbectomy were detected over the course of 28 days following surgery in adult mice whose olfactory bulbs had been removed. In these mice, trk immunoreactivity in regenerating cells and nervi of the olfactory epithelium was increased 7-28 days after bulbectomy, while trkB and trkC immunoreactivities in olfactory nervi were increased 1-21 days after bulbectomy. Taken together, these results suggest that a high-affinity NGF-receptor is produced in the olfactory cells and distributed to the regenerating olfactory system. Among the three neurotrophic factors, i. e. NGF, BDNF and NT-3, NGF may play the most important role in the olfactory pathway.
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作本 真, 菊地 さおり, 浦本 直紀, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
65-70
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Japanese cedar pollinosis is one of the most common pollinosis in Japan.
We have measured the amount of Japanese cedar pollen in the air, using Durham's standard pollen sampler method, at seven observation sites in Ishikawa prefecture. The total seasonal pollen count was greater at five observation sites in 1992 and 1993, while they were not as high at the other two sites each year. This finding suggests that the pollen count is influenced by the surroundings. Although there was no difference in the duration of the pollination season among the seven observation sites, The daily changes in the pollen count in the Noto area differed from those in the Kaga area. Therefore at least two observation sites, in the Noto and the Kaga areas, are necessary to investigate the daily changes in the pollen count.
With regard to pollen counts and meteorological factors, this study was in agreement with previous reports: there was a good correlation between the total seasonal pollen counts and meteorological factors the previous summer, and between the beginning date of pollen scattering and meteorological factors in January and February. We hope that a forecast of Japanese cedar pollen count in Ishikawa prefecture will be started in the near future.
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長山 郁生, 作本 真, 渡辺 宏, 木村 恭之
1995 年 1995 巻 Supplement85 号 p.
71-74
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Patients with nasal allergy who did not respond to conservative therapy were treated by surgical therapy combined with laser treatment. These patients consisted of twenty-two males and females, ranging from 13 to 81 years of age. Surgical therapy included submucosal resection of the nasal septum, submucosal resection of the inferior turbinate and irradiation with a CO2 laser, used either jointly or independently. One year after surgery, assessment of the surgical therapy was obtained by questionnaire. Five of the patients were assessed at our clinic and 19 of the patients replied to the questionnaire. Of these,92% indicated an improvement in nasal obstruction,75% in nasal discharge and 71% sneezing. Twenty-two of 24 patients expressed satisfaction with the surgical effect. There were no surgical complications except for a case of asthma attack and a case of atrophic rhinitis, both of which recovered uneventfully. Laser surgery showed marked effectiveness on allergic change of the nasal mucosa.
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木村 恭之, 中川 圭, 西村 俊郎, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
75-80
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Sixteen cases of maxillary sinus carcinoma treated at the Department of Otolaryngology of Kanazawa University during the period between 1990 and 1994 were retrospectively analyzed.
Patient ages ranged from 33 to 88 years and the mean age was 59.4 years. According to the 1987 UICC TNM classification system, one patient was in Stage II, nine were in Stage M and six were in Stage IV. We treated most cases using radiation therapy following radical surgery. The one-year survival rate was 76.9% and the three-year survival rate was 61.6%. Distant metastasis occurred in three cases. Local recurrence occurred in only two cases. The main cause of death was distant metastasis. From CT findings, patients whose pterygopalatine fossa was destroyed had a poor prognosis. However, the destruction of the orbital floor was not considered a prognostic factor. We were able to preserve the orbital contents in most cases.
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三輪 泰子, 三輪 高喜, 西村 俊郎, 長山 郁生
1995 年 1995 巻 Supplement85 号 p.
81-84
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
A rare case of adult rhabdomyosarcoma originating from the left nasal cavity is reported. A 57year-old woman was referred to the Department of Otolaryngology, Kanazawa University, for investigation and treatment of a tumor in her left nasal cavity. Roentgenographic examination revealed a large left nasal mass without destruction of the surrounding bony tissue. Biopsy specimen from the tumor was pathologically suspected to be rhabdomyosarcoma.
She was initially treated by radical resection via an extranasal approach. Pathological diagnosis of the resected specimen was alveolar rhabdomyosarcoma based on PAS staining and immunohistochemical staining. Systemic chemotherapy consisting of high-dose Vincristin and Actinomycin D was administered following radical resection, but was stopped due to severe muscular pain and intestinal paralysis. Following chemotherapy, irradiation was given and during the fourteen months following surgery, the patient has remained free from local or systemic recurrence.
Rhabdomyosarcoma carries a worse prognosis than other sarcomas and chemotherapy is not as effective for adults as it is for children. Although curative surgery is important for alveolar rhabdomyosarcoma in adults, invasion to the central nervous system and distant metastasis to the lung are not rare. Therefore combined chemotherapy and irradiation are recommended.
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杉本 香織, 渡辺 宏, 西村 俊郎, 長山 郁生
1995 年 1995 巻 Supplement85 号 p.
85-89
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Malignant tumors arising in the nasal vestibule are relatively rare. We present two cases of malignant tumor in the nasal vestibule. In the first case, a 73-year-old man had an early lesion of well differentiated squamous cell carcinoma and received curative radiation therapy. He has survived with no evidence of disease for 6 months. Squamous cell carcinoma of the nasal vestibule has a more favorable prognosis than other posterior nasal cavity and nasal skin cancers. Tumor size, histological grading, and metastasis to lymph nodes in the neck are important factors in the prognosis. In the second case, an 82-year-old woman had a solitary malignant schwannoma in the nasal vestibule. The tumor was controlled by surgical enucleation. Though wide radical excision and postoperative radiotherapy is considered the best treatment for malignant schwannoma, the prognosis is usually poor. Death is usually caused by intracranial invasion and pulmonary metastasis. So we need to follow this case closely.
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室野 重之, 吉崎 智一, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
90-94
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Nasopharyngeal carcinoma (NPC) is closely related with Epstein-Barr virus (EBV). In latent EBV-infection of cells, EBV-encoded small RNAs (EBERs) are abundantly expressed, approximately 10
7 copies per cell. We examined the detection of EBER-1 which is one of two EBERs using the in situ hybridization method in 5 cases of formalin-fixed, paraffin-embedded NPC tissues. Specimens consisted of 5 primary nasopharyngeal carcinoma tissues (NP),3 metastatic cervical lymph nodes (MCL) and 1 non-metastatic cervical lymph node. EBER-1 expression was strongly demonstrated in 4 of 5 NP and 2 of 3 MCL. Positive signals were only shown within the nuclei of tumor cells. Anti-EBV antibody titer was investigated in 3 cases,2 EBER-1 positive cases and 1negative case. The titer, especially against VCA-IgA and EA-IgA, was high in the 2 EBER-1positive cases and low in the negative case. Thus, in situ hybridization with an EBER-1 probe is a sensitive and specific method of detecting EBV in formalin-fixed, paraffin-embedded NPC tissues.
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ESWLと疹痛
宮永 路子, 吉崎 智一, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
95-98
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Extracorporeal shock wave lithotripsy (ESWL) has been used clinically for the treatment of renal stones and gall bladder stones since 1980. Recently, ESWL was successfully used for sialolithiasis. We have been treating sialolithiasis patients with ESWL for four years. In this report, we demonstrate the dual benefit of taping around the affected salivary gland. First, the guarding tape reduced pain around the stone, and as a result, a more frequent pulse rate and stronger shock wave could be focused on the stones. Second, surrounding the affected organ with tape which blocks the ultrasound wave of monitoring echo makes it easier to identify the target stone. To obtain better results when using ESWL for salivary stones, an improved method of destroying the stones is essential, although improvement of excretion is also important. These problems will be resolved by some device, such as our procedure.
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田中 佐一良, 中川 士郎, 吉崎 智一, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
99-104
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Abnormal regulation of cytokines may contribute to the pathogenesis of habitual tonsillitis and tonsillar focal infection. We examined cytokine gene expression and the presence of Epstein-Barr virus (EBV) DNA in tonsillar diseases. Subjects included 11 patients with habitual tonsillitis, three with tonsillar focal infection and six with tonsillar hypertrophy. Freshly isolated mononuclear cells from human palatine tonsils were examined for messenger RNA (mRNA) expression of interleukinla (IL-1α), IL-2, IL-4, IL-6, interferon-γ (IFN-γ) and tumor necrosis factor-a (TNF-α) using the RTPCR method, and the presence of EBV DNA using the PCR method. Expression of TNF-amRNA was detected in 11 of 20 tonsils. IL-1αmRNA was detected in two tonsils and IL-2mRNA was detected in one tonsil. No expression of IL-4, IL-6 and IFN-γmRNA was detected. EBV DNA was not detected in any of 20 tonsils. These findings suggest that TNF-α may play an important role in tonsillar diseases.
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三輪 高喜, 中村 保子, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
105-112
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Between 1982 and 1983,42 patients with clinical Stage I or II non-Hodgkin's lymphomas of Waldeyer's ring were treated at our department. In eleven Stage I patients treated with radiation alone, both five-year survival and relapse-free survival rates were 100%. In 31 Stage II patients treated with chemotherapy (ACOP or CHOP) and radiation, these rates were 75.8% and 72.3%, respectively. In Stage IC patients, poor survival was significantly correlated with cervical lymph nodes greater than 6 cm in diameter. Prognosis for Stage II cases improved with the recent protocol for chemotherapy preceding radiation (5-year survival rates in the chemotherapy-preceding group and radiation-preceding group were 90.9% and 63.7%). Seven patients died of disease. The mean age of these patients was 70.3-yrs and mean survival time was 12.4 M. Six of the seven who died were treated with radiation prior to chemotherapy, and six cases had bulky lymph nodes or tumor. In conclusion, treatment with radiation alone is adequate for cases of Stage I NHL, and combination of chemotherapy and radiation is adequate for cases of Stage IC. In addition, intensive and short duration chemotherapy is necessary for patients with poor prognosis, especially those with bulky mass.
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手術および化学療法が有効であった症例
丸山 裕美子, 古川 仭, 北川 和久, 加納 美樹子
1995 年 1995 巻 Supplement85 号 p.
113-118
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
A case of stage II malignant melanoma of the mandibular gingiva is presented. After undergoing radical surgery with repair of the mandible using a titanium-mesh plate and adjuvant chemotherapy with Dacarbazine (DTIC), ACNU and vincristine (VCR), so to speak DAV therapy, the patient has survived for forty-five months.
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土定 建夫, 堀川 勲, 三輪 高喜, 木村 恭之, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
119-122
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Laryngeal granuloma can be classified into specific granuloma and non-specific granuloma. The latter is relatively rare and recurs frequently. The causes of non-specific laryngeal granuloma are divided into intubation, contact and idiopathic types. We reported two cases of laryngeal granuloma with sinobronchial syndrome that were cured by laryngeal microsurgery using a CO
2 laser. The mechanism of granuloma formation is considered that the vocal cord membrane was damaged by strong pressure during consecutive coughing and chronic stimulation by post nasal drip and sputum in the patients with sinobronchial syndrome. We concluded that sinobronchial syndrome is one of causes of laryngeal granuloma formation.
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温 慶華, 三輪 高喜, 吉崎 智一, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
123-130
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Expressions of epidermal growth factor receptor (EGFR) and one of its ligands, transforming growth factor-α (TGF-α), were determined immunohistochemically in 49 laryngeal squamous cell carcinomas.
Overexpression rates of EGFR and TGF-a were 38.8% and 55.1% respectively, without significant difference due to age, lymphnode status, location of tumor or grade of cancer tissues.
The survival rate was significantly lower in patients with EGFR(+) than in those with EGFR(-) (P<0.05). Patients with TGF-α(+) also showed a lower survival rate than those with TGF-α(-). However, recurrence rates were significantly higher in patients with EGFR(+) and TGF-α(+) than in those with EGFR(-) and TGF-α(-) (P<0.05, both). Futhermore, according to the staining status of the two immunological factors, four subgroups were classified: A: E(-)/T(-), B: E(+)/T(-), C: E(-)/T(+), D: E(+)/T(+). Both the survival rate and the recurrence rate of patients in the “D-subgroup” were the worst, with significant differences noted. Since the overexpression rates of the two factors increased with stage, further analyse were separately demonstrated in stage I, II and stage III, IV. In stage I, II,6 of 16 cases developed recurrence after radiation treatment, in which,5 cases were TGF-α(+) and 1 case was TGF-α(-), but for EGFR, this trend did not appear; in stage III,IV, survival rates in patients with EGFR(-) and TGF-α(-) were 91% and 100%. However, for those with EGFR(+) and TGF-α(+), these ra tes declined to 40% and 56%, respectively. These results also showed significant differences (P<0.05, both).
As a whole, the results suggested that TGF-a may act as an autocrine growth factor through overexpression of EGFR, and overexpression of both EGFR and TGF-a can be used as valuable prognostic indicators for patients with laryngeal squamous cell carcinoma.
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西村 俊郎, 脇坂 尚宏, 長山 郁生, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
131-134
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Reconstruction of the soft palate remains a great challenge for head and neck surgeons, although several new reconstructive procedures have been developed. As the reconstructed soft palate is immobile, postoperative velopharyngeal function would be impaired.
A 45-year-old female was admitted to Kanazawa University Hospital due to palatal adenoid cystic carcinoma that invaded the hard palate, lateral pharyngeal wall and left medial pterygoid muscle.
The tumor was resected and reconstruction was performed with free peroneal fasciocutaneous flap transfer. Since the peroneal flap is as thin and pliable as a radial forearm flap, a good postoperative velopharyngeal function was obtained.
We reviewed other reconstructive procedures in comparison with our method.
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長山 郁生, 土定 建夫, 西村 俊郎, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
135-139
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
Deep neck infection, despite its rare incidence, is still a potential disease for head and surgeons to deal with because rational antibiotic therapy and strict indications for surgical therapy are required. Although mediastinitis secondary to deep neck infection following pharyngitis is quite rare, some patients with diabetes mellitus (DM) are at risk for this illness. A 72-year-old male patient with DM, who had acute tonsilitis, developed mediastinitis a few days after a sore throat. Appropriate measures consisting of surgical drainage and antibiotics led to complete recovery. Computed tomography was useful for diagnosis and treatment, suggesting the extent and the localization of inflammation or abscess. Recognizing that the process of the disease develops according to the anatomical subdivision of the retropharyngeal space helps surgeons deal with this clinical entity.
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吉崎 智一, 室野 重之, 温 慶華, 古川 仭
1995 年 1995 巻 Supplement85 号 p.
140-144
発行日: 1995/11/01
公開日: 2012/11/27
ジャーナル
フリー
In 13 cases of Hodgkin's lymphoma, which consisted of 4 MC subtypes and 9 NS subtypes, expression of both latent and replicative markers were examined by in situ hybridization and immunohistochemical analysis. In three specimens, EBERs(EBV-encoded small RNAs) and LMP(latent membrane protein) were detected on Reed-Sternberg and Hodgkin cells, although, neither BHLF1 (BamH1 Left Frame 1)mRNA nor BZLF1(BamHl Left Frame 1) protein were detected in any case, indicating that these patients had latent EBV infection. EBNA2(EBV-associated nuclear antigen 2) was not detected in EBERs positive cases, indicating that these patients were in the Latency-2 state with nasopharyngeal carcinoma. Although the etiological role of EBV remains unknown, association of this virus was confirmed in some cases of Hodgkin's disease.
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