-
秋定 健, 折田 洋造, 吉弘 剛, 河合 晃充, 武 浩太郎, 東川 康彦, 竹本 琢司, 奥本 香苗, 日高 利美, 卜部 吉博, 粟飯 ...
1998 年 1998 巻 Supplement96 号 p.
1-7
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A retrospective study of outpatient statistics for the Department of Otorhinolaryngology of Kawasaki Medical School between December 1973 and December 1996 was made.
The total number of new patients was 72,359 and the number of diseases treated was 87,579. The number of outpatients had increased gradually, while the number of patients over 60 years of age had increased rapidly. Regarding the sites of these diseases,38.7% were in the ear,27.7%were in the nasal cavity and paranasal sinuses,16.8% were in the larynx,13.7% were in the oral cavity and pharynx,2.2% were in the neck, and 0.9% were in the trachea and esophagus. The number of patients with disorders of the larynx, neck, trachea, and esophagus had increased gradually, over the time period studied.
抄録全体を表示
-
奥本 香苗, 佐藤 幸弘, 奥 雅哉, 秋定 健, 吉弘 剛, 河合 晃充, 武 浩太郎, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
8-14
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
The sole function of the supporting cells has been thought to be maintenance of the structure of the organ of Corti. Recently, however, the physiological function of these supporting cells has been further studied. In our department, we have studied the electrical characteristics of the supporting cells by the patch-clamp technique since 1992.
Specifically, we have focused on the gap junctions and ionic currents. This report summarizes our studies. In addition, the characteristics of the supporting cells are described.
抄録全体を表示
-
日高 利美, 折田 洋造, 秋定 健, 竹本 琢司, 森 幸威
1998 年 1998 巻 Supplement96 号 p.
15-22
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Inner ear changes were studied in five different age groups of golden hamsters: 2 months,6months,12 months,18 months and 24 months. Auditory brainstem responses (ABR) and morphological changes in the inner ear were investigated by scanning electron and light microscopy.
At 18 months and 24 months, the ABR threshold was significantly higher than at 2 months,6months and 12 months.
No morphological changes were observed in the inner ear before 12 months of age, but distinct changes were noted at ages over 18 months under scanning electron and light microscopy.
Degenerative changes in the organ of Corti and spiral ganglion developed simultaneously in the region from the basal turn to the apical turn. Atrophy of the stria vascularis was evident in the ba sal turn at 24 months. The pattern of inner ear changes with aging in the golden hamster was simil ar to that in humans.
抄録全体を表示
-
河合 晃充, 佐藤 幸弘, 秋定 健, 吉弘 剛, 武 浩太郎, 奥本 香苗, 奥 雅哉, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
23-30
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Patch-clamp methods were developed to investigate the ion channel of the cellular membrane. The methods and modes of patch-clamp study and the physiological role of various ion channels have been briefly described in the literature. Patch-clamp methods have been used to study with isolated outer hair cells of the guinea pig cochlea, and various channels, such as voltage-dependent channels, mechano-electrical transduction channels and chemo-receptor channels, have been investigated. In this study, the effect of nicorandil, an ATP-regulated potassium channel opener, on isolated outer hair cells of the guinea pig cochlea were investigated using patch-clamp techniques in a conventional whole-cell mode. A characteristic effect of nicorandil is an increase in membrane potassium conductance due to opening of the plasmalemma ATP-regulated potassium channel in cardiac muscle and vascular smooth muscle. This effect results from membrane hyperpolarization and a consequent reduction in the probability of voltage-dependent calcium channel opening.
Application of nicorandil with 2 mM ATP concentration in a pipette ([ATP]i) activated an outward current in a concentration-dependent manner. Both an increase in [ATP]i to 10 mM and a decrease in [ATP]i to 0 mM inhibited this reaction. This outward current was reversed to the initial current after wash-out of nicorandil by application of the control artificial external solution. Tetraethylammonium inhibited the nicorandil-activated outward current. These results suggest that the nicorandil-activated outward current was an ATP-regulated potassium current, and that an ATP-regulated potassium channel exists in the membrane of the outer hair cells of the guinea pig cochlea.
抄録全体を表示
-
武 浩太郎, 折田 洋造, 秋定 健, 吉弘 剛, 河合 晃充
1998 年 1998 巻 Supplement96 号 p.
31-35
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
The therapeutic effects of L-V therapy for sudden deafness were examined between April 1990and March 1996. Seventeen of the 56 cases in which this therapy was used experienced “complete recovery”,9 cases had “marked recovery”,13 cases experienced “recovery” and 17 cases had “no change”. Marked hearing recovery was observed in those patients who began this therapy with in seven days from the onset of deafness. The degree of hearing loss at the beginning of the therapy bore almost no relation to the final therapeutic outcome. We had many cases which experienced “complete recovery” among those patients who had been treated with steroids. Therefore, L-V therapy was effective on cases of sudden deafness.
抄録全体を表示
-
秋定 健, 折田 洋造, 吉弘 剛, 河合 晃充, 東川 康彦, 奥本 香苗, 竹本 琢司, 武 浩太郎, 日高 利美
1998 年 1998 巻 Supplement96 号 p.
36-43
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Cytomegalovirus (CMV) is the most common cause of congenital viral infection with a reported incidence of 0.29-0.42% of live births. Bilateral and unilateral sensorineural hearing loss of varying degrees has been reported in children with symotomatic and asymptomatic congenital CMV infections.
In this paper, case studies from three infants with hearing impairments diagnosed by pediatricians as symptomatic congenital CMV infections are reported. The follow-up hearing assessments were performed by ABR and pure tone audiography. According to their ABR thresholds, the three cases had severe, severe and moderate bilateral sensorineural hearing impairment, respectively. We administered acyclovir and anti-CMV γ-globlin, and the ABR thresholds of all three cases improved. However, in two cases, delayed progressive hearing loss and vestibular impairment were found.
抄録全体を表示
-
卜部 吉博, 折田 洋造, 秋定 健, 吉弘 剛, 河合 晃充, 武 浩太郎
1998 年 1998 巻 Supplement96 号 p.
44-50
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A clinical study of 176 ears with otitis media with effusion in 92 children who had been treated by ventilation tube therapy was conducted at the Kawasaki Medical School Hospital between 1985and 1996. The Goode T-tube was inserted in 86 children, the Paparella type I in 4 children and the Paparella type II in 2 children. The average period of intubation was 11 months. The group in which the tube was removed after over one year showed a recurrence rate of 16%, whereas the recurrence rate for those with the tube inserted for less than one year was 36%. Better results were also noted in those children treated with an adenotomy and tonsillectomy in addition to the ventilation tube therapy. There were many children aged five to seven years old in whom the ventilation tube was removed in the spring or winter, avoid resulted in a poor outcome.
抄録全体を表示
-
秋定 健, 折田 洋造, 吉弘 剛, 河合 晃充, 武 浩太郎, 卜部 吉博, 東川 康彦, 竹本 琢司, 奥本 香苗, 日高 利美, 山本 ...
1998 年 1998 巻 Supplement96 号 p.
51-58
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
From 1988 to 1997,243 ears with chronic otitis media were treated surgically at the Kawasaki Medical School Hospital.
The patients consisted of 125 males and 118 females, ranging in age from 4 to 80 years old. There were 145 ears with cholesteatomas and 98 ears without cholesteatomas. The former condition affected men more often than women, and especially children. Of the 243 ears,35 ears underwent a closed method tympanoplasty; 195 ears underwent a open method tympanoplasty, and 13ears received a radical mastoidectomy. Tympanoplasty types I, II, III and IV were performed in 82,35,82 and 31 ears, respectively, and the success rate in improved hearing was 69.6%,80.0%,44.4% and 25.9%, respectively.
Corynebacterium, Staphylococcus epidermidis and non-fermenting gram negative rods were isolated at a significantly higher incidence from the ear discharge. Twenty-three cases exhibited resorption of the bony wall of the facial nerve (incidence 9.5%) and 11cases had labyrinthine fistulas (incidence 4.5%). Finally, a discussion on the operative techniques for middle ear surgery is presented.
抄録全体を表示
-
吉弘 剛, 折田 洋造, 秋定 健, 卜部 吉博, 平井 滋夫
1998 年 1998 巻 Supplement96 号 p.
59-63
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
With the advent of broad-spectrum antibiotics, the incidence of acute mastoiditis has been markedly reduced. We report two cases of acute mastoiditis due to penicillin-resistant
Streptococcus Pneumoniae infections.
The first case was a 1 year-old female, and the second case was a 7 month-old female. Bacteria cultured from both patients revealed the presence of penicillin-resistant Streptococcus pneumoniae, and both patients were treated with a mastoidectomy.
Since penicillin-resistant
Streptococcus Pneumoniae was first recognized in 1967, the incidence of penicillin-resistant
Streptococcus Pneumoniae infection has been increasing.
Penicillin-resistant Streptococcus pneumoniae infection results from the inappropriate use of antibiotics, and thus it is crucial to treat it with an accurate and precise choice of antibiotics.
抄録全体を表示
-
福島 久毅, 折田 洋造, 秋定 健, 佐藤 幸弘, 卜部 吉博, 日高 利美
1998 年 1998 巻 Supplement96 号 p.
64-70
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Klippel-Feil syndrome, which is characterized by the congenital fusion of two or more cervical vertebrae, has a clinical triad consisting of a short neck, decreased cervical mobility and a low posterior hairline. Various musculo-skeletal anomalies and defects of the other organ systems, including hearing loss, have been reported in association with this syndrome. The hearing loss is usually a sensorineural impairment, but can be conductive or mixed deafness in rare instances. A 29 year-old man presented with fusion of several cervical vertebrae, torticollis, scoliosis, platybasia, basilar impression, polydactylia, an undescended testis, a spontaneous pneumorthorax and mixed deafness of the right ear. A tympanotomy revealed a hypoplastic long process of the incus, a defect in the stapes, an abnormal facial nerve and a defect in the oval window.
抄録全体を表示
-
東山 エミ, 折田 洋造, 秋定 健, 吉弘 剛, 河合 晃充, 奥 雅哉
1998 年 1998 巻 Supplement96 号 p.
71-75
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Foreign bodies are commonly found in the ear by otorhinolaryngologists. We treated a 73 year-old female with a foreign body reaction to a
H. longicornis tick in the external ear canal. She visited our clinic complaining of auditory discomfort and marked depression of hearing acuity of the right ear.
The tick, which was engorged with blood, had obstructed her external auditory canal and resembled an ear polyp.
抄録全体を表示
-
森 幸威, 秋定 健, 卜部 吉博, 佐藤 幸弘, 武 浩太郎, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
76-80
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A clinical survey of 21 patients with psychogenic hearing loss who were treated at our clinic between 1989 and 1997 was retrospectively carried out. The patients included 6 males and 15 females ranging in age from 6 to 65 years. Eight of the patients (38%) were between 7 and 9 years. The occurrence of this condition in so many patients of such a young age is greater than that in previous reports.
We understand this disease to be a psychosomatic disease and feel it is important to recognize the influence of social conditions and home environment.
抄録全体を表示
-
特に顔面動脈の関連について
粟飯原 輝人, 折田 洋造, 秋定 健, 吉弘 剛, 亀井 健, 今井 茂樹, 梶原 康正, 半田 徹
1998 年 1998 巻 Supplement96 号 p.
81-90
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Fifteen cases of severe epistaxis were treated by superselective intra-arterial embolization of a branch of the external carotid artery during a 5-year-period from April 1992 to April 1997.
Initially, a 5-6 Fr. catheter was used for the selective angiography, after which a 3 Fr. catheter was employed for the superselective angiography and embolization. Gelform powder and microcoils were then delivered to a distal branch of the external carotid artery by means of the 3 Fr. catheter. In six cases, this branch was the unilateral maxillary artery, in three cases it was the bilateral maxillary arteries, in four cases it was the unilateral maxillary artery plus a unilateral facial artery, in one case it was the bilateral maxillary arteries plus a unilateral facial artery, and in one case it was the bilateral maxillary arteries plus bilateral facial arteries. In two cases, the facial artery was the origin of the epistaxis. Epistaxis re-occurred after the embolization in two cases. Re-embolization was performed in one of these cases, and a bilateral facial artery ligation was performed in the other case. In this study, a few complications were noted in two cases, including swelling, tenderness, erosion and ulcer formation in the embolized artery.
Therapeutic intra-arterial embolization of the maxillary and facial arteries is considered to be an effective form of therapy for severe epistaxis.
抄録全体を表示
-
河合 晃充, 折田 洋造, 秋定 健, 吉弘 剛, 武 浩太郎, 卜部 吉博, 森 幸威
1998 年 1998 巻 Supplement96 号 p.
91-98
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
The prognosis of malignant melanoma is very poor, especially when it originates in the head and neck region. Although radical surgery has been proposed as the best therapy for malignant melanoma of this area, it is difficult to perform with a sufficient safety margin because of the extensiveness of tumors and anatomical difficulties. Various methods, such as chemotherapy, radiotherapy, immunotherapy, interferon therapy and other therapies have been suggested for treatment of this disease, but there are still no well established effective therapies.
We treated a 63-year-old female with malignant melanoma of the nasal cavity with chemohormonal therapy (DTIC, CDDP, MCNU and TAM), intra-arterial IFN-p infusion and radiation therapy. Because the initial treatment, involving only intra-arterial IFN-β infusion, had achieved only minor remission, we subsequently treated her with a combination of chemo-hormonal therapy, intra-arterial IFN-β infusion and radiotherapy. During the first course of this combination therapy, tumor regression occurred and the tumor almost regressed finally. Although the patient had metastasis to the right parotid gland and the cervical lymph nodes, both the primary tumor and metastatic lesions responded to this combination therapy. It was suggested that the combination of chemo-hormonal therapy, intra-arterial IFN-β infusion and radiation therapy could become a very effective treatment for malignant melanoma of the head and neck.
抄録全体を表示
-
竹本 琢司, 秋定 健, 半田 徹, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
99-103
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
The case of a 64-year-old man with squamous cell carcinoma after irradiation is reported. The patient had undergone resection of an adenocarcinoma of the ethmoidal sinus and irradiation (5400 rad) in 1973. Twenty years later, a squamous cell carcinoma was detected at the same site, and he underwent resection of the carcinoma and chemotherapy. This recurrent tumor appears to have been radiation-induced, because the patient received irradiation (5400 rad) at the precise location where the second cancer occurred 20 years later.
抄録全体を表示
-
卜部 吉博, 折田 洋造, 秋定 健, 吉弘 剛, 粟飯原 輝人, 森 幸威
1998 年 1998 巻 Supplement96 号 p.
104-111
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A rare case of sphenoidal sinusitis with internal carotid artery occlusion is reported.
A 62-year-old woman with a headache, fever, right ocular motor palsy, right hemiplegia and a disturbance of her consciousness was referred to our hospital. MRI revealed sphenoidal sinusitis and inflammation, with a less enhanced mass in the cavernous sinus. Right carotid angiography demonstrated the occlusion of the intracavernous portion of the internal carotid artery. The patient had meningitis, and her right cranial nerve function (III, IV, VI) was compromised. Her symptoms were believed to be derived from the inflammation of the cavernous sinus spread from the sphenoidal sinus. The bilateral sphenoidal sinuses were opened by intranasal ethmosphenoidectomy under local anesthesia, and the treatment of the patient's inflammation was followed with chemotherapy. After the operation, a head-CT showed a cerebral infarction, but she nevertheless made an almost complete recovery, and was discharged after four months because she had completed the rehabilitation of her limbs and eye.
This case of sphenoidal sinusitis is discussed and the literature is reviewed.
抄録全体を表示
-
山下 眞代, 秋定 健, 半田 徹, 河合 晃充, 森 幸威, 奥本 香苗, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
112-116
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Primary malignant lymphomas of the nasal cavity are relatively uncommon.
Malignant lymphomas arising in the breast are even more rare, and the incidence of a bilateral synchronous malignancy is extremely rare. We encountered a case of a malignant lymphoma in the nasal cavity plus both breasts (diffuse, large cell type, B) determined by aspiration biopsy. The patient underwent chemotherapy consisting of CHOP treatment. One year after the chemotherapy, the patient is still alive and in complete remission.
抄録全体を表示
-
奥本 香苗, 折田 洋造, 秋定 健, 吉弘 剛, 河合 晃充, 竹本 琢司, 武 浩太郎, 日高 利美
1998 年 1998 巻 Supplement96 号 p.
117-125
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Seventy-three cases of major salivary gland tumors (36 males and 37 females) treated in our department between 1990 and 1996 were reviewed and analyzed clinically. These patients ranged in age from 19 to 86 years. There were 64 parotid gland tumors (88%) and 9 submandibular gland tumors (12%).
The most prevalent tumor among the benign parotid gland tumors was pleomorphic adenoma (47.2%), followed by Warthin's tumor (28.3%). Malignant tumors consisted of three malignant pleomorphic adenomas, two mucoepidermoid carcinomas, two adenocarcinomas, two salivary duct carcinomas, one adenoid cystic carcinoma and one malignant lymphoma. Surgery alone was performed for all the benign tumors. For the malignant tumors, combined treatment with surgery, irradiation and anticancer drugs was performed. Facial nerve palsy, salivary fistula or Frey's syndrome occurred in some patients after surgery. Only one of the benign tumors recurred. All patients with stage I or II disease are alive, but most of the patients with stage III and IV disease died within three years.
抄録全体を表示
-
粟飯原 輝人, 秋定 健, 吉弘 剛, 折田 洋造, 半田 徹
1998 年 1998 巻 Supplement96 号 p.
126-131
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
We describe the effects of the administration of CDDP (cis-diamminedichloroplatinum) plus radiation on a 42 year-old female with nasopharyngeal cancer and chronic renal failure undergoing hemodialysis. Since one of the major side effects of CDDP is renal toxicity, the administration of CDDP to patients with renal failure is greatly restricted.
Fifty mg of cisplatin was infused 60 minutes before dialysis. The total plasma platinum and free platinum concentrations at 1,2,3,4,5,6,12,24,48 and 72 hours after the administration of CDDP were then measured. During dialysis, total plasma platinum and free platinum levels decreased rapidly in a diphase fashion to 275 ng/ml and 61 ng/ml, respectively, at 72 hr after the administration. No severe side effects were observed after the administration of CDDP.
In conclusion, we believe that CDDP can be given to those patients with malignant tumors who have chronic renal failure, and are undergoing hemodialysis. However, it is suggested that smaller doses should be given in order to prevent side effects.
抄録全体を表示
-
武 浩太郎, 折田 洋造, 秋定 健, 吉弘 剛, 卜部 吉博
1998 年 1998 巻 Supplement96 号 p.
132-136
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A 54-year-old female was found to have a large tumor of the soft palate and two small tumors in the parotid gland. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large mass in the left parapharyngeal space and two small masses in the left parotid gland. The large tumor in the parapharyngeal space was removed by an intraoral approach. Histologically, the tumor was found to be a pleomorphic adenoma. There are several possible approaches to tumors of the parapharyngeal space. The preoperative radiologic evaluation, which included CT and MRI, as well as fine needle aspiration biopsy were both very useful in making the preoperative diagnosis and in the selection of the surgical approach. The intraoral approach should be restricted to cases outside of the parotid glands, well encapsulated, tumors with low vascularity and benign tumors.
抄録全体を表示
-
奥 雅哉, 秋定 健, 吉弘 剛, 武 浩太郎, 奥本 香苗, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
137-140
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
We encountered a 59 year-old female with parotid spindle cell lipoma. Histopathologically, spindle cell lipoma is a relatively rare type of lipoma, and lipoma of the parotid gland is similarly considered to be relatively rare in occurrence. The parotid tumor in this patient was mobile, soft and flat, and was considered to be benign. The tumor was removed under general anesthesia, and was histopathologically diagnosed as a parotid spindle cell lipoma. A review of relevant literature is also included.
抄録全体を表示
-
宇野 雅子, 吉弘 剛, 秋定 健, 半田 徹, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
141-145
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Pyogenic granuloma is a benign tumor of the dermis and mucosa. In the head and neck region, pyogenic glanulomas are most frequently located in the oral and/or nasal mucosa. A 70-year-old woman was admitted to our hospital because of laryngeal discomfort and hoarseness. Laryngoscopy revealed a mass with a smooth and hemorrhagic surface in the oropharynx. Shortly after her admission, the mass was removed because it showed rapid growth, resulting in severe dyspnea. CT scan and angiographic findings suggested that the growth was a hemangioma or malignant tumor. The mass was resected by laryngomicrosurgery and histological study revealed it to be a pyogenic granuloma. The patient has been followed for three years without recurrence.
抄録全体を表示
-
平井 滋夫, 秋定 健, 吉弘 剛, 武 浩太郎, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
146-148
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A 63-year-old woman visited our clinic complaining of a pharyngeal growth of a few months duration. The tumor grew gradually at first, but then became larger and grew rapidly.
This tumor had arisen from the right palatine tonsil.
After surgical extirpation, pathological examination revealed tonsil-like tissues and the presence of a few Actinomyces drusen.
抄録全体を表示
-
竹本 琢司, 折田 洋造, 秋定 健, 堀 香苗, 日高 利美
1998 年 1998 巻 Supplement96 号 p.
149-153
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
An expandable metallic stent was used in the treatment of a 53 year-old man with laryngeal cancer. The patient had dyspnea due to progressive tracheal stenosis caused by mediastinal invasion of laryngeal cancer. After insertion of the expandable metallic stent, the diameter of the trachea had expanded and his dyspnea was improved. The patient died of cardiopulmonary arrest however, thought to be due to obstruction by sputum 13 days after insertion.
抄録全体を表示
-
河合 晃充, 折田 洋造, 秋定 健, 吉弘 剛, 武 浩太郎, 粟飯原 輝人, 日高 利美, 半田 徹
1998 年 1998 巻 Supplement96 号 p.
154-158
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Post-intubation granuloma of the larynx is one of the complications following tracheal intubation. The lesions in many cases are located on the mucous membrane of the process vocalis of the arytenoid cartilage. We treated a 58 year-old female patient with multiple post-intubation granulomas of the larynx, who complained of hoarseness and mild dyspnea two months after an operation for subarachnoid hemorrhage. A granuloma was found in the supraglottic space by laryngoscopy. X-ray films and CT findings suggested multiple lesions in the larynx. A diagnosis of multiple post-intubation granulomas of the larynx was made and excision was performed using laryngomicrosurgery after tracheotomy under local anesthesia. During the operation, granulomas were found on the epiglottis and bilateral process vocalis of the arytenoid cartilage. We succeeded in performing a complete excision. Histological examination showed unspecific granulomas. There has been no evidence of recurrence since the patient was released from the hospital. We also present a brief review of the literature.
抄録全体を表示
-
秋定 健, 折田 洋造, 吉弘 剛, 竹本 琢司, 卜部 吉博, 奥 雅哉, 粟飯原 輝人
1998 年 1998 巻 Supplement96 号 p.
159-163
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Pemphigoid is an autoimmune disease characterized by the formation of dermal bulla in the basement membrane zone. Cicatricial pemphigoid is a variant which typically involves the mucosal surfaces, and is characterized by its predilection for scarring. However, cicatricial pemphigoid in the aerodigestive system is rare. In this paper, we report a case of severe, total laryngeal stenosis caused by cicatricial pemphigoid which necessitated a tracheostomy. Laser surgery and a T tube were very effective for the resection of the cicatrix and for the prevention of recurrence. The historical, clinical, histological and therapeutic features of cicatricial pemphigoid are presented with special reference to the laryngeal lesions.
抄録全体を表示
-
奥 雅哉, 秋定 健, 吉弘 剛, 奥本 香苗, 竹本 琢司, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
164-168
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
We present a case of cat scratch disease. The patient was an 18 year-old female with no history of cat scratches, although she kept five cats. She noticed lymph node swelling in the right subparotid region. A malignant lymphoma was suspected, so the mass was surgically removed. Histopathologically, focal granulomatous lesions with necrosis were found in the subparotid lymph node. The necrosis was surrounded by a layer of epithelioid cells. The diagnosis of cat scratch disease was made on the basis of the clinical and histopathological features.
抄録全体を表示
-
吉弘 剛, 折田 洋造, 秋定 健, 河合 晃充, 武 浩太郎, 奥本 香苗, 粟飯原 輝人, 今井 茂樹, 梶原 康正, 半田 徹
1998 年 1998 巻 Supplement96 号 p.
169-177
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Since 1992, we have treated 51 head and neck tumor patients with superselective intra-arterial infusion chemotherapy combined with radiotherapy.
Under fluoroscopic guidance, an angiographic catheter was inserted into the main feeding artery of the tumor via the femoral artery. Since a 5-6 Fr. catheter is used for conventional selective angiography and infusion chemotherapy, a 3 Fr. catheter was employed for the superselective angiography and infusion chemotherapy. For the chemotherapy,50-75 mg/body of CDDP and 200-300 mg/body of CBDCA were used.
The lingual artery was used for the treatment of tongue tumors, the lingual and facial arteries for oral tumors, the ascending pharyngeal and maxillary arteries for nasopharyngeal tumors, and the superior thyroidal and inferior thyroidal arteries were used for laryngeal and hypopharyngeal tumors.
The thyrocervical trunk, occipital and superior thyroidal and facial arteries were used for the treatment of neck lymph node metastases.
A complete response rate of 61% was achieved for primary tomor treatment, and a 43% CR rate was achieved for neck lymph node metastases.
抄録全体を表示
-
森 幸威, 折田 洋造, 秋定 健, 半田 徹, 東 祐史, 今井 茂樹, 梶原 康正
1998 年 1998 巻 Supplement96 号 p.
178-181
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
We report the results of continuous intra-arterial infusion therapy via the occipital artery, cornbined with radiotherapy, for treatment of head and neck carcinomas in three patients. An angiographic catheter was inserted retrogradely into the artery feeding tumor, via the occipital artery which is used for rotational DSA.
Two of the three patients treated had temporal carcinoma and the other had maxillary sinus cancer. No complications occurred in any of the patients as a result of this procedure.
This procedure was considered very useful when an approach from the superficial temporal artery was impossible due to prior treatment or direct invasion.
抄録全体を表示
-
粟飯原 輝人, 秋定 健, 吉弘 剛, 折田 洋造, 半田 徹
1998 年 1998 巻 Supplement96 号 p.
182-188
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
We are currently using a new radiodiagnostic device for rotational digital subtraction angiography (R-DSA: INTEGRIS V3000) in which the gantry can be rotated from 0 to a maximum of 180 degrees. If the gantry rotation is set for 10 to 30 degrees, we can scan 15 fields per second. A three dimensional image of up to 180 degrees can thus be obtained with a one-shot contrast media injection for head and neck angiography. The subjects of this report consisted of 33 cases in whom R-DSA had been used for the head and neck region, including 27 cases which underwent superselective intra-arterial chemotherapy for cancer,3 cases which underwent superselective intraarterial embolization for severe epistaxis and 3 cases which underwent cancer chemotherapy via the intra-arterial catheterization of the posterior occipital artery. This method was especially useful in evaluating the locations of the branches of the external carotid and subclavian arteries, and their angles on two-dimensional images.
Recently, the use of R-DSA for the head and neck region has become more convenient, and the angiography performed on these patients has improved. We conclude that R-DSA is a very useful method for examining the head and neck region.
抄録全体を表示
-
宇野 雅子, 秋定 健, 吉弘 剛, 河合 晃充, 折田 洋造
1998 年 1998 巻 Supplement96 号 p.
189-193
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
The clinical, histological and prognostic features of 27 patients with lymphomas treated at Kawasaki Medical School Hospital between June,1989 and July,1997 were reviewed. The results were as follows;
The 27 patients (14 males and 13 females) ranged in age from 16 to 90 years old (mean age 58.8years old). According to the stage distribution of the Ann Arbor classification system,13 cases were stage I,9 were stage II,4 were stage ifi, and 1 was stage IV. By site grouping,13 cases were in Waldeyer's ring and 9 were in lymphonodi of Waldeyer's ring. Histologically, these cases were categorized according to the working formulation. Two cases were low grade,22 were intermediate grade and 1 was high grade. The five-year survival rate was 76%.
抄録全体を表示
-
奥 雅哉, 折田 洋造, 秋定 健, 吉弘 剛, 河合 晃充, 武 浩太郎, 卜部 吉博, 平井 滋夫
1998 年 1998 巻 Supplement96 号 p.
194-198
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
Between 1993 and 1997,105 cases of foreign bodies in otolaryngological regions were treated in our department. The location of the foreign bodies included the ear (35.2%), nose (8.6%), oral cavity and pharynx (40.0%), esophagus (13.3%) and trachea and bronchus (2.9%). The most frequently found foreign body in the ear was hair. All cases involving the nose were in children under 5 years of age.
In the oral cavity and pharynx, foreign bodies were mainly found in the tonsils, and fish bones (97.6%) were the most common foreign bodies.
Coins were the most common foreign body in the esophagus, and were found at the cricopharyngeus. Most cases involving the trachea and bronchus were in children.
抄録全体を表示
-
日高 利美, 秋定 健, 吉弘 剛, 河合 晃充, 東川 康彦, 竹本 琢司, 奥本 香苗, 武 浩太郎, 卜部 吉博, 奥 雅哉, 粟飯原 ...
1998 年 1998 巻 Supplement96 号 p.
199-209
発行日: 1998/03/20
公開日: 2012/11/27
ジャーナル
フリー
A retrospective study was made of inpatient statistics for the Department of Otorhinolaryngology, Kawasaki Medical School between April 1977 and March 1997.
The total number of patients was 6,627 and the number of diseases treated totalled 7,033. Regarding the sites of disease,2,480 were in the pharynx (35.3%),1,721 were in the nasal cavity and paranasal sinuses (24.5%),1,018 were in the ear (14.5%),954 were in the larynx (13.6%),268 were in the salivary glands (3.8%),218 were in the neck (3.1%),184 were in the oral cavity and tongue (2.6%),102 were in the trachea and esophagus (1.4%), and 88 were in the face (12.5%).
抄録全体を表示
