耳鼻咽喉科展望
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
18 巻 , Supplement1 号
選択された号の論文の4件中1~4を表示しています
  • Fujiko TANAKA
    1975 年 18 巻 Supplement1 号 p. 5-19,1
    発行日: 1975/06/15
    公開日: 2011/08/10
    ジャーナル フリー
    Vestibular endolymphatic tube and sacの構造, 機能については, なお不明な点が多く, Meniere症候群に関する観察を除けば, ひろくその病理学的変化を論じた業績はない。著者は40剖検例について系統的に組織学的検索を行い, 一部人体例の電顕的観察を加えた。
    Endolymphatic tube and sacの構造は個人差, 左右差が著しいが, その解剖学的関係よりproximal, intermediateおよびdistalportionの三部に分って観察した。就中, rugosityを示すintermediate portionは特異的で, その上皮は, chief cell, secretory (light) cellおよびintermediate cellを含むが, これらはいずれも豊富なfibrilsを有し, myoepithelialcellに類似し, 収縮性を有し, またlight cellの微細構造より分泌ならびに吸収機能を有することが推察される。従って, endolymphの流動, 内圧などの調整が, この部で行われ, 硬膜の緊張性がこれに関与すると考えられる。
    病理学的変化は, 原疾患の示す諸病変を反映し, 変性, 循環障害性, 炎症性変化などを伴う。
  • 橋本 東洋
    1975 年 18 巻 Supplement1 号 p. 21-52,2
    発行日: 1975/06/15
    公開日: 2011/08/10
    ジャーナル フリー
    Radiographic observations of deglutitory function were made in subjects complaining of abnormal sensation of the throat in order to evaluate possible changes.
    Two hundred patients with the above complaints and 63 normal subjects were examined by 15-second serial radiography with a 30 cc barium swallow. Results were, 1) The dilated type and spastic type which are considered pathological were seen in 23% of the patients.
    2) In patients with abnormal sensation, the esophageal passage time and evacuation time were all prone to protraction, and barium retention was frequently seen.
    3) Patterns of esophageal passage time curves displayed by these subjects may be classified into 4 distinct types ; normal, slow, static and mixed. And it would be appropriate to add a dilated type to these 4 types.
    4) As for evacuation of esophageal contents, achalasia-like findings were noted in only 3% of the patients whereas findings suggestive of transient, mild dysfunction of the cardia were frequent.
    5) The esophageal function seems to be closely affected either by gastric tonicity or acidity but there was no evidence that its impairment is related to aging or to general autonomic nerve imbalance.
    Pharmacodynamic tests revealed that cholinergic drugs tend to affect the lower segment of the esophagus whilst adrenergics are liable to affect the upper portion.
    6) 43% of the patients showed radiographic evidence of abnormality in phase 2 of swallowing, where, except for 4 cases of true cricopharyngeal dysphagia, the abnormality was no more than a slight hypertonicity of the adit possibly reflecting prolonged passage of contents in the lower esophageal segment.
    The findings obtained suggest involvement of the higher center in the development of esophageal hypertonia.
    7) The authors discussed the clinical implication of the protracted passage of contents in the lower esophageal segment in approximately a half of subjects with abnormal sensation of the throat.
  • 高野 元英
    1975 年 18 巻 Supplement1 号 p. 53-79,3
    発行日: 1975/06/15
    公開日: 2011/08/10
    ジャーナル フリー
    A morphologic study of the distribution of the autonomic nerve fibers in mucosa of the maxillary sinus was undertaken, particularly with respect to changes in the nerve fibers in accordance with the various types of morbid processes in the sinus mucosa.
    Pathology in the maxillary sinus were divided into two groups on the basis of their severity, mild or harsh, as determined by x-ray mucous membrane function test. There were 10 cases in each group, and mucosal specimens for study were obtained from four sites, the medial, lateral and superior walls and the floor, of the sinus. The distribution of and changes in peripheral nerve fibers, in relation to his, topathologic findings regarding the mucosa as well as clinical findings and past histories of the patients, were studied. The ages of the patients from whom the mucosal specimens were obtained ranged from 17 to 45.
    Results:
    1) The distribution of nerve fibers to the sinus mucosa was sparse, definitely less than to the nasal mucosa.
    2) Direct distribution of nerve fibers to the epithelial cells of the sinus mucosa was not observed.
    3) Numerous fine nerve fibers running parallel to and near the capillaries in the upper part of the tunica propria were observed.
    4) There was meager distribution of nerve fibers to mucosal glands and they were rarely observed around or leading directly to glandular alveoli except in one paticular parts. When they were present, the nerve fibers usually coursed through the connective tissue between the glandular alveoli.
    5) Distribution of fine nerve fibers to edematous areas of the mucous membrane was rarely observed. In view of the demonstrably poor or defective staining of nerve fibers in such areas, it is possible that the presence of edema, which is a primary change in the early stage of a disease, compromises neural control of the integrity of the membrane, especially when the edematous change persists for long periods.
    6) Cellular infiltration was associated with defective staining of nerve fibers in many specimens, but this finding was not consistent as many areas of severe cellular infiltration showed no signs of insufficiently stained nerve fibers.
    7) Nerve bundles were obseved coursing through the tunica propria in fibrotic areas of the mucosa, but few or no fine nerve fibers were obseved in fibrotic tissue.
    8) There were no fine nerve fibers along or near revasculized vessels in granular tissue.
    Conclusion: In view of sparse autonomic innervation in mucous membrane of the maxillary sinus, thickening or swelling of mucosa due to inflammatory lesions might easily lead to disruption of neural maintenance of mucosal integrity. Furthermore, observation of poor or defective staining of nerve fibers under such conditions could indicate adverse effects on functions of blood vessels and glands innervated by these nerves which would lead to impairment of mucosal function.
    This, together whith various other adverse factors, could be considered as a contributing factor in development chronic paranasal sinusitis.
  • 向井 敬
    1975 年 18 巻 Supplement1 号 p. 81-102,4
    発行日: 1975/06/15
    公開日: 2011/08/10
    ジャーナル フリー
    両耳聴が片耳聴よりすべての点で有利であることは, 多くの学者の研究報告によつても事実であると思われる。就中その有利性は方向覚, 語音明瞭度などにおいて著しいといわれる。また遠近覚については方向覚に比較して非常ににぶいものとされている。著者は両耳聴の優利点を確認できたので, これを臨床上に応用した。すなわち (1) 可聴閾値検査ではレシーバー法, スピーカー法のいずれにおいても両耳聴の可聴閾値は良聴耳のそれとほとんど大差はなかつた。(2) 語音明瞭度検査においてレシーバー法と無騒音下のスピーカー法の揚合は, 両耳聴の成績は良聴耳のそれとほとんど大差はなかつた。騒音下のスピーカー法において語音と騒音が同方向にある場合よりも方向が異なる場合に明瞭度上昇の傾向を認めた。(3) FITテストにおいて良聴耳よりも難聴耳はかすかな強さの音にも反応し, 難聴耳側に音像が移動した。(4) レシーバー法による方向覚は正常者, 難聴者ともに水平面上の左右方向がもつとも良く, 難聴者では良聴耳だけでも快適聴取レベルで音を聴かせると正常者とあまり差はなかつた。遠近覚は概して正常者と難聴者の問に大差はなかつた。(5) 移動音源による方向覚検査においては, 正常者は前後方向がもつとも良く, 片側難聴者は良聴耳側と後方向にかたよる傾向を認め, 両側難聴者は正常者と大差はなかつた。(6) 移動音源による遠近覚検査においては, 正常者, 難聴者ともに70%以上の正答率で遠近認知が可能であつた。(7) 両耳補聴器装着時の方向覚は, マイクロホンにホーンのないしかも2個のマイクロホンの間にT字型隔壁を有する補聴器を使用した場合がもつとも良かつた。(8) 移動音を他覚的幼児聴力検査に応用し, 移動音が検査音として断続音にまさることがわかつた。
feedback
Top