JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
Volume 42, Issue 4
Displaying 1-18 of 18 articles from this issue
  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 6-7
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
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  • Mamoru Suzuki
    1999 Volume 42 Issue 4 Pages 350-357
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    The positional nystagmus test is one of the most essential vestibular tests. Types of the positional nystagmus frequently suggest lesions of vertigo or dizziness. In the peripheral lesions, paroxysmal positional vertigo is the most common. They are direction-changing torsional nystagmus, or geotropic nystagmus. These types of nystagmus are occasionally mixed together, thus giving an impression of central lesions. Effects of tympanoplasty on the vestibular system was studied by observing nystagmus one day after the surgery. Half of the patients showed positional nystagmus beating toward the operated side. Tympanoplasty affects the vestibular system, especially the otolithic organ by vibratory effect of the surgical drill.
    Several cases of periodically changing positional and positioning nystagmus are presented. All showed unremarkable findings on the neurological tests and brain MRI. The majority showed a direction-changing geotropic nystagmus and a down-beating nystagmus. The direction and type of the nystagmus frequently changed. The direction changing geotropic type often altered into the apogeotropic type, or was mixed with a down-beating nystagmus. A vascular disorder within the brain stem or cerebellum was suspected. The above findings support the importance of a nystagmus test, even when the MRI findings are unremarkable.
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  • Yoshinori Matsuwaki, Masaya Fukami, Mitsunori Yoshimi, Shin-ichi Harun ...
    1999 Volume 42 Issue 4 Pages 358-367
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Nitric oxide (NO) plays an important role in airway function (previously reported to be responsible for mucociliary activity as a regulator and for bacteriostatic effect) and seems to be implicated in the pathophysiology of several airways diseases.
    We measured and examined the exhaled NO concentration in patients (three groups : deviated nasal septum, allergic rhinitis and asthma, and chronic sinusitis) using a chemiluminescence analyzer (CLM-500, Shimazu, Tokyo) both through the mouth and the external nostril. The results showed that in most patients, the measured levels of exhaled NO through the external nostril was higher than when measured through the mouth, thus, indicating that most exhaled NO is derived from the nose and sinus. In comparing the three groups, the exhaled concentration of NO through the external nostril in patients suffering from allergic rhinitis and asthma was significantly higher than that of patients suffering from chronic sinusitis and deviated nasal septum. The changes in exhaled NO concentration in patients before and after surgery were examined periodically for a year. When measured two weeks after surgery, the concentration of exhaled NO showed a decrease in measurements at the time of operation, and gradually increased two weeks after in all cases.
    Furthermore, we studied the histological localization of NO in the nasal and sinus mucosa by the immunohistochemical method using antiserums against inducible Nitric Oxide Synthase (iNOS) and endothelial Nitric Oxide Synthase (eNOS). Immunostaining for iNOS was localized to ciliated epitheliums, inflammatory cells and serous parts of glandular cells. For eNOS, immunostaining was localized to vascular endothelium and vascular smooth-muscle cells. Marked staining for iNOS was seen in the apical part of the epithelium in the nasal mucosa obtained from subjects with high concentrations of exhaled NO.
    We suggest that NO may be an important inflammatory mediator in nasal diseases, and that the apical part of the nasal epithelium may be one of primary sources of NO production in the upper airways of humans.
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  • Masutoshi Nishikawa, Keiko Nishikawa
    1999 Volume 42 Issue 4 Pages 368-373
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Electrocochleography was performed in patients suffering from Meniere's disease and other conditions. The delayed cochlear microphonic potentials (delayed CMs) recorded in response to low stimuli were then analyzed.
    Delayed CMs were evoked more frequently by 1, 000 Hz short tone bursts than by 500 Hz short tone bursts. Patients with delayed CMs had better hearing acuity and higher cochlear action potentials (AP) than those without delayed CMs.
    Delayed CMs evoked by 500 Hz short tone bursts were clearly observed in patients who retained low-frequency sensitivity, while delayed CMs evoked by 1, 000 Hz short tone bursts were clearly observed in patients who retained high-frequency sensitivity. No significant differences were found in the presence or absence of delayed CMs between Meniere's disease and other conditons.
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  • Minoru Iida, Hirohiko Hesaka, Fumikazu Ohta, Hiroshi Moriyama, Masanor ...
    1999 Volume 42 Issue 4 Pages 374-379
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    We investigated 170 patients (106 men and 64 women) with epiglottitis. The mean age of the patients was 47.0 years. Seasonal occurrence of the disease was not observed. The predominant symptoms were pharyngeal pain and difficulty swallowing. Dyspnea occurred in 28.8% of the cases. A tracheotomy was performed in 3 patients (1.8%), all of whom survived.
    In severe epiglottitis, patients develop dyspnea shortly after the onset of pharyngeal pain. Certain changes appearing in the early stages of inflammation can aggravate the symptoms. The respiratory state of the patient must therefore be examined carefully to ensure that the airway does not become blocked.
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  • Akiko Horiguchi, Yuzo Shimode, Noriko Iwasaki, Yuko Suzuka, Koichi Tom ...
    1999 Volume 42 Issue 4 Pages 380-384
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    The characteristics of allergic otitis media are as follows : in combination with other allergic diseases, such as bronchial asthma and nasal allergy, with eosinophils from ear discharge or middle ear mucosa; resistance to antibiotics; antiallergic medicine is most effective; and surgical treatments generally are not effective.
    We treated 2 cases of this diseases accompanied onsets of asthma and ear discharge complaints. The ear discharges coincided with the asthma attacks.One case was accompanied by Sweet's diseases an autoimmune disease. We detected eosinophils from ear discharge or middle ear mucosa, however, there was no increase in the serum IgE level in either of the cases, so diagnoses of eosinophiylic otitis media were determined.
    One case has been treated with tubing, and with steroid and antiallergic medications, and the other case has undergone surgery.
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  • Takeya Inaba, Masanori Shiwa, Akira Uchida, Daiya Asaka, Masahiro Naka ...
    1999 Volume 42 Issue 4 Pages 385-390
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    We treated 3 patients with laryngeal tuberculosis associated with pulmonary tuberculosis. The diagnosis was made on the basis of the Gaffky scale and shadows in the lung field of chest X-rays in all patients.
    Case 1 : A 59-year-old man whose left vocal cord was found to have granuloma-like lesions. He responded to medical therapy using antituberculosis drugs (isoniazid, rifampicin, ethambutol) and showed marked improvement in laryngeal findings.
    Case 2 : A 56-year-old man was diagnosed by pathological examination, which revealed typical findings of tuberculosis.
    Case 3 : A 61-year-old man whose larynx was coated by mucosal sputums. He died due to respiratory failure caused by miliary tuberculosis.
    Because laryngeal tuberculosis is often associated with pulmonary tuberculosis, tubercle bacilli are usually detected in the sputum. Physicians may be exposed to these tubercle bacilli during examination or biopsy of the larynx. Laryngeal tuberculosis is difficult to differentiate macroscopically from malig nant tumors because both diseases present granuloma-like lesions. Furthermore, risk of mass outbreak or spread to other persons increases as the diagnosis is delayed, and early diagnosis and treatment are essential.
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  • Yoshihiro Dake, Tadao Enomoto, Akira Shibano, Takema Sakoda, Yuko Sait ...
    1999 Volume 42 Issue 4 Pages 391-395
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Evidence is growing that patients suffering from cedar pollinosis are increasing. Diagnosis of cedar pollinosis requires identifying the allergen either by skin test or by specific anti-IgE antibody assay. The skin test has drawbacks such as pain, inconvenience of preparing for reactions like anaphylatic shock, and experience because they can see it However it can be diagnosed in a short time and on the cheap. On the other hand, specific anti-IgE antibody assay is expensive and results require a longer time for final diagnosis.
    We reevaluated skin tests results in patients having evidence of positive specific anti-IgE antibody against cedar pollen as examined by the Lumiward immunoassay system that is considered a sensitive test. The skin test data coincided with the results of the Lumiward immunoassay in 88.4% of the tests. The positive concordance rate was 95%, and the negative concordance rate was 59.3%.
    When skin test was observed over a lapse of time, it was positive in 56.7% of the patients in 5 minutes and in 73.3% in 10 minutes.
    Whereas, the scratch test was positive in 76.7% in 5 minutes and 90% in 10 minutes.
    The results suggest that the scratch test may be more sensitive than the skin test, but the antigen dose of the diagnostic reagent as well as the stability of the antibody activity remain as topics for future investigation.
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  • EFFICACY OF A COMBINED THERAPY OF CARBOCISTEINE AND ERYTHROMYCIN IN THE TREATMENT OF CHRONIC SINUSITIS
    Takaharu Tatsukawa, Shitau Hirata, Noriyuki Fukushima, Katsuhiro Hirak ...
    1999 Volume 42 Issue 4 Pages 396-408
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    The clinical efficacy of a combined therapy for chronic sinusitis consisting of the administration of carbocisteine and erythromycin was assessed. Two regimens were compared : a combined therapy of carbocisteine and erythromycin (EC group), and the administration of only erythromycin (E group). The sialic acid (S) and fucose (F) concentrations in the postnasal drip of the subjects were analyzed before and after treatment.
    1) Both the E group and the EC group showed an improvement in subjective and objective symptoms as well as X-ray opacity. Overall, the improvement was higher in the EC group (92.3%) than in the E group (77.8%).
    2) Before treatment, subjects with severe cases of chronic sinusitis had high concentrations of sialic acid and fucose in their postnasal drip. In those cases showing an excellent response to treatment, the S/F ratio was reduced and the concentration of fucose increased after treatment.
    3) The study suggests that a combined therapy of carbocisteine and erythromycin or of erythromycin alone is closely related to the S/F ratio in postnasal drip, and that both of these regimens offer benefits for the treatment of chronic sinusitis. Furthermore, the study suggests that the S/F ratio may be a useful index for evaluating the improvement of chronic sinusitis.
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  • Hiromi Kojima, Hiroshi Moriyama
    1999 Volume 42 Issue 4 Pages 409-413
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Tympanoplasty with mastoid obliteration is sometimes performed on patients with cholesteatoma or sequelae after radical middleear surgery (i. e., open cavity problem, etc.). However, long-term continuous release of an exudate from the ground bone surface, mucosa or the tissues surrounding the surgical wound may follow surgery. This results in delayed drying of the grafted tissue and has been known to cause hematoma and even subsequent infection in the retroauricular region.
    In this study, a continuous drainage tube was implanted subcutaneously in the retroauricular region of 17 patients who had undergone surgery for mastoid cavity obliteration, and was left in place for a number of days. As a result, drying of the surgical wound and the inner ear was achieved within a short period of time.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1999 Volume 42 Issue 4 Pages 414-420
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 421-423
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Download PDF (479K)
  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 424-426
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Download PDF (1655K)
  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 427-429
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese]
    1999 Volume 42 Issue 4 Pages 430-433
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 434-446
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
    Download PDF (2687K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1999 Volume 42 Issue 4 Pages 447-458
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
  • [in Japanese]
    1999 Volume 42 Issue 4 Pages 459-466
    Published: August 15, 1999
    Released on J-STAGE: March 18, 2011
    JOURNAL FREE ACCESS
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