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Volume 34 (1991)
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Volume 31 (1988)
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Volume 43, Issue 3
Displaying 1-14 of 14 articles from this issue
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[in Japanese]2000 Volume 43 Issue 3 Pages 180-181
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese]2000 Volume 43 Issue 3 Pages 182-185
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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Maki Inoue, Shigeru Furukawa, Hideki Matsuda, Toshiro Kawano, [in Japa ...2000 Volume 43 Issue 3 Pages 186-191
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSHemorrhage is the most common complication after a tonsillectomy. Subcutaneous emphysema and pneumomediastinum after a tonsillectomy have only been rarely reported.
A 22-year-old female who had been sufferring from recurrent chronic tonsillitis and a right peritonsillar abscess received a tonsillectomy under general anesthesia. The tonsils were easily dissected from their beds, and a purulent discharge that was seen on the right tonsillar bed was completely suctioned. One hour after surgery, the patient's face began to swell after she had blown her nose. Four hours after surgery, her face, neck, chest and back were swollen, and palpation revealed crepitus and tenderness in these regions. A CT-scan showed the presence of subcutaneous emphysema in her face, neck, chest and back as well as air in her bilateral parapharyngeal and retropharyngeal spaces. Pneumomediastinum was also seen. Since the emphysema appeared to have been caused by the patient's blowing of her nose, she was prohibited from blowing her nose. The air was nearly completely absorbed after 7 days of conservative treatment.
Damage to the tonsillar bed during tonsillectomy, anesthesic intubation, or the use of a mouth gag can sometimes create an entry point for air into the pharyngeal spaces. In this case, the entry point was probably created by surgical trauma during the suctioning of the discharge from the right tonsillar bed. We suspect that air may have entered from the right tonsillar bed as a result of the high intrapharyngeal pressure created when the patient blowed her nose, and that the air spread to her subcutaneous areas and mediastinum through the fascia-defined spaces.View full abstractDownload PDF (2172K) -
Shin-ichi Haruna, Nobuyoshi Otori, Shin-ichi Sano, Hiroshi Moriyama, M ...2000 Volume 43 Issue 3 Pages 192-198
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSEndoscopic surgery by the transethmoidal·transsphenoidal approach for pituitary adenomas provides not only a well-illuminated, clear view of the entire sphenoidal sinus, but enables the use of a variety of endoscopes with different visual angles. Since the sella turcica can be completely visualized, the risk of leaving tumor tissue behind is greatly reduced. Another, major advantage of this approach is that a second surgery can be easily performed at a future date, if necessary. Pituitary adenomas accompanied by chronic sinusitis involve the risk of infection in the sella turcica. For this reason, the correction of both conditions in a single operation is contraindicated. Surgery for the chronic sinusitis should be performed first, and only when that condition has completely disappeared should the adenoma be excised. In this case, the selection of the transethmoidal·transsphenoidal approach makes it possible to operate on the pituitary adenoma using the same route that was used to correct the chronic sinusitis. We have recently diagnosed three cases of pituitary adenoma accompanied by chronic sinusitis. Endoscopic intranasal surgery was performed first. Several months later, once the suinus mucosa, had epithelized, the pituitary adenoma was excised using the same route. Thus, in cases where the presence of a pituitary adenoma is accompanied by chronic sinusitis and two sargeries are required, endoscopic surgery via the transethmoidal·transsphenoidal approach is very advantageous.View full abstractDownload PDF (3662K) -
A CASE REPORTRika Ide, Kaoru Ogawa, Hiroshi Kumanomido, Takeshi Matsunobu, [in Japa ...2000 Volume 43 Issue 3 Pages 199-203
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSNodular fasciitis has been generally considered as a benign and probably reactive fibroblastic growth originating from the subcutaneous fascia.
In the present paper, we report a case with nodular fasciitis arising in the retroauricular region. The patient was a 23-year-old woman who had noticed a mass about 5 mm in diameter in the left retroauricular region. She was referred to our hospital because the mass was gradually growing and was tender to touch. At the initial examination, a pigmented mass about 1 cm in size was found in the left retroauricular region. The surface was smooth and the mass was freely mobile.
Computed tomography (CT) revealed a mass-like tension which showed the same enhancement as a venous intensity. At operation, we found a white solid mass which had no capsule. The mass was easily removed, because it was not adherent to the surrounding tissues.
The pathological diagnosis was nodular fasciitis which showed positive immunostaining for vimentin, HHF 35 (muscle actin), type III collagen and lysozyme, but negative immunostaining for desmin, S-100 protein and CD 34. This rare condition can be diagnosed only by pathological examination, however, it must be kept in mind in the differential diagnosis of retroauricular mass lesions.View full abstractDownload PDF (2207K) -
DIFFERENTIAL DIAGNOSIS FOR KERATOACANTHOMA, VERRUCOUS CARCINOMA, AND SQUAMOUS CELL CARCINOMAToshinobu Yashiro, Yasuhiro Tanaka, Naoya Ui, Youji Niwa, Hiroshi Mori ...2000 Volume 43 Issue 3 Pages 204-208
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSWe recently encountered a patient with a well-differentiated squamous cell carcinoma (SCC) appearing as a primary tumor of the external auditory canal. The tumor was fatal, although repeated histopathological testing performed during the course of the disease failed to yield a diagnosis of malignancy. We suspect that the tumor may have been a keratoacanthoma, but the tumor also resembled the tumors in reported cases of verrucous carcinoma.
Differential diagnoses for SCC, keratoacanthoma and verrucous carcinoma are extremely difficult. Accordingly, the final diagnoses in these cases are sometimes inaccurate. In cases where a definitive diagnosis is difficult or impossible, and the patient presents pathological findings or a clinical course suggestive of keratoacanthoma or verrucous carcinoma, curative therapy should be instituted immediately.View full abstractDownload PDF (2818K) -
Yuji Yoshiyama, Motoko Kanke2000 Volume 43 Issue 3 Pages 209-214
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSUltrasonic nebulization is a widely used method of inhalant therapy. However, the drugs used in the inhalant solutions are sometimes unstable, causing difficulties. We have reported that the ratio of some drugs remaining after nebulization was below 90% for conventional ultrasonic nebulizers. Drugs that exhibit a decrease in concentration, a change in appearance, or produce a bad smell after ultrasonic nebulization should be used with caution. Furthermore, special preparations for nebulizaton therapy must be developed.
A new ultrasonic nebulizer has been developed by OMRON. We investigated the effect of the new ultrasonic nebulizer on the stability of cefmenoxime hydrochloride, which was recently commercialized. Stability tests were performed, and the ratio of the drug remaining after ultrasonic nebulization with the new ultrasonic nebulizer was more than 93%. Therefore, the drug appears to be highly stable when administered with the new ultrasonic nebulizer and should be effective. The new ultrasonic nebulizer creates an aerosol with a smaller particle size than that produced by a compressor nebulizer and has a small dead volume in the medicine bottle. In addition, the nebulizer is compact, light, and uses dry batteries, making it more portable and convenient.
We conclude that the new ultrasonic nebulizer can be effecticvely used for cefmenoxime hydrochloride inhalant therapy.View full abstractDownload PDF (1277K) -
[in Japanese]2000 Volume 43 Issue 3 Pages 215-219
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese]2000 Volume 43 Issue 3 Pages 220-224
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese]2000 Volume 43 Issue 3 Pages 225-226
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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2000 Volume 43 Issue 3 Pages 227-244
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese]2000 Volume 43 Issue 3 Pages 245-247
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2000 Volume 43 Issue 3 Pages 248-252
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]2000 Volume 43 Issue 3 Pages 253-257
Published: June 15, 2000
Released on J-STAGE: March 18, 2011
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