著者

藤田 裕人 小泉 敏三 乾 洋史 伊藤 妙子 北原 糺

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.116, no.9, pp.851-857, 2023 (Released:2023-09-01)

参考文献数

21

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There have been many reports of endolymphatic hydrops (EH) in patients with Meniere’s disease (MD) since the first report by Hallpike and Yamakawa in 1938. Mental/physical stress and subsequent increase in release of the stress hormone arginine vasopressin (AVP) supposedly triggers MD. Recently, many lines of evidence have suggested the possibility that AVP is closely linked to the formation of EH in cases of MD. In the present study, we attempted to investigate the relationship between stress and EH in patients with unilateral Meniere’s disease (uMD).We enrolled 113 definite uMD patients from July 2014 to October 2019. All patients underwent 3-T magnetic resonance imaging (MRI) 4 hours after intravenous gadolinium injection. We adopted the criteria for evaluation of EH proposed by Nakashima et al. Stress was evaluated using the depressive self-rating scale (SDS), the psychological stress response scale (SRS), and the dizziness handicap inventory (DHI) modified by Nishiike et al. These stress scores and the blood AVP levels were compared in patients with EH.There was no significant correlation between EH and the stress scores on the affected side, but the anxiety score showed a significant correlation with EH on the sound side (p = 0.04). There was no significant correlation between the EH and AVP in either the affected side or the sound side. We suppose that the formation of EH involves a complex process of stresses.

著者

川口 航平 山神 良太 河野 賢一 鹿毛 智文 村上 亮 武冨 修治 田中 栄 乾 洋

出版者

日本関節病学会

雑誌

日本関節病学会誌 (ISSN:18832873)

巻号頁・発行日

vol.42, no.2, pp.54-60, 2023 (Released:2023-07-31)

参考文献数

27

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はじめに:人工膝関節手術に対しての術後患者立脚型評価が標準化しているが,術後患者立脚型評価には術前の心理的因子が影響すると報告されている。しかしTKA,UKAにおいての術前の心理的因子の違いや術後患者立脚型評価に与える影響の違いなどは明らかではない。本研究の目的はTKAとUKAにおける術前の心理的因子の違いとその心理的因子が術後臨床成績に与える影響の違いを明らかにすることである。方法:2018年10月から2021年3月に当科にて人工膝関節手術を行った症例で,術後1年以上の臨床成績の評価が可能であったTKA192膝とUKA43膝を対象とした。術前心理的因子は痛みに対する中枢性感作の評価スコアであるCSIと破局的思考の評価スコアであるPCSにて評価した。術後患者立脚型評価として術後1年でのKOOS,New Knee Society Scoreを使用した。TKAとUKAでの術前心理的因子の違いと術前心理的因子と術後患者立脚型評価の関連の違いを評価し2群で比較した。結果:術前心理的因子であるCSIはTKA群23.5,UKA群21.5,PCSはTKA群27.3,UKA群26.1とともに両群で有意差はなかった。CSIと術後患者立脚型評価の関係は,TKA群では術後患者立脚型評価のすべての項目で負の相関を示したが,UKA群ではすべての項目と相関がなかった。PCSと術後患者立脚型評価の関係では,TKA群では立脚型評価のすべての項目で負の相関を示したが,UKA群ではKOOSのADLとNew Knee Society Scoreの満足度の項目のみ負の相関を示した。結論:TKAとUKAにおいては術前心理的因子(中枢性感作,破局的思考)には差がなかった。しかしTKAとUKAにおける術前心理的因子(中枢性感作,破局的思考)が術後患者立脚型評価に与える影響の程度は異なっていた。

著者

乾 洋史 伊藤 妙子 北原 糺

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.113, no.10, pp.667-678, 2020 (Released:2020-10-01)

参考文献数

44

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Magnetic resonance (MR)-based volumetric measurement of the endolymphatic space (ELS) was conducted in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere’s disease (cMD), and unilateral MD (uMD), and the results were compared with those in control subjects (CS). Seventy-nine patients with ALHL, 99 with SD, 65 with cMD, 77 with uMD, and 47 CS participated in this study. With the exception of the patients with uMD, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph and positive endolymph signal were acquired using a 3-T MR imaging scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images with the ELS images. The cochlear and vestibular ELS/total fluid space (TFS) volume ratios were 10.2%±6.8% and 17.7%±10.2%, respectively. The cochlear ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS, and patients with ALHL, SD, and cMD (CS=ALHL<SD<cMD<uMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and other patients groups (CS=ALHL=SD<cMD<uMD). The cochlear and vestibular ELS volume ratio in patients with uMD and other endolymphatic hydrops-related diseases differed from that in the CS. These results suggest that assessment of the prognosis is possible by MR evaluation in patients with endolymphatic hydrops-related inner ear diseases.

著者

乾 洋輔

巻号頁・発行日

2013

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Thesis (Ph. D. in Biotechnology)--University of Tsukuba, (A), no. 6516, 2013.3.25