著者

古川 仭 三輪 高喜

出版者

耳鼻咽喉科展望会

雑誌

耳鼻咽喉科展望 (ISSN:03869687)

巻号頁・発行日

vol.37, no.5, pp.571-577, 1994-10-15 (Released:2011-08-10)

参考文献数

9

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嗅覚における基礎的観点から述べた先の解説をうけて, 本稿では臨床的観点からみた最近の話題を取り上げる。

著者

馬場 駿吉 高坂 知節 稲村 直樹 佐藤 三吉 鈴木 茂 遠藤 里見 石戸谷 雅子 小野寺 亮 山田 公彦 大久 俊和 荒井 英爾 鈴木 雅明 大山 健二 粟田口 敏一 戸川 清 岡本 美孝 松崎 全成 寺田 修久 喜多村 健 石田 孝 馬場 廣太郎 島田 均 森 朗子 池田 聖 金子 敏郎 今野 昭義 山越 隆行 石井 哲夫 窪田 市世 鍋島 みどり 田口 喜一郎 石山 哲也 中野 雄一 中村 英生 五十嵐 文雄 古川 仭 作本 真 山下 公一 久保田 修 宇佐神 篤 伊藤 博隆 鈴木 元彦 間宮 紳一郎 横田 明 加藤 薫 大屋 靖彦 河合 〓 岩田 重信 横山 尚樹 井畑 克朗 瀧本 勲 稲福 繁 坂倉 康夫 鵜飼 幸太郎 雨皿 亮 山田 弘之 坂倉 健二 平田 圭甫 伊藤 由紀子 村上 泰 竹中 洋 山下 敏夫 久保 伸夫 中井 義明 大橋 淑宏 阪本 浩一 村田 清高 平沢 昌子 原田 康夫 森 直樹 白根 誠 多田 渉 小林 優子 竹林 脩文 河野 嘉彦 夜陣 紘治 平田 思 宮脇 修二 津田 哲也 山下 隆司 二階堂 真史 柿 音高 永澤 容 増田 游 後藤 昭一 西岡 慶子 折田 洋造 東川 康彦 武 浩太郎 進 武幹 前山 忠嗣 百田 統洋 堤 昭一郎 茂木 五郎 川内 秀之 松下 太 吉村 弘之 高田 順子 石川 哮 定永 恭明 大山 勝 松崎 勉 坂本 邦彦 廣田 常治 内薗 明裕 鯵坂 孝二 中島 光好

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.88, no.3, pp.389-405, 1995-03-01

被引用文献数

13 16

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The efficacy and safety of Kampo preparation Sho-seiryu-to were studied in a joint double-blind trial in comparison with a placebo. The study was carried out on 220 patients with perennial nasal allergy at 61 hospitals. Granules in a dose of 3 g were administered 3 times daily for 2 weeks. Moderate to high improvement was recorded in 44.6% of the treated patients and in 18.1% of those receiving placebo. The difference is significant (p <0.001). Side effects were noted in 6.5% of the treated patients and in 6.4% of the controls (not a significant deference). The side effects were mild and had no influence on the daily life of the patients.

著者

丸山 裕美子 古川 仭

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.95, no.5, pp.513-520, 2002-05-01 (Released:2011-11-04)

参考文献数

13

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We report 7 cases of acute and recurrent inspiratory dyspnea in which no organic cause could be identified. Patients were from 12 to 68 years old (43.6 in average), consisting of five males and two females. In three of the seven cases, fiberoptic laryngoscopy during an attack of dyspnea revealed laryngospasms following symmetric adduction of the vocal cords. Each patient experienced loud, stridorous noise during inspiration at the beginning of an attack as well as the subsequent inability to inspire. The attacks ranged from several tenths of a second to a few minutes in duration and occurred frequently, several times a day in some cases. Results of physical examinations, lung function tests, roentgenograms of the chest and larynx, and CTs of the lungs and the neck were unremarkable. Laboratory findings including blood gas analysis between attacks were within normal limits. No atopic stigmata were found.Drinking water or swallowing could sometimes relieve the grade of the attack, and the patient could completely prevent attacks once they understood the condition of the dyspnea and mastered a breathing maneuver during the attack. Previous upper respiratory infection, cough, and sleep apnea were suggested to correlate with the episodes. Our patients did not require drastic maneuvers such as tracheostomy or intubation. Administration of Eperisone hydrochloride and Etizolam proved effective in some cases.Laryngospasm as a cause of recurrent inspiratory dyspnea is functional, and we suspect that it is not such a rare occurrence. An awareness of this entity could prevent unnecessary tracheotomies.

著者

張 暁彦 伊藤 真人 渋谷 和郎 塚谷 才明 古川 仭

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.11, no.3, pp.232-234, 2001-07-25 (Released:2011-06-17)

参考文献数

14

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Lyme disease is Borrelia infection that primarily affects the skin with a characteristic rash, erythemamigrans (EM), but recently the neurologic manifestations (Neuroborreliosis) of this disease have beenreported.A 27 year-old woman presented with unilateral acute sensorineural hearing loss and tinnitus in her leftear. These symptoms were progressive. Vision in her left eye has been hampered considerably after threeweeks, and it was diagnosed as post-ocular neuritis. And paralysis of the left side body was developed withina month. Because this patient didn't have a history of tick bite nor skin rash (EM), the diagnosis wasextremely difficult. After taking minocycline hydrochloride to treat atheroma with infection in her left auricle, incidentally the symptoms were improved.Systemic infection was considered and Borrelia burgdorferi serum antibodies was examined. IgM-antibodiesof B. garinii and B. afzelii were detected in her serum, so Lyme disease was diagnosed. The left sensorineuralhearing loss and other symptoms were recovered in some degree after treatment for Lyme disease.After half-year the left sensorineural hearing loss with other neurologic manifestations were recurred, and the periodical observation should be required.

著者

小川 晃弘 岡野 光博 土井 彰 前田 幸英 西崎 和則 久保田 聡 古川 仭

出版者

Japan Rhinologic Society

雑誌

日本鼻科学会会誌 (ISSN:09109153)

巻号頁・発行日

vol.42, no.1, pp.23-27, 2003-04-01 (Released:2010-03-11)

参考文献数

11

被引用文献数

1 1

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Changes in the sense of smell may be quantitative and qualitative, or possibly even a combination. Quantitative changes may manifest themselves partly as hyperosmia and partly as hyposmia, although hyposmia is much more common. Qualitative changes are segignated a parosmia. Disosmia is a condition in which stimulation of the sense of smell does not result in an adequate olfactory impression, but rather in a distorted sensation, usually unpleasant. The precise mechanism and etiology of parosmia remain to be classified.Recent molecular biological advances enable us to a more accurately assess the prognosis for parosmia or suggest more successful treatment. We present an overview of modern classification or definition of parosmia and related clinical issues requiring greater discussion. We collected 94 parosmic patients from 9 dysosmia clinics and discussed them in this reports.Women over 40 years old are most susceptible to parosmia. Upper respiratory viral disease including common cold, head trauma and also zinc deficiency, are conditions that put patients at high risk for parosmia. About 6% of all patients seen at dysosmia clinics have parosmia. We classified parosmia patients by sites, etiology, and severity.Sites are usually the site of responsible for hyposmia or anosmia. Parosmia patients were divided into organic and functional. The organic type was divided into peripheral, central and mixed peripheral and central. The functional type includes the psychological disorder such as illusions of smell, olfactory hallucination, and the uncinates fits. Etiology was classified as sinonasal disease, upper respiratory disease, head injury, other or miscellaneous. Other categories includes zinc-deficient and drug-inducced. We classified severity as slight, moderate, or severe. Twelve factors, including gender, age, and duration, affect the prognosis of parosmia. We summed up the score for these factors and judged severity. For sever parosmic patients, medical treatment such as medication, local treatment, or surgery must be considered. Major tranquiraizer and surgery should be selected for patients with severe or intractable parosmia.

著者

古川 仭

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.86, no.3, pp.305-310, 1993-03-01 (Released:2011-11-04)

参考文献数

7

被引用文献数

3 1

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Squamous cell carcinoma accounts for approximately 98 per cent of all malignant neoplasms that occur in the nasopharynx. The high incidence of nasopharyngeal carcinoma (NPC) is a characteristic of the Oriental races. Viral and environmental factors appear to have an etiologic impact on this disease. The most common sites are the lateral wall followed by the roof. NPC spreads primarily by local infiltration and regional metastases. Local infiltration of the eustachian tube is evidenced clinically when the patients presents with a unilateral conductive hearing loss secondary to the development of a secretory otitis media. Multiple cranial nerve deficits can develop. The maxillary and mandibular branches of the trigeminal complex (V2 and V3) are the most commonly involved cranial nerves and indicate extension of the tumor through the foramen rotundum and foramen ovale. Lateral rectus deficits cause the patient to complain of diplopia, especially on lateral gaze, indicating tumor involvement along the course of cranial nerve VI. More extensive internal and external ophthalmoplegias suggest orbital or cavernous sinus involvement. Lateral extension or spread into the pterygomaxillary fossa and the infratemporal fossa can easily affect the lower cranial nerves (IX, X, XI, XII), indicating that the tumor has progressed into the area of the jugular foramen. Lack of significant tumor bulk in the nasopharynx or parapharyngeal spaces with paralysis of the lower cranial nerves usually indicates involvement of adjacent lymph nodes surrounding the jugular foramen rather than direct extension from the primary tumor. Lymphatic spread from the nasopharynx may be either unilateral or bilateral. When the tumor has spread into the upper deep cervical lymph nodes, a cervical mass usually first becomes detectable clinically.

著者

上出 文博 滝元 徹 古川 仭 作本 真 竹下 元 梅田 良三

出版者

耳鼻咽喉科展望会

雑誌

耳鼻咽喉科展望 (ISSN:03869687)

巻号頁・発行日

vol.31, no.1, pp.25-30, 1988-02-15 (Released:2011-08-10)

参考文献数

12

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The patient was a 42-year-old female whose chief complaints were headache and unilateral hyposmia for 2 months. There was no unusual finding in her nasal cavities. Roentogenography of the olfactory clefts and paranasal sinuses revealed no abnormality. Standard olfaction test using T & T olfactometer revealed right side severe hyposmia. Olfactory discrimination test carried out at the right nasal cavity showed hyposmia due to intracranial disorders. Intravenous olfaction test (Alinamin 10 mg) with bilateral nasal cavities indicated normal duration time, but the same test with right nasal cavity indicated redution of the duration time due to intracranial disorders. As we could set the electrode and the odorous stimulation while observing the olfactory portion with Olympus selfoscope SES 1711D, we recorded the typical slow negative potential similar to those in normal olfaction cases.RI angiography, computed tomography and right carotid angiography done at neurosurgery were useful in this case and showed a typical frontal fossa tumor.Total removal of tumor was performed by neurosurgeons under general anesthesia. Histological examination revealed a typical meningioma with psammoma body and micronecrosis.Unilateral olfactory disorder is one of the important symptoms not only in nasal and paranasal sinuses diseases but also in intracranial diseases however unilateral olfaction test is not yet a routine test even for ear-nose-throat specialists at present.

著者

石丸 正 作本 真 長山 郁生 古川 仭

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.87, no.11, pp.1489-1494, 1994-11-01 (Released:2011-11-04)

参考文献数

8

被引用文献数

1

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We usually use 6 frequencies, 250, 500, 1000, 2000, 4000 and 8000 Hz, in conventional pure tone audiometry. When these 6 points do not show hearing loss, our clinical diagnosis is no hearing loss. If the hearing loss is not located in the clinical 6 frequencies, we cannot detect it.The authors diagnosed 6000 Hz-dip type acute hearing loss in a 43-year-old male with tinnitus. We measured the hearing levels at 6 frequencies and found no hearing loss. The pitch of his tinnitus was 6000 Hz, so we measured the hearing levels at 4 other frequencies (800, 1500, 3000 and 6000 Hz) and detected a 6000 Hz-dip.Steroid treatment cured both the tinnitus and the 6000 Hz-dip hearing loss.When hearing loss occurs at a frequency other than the conventional pure tone audiometric frequencies, a mistaken diagnosis of no hearing loss is made. If the patient complains of tinnitus, the clinician should investigate the pitch and measure the hearing level near the frequency of the tinnitus. This is a useful method of discovering narrow diptype acute hearing loss.

著者

吉崎 智一 前川 謙一 金泉 秀典 丸山 裕美子 白井 明子 古川 仭

雑誌

頭頚部腫瘍 (ISSN:09114335)

巻号頁・発行日

vol.27, no.3, pp.659-662, 2001-11-25

参考文献数

12

著者

岡部 陽三 長山 郁生 三輪 高喜 宮永 路子 古川 仭

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.85, no.8, pp.1281-1284, 1992-08-01 (Released:2011-11-04)

参考文献数

10

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A 62-year-old woman visited our hospital complaining of abnormal sensation in the pharynx. Physical examination revealed a pulsating mass on the right side of the posterior wall of the mesopharynx. CT and angiography confirmed that the internal carotid artery had an abnormal course and was compressing the pharyngeal wall.The clinical importance and etiology of tortuosity of the internal carotid artery are discussed.

著者

伊藤 真人 長山 郁生 岡部 陽喜 古川 仭

出版者

耳鼻咽喉科展望会

雑誌

耳鼻咽喉科展望 (ISSN:03869687)

巻号頁・発行日

vol.34, no.5, pp.527-531, 1991-10-15 (Released:2011-08-10)

参考文献数

17

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近年Bell麻痺に対してはStennert法が普及し, Hunt症候群には抗ウイルス剤 (アシクロビル) とStennert法の併用療法が試みられ, 良好な治療成績が得られている。我々は臨床的にBel1麻痺と診断される症例 (Huntの一部を含む) に対してもHunt症候群と同様にアシクロビルとStennert法とを併用しているので報告した。本治療の目的は臨床的Bell麻痺の中に含まれるHunt不全型の治療と, 病初期に帯状疱疹を認めないHunt典型例の重症化の予防, VZV以外のウイルスが関与するBell麻痺症例の治療が目的である。結果は25例中治療開始が遅れた1例を除き他は全例完治した。

著者

鈴木 重忠 能登谷 晶子 古川 仭 宮崎 為夫 梅田 良三

出版者

日本音声言語医学会

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.29, no.3, pp.280-286, 1988-07-25 (Released:2010-06-22)

参考文献数

30

被引用文献数

1 2

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文字言語も早期から指導する文字・音声法 (金沢方式) で言語治療を受けた難聴幼児の言語発達を客観的に知ることを目的に, 就学前に行った修正版絵画語い発達検査, 聴覚障害児用単語了解度検査, 音読明瞭度, 幼児・児童読書力テスト, 改訂版教研式全国標準新読書力診断検査成績を検討し, 以下の知見を得た.1) 音声言語の了解は従来の指導法による成績を上回る傾向を示した.2) 発音の明瞭度は従来の指導による成績を下まわることはないと推測された.3) 読書力は学齢前でも普通小学校2年相当を獲得できることがわかった.4) この読書力は先に行った幼児・児童読書力テスト成績と強い相関を示した.以上より, 文字・音声法は難聴幼児の言語発達促進に有用であることが示された.

著者

能登谷 晶子 鈴木 重忠 岡部 陽三 古川 仭

出版者

一般社団法人 日本耳鼻咽喉科学会

雑誌

日本耳鼻咽喉科学会会報 (ISSN:00306622)

巻号頁・発行日

vol.97, no.7, pp.1207-1210, 1994 (Released:2008-03-19)

参考文献数

5

被引用文献数

1

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A 6-years 9-month-old child with congenital severely hearing impaired received a Nucleus 22 channel implant. Twenty-two CG electrodes are now in use. In the 5 months since the cochlear implant, the patient has made good progress. Her vowel discrimination score has reached 100%. However, her consonant discrimination has remained at the chance level. On the other hand, auditory reception of environmental sounds has shown relative improvement. Problems encountered in pediatric use of the cochlear implant are also discussed herein.

著者

瀧口 哲也 岡部 陽三 古川 仭 中川 士郎 大尾 嘉宏巳 道岸 隆敏 水上 勇治

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.85, no.4, pp.607-613, 1992

被引用文献数

1

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A 57-year old man had a left anterior neck tumor, and another small tumor was found in the laryngeal ventricle by indirect laryngoscopy. A CT scan showed a well-circumscribed tumor growing from the thyroid lamina into the paraglottic space. Under general anesthesia the tumor was dissected with fenestration of the thyroid ala without any complications, such as hoarseness or deformity. In Japan 35 cases of cartilagenous tumors arising in the laryngeal cartilage have been reported, including our case. In six of these 35 cases the tumor was in the thyroid cartilage. Both chondrosarcoma and chondroma are often seen in the thyroid cartilage, whereas chondroma is seen more frequently than chondrosarcoma in the cricoid carilage.

著者

木村 恭之 土定 建夫 塚谷 才明 作本 真 三輪 高喜 古川 仭

出版者

耳鼻咽喉科展望会

雑誌

耳鼻咽喉科展望 (ISSN:03869687)

巻号頁・発行日

vol.36, no.6, pp.709-716, 1993-12-15 (Released:2011-08-10)

参考文献数

15

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中枢性嗅覚障害で病変の局在がはっきりしている脳腫瘍10例を対象に臨床的検討を行った。自覚的に「正常」と答えた7例中, 実際に検査上正常だった症例はなかった。認知嗅力損失で左右差のあった症例が8例あり, 単鼻孔嗅検査は不可欠と考えられた。検知/認知の差が2.0以上あった解離現象を示した症例が5例あった。解離現象は第3次嗅覚中枢の障害の他に嗅覚の伝達情報量が不足した場合でも起こりうると考えられた。静脈性嗅覚検査では潜伏時間は正常で持続時間が短縮していることが特徴的であったが, この現象は病変の局在を反映するものではなかった。病変と同側性あるいは両側性に嗅覚障害が発症した例が多かったが, 必ずしも当てはまらない症例もみられた。これは頭蓋内は圧迫が他の部分に影響しやすく, 周囲には浮腫性病変も合併しやすいことと関連があると考えられた。