著者
田中 是 菊地 茂 大畑 敦 堤 剛 大木 雅文
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.118, no.11, pp.1301-1308, 2015-11-20 (Released:2015-12-11)
参考文献数
35

急性喉頭蓋炎は急速に気道閉塞を引き起こし, 死に至る可能性がある感染症である. 呼吸困難がある症例では速やかに気道確保を行うことは言うまでもないが, 喉頭蓋や披裂部などの腫脹はみられるものの呼吸困難を生じていない症例に対して気道を確保すべきか判断に迷うことが多い. 1998年1月から2014年12月までの17年間に埼玉医科大学総合医療センター耳鼻咽喉科において入院加療を行った急性喉頭蓋炎285例 (男性180例, 女性105例, 平均年齢49.6±16.3歳) についてその臨床像を後方視的に解析した. 咽頭痛は全例にみられ, 呼吸困難感を訴えた症例は62例 (21.8%) であったが, 他覚的に高度な呼吸困難症状を呈した症例は17例 (6.0%) であった. 気道確保を行った症例は27例 (9.5%) であった. また, 喉頭蓋および披裂部の腫脹の程度によって, 急性喉頭蓋炎の重症度を1点から5点まで5段階に重症度スコアとして評価した結果, 他覚的に高度呼吸困難症状を認めた症例および気道確保を要した症例はすべて重症度スコアが4点以上であり, 今後前方視的な検討を要するものの, 重症度スコアは気道確保の適応を決定する上で有用と思われた. さらに, 気道確保を施行した群と施行しなかった群とを比較すると, 前者では有意に初診時の白血球数と体温が高く, 咽頭痛出現から初診までの日数が有意に短かったが, 初診時の血清 CRP 値は両群間で差はなかった.
著者
大津 隆行 的場 啓子 菊地 茂行 平尾 一郎
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.75, no.4, pp.368-371, 1955-04-25 (Released:2010-02-19)
参考文献数
8
被引用文献数
3

Polyvinylpyrrolidone, used as the substitute plasma, is said to be effective when the molecular weight is around 30, 000 to 50, 000, and the inclusion of lower or higher molecules is thought to give adverse effect as a substitute plasma. The polymer obtained by the polymerization of vinylpyrrolidone with hydrogen peroxide and ammonia catalyst was extracted with acetone at a room temperature and fractionated by reprecipitaton from aqueous solution with acetone, obtaining a distribution curve for molecular weights.On the other hand, distribution curve of molecular weights was also obtained by the same method from the polyvinylpyrrolidone marketed by the German Bayer and the two curves were found to be very similar. These results show that the extraction of low molecular polymers with a solvent like acetone is effective in obtaining polyvinylpyrrolidone of high homogeneity. Polyvinylpyrrolidone is known to take a coiled form in a solution that its viscositic characteristics in dilute aqueous solution were also examined and it was observed that the Huggins' viscosity constant, k', markedly changes with the degree of polymerization.
著者
山岨 達也 菊地 茂 八木 昌人 菅沢 正 原田 勇彦
出版者
The Oto-Rhino-Laryngological Society of Japan, Inc.
雑誌
日本耳鼻咽喉科学会会報 (ISSN:00306622)
巻号頁・発行日
vol.95, no.1, pp.41-50, 1992
被引用文献数
18 1

We studied 50 patients with acute low-tone sensorineural hearing loss (ALHL) who were examined at the Department of Otolaryngology, University of Tokyo, and followed up for 18 months or more. We investigated the prognosis of hearing loss within 3 months after onset, rate of recurrence during long-term follow-up, interval between the first and the second episodes of hearing loss or between onset and the time when the diagnosis of Meniere's disease was made, and factors affecting prognosis.<br>The results were as follows.<br>1. Within the initial 3 months of follow-up, hearing loss continued to fluctuate in 5 patients. In the remaining 45, hearing returned to normal in 34, improved without returning to normal in 6, showed no marked change in 4, and became worse in one.<br>2. In long-term follow-up, the recurrence of hearing loss without vertigo occurred in 16 patients, and 5 others were eventually diagnosed as having Meniere's disease. The average interval between the first and second episodes of hearing loss was 9.2 months, and the diagnosis of Meniere's desease was made an average of 27 months after onset.<br>3. Recurrence was not significantly related to the initial prognosis of hearing loss.<br>4. Within the initial 3 months of follow-up, the prognosis of hearing loss was significantly better in patients whose hearing loss at 1kHz was within 20dB, and tended to be better in females and in patients attending within one week of onset. Long-term follow-up showed that the rate of recurrence was significantly lower in patients aged 40 years or more, and tended to be lower in patients who visited the hospital within one week of onset or whose hearing loss at 1kHz was within 20dB.<br>5. There were no significant differences between patients with single and recurrent attacks with respect to sex, subjective symptoms, and results of the glycerol test and electrocochleography.<br>ALHL tends to recur without any relationship to the initial prognosis of hearing loss. Since it is still difficult to predict whether or not hearing loss will recur, long-term follow-up is necessary even in patients with good initial prognosis.
著者
奥田 稔 深谷 卓 小林 恵子 伊藤 依子 調所 廣之 設楽 哲也 八尾 和雄 小川 浩司 橋口 一弘 佐伯 哲郎 山越 隆行 濱田 はつみ 川崎 和子 石井 豊太 鳥山 稔 増田 哲也 杉山 博 川端 五十鈴 川島 佳代子 八木 昌人 田部 浩生 岡村 浩一郎 木場 玲子 斉藤 晶 安藤 一郎 野村 恭也 吉見 健二郎 窪田 哲明 大谷 尚志 波多野 吟哉 竹山 勇 上杉 恵介 林崎 勝武 鈴木 淳一 澤木 誠司 石塚 洋一 古屋 信彦 安達 忠治 坂井 真 新川 敦 小林 良弘 佐藤 むつみ 山崎 充代 斎藤 洋三 舩坂 宗太郎 斉藤 啓光 石井 正則 浅井 和康 森山 寛 遠藤 朝彦 小林 毅 関 博之 林 成彦 石井 哲夫 窪田 市世 水谷 陽江 荒 牧元 大竹 守 北嶋 整 上田 範子 山口 宏也 牛嶋 達次郎 坊野 馨二 菊地 茂 佐橋 紀男 臼井 信郎 原 俊彰 宮川 晃一 田中 康夫 喜友名 朝盛 井上 庸夫 八木 聰明 大久保 公裕 服部 康夫 町野 満 大塚 博邦 稲葉 真 島田 早苗 添野 眞一 星 慎一 頼 徳成 大橋 和史 村山 貢司 飯塚 啓介 市川 朝也 冨田 寛 小山 明 山内 由紀 渡辺 健一 佐藤 かおる 山田 久美子 木田 亮紀 牧山 清 亀谷 隆一 藤田 洋祐 井上 鐵三 田村 悦代 野原 理 阿部 和也 水野 信一 岩崎 真一 小川 裕 加賀 達美
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.6, pp.797-816, 1995-06-01
被引用文献数
6 3

To evaluate the effectiveness, safety and utility of Emedastine difumarate (ED) in the treatment of Japanese cedar pollinosis, a multicentered, double-blind comparative study was performed in 290 patients in 1994.<br>Patients with Japanese cedar pollinosis were divided into two groups; the first group was treated with ED at a dose of 4mg/day starting two weeks before the season and continuing for the whole season. The second group was given an inactive placebo instead of ED during the pre-season and the early portion of the season and then replaced with ED during the later portion of the season.<br>As a result, the final improvement rate was significantly higher in the first group than that in the second group.<br>All subjective symptoms such as sneezing, nasal discharge, nasal obstruction and eye itching were suppressed due to ED treatment.<br>In conclusion, it was better to continuously administer ED to patients with pollinosis from the preseasonal period till the end of the season.<br>However, when the ED treatment was started in the midseason, the outcome was good, although less satisfactory than the outcome of continuous treatment given throughout the entire pollen season.
著者
菊地 茂 洲崎 春海 青木 彰彦 伊藤 修 野村 恭也
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.84, no.1, pp.41-47, 1991
被引用文献数
41 24

Twenty six adult patients with chronic sinusitis who had undergone Caldwell-Luc operation and received conservative therapy for a long time, but still complained of nasal symptoms, were treated with 400-600mg of erythromycin (EM) per day for 7.9 months on the average.<br>1) Rhinorrhea was reduced in 60.0%, postnasal drip in 50.0%, nasal obstruction in 60.0%, hyposmia in 11.8% and sense of dullness in the head in 100%.<br>2) Rhinoscopy showed reduced mucosal swelling in 10.5%, lower volume of rhinorrhea in 80.0%, better quality of rhinorrhea in 70.0% and reduced postnasal drip in 85.7%.<br>3) This therapy was effective even when EM-resistant bacteria such as Hemophilus influenzae were present.<br>4) No significant side effects were noted in any of the patients during this therapy. Long-term low-dose EM therapy is useful in the treatment of chronic sinusitis. We consider that its effect is not due to its antibacterial activity but to some as yet unknown mechanism.