著者

山田 卓生 蓑田 涼生 三輪 徹 増田 聖子 兒玉 成博 鮫島 靖浩 湯本 英二

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.57, no.6, pp.283-289, 2011 (Released:2012-11-01)

参考文献数

24

被引用文献数

5

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当科で施行した人工内耳埋込術 72 例について、「人工内耳埋込術後に何らかの追加の治療・処置を必要とした症状」を術後合併症と定義し、術後の合併症の有無について診療録の記載より調査を行った。72 例中 9 例(12.5%)に術後合併症を認めた。保存的治療もしくは経過観察のみで対処可能であった合併症(軽度合併症)は 4 例、観血的治療を必要とした合併症(重度合併症)は 5 例であった。軽度合併症の内訳は、味覚障害が 2 例、遅発性顔面神経麻痺が 1 例、人工内耳埋込部の感染が 1 例であった。また、重度合併症は、インプラント故障が 2 例、人工内耳埋込部の感染が 2 例、インプラントの露出が 1 例であった。このうち埋込部感染を認めた 2 例は、基礎疾患との関連が考えられた。インプラント故障を認めた 2 例においては、頭部打撲が原因であった。インプラントの露出を来した 1 例については、人工内耳埋込部と耳掛けの体外部との接触が原因と思われた。

著者

村上 大造 松吉 秀武 蓑田 涼生 鮫島 靖浩 湯本 英二

出版者

特定非営利活動法人 日本頭頸部外科学会

雑誌

頭頸部外科 (ISSN:1349581X)

巻号頁・発行日

vol.19, no.1, pp.73-78, 2009-06-30 (Released:2010-02-10)

参考文献数

15

被引用文献数

1

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今回われわれは3例の小児・若年者(19歳以下)甲状腺乳頭癌症例を経験し,主に治療方針について文献的考察を加えて報告する。3症例とも広範な両側頸部リンパ節転移を有し,1例に多発性肺転移,また,残りの2例にも肺野に小結節陰影を認めた。全例に甲状腺全摘出術,両側頸部郭清術を行い,1例は患側の反回神経浸潤を認めたため,神経切除のうえ神経再建術を行った。また,全例,術後にI131大量療法を施行した。多発性肺転移例は現在も肺野に結節陰影を認めているが,治療後16年経過し明らかな増大傾向はない。また,1例に術後鎖骨下リンパ節にI131の集積を認めたが,リンパ節径の増大傾向やサイログロブリン値の上昇がないため,現在は外来にて厳重経過観察を行っている。全例生存し,日常生活に支障を来す合併症は認めていない。小児・若年者甲状腺乳頭癌の場合,腺内転移,リンパ節転移,肺転移の頻度が成人症例よりも高いという特徴がある。そのため,甲状腺全摘出,徹底した頸部郭清術を行い,必要に応じてI131大量療法を施行する必要があると考えられる。

著者

蓑田 涼生 宇野 研吾 福島 正人 土生 健二郎 杉 宣宏 石川 哮

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.40, no.5, pp.780-786, 1994-09-20 (Released:2013-05-10)

参考文献数

12

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オフロキサシン (以下OFLX) はグラム陽性菌, グラム陰性菌に広い抗菌力が認められているキノロン系抗菌剤で, 耳用液は各種感染性耳疾患において用いられている. 耳浴時間は従来の耳浴時間にならつて10分間とされているが, 薬剤の性質を考慮すると, 耳浴時間の短縮は充分可能であると思われる. 今回, 従来通りの10分耳浴群と2~3分の短縮耳浴群の2群においての臨床効果について比較検討を行い, その可能性について検討した. その結果2~3分耳浴両群においても10分耳浴と同様に高い臨床効果と安全性を認めた.

著者

三輪 徹 蓑田 涼生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.78, no.2, pp.93-101, 2019

被引用文献数

3

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<p> Past major earthquakes have been associated with an increase in the prevalence of vertigo or dizziness; the 2016 Kumamoto earthquakes on April 14 and 16 (JST, moment magnitude=7.0, Shindo 7 [Japanese seismic scale]) and the large numbers of aftershocks were no exception. Several months after the initial earthquake, significant outbreaks of vertigo or dizziness occurred over a large area surrounding the epicenter of the earthquake. However, it is unclear why major earthquakes cause these symptoms. After the major earthquake in Kumamoto, we conducted a questionnaire and medical records survey to investigate post-earthquake dizziness (PED). This survey covered a total of 575 subjects who complained of exacerbation of vertigo or dizziness after the earthquake and visited the hospital for follow-up before the scheduled dates. Our results showed that the number of patients with vertigo or dizziness who visited the hospital increased after the earthquake, and peaked between 2 and 4 weeks after the earthquake. The timing of onset of vestibular disorders varied according to the underlying disease. This study also suggested that earthquake-related psychological stress or stress resulting from earthquake evacuation could cause the onset of some vestibular disorders. We speculated that PED could be caused by stimulation of the vestibular and visual systems and bathyesthesia, psychological stress, potential effects of autonomic stress on the equilibrium function, and/or sensory mismatch. Our study could contribute to establishing PED as a new concept in the area of vestibular disorders.</p>

著者

三輪 徹 蓑田 涼生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.78, no.2, pp.93-101, 2019-04-30 (Released:2019-06-04)

参考文献数

22

被引用文献数

1 3

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Past major earthquakes have been associated with an increase in the prevalence of vertigo or dizziness; the 2016 Kumamoto earthquakes on April 14 and 16 (JST, moment magnitude=7.0, Shindo 7 [Japanese seismic scale]) and the large numbers of aftershocks were no exception. Several months after the initial earthquake, significant outbreaks of vertigo or dizziness occurred over a large area surrounding the epicenter of the earthquake. However, it is unclear why major earthquakes cause these symptoms. After the major earthquake in Kumamoto, we conducted a questionnaire and medical records survey to investigate post-earthquake dizziness (PED). This survey covered a total of 575 subjects who complained of exacerbation of vertigo or dizziness after the earthquake and visited the hospital for follow-up before the scheduled dates. Our results showed that the number of patients with vertigo or dizziness who visited the hospital increased after the earthquake, and peaked between 2 and 4 weeks after the earthquake. The timing of onset of vestibular disorders varied according to the underlying disease. This study also suggested that earthquake-related psychological stress or stress resulting from earthquake evacuation could cause the onset of some vestibular disorders. We speculated that PED could be caused by stimulation of the vestibular and visual systems and bathyesthesia, psychological stress, potential effects of autonomic stress on the equilibrium function, and/or sensory mismatch. Our study could contribute to establishing PED as a new concept in the area of vestibular disorders.

著者

三輪 徹 竹田 大樹 蓑田 涼生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.76, no.6, pp.712-719, 2017

被引用文献数

3

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<p> Genetic defects are a major cause of hearing loss in newborns. Numerous causative genes for genetic hearing loss have been identified. Most genes cause only hearing loss which is referred to as non-syndromic deafness. On the other hand, some genes cause not only congenital hearing loss but also vestibular dysfunction,<i> etc</i>., which is referred to as syndromic deafness. However, presently, there are no truly curative treatments for this condition. One of the feasible treatments for congenital inner ear disease is "gene therapy during the embryonic stages" before the expression of abnormal morphology and function of the inner ear. In 2008, Gubbles et al. reported on gene transfer by transuterine-mediated injection into the embryonic inner ear (otocyst) and electroporation at embryonic day 11.5 (E11.5). We also utilized those methods, and performed electroporation-mediated transuterine gene transfer into otocysts (EUGO) for two models of congenital inner ear disease. One is the Connexin (Cx) 30 knockout (KO) mouse in which GJB6 gene coding Cx30 is deleted. The other is the pendrin KO mouse in which the SLC26A4 gene coding pendrin is deleted. The former is the model of non-syndromic deafness, the latter is the model of syndromic deafness. EUGO caused the vast expression of normal genes in the inner ear and successfully improved the hearing and vestibular function in both models. Although we utilized the otocyst at E11.5, this method must be demonstrated before the beginning of gene expression in the inner ear. Thus, the timing of embryonic gene therapy is important, because each gene has a different timing of expression in the inner ear. Herein, we describe state-of-the-art research on genetic inner ear disease treatment through gene therapy and discuss the obstacles to overcome in curative treatments of genetic inner ear diseases in humans.</p>