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 27

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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.

著者

中江 進 水田 康雄 八木 美知 平杉 嘉昭 水越 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.72, no.11, pp.1469-1477, 1979

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Five patients with a congenital deafness caused by maternal rubella infection during pregnancy visited our clinic in 1977. The ages ranged from 3 to 11 months. The diagnosis of deafness was made mainly by Brain Stem Response, partly startle response and C. O. R.<br>Case 1 was diagnosed as a typical congenital rubella syndrome, because of the high HI titer, congenital deafness, PDA+ASD, retinochoroidal degeneration, thrombocytopenia, and hepatosplenomegaly. Case 4 whose HI titer was high was accompanied by microphthalamia and anophthalamia with a positive response at 40dBSL in BSR the left ear and 50dBSL in the right ear.<br>We conclude that congenital deafness should be determined by Brain Stem Response as early as possible so that an early diagnosis of hearing impairment can be made.

著者

西村 宏子 山本 悦生 山内 盛雄 岩永 迪孝 藤田 佳代子 岩崎 博 佐藤 宏昭 竹内 俊二 鶴原 秀晃

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.76, no.2special, pp.328-337, 1983 (Released:2011-11-04)

参考文献数

31

被引用文献数

1

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昭和52年1月から昭和57年9月までの6年9ヵ月間, 京大病院耳鼻咽喉科を訪れた顔神麻痺患者662名について統計的観察を行い以下の結果が得られた.(1) 顔神麻痺患者は, 外来新患数の1.8%を占めていた.(2) 年度別発生件数では, 各年ともベル麻痺が1番多く, 62.0~80.5%を占め, その他の頻度はまちまちであった.(3) 診断別分類では, ベル麻痺が1番多く, 447例 (67.5%), 以下, ハント症候群59例 (8.9%), 手術損傷性45例 (6.8%), 頭部外傷性45例 (6.8%), 先天性23例 (3.5%), 耳炎性15例 (2.3%), 中枢性6例 (0.9%), 側頭骨外疾患4例 (0.6%), 聴神経腫瘍2例 (0.3%), その他16例 (2.4%) であった.(4) ベル麻痺, ハント症候群における男女の差は著明でなかった.(5) ベル麻痺, ハント症候群とも左側にわずかに多かった.(6) ベル麻痺, ハント症候群の月別発生頻度は, 前者は11月に少なくなっている他は著明な差は見られなかった. 後者も季節的な一定の結論を出すのは困難であった.(7) ベル麻痺, ハント症候群とも青壮年が多く罹患していた.(8) 再発性麻痺は40例あり, 一側反復性麻痺14例, 両側交代性麻痺25例, 両側同時性麻痺1例を含んでいた.(9) ウイルス感染については, 検索を行った73例のうち, 感染ベルは21.3%で, ハント症候群では75%に帯状疱疹ウィルスに感染が認められた.

著者

堀 龍介 安里 亮 田中 信子 嘉田 真平 平塚 康之 金子 賢一 児嶋 久剛 赤水 尚史 伊藤 壽一

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.95, no.8, pp.825-829, 2002-08-01

被引用文献数

8 9

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Congenital piriform sinus fistula, which is usually unilateral, is recognized as a cause of acute suppurative thyroiditis. We have encountered a rare case of bilateral piriform sinus fistulae. The patient, a 53-year-old female, was referred to our hospital because of right neck swelling, which improved after conservative treat. Three months later, an abscess of the left thyroid lobe was presented and was improved after incision and drainage. The diagnosis of bilateral piriform sinus fistulae was made by hypopharyngeal enhancement radiography. Total fistulectomies were performed. There was no recurrence observed six months after surgery.

著者

岩塚 和子

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.98, no.6, pp.447-452, 2005-06-01 (Released:2011-10-07)

参考文献数

11

被引用文献数

2 1

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A 31-year old woman with Churg-Strauss Syndrome (CSS) including eosinophilic otitis media is presented. Other manifestations included an 11-year history of nasal allergy followed by bronchial asthma, sinusitis with nasal polyps, eosinophilic pneumonia accompanied by peripheral eosinophilia (34% of 6, 600/μl leukocytes), and erythema in both legs. Repeated episodes of painless right otitis media occurred without fever during the first stage of CSS characterized by an allergic state. This progressed to bilateral otitis media with gelatinous mucoid fluid accumulations shortly before the second stage of CSS characterized additionally by peripheral eosinophilia and eosinophilic pneumonia. Numerous eosinophils were found in gelatinous fluid within the tympanic cavity.The patient was diagnosed with bilateral eosinophilic otitis media, which was controlled by nebulizer therapy with 2% fosfomycin and 0.2% betamethasone solution directed into the Eustachian tube and tympanic cavity. Hearing loss and vertigo have been avoided. This case strongly suggests that eosinophilic otitis media can be a manifestation of CSS.

著者

立木 孝

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.75, no.2, pp.305-315, 1982 (Released:2011-11-04)

参考文献数

58

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The idea that sensorineural hearing loss without an associated conductive loss due to stapes fixation can be attributed to otosclerosis is presented.The literature on sensorineural hearing loss in otosclerosis is reviewed. Although a considerable number of related findings seems to support this idea, no confirming evidence has been found.It has been believed that otosclerosis is rare in Japan and many otologists are uninterested in the idea of inner ear otosclerosis. Recently, however, some investigators reported a considerable number of patients with clinical and/or histological otosclerosis.There are many cases of sensorineural hearing loss of unknown cause and its etiology has been a matter of concern.As inner ear otosclerosis is clinically characterised by sensorineural hearing loss of unknown origin, it should be included in differential diagnosis when evaluating the etiology of sensorineural hearing loss in general.

著者

関谷 忠雄

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.66, no.6, pp.693-694, 1973 (Released:2011-11-04)

著者

近松 一朗 増山 敬祐

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.105, no.2, pp.87-94, 2012 (Released:2012-02-01)

参考文献数

32

被引用文献数

1

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Cancer immunotherapy is designed to activate and up-regulate the host immune responses against tumor cells and is currently in use or under investigation for cancer treatments. Although tumor cells can use a variety of mechanisms to create an immunosuppressive environment, many agents and strategies to reduce or eliminate tumor-induced immune suppression are either being developed or already in clinical trials. This review deals with recent advances in cancer immunotherapy, focusing on new strategies to enhance antitumor immunity. Numerous approaches have been tested for the development of therapeutic cancer vaccines. Recently, several promising reports suggest that clinical benefit has been shown in randomized phase III trials for vaccines against prostate cancer, follicular lymphoma, and melanoma. Moreover, in 2010, the first patient-specific immunotherapy (sipuleucel-T) was approved by the FDA for the treatment of prostate cancer. On the other hand, some chemotherapeutic agents such as cyclophosphamide and docetaxel, have direct effects on the immune system that is likely to contribute to an improved antitumor immunity. Therefore, cancer immunotherapy combined with chemotherapy may represent one approach for breaking tumor-induced immune suppression. To date, a number of monoclonal antibodies are in use or under evaluation. Among these antibodies, blocking negative immunoregulatory receptors, CTLA-4 and PD-1, also represent a new strategy to induce antitumor immunity by manipulation of the immune system. In clinical trials, these antibodies could increase anti-tumor T-cell immunity and result in objective tumor regression in some patients. Thus, accumulating data from recent cancer vaccine trials, the manipulation of immune suppression using chemotherapeutic agents, and the use of immune-stimulatory antibodies raise the hope that immunotherapy could become the fourth modality of cancer treatment. Based on these new findings, in our hospital, a clinical trial using dendritic cells combined with low dose cyclophosphamide and docetaxel in patients with relapsed and refractory head and neck squamous cell carcinoma is under way (UMIN000003725, ClinicalTrials.gov identifier, NCT01149902). In the near future, various immunotherapeutic modalities will most probably be applied as novel approaches in the treatment of head and neck cancer.

著者

深澤 達也 藤村 英一 加納 直行 牧本 一男

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.74, no.8, pp.1761-1766, 1981-08-01 (Released:2011-11-04)

参考文献数

6

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Differentiated thyroid cancer is regarded to be of low grade malignancy with a good prognosis. We made statistical analyses of 138 cases of differentiated thyroid cancer treated in Kyoto University during the past ten years.Our study proved the propriety of the standard surgical procedures for thyroid cancer. These established indications of surgical procedure for various stages of the cancer were found to have been properly followed in our series. This could conceivably be related to a lower recurrence rate in our series.

著者

野添 恒幹 和田 安弘 木下 卓也 熊沢 忠躬 浜田 栄幹

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.78, no.6, pp.1041-1049, 1985

被引用文献数

1 1 3

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30才男性の両側性他覚的耳鳴を経験し, 耳鳴の発生に関与する筋および機序について検討した. その結果, 口蓋帆張筋間代性痙攣で耳管軟骨部内壁の急激な離開あるいは耳管周囲軟骨の変形が生じ, これが他覚的に click 音として聴取されたものと推定した. また本症例では口蓋帆張筋のみならず鼓膜張筋の間代性痙攣も確認された. 耳鳴時の鼓膜コンプライアンスの増大は鼓膜内陥運動と外耳道容積の増大とによるものと考えられた.

著者

山中 昇

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.105, no.5, pp.407-412, 2012 (Released:2012-04-27)

参考文献数

18

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Currently, the evidence-based medicine, EBM, has become essential in every field of medicine and many clinical guidelines have been developed based on the high-quality evidence. Such evidence has usually classified into 6 levels according to the quality of the studies. A meta-analysis of randomized controlled trials is considered as the highest level of evidence. The meta-analysis, however, has several pit-falls that we should keep in mind. The pit-falls are Simpson’s paradox, the selection bias, the publication bias, and the geographical bias. In the clinical setting of otolaryngology, it is not always possible to obtain a high level of evidence for conventional clinical treatments such as myringotomy, sinus puncture and aspiration, aeration of the Eustachian tube for the treatment of otitis media with effusion, and so on. Since these treatment modalities have no high-level of evidence, should we therefore stop performing them? No. We should have a further look at these treatments as “good practice points (GPP)”. Otolaryngological specialists should play an important role in combining high-quality evidence and GPP to seek the optimum treatment approach for each patient.

著者

国部 勇 野村 研一郎 野澤 はやぶさ 片田 彰博 今田 正信 小林 吉史 野中 聡 原渕 保明

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.95, no.10, pp.1005-1009, 2002-10-01

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著者最終原稿版44歳男.以前に長管骨だけでなく頭蓋骨にも病変が及ぶことを報告したが,対象は同一家系内に発症した難聴をはじめとする多発性脳神経麻痺を呈したEngelmann症であった.主訴は難聴で右耳は伝音難聴,左耳は感音難聴を示していた.右耳においては所見上外耳道狭窄や中耳滲出液は認められず,耳小骨病変が難聴の主な原因であると考えられた.左耳ではCT所見で内耳道の直径が約2.5mmと右耳の4mmと比較して著明に狭窄していた.本症例の左感音難聴は内耳道狭窄が主な原因と考えて矛盾ないと考えられたが,SISIテストではリクルートメント陽性を示しており,内耳病変も少なからず関与している可能性も示唆された

著者

野澤 はやぶさ 國部 勇 柳内 充 片田 彰博 林 達哉 野中 聡 原渕 保明

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.96, no.1, pp.9-13, 2003-01-01

被引用文献数

1

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Anti-phospholipid syndrome (APS) was first reported by Harris in 1985 as one of a variety of clinical features associated with episodes of arterial or venous thrombosis. We report a rare case of acute sensorineural hearing loss due to APS. A 40-year-old woman complained of acute sensorineural hearing loss. She had been diagnosed with APS because of positivity for serum anti-phospholipid antibody and 3 episodes of natural abortion. The hearing loss was improved by treatment with predonisolone, but after 4 months, hearing loss recurred. Since she refused steroid therapy and anticoagulation therapy, continuous administration of aspirin was performed. Six months later, her hearing had recovered. If a patient presents with sudden sensorineural hearing loss, it is important to suspect APS and inquire into histories such as thrombosis and recurrent abortion.

著者

駒林 優樹 野澤 はやぶさ 和田 哲治 金井 直樹 原渕 保明

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.100, no.7, pp.559-563, 2007-07-01

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Lingual dermoid cysts are uncommon. To date, there have been twenty reported cases. We report an additional case of lingual dermoid cyst. The patient was a sixteen-year-old girl. She was referred to our clinic for painful tongue swelling. A firm, tender lingual mass with purulent drainage from the midline of the dorsum of the tongue was noted. After treatment with antibiotics and drainage, the size of the mass reduced gradually. Eight months later, regrowth of the mass was observed. The mass was totally excised via an oral and external approach. According to histopathological examination, the mass was diagnosed as dermoid cyst.

著者

原渕 保明 坂東 伸幸 高原 幹 岸部 幹 後藤 孝 野澤 はやぶさ 吉崎 智貴

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.99, no.10, pp.805-812, 2006-10-01

被引用文献数

2 1

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Pustulosis palmaris et plantaris (PPP), Sterno-costo-claviclar hyperostosis (SCCH), IgA nephropathy, and some other autoimmune diseases have been regarded as tonsillar focal infections since tonsillectomy is quite effective in the treatment of these diseases. In this paper, we reviewed recent clinicopathological evidence on tonsillar focal infections obtained through our experience as well as in the literature. In addition, we summarized experimental results regarding mechanisms of the development and progression of tonsillar focal infections. It has been speculated that abnormal immune responses in the tonsils may cause or worsen the disease. Therefore, tonsillectomy should be recommended for the treatment of tonsillar focal infections.

著者

岸部 幹 吉野 和美 和田 哲治 金井 直樹 原渕 保明

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.99, no.9, pp.795-800, 2006-09-01

被引用文献数

2

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著者版17歳男、前胸部痛、呼吸困難感を主訴とした。40〜60本/日の喫煙習慣があった。身長166cm、BMI 17.4であり、右側頸部に握雪感を伴う皮下気腫を認めた。胸部単純X線にて右鎖骨上窩の皮下気腫像を、頸・胸部CTにて右咽頭外側面〜胸鎖乳突筋裏面〜気管分岐部に気腫像を認めた。予防的にセフォペラゾンナトリウム:スルパクタムナトリウム合剤を開始したところ、前頸部から胸部の痛みは発症後2日で消失し、皮下気腫像は発症後6日目に消失した。食道造影、気管支ファイバーで異常はなく、特発性縦隔気腫と診断した。退院後43日目、誘引なく左頸部疼痛と呼吸困難感を認め、咳が多かった。CTにて左頸動脈間隙から胸鎖乳突筋裏面、鎖骨上窩、胸骨裏面、気管分岐部周囲、腹部大動脈周囲に気腫を認めた。後頸部から硬膜外ブピバカイン持続注入を開始したところ、翌日には疼痛、咳が消失した。また、セフォペラゾンナトリウム:スルパクタムナトリウムを7日間点滴した。気腫は消失し、禁煙を勧めて退院となった。以後、再発は認めなかった。

著者

森田 武志 藤木 暢也 倉田 響介 岡野 高之

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.92, no.12, pp.1355-1357, 1999-12-01

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A 49-year-old male was treated for chronic tonsillitis with brachytherapy 40 years ago. The inflammation of the tonsils was improved by the treatment. On August 18th, 1998, he consulted our hospital complaining of sudden throat pain. The pain deviated to the left, intensified with eating and continued for several hours every day for one month. An X-ray revealed a metallic foreign body in his left tonsil. A left tonsillectomy was done on January 14th, 1999, and the foreign body was removed completely. It was a small gold tablet, 3×1×1mm in size. A scintillation counter proved that the metallic foreign body was a radon (²²⁰Rn) seed. This is a rare case of a radon seed buried in the left tonsil of a patient for 40 years.

著者

木村 貴昭 山中 昇 九鬼 清典 林 泰弘 斉藤 匡人 木下 和也 田村 真司 赤城 ゆかり 山本 良一 玉置 かおり 高野 郁晴 保富 宗城 戸川 彰久 山室 日出子 島田 純 藤原 啓次 寒川 高男 神人 崇

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.90, no.1, pp.121-130, 1997-01-01

被引用文献数

2

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A comparative study was performed for the purposes of studying the prophylactic effectiveness of an antecedent treatment for Japanese cedar pollinosis with DAREN^® (emedastine difumarate), an anti-allergic drug. Thirty-five cases (A group) received the drug at 4mg/day at least 2-4 weeks before the day when the pollen began to scatter. Another thirty-nine patients received the treatment after the scattering (B group). A significant inter group difference was observed in the global improvement rate for pollinosis. These findings suggest that DAREN^® produces a slow, long-acting effect such as the inhibition of the release of chemical mediators. Prophylactic medication seems to be suitable for the treatment of Japanese cedar pollinosis, because sufficient anti-allergic action is obtained a few weeks later. Side effects occurred in 6.9% of all of the cases, but the incidence was lower than with any other anti-allergic drug previously reported.<br>In summary, a prophylactic treatment with DAREN^® is effective in treating Japanese cedar pollinosis.

著者

深本 克彦 市川 銀一郎

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.773-779, 1995-06-01

被引用文献数

30 11

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Advanced deep neck infection (ADNI) can spread into spaces and cause death rapidly. In 1990 we reported a case of ADNI secondary to tonsillitis, with general deterioration due to duodenal perforation and liver cirrhosis. Since then there have been also many case reports on ADNI, and which some patients have died.<br>To determine the rational treatment of ADNI, 55 cases were collected from the literature in Japan and were analyzed statistically.<br>It was conclusions that the most important point is the prevention of the spread of infection, especially downward into the mediastinum. Drainage by a vertical incision is useful, and effective antibiotics must be administered such as clindamycin, lincomycin, cefmetazole, sulbenicillin or imipenem/cilastacin. Special care is needed in the treatment of elderly patients and those with diabetes other diseases in which immunity is reduced.