著者

南 由優 塩崎 由梨 加藤 千晶 伊藤 真貴 竹内 紀子 小柳 桃朱 荻野 敏

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.49, no.4, pp.481-489, 2010 (Released:2010-12-23)

参考文献数

29

被引用文献数

5 5

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Japanese cedar pollinosis (JCP), an unfortunately common chronic breathing problem, interferes with cognitive function, impairing work productivity and inducing economic loss. We evaluated JCP impact on work productivity, QOL, and symptoms.Our study, conducted during Japan's peak pollen season, used questionnaires on work productivity and activity impairment allergy-specific (WPAI-AS) and Japanese rhino conjunctivitis QOL (JRQLQ).The pollen count in 2009-4067.5/cm2 was 3 times that in 2008-1468.4/cm2. Subjects numbered 227 (202 employees and 25 students) in 2008 and 308 (277 employees and 31 students) in 2009. Mean workplace absence was 0.9% in 2008 and 1.2% in 2009 and mean work efficiency loss 33% in 2008 and 42% in 2009. Mean classroom absence was 0% in 2008 and 1.5% in 2009 and mean study efficiency loss 33% in 2008 and 48% in 2009, showing a positive correlation between work productivity score, QOL, and symptoms. Work productivity decreased more in 2009 with increased pollen count.With the large economic loss due to pollinosis, both symptom severity and QOL must be improved to increase work productivity.

著者

佐久間 康徳 佃 守

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.47, no.4, pp.331-335, 2008 (Released:2009-11-04)

参考文献数

10

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Necrotic lesions in the nasal cavity are induced by a variety of diseases that cause necrosis of the mucosa, bone, and cartilage in the nasal cavity, and Wegener's granulomatosis and sinonasal natural killer cell or T-cell lymphoma must be included in the differential diagnosis. Necrotic lesions induced by cocaine inhalation, on the other hand, are very rare in Japan, and cocaine inhalation also needs to be included in the differential diagnosis.We report the case of a 33-year-old male who complained of nasal pain and necrosis in the nasal cavity. Although we initially suspected Wegener's granulomatosis based on the endoscopic findings and results of laboratory tests, especially based on a slight elevation of the PR3-ANCA value, we did not detect any giant cell granulomas or necrotizing vasculitis, which are histological characteristics of Wegener's granulomatosis in repeatedly biopsyed specimens. Systemic steroid therapy was started based on suspicion of localized Wegener's granulomatosis, but was ineffective. Two months after the start of treatment, the patient failed to return for follow up. He was later arrested for the illegal possession of cocaine, and we realized that the necrotic lesions were caused by cocaine inhalation.Necrosis induced by cocaine inhalation should be included the differential diagnosis of necrotic nasal lesions.

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.53, no.2, pp.103-160, 2014 (Released:2014-09-09)

被引用文献数

4 5

著者

野々田 岳夫 細田 泰男 大谷 真喜子

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.51, no.4, pp.450-454, 2012 (Released:2012-12-27)

参考文献数

16

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鼻腔の重要な機能に加温・加湿機能があるが,日常診療で簡便に検査できる方法はない。一般に冷たい外気を鼻で吸入しても,上咽頭では温度30°C前後,湿度90%前後に加温加湿され,潤いある空気が下気道に入る。一方,口には鼻腔ほどの加温・加湿機能はないため,冷たい乾燥した空気が直接下気道に入りやすく,気管を痛める原因となる。鼻腔の加温・加湿機能を評価するためには,狭い鼻腔内にセンサーを挿入する必要があるが容易ではない。そこで我々は,呼気に着目した。呼気で肺から鼻や口で呼出されるまでに,どれくらいの呼気中の水分が粘膜に回収されたかを水分回収率と定義した。この呼気の水分回収率が高いほど次の吸気の加湿に有利ではと考えた。(対象と方法)今回,我々は鼻腔所見が正常な18人(男性8人,女性10人)を対象に,鼻と口の水分回収率,鼻へ血管収縮薬噴霧後の鼻の水分回収率を測定し比較した。(結果)鼻の水分回収率は,口より有意に高くなった(p<0.001)。また,鼻に血管収縮薬を噴霧すると,鼻の水分回収率は噴霧前に比べて有意に低下することがわかった(p<0.01)。(まとめ)このことは,通常鼻呼吸のみでは鼻が乾いた感覚は出現ないのに対し,口呼吸や鼻へ血管収縮薬を噴霧すると,口や鼻が乾きやすくなることと矛盾しない。呼気の水分回収率は,次の吸気で利用できる水分を反映するため,鼻腔での加温・加湿機能評価の一助になると考えた。

著者

都築 建三 深澤 啓二郎 竹林 宏記 岡 秀樹 三輪 高喜 黒野 祐一 丹生 健一 松根 彰志 内田 淳 小林 正佳 太田 康 志賀 英明 小早川 達 阪上 雅史

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.48, no.1, pp.1-7, 2009 (Released:2009-12-18)

参考文献数

9

被引用文献数

12 14

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We evaluated a 20-item self-administered odor questionnaire for assessing olfactory function, proposed in 2003 by the Japan Rhinologic Society committee on olfaction tests. The 20-items selected based on results of olfactory studies in Japan were steamed rice, miso, seaweed, soy sauce, baked bread, butter, curry, garlic, orange, strawberry, green tea, coffee, chocolate, household gas, garbage, timber, stercus (shit), sweat, flower, and perfume. Subjects were 302 people —179 men and 123 women (average age: 35.7 years)— having no history of nasal or paranasal disease and tested between December 2004 and December 2007. Subjects were asked to score items as follows: “always smelled” (2 points); “sometimes smelled” (1 point); “never smelled” (0 points); or “unknown or no recent experience” (no score). Scores were calculated and represented using a percentage. Response was 99.3% (300/302), with two subjects excluded for reporting more than 10 “unexplainable” items. The mean score was 95.2% (n=300). Of the 302, 281 (93.0%) agreed on the number and 252 (83.4%) on the content of items. Scores correlated statistically significantly with those of a visual analogue scale (rs=0.501, p<0.0001, n=300). We concluded that the self-administered odor questionnaire is useful in assessing olfactory function in normal subjects. The next step will be to administer the questionnaire to diseased or otherwise compromised subjects to determine whether it is useful for clinically diagnosing such olfactory dysfunction.

著者

平川 勝洋 益田 慎 川本 浩子 堀部 よし恵 石井 秀将 夜陣 紘治

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.36, no.2, pp.162-168, 1997-05-15 (Released:2010-03-11)

参考文献数

4

被引用文献数

1

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Nasal obstruction is evaluated by several methods, such as measurement of nasal resistance with a nasomanometer and of nasal capacity by acoustic rhinometry, while in everyday life nasal obstruction is sometimes impressed (evaluated) by an acoustic clue, i.e. hearing the voice.In this study the possibility that acoustic impression allows evaluation of nasal obstruction was examined in normal volunteers and patients who underwent sinus surgery. The acoustic impression of nasal obstruction, the nasal flow resistance and the nasal cavity volume were compared with self-evaluation values of obstruction. The coincidence rate of evaluation by acoustic impression is equal to that of the nasal flow resistance. Acoustic analysis of the humming sound suggests a possibility that the nasal obstruction indicator is in the regions below 800Hz and above 3000Hz.

著者

高崎 賢治 江夏 薫 高橋 晴雄

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.48, no.4, pp.378-384, 2009 (Released:2010-02-10)

参考文献数

12

被引用文献数

1

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We analyzed the results of a questionnaire on intranasal/peroral medication against nasal allergy given to subjects with seasonal allergic rhinitis treated by otorhinolaryngologists from January to May 2009. Valid responses were obtained from 273 patients (108 men and 165 women). Epinastine hydrochloride showed high drug compliance (93%) and satisfaction (76%). Many patients prefered peroral medication (61%) over internasal medication. Administration frequency for intranasal spray to treat nasal allergy varied from once (36%) to twice (36%) a day and others (28%). These results provided information useful to otorhinolaryngologist in devising better strategies in nasal allergy therapy.

著者

山西 貴大 五十嵐 賢 上條 篤 松岡 伴和 増山 敬祐

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.51, no.1, pp.1-7, 2012 (Released:2012-05-22)

参考文献数

21

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浸潤型副鼻腔真菌症は,骨破壊や病変の眼窩内および頭蓋内浸潤により容易に重症化しうる疾患である。その予後は悪性腫瘍と同様に悪く,かつ鑑別診断が非常に難しい場合がある。今回我々は,右眼窩内浸潤を呈し上顎癌との鑑別を要した浸潤型副鼻腔アスペルギルス症例を経験したので報告する。症例は糖尿病性腎症と脳梗塞の既往のある80歳男性。主訴は頭痛であったが,当科初診時の血液検査にて腫瘍マーカー(SCC・CYFRA)の上昇が認められた。またCT,MRIで右上顎洞に,骨破壊と右眼窩内浸潤を伴う腫瘤状陰影を認めた。検査結果から悪性腫瘍を強く疑い,診断確定を目的に内視鏡下生検を施行したが,生検肉芽組織内にアスペルギルス類似構造を持つ菌糸の組織内浸潤を認め,さらに血液検査でβ-Dグルカン値の異常高値とアスペルギルス抗原陽性が判明した。以上からアスペルギルスを原因とする浸潤型副鼻腔真菌症の確定診断に至った。糖尿病性腎症を考慮し,重度腎機能障害患者に対して安全に使用できる抗真菌薬ボリコナゾールにて直ちに治療を開始したが奏功せず,全身状態の悪化と患側眼症状の増悪が進行し永眠された。浸潤型副鼻腔真菌症の中には,副鼻腔悪性腫瘍がより強く疑われるような,診断が難しい症例が存在する。従って浸潤型副鼻腔真菌症を考える場合,早期診断確定のためには積極的な内視鏡下生検が必須で,それが早期治療ならびに予後改善につながる。

著者

市村 恵一 瀬嶋 尊之 太田 康 牧野 伸子

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.41, no.2, pp.149-155, 2002-08-05 (Released:2010-03-11)

参考文献数

24

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The elderly often report watery rhinorrhea without other symptoms. Allergic rhinitis is not common in individuals aged over 65 years. The color of nasal mucosa in the elderly is not usually pale, and antigens are not identified. Taken together, such nasal discharge is usually non-allergic and called “old man's drip.” The mechanism behind it is not fully understood. To determine the demographic data on patients with this condition, the concerns of physicians treating it and actual patient management, we sent questionnaires to 124 oto-laryngologists, with a response of 58% (64). Most were not familiar with the term “old man's drip.” Although nasal discharge was a leading symptom in the elderly, and 10 to 30% of patients reported rhinorrhea, less than 30% of these suffered from allergic rhinitis. Chronic rhinitis, vasomotor rhinitis, and chronic sinusitis were often used in tentative diagnosis. Fewer than 50 patients with old man's drip consulted a clinic each year. Antihistamines were most frequently prescribed for these patients, followed by antiinflammatory enzymes and anticholinergic nasal drops. The elderly are, however, specifically at risk from complications of such drugs.Atrophic change in nasal mucosa becomes apparent in the 60's, lowering mucosal temperature in the nose and nasopharynx and diminishing heating capacity. Water reabsorption from nasal mucosa becomes incomplete in expiration and water droplets remaining on the surface may increase. Condensed water cannot be used for humidification in the next inspiration because of the lower heating potencial of nasal mucosa, causing nasal drip after water droplets collect. Water provided by vascular leakage but not glandular secretion appears to be dominant in nasal drip. Nasal drying caused by medication also decreases air conditioning potential. Old man's drip often occurs during eating. Conditions differentiated from this condition are cold air-induced rhinorrhea and gustatory rhinorrhea, considered due to reflex parasympathetic activation of the nasal glands, and anticholinergics are effective. These are not, however, indicated for old man's drip, for which we suggest heating nasal mucosa resulting in increased water absorption during expiration.

著者

湯田 厚司 荻原 仁美 宮本 由起子 佐橋 紀男 竹内 万彦

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.50, no.1, pp.13-18, 2011 (Released:2011-04-28)

参考文献数

9

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スギ花粉症の初期療法は有用で, 広く浸透している。薬剤投与開始日は薬剤で異なるが, スギ花粉開始予想日に左右される。適切で効率よい初期療法を行うには, 適確な飛散開始日予測が必要だが, その予想方法は見いだされていない。そこで, 三重県津市におけるスギ花粉飛散開始日の予測方法を検討し, その結果から全国的な予想に応用できるかを検討した。【方法】気象庁ホームページから収集した気象データをもとに三重県津市のスギ花粉飛散開始の予測が可能かを検討した。その結果を基に, 既報で公開された全国のスギ花粉飛散開始日のデータを参照して, 全国の飛散開始日予想を試みた。【結果】津市の飛散開始日は11月中旬平均気温 (p=0.0027, r=0.67), 平均最高気温 (p=0.0011, r=0.70) と有意に正に相関した。11月中旬が寒いと花粉飛散が早まった。全国30都市を調査した結果, 全国的に11月中旬平均気温との相関が良く, 福岡市, 広島市, 徳島市, 西宮市, 東大阪市, 和歌山市, 大垣市, 静岡市, 中央市, 八王子市, 埼玉県坂戸市の各市と東京都が有意に相関した。名古屋市, 水戸市は平均最高気温のみ相関した。岡山市, 米子市, 松山市, 高松市では相関がなかった。また, 関東以北や日本海側の都市でも相関がなかった。九州から関東の太平洋岸都市を中心に11月中旬平均気温から飛散開始日が予想できると考えた。【結論】飛散開始日予想は初期療法開始日決定に有用であり, 誰でも収集可能な気象情報からの予想は有用度が高い。

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

加瀬 康弘

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.39, no.4, pp.303-312, 2000-12-15 (Released:2010-03-11)

参考文献数

36

被引用文献数

2 3

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To detect factors that may affect the prognosis of diplopia caused by orbital wall fractures, retrospectibely evaluated 82 cases were seen at the Saitama Medical School between January 1995 and July 1999. Of these, 44 (54%) reporting diplopia were divided into 2 groups. One in which diplopia lasted more than 1 month and one in which recovery occurred within 1 month. To study diplopia quantatively, the area within 15 degrees on the Hess chart was calculated and the ratio of area of affected side against that of normal side was obtained. Statistically, in patients in there low teens, cases with positive symptoms in the forced duction test and abnormalities in CT or MRI imaging tended to have a poor prognosis, indicating the need for early surgery. The absence of these factors suggested that a wait-and-see policy would produce a better prognosis.

著者

西川 仁 日高 浩史 工藤 貴之 小林 俊光

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.51, no.4, pp.481-488, 2012 (Released:2012-12-27)

参考文献数

20

被引用文献数

1 1

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2003年から2011年の9年間に入院加療を要した鼻出血症例203例の検討を行った。男女比は2:1で,50~70歳代に多く,また冬季から春季に多く,夏季に少ない傾向であった。出血部位は,部位不明47%,キーゼルバッハ24%,下鼻道および中鼻道が各々8%であった。初回時の止血方法は,ガーゼタンポン55%,電気焼灼29%,バルーンタンポン8%であった。再出血症例は46%に認められ,再出血なしの症例と比較して,キーゼルバッハ例や電気焼灼例の割合が有意に低く,出血部位不明例やガーゼタンポン例の割合が有意に高かった。基礎疾患および出血素因となる薬剤の服用は,再出血症例との関連がなかった。入院理由は,止血困難な絶対的入院適応が13%のみで,他は反復性のため24%,処置時意識障害22%,不安等の入院希望13%と経過観察目的の入院が多かった。平均入院期間は7.8日であり,再出血症例で10.4日,再出血なしの症例で5.8日であった。経過観察目的入院の症例でも再出血例が多く,また,再出血症例の全てが4日以内の再出血であり,入院経過観察期間として4日間(5日目の退院)が妥当と考えた。出血部位不明症例の初回治療はガーゼタンポン67%(再出血率74%),バルーンタンポン15%(再出血率50%)であったが,54%に入院中出血部位が判明できた。迅速に対応し出血部位を同定できることが入院加療の利点と考えた。