記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To clarify whether age impacts the development of endolymphatic hydrops (ELH) in neurotologic patients. Documentation of ELH in living patients on magnetic resonance imaging (MRI) allows analysis of patient age and formation of ELH, which is impossible by means of postmortem temporal bone pathology. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fifty patients (100 ears) with top 3 diagnoses of definite Menière's disease, delayed ELH, or probable Menière's disease. INTERVENTIONS: Endolymph MRI after intravenous gadolinium injection and pure-tone audiometry. MAIN OUTCOME MEASURES: Cochlear and vestibular ELH confirmed by MRI. RESULTS: The prevalences of ears showing both cochlear and vestibular ELH were similar among age groups <30 years (30%), 30-59 years (25.9%), and ≥60 years (34.4%; p > 0.05; χ2 test). Using logistic regression modeling, mean hearing level at the six frequencies was positively associated with a higher risk of cochlear ELH (odds ratio, 1.3; 95% confidence interval, 1.1-1.5 per 10-dB increment). In the same regression model, age did not impact the outcome of cochlear ELH (odds ratio, 1.0; 95%confidence interval, 0.7-1.4 per 10-year increment). Age did not differ among ears with no ELH (mean ± standard deviation age, 48.6 ± 14.4 yr), ears with only cochlear ELH (59.3 ± 10.7 yr), ears with only vestibular ELH (50.4 ± 16.9 yr), or ears with both cochlear and vestibular ELH (51.5 ± 18.4 yr; p > 0.05, analysis of variance). CONCLUSION: Chronological age was not associated with the formation of ELH. Aging per se may not be associated with the development of ELH in neurotologic patients.

DOI： 10.1097/MAO.0000000000003945

PubMed

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：英語  

Autoimmune mechanisms may play crucial roles in the etiology of endolymphatic hydrops (ELH), which was previously regarded as a postmortem finding in the temporal bone. Recently, ELH has been visualized using 3-T MR imaging in living patients. A 47-year-old woman with deafness in the left ear since adolescence developed right-sided steroid-responsive sensorineural hearing loss in the low frequencies. During over 15 years of follow-up at our otolaryngology clinic, acute deteriorations of hearing in the only hearing ear repeatedly recovered with administration of intravenous and oral steroids. Hearing in the only hearing ear at 62 years old was preserved and comparable to that at 47 years old. At 61 years old, cochlear ELH was documented bilaterally on MR imaging, appearing more severe in the deafened ear than in the hearing ear. This case provides new evidence of the potential steroid-responsiveness of hearing loss due to contralateral-type delayed ELH distinctly visualized on MR imaging.

DOI： 10.1016/j.anl.2023.03.009

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Hearing loss is the most common sensory deficit, of which genetic etiologies are a frequent cause. Dominant and recessive mutations in TMC1, a gene encoding the pore-forming subunit of the hair cell mechanotransduction channel, cause DFNA36 and DFNB7/11, respectively, accounting for ∼2% of genetic hearing loss. Previous work has established the efficacy of mutation-targeted RNAi in treatment of murine models of autosomal dominant non-syndromic deafness. However, application of such approaches is limited by the infeasibility of development and validation of novel constructs for each variant. We developed an allele-non-specific approach consisting of mutation-agnostic RNAi suppression of both mutant and WT alleles, co-delivered with a knockdown-resistant engineered WT allele with or without the use of woodchuck hepatitis virus post-transcriptional regulatory element (WPRE) to augment transgene expression. This therapeutic construct was delivered into the mature murine model of DFNA36 with an AAV vector and achieved robust hair cell and auditory brainstem response preservation. However, WPRE-enhanced Tmc1 expression resulted in inferior outcomes, suggesting a role for gene dosage optimization in future TMC1 gene therapy development.

DOI： 10.26508/lsa.202201592

PubMed

researchmap

掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.anl.2022.10.004

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

researchmap

記述言語：英語  

DOI： 10.1016/j.alit.2022.03.003

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

78歳男性。発熱、呼吸苦を主訴に、近医のPCR検査にてCOVID-19陽性と診断された。診断後は4日間の自宅療法ののち、診断5日後に前医の入院加療を開始したが、動脈血酸素飽和度が徐々に増悪し、診断7日後に当院搬送となった。当院でHFNC管理を継続し、レムデシベル、トシリズマブ、バリシチニブによる加療を開始したが、酸素状態は改善せず、診断29日後に肺炎、呼吸不全の改善目的でシングルユース軟性鼻咽喉鏡(Ambu内視鏡)を用いて気管切開術を施行した。術後は引き続き人工呼吸器管理、加療を継続中である。単回使用製品であるAmbu内視鏡はスタッフの感染防御に有用であった。

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

胆道感染症は,胆石や胆泥により胆汁が鬱滞することで十二指腸乳頭より上行性に細菌感染が生じ発症する。長期間の絶食や経口摂取量不足が続くと胆汁がよどみ,胆石や胆泥発生の好条件となる。また,オピオイド鎮痛薬によるオッジ括約筋機能不全に陥る場合もあり,化学放射線療法中の腹部症状には注意を要する。今回われわれは外耳道癌に対するセツキシマブ併用放射線療法中に発症した胆道感染症を経験した。胆道感染症は診断と治療が遅れれば,開腹手術を要することがある。化学放射線療法を行う機会のある耳鼻咽喉科医は留意すべき治療中合併症のひとつであろう。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Voltage-gated Ca2+ channels are critical for the development and mature function of the nervous system. Variants in the CACNA2D4 gene encoding the α2δ-4 auxiliary subunit of these channels are associated with neuropsychiatric and neurodevelopmental disorders. α2δ-4 is prominently expressed in the retina and is crucial for vision, but extra-retinal functions of α2δ-4 have not been investigated. Here, we sought to fill this gap by analyzing the behavioral phenotypes of α2δ-4 knockout (KO) mice. α2δ-4 KO mice (both males and females) exhibited significant impairments in prepulse inhibition that were unlikely to result from the modestly elevated auditory brainstem response thresholds. Whereas α2δ-4 KO mice of both sexes were hyperactive in various assays, only females showed impaired motor coordination in the rotarod assay. α2δ-4 KO mice exhibited anxiolytic and anti-depressive behaviors in the elevated plus maze and tail suspension tests, respectively. Our results reveal an unexpected role for α2δ-4 in sensorimotor gating and motor function and identify α2δ-4 KO mice as a novel model for studying the pathophysiology associated with CACNA2D4 variants.

DOI： 10.1371/journal.pone.0263197

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

WHO has recommended various measures to combat the COVID-19 pandemic, including mask-wearing and physical distancing. However, these changes impair communication for individuals with hearing loss. We investigated the changes in auditory communication associated with COVID-19 measures in 269 patients (male: 45.7%, female: 54.3%, median age: 54 y.o.). Most patients with hearing loss had difficulty engaging in auditory communication with people wearing masks, especially in noisy surroundings or with physical distanc-ing. These difficulties were noticeable in patients with severe hearing loss. Developing communication support strategies for people with hearing loss is an urgent need while COVID-19 measures are in place.

DOI： 10.18926/AMO/62404

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Epidemiological data suggest that inflammation and innate immunity play significant roles in the pathogenesis of age-related hearing loss (ARHL) in humans. In this mouse study, real-time RT-PCR array targeting 84 immune-related genes revealed that the expressions of 40 genes (47.6%) were differentially regulated with greater than a twofold change in 12-month-old cochleae with ARHL relative to young control mice, 33 (39.3%) of which were upregulated. These differentially regulated genes (DEGs) were involved in functional pathways for cytokine-cytokine receptor interaction, chemokine signaling, TNF signaling, and Toll-like receptor signaling. An NF-κB subunit, Nfkb1, was upregulated in aged cochleae, and bioinformatic analyses predicted that NF-κB would interact with the genomic regulatory regions of eight upregulated DEGs, including Tnf and Ptgs2. In aging cochleae, major proinflammatory molecules, IL1B and IL18rap, were upregulated by 6 months of age and thereafter. Remarkable upregulations of seven immune-related genes (Casp1, IL18r1, IL1B, Card9, Clec4e, Ifit1, and Tlr9) occurred at an advanced stage (between 9 and 12 months of age) of ARHL. Immunohistochemistry analysis of cochlear sections from the 12-month-old mice indicated that IL-18r1 and IL-1B were localized to the spiral ligament, spiral limbus, and organ of Corti. The two NF-κB-interacting inflammatory molecules, TNFα and PTGS2, immunolocalized ubiquitously in cochlear structures, including the lateral wall (the stria vascularis and spiral ligament), in the histological sections of aged cochleae. IBA1-positive macrophages were observed in the stria vascularis and spiral ligament in aged mice. Therefore, inflammatory and immune reactions are modulated in aged cochlear tissues with ARHL.

DOI： 10.1371/journal.pone.0258977

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本聴覚医学会  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00125&link_issn=&doc_id=20200917530048&doc_link_id=10.4295%2Faudiology.63.343&url=https%3A%2F%2Fdoi.org%2F10.4295%2Faudiology.63.343&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Hyaluronan is one of the major extracellular matrixes in chronic rhinosinusitis (CRS) associated with tissue remodeling. Prostaglandin D2 (PGD2) is also associated with the pathogenesis of CRS. However, little is known about whether PGD2 regulates hyaluronan production by human airway fibroblasts. OBJECTIVE: We sought to determine the effect of PGD2 on the mRNA expression of three isoforms of membrane-bound hyaluronic acid synthase (HAS1, HAS2 and HAS3) in fibroblasts, the major source of hyaluronan production, derived from CRS patients. METHODS: Nasal polyp-derived fibroblasts (NPDF) and uncinate tissue-derived fibroblasts (UTDF) were established from CRS patients with nasal polyps and those without, respectively. These fibroblasts were stimulated with PGD2 or PGD2 receptor (DP/CRTH2)-selective agonists in the presence or absence of receptor-selective antagonists. mRNA levels for HAS1, HAS2 and HAS3 were determined by real-time quantitative PCR. RESULTS: PGD2 (1 µM) significantly enhanced HAS1 but not HAS2 or HAS3 mRNA expression by NPDF. Enhanced HAS1 mRNA expression was also obtained by stimulation with a DP receptor-selective agonist, but not with a CRTH2 receptor-selective agonist. In addition, PGD2-induced HAS1 mRNA expression was significantly inhibited by pre-treatment with DP receptor-selective antagonists. Similar induction of PGD2-induced HAS1 mRNA expression was seen in UTDF. CONCLUSION: PGD2 selectively stimulates HAS1 mRNA expression in local fibroblasts in CRS via DP, but not CRTH2, receptors.

DOI： 10.1177/1945892420932781

PubMed

researchmap

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

Gene delivery is a key component for the treatment of genetic hearing loss. To date, a myriad of adeno-associated virus (AAV) serotypes and surgical approaches have been employed to deliver transgenes to cochlear hair cells, but the efficacy of dual transduction remains unclear. Herein, we investigated cellular tropism of single injections of AAV serotype 1 (AAV1), AAV2, AAV8, AAV9, and Anc80L65, and quantitated dual-vector co-transduction rates following co-injection of AAV2 and AAV9 vectors in adult murine cochlea. We used the combined round window membrane and canal fenestration (RWM+CF) injection technique for vector delivery. Single AAV2 injections were most robust and transduced 96.7% ± 1.1% of inner hair cells (IHCs) and 83.9% ± 2.0% of outer hair cells (OHCs) throughout the cochlea without causing hearing impairment or hair cell loss. Dual AAV2 injection co-transduced 96.9% ± 1.7% of IHCs and 65.6% ± 8.95% of OHCs. Together, RWM+CF-injected single or dual AAV2 provides the highest auditory hair cell transduction efficiency of the AAV serotypes we studied. These findings broaden the application of cochlear gene therapy targeting hair cells.

DOI： 10.1016/j.omtm.2020.05.007

PubMed

researchmap

掲載種別：研究論文（学術雑誌）  

The authors regret that the following two corrections are needed. The authors would like to apologize for any inconvenience caused. 1. The current text for the Authors' Contributions: “MO and KN designed the study and wrote the manuscript. TF, SK, KK, SM and YH contributed to data collection. TH and RO performed the statistical analysis and interpretation of the results”. The correct text should be “KK, MO and KN designed the study and wrote the manuscript. TF, SK, KK, SM and YH contributed to data collection. TH and RO performed the statistical analysis and interpretation of the results”. The underlined initial has been added. 2. The affiliation number of the last author “Kazunori Nishizaki” was mentioned incorrectly as “b”. The correct affiliation should be “a”.

DOI： 10.1016/j.alit.2019.11.001

Scopus

PubMed

researchmap

掲載種別：研究論文（学術雑誌）   出版者・発行元：Oxford University Press ({OUP})  

DOI： 10.1093/hmg/ddz129

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/MAO.0000000000001874

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

To comprehensively analyze cochlear gene expressions related to innate immunity and glucocorticoid signaling at onset of acute noise-induced hearing loss (NIHL).Recent studies suggested innate immunity is involved in the cochlear pathology of NIHL. Glucocorticoids may modulate immune actions in cochleae.Mice were exposed to 120 dB-octave band noise for 2 hours. Twelve hours later, a targeted PCR array analyzed cochlear expressions of 84 key genes in inflammation and immune pathways and 84 genes in the glucocorticoid signaling pathway. Real-time RT-PCR was used to analyze expression of two immune-related genes, Ccl12 and Glycam1, in noise-exposed cochleae with or without dexamethasone.In inflammatory and immune gene pathways, 31.0% (26/84 genes) were significantly upregulated (&gt;2-fold change) or downregulated (&lt;0.5-fold change) (p &lt; 0.05) in noise-exposed cochleae compared with controls. Sixteen of these differentially expressed genes (DEGs) encoded chemokines. DEGs included Ccl12, Ccl2, Ccl4, Ccl7, Cxcl1, Cxcl10, and Ptgs2 (upregulated genes), and Ccr7, Cxcr2, Kng1, Ltb, and Tnfsf14 (downregulated genes). In the glucocorticoid signaling pathway, 92.9% (78/84 genes) were unchanged in noise-exposed cochleae without dexamethasone administration. Cochlear expressions of Ccl12 and Glycam1 were significantly upregulated by noise and downregulated by dexamethasone.The targeted PCR array demonstrated that several dozen genes involved in innate immunity are actively regulated in cochleae with NIHL. The glucocorticoid signaling pathway was not endogenously regulated at 12 hours post-noise trauma. Systemic dexamethasone downregulated Ccl12 and Glycam1, which are upregulated in noise-exposed cochleae. These data may provide a basis for genomic medicine treatment of acute sensorineural hearing loss.

DOI： 10.1097/mao.0000000000001874

DOI： 10.1097/MAO.0000000000001874

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ireland Ltd  

Transcanal endoscopic ear surgery (TEES) will become a very useful therapeutic option. A perilymphatic fistula (PLF) is defined as sudden sensorineural hearing loss and/or vertigo caused by leakage of the perilymph through a fistula from the oval window and/or round window. We report a case of PLF after electric acoustic stimulation (EAS), a kind of cochlear implant, successfully treated by TEES. A 38-year-old man presented to our hospital with vertigo and hearing loss (HL). His vertigo was induced by Valsalva maneuvers. Eight months ago, he underwent EAS for his right ear for congenital sensorineural HL. Although he maintained his hearing level after EAS, his pure tone audiogram this time showed deterioration of hearing at low frequencies in his right ear. A diagnosis of right PLF was made. After confirming the non-effectiveness of oral prednisolone treatment, PLF repair surgery to patch the oval and round windows by TEES was performed. His vertigo did not recur after the surgery. To the best of our knowledge, this is the first report of PLF repair surgery by TEES without a microscope. The wide-field view of the middle ear by TEES was useful to prevent electrode damage in a PLF patient with a cochlear implant.

DOI： 10.1016/j.anl.2017.10.004

Scopus

PubMed

researchmap

掲載種別：研究論文（学術雑誌）  

In 2013, the Japanese Rhinologic Society proposed a simple classification for endoscopic sinus surgery (ESS). This classification consists of five procedures (type I, fenestration of the ostiomeatal complex, with uncinectomy and widening of the natural ostium; type II, single-sinus procedure, with manipulating the inside of the sinus; type III, polysinus procedure; type IV, pansinus procedure; type V, extended procedure beyond the sinus wall). The clinical relevance of this classification in chronic rhinosinusitis (CRS) and paranasal sinus cyst was evaluated.A retrospective validation study.A total of 122 patients (195 sinuses) who underwent ESS in Okayama University Hospital in 2012 were enrolled. The relationships between the ESS classification and the clinical course, including the operation time, bleeding amounts during surgery and postoperative changes of olfaction, the computed tomography (CT) score, and nasal airway resistance were analyzed.A total of 195 ESS procedures were classified into type I (n = 3), type II (n = 17), type III (n = 91), type IV (n = 82), and type V (n = 2). The major phenotypes of type II, III, and IV ESS were paranasal sinus cyst (68%), CRS without nasal polyps (77%), and CRS with nasal polyps (55%), respectively, and the difference was significant. The degree of ESS based on this classification was positively and significantly correlated with the operation time and bleeding amounts. As a whole, olfaction, CT score, and nasal airway resistance were significantly improved after surgery. The degree of improvement was similar between type III and type IV ESS.This simple classification for ESS reflected the perioperative burden of the disease.

DOI： 10.2500/ar.2017.8.0208

PubMed

researchmap

その他リンク： http://orcid.org/0000-0001-5441-9796

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Aim: To elucidate molecular mechanisms of noise-induced hearing loss (NIHL) and glucocorticoid therapy in the cochlea.
Background: Glucocorticoids are used to treat many forms of acute sensorineural hearing loss, but their molecular action in the cochlea remains poorly understood.
Methods: Dexamethasone was administered intraperitoneally immediately following acoustic overstimulation at 120 dB SPL for 2 hours to mice. The whole cochlear transcriptome was analyzed 12 and 24 hours following noise trauma and dexamethasone administration by both next-generation sequencing (RNA-seq) and DNA microarray. Differentially expressed genes (DEGs) with more than 2-fold changes after noise trauma and dexamethasone administration were identified. The functions of these DEGs were analyzed by David Bioinformatics Resources and a literature search.
Results: Twelve hours after acoustic overstimulation, immune-related gene pathways such as "chemokine signaling activity,'' "cytokine-cytokine receptor interaction,'' and "cell adhesion molecules (CAMs) in the immune system'' were significantly changed compared with the baseline level without noise. These DEGs were involved in immune and defense responses in the cochlea. Dexamethasone was administered to this NIHL model, and it modulated gene pathways of "cytokine-cytokine receptor interaction'' and "cell adhesion molecules (CAMs) in the immune system'' at 12 hours, compared with saline-injected control. Dexamethasone-dependent DEGs were also involved in immune and defense responses. A literature search showed that 10 other genes associated with hearing functions were regulated by dexamethasone both at 12 and 24 hours post-administration.
Conclusion: Dexamethasone modulates the immune reaction in the traumatized cochlea following acoustic overstimulation. Dexamethasone may also regulate cochlear functions other than immunity.

DOI： 10.1097/MAO.0000000000001373

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Aim: To elucidate molecular mechanisms of noise-induced hearing loss (NIHL) and glucocorticoid therapy in the cochlea.
Background: Glucocorticoids are used to treat many forms of acute sensorineural hearing loss, but their molecular action in the cochlea remains poorly understood.
Methods: Dexamethasone was administered intraperitoneally immediately following acoustic overstimulation at 120 dB SPL for 2 hours to mice. The whole cochlear transcriptome was analyzed 12 and 24 hours following noise trauma and dexamethasone administration by both next-generation sequencing (RNA-seq) and DNA microarray. Differentially expressed genes (DEGs) with more than 2-fold changes after noise trauma and dexamethasone administration were identified. The functions of these DEGs were analyzed by David Bioinformatics Resources and a literature search.
Results: Twelve hours after acoustic overstimulation, immune-related gene pathways such as "chemokine signaling activity,'' "cytokine-cytokine receptor interaction,'' and "cell adhesion molecules (CAMs) in the immune system'' were significantly changed compared with the baseline level without noise. These DEGs were involved in immune and defense responses in the cochlea. Dexamethasone was administered to this NIHL model, and it modulated gene pathways of "cytokine-cytokine receptor interaction'' and "cell adhesion molecules (CAMs) in the immune system'' at 12 hours, compared with saline-injected control. Dexamethasone-dependent DEGs were also involved in immune and defense responses. A literature search showed that 10 other genes associated with hearing functions were regulated by dexamethasone both at 12 and 24 hours post-administration.
Conclusion: Dexamethasone modulates the immune reaction in the traumatized cochlea following acoustic overstimulation. Dexamethasone may also regulate cochlear functions other than immunity.

DOI： 10.1097/MAO.0000000000001373

Web of Science

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oto-Rhino-Laryngological Society of Japan Inc.  

Since April 2012, genetic testing for congenital hearing loss is covered by the public health insurance in Japan. Recent(since August 2015)developments in next-generation sequencing technology have enabled the detection of 154 mutations in 19 genes. Genetic testing provides valuable information on hearing phenotype, prognosis, and prediction of associated symptoms. We report a hearing-impaired patient in whom multiple genetic mutations were detected. This patient carries two missense mutations in GJB2(p.G45E, p.Y136X), as well as a mitochondrial mutation(7445A&gt
G). Since the number of genes detectable by genetic testing has increased, the diagnosis of hearing loss can be made with greater accuracy. However, it is often difficult to clinically understand and interpret the genotype information, especially when multiple gene variants are detected in one patient or family. Genetic counseling plays an important part in the intervention for or follow-up of such patients. Genotypic and phenotypic information of other family members is necessary, so that both the patient and the family can understand and accept the results of genetic testing.

DOI： 10.3950/jibiinkoka.120.131

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Vascular endothelial growth factor (VEGF) is known to be associated with the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). VEGF is produced by a variety of cells including fibroblasts. It was recently reported that prostaglandin (PG) E-2 induces VEGF release by nasal polyp fibroblasts. However, little is known regarding possible regulation of VEGF by other PGs. We have reported that molecules that regulate PGD(2) metabolism play roles in the pathogenesis of CRS including in local eosinophilia and type 2 cytokine production. In the present study, we sought to determine whether PGD(2) regulates VEGF release by nasal polyp fibroblasts.
Methods: Nasal polyp fibroblasts were established from nasal polyps. These fibroblasts were stimulated with serial dilutions of PGD(2) or PGD(2) receptor (DP/CRTH2)-selective agonists in the presence or absence of receptor-selective antagonists. The concentration of VEGF in the culture supernatants was determined using ELISA.
Results: 5 mM of PGD(2) significantly induced VEGF release by nasal polyp fibroblasts. VEGF release was also obtained by stimulation with a DP receptor-selective, but not with a CRTH2 receptor-selective agonist. In addition, PGD(2)-induced VEGF release was significantly inhibited by pre-treatment with DP receptor-selective antagonists. In contrast, pre-treatment with a CRTH2 receptor-selective antagonist significantly enhanced PGD(2)-induced VEGF release.
Conclusions: PGD(2) stimulates VEGF production via DP but not CRTH2 receptors in nasal polyp fibroblasts. Copyright (C) 2016, Japanese Society of Allergology. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license.

DOI： 10.1016/j.alit.2016.03.003

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Central auditory processing disorder (CAPD) is a condition in which dysfunction in the central auditory system causes difficulty in listening to conversations, particularly under noisy conditions, despite normal peripheral auditory function. Central auditory testing is generally performed in patients with normal hearing on the pure tone audiogram (PTA). This report shows that diagnosis of CAPD is possible even in the presence of an elevated threshold on the PTA, provided that the normal function of the peripheral auditory pathway was verified by distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), and auditory steady state response (ASSR). Three pediatric cases (9- and 10-year-old girls and an 8-year-old boy) of CAPD with elevated thresholds on PTAs are presented. The chief complaint was difficulty in listening to conversations. PTA showed elevated thresholds, but the responses and thresholds for DPOAE, ABR, and ASSR were normal, showing that peripheral auditory function was normal. Significant findings of central auditory testing such as dichotic speech tests, time compression of speech signals, and binaural interaction tests confirmed the diagnosis of CAPD. These threshold shifts in PTA may provide a new concept of a clinical symptom due to central auditory dysfunction in CAPD. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2016.02.005

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CAMBRIDGE UNIV PRESS  

Background: Superficial siderosis is a rare disease that results from chronic bleeding in the subarachnoid space. Haemosiderin deposits throughout the subpial layers of the brain and spinal cord lead to progressive sensorineural hearing loss, which is seen in 95 per cent of patients with superficial siderosis. The impact of cochlear implantation on the quality of life of superficial siderosis patients is under debate.
Case report: A 38-year-old male with superficial siderosis presented with bilateral progressive sensorineural hearing loss. The patient underwent cochlear implantation and his quality of life was improved as evaluated by the Abbreviated Profile of Hearing Aid Benefit inventory.
Conclusion: The remarkable improvement in Abbreviated Profile of Hearing Aid Benefit scores shown in this study indicates that cochlear implantation leads to a better quality of life in superficial siderosis patients.

DOI： 10.1017/S0022215116000335

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Toll-like receptor 3 (TLR3) is expressed in upper airways, however, little is known regarding whether Toll-like receptor 3 (TLR3) signals exert a regulatory effect on the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP), especially on eosinophilic inflammation. We sought to investigate the effect of Poly(IC), the ligand for TLR3, on cytokine production by dispersed nasal polyp cells (DNPCs).DNPCs were pretreated with or without Poly(IC), and were then cultured in the presence or absence of staphylococcal enterotoxin B (SEB), following which the levels of IL-5, IL-10, IL-13, IL-17A and interferon (IFN)-γ in the supernatant were measured. To determine the involvement of IL-10 and cyclooxygenase in Poly(IC)-mediated signaling, DNPCs were treated with anti-IL-10 monoclonal antibody and diclofenac, the cyclooxygenase inhibitor, respectively. Poly(IC)-induced prostaglandin E2 (PGE2) production was also determined.Exposure to Poly(IC) induced a significant production of IL-10, but not of IL-5, IL-13, IL-17A or IFN-γ by DNPCs. Pretreatment with Poly(IC) dose-dependently inhibited SEB-induced IL-5, IL-13 and IL-17A, but not IFN-γ production. Neutralization of IL-10 significantly abrogated the inhibitory effect of Poly(IC). Treatment with diclofenac also abrogated the inhibitory effect of Poly(IC) on SEB-induced IL-5 and IL-13 production. However, unlike exposure of diclofenac-treated DNPCs to lipopolysaccharide, the ligand for TLR4, exposure of these cells to Poly(IC) did not enhance IL-5 or IL-13 production. Poly(IC) did not significantly increase PGE2 production by DNPCs.These results suggest that TLR3 signaling regulates eosinophilia-associated cytokine production in CRSwNP, at least in part, via IL-10 production.

DOI： 10.1016/j.alit.2015.08.005

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TAYLOR & FRANCIS LTD  

Conclusion: The prevalence of low-tone hearing loss (LTHL) is significantly high in spinocerebellar degeneration (SCD) with cerebellar predominance, including multiple-system atrophy C (MSA-C) and cortical cerebellar atrophy (CCA). Objective: This study aimed to test the hypothesis that SCD with cerebellar predominance, MSA-C and CCA may cause auditory symptoms. Methods: The shape and threshold of pure-tone audiograms were evaluated for MSA-C (n = 47; mean (+/- SD) age, 61.6 +/- 8.9 years), CCA (n = 16; 62.8 +/- 9.5 years), and age-matched controls (n = 169; 62.5 +/- 10.7 years). To differentiate specific hearing loss for MSA-C and CCA from presbycusis, the shape of audiograms was examined based on previously established audiological criteria. Results: When audiogram shape was defined according to audiological criteria, the odds ratio for LTHL in SCD compared to controls was 2.492 (95% confidence interval (CI) = 1.208-5.139; p &lt; 0.05, Pearson's Chi-square test) in MSA-C and 2.194 (95% CI = 0.709-6.795) in CCA. When the selection of audiogram shape according to these criteria was verified by three certified audiologists, odds ratios for LTHL in MSA-C and CCA were 3.243 (95% CI = 1.320-7.969) and 3.692 (95% CI = 1.052-12.957), respectively, significantly higher than in controls.

DOI： 10.3109/00016489.2015.1104722

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Objectives: Early hearing detection and intervention (EHDI) is critical for achievement of age-appropriate speech perception and language development in hearing-impaired children. It has been 15 years since newborn hearing screening (NHS) was introduced in Japan, and its effectiveness for language development in hearing-impaired children has been extensively studied. Moreover, after over 20 years of cochlear implantation in Japan, many of the prelingual cochlear implant (CI) users have reached school age, and the effect of Clan language development have also been assessed. To identify prognostic factors for language development, audiological/language test scores and demographic factors were compared among prelingual severe-to-profound hearing-impaired children with CI divided into subgroups according to age at first hearing aid (HA) use and whether they received NHS.
Methods: Prelingual severe-to-profound deafened children from the Research on Sensory and Communicative Disorders (RSCD) project who met the inclusion criteria were divided into groups according to the age (in months) of HA commencement (before 6 months: group A, after 7 months: group B), and the presence or absence of NHS (groups C and D). Language development and socio-economic data were obtained from audiological/language tests and a questionnaire completed by caregivers, respectively.
Results: In total, 210 children from the RSCD project participated in this study. Group A (n = 49) showed significantly higher scores on comprehensive vocabulary and academic achievement (p &lt; 0.05) than group B (n = 161), with no difference in demographics except for significantly older age in group B. No differences in language scores were observed between group C (n = 71) and group D (n = 129), although participants of group D was significantly older and had used CIs longer (p &lt; 0.05).
Conclusions: Early use of HAs until the CI operation may result in better language perception and academic achievement among Cl users with prelingual deafness. A long-term follow-up is required to assess the usefulness of NHS for language development. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijporl.2015.09.036

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TAYLOR & FRANCIS LTD  

Conclusion: Performance in consonant-vowel (CV) monosyllable speech perception after cochlear implantation (CI) in the elderly (&gt;= 65 years) is equivalent to that of young adults (18-64 years). Present data in the Japanese language supported the indication for CI in the elderly. Word recognition after CI was significantly lower in the elderly than young adults. Objective: This study compared outcomes of monosyllable perception and word recognition after CI between elderly patients and young adults with post-lingual deafness. Age-related differences in CV monosyllable speech perception in Japanese were examined. Methods: A retrospective chart review of 137 patients with post-lingual deafness who underwent CI at Okayama University Hospital during 1992-2014 [young adults aged 18-64 years (n = 96) and elderly aged &gt;= 65 years (n = 41) at implantation] was conducted. CV monosyllable speech perception post-CI was compared among age groups (18-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89). CV monosyllable perception and word recognition scores post-CI were compared between the elderly and young adults. Results: There was no significant difference in CV monosyllable speech perception among age groups. CV monosyllable speech perception in the elderly (61.4 +/- 25.5%) did not differ from that of young adults (65.9 +/- 24.8%). Word recognition scores were significantly lower in the elderly (64.3 +/- 28.1%) than young adults (80.4 +/- 25.9%) (p &lt; 0.05).

DOI： 10.3109/00016489.2015.1062547

Web of Science

PubMed

researchmap

その他リンク： http://orcid.org/0000-0001-5441-9796

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PUBLIC LIBRARY SCIENCE  

Mitogen-activated protein kinases (MAP kinases) are intracellular signaling kinases activated by phosphorylation in response to a variety of extracellular stimuli. Mammalian MAP kinase pathways are composed of three major pathways: MEK1 (mitogen-activated protein kinase kinase 1)/ERK 1/2 (extracellular signal-regulated kinases 1/2)/p90 RSK (p90 ribosomal S6 kinase), JNK (c-Jun amino (N)-terminal kinase)/c-Jun, and p38 MAPK pathways. These pathways coordinately mediate physiological processes such as cell survival, protein synthesis, cell proliferation, growth, migration, and apoptosis. The involvement of MAP kinase in noise-induced hearing loss (NIHL) has been implicated in the cochlea; however, it is unknown how expression levels of MAP kinase change after the onset of NIHL and whether they are regulated by transient phosphorylation or protein synthesis. CBA/J mice were exposed to 120-dB octave band noise for 2 h. Auditory brainstem response confirmed a component of temporary threshold shift within 0-24 h and significant permanent threshold shift at 14 days after noise exposure. Levels and localizations of phospho-and total-MEK1/ERK1/2/p90 RSK, JNK/c-Jun, and p38 MAPK were comprehensively analyzed by the Bio-Plex (R) Suspension Array System and immunohistochemistry at 0, 3, 6, 12, 24 and 48 h after noise exposure. The phospho-MEK1/ERK1/2/p90 RSK signaling pathway was activated in the spiral ligament and the sensory and supporting cells of the organ of Corti, with peaks at 3-6 h and independently of regulations of total-MEK1/ERK1/2/p90 RSK. The expression of phospho-JNK and p38 MAPK showed late upregulation in spiral neurons at 48 h, in addition to early upregulations with peaks at 3 h after noise trauma. Phospho-p38 MAPK activation was dependent on upregulation of total-p38 MAPK. At present, comprehensive data on MAP kinase expression provide significant insight into understanding the molecular mechanism of NIHL, and for developing therapeutic models for acute sensorineural hearing loss.

DOI： 10.1371/journal.pone.0058775

Web of Science

PubMed

researchmap

その他リンク： http://orcid.org/0000-0001-5441-9796

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

Reactive lymphoid hyperplasia(RLH)は、組織学的に胚中心を伴うリンパ濾胞の反応性過形成を示し、個々のリンパ球の異型が少なくpolyclonalな増殖を認めるものと定義される。今回我々は、IgG4陽性形質細胞の集簇を認めた鼻腔底RLHの一例を経験した。症例は69歳女性。主訴は左鼻腔腫瘤、右難聴。右難聴で近医受診した際に、左鼻腔底前方に隆起性病変を認めた。唾液腺腫脹や鼻症状は認めなかった。IgG4値は45.5mg/dlと正常範囲内であった。2度の生検を施行し悪性リンパ腫の可能性も否定できず、摘出術を施行した。病理組織所見は、HE染色では、粘膜上皮下に著明なリンパ球・形質細胞の浸潤を認め、リンパ濾胞の過形成を伴っていた。免疫染色では、濾胞間に多数のIgG4陽性形質細胞を認め、400倍1視野あたり100個を超え、IgG4/IgG陽性細胞比は40%を超えていた。しかし、線維化の所見や高IgG4血症を認めず、包括診断基準に照らしIgG4関連疾患には合致しなかった。摘出後、約1年を経過するが、再発所見を認めていない。今後、病変の再発や悪性転化する可能性も考えられることから、治療後も厳重な経過観察を行う必要があると考えられる。(著者抄録)

DOI： 10.7248/jjrhi.56.619

CiNii Article

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科感染症・エアロゾル学会  

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科感染症・エアロゾル学会  

researchmap

記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

2012年4月難聴遺伝子検査は保険収載され、現在19遺伝子154変異の検索が行われている。難聴遺伝子検査は、聴力型や聴力予後、随伴症状の予測、難聴の進行予防といった情報が得られる可能性があるため、診断や介入、フォローアップを行う上での有用性は高い。今回遺伝子検査で複数の難聴遺伝子ヴァリアントが検出された症例を経験した。検索可能な遺伝子数が増加することにより、診断率の向上が見込める一方で、複数の遺伝子ヴァリアントが検出され、結果の解釈に難渋する例も増えることが推測される。臨床情報との照らし合わせや家族の遺伝子検査も検討し、患者、家族が理解、受容できるように遺伝カウンセリングを行う必要がある。(著者抄録)

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科感染症・エアロゾル学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

小児の健全な心身の育成のためには、人工内耳装用児においてもスポーツ参加は望ましいことであるが、機器の故障やコミュニケーションのしにくさなど問題を抱えている児も少なくない。今回我々は、人工内耳装用児のスポーツ実施状況に関するアンケート調査を実施した。有効回答者76例中スポーツ経験者は53例(69.7%)であり、その73.6%がスポーツ中も人工内耳を装用していた。人工内耳体外機器の故障はほとんどが経験しており、その内容としてはケーブル断線、プロセッサやコイルの故障、サビなどがみられたが、スポーツによるインプラントの故障例はなかった。スポーツ経験者は体外機器の落下、コミュニケーションの困難さ、汗・雨などで濡れるといった不便さを有しており、工夫や注意をすることで対処していた。人工内耳装用児はスポーツ参加において留意は必要であるが、過剰に制限を加える必要はない。医療、療育者として適切な情報提供や指導を心がけたい。(著者抄録)

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

平成26年の小児人工内耳手術のガイドラインの改正により,今後は人工内耳手術の低年齢化および両側人工内耳の症例が増えると予想される。両側人工内耳手術の効果については,本邦ではまだ報告が少なく,その検証が必要である。当科ではこれまでに50例の小児両側人工内耳症例を経験しており,その背景因子や術後の聴取能,言語発達等について検討した。当科では平成14年4月から平成27年1月までに50名の小児(18歳未満)が両側人工内耳手術を受けていた。これらの児のうち37名が新生児聴覚スクリーニングにて両耳要精密検査とされ,その全例が早期補聴をなされており,両側人工内耳術後の聴力閾値は3分法にて38.0dBから32.1dBへと,また語音明瞭度も72.5%から87.8%へと一側の人工内耳装用時よりも改善していた。言語発達についてはまだ十分なデータがないため,今後長期的なフォローアップを行う必要があると考える。(著者抄録)

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

浸潤型蝶形骨洞真菌症に対し,緊急内視鏡下鼻副鼻腔手術(ESS)を施行し,抗真菌薬を投与したが,頭蓋内浸潤を生じ,最終的に不幸な転機をたどった2例を経験したので,剖検所見からの考察を含め報告する。症例1は61歳男性。主訴は頭痛,左視力低下。CT・MRIにて浸潤型蝶形骨洞真菌症が疑われ,緊急ESSを施行。左蝶形骨洞に真菌塊と骨破壊を認めた。病理組織検査では,真菌ではあるが菌種の確定診断には至らなかった。左視力の改善は認めなかったが,頭痛は軽快した。その後,対側の右視力低下を認め,最終的にくも膜下出血を発症し永眠された。症例2は82歳男性。主訴は頭痛,右視力低下。CT・MRIで浸潤型蝶形骨洞真菌症の診断で緊急ESSを施行。右蝶形骨洞を開放し真菌塊を認め,アスペルギルスが確認された。右視力の改善は認めなかったが,頭痛は軽快した。術後8ヵ月後に頭痛の再燃,左視力低下が出現した。CT・MRIで真菌の左蝶形骨洞への浸潤が疑われ,左蝶形洞を開放したが粘膜浮腫のみで真菌塊は認めなかった。その後,心不全が増悪し永眠された。剖検所見では,洞内の粘膜表面には真菌感染を認めなかったが,真菌の頭蓋内浸潤を認めた。真菌の動脈壁浸潤により動脈瘤が形成され,くも膜下出血に至ることがあり,MRAなどによる定期的な経過観察が必要と思われた。また,頭蓋底領域深部に真菌が浸潤している場合は,表層粘膜の検査では確認できない可能性が示唆された。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：香川県立中央病院  

喉頭全摘後の咽頭皮膚瘻に対して、陰圧閉鎖療法(NPWT:negative pressure wound therapy)を使用した。唾液瘻確認から経口摂取開始までは63日(術後70日)であり、従来の方法に比較して早期に経口摂取が開始できた。陰圧閉鎖療法により唾液がコントロールできるため、感染コントロール、創傷治癒促進を可能にした。また同時に、頸部処置回数が大幅に減り、患者・医療スタッフ双方の負担軽減に貢献できた。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

glomangiopericytomaは鼻副鼻腔原発の血管周囲筋様細胞の表現型を伴う境界から低悪性度の新生物である。その発生頻度は全鼻副鼻腔腫瘍のうち1%以下とされており、非常にまれな腫瘍である。この腫瘍は従来hemangiopericytomaの一亜型とされてきたが、一般的な軟部組織に発生するhemangiopericytomaとは発生部位、生物学的挙動、組織学的特徴の観点から区別され、2005年のWHO基準にて正式に疾患分類として登録された。比較的新しい疾患概念であることなどから、hemangiopericytomaとの鑑別が十分なされていないことがあり、注意を要する疾患とされている。われわれは今回鼻出血を主訴に来院した右鼻腔原発のglomangiopericytomaに対し、内視鏡下に切除手術を施行し、良好な経過を得た1例を経験したので報告する。(著者抄録)

DOI： 10.5106/jjshns.23.141

CiNii Article

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014086069

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー学会  

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科感染症研究会  

79歳女性。関節リウマチ、糖尿病、高血圧症、右人工股関節留置ほか、原因不明のS状結腸穿孔後ストーマ留置の既往歴があり、プレドニゾロン+タクロリムス水和物などを内服中であった。今回、左耳の耳漏を主訴に近医を受診、外耳炎と診断され、点耳治療中であったが、耳漏が改善せず、食事摂取時の耳漏流出が止らないため、著者らの施設へ来院となった。初診時、採血で炎症所見が認められ、即日入院となり、Chiari点を中心とした扁桃周囲の切開排膿、更に超音波ガイド下に穿刺排膿およびCEZ+CLDMの投与が行われた。その結果、入院第4病日目には炎症所見はやや改善したがALPが高値のためCLDMの影響と考え中止した。以後、第5病日目には膿瘍および耳漏の培養の結果から、Streptococcus anginosusが原因菌と判明したため抗菌薬をアンピシリンに変更、第8病日目にはCRP値が正常化し、第10病日目に経過良好で退院となった。以上より、深頸部感染症は糖尿病・高血圧・慢性腎不全・慢性肝炎などの基礎疾患を有する症例で多くみられ、本症例も基礎疾患が多岐にわたることから今後の厳重な経過観察が必要と考えられた。

researchmap

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科感染症研究会  

16歳男性。幼少時より右高度感音難聴があった。今回、意識障害で前医に救急搬送され、細菌性髄膜炎の診断にてCeftriaxone(CTRX)投与のもとICU入院加療となった。頭痛・嘔吐は改善したが、CRPは陰転化せず、CTにて中耳陰影、内耳奇形を疑われ、原因精査目的で著者らの施設へ紹介となった。来院時、右鼓膜は膨隆し軽度混濁していたが発赤はなかった。だが、右耳管咽頭口よりは透明な液体の流出がみられた。また、左鼓膜は正常で、純音聴力検査では右側は聾、左側は正常であった。一方、側頭骨CTでは右鼓室内・乳突腔内に貯留液様の軟部陰影がみられ、右蝸牛は低形成で、蝸牛と前庭は癒合し、内耳道底の隔壁の欠損が疑われた。以上より、本症例は内耳奇形(Incomplete partition type I)に伴う髄液漏出による細菌性髄膜炎と診断され、髄液からはStreptcoccus pneumoniaeが検出された。治療として内耳開窓閉鎖術を施行したところ、術後4日目より耳内は乾燥、耳管咽頭口からの髄液漏出は認めずCRPも陰性化した。目下、術後3ヵ月経過で液漏出や髄膜炎の再発は認められていない。

researchmap

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：日本小児耳鼻咽喉科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02661&link_issn=&doc_id=20110823470041&doc_link_id=10.14821%2Fstomatopharyngology.24.270&url=https%3A%2F%2Fdoi.org%2F10.14821%2Fstomatopharyngology.24.270&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02661&link_issn=&doc_id=20110823470095&doc_link_id=10.14821%2Fstomatopharyngology.24.324&url=https%3A%2F%2Fdoi.org%2F10.14821%2Fstomatopharyngology.24.324&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap

記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

researchmap