巻号一覧
23 巻 (1972)
- 6 号 p. 295-
- 5 号 p. 241-
- 4 号 p. 175-
- 3 号 p. 123-
- 2 号 p. 51-
- 1 号 p. 1-
23 巻, 2 号
選択された号の論文の12件中1～12を表示しています
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吉松 博1972 年 23 巻 2 号 p. 51-58
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーMediastinoscopy, first described by Carlens in 1959, as a method for directly examining the superior mediastinum of pulmonary carcinoma, has now been in use for more ten years.
We experienced 220 mediastinoscopic examinations. The most frequent diagnosis made was pulmonary carcinoma, followed by mediastinal tumors. Pulmonary tuberculosis, middle lobe syndrome, chronic pneumonia, mediastinal lymphadenitis and vascular abnormalities were also encountered.
Metasteses in the superior mediastinum were found in 33 per cent of the pulmonary carcinoma cases examined. Contralateral metastases were found in 20 per cent in these cases. These results were in agreetment with reports of various workers.
Accuracy in judgement on resectability was very high, resection being possible in 85 per cent of cases diagnosed as resectable by mediastinoscopy, and in some report was achieved in 94 per cent of the cases.
The trial of extended mediastinoscopy with flexible mediastinoscope (Takeno) and the combination method with microscopic technique (Meuser) or with thoracoscope (Hitomi) were discussed.
We conducted mediastinoscopic investigations of the anterior superior mediastinum and retrosternal area. It was useful to perform biopsy or removal of the portion of thymic tumors which reveal a high incidence of various systemic symptoms. Based on these experiences, in the cases representing hypothesized autoimmune diseases such as myasthenia gravis, thymectomy via the suprasternal notch has been now adopted in our practice. Portions of the thyroid, the muscle and mediastinal lymph node, were simultaneously obtained for the histological study. Interesting findings regarding the etiology and therapy of these diseases were observed.
We also found the usefulness and significance of examination in the cases of sarcoidosis, esophageal carcinoma and silicosis.抄録全体を表示PDF形式でダウンロード (3208K) -
久保 正治1972 年 23 巻 2 号 p. 59-60
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーPDF形式でダウンロード (245K) -
大畑 正昭1972 年 23 巻 2 号 p. 61-62
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーPDF形式でダウンロード (275K) -
北村 武1972 年 23 巻 2 号 p. 63-71
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーThe symposium consisted of the reports and discussions of the reconstruction of the larynx after partial or total laryngectomy and laryngeal trauma, and transplantation of the larynx.
The main subjects of the symposium included the improvement of the post-operative phonatory function and the shortening of the treatment period. The transplantation of the larynx was discussed as the promising problem in future.
As the moderator of the symposium, the author proposed the following nomenculature that the reconstruction of the larynx means the restoration of the laryngeal functions of the respiration, phonation and the sphincteric activity and the reconstruction of the glottis means only the restoration of the phonation and the sphincteric activity lowing.抄録全体を表示PDF形式でダウンロード (217K) -
金子 敏郎1972 年 23 巻 2 号 p. 63a-71
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーIn order to establish the principles of reconstruction surgery after the partial laryngectomy, the correlation between post-operative function and shape of the remnant larynx was analysed from a acoustical or aerodynamical viewpoint and the following conslusion was obtained.
1) For the vertical partial laryngectomy, convex smooth surface of operated side is necessary to obtain good phonation.
2) For the supraglottic horizontal laryngectomy, supraglottal orifice and shortening of the aryepiglottic fold increase the hoarseness or inhibit the laryngeal vibration. On the other hand, the descendence of the larynx, especially of the aryepiglottic fold provoke mal deglutition. To obtain good post-operative function, therefore, these obstacles must be resolved.
Finally, some procedure based upon the above-mentionned principle for the reconstruction surgery was proposed.抄録全体を表示PDF形式でダウンロード (7636K) -
設楽 哲也1972 年 23 巻 2 号 p. 65-71,62
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーLaryngeal stenosis caused by trauma has been increasing in number.
In this paper, the auther presented 15 cases of the laryngeal stenosis and his three surgical methods were discussed.
1) Fistulization of air way on the cricoid arch.
This operation was performed for the chronic laryngeal stenosis after fracture and injuly of the arch of cricoid cartilage following the car accident and reffered tracheotomy.
Method.
After removal of scar and necrotic cartilage, the skin was sutured to the mucosa to-to for fistula formation.
The scar around the fistula had become stiff enough, then the fistula was closed with skin flap three week after the operation.
2) Widening of anterior glottal space.
In stenosis with median fixation of the vocal cords, the auther applied this technique instead of the lateralization method.
Method.
Skin incision is made in midline over the thyroid cartilage and the perichondrium is elevated from cartilage lOmm width from the midline. The cartilage is separated longitudinally and the median portion of cartilage are resected 5 to 6mm in width bilaterally. The mucosa of the anterior wall of the glottis is separated in the midline. The edge of each side mucosa is sutured to the edge of the perichondrium and to the skin of same side. The created fistula is closed three weeks after the operation. The anterior part of the glottic space was wide-opened to get good respiratory results.
3) Operation method for the supraglottic stenosis.
The removal of the necrotic thyroid and cricoid cartilages results in the reduce the oedema of air way though, another stenosis reveals, later.
The loss of the cricoid cartilage as the posterior framework of air way causes the shortage of antero-posterior distance, especially in the ary-epiglotic space.
Method.
2 to 3 skin flaps of the anterior neck are transposed and partially resected in order to make a short neck. Longitudinal shortning of the neck surface causes the widening of air way and scar tissue of the wound should be the framework around the air way. The fistula is closed after an appopriate period of time when it is apparent that the lumen is well maintained.
The auther reported three cases treated with this method.抄録全体を表示PDF形式でダウンロード (10134K) -
岩井 一1972 年 23 巻 2 号 p. 72-78
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーA new larynx could successfully be reconstructed immediately after total laryngectomy.
The postoperative voice was as good as in Asai's laryngoplasty. The aspiration was negligible. The operative techniques are summarized as follows:
1. The lateral halves of the thyroid laminae are preserved on the both sides.
2. The posterior laryngeal wall is formed utilizing the superior horns.
3. The inner surface of the new larynx is covered with the hypopharyngeal mucosal flaps.
4. The reconstructed larynx is fixed closely to the lingual basis.
In eight cases with extended laryngeal cancer, the primary laryngoplasy was performed. Post-operatively, in three of them, a protracted local healing was seen due to the development of a pharyngeal fistula. All of them restored their voice and fair degultition.抄録全体を表示PDF形式でダウンロード (5856K) -
竹之内 智, 岡本 康比古, 鶴岡 隆, 佐藤 文彦, 松井 隆史, 岡本 一也1972 年 23 巻 2 号 p. 79-86
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーAuto-and allotransplantation of the canine larynx were performed. In the autotrans-plantation experiment, the completely excised larynx was replanted in the former place after 1 or 2 hours preservation.
In the allotransplantation experiment, the heparinized donor cadaver was preserved in a hypothermic chamber under perfusion from one side of the common carotid arteries which were damped bilaterally at the upper and lower parts of the diverging portion of the cranial thyroid arteries. Following 24 hours storage in this setting, the larynx was removed and transplanted to the recipient.
The vessel anastomosis vas performed on the unilateral common carotid artery and on the lingual, facial and external maxillary veins bilaterally.
For the nerve anastomosis, the pedicled nerve muscle graft method was deviced, that is, laryngeal nerve pedicled intrinsic laryngeal muscle block was implanted on the corresponding muscle of the transplanted larynx.
Temporary tracheotomy was performed and nutrition, antibiotics and immunosuppressive administration were provided by preliminary gastrostomy during the period of intensive care.
Endoscopic observation showed almost normal movement of the vocal cords with normal color and tone in 5 weeks after operation and servived over 2 years in the autotransplanted cases and inwards movement of the vocal cords to the paramedian position at the time of phonation in 8 weeks postoperatively in the allotransplanted cases.
Azathioprine and steroid were administrated as the immunosuppressive agent. At present, the longest servival time of animals along with their allotransplanted larynges is 65 days.抄録全体を表示PDF形式でダウンロード (7454K) -
平野 実1972 年 23 巻 2 号 p. 87-93
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーA need to establish an essential idea in reconstructing a new glottis after complete removal of one vocal cord led us to experimental studies with canine larynges and phoniatric investigations with patients. Multiple techniques for reconstruction were classified into four categories: (1) no active reconstruction, (2) transplantation of mucosa, (3) filling up the defect, and (4) filling up plus mucosal transplantation. The following conclusions appear to be justified:
1. The best phonatory function can be obtained by glottal reconstruction which Involves filling up the defect with non-denervated muscular structure and transplantation of mucosa.
2. When one fills up the defect, he should be careful to make a bulge not at the level of the false cord but at the level of the vocal cord.抄録全体を表示PDF形式でダウンロード (5058K) -
高山 乙彦1972 年 23 巻 2 号 p. 94-98
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーAuthors conducted a study of the phonetic changes of the larynx after reconstruction surgery of the true cord and soft tissues of the larynx. The results obtained were as follows:
1) Phonations of the high tone and louder voice after reconstruction surgery exhibited difficult. The patients, however, demonstrated much easy phonations when the head positions were changed. This was confirmed by patient's records.
2) Eminences of the tissue were seen in the same area of the larynx after recons-truction surgery. It became more obious by the time passed.
3) Eminences of the tissue in the larynx after reconstruction surgery were also confirmed by animal experiments.抄録全体を表示PDF形式でダウンロード (3650K) -
河本 和友, 中川 惇, 佐藤 良樹, 草刈 潤, 小林 信一1972 年 23 巻 2 号 p. 99-105
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーObservation of swallowing movement was done using X-ray TV in 160 patients including 14 cases of the malignancy in the hypopharynx and the esophagus and following results were obtained.
1. There js a possibility that the so-called “foreign body sensation” could be the initial symptom of the malignancy in this region.
2. X ray examination, as first choice and then endoscopy if necessary as a result of X ray examination should be done in such patients as a routine examination.
3. Pharyngeal stasis was very frequently observed in the malignancy in this region.抄録全体を表示PDF形式でダウンロード (530K) -
遠藤 光夫, 小林 誠一郎, 鈴木 茂, 井手 博子, 飛田 洋一, 羽生 富士夫, 矢沢 知海, 竹本 忠良, 中山 恒明1972 年 23 巻 2 号 p. 106-108
発行日: 1972/04/10
公開日: 2010/10/20
ジャーナル フリーPreviously Palmer (1964) reported the esophageal marking by the silver brain clip.
The rigid esophagoscope was adequate for the manipulation of these clips because of the wide lumen. But the biopsy cannal of the esophagofiberscope was small 3mm in size, so the use of the big forceps was impossible. The special injector through the cannal of the esophagofiberscope was devised and a little amount of the radiopaque medium was poured into the esophageal mucosa.
This injector was 2, 5mm in size and movable up to 45°in the apex portion. The application of the esophageal marking is useful for co-working with the roentgenologist and the decision of the irradiation field in cobalt therapy.抄録全体を表示PDF形式でダウンロード (3926K)
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