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Volume 28 (1977)
- Issue 6 Pages 323-
- Issue 5 Pages 281-
- Issue 4 Pages 225-
- Issue 3 Pages 179-
- Issue 2 Pages 59-
- Issue 1 Pages 1-
Volume 28, Issue 2
Displaying 1-20 of 20 articles from this issue
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Tadaaki Sumi1977 Volume 28 Issue 2 Pages 59-66
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDepartment of Physiology, Fujita-Gakuen University School of Medicine, Toyoake, 470-11
Neural organization leading to elicitation and achievement of swallowing is of reflex in its fundamental character. Afferent impulses from the oral, pharyngeal and laryngeal mucosa readily trigger the center of the reflex, the medullary swallowing center, into action. The center is endowed with characteristic property of intergration that controls rigidly the order, duration, intensity and type of behaviour of the participating motoneurons, and hence of the muscles of swallowing. Furthermore, the activity level of the center for repetitive excitation is subserved by an intricate coordination between neurons situated in the anterolateral areas of the frontal cerebral cortex and those in the pontine reticular formations delimitted dorsolaterally to the superior olivary nucleus in both sides.
The integrating property of the medullary swallowing center, however, seems immature at the stage of birth, and likely to develop through the period of 2 to 3 months postnatally. During this period of immaturity, the achievement of swallowing would depend variously upon the afferent impulses that are initiated secondarily by the act of swallowing.
When swallowing occurs, the neurons of respiratory organization behave consistently as if they were the neurons that participate to swallowing, by revealing momentary activation or arrest in the discharge of impulses. Conversely, when asphyxia occurs, the medullary motoneurons that participate to swallowing become active to discharge volleys of impulses in phase with inspiration or expiration. Reflex swallowing is more readily produced during inspiration than during expiration. Rhythmic activities of motoneurons of mastication are also modified by swallowing. These swallow-combined modifications of respiration and mastication are well preserved after motoparalysis, and hence would suggest mutual and inter-central relations between neural organizations of swallowing and the two others.
Based on these facts, some comments have been made on the possible mechanism of dysfunction of swallowing and on future problems involed.View full abstractDownload PDF (1994K) -
On the Basis of Our Recent StudiesTadafumi Hagihara1977 Volume 28 Issue 2 Pages 67-73
Published: April 10, 1977
Released on J-STAGE: November 26, 2010
JOURNAL FREE ACCESSRecent Studies especially made in our department would be prsented in regard to “Defense Functions of Broncho-alveolar system”. Brancho-alveolar system is always in contact with atmosphere and is exposed to various dusts, microorganisms and noxious gases. Furthermore, lungs have anatomical and physiological characteristics, i, e., lungs are functioning as a filter of systemic ciculation and react sensitively to various stresses in the whole body. Therefore, one could easily understand that lungs have ingenious and powerful defense functions and mechanis ms.
Many studies have been performed in this regard, however, many areas have been remained unsolved. Defense functions of broncho-alveolar system are simply classified to non-specific and specific defense, i. e., immunological defense. This is similar to other organ.
In broncho-alveolar system, however, various tissues contribute each other in complicated ways. Additionally, host and environmental factors contribute to defense functions of a living body, and different pattern of defense is occassionally noticed between healthy and diseased condition. Various chemical and immunogical substances also contribute to defense of broncho-alveolar systern anywhere.
In this presentation, problems in defense functions or mechanisms of bronch-alveolar system mentioned previously would be discussed on the basis of physiological, biochemical, immunological, and clinical stand pointsView full abstractDownload PDF (1739K) -
Mitsuo Endo1977 Volume 28 Issue 2 Pages 74b-78
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe early diagnosis of the esophageal cancer was most effective to improve the post-operative survival rate of the esophageal cancer. For the last eleven years, 22 cases of the early esophageal cancer of which infiltration was limited the submucosa without lymphnode metastases, have been resected in our hospital. They represented 3 percent of all resected esophageal cancer. The five survival rate of the esophageal cancer was 20 per cent, otherwise that of the early esophageal cancer was 67 percent.
Most of the patients of the early cancer had some slight esophageal symptomes. But two of22 cases had no subjective symptomes and could be found unexpectedly in the periodical examinationof the stomach.
Prior to the surgical intervention, superficial type of the esophageal cancer was confirmed in 70percent endoscopically and in the X-ray examination.
A definite difference in the prognosis of superficial type of cancer was seen between early cancerfree of lymphnode metastasis and superficial cancer involving lymphnode and other organs.For differentiation of the early esophageal cancer of the esophagus, some points were presentedas follows:
1) In f he superficial type of cancer, neoplasms less than 3cm in diameter were suspected the early cancer.
2) It has been suggested that combination of elevated and erosive types comfirmed by endoscopy was superfical cancer and clinically more malignant than otheps not only from the pathological characteristics, but from the post-operative end-results as well.
3) There was a cicss relationship between the histological types of cancer and the vascular invasion and lymphnode metastasis. The vascular invasion was recognized in almost all cases of poorly differentiated carcinoma and in many cases of moderately differentiated carcinoma.
It was found in the cases cf well differentiated cancer in only 17 percent. Lymphnode metastases was not not found in the cases of well differentiated cancer. In this respect, preoperative determination of the histologic types by means of biopsy seems necessary in predicting early or superficial cancer.View full abstractDownload PDF (995K) -
[in Japanese]1977 Volume 28 Issue 2 Pages 74a
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
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Hiroshi Sato1977 Volume 28 Issue 2 Pages 78-81
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe over-all operative death rate was 7%, among 1.243 cases of esophageal carcinoma treated in my department for the last 30 years between 1946 and 1975. For the purpose of comparison of the progress in these years, 30 years were divided into two periods.
In the former half, that of the right thoracotomy approach was 9.6% and that of the left thoracotomy approach was 6.6%, while in the latter half, that of the right thoracotomy approach was improved to be 6.9% and that of the left thoracotomy approach was improved to be 2.4%.
Looking on the changes of the operability of esophageal carcinoma, the rate of cancers with a radiological length over 10cm was 8.3% in the former half, while it increased to be 14.4% in the latter half.
The rate of a3 in the depth of cancer invasion was 6.1% in the former half, while it remarkably increased to be 22.2% in the latter half.
One of the troublesome post-operative complications with frequent occurrence was an anastomotic failure. I have improved technically the method of ante-thoracic esophago-gastrostomy in adding resection of clavicle. With the merit of this improvement, there were nocurving or compression of esophagus due to clavicle, and accordingly there was no tension around the anastomotic potion with smooth passage of saliva and food.
Lastly looking on the follow-up results, the over-all 5 years survival rate was 12.1%, being rather unsatisfactory. This was taken to be due to the greater occupation of advanced cases as much as 70% of all.View full abstractDownload PDF (719K) -
Toshifumi Iizuka1977 Volume 28 Issue 2 Pages 82-87
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSAmong 414 patients with esophageal carcinoma who were operated upon, 350 cases (85%) were irradiated before operation. Resection was done in 377 cases, so the resectability rate was 91%. After operation, resected specimens were studied carefully. Irradiation effect was estimated by microscopic examination. The patients, in whom radiation effect was marked, were lived longer than those of whom radiation effect was slight. So it is is concluded that marked radiation effect is one factor to decide the prognosis.
In another series, in that chemotherapy was combined with preoperative irradiation, survival rate is superior to that of control series.
So, combined therapy of operation, radiation, chemotherapy and immunotherapy is most important for the treatment of advanced esophageal carcinoma.View full abstractDownload PDF (2612K) -
Teruo Kakegawa, Shingo Shima, Takashi Bessho, Hiromasa Fujita1977 Volume 28 Issue 2 Pages 87-93
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDuring the recent 10 years from 1965, we have seen 336 patients with primary carcinoma of the esophagus, of whom 207 (61.6%) were rescted. And 68 of these resecfed cases, were considered far advanced (Stage 4). This study was designed what would be favorable to manage the far advanced esophageal cancer patients such as these 68 palliatively resected patients and the remaining 129 unresectable patients. We obtained the following results,
1) For the unresectable cases, radiation therapy was the best methode.
2) For the patients having metastasis in the distant regional lymph nodes such as supraclaviculcr lymph node, even if the local lesion would be resectable, surgical resection was not recommended because of its poor prognosis.
3) For the patients having no distant lymph metastasis, even if the local invasion was thou. ght to be so advanced such as esophagopleural fistula, irradiation followed by surgical resection was encouraging.View full abstractDownload PDF (2788K) -
[in Japanese]1977 Volume 28 Issue 2 Pages 94
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
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[in Japanese]1977 Volume 28 Issue 2 Pages 95
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDownload PDF (236K) -
[in Japanese]1977 Volume 28 Issue 2 Pages 96-97
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDownload PDF (421K) -
[in Japanese]1977 Volume 28 Issue 2 Pages 97
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDownload PDF (169K) -
Takeo Sato1977 Volume 28 Issue 2 Pages 98-102
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSFrom the viewpoints of anatomical and physiological specificity of human larynx, histopathological findings of laryngeal diseases were discussed.
Mainly on the aging of larynx, smoker's larynx, vocal cord polyp, precancerous lesion, histogenesis of the laryngeal cancer and its stromal reactions, histopathologicalstudies were made by the method of whole laryngeal sections in the throat banksystem.
It can be assumed that diseases of throat and their behavior depend onthe organ specificityof larynx and the outbreaks of cancer of the larynx can beseen only in human beings.View full abstractDownload PDF (2694K) -
Hajime Hirose1977 Volume 28 Issue 2 Pages 103-107
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSResearch Institute of Logopedics and Phoniatrics, Faculty of Medicine, University of Tokyo
The disorder of voice is one of the most common problems of laryngeal pathologies. In the present report, phoniatric profiles of typical laryngeal disorders were presented and the relationship between the characteristics of abnormal voice and underlying laryngeal conditions was discussed. Acoustical characteristics of hoarse voice were investigated based on a psychoacoustic experiment using synthesized vowels. From clinical viewpoints, it was pointed out that it was often difficult to obtain good vocal function compatible with ideal respiratory function in the case of bilateral midline fixation of the vocal cords or laryngeal malignancy. Significance of maintaining patent laryngeal airway was emphasized as the prerequisite in these particular cases. It was expected that further development in phonosurgical approach would lead to better understanding and solution of phoniatric problems in laryngological practice.View full abstractDownload PDF (706K) -
Kyozo Kikuchi1977 Volume 28 Issue 2 Pages 108-112
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSElectron microscopy was used to study the morphological changes of the tracheal epithelia in the laryngeal carcinoma. Nine humen tracheae were used for this study. Under the local anesthesia, tracheotomy was performed and a piece of the tracheal wall was removed. The specimen was treated by usual way for fixation, decalcification and cutting, then the tracheal epithelia with special reference to the cilia of the ciliated cells were observed with the aid of transmission and scanning electron microscopy. The results obtained were as follows:
1) The morphological changes of the tracheal cilia were compared with the clinical findingsrespectively. There were not always found on relation between serious grade of carcinoma and histological changes of the tracheal cilia.
2) The first morphological change of the cilium was observed as partial swelling of the cilium. Thenarrangement of the cilia became irregular.
3) When pathological changes of the cilia were increased, adhesion and collapse of the cilia were found.
4) The author and his associates have investigated morphological changes of the tracheal walls due to air pollutants such as SO2, NOx, O3, exhaust gas of gasoline motor car and others. Comparison of their findings and the results of this study was performed. It was a striking feature that the findings due to air pollutants were almost the same as those of carcinoma. The results above mentioned suggest that effects of chemical stimulation such as air pollutants were similar in appearance to those of physical stimulation such as air way stenosis due to carcinoma.View full abstractDownload PDF (5160K) -
Hiromaru Ogata1977 Volume 28 Issue 2 Pages 113-115
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
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Naomaru Miyaji, Takashi Horie1977 Volume 28 Issue 2 Pages 115-119
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSAs a cause of dyspnea, upper airway obstruction (UAO) is rarely considered. However, it should be recognized that dyspnea could be improved by an adequated treatment if dyspnea is caused by UAO.
In order to find out sensitive parameter of pulmonary function test in UAO, we performed several expriment: 1. Spirometry, respiratory resistance (Rr), Flow-Volume (F-V) curve in normal subjects with external resistance (4-9mm of orifice diameter). 2. Spirometry, Rr and F-V curve in UAO, and normal and chronic obstructive lung diseases (COPD). 3. Exercise study on normal subjects with and without external resistance.Naomaru, Miyaji;Takashi, Horie
Following results are obtained:
1) FIV and MVV are sensitive spirometry to detect UAO.
2) Expiratory portion of F-V curve is flat near peak flow and inspiratory portion reveals reduced flow at entire lung volume. Reduction of PEF, PIP and VI50, and elevation of VE50/VI 50, VE25/. PEF and FEV1.0/ PEF are sensitive parameter.
4) Exercise performance is significantly impared in UAO.View full abstractDownload PDF (957K) -
Hikoemon Maekawa1977 Volume 28 Issue 2 Pages 120-125
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSIt is needless to say that cases with laryngeal disturbances develop various influences on the lower air way. I have patho-physiologically examined the lower air way of cases who underwent tracheotomy and total laryngectomy. The study was comprised of observations on the ciliary activity and bacteriogical, immunological observations. The following results have been obtained.
1) As a preliminary examination, ciliary movement (beat numbers) of the tracheobronchial tree at different levels were measured in normal dogs by the rose-chamber method. It was demonstrated that the ciliary activity becomes reduced, though very slightly, in the peripheral part of the tracheo-bronchial tree. The decreasing degree in the activity was not so remarkable as that of the mucous flow rate reported by Kilburn (1970).
2) The ciliary activity of the tracheo-bronchial tree at different levels in the rabbits at one week after tracheotomy was found to show the similar tendency as mentioned above for the normal dogs, except of the region where the mucous membrane was direcely damaged by the surgery. This fact suggests that the cleaning function on the lower air way is little affected by laryngeal disturbance.
3) No bacterium was detected from the bronchus at the time of tracheotomy and laryngectomy. With the lapse of time after the surgery, however, bacteria became detected from the bronchus approximately in 2/3 cases of tracheotomy and a half of cases of laryngectomy, respectively. The strains of bacteria detected after tracheotomy were similar to those detected from the pharynx, while those detected after laryngectomy were not. This seems to indicate that bacteria in the pharynx fall down and invade to the lower air way when laryngeal disturbanc are caused
4) By measuring anti-body titer of the serum and the bronchial secretion, the presence of bacteria responsible for inflammation on the lower air way was recognized. It was also made known that changes in the anti-body titer arein accordance with the progress of clinical sign.View full abstractDownload PDF (1109K) -
[in Japanese]1977 Volume 28 Issue 2 Pages 125
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDownload PDF (213K) -
[in Japanese], [in Japanese], Kurt Jatho, [in Japanese], [in Japanese] ...1977 Volume 28 Issue 2 Pages 126-155
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1977 Volume 28 Issue 2 Pages 156-173
Published: April 10, 1977
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSDownload PDF (5536K)
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