巻号一覧
29 巻 (1978)
- 6 号 p. 337-
- 5 号 p. 279-
- 4 号 p. 239-
- 3 号 p. 185-
- 2 号 p. 71-
- 1 号 p. 1-
29 巻, 5 号
選択された号の論文の8件中1～8を表示しています
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岩村 忍, 谷島 貴志子1978 年 29 巻 5 号 p. 279-283
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーAs compared to conventional indirect laryngoscopy and the lately developed endonasal fiberscopy, laryngeal tomographies may prove more useful in terms of a precise understanding of the contour of the ventricle, level difference of bilateral vocal cords, the thickness and also the direction of a paralyzed cord and finally, the subglottic angle formed by either the adduction or fixation of the vocal cord during phonation. The results of a laryngeal tomographic analysis on 47 cases with unilateral recurrent laryngeal nerve paralysis were summarized as follows. Every analysis was made on tomograms taken during phonation and also compared with hemilarynx of the healthy side as well as indirect laryngoscopic findings.
1) An apparent enlargement of the paralyzed ventricle appears to be related to the paralyzed vocal cord fixed at the intermediate position in 61 per cent of the cases.
2) A higher level for the paralyzed vocal cord was observed in 23 cases (49 per cent). The paralyzed vocal cord showing fixation at the intermediate position, as well as bowing in the mirror, tends to be located at a higher level in the tomograms than the fixed vocal cord at the paramedian position and of straight appearance. The consistency of these findings as to the level of a paralyzed vocal cord may be only 50 per cent when comparing indirect laryngoscopic views with the tomographic studies.
3) Twenty nine cases (62 per cent) showed a significantly thinner vocal cord on the paralyzed side and also an upward direction for the median edge of the paralyzed vocal cord.
4) A significantly greater angle of the subglottis on the paralyzed side was demonstrated in 45 cases (95 per cent).
These results stress the medical and/or surgical aspects of not only the median displacement but also the sagittal correction of a paralyzed vocal cord to achieve vocal improvement.抄録全体を表示PDF形式でダウンロード (3760K) -
鴨下 一郎, 嘉山 保美, 松枝 脩仁, 大石 光雄, 津谷 泰夫, 山口 道也, 中島 重徳1978 年 29 巻 5 号 p. 284-290
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーA clinical and epidemiological study was made on complicated mediastinal and subcutaneous emphysema. A close relationship was found between asthmatic attack and the occurrence of mediastinal and subcutaneous emphysema. The interval between asthmatic attack and the onset of emphysema was 2.8 days on the average in the adults and 1.9 days in children. The most common site of complicated emphysema was the neck, which was followed by the anterior chest and the face. The chief complaints and symptoms were chest pain, neck pain and swelling in the neck in both the adults and children. Mediastinal emphysema subsided within 8.8 days on the average, while subcutaneous emphysema subsided within 9.2 days. No specific treatment was given to the patients who developed emphysema except for symptomatic treatments of asthmatic attack. Good prognosis was obtained in all the cases except one fatal case.抄録全体を表示PDF形式でダウンロード (3782K) -
リドカイン液の抗菌作用加藤 秀雄, 福原 徳光, 真下 啓明, 松嶋 慎吾, 斉藤 健利1978 年 29 巻 5 号 p. 291-298
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーAntimicrobial action of lidocaine solutions was studied as part of the serial transbronchial bacteriological culture study using the flexible fiberoptic bronchoscope. Clinical strains of E. coli, Klebsiella, Sta. aureus, Serratia, Str. hemolyticus, Str. viridans, Str. pneumoniae, Ps. aeruginosa, Mycobacterium tuberculosis and atypical mycobacterium were all used for these experiments. The colony count of these microorganisms were distributed between 8×106/ml to 68×1010/ml. Each lidocaine solution was prepared from 4% xylocaine containing methylparaben, and pure lidocaine powder. The hydrogen ion concentration of each solution was kept around 6.4 by using phosphate buffer system. Conclusive results were obtained and the following cautions should be observed, when transbronchoscopic bacteriological culture is performed under local anesthesia using lidocaine solution. The antimicrobial action of lidocaine solution was bacteriostatic and this inhibitory action was proportional to the mixing time of the lidocaine solution and the bacterial growth. However, at a concentration of 8, 000-24, 000γ/ml or more, it changed to bacteriocidal, so possibly a smaller amount, say 2% lidocaine solution, should be used instead of the usual 4% solution. Take the bacterial specimens and cultivate them as quickly as possible. If this is not done, general bacterial specimens must be kept in an incubator. For acid fast bacterial culture specimens must be kept in a refrigerator. In any case, both specimens should be cultivated within one hour. In some cases, airway lavage with normal saline solution prior to taking a bacterial specimen is advisable for the lidocaine dilution.抄録全体を表示PDF形式でダウンロード (4244K) -
高橋 義勝1978 年 29 巻 5 号 p. 299-310
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーFor the purpose of clarifying the etiological factors of the so-called foreign body sensation of the pharyngolarynx, the author investigated the degree of hypertrophy of the lingual tonsil and the mobility of the pharyngolaryngeal region by means of laryngograms.
Forty-two patients suffering from the so-called foreign body sensation of the throat were examined in this study. Twenty nomal subjects were also examined as a control. The results obtained were as follows.
1. As compared to the control group, hypertrophy of the lingual tonsil was more frequently found in the cases suffering from the so-called foreign body sensation. Severe hypertrophy was found in 14 cases (33%); moderate hypertrophy was found in 11 cases(26%), and slight hypertrophy was found in 17 cases (41%). In the control group, 5 cases (25%) and 15 cases (75%) showed moderate and slight hypertrophy, respectively, while no cases showed severe hypertrophy.
2. The more the lingual tonsil was hypertrophic, the more often it kept touching the epiglottis.
3. An apparent abnormality in the mobility of the pharyngolarynx was frequently found in the cases suffering from the so-called foreign body sensation in the throat. The abnormality in mobility was found in the recessus pyriformis, in the true and false vocal cords and in the epiglottis vallecula. For each degree of hypertrophy of the lingual tonsil, the abnormality was found in 33 cases (79%), 32 cases (76%) and 19 cases (45%), respectively. In the control group, it was found in 4 cases (20%), 1 case (5%), and 3 cases (15%), respectively.
4. No significant relationship was found between the degree of the hypertrophy of the lingual tonsil and the incidence of abnormal mobility in the pharyngolaryngeal region.抄録全体を表示PDF形式でダウンロード (5354K) -
佐藤 学, 村上 泰, 猪狩 武詔, 原口 茂徳, 甲能 直幸1978 年 29 巻 5 号 p. 311-316
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーWe present a case of 69-year-old male who underwent partial hypopharyngectomy with preservation of the larynx for his hypopharyngeal cancer localizing from the posterior wall of the hypopharynx to the lateral wall of the pyriformis. Primary reconstruction of the neck with a D-P skin flap was also done at the same time.
The operation appeared to be successful for the first postoperative week, then the patient developed acute hemorrhagic gastric ulcer for which we were forced to have a reoperation on him despite of his poor general condition.
Furthermore, the patient had to have another reoperation eight days later because of great amount of bleeding from a necrotic area of the brachiocephalic artery, which was followed by the third reoperation for the same reason five days after the second reoperation.
The patient's clinical course turned out to be miserable ending up with his death mainly due to his serious condition caused by several operations and his old age as well.抄録全体を表示PDF形式でダウンロード (3003K) -
林 恒男, 遠藤 光夫, 木下 祐宏, 山田 明義, 井手 博子, 吉田 操, 荻野 知巳, 吉田 克己1978 年 29 巻 5 号 p. 317-322
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーThe pathological state of corrosive strictures of the esophagus differs in each clinical case depending on the nature and quantity of agents ingested and the mode of ingestion. Therefore, it is mandatory to take a suitable treatment that fits each case of corrosive strictures. For the reason that these strictures are not malignat in general, the authors have performed dilatation by bougienage or a by-pass operation in most cases.
It should be noted, however, that carcinoma of the esophagus could occur secondary to corrosive stricture. Forty such cases have been reported in literature and two additional cases were also reported in Japan recently by Nakayama. The incidence of carcinoma of the esophagus has been claimed to be from 22 to 1, 000 times higher in the cases with corrosive stricture than in normal population.
If the extent of corrosive stricture is limited or short, bougienage of the stricture is attempted as the first choice. When bougienage is found to be ineffective or the stricture is too extensive, srugical treatment should be considered. Considering the possibility of future development of malignancy at the site of corrosive legions, resection of the constricted portion of the esophagus is more desirable than a by-pass operation. Because of the fact that the procedure should be made from the prophylactic viewpoint, esophagectomy without thoracotomy-the so-called blunt dissection after Akiyama-is considered to be a reasonable and valuable approach. The authors operated one case using the same technique with successful result. Even in non-resected cases, a close long-term follow-up study should be made considering the possibility of later development of carcinoma.抄録全体を表示PDF形式でダウンロード (6792K) -
前坂 明男, 宮崎 為夫, 徳田 紀九夫, 杉盛 恵, 米野 邦彦1978 年 29 巻 5 号 p. 323-327
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーA statistical study was made on 50 cases who were treated for denture foreign bodies in the esophagus at the Department of Otorhinolaryngology, Kanazawa University Hospital during the past 43 years (1953-1977). There was a preponderance in male patients (76%). Seventy per cent of the cases were in the age range from 40 to 70 years. Sixty-two per cent of denture foreign bodies lodged in the hypopharynx and at the level of cricopharyngeal muscle in the esophagus. Thirty-seven dentures were removed successfully by esophagoscopy, but 7 dentures had to be withdrawn by external esophagotomy because of unsuccessful endoscopic removal. There were 38 upper jaw dentures in the 50 cases. Large dentures (over 6cm in maximum diameter) were 15, 10 of which were lower jaw dentures. Among 3 extremely large complete dentures, 2 were lower jaw dentures. Eight dentures had a single hook and 30 had double hooks. Single arm clasps were observed in 33 dentures (66%), while two arm clasps were in 5 cases (10%). Single arm clasp was considered to be less effective for holding clasped tooth than two or three arm clasp.
As for the cause of dislocation and misswallowing of dentures, 70per cent of the cases were considered to be due to deformity, fracture or deficit of hook (clasp) of dentures. It was proposed that dentists should continue their effort to improve dentures, and that instruction and follow-up should be given to denture-wearers not to keep their inappropriate dentures but to consult with their dentists for necessary repair.抄録全体を表示PDF形式でダウンロード (556K) -
平出 文久, 井上 鉄三, 沢田 政道1978 年 29 巻 5 号 p. 328-332
発行日: 1978/10/10
公開日: 2010/02/22
ジャーナル フリーA case of dysphagia due to traumatic cervical emphysema is reported. The patient was a 51-year-old female who had complained of a foreign body sensation in the throat. She thought that she might have pharyngeal cancer. She occasionally found a firm mass in the lateral region of the pharynx (this was actually a lateral pharyngeal band). She tried to remove it by an iron needle stick. The patient noticed cervical swelling after repeated swallowing action.
Roentgenographic examination revealed a marked thickness of the posterior wall of the hypopharynx due to submucosal emphysema. Submucosal emphysema disturbed mechanically the elevation of the larynx and the movement of the epiglottis. Thus, the bolus of food was easily aspirated into the tracheal lumen.
Cervical emphysema disappeared in approximately 2 weeks after the injury of the pharynx without any intensive antibiotic therapy.抄録全体を表示PDF形式でダウンロード (5815K)
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