巻号一覧
34 巻, 1 号
選択された号の論文の9件中1～9を表示しています
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鈴木 隆, 石原 恒夫, 深井 志摩夫, 菊池 功次, 水渡 哲史, 根本 悦夫, 武十 昭彦1983 年 34 巻 1 号 p. 1-6
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーA morphological aspect of cough mechanism was studied by means of cinebronchography and sequential changes in the glottis and tracheobronchial tree during cough were observed.
The subjects were eleven patients of various chest diseases including seven lung cancer patients. After instillation of opaque medium in the trachea, the recumbent patient was asked to produce violent cough and the motion pictures were taken at a speed of 100-120 frames per second.
We could observe sequential movements of the glottis and trachea corresponding to the reported three phases of cough. During the initial inspiratory phase, the glottis opened and the trachea was widened, and a large amount of air was inspired. The second compressive phase began with a firm closure of the glottis. During this phase the caliber of the trachea almost unchanged in spite of the compression probably due to the firm closure of the glottis.
The third expiratory phase was initiated by the opening of the glottis. Subsequently we could find that the contrast medium was expectorated suddenly and the trachea was compressed and narrowed. The narrowing was considered to be caused by a high pressure gradient between the pleural cavity and airway.
In our study, two patients; one patient with extremely dilated trachea and another with lung cancer invaded to the lower trachea, showed only insignificant change in the tracheal caliber throughout the three phases and could not expectorate the contrast medium effectively. This finding indicated that the change in the tracheal caliber was an important part of cough mechanism as suggested by Ross.抄録全体を表示PDF形式でダウンロード (4875K) -
鈴木 留美, 山川 育夫, 龍華 一男, 佐竹 辰夫1983 年 34 巻 1 号 p. 7-14
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーClearance of airway secretion is one of the most important problems in the patients with chronic airway diseases.
We deviced a new method assisting clearance of airway secretion, and evaluated the validity of the method experimentally and clinically.
In experimental studies, the resonance frequency of sputum was sought with Matsudaira's vibrator and the mucociliary transport rate of sputum plugged in dissected chicken trachea was measured, with and without administration of oscillatory pressure at near the resonance frequency.
In clinical study, 15 patients with chronic pulmonary disease were applied oscillatory pressure via mouthpiece during respiration and sputum volume, VC, FEV1.0 and blood gas were examined.
The results were as follows.
1. The resonance frequencies of most sputa were less than 10Hz.
2. In the experiment with chicken trachea, oscillation (via the airway) at near the resonance frequency of human sputa enhanced the movement of impacked human sputum toward the oral site, which increased with declivity of the trachea.
3. This phenomenon was not observed in the trachea whose activity of mucociliary transport had been lost.
4. This method was applied for 15 patients together with postural drainage. In 14 patients, volume of expectrated sputum increased, but no remarkable changes were found in the clinical examination data, lung function test or blood gas analysis.抄録全体を表示PDF形式でダウンロード (3412K) -
渡辺 雄司1983 年 34 巻 1 号 p. 15-25
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーRecently immotile cilia syndrome has gained the interest of a number of investigators from the aspects of physiology and pathology of the ciliary movement . This is because microstructual abnormalities of the dynein arms in the cilia of the respiratory mucosal epithelium and in the flagella of sperm tails have been identified in this syndrome.
The present study was designed to find a simple clinical method for detecting patients having this syndrome, and was - conducted to elucidate the clinical significance and etiology of this syndrome. In addition, the author carried out an animal experiment as to whether or not morphological abnormalities of the cilia can be caused by external factors, namely, by sulfur dioxide (SO2) gas inhalation.
In order to detect patients with immotile cilia syndrome, 62 male patients with one or more conditions such as paranasal sinusitis, bronchiectasis, situs inversus and sterility were examined using a ciliary function test and electron microscopic observation of the nasal cilia and sperm tails. Seven of the examined patients were diagnosed as having immotile cilia syndrome on the basis of the presence of the characteristic ultrastructural patterns of the nasal cilia and sperm tails, i. e., disorders of the dynein arms. The possibility of positive test results increases greatly as the degree of the complications increases, especially in the case of a combination of chronic inflammation of the respiratory tract with situs inversus and sterility.
As the electron microscopic findings of this syndrome, Afzelius has reported defects of the dynein arms, spoke head and central sheath. Beyond these microstructural abnormalities, the author identified abnormal attachment of the dynein arms as a new parameter in the electron microscopic diagnosis of immotile cilia syndrome.
This syndrome is hereditary in origin, since external stimulation by both chronic inflammation and SO2 gas has not produced the ultrastructural changes of the cilia characteristic of this syndrome.抄録全体を表示PDF形式でダウンロード (9499K) -
遊離空腸移植の生着動向の指標について西罵 渡, 竹生田 勝次, 寺邑 公子, 野崎 幹弘1983 年 34 巻 1 号 p. 26-30
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーFree jejunal graft for reconstruction of the pharynx and cervical esophagus were performed on two patients with carcinoma of the hypopharynx, T2N0M0 and T4N0M0, respectively, who underwent total laryngectomy and hypopharyngectomy. Free jejunum with its own feeding vessels, 30 cm long, was removed from the abdomen, 10 cm distal to the Treitz's muscle. The vessels used in the cervical region were the lingual artery and external jugular vein and microvascular surgery was performed. Care was taken to ensure that the proximal jejunum was anastomosed to the proximal defect to prevent the establishment of an antiperistaltic segment.
To observe the post-operative condition of the jejunal graft, two flexible thermometers for esophagus were used. One was put into the jejunal graft, 18 cm distal from the anterior nostril and the other was put into the thoracic esophagus, 28 cm distal from the anterior nostril. Jejunal temperature was compared with thoracic esophageal temperature and axillary temperature. The result of the thermometry indicated that during 3 days after the operation, jejunal temperature was higher than esophageal and axillary temperature.
In this paper, we emphasized that correct information on the success of the graft should be obtained by our three point thermometry.抄録全体を表示PDF形式でダウンロード (2480K) -
田中 英一, 井上 鐵三, 平出 文久, 椿康 喜代, 都川 紀正, 沢田 政道1983 年 34 巻 1 号 p. 31-37
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーA case of radiation necrosis of the larynx is reported.
The patient was a 79-year-old man who was radiated with the dosis of 3900 rad for suspected carcinoma of the larynx in 1976 and 5300 rad for carcinoma of the larynx in 1980.After completion of radiation therapy, he started to have hoarseness. He was admitted to the hospital because of severe dyspnea. Fiberoptic examination revealed almost complete obstruction of the laryngeal lumen by necrotic tissues due to radiation necrosis. There was little space reserved for respiration. No motility of the vocal cords and arytenoids was observed. After tracheostomy, conservative local and systemic treatments and repeated removal of necrotic tissues through laryngomicrosurgery wereperformed. However, an advanced necrosis with infection could not be controlled. Therefore, total laryngectomy was performed. Microscopically, no malignant cells were noted in the larynx. As most soft tissues were degenerated into fibrosis, the pharynx was left open.When infection was' entirely controlled, the lining flap method from the anterior chest was applied to close the pharynx.
When severe radiation necrosis occurs in the larynx, laryngectomy is sometimes mandatory to be performed. It is important that infection should be controlled before and after laryngectomy. Delayed skin flap method is advised.抄録全体を表示PDF形式でダウンロード (7023K) -
宮原 裕, 里見 真美子, 佐藤 武男1983 年 34 巻 1 号 p. 38-41
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーA case of amyloidosis of the larynx is reported. The patient was a 39-year-old woman who complained of hoarseness of approximately 8 months' duration. Indirect laryngoscopy showed a yellow-red tumorous swelling in the bilateral false vocal cords, with normal mobility. Results of physical and laboratory examinations were all normal. Biopsy of the lesion revealed amyloidosis. Final diagnosis was made of solitary amyloidosis of the larynx. Laryngeal amyloid mass was entirely removed through the thyrotomy. A polarized microscopic examination showed that eosinophilic materials observed in H.E. stain were yellow-green positive in Congored stain, indicating that these materials were amyloid in nature. Amyloid fibrils in (4-10) nm width were observed in the lesion by electron microscopy. The patient remains asymptomatic for approximately four years after operation.抄録全体を表示PDF形式でダウンロード (4827K) -
II.治療と予後に関する検討栄 春海, 梅澤 祐二, 遠藤 朝彦, 上出 洋介, 内田 豊1983 年 34 巻 1 号 p. 42-46
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーThe characteristics of airway disturbances in children were reviewed in a previous paper where it was considered that the most important points in the management of these cases were to ascertain the causes of such disturbance and to obtain close cooperation of pediatricians. Diagnosis and treatment should be made on the basis of good knowledge of the characteristics of airway diseases in children.
In the present paper, the authors report 104 such cases. Due to the development of new medical equipment, techniques and methods, most of these cases, especially organic disturbances have been controlled successfully by surgical measures. On the other hand, congenital cases such as laryngomalacia have been controlled conservatively with proper systemic managements.
It is concluded that in airway disturbances in children an early diagnosis and early treatment with cooperation from the pediatrician for systemic care are essential factors directly affecting the prognosis of such cases.抄録全体を表示PDF形式でダウンロード (1085K) -
細田 兵之助, 村上 泰, 猪狩 武詔, 原口 茂徳, 岡田 康司, 丸山 毅, 小津 雷助, 岡本 亮二, 佐藤 学1983 年 34 巻 1 号 p. 47-55
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーWe experienced 4 cases of acute gastric bleeding in the postoperative period of hypopharyngeal cancer. Contrast to relatively easy diagnosis, the treatment of these cases offered many problems with poor prognosis.
We consider that various factors may concern to induce or activate this serious complication and that thorough elimination of possible causes may enhance its prognosis.
In this paper, we studied clinical data of these 4 cases retrospectively, and tried to find the genetic mechanism of this life-threatening complication. Though it has not completely been clarified, we conclude that this complication should be prevented by an effort to lessen surgical stresses and to eliminate possible factors in the postoperative period.抄録全体を表示PDF形式でダウンロード (5118K) -
粟田口 省吾1983 年 34 巻 1 号 p. 56-57
発行日: 1983/02/10
公開日: 2010/10/20
ジャーナル フリーPDF形式でダウンロード (520K)
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