巻号一覧
36 巻 (1985)
- 6 号 p. 465-
- 5 号 p. 415-
- 4 号 p. 345-
- 3 号 p. 261-
- 2 号 p. 59-
- 1 号 p. 1-
36 巻, 4 号
選択された号の論文の8件中1～8を表示しています
- |<
- <
- 1
- >
- >|
-
野中 聡, 富山 知隆, 金谷 健史, 海野 徳二, 太田 善博1985 年 36 巻 4 号 p. 345-352
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーSneeze is one of the most essential airway reflexes. In order to study the neuromuscular mechanism of sneeze, experiments were done on 23 anesthetized dogs. Electrical stimulation (0.5-1.0mA, 0.2ms duration, 50 pulses/s) to the nasal membrane interrupted normal respiratory rhythm and evoked sneeze attacks with a latency of 2-3s from the stimulus onset. Sneeze attacks were also evoked by stimulation (20-50μA, 0.2ms duration, 10 pulses/s) delivered to a ventro-medial part of the spinal trigeminal nucleus within the medulla oblongata by means of a glass microelectrode filled with metal.
Preceding the beginning of sneeze, the subglottic pressure (SGP) gradually decreased reflecting the preparatory inspiratory phase. During sneeze, it abruptly increased to a peak pressure level of 80-100cm H2O reflecting the explosive expiratory phase. During the preparatory inspiratory phase, the diaphragm (DIA) was activated. Approximately 180ms before the moment of the peak SGP, the increased activity of the DIA was terminated and then the rectus abdominis muscle (RA) became active.
The thyroarytenoid muscle (TA) and the posterior cricoarytenoid muscle (PCA) showed transient and reciprocal discharge patterns. The duration of discharge was about 80ms in both muscles. The switch over from the TA activity to the PCA activity occurred about 90ms preceding the peak SGP. The RA and the TA co-contracted for a brief period of about 60ms. During this period the SGP greatly increased. These observed sequential activation patterns of respiratory and intrinsic laryngeal muscles were essentially similar both in the nasal membrane-induced sneeze and the brainstem-induced one.
All these results suggest integrated activity of respiratory and intrinsic laryngeal muscles underlies the sneeze. Such an integration is possibly performed at the level of the medulla oblongata.抄録全体を表示PDF形式でダウンロード (1286K) -
とくに咽喉頭異常感症との対比加藤 孝邦, 内田 正興, 鎌田 信悦, 河西 信勝1985 年 36 巻 4 号 p. 353-362
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーWe investigated 159 cases of carcinoma of the hypopharynx and the cervical esophagus (CHCE), 32 cases of abnormal sensitiveness with esophageal web, and 58 cases without esophageal web.
The ages of the patients with CHCE on the initial treatment concentrated in the 6th decade, while those over 40 years in the patients of abnormal sensitiveness with esophageal web were the most common, showing a slightly larger number of elderly subjects than in the patients of abnormal sensitiveness without esophageal web.
Most of the patients with pyriform sinus cancer (PSC) had a chief complaint of sore throat, hoarseness and odynophagia when the cervical masses increased and advanced, while those with postcricoid cancer (PCC) or posterior wall cancer (PWC) complained of dysphagia or odynophagia. Most of the patients with carcinoma of the cervical esophagus complained of dysphagia, while those with abnormal sensitiveness in the pharyngolarynx complained of sensitiveness to foreign bodies or zonesthesia.
The period of suffering lasted two or three months in most cases of PSC and PCC, while it was four or five months in most cases of PWC and carcinoma of the cervical esophagus. Moreover, the duration of suffering in the patients of abnormal sensitiveness without esophageal web was usually less than one month, while that in the patients of abnormal sensitiveness with esophageal web was long, two or three months.
Hemoglobin in the blood had the lowest value in the patients of abnormal sensitiveness without esophageal web, and 18.4% of the patients with postcricoid cancer showed less than 10μg/dl of hemoglobin, while the other cancerous patients showed values within the normal range.
The patients of abnormal sensitiveness with esophageal web and patients with PCC showed lower values of serum iron than the other cancerous patients.
The incidence of hypopharyngeal web was 1.93% of 2, 280 patients who had visited our hospital with a complaint of abnormal pharyngeal sensitiveness, while it was high in CHCE; 20.0% in PSC, 27.9% in PCC and 14.3% in PWC and carcinoma of the cervical esophagus.抄録全体を表示PDF形式でダウンロード (1403K) -
森 敏裕, 丘村 煕1985 年 36 巻 4 号 p. 363-370
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーThe authors proposed the following classification of the swallowing pressure curve depending on the site of lesion on the basis of swallowing pressure recordings of 47 patients with dysphagia.
Type I: Normal type. It has three peaks of the swallowing pressure which correspond to the velopharynx, hypopharynx and cervical esophagus respectively.
Type II: Abnormal elevation of the pressure. This type consists of the following two subtypes.
Type IIa: indicating the upper esophageal sphincter spasmus. The pressure at the entrance of the esophagus elevates over the upper normal limit of that region.
Type IIb: indicating stenosis at the entrance of the esophagus. The peak of the pressure at the hypopharynx elevates over the upper normal limit of that region.
Type III: Abnormal depression of the pressure. This type consists of the following two sub-types.
Type IIIa: indicating depression of the pressure in the pharynx. The peak of the pressure at the hypopharynx reduces or disappears.
Type IIIb: indicating soft palatal paralysis. The peak of the pressure at the level of the velopharynx reduces or disappears.
The above classification might be helpful for the choice of treatments in various types of dysphagia.抄録全体を表示PDF形式でダウンロード (1052K) -
木村 景柱1985 年 36 巻 4 号 p. 371-381
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーTo clarify the objective effect of prognostic factors in the esophageal cancer and predict the survival time of those patients, 337 resected esophageal cancer cases were studied. Seventeen prognostic factors were examined statistically. Factors chosen in this study were sex, size, location of the tumor, radiologic type, stage, resectability, radicality of operation, invation to the adventitia, lymph node metastasis, histological type, lymphatic invasion, blood vessel invasion, cellular atypism, structual atypism, infiltration, preoperative irradiation, and postoperative irradiation.
The multiple regression analysis was performed. By evaluating the regression estimate, it seemed to be possible to foresee the postoperative survival time.
Among these factors, the radicality of operation was defined as the most effective factor for 10 years prognosis. As for the factors for short-term prognosis, pre- and postoperative irradiation, resectability, histological type, and lymph node metastasis were statistically significant factors. Structural atypism and size had some influences on middle-term prognosis and cellular atypism on long-term prognosis. In this study, sex, stage, invasion to the adventitia, lymphatic invasion were not statistically significant prognostic factors.抄録全体を表示PDF形式でダウンロード (1554K) -
小河原 昇, 石橋 康, 西本 喜胤, 柊 光一, 佐々木 佳郎1985 年 36 巻 4 号 p. 383-388
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーA juvenile case with hypopharyngeal fibrosarcoma was reported. The patient was a 14-year-old boy who was refered to our clinic for dyspnea. Fiberscopic examination of the hypopharynx and X-ray examination of the neck revealed a mass which occupyed the almost whole space of the hypopharynx and larynx. Emergent tracheostomy was performed and biopsy specimen was taken. Endoscopic examination made it clear that the tumor originated from the left hypopharyngeal wall. Histological examination of the tumor showed fibrosarcoma. Preoperatively, total doses of 4100 rails irradiated with 60Co. Then tumor was resected by lateral pharyngotomy. Postoperative irradiation of 1950 rads and the chemotherapy using Vincristin, Cyclophosphamide and Actinomycin-D were given. The patient has been strictly followed up, and no sign of recurrence has been detected for 16 months after the operation.抄録全体を表示PDF形式でダウンロード (5692K) -
伊藤 修, 田中 寛, 新美 誠司, 廣瀬 肇1985 年 36 巻 4 号 p. 389-395
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーA case of oculopharyngeal muscular dystrophy was reported. A 61-year-old male was referred from the Department of Neurology with chief complaints of dysphagia and hypernasality preceded by diplopia. On clinical examination, bilateral potsis, ophthalmoplegia, soft palate palsy and marked salival retention in the hypopharynx were noted. Barium swallow revealed mixed type misdeglutition with retention of barium in the pyriform fossae. Insufficient nasopharyngeal closure was also noted. Cricopharyngeal myotomy combined with thyrohyoidpexy and infrahyoid myotomy resulted in prompt relief of dysphagia. Histological examination on muscle specimens revealed dystrophic changes of myogenic nature in the cricopharyngeal muscle but not in the infrahyoid muscles. It was argued that wider resection of muscle tissues should be more effective than ordinary cricopharyngeal myotomy.抄録全体を表示PDF形式でダウンロード (6762K) -
自験例と本邦報告例の検討谷 光毅, 天津 睦郎, 坪田 紀明, 青垣内 龍太, 山本 邦之1985 年 36 巻 4 号 p. 396-405
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーA case of primary squamous cell carcinoma of the thyroid gland is reported. Such a neoplasm is extremely rare, and comprises 1.1% of all primary thyroid cancers. Up to now, only 30 cases dealing specifically with this subject were found in a review of Japanese literatures.
Metastasis and direct extension of squamous cell carcinoma in the thyroid gland are much more frequent than primary squamous cell carcinoma of the thyroid gland, and must be excluded before the diagnosis is established.
The histogenesis of this neoplasm has been debated in most reports. Some clinicopathologic evidence makes recent investigators lend credence to the theory that these lesions arise from previous adenocarcinomas through metaplastic alteration of tumor cells.
These lesions are seen mostly in older individuals, generally in their sixth or, seventh decades. In most cases, there is a history of long-standing goiter which suddenly increases in size with associated dysphagia, dyspnea and hoarseness. The tumor is usually far advanced at the time of discovery, and shows an extreme biological malignancy: universally radioresistant and chemotherapy inconclusive. Thus, it seems that early diagnosis followed by aggressive surgical therapy and postoperative chemotherapy offers the best opportunity for cure, although the prognosis is poor even with the above treatments.抄録全体を表示PDF形式でダウンロード (6903K) -
上原 真由美, 荒牧 元, 清 恵里子, 宮野 良隆1985 年 36 巻 4 号 p. 406-409
発行日: 1985/08/10
公開日: 2010/02/22
ジャーナル フリーRecently Heimlich maneuver has been recommended for the treatment of food choking in Japan. We think that the foreign body in the respiratory tract can not be removed by Heimlich maneuver in case of choking by some Japanese foods.
We experimentally packed a small ping-pong ball, a mass of chicken, rice cake and chewing pork into the larynx of a mongrel dog, and tried Heimlich maneuver for removal of foreign bodies. A ping-pong ball and a mass of chicken could be removed by this maneuver, however, a mass of rice cake and chewing pork could not. Accordingly, we tried to remove these foreign bodies by finger maneuver and could remove them successfully.
We recommend finger maneuver in case of difficulty in removing the foreign body by Heimlich maneuver.抄録全体を表示PDF形式でダウンロード (3752K)
- |<
- <
- 1
- >
- >|