巻号一覧
36 巻 (1985)
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36 巻, 6 号
選択された号の論文の7件中1～7を表示しています
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宮原 裕, 鶴田 至宏, 馬谷 克則, 吉野 邦俊, 佐藤 武男1985 年 36 巻 6 号 p. 465-472
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーThree hundred and fifteen patients with laryngeal cancer including 27 past-treated cases, were treated in our clinic from July 1978, to December 1982. Until December 1983, 70 patients died. Causes of death were original cancer (38 cases, 54.3%), additional malignancy (12 cases, 17.1%), intercurrent disease (17 cases, 24.3%) and others (3 cases, 4.3%). Of the primary 62 cases, 22 were classified as the supraglottic type, 30 as the glottic, 8 as the transglottic and 2 as the subglottic.
Deaths of original cancer were attributable to the metastasis to the cervical lymph node and/or distant metastasis, mainly to the lung. Deaths of intercurrent disease were due to mainly cerebral or cardiac disorders. Deaths of additional malignancy included cancer of the stomach, liver or lung.
Metastatic lymph nodes at the initial treatment were found in 62.5% of patients who died of laryngeal cancer. In order to improve survival rates, general control of the patients, early diagnosis and early treatment for additional malignancy and radical dissection of positive lymph nodes are seemed to be important.抄録全体を表示PDF形式でダウンロード (1055K) -
岩崎 剛和, 津谷 泰夫, 志波 邦夫, 藤本 知久, 藤田 悦生, 杉原 練三, 田中 明, 波津 竜平, 秋山 裕由, 岸上 直子, 高 ...1985 年 36 巻 6 号 p. 473-479
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーTo evaluate the validity of scoring method of small airway function tests, selective alveolobronchography (SAB) was performed on 7 patients with bronchial asthma, 7 patients with chronic pulmonary emphysema and a patient with chronic bronchitis. The small airway lesion observed on SAB film was compared with the pulmonary function data including closing volume (CV), ΔN2/L, volume of isoflow (Visov) and ΔV50 and further with total score of the abnormalities in CV, ΔN2, Visov, and ΔV50 (SAO score).
The severity of small airway lesion in SAB was expressed as the mean of maximum diameter/minimum diameter ratioes (ratio of bronchial diameter, RBD) in each 1cm-long segment on magnified film (3 to 4 fold).
1. Significant but loose correlation was found between FEV1.0% and RBD, but correlation was not significant between respiratory resistance and RBD.
2. Among small airway parameters, only CV was significantly correlated with RBD.
3. Significant correlation was found between SAO score and RBD.
We conclude that the scoring method of small airway function tests is meaningfull for evaluation of small airway obstruction.抄録全体を表示PDF形式でダウンロード (2674K) -
木西 實, 牧野 邦彦, 谷 光毅, 天津 睦郎1985 年 36 巻 6 号 p. 481-487
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーIn 1979, Singer and Blom reported an endoscopic tracheoesophageal puncture technique for secondary voice restoration after total laryngectomy. During the past two years, we have performed the tracheoesophageal puncture on 23 total laryngectomy patients. Fifteen and eight cases were categorized into primary and secondary method, respectively. Out of twenty-three patients, 18 (78%) acquired fluent and intelligible speech. First day of phonation after operation was at the thirty-second and third day in the primary and secondary method, respectively. Maximum phonation time was 14 second in average.
Phonatory function was evaluated in 12 cases. The results obtained were as followed.
1) The fundamental frequency of voice was low and the range of voice frequency was narrow compared to normal subjects.
2) The intensity of voice ranged from 62 to 88dB SPL.
3) Mean airflow rates were below 200ml/sec in almost cases.
4) Tracheal pressure and airway resistance of esophageal source were high compared to normal subjects.
5) Efficiency of voice ranged from 0.1×10-4 to 2.3×10-4.
Relative advantages to use tracheoesophageal speech were compared to conventional esophageal speech. A comparison of speech rehabilitation between Amatsu tracheoesophageal shunt operation and tracheoesophageal puncture technique was discussed.
The causes of unsatisfactory result in tracheoesophageal speech using voice prosthesis were divided into three groups: 1) loss of motivation, 2) inability to manage the prosthesis and 3) inability to divert air through the constructed pharynx due to pharyngeal stricture, which consists of thyreopharyngeal muscle and cricopharyngeal muscle.抄録全体を表示PDF形式でダウンロード (972K) -
気管端々吻合術の一工夫梅原 豊治, 梅原 美枝子, 梅原 亨, 赤尾 伸二, 澤田 英明, 茂木 五郎1985 年 36 巻 6 号 p. 488-492
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーA 62-year-old male patient had a metastatic carcinoma of the thyroid gland from lung cancer for which he had received surgical treatment 4 years ago. The tumor lesion involved the right recurrent nerve and the trachea, resulting in a stenosis at the level of 5 cm beneath the glottis. The tumor lesion was resected together with 2nd to 5th tracheal rings, and end-to-end anastomosis was performed following suprahyoid laryngeal release. A tracheal cannula was inserted from the anastomosed portion where an anterior third of the trachea was left open. The patient had a more reliable airway than endo-tracheal intubation. Histologic examination of both the thyroid lesion and the previously-resected lung cancer revealed that both lesions were very similar. Postoperative course was uneventful, and no signs of recurrence have been detected for 27 months after the operation.抄録全体を表示PDF形式でダウンロード (7301K) -
甲能 直幸, 桜井 栄, 凌 梅英, 館野 まゆみ, 猪狩 武詔, 山本 渉, 鈴木 理文, 中山 尚樹, 藤井 みゆき, 岡田 康司, 橋 ...1985 年 36 巻 6 号 p. 493-499
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーIn 1980 Singer and Blom introduced a one-way silicone valve which allows for sufficient air flow from the trachea to the oral cavity. Eventually they described two-way respiratory valve with the voice prosthesis by which voice can be produced without occlusion of the stoma by a finger. After their introductory report, many authors reported a clinical application of these two devices.
We have started clinical application of these two devices since 1983. The present paper describes our experience with the Blom-Singer voice prosthesis and the tracheostoma valve, together with our surgical technique for tracheoesophageal puncture. Nine patients were included in this study. The main problems for the voice prosthesis are irritation of the skin and displacement of the tracheoesophageal shunt. The limitation of the application for the tracheostoma valve was caused by irritation of the skin and the excessive secretion of the trachea.
There is no major complication with the tracheoesophageal puncture. The results of this method are satisfactory to sure extent, and we need more cases in order to evaluate this method exactly.抄録全体を表示PDF形式でダウンロード (6674K) -
藤田 博正, 川原 英之, 日高 正晴, 吉松 博1985 年 36 巻 6 号 p. 500-510
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーThe blunt dissection via partial sternectomy was carried out for four patients with carcinoma at the boundary between the superior mediastinal and cervical segment of the esophagus. This procedure must be devised to prevent recurrence in the thoracic lymph nodes, tracheal necrosis, bronchopneumonia followed by the short trachea and stenosis of the tracheal stoma.
As a new method, the laryngo-esophagectomy via the right thoracotomy and partial median sternotomy with some modifications was carried out. This devised surgical procedure seems to be an appropriate operative method for carcinoma of the esophagus in this location, because intrathoracic lymph nodes were able to be dissected and the trachea was protected from necrosis by preserving of the right bronchial artery and by covering with the muscle flap of the latissimus dorsi.抄録全体を表示PDF形式でダウンロード (10398K) -
菊池 功次, 加藤 良一, 酒井 章次, 西村 嘉裕, 根本 悦夫, 水渡 哲史, 鈴木 隆, 加勢田 静, 深井 志摩夫, 小林 紘一, ...1985 年 36 巻 6 号 p. 511-515
発行日: 1985/12/10
公開日: 2010/02/22
ジャーナル フリーTracheal silicone T-tube was used as a stent in the management of 5 patients with glottic stenosis due to bilateral vocal cord paralysis occurred after the resection of the trachea infiltrated by thyroid carcinoma. The upper limb of the T-tube is brought through the vocal cords with preservation of a functional voice and without injury to the vocal cords. The T-tube provides respiration through the nasopharynx, so that humidification and phonation are maintained. It is generally trouble free and remains in place for five or six months. After the extubation of T-tube, the patients are possible to breathe and phonate almost normally without dyspnea.抄録全体を表示PDF形式でダウンロード (3209K)
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