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Volume 37 (1986)
- Issue 6 Pages 429-
- Issue 5 Pages 373-
- Issue 4 Pages 305-
- Issue 3 Pages 241-
- Issue 2 Pages 69-
- Issue 1 Pages 1-
Volume 37, Issue 2
Displaying 1-20 of 20 articles from this issue
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Kikuo Nomoto1986 Volume 37 Issue 2 Pages 69-76
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSBio-defense includes functions for the elimination of foreign substances, aged substances or tumor cells derived from self components and is composed of 1) active substances which distribute diffusely in the body fluid, 2) non-specific humoral elements of professional bio-defense which express their functions selectively at the site for the production of effector cells or molecules or for the elimination of foreign substances, 3) nonspecific functions of cellular elements such as neutrophils, macrophages and NK cells, and 4) humoral and cellular immunity. In order to understand the role of each element in the sequential process for in vivo bio-defense, new concepts to organize the functions of these many elements may be needed. We have proposed, 1) differring contribution of individual elements under the various in vivo conditions, 2) comparison of functions in terms of systemic and local expression, and 3) primitive T cell response which covers the time gap between the phagocyte and the typical immunity.View full abstractDownload PDF (920K) -
James B. Snow1986 Volume 37 Issue 2 Pages 77-83
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
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H. Hirose1986 Volume 37 Issue 2 Pages 84-85
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
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Shimpei Tada, Sumiko Sugimoto, Masahiro Ida, Mitsuko Ariizumi, Toshiyu ...1986 Volume 37 Issue 2 Pages 86-91
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe radiodiagnosis has made a great progress since the advent of computed tomography in 1970s. Magnetic resonance imaging (MRI) is also a kind of computed tomography. These recently developed modalities have been readily utilized in the field of bronchoesophagology. Thirty-one cases of surgically resected laryngeal carcinoma were studied as to the extent of the disease by CT. CT delineated the paralaryngeal space and cricoarytenoid joint so well that CT was quite accurate in the staging of laryngeal carcinoma. Twenty-two cases of esophageal carcinoma were studied by MRI as to “A” factor. MRI was considered to be effective in the diagnosis of invasion to the aortic wall. Much has to be done, however, to confirm the effectiveness of MRI in the staging of esophageal carcinoma.View full abstractDownload PDF (6991K) -
Hiroyuki Fukuda, Hiroshi Muta, Etsuyo Takayama, Shigeru Kano, Tadashi ...1986 Volume 37 Issue 2 Pages 92-98
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSNobody can deny that the endoscopic evaluation of the larynx or the hypopharynx including the inlet of the esophagus plays a very important role in laryngological clinic.
Today, many types of endoscopes for the larynx are on market. Therefore, we can use a selective one according to the purpose or to a patient's condition.
If you want to observe the larynx with minimum painful sensation to a patient, use a small sized flexible fiberscope through the vocal cavity.
If you want to observe the larynx and obtain a clearer photograph, use a straight rigid type fiberscope to obtain a clearer and whole image of the larynx.
If you want to observe a special area of the larynx, for example anterior commisure, use a curved telelaryngoscope to obtain a very magnified view of some part of the larynx.
The most advanced thing in our clinic is “fiberstrobovideogrophy”. In order to videotape a stroboscopic image of the vocal fold vibration, we combine Nagashima'a brightest laryngostroboscope with Victor's home-use video camera. Then, we can stroboscopically observe and videotape the vocal fold vibration with a reasonably priced system.View full abstractDownload PDF (11930K) -
Shigenori Nakajima, Yasuo Tsuya, Fumihiko Ohta, Hiroko Yonekawa1986 Volume 37 Issue 2 Pages 99-107
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSFor the diagnosis of the upper airway obstruction, flow volume (FV) curve provides useful informations, since it shows a characteristic pattern. However, it may be difficult to identify the pattern when forceful expiration is not sufficiently performed or when the patient has a mild impairment of upper airway diseases. The purpose of the present paper was to study the utility of the He-O2 FV curve for the diagnosis of the upper and central airway obstruction and for the detection of the extent of obstruction. In this study, six healthy subjects and fourty nine patients with upper airway diseases (vocal cord polyp, vocal cord paralysis, cancer of ralynx), were examined. In order to simulate the upper airway obstruction, external resistance tubes with the inner diameters ranging from 4 to 15mm were inserted to the air passage. 1) Even when the external resistance increased, FVC did not change. 2) FEV1.0 showed no substantial change when the inner diameter was larger than 6mm, however it obviously decreased when the inner diameter was 5mm or less. 3) FEV1.0/PF ratio increased as the inner diameter decreased and the increase of this ratio became distinctive when the inner diameter was under 7mm reaching 10ml/l/min or more. 4) ΔPF increased as the inner diameter decreased, and the increment was significant when the inner diameter was less than 9mm. 5) Upper airway impairment of vocal cord polyp, vocal cord paralysis and cancer of larynx were detected by FEV1.0/PF and ΔPF of air FV curve and He-O2 FV curve. 6) The He-O2 FV curve was considered to be useful for the diagnosis of the upper airway obstruction.View full abstractDownload PDF (5685K) -
Sohtaro Komiyama1986 Volume 37 Issue 2 Pages 108-114
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe intraluminal pressure of the oral cavity, pharynx, esophagus and trachea has been measured since late nineteenth century. But the methods employed were troublesome for practical use and the acuracy of the obtained data was doubtful compared to the recent technical standard. For these reasons, the measurement of the intraluminal pressure did not play a role of a routine clinical examination.
Meanwhile, the miniture transducer has been employed for clinical use especially in the cardiovascular fields to measure the blood pressure directly. With this device we can measure intraluminal pressure acurately and safely. We have measured the pharyngoesophageal, subglottic and oral pressures and evaluated the swallowing function and vocal efficiency. In this paper, devices and methods measuring intraluminal pressure and the results were reported.View full abstractDownload PDF (7390K) -
Spontaneous Recovery Ratio of Recurrent Laryngeal Nerve Paralysis in Relation to Etiology and Vocal Cord FindingsShinobu Iwamura1986 Volume 37 Issue 2 Pages 115-120
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA total of 311 cases with recurrent laryngeal nerve (RLN) paralysis, comprising of unilateral and bilateral, are statistically analyzed to obtain the following results:
1. The spontaneous recovery from RLN paralysis can occur as low as 20% of all the cases examined.
2. Eighty per cent of the cases having shown eventual recovery from RLN paralysis demonstrated their recovery sign as early as before 3 months following the onset.
3. The complete recovery from RLN paralysis occurred in 74% of the spontaneously recovered cases while incomplete recovery was seen in 26%.
4. An intubation tube might ensure the highest recovery rate of 73% among other etiological factors.
5. The right RLN paralysis tended to improve more greatly with a ratio of 38% than the left in 24% while the bilateral RLN paralysis spontaneously recovered only in 17%.
6. The cases presenting both the median and the paramedian fixation of the vocal cord (s) improved in 29% while other cases with the intermediate fixation showed spontaneous recovery in 23%.
7. The paralyzed vocal cord (s) with the straight appearance improved more greatly in 38% than the vocal cord with the bowed appearance in 21%.View full abstractDownload PDF (710K) -
Yoshikazu Yoshida, Minoru Hirano, Tetsuji Yoshida, Hiroshi Ohkubo, Osa ...1986 Volume 37 Issue 2 Pages 121-123
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe observations of the laryngeal behavior on deglutition and phonation using a video tape recording system were reported. This was a simultaneous electromyogram and fluoroscopic image recording system of swallowing, and a stroboscopic color video recording of vocal fold vibration. The usefulnesses of the former system were (1) multidimensional observations, (2) observation of relationships between actions of muscles (4ch EMG) and movements of each part of the food channel, (3) easy reproduction, easy set-up and untroubled operation, (4) deciding of aspiration's type. Those of the latter were (1) objectivity and reproducibility, (2) comparisons of pre-and post-therapeutic status, (3) compact equipment and ease of operation.View full abstractDownload PDF (1564K) -
M. Hirano1986 Volume 37 Issue 2 Pages 124-125
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
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Fumihiko Sato, Hitoshi Saito, Hiroshi Takenaka, Kazuo Uede, Takehisa S ...1986 Volume 37 Issue 2 Pages 126-132
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSAs functional reconstructive surgeries for recurrent laryngeal nerve paralysis, there are static reconstruction such as intracordal silicone injection or Woodmann's operation, and dynamic reconstruction such as free nerve grafting and pedicle nerve muscle grafting.
This paper is mainly concerned with the present situation and indication of each surgical procedure for recurrent laryngeal nerve paralysis. In order to clear the indication of the surgery, recurrent laryngeal nerve paralysis was classified pathophysiologically into four degrees: I. Condition of neurapraxia or its combination with axonotmesis, in which vocal cord movement might be recovered. II. Condition of axonotmesis or its combination with few neurotmesis, in which atrophy of the vocal cord exists and the movement could not be recovered. III. Condition of neurotmesis, in which atrophy and high level of the vocal cord exist. IV. Condition of severe neurotmesis, in which the vocal cord atrophies progressively.
The mediofixation of the vocal cord for unilateral paralysis is indicated to vocal cord atrophy (II grade) and mediofixation of the vocal process by adduction of the arytenoid cartilage is indicated to the high level vocal cord. Dynamic reconstruction is needed for unilateral nerve defect at thyroidectomy. Surgical procedure for bilateral paralysis is selected depending on the degree of dyspnea.View full abstractDownload PDF (793K) -
Mutsuo Amatsu1986 Volume 37 Issue 2 Pages 133-140
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSOver the past twenty years, several authors reported on various surgical techniques for voice restoration after total laryngectomy. The principle behind these procedure is to divert pulmonary air into pharynx or esophagus, to achieve an intelligible voice. The resultant speech compared satisfactorily with esophageal speech which had been the most frequently used method for vocal rehabilitation.
However, tracts made between the trachea and the esophagus for phonatory purposes risk possible aspiration, unless a protective mechanism provides a sphincter or valve during deglutition. To achieve surgical voice restoration, it is realized that voice production must be compatible with normal deglutition.
In this paper, a surgical voice restoration technique with a sphincter mechanism is described followed by a brief historical review of the said procedures. This technique, utilized in twenty six patients, consists of a unique combination of treacheal flap for voice production and bilateral esophageal constrictor muscle flaps to prevent aspiration.
Twenty four patients, developed satisfactory tracheo-esophageal speech of which twenty had normal deglutition without problems of aspiration. Proper case selection may achieve high success rate for preserving normal delutition and restoring speech after total laryngectomy.View full abstractDownload PDF (3168K) -
Hiroshi Okamura, Eiji Yumoto, Kazunori Okamoto, Yuji Kawamura1986 Volume 37 Issue 2 Pages 141-146
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA carbon dioxide laser has being used with increasing frequency for treating various lesions of the head and neck areas during these thirteen years. Especially, it is used most effectively for treating laryngeal diseases. The authors also are utilizing a carbon dioxide laser in laryngeal microsurgery for granuloma, laryngeal stenosis, papilloma, hyperepithelial lesions and cancer. In this paper, the authors described the advantages, disadvantages and indications of the laser surgery in the larynx. The application of the laser surgery for treating cancer was classified into the following three groups; 1. removal of tumor with laser alone, 2. reduction of tumor with laser and the postoperative irradiation, 3. removal of the residual tumors with laser after irradiation. Moreover, the postoperative phonatory function investigated by aerodynamic and acoustic analyses showed that patients retained sufficient phonatory function in daily use of their voice.View full abstractDownload PDF (690K) -
Harubumi Kato, Kazuo Yoneyama, Shinya Otomo, Hiroshi Iwabuchi, Yoshihi ...1986 Volume 37 Issue 2 Pages 147-153
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSPhotodynamic therapy (PDT) using hematoporphyrin derivative (HpD) has been performed in 139 lesions of 115 lung cancer cases since 1980. The efficacy of and indication for PDT were discussed in this paper. Twenty-six cases were early stage lung cancer and 17 were stage I, 11 were stage II, 42 were stage III and 19 were stage IV, respectively. Complete remission was obtained in early stage cases with small lesion, however incomplete remissions or tumor recurrences were observed in large extent lesions.
Opening of obstructed bronchus was obtained in the advanced lung cancer cases and improvements of performance status were obtained. It was also possible to increase the operability and to reduce the extent of resection area in the advanced cases.
This modality has more possibilities in the treatment of malignant tumors in future.View full abstractDownload PDF (8611K) -
Mitsuo Endo, Kunihide Yoshino, Toru Takiguchi, Akiyoshi Yamada, Hiroko ...1986 Volume 37 Issue 2 Pages 154-158
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSMucosal and submucosal esophageal cancer has been defined as superficial cancer of the esophagus. And superficial cancer without metastasis was defined as early cancer of the esophagus. Of 104 cases of superficial esophageal cancer resected in the past twenty years, 62 were early cancer. The operative mortality rate of supeficial cancer was 1.9%. The 5-year survival rate of early cancer was 62%. Only 14 of 104 cases were mucosal cancer cases. 12 of 14 mucosal cancers belonged to early cancer and no vascular invasion was also recognized in 11 cases. There has been no case died of cancer in the early mucosal cancer. So the detection and surgical treatment of mucosal cancer are mandatory to obtain the excellent results. The endoscopic examination has come to a large role for this purpose.View full abstractDownload PDF (521K) -
Yoshiaki Tai, Yojiro Inoue, Kensuke Kiyokawa, Minoru Hirano, Mamoru Oh ...1986 Volume 37 Issue 2 Pages 159-164
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe skin flap for reconstruction of hypopharyngo-esophagus is one of the good tissues functionally.
The problems of the method using skin flaps are the difficulty in primary and one stage reconstruction, the necrosis of skin flaps and the stenosis in anastomosing the skin flap to the esophagus.
In 1981, we studied the new findings of flap and developed the pectoral arcade falp for primary and one stage reconstruction of pharyngo-esophagus.
We experienced 10 cases of this method and recognized the following two excellent result.
1. The esophagus is reconstructed to the level of the second thoracic spine without difficulty.
2. The stenosis in anastomosing the skin flap to the esophagus is not recognized.
The defect of thoracic esophagus is generally reconstructed by the method using the gastric tube or the colon. However, the method using the local flap and the pectoralis major muscle is very effective when the digestive tract is not used.
This method can reconstruct about 90% of the thoracic esophagus with less surgical intervention.View full abstractDownload PDF (7355K) -
Seiichi Ryu1986 Volume 37 Issue 2 Pages 165-168
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSHistochemical change of the laryngeal muscles in experimentally simulated recurrent nerve paralysis were investigated. The recurrent nerve of the dog was damaged under surgical techniques. The laryngeal muscles were removed at 1, 2, 3, 4, 5 and 6th month after surgery and serial section was made using cryostat. Histochemical staining of the section was carried out for the presence of myofibrillar ATPase, phosphorylase, nicotine amidadenin dinucleotid dehydrogenase (NADH) and succinic dehydrogenase (SDH).
Following the removal of the recurrent nerve, the activity of phosphorylase has decreased rapidly and disappeared almost completely within one month after the operation. Activities of NADH and SDH have lowered gradually but not disappeared within 6 months. ATPase activity did not change throughout the period of our observation. When the nerve was crushed, the level of enzyme activity did not change significantly. The enzyme activities in the section of the recurrent nerve also changed. However, the degree of the changes in the section was weaker than that in the removal of the nerve. Grouping of the same type of muscle fibers was observed predominantly in this damage. This finding indicates that misdirection of the recurrent nerve in the laryngeal muscles may occur in patients with recurrent nerve paralysis.View full abstractDownload PDF (2628K) -
1986 Volume 37 Issue 2 Pages 169-191
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
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1986 Volume 37 Issue 2 Pages 192-210
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
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1986 Volume 37 Issue 2 Pages 211-235
Published: April 10, 1986
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSDownload PDF (5161K)
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