巻号一覧
38 巻 (1987)
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38 巻, 4 号
選択された号の論文の11件中1～11を表示しています
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岸本 誠司, 竹内 俊二1987 年 38 巻 4 号 p. 343-347
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーThe purpose of this paper is to present our diagnostic procedures for the patients with abnormal sensation in the throat. Results of thorough examinations of 141 patients were analyzed. The results showed that the most importance was careful palpation in the pharyngeal cavity including the epipharynx and on the neck. Careful attention was necessary to seek for the coincident point where the patient felt the abnormal sensation. By the palpation and supplemental radiological and laboratory examinations, local organic lesions were detected in 111 out of 141 patients (79%). Referred areas for the organic lesions were defined. The conspicuous were the elongated styloid process to the great hone of the hyoid, and the thyroid disorders to the thyroid area. We would stress on that most of the patients with abnormal sensation in the throat have organic lesions.抄録全体を表示PDF形式でダウンロード (2470K) -
走査電顕法による観察渡辺 繁, 小林 武夫, 平野 寛1987 年 38 巻 4 号 p. 348-351
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーThe fiber arrangement of the normal left-sided recurrent laryngeal nerve at the level of second to eighth tracheal cartilage was examined mainly by SEM after the removal of connective tissue components of surrounding the nerve fibers. Formalin-fixed specimens were taken by autopsy from eight individuals, then refixed with glutaraldehyde, hydrolyzed with hydrochloric acid (HCl), digested with collagenase, and processed for SEM observation.
Extracellular materials such as fibroblasts and collagen fibers were completely digested, and each nerve fiber was exposed and clearly visible under the SEM. The nerve bundles were composed of parallel running and slightly wavy fibers which practically lacked anastomosis. Fibers with Ranvier's nodes were occasionally observed and definitely identified as the myelinated type. However, its accurate ratio in the recurrent nerve was not yet determined in the present study.
By means of SEM in combination with the digestion method (Evan et al., 1975), it was quite easy to obtain the precise stereoscopic image of the course and arrangement of the normal human recurrent laryngeal nerve fibers. This method will be useful to detect pathological changes, such as post-paralytic, misdirected innervation, and neurinoma.抄録全体を表示PDF形式でダウンロード (7045K) -
森 一功, 深澤 達也, 土師 知行, 本庄 巖1987 年 38 巻 4 号 p. 352-355
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーUsing micro-computer both normal and hoarse voices were analyzed by the frequency perturbation and the noise intensity (Br-index) defined as the summation of squared second order differentiations of the voice wave normalized by the summation of the wave powers.
Br-index correlated with the auditory impression at a 0.5% significant level and were thought to be an objective evaluation of the hoarse voice.
With regard to low-grade hoarse voice, Br-index was more sensitive than frequency perturbation, so Br-index was proved to be a clinically useful method of discriminating hoarse voice.抄録全体を表示PDF形式でダウンロード (425K) -
作 和明, 森満 保, 永井 知幸, 永井 みどり, 井手 稔, 東野 哲也, 牧野 浩二, 安達 裕一郎1987 年 38 巻 4 号 p. 356-360
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーIn this paper, the postoperative functions of the new larynx operated on with hyoid transposition laryngoplasty will be reported. Thirteen of 16 operated cases were examined in their swallowing, nasal respiration and phonetical functions. All cases had no difficulty in usual dietary life, although 7 cases have a fit of coughing with fluid occasionally. Nasal respiration was possible only in 3 cases and in one of them his tracheostoma was closed. In 7 cases, nasal respiration was possible, although they could not continue it over few minutes. Twelve cases were possible to speak with good articulation. In one case phonation was a little difficult because of stenosis of the new larynx. Phonetical examinations were made in 11 cases. Maximum phonation time was distributed between 2.5sec and 10.5sec. Mean exspiration score was distributed between 400ml/sec and minimum. Speaking fundamental frequency was distributed between 200Hz and 60Hz. Voice intensity was distributed between 96dB spl. and 77dB spl. From the results obtained, some surgical techniques for improvement, especially in nasal respiration, were discussed.抄録全体を表示PDF形式でダウンロード (4325K) -
田中 克彦, 末永 通, 大橋 正實, 吉村 理, 佐藤 信清1987 年 38 巻 4 号 p. 361-365
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーVocal rehabilitation of laryngectomized patients by means of TE shunt operation became popular in recent years. Since many of the candidates of this operation are heavily irradiated before the surgery, it appears important to evaluate the risk of the irradiation to such operation properly.
In this communication, we report the retrospective evaluation of TE shunt operation performed in 16 patients who received 65Gy or 40Gy preoperatively. The surgical procedure used was mostly the modified Amatsu method. By this procedure, the duct as the inlet of the air was made by the tracheal wall containing cartilage rings, instead of the tracheal mucosa only.
Minor wound complication occurred in 3 of 10 patients with 65Gy irradiation but this did not ruin the shunt. Twelve patients (75%) acquired satisfactory phonation after the surgery but 4 failed because of obstruction of the shunt. The aspiration inherent to this operation was generally acceptable, though 5 out of 16 patients (31%) complained slight leakage of the fluid. Our results show that TE shunt operation is safe enough in those who received high-dose irradiation preoperatively.抄録全体を表示PDF形式でダウンロード (665K) -
狩野 季代, 安達 裕一郎, 井手 稔, 永井 知幸, 森満 保, 東野 哲也, 松元 一郎1987 年 38 巻 4 号 p. 366-373
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリー1. One hundred and three cases of trachea-bronchial and esophageal foreign bodies treated in Miyazaki Medical College and Miyazaki Prefectural Hospital during the past nine years were statistically analyzed and reported.
2. In regard to the esophageal foreign bodies, coins ranked first and followed by fish bones and pieces of meat. Sixty percent of foreign bodies were radiolucent.
3. In regard to the tracheo-bronchial foreign bodies, beans were found in seventy percent of cases. Unexpectedly, the foreign bodies were lodged in the left bronchus 2.5 times more frequently than in the right bronchus.
4. Effectiveness of capsule esophagography and pulmonary scintigraphy was evaluated in cases of radiolucent foreign bodies.抄録全体を表示PDF形式でダウンロード (5333K) -
太田 久彦1987 年 38 巻 4 号 p. 374-384
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーCold environment may alter cardiopulmonary function. The alteration of pulmonary blood flow (QC), respiratory water loss (VH2O), convective heat loss (CHL) and respiratory heat loss (RHL) were studied with subjects exposed to cold environment (5°C) and to thermoneutral environment. QC varied according to posture (supine, sitting and standing) and there was no significant difference between cold and thermoneutral temperature at the same posture. Apparently cold exposure of short duration had no effect on QC At the same temperature, QC was larger in the supine position than in the other positions.
Before, during and after stepwise exercise in normal subjects, there was no significant difference in QC between cold and thermoneutral temperature.
CHL increased significantly during stepwise exercise in the cold environment in compared with those at the thermoneutral temperature, however, VH2O and RHL also increased no significant degree. At both temperatures, VH2O, CHL and RHL increased during exercise in compared with those before exercise. RHL was elevated according to the increment of ventilation, and this elevation was more marked in the cold environment.抄録全体を表示PDF形式でダウンロード (1472K) -
陳旧性肺結核症例について上出 洋介, 部坂 弘彦, 森山 寛, 本多 芳男, 大西 俊郎1987 年 38 巻 4 号 p. 385-390
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーWe report three cases of recurrent nerve paralysis which was associated with old pulmonary tuberculosis. We considered that the causes of these paralysis were not only due to fibrosis and shift of intrathoracic organs, but also due to pulmonary hypertension and dilatation of the pulmonary artery which had been caused by secondary pulmonary fibrosis.
Many authors described old pulmonary tuberculosis as a cause of recurrent nerve paralysis. These authors have indicated that simple traction or compression of the recurrent nerve by fibrous changes in the thorax had been the sole cause of the recurrent nerve paralysis. But in our cases, it was most probable that dilatation of the pulmonary artery had compressed the left recurrent nerve against the aortic arch.
In one autopsy case (74-year-old male), no fibrous changes along the left recurrent nerve and vagus nerve were seen. Instead, right atrial and ventricular enlargements were seen.
In the second case (75-year-old female), dilatation of pulmonary artery was observed both in chest X-ray films and enhanced CT scan.
In the third case (55-year-old male), left recurrent nerve paralysis appeared immediately after an acute heart failure. Only in this case, the nerve paralysis improved 4 months later.抄録全体を表示PDF形式でダウンロード (6541K) -
山下 弘幸, 西原 一善, 杉谷 篤, 尾畑 秀明, 川上 克彦, 村上 栄一郎, 奥村 隆司, 酒井 俊一1987 年 38 巻 4 号 p. 391-394
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーWe report here a case of esophageal cancer developed in a 64-year-old male patient who had received total laryngectomy and Amatsu tracheoesophageal shunt operation (T-E shunt) for laryngeal cancer five years ago.
The patient was admitted for thoracic (Im) esophageal cancer to our department. At the admission he could speak well using T-E shunt and food had not wrongly gone down through T-E shunt until he noticed difficulty of swallowing.
Thoracic esophagectomy and upper part gastrectomy were performed, and reconstruction was done retrosternally by end-to-end esophago-colonostomy using the left colonic vesicle with preserving the T-E shunt.
Postoperatively choking with food through the shunt occurred so often that surgical closure of the shunt was decided. It was thought that postoperative choking with food through the shunt had been caused by deviation of cervical esophagus from posterior mediastinum toward anterior mediastinum resulting from retrosternal reconstruction after removal of thoracic esophagus.
This experience inspired us to examine surgical procedures for esophageal cancer in patients with T-E shunt after total laryngectomy.抄録全体を表示PDF形式でダウンロード (4242K) -
吉岡 博英, 原 誠, 工藤 裕弘1987 年 38 巻 4 号 p. 395-398
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーA newly designed DMPS block prosthesis is described, which achieves successful protection of the residual teeth against iatrogenic damage during peroral endoscopy. This dental guard is exclusively warranted for those patients whose residual upper dentition is at high risk because of the missing of central and/or lateral incisors. Its clinical advantages include the distribution of tension from the scope against the hard palate, minimizing stress on the residual teeth. A typical case is also demonstrated.抄録全体を表示PDF形式でダウンロード (2954K) -
岡安 大仁1987 年 38 巻 4 号 p. 400-401
発行日: 1987/08/10
公開日: 2010/02/22
ジャーナル フリーPDF形式でダウンロード (275K)
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