巻号一覧
41 巻 (1990)
- 6 号 p. 417-
- 5 号 p. 327-
- 4 号 p. 265-
- 3 号 p. 159-
- 2 号 p. 78-
- 1 号 p. 1-
41 巻, 3 号
選択された号の論文の12件中1～12を表示しています
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柴田 伊十児1990 年 41 巻 3 号 p. 159-168
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーThe change of the mode of respiration by two kinds of artificial nasal occlusion was investigated. For the short term occlusion (less than 2 hours), 6 normal adults with the nasal packing were used as subjects, and for the long term occlusion (24 hours) 30 patients who underwent intranasal small surgery with postoperative nasal tamponade were used. The parameters investigated were: respiration time, tidal volume, closing volume, ventilation equivalent, respiratory exchange ratio, and some others.
The results were as follows. 1. After the short term occlusion, the inspiration time and the tidal volume increased, and the ventilation equivalent decreased, showing the temporary amelioration of respiratory efficiency. 2. After the long term occlusion, on the other hand, the inspiration time, the tidal volume, and the respiratory exchange ratio decreased, while the ventilation equivalent increased. Therefore, the long term nasal occlusion results in decrease of respiratory efficiency. 3. The increase of the closing volume was observed one hour after the nasal occlusion and continued even after the long term nasal occlusion. This suggests the existence of peripheral air way stenosis.
Generally speaking, continuous inspiration of dry air due to the loss of humidifying function of the nose results in the stenosis of peripheral airways by desiccated mucous. Also, the expansion of alveoli becomes insufficient due to the decreased surfactant function.
In the condition of this study, the respiration was inhibited after the short term nasal occlusion, because the nasopulmonary reflex caused by the nasal packing overcame the influence of the loss of humidifying effect.
On the other hand, after the long term occlusion, as the nasopulmonary reflex was already decreased, the respiration was accelerated although the respiratory function was aggravated.抄録全体を表示PDF形式でダウンロード (1883K) -
平林 秀樹1990 年 41 巻 3 号 p. 169-182
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーThe human larynx is an essential organ not only for speech, but also for swallowing and respiration. Its tissues are affected by the presence of alcohol and cigarette smoke. In this report we present our findings on the effects of smoking and drinking on histological changes in laryngeal tissue.
The larynges studied were those of in autopsy patients: cases with damaged tissue were excluded. We studied the larynges of 84 men (non-smoker and non-drinker; 22 cases, smoker and drinker; 62 cases) and 48 women (non-smoker and non-drinker; 40 cases, smoker and drinker; 8 cases) between the ages of 12 and 88.
The squamous metaplasia of laryngeal epithelium was examined using the gross staining method Pyronine Y designed by Stell et al. The squamous epithelium is unstained, whereas the respiratory epithelium is stained with brilliant red.
Microscopic changes of the laryngeal epithelium were investigated using the hematoxylin eosin staining method. The thicknesses of the epithelium in the supraglottic region and vocal cord were measured by TV image processor.
Results: 1) The area of metaplasia in the supraglottic region increased with aging, tobacco and alcohol consumption.
2) The dysplasia were found in the squamous epithelium of the laryngeal surface of epiglottis in heavy drinker.
3) The thickness of epithelium of the supraglottic region and vocal cord increased with age.
4) There is a significant difference in the thickness of the epithelium of the supraglottic region and vocal cords of smoking and drinking patients, when compared with the same tissues of non-smokers and non-drinkers.
5) There is a significant difference in the thickness of the epithelium of the supraglottic region of heavy smokers, when compared with light smokers, but no significant difference when compared with drinkers. However, there is no significant difference in the thickness of vocal cord tissues between light smokers and drinkers, and heavy smokers and drinkers.抄録全体を表示PDF形式でダウンロード (2204K) -
佐々木 裕美, 丘村 煕1990 年 41 巻 3 号 p. 183-188
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーIn order to analyze the movement of vocal folds and the circumferential soft tissue during phonation, we tried to use digital subtraction techniques with digital fluorography system. Digital imaging was performed in 512 x 512, 8 bit matrix resolution at 30 frames per second. As subtraction techniques, continuous image (CI) mode and time interval difference (TID) mode were employed. These techniques were applied to two cases, one with normal larynx and one with unilateral vocal fold paralysis.
The subtracted images provided the moving portion and distance of larynx during phonation clearly. Especially, the movement of vocal folds at the beginning and ending of phonation could be observed in detail. In addition, the vibrations of vocal folds during continuous phonation could be seen with stroboscopic effect.
From these results, the above methods were thought to be useful for analyses of phonatory movement of larynges with some laryngeal diseases.抄録全体を表示PDF形式でダウンロード (857K) -
栃木県内の開業医に対してのアンケート調査の結果について平出 文久, 栫 博幸1990 年 41 巻 3 号 p. 189-195
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーThe authors have questionnaired 67 ENT practitioners in Tochigi prefecture on acute epiglottitis. Several interesting answers have been obtained.
Almost a half of doctors have had an impression that incidence of this disease gradually decreased in recent years.
Eleven per cent of doctors have pointed out that acute epiglottitis occurred more frequently in children than adults. This tendency is noted in U.S.A. and often European countries. However, previous several reports in Japan have indicated that the disease more frequently affects adults than children.
All the doctors (100%) have made a diagnosis of acute epiglottitis by indirect and/or direct laryngoscope, with reference to several characteristic symptoms of the disease.
The majority of doctors have not regarded an incision of the edematously swollen epiglottis as the first choice of the surgical treatment. Penicillins and/or cephems have been most commonly used in cases.
Some doctors have encountered the patients who died because of airway obstruction in the course of the desease.抄録全体を表示PDF形式でダウンロード (1320K) -
高山 悦代, 福田 宏之, 川井田 政弘, 川崎 順久, 酒向 司, 大築 淳一, 井上 泰宏, 富澤 郁子1990 年 41 巻 3 号 p. 196-201
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーVoice disorders to which intracordal injection for vocal rehabilitation can be applied have been expanded by the introdution of collagen. Attention has been focused on intracodal injection as an effective method for rehabilitation. This method is applicable not only to unilateral vocal paralysis, but also cases of insufficient glottal closure, such as sulcus vocalis and vocal atrophy.
Injection of 3% atelocollagen was conducted in 9 cases of sulcus vocalis and one case of postoperative vocal fold scaring. These voice disorders show insufficient glottal closure and problem of vocal fold flexibility.
Following results have been obtained with the study of 10 cases of such disorders: (1) In 80% of cases, vocal fold vibration, hoarseness and tiredness during phonation were improved. (2) In cases where the symptoms improved, the maximum sustained phonation time was prolonged. However the mean flow rate decreased in some cases and increased somewhat in others. (3) In cases where the symptoms were aggravated, the injection of DMPS had been carried out within one year previous to the operation.抄録全体を表示PDF形式でダウンロード (709K) -
換気量, 換気時間, 血液ガスの検討宇野 功, 大森 研史, 宮宗 彰, 柴田 伊十児, 高橋 宏明1990 年 41 巻 3 号 p. 202-210
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーIn the field of respiratory physiology, it seems interesting to evaluate the change of respiratory pattern as the results of alteration of the respiratory route before and after the closure of tracheostoma.
Tracheostomized patients breathe without the upper airway such as the nose, the mouth and the larynx. When tracheostoma is closed, the patients are suddenly forced to breathe through the upper airway. As the result, an anatomical dead space, a respiratory resistance and a humidifying function are added to their airway abruptly. The purpose of this study was to examine the above-mentioned change of respiratory pattern before and after the closure of tracheostoma.
The subjects were seven tracheostomized patients with normal lung function. Tidal volume, respiration time and blood gases were measured before and just after, 1 hour and 2 hours after the closure of tracheostoma.
The results were as follows: 1) When tracheostoma was closed, tidal volume and respiration time increased and respiratory minutes volume tended to decrease gradually in the course of time. 2) While Pao2 did not change in the course of time before and after the closure of tracheostoma, Paco2 was increased slightly after the closure and the value continued in 2 hours almost constantly.
These changes were statistically significant except for minutes volume.
It is obvious that the anatomical dead space increases when the tracheostoma is closed. As the results, the efficiency of ventilation would decrease.
Our results showed, however, Pao2 did not decrease after closing the tracheostoma. On the other hand, respiratory minutes volume tended to decrease, and Paco2 increased just after the closing it and the value continued constantly for two hours.
These results confirm that the ventilatory efficiency would be improved sometimes after the closure of tracheostoma in spite of the increased dead space, suggesting that the humidifying function and the resistance of the upper airway play a significant role in the respiration.抄録全体を表示PDF形式でダウンロード (1537K) -
藤沢 勉, 越井 健司, 平林 秀樹, 宇野 浩平, 大垣 治幸, 仲宗根 康二, 日野原 正1990 年 41 巻 3 号 p. 211-217
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーThe therapeutic procedures with Celestin dilator were performed on postoperative strictures of the Hypopharynx and Esophagus. Twenty trans-oral dilatation procedures were performed on 9 patients with esophageal strictures.
For the case of the hypopharyngeal and esophageal stricture, success rates for this technique averaged 77.7% defined as the resolution of dysphagia and besides X-ray examination showed obviously the dilatation. Efficacy of the dilatation was influenced by the local condition of disease, but strictures with a diameter as small as 4 mm and as long as 12 mm could be fully expended with a single treatment. With multiple applications, these procedures can be extended to treat strictures with a diameter of 2 mm and a total length of up to 22 mm. In one of the nine patiants, there was a complication of a small perforation in the postoperative suture, but it naturally closed one week late. It is cosidered, that in this case, the procedure was performed too early after operation. If the procedure is performed at least 30 days after operation, and the stricture isn't excessively dilated, it will be possible to avoid complications.
The procedures with Celestin dilator can be safely and easily applied to esophageal strictures of a variety of causes, with a high degree of clinical success. Celestin dilator treatment for the hypopharyngeal and esophageal strictures must, however, be coupled with appropriate medical management to optimize the clinical response.抄録全体を表示PDF形式でダウンロード (4244K) -
鈴木 衛, 郷原 良治, 浜村 宣宏, 永沢 昌, 夜陣 紘治, 田頭 宣治, 原田 康夫, 有木 健, 弓劇 孟文1990 年 41 巻 3 号 p. 218-223
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーA rare case of childhood bronchial mucoepidermoid carcinoma is reported. The patient is a 9-year-old girl who had been suffering from intermittent cough and high fever for several weeks. The chest X-ray showed pulmonary emphysema on the right side and the tomogram showed a smooth mass obstructing the right main bronchus. She was referred to our clinic on March 17, 1989 under suspicion of foreign body incarcerated in the right main bronchus. Emergency bronchoscopy was performed under general anesthesia. A round mass almost totally obstructing the right main bronchus was identified through the bronchoscope. Because of difficulty in removing the entire mass, inferior bronchoscopy was indicated. The round mass with the diameter of 6 mm was removed through the bronchoscopy. During the procedure the patient suffered from dysoxigenation and cyanosis developed. This was followed by gradual decrease in the heart rate and finally cardiac arrest. Despite intensive resuscitative care at ICU, she remained unconscious with all the deep reflexes disappeared. She died 13 days after the procedure. Histopathological diagnosis of the removed mass was mucoepidermoid carcinoma. At autopsy, a tumor with partial necrosis was found in the posterior wall of the right main bronchus which extended toward the carina. Otolaryngologists must be aware of bronchogenic neoplasm in cases with persistent respiratory symptoms.抄録全体を表示PDF形式でダウンロード (5890K) -
佐藤 博信, 村山 公, 鈴木 武樹, 大塚 善久, 森洋 幸, 大槻 穣治, 武谷 克重, 田中 隆1990 年 41 巻 3 号 p. 224-229
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーbronchogenic neoplasm in cases with persistent respiratory symptoms. bronchogenic neoplasm in cases with persistent respiratory symptoms. esophageal rupture, only had drainage of the mediastinum and died on the 3rd and the 15th postoperative day, respectively. The patients who recoverd after surgery had primary repair with a fundic patch within 10 hours to 15 days from onset of the sumptoms. The importance of eary and correct diagnosis, and the advantages of the fundic patch method for the treatment of spontaneous rupture of the esophagus are emphasized.抄録全体を表示PDF形式でダウンロード (2513K) -
折田 浩, 折田 洋造, 秋定 健1990 年 41 巻 3 号 p. 230-235
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーWe report a case of asymptomatic tubular esophageal duplication that was discovered incidentally. A 60-year-old man was hospitalized for investigation of the sudden onset of dyspnea. Under esophagography, a tubular outline was noted both in the cervical and the mid-esophageal regions. Tubular walls were endoscopically observed at a distance of 24 cm and 34 cm from the upper incisors of which diameters were respectively, 15×10 mm and 8×10 mm. Thus, the diagnosis of esophageal duplication was confirmed. Biopsy was not performed. A esophageal duplication that remains asymptomatic since birth and has the specific tubular pattern as seen in this case is extremely rare.抄録全体を表示PDF形式でダウンロード (4563K) -
川崎 順久, 福田 宏之, 辻 ドミンゴス浩司, 塩谷 彰浩, 高山 悦代, 川井田 政弘1990 年 41 巻 3 号 p. 236-240
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーRecently CO2 laser surgery has been employed for Ti glottic cancer to avoid side effects caused by irradiation. However phonatory disturbance caused by post-operative anterior glottic web is sometime troublesome to patients. In this study, a survey of 17 patients with Ti glottic cancer, whose anterior comissure was vaporized with CO2 laser, was reviewed. In eight cases among them, anterior glottic web was observed during post operative course. Hence, we applied the fibrin glue (Tisseel) on the vaporized wound in 4 cases of Ti glottic cancer to avoid post-operative anterior glottic web. Post-operative wound healing of vocal folds were excellent in each cases. In the cases of anterior comissure involvement, the fibrin glue is applicable adjunct for prevention of anterior glottic web with CO2 laser surgery.抄録全体を表示PDF形式でダウンロード (3656K) -
高須 昭彦1990 年 41 巻 3 号 p. 242-243
発行日: 1990/06/10
公開日: 2010/10/20
ジャーナル フリーPDF形式でダウンロード (397K)
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