巻号一覧
42 巻, 1 号
選択された号の論文の10件中1～10を表示しています
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古沢 慎一, 金子 功, 原田 宏一, 古川 浩三, 樋口 彰宏, 岡本 牧人1991 年 42 巻 1 号 p. 1-6
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーTreatment of tracheobronchial foreign bodies and thier complications were clinically studied in 81 cases in the ENT clinic of Kitasato University Hospital from 1971 to 1990.
The results were as follows:
1) The patient's age and the degree of the skill to perform bronchoscopy do not affect on the time which is necessary for removal of foreign bodies, and on the anesthetic time.
2) Among the cases with long term hospitalization, it is easy to find the cases with reexamination and tracheotomy.
3) The foreign body in the bronchus for the longest duration about one year was a gold dental cap.
4) Tracheotomy was needed to remove a foreign body and to keep the air way in 4 cases.
5) Thoracotomy was performed in one case aged one year and 8 months girl.
6) One case who transported to the clinic, died 3 days after the removal of the foreign body.抄録全体を表示PDF形式でダウンロード (1177K) -
二宮 優子1991 年 42 巻 1 号 p. 7-19
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーAspiration of gastric contents induces not only severe pneumonitis but also large airway damages. This study is designed to elucidate which component of gastric juice is responsible for damage of the tracheal mucosa. Forin vivostudy, human gastric juice with bile (pH 4.0 and 1.5), human gastric juice without bile (pH 1.2), pepsin solution and hydrochloric acid were injected into the trachea of rats. Forin vitrostudy, the extracted tracheas were incubated in human gastric juice with or without bile, human duodenal juice and hydrochloric acid. After the treatment, the morphological changes were observed by scanning and transmission (ruthenium red staining) electron microscopy. The tracheal damage induced by injection of gastric juice with bile showed spotty desquamation of the epithelial cells, remaining the basement membrane. On the other hand, the trachea injected of gastric juice without bile showed only an increase of secretion and destruction of junctional complex and cell membrane. The effect induced by pepsin solution showed milder desquamation as compared with gastric juice with bile. However, hydrochloric acid caused no pathological change. These findings were well comparable to those of thein vitroexperiment.
As a result, pepsin and bile acids in the gastric juice are most responsible for the damage of the tracheal mucosa in rats.抄録全体を表示PDF形式でダウンロード (1468K) -
倉科 桂司, 佐々木 巌, 大塚 健蔵, 吉沢 孝之, 赤柴 恒人, 堀江 孝至1991 年 42 巻 1 号 p. 20-26
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーWe examined the risk factors of sleep apnea syndrome (SAS) with 64 patients (59 males and 5 females) who referred to our hospital complaining of heavy snoring, excessive daytime sleepiness and breathing abnormalities during sleep. All patients underwent the questionnaire including the habit of smoking and drinking, onset of snoring and apnea during sleep, and also were examined clarify the degree of apnea with apnomonitor for two consecutive nights. According to the apnea index (A.I.) by the analysis of apnomonitor recording, they were divided into two groups, SA positive (A.I. ≥5no. /hour, n=44) and SA negative (A.I. <5no. /hour, n=20). Mean age was significantly higher in SA positive group (51.0±11.8 years old) than in SA negative group (43.0±12.9 years old). In SA positive group, A.I. was significantly and negatively correlated with age (P<0.01) and onset time of snoring and apnea (P<0.02). Smokers and everyday drinkers were more susceptible to Sleep Apnea significantly (P<0.05). Additionaly hypertension, liver dysfunction and proteinuria were more common in SA positive group.抄録全体を表示PDF形式でダウンロード (1288K) -
藤田 博正, 井上 要二郎, 田中 信三, 掛川 暉夫, 山名 秀明, 白水 玄山, 南 泰三, 田井 良明, 平野 実1991 年 42 巻 1 号 p. 27-34
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーAn esophageal reconstruction using a free bowel graft following pharyngolaryngoesophagectomy for a carcinoma involving the pharynx or cervical esophagus can be termed“typical”free gut transfer, while other types of reconstruction using a free bowel graft can be termed“atypical. ”During the period from 1988 to 1989, we have experienced 23 cases of free gut transfer in our hospital. Twelve cases of these underwent typical operation. An atypical operation was performed in 11 cases involving 4 cases of a carcinoma of the hypopharynx or cervical esophagus, 3 cases of a recurrence following esophagectomy for a carcinoma in the thoracic esophagus, one case of a carcinoma in the esophagus at the cervicothoracic junction, one case with cervical esophagostomy following esophagectomy for a carcinoma in the thoracic esophagus, one case of recurrence following chemotherapy for a breast carcinoma, and one case of pharyngoesophageal corrosive stricture. From our experience of atypical free gut transfer, we conclude that the free gut transfer is useful for the reconstruction of various types of a pharyngoesophageal defect. Also we conclude that the cervical transverse artery and the external jugular vein as the recipient vessels in the neck are most convenient, and the thoracoacromial artery and the cephalic vein are most convenient in the anterior chest wall. Important postoperative complications involved aspiration pneumonia in cases preserving the larynx, dysphagia in cases with free graft of the long intestine, and graft failure due to a vascular obstruction. However, these complications could be avoided with improvement in the operative indications, the procedures and techniques employed.抄録全体を表示PDF形式でダウンロード (1726K) -
田山 二朗, 村上 泰, 水野 正浩, 野村 恭也, 近藤 玲子, 川端 五十鈴, 新美 成二, 廣瀬 肇1991 年 42 巻 1 号 p. 35-39
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーThis paper concerns with a case with severe dysphagia and dysphonia caused by removal of a carotid body tumor. The patient, a 33-year-old female, was operated on for the removal of the right carotid body tumor. Since the operation, she had been suffering from severe misdiglutition associated with nasal leakage of liquid and severe dysphonia. Six months after operation, she was referred to our clinic. Clinical examinations revealed that her right IXth, Xth, XIth and XIIth cranial nerves were paralyzed so that hemiatrophy and deviation of tongue, incomplete closure of the velopharyngeal port, poor constriction of the pharynx and right vocal cord fixation at the intermediate position could be the contributing factors for her complaints. In order to get complete closure of the glottis and to reduce the resistance of the esophageal entrance, medio-fixation of the right vocal cord (arytenoid rotation) with the cricopharyngeal myotomy was performed. Then, to get a tight sealing of the velopharyngeal port during swallowing, a pharyngeal flap operation was done. A small amount of silicone gel was injected to her paralysed vocal cord to improve her voice quality. After these“multisurgical”treatments, her swallowing and phonation ability improved satisfactorily.抄録全体を表示PDF形式でダウンロード (1675K) -
滝元 徹, 吉崎 智一, 大尾嘉 宏巳, 坂下 英雄1991 年 42 巻 1 号 p. 40-43
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーWe presented an extremely rare case of acquired complete fourth branchialfistula in a 23-year-old male. The characteristic clinical feature was a recurrent left neck abscess at the left lateral neck which did not respond to appropriate medical and surgical therapies. Barium meal roentogengram revealed a fistula running from the apex of the left piriform sinus. The fistula was surgically excised. Histological examination of the excised fistula revealed a squamous epithelial lining and subepithelial lymphoid tissue.抄録全体を表示PDF形式でダウンロード (1514K) -
秋山 義彦, 細川 芳文, 森田 祐二, 萩原 照久, 山口 道也, 堀江 孝至, 岡安 大仁, 大畑 正昭, 大森 一光, 伊良子 光正, ...1991 年 42 巻 1 号 p. 44-48
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーA 63-year-old man visited our hospital with a complaint of recurrent pneumonia in right upper lobe (S2). Bronchofiberscopy was carried out and a polypoid tumor was detected at the orifice of right B2.
The histological examination of biopsy specimens revealed the atypical cell infiltration in the bronchial mucosa. However it was not unclear whether the polypoid tumor was malignant or not. Therefore surgical approach was chosen to obtain the difinite diagnosis and then the right upper lobectomy was performed.
The histopathological study of the ressected lung indicated the inflammatory pseudopolyp.
Inflammatory pseudo-polyp is relatively rare disease in comparison with tumor polyp, and it is quite important to differentiate from malignant tumor.
It might be suggested that the bronchofiberscopy should be performed when a patient has experienced the recurrent pneumonia in the same pulmonary region.抄録全体を表示PDF形式でダウンロード (4388K) -
木西 實, 天津 睦郎, 田原 真也, 細見 慶和, 松森 正之, 渡部 宜久1991 年 42 巻 1 号 p. 49-53
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーStevens-Johnson syndrome is characterized by acute onset, high fever and extensive involvements of the skin, mucosa and eyes. Although mucosal lesion is frequently seen in oropharyngeal, ocular, anal and urogenital area, esophageal lesion is rare. Only 11 cases have been reported in the literature.
A 65 year-old male was diagnosed as Stevens-Johnson syndrome by sudden onset of erythematous eruption and mucosal involvements of oral and ocular areas. He could not swallow liquids or foods at all during more than 1 year after the onset because of progressive dysphagia and frequent aspiration pneumonia due to cervical esophageal stricture detected by a barium swallow and endoscopy. Attempts to pass catheters into the esophagus were unsuccessful. A free jejunal graft was interposed between the left pyriform sinus and intact cervical esophagus preserving the larynx. Postoperative course was uneventful and the patient started to swallow on the 16th postoperative day and developed to take a regular diet at 2 months after the operation.
The pathologic involvements of the esophagus with Stevens-Johnson syndrome were bibriographically reported only in 11 patients. Initial descriptions of esophageal lesion were postmortem findings. Stein et al. first reported the esophageal stricture located in the distal esophagus. Conservative therapy with subsequent dilatations and antiacids allowed the patient to take a regular diet. The successful reports of dilatations for esophageal stricture were followed by Peter et al. and Howell et al. The case presented here is the first patient treated surgically with free jejunum interposition for esophageal stricture associated with Stevens-Johnson syndrome.抄録全体を表示PDF形式でダウンロード (2139K) -
小坂 和子, 村山 公, 笠倉 雄一, 山崎 猛, 佐藤 博信, 田中 隆1991 年 42 巻 1 号 p. 54-58
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーA 57-year-old female was admitted because of dysphagia. Esophagogram showed tumorous carcinoma at the lower third of the intrathoracic esophagus. The right hilar lymphnode swelling was recognized on the chest X-ray. The patient had a few flat ruber tetter on he cheak. Through the right thoracolaparotomy, subtotal esophagectomy, and lymphnode dissection were performed. Histologically, the specimen showed well differentiated squamous cell carcinoma. Epithelioid cell glanulomas with giant cells were observed in lymphnodes of the mediastinum, intraabdomen and skin lesion. In mediastinal lymphnodes, metastasis associated with squamous cell carcinoma and sarcoid glanuloma were mixturelly detected. The coexistence, associated with esophageal carcinoma and sarcoidosis is rare. There was only two case reports in Japan.抄録全体を表示PDF形式でダウンロード (467K) -
塩谷 彰浩, 福田 宏之, 川崎 順久, 川井田 政弘, 辻 ドミンゴス浩司, 酒向 司, 牧野 克巳, 高山 悦代, 加納 滋1991 年 42 巻 1 号 p. 59-65
発行日: 1991/02/10
公開日: 2010/10/20
ジャーナル フリーIt is very important to maintain the adequate stiffness of the vocal folds on phonosurgery. When the surgical procedure reaches to the deep layer of the lamina propria or the vocalis muscle, dysphonia tends to occur because of scar formation.
Chronic experiments using canine larynges were performed to clarify the usefullness of the fibrin tissue adhesive (Tisseel-kit®) for the wound healing.
After removing the mocosa of 2mm in depth on the bilateral side of the canine vocal folds, the fibrin tissue adhesive was applied to the one side. After 1, 2, 3, and 5 weeks, following procedures were carried out: (1) laryngomicroscopic observation of the vocal folds (2) resection of the larynges (3) recording of the vocal fold vibration with an ultra high speed camera (4) analysis of the vocal fold vibration by using a film motion analizer (5) histopathological study.
The results were summarized as follows: (1) Good epithelization was observed on both sides laryngomicroscopically. (2) Better vibration of the vocal fold was observed on the adhesive applied side. (3) In contrast to marked fibrosis on the non-applied side, loose fibrosis and granulomatous lesion were observed on the applied side.
Our results suggest the fibrin tissue adhesive might have good effect on the wound healing of the vocal fold.抄録全体を表示PDF形式でダウンロード (4219K)
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