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Volume 44, Issue 1
Displaying 1-11 of 11 articles from this issue
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Species VariationReizou Ohgi, Insung Nahm, Tadatsugu Maeyama, Takemoto Shin1993 Volume 44 Issue 1 Pages 1-7
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThis study was carried out to determine the different densities in laryngeal intraepithelium of substance P (SP) and calcitonin gene-related peptide (CGRP) immunoreactive (IR) nerve fibers in the dog, rat, guinea pig and cat. In the supraglottic and subglottic regions, the densities of SP and CGRP IR nerve fibers occured in decreasing order as follows: dog, rat, guinea pig and cat. Only a few fibers were found in the vocal folds of all species. We observed a greater density of CGRP IR nerve fibers than SP in all the animals studied. It was suggested that the difference in the distribution of SP and CGRP IR nerve fibers is related to differences in the sensory and reflex system of the larynx.View full abstractDownload PDF (11588K) -
Koji Nakano, Yasuhiro Samejima, Keisuke Masuyama, Kazuaki Chikamatsu, ...1993 Volume 44 Issue 1 Pages 8-13
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSFrom 1981 to 1990, we have experienced 46 cases with tracheo-bronchial foreign body. Twenty nine out of these were male (63%), and age of 41 cases (89%) was under 3 years. Twenty seven cases (58.7%) had aspirated peanuts.
Foreign bodies were found under direct bronchoscopy in the larynx or the trachea of 10 cases, in the right bronchus of 22, and in the left bronchus of 17 cases. Auscultation revealed a decreased sound unilaterally in the lung in 29 cases (63.0%) that was concordant with the side containing the foreign body in 78.9%. In radiorogical diagnosis, emphysema and atelectasis were found in 14 cases (30.4%) and in 13 cases (28.3%), respectively. These were concordant with the side existing the foreign body in 92.3% and 71.4% of the cases, respectively. Foreign bodies were removed by means of a ventilation bronchoscope (Jackson: 23 cases, Machida FS-VB 250:23 cases) under general anaesthesia. The FS-VB 250 made it easier to remove the foreign bodies, resulting in a saving of operation time when compared to Jackson's ventilation bronchoscope.View full abstractDownload PDF (748K) -
Kazuaki Chikamatsu, Yasuhiro Samejima, Keisuke Masuyama, Koji Nakano, ...1993 Volume 44 Issue 1 Pages 14-19
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe reported on eleven cases with postintubation granuloma. Six cases were male, and five female. The ages ranged from 7 to 68 years, with a mean age of 38 years. Laryngeal granuloma was found on the vocal process of the arytenoids in 3 cases, and in the subglottic space in 2 other cases.
In this paper, we described in detail one of case with laryngeal granuloma whose granuloma developed from the bilateral vocal cords adhering at the midline. Six cases other than those with laryngeal granuloma suffered from intratracheal granuloma. Four out of these were found surrounding the stoma and one above the bifurcation of trachea. Another case with granuloma on the bifurcation gave us much trouble with bleeding during LASER surgery, which is described in detail in this paper.
It should be noted that LASER therapy with careful management was useful in the surgical treatment of laryngeal and bronchial granuloma.View full abstractDownload PDF (5491K) -
Yuki Fujiwara, Noriya Kakitsuba, Hiroaki Takahashi, Ryuichi Kanai, Tat ...1993 Volume 44 Issue 1 Pages 20-26
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSPolysomnography (PSG) is essential in diagnosing patients with obstructive sleep apnea syndrome (OSAS). This test is, however, too complicated to use with all patients. Therefore, we must select patients as examinees.
We performed mesopharyngometry as a method of screening patients suspected of OSAS.
There were 53 subjects in the normal group, 112 in the snoring group and 18 in the OSAS group.
The mesopharyngometry involved measurements of the uvula, posterior palatine arch and fauces. The palatine tonsil, lateral pharyngeal folds and tongue, which are impossible to measure directly, were evaluated by scoring according to Mackenzie's classification and our own classification.
All examined parameters differed significantly between the groups. The OSAS group had a longer and wider uvula than the normal group or the snoring group. The width of the posterior palatine arch, the size of the palatine tonsil and the lateral pharyngeal folds were also larger in the OSAS group. A swollen tongue narrowed the oral cavity in the OSAS group.
With mesopharyngometry, the site of the obstruction at the tongue base and larynx cannot be detected. However, in combination with CT scan and cephalometry, identification of the site of stenosis in the upper airway will be possible with much greater accuracy, and our ability to select patients suspected of OSAS will improve.View full abstractDownload PDF (1968K) -
Satoshi Nonaka, Tokuji Unno1993 Volume 44 Issue 1 Pages 27-33
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSVomiting is a nonrespiratory behavior during which the major respiratory muscles contract in a characteristic pattern which generates changes in the intrathoracic and intra abdominal pressures that lead to expulsion of gastric content. During vomiting, the major inspiratory muscles (the diaphragm and the external intercostal) co-contract with the expiratory abdominal muscles in a series of activity bursts.
The question arises whether brain stem respiratory neurons are involved in the control of these muscles during vomiting. In the present study, we undertook to determine whether bulbospinal inspiratory neurons in the dorsal respiratory group (DRG) and in the para-ambiguus region of the ventral respiratory group (VRG), together with the upper cervical inspiratory propriospinal neurons, are important for activation of the diaphragm and external intercostal muscles during vomiting. To analyze the behavior of these neurons, we elicited “fictive vomiting” using either emetic agents or electrical stimulation of the supradiaphragmatic vagal nerve afferents in decerebrate paralyzed cats. This fictive vomiting was identified by a characteristic series of bursts from coactivation of the phrenic nerve and some other nerves innervating abdominal muscles, which would be expected to produce an expulsion of gastric contents in nonparalyzed animals.
Only a few (<10%) bulbospinal DRG and VRG inspiratory neurons were found to have a response capable of initiating a discharge of the phrenic and external intercostal motoneurons during fictive vomiting. In contrast to the behavior of the bulbospinal inspiratory neurons, more than one-half of the upper cervical inspiratory propriospinal neurons were active in phase with the phrenic discharge during fictive vomiting. These results indicate that the DRG and VRG bulbospinal inspiratory neurons do not make a major contribution to the activation of the major inspiratory muscles, and that the upper cervical inspiratory neurons may be one candidate for the activation of these inspiratory muscles during fictive vomiting.View full abstractDownload PDF (1070K) -
Noboru Sakai, Mitsugu Kawanami, Tsuyoshi Takasu, Naoaki Terakura, Masa ...1993 Volume 44 Issue 1 Pages 34-37
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSIsshiki Thyroplasty Type I, a surgical procedure to medialize a paralyzed vocal cord through a window made in the thyroid lamina, has been widely performed to improve hoarseness and misdeglutition in cases of unilateral recurrent nerve paralysis. The medialization of the vocal cord is usually obtained by the insertion of a silicone shim through the window, but the trimming of the silicone is troublesome, and the operation cannot be done without silicone. Thus, we recently devised a new method using a fragment of cartilage instead of silicone. In this method, a vertical portion of the rectangular cartilage removed from the window in the thyroid lamina was inserted between the thyroid cartilage and the endochondrium at the level of the window and was fixed with fibrin glue. This procedure is easy to perform and does not necessitate silicone. Two cases with good results using this method were reported.View full abstractDownload PDF (509K) -
Michiya Satoh, Satoshi Kitahara, Etsuyo Tamura, Yohko Hanyu, Masami Og ...1993 Volume 44 Issue 1 Pages 38-42
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA mutational voice disorder was treated with Thyroplasty Type III. A 29-year-old male, whose chief complaint was his inability to lower his vocal pitch, had no laryngeal prominence in the anterior cervical region on inspection, and the angle formed by the lateral plates of the thyroid cartilage was markedly large and the plates themselves were palpated flat, thin and soft. Image diagnosis also showed an abnormally shaped thyroid cartilage. The mutational voice disorder was thought to be due to this abnormally shaped thyroid cartilage.
Voice therapy was initiated to lower the patient's speaking pitch range of 285Hz, which is equivalent to female pitch, but was ineffective. Thyroplasty Type III was performed and the voice immediately fell to 139Hz.
There have been many reports regarding congenital malformations of the larynx. However, the malformation in this case was unnoticed until after puberty in the form of a mutational voice disorder since no other disturbance such as dyspnea or hoarseness, which usually accompany an abnormally shaped thyroid cartilage, had occurred.View full abstractDownload PDF (4134K) -
Yoshihisa Kawasaki, Hiroyuki Fukuda, Akiko Fujimura, Tsukasa Sakoh, Sy ...1993 Volume 44 Issue 1 Pages 43-47
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA case of glottic interarytenoid adhesion following endotracheal intubation was reported. A sixty-nine year-old female with severe dyspnea due to bronchiectasis had had a tracheostomy 4 days after the initial intubation. Two months after decannulation, her dyspnea and dysphonia developed. Laryngoscopy under general anesthesia revealed an adhesion of the tips of the vocal processes. This adhesion was divided with carbon dioxide laser. The post operative course was successful in terms of phonation, and laryngoscopy revealed a normal larynx. Adhesion between the posterior ends in the inter-arytenoid area is a frequent cause of laryngeal stenosis after intubation. To avoid glottic stenosis due to intubation, earlier phonation following decannulation will be necessary. Endoscopic management can be successful if it is started as early as possible.View full abstractDownload PDF (2351K) -
Tohru Tadaki, Hiro-oki Okamura, Iwao Ohtani, Tomohiro Anzai1993 Volume 44 Issue 1 Pages 49-53
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe have seen a case of tracheal injury caused by extubation. A 16-year-old boy who was sent to our hospital after a traffic accident was extubated by himself. Three day later, he coughed out a substance which was pathologically diagnosed as necrotic mucous membrane of the trachea. Tracheal fiberscopy revealed rubor, hemorrhage and discharge in the upper tracheal region. As the respiratory state and a chest X-ray revealed no pathological changes, a conservative therapy was chosen. We observed the recovery process with a fiberscope. Fourteen days later, the tracheal mucous membrane had healed up without complications.View full abstractDownload PDF (3546K) -
Yoshimasa Kojima, Tatsuro Koizumi, Jin-Ichi Shidara, Nobuyuki Kikuchi, ...1993 Volume 44 Issue 1 Pages 55-59
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe reported on a 66-year-old male who developed a severe obstruction of a portion of the intermedistinal trachea as a result of tracheostomy and endotracheal intubation following surgery for hepatoma. He had the endotracheal intubation for 42 days. After the tracheal hole closed, he had no respiratory symptoms for about 2 months. He complained of difficulty in breathing, and his symptoms progressed rapidly. Endoscopy revealed endotracheal stenosis, with the narrowest part being 3-4mm in diameter. The stenotic portion was in the intermediastinal space. During open mediastinal surgery, an annular excision was performed, three tracheal cartilages were cut and an end-to-end anastomosis was performed. As intubation through the stenotic part was impossible, the incubate tube was kept just above the oral side of the stenotic portion, and, during the operation, anesthetic control was maintained under spontaneous respiration. The postoperative couse was satisfactory, and the patient could stand up 20 days after the operationView full abstractDownload PDF (4429K) -
Shogo Shinohara, Shiniti Satoh, Tetuya Ogata, Nobuya Yagi, Katuhiro As ...1993 Volume 44 Issue 1 Pages 61-66
Published: February 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSAn eleven-month-old boy accidentally ingested a micro litium battery. A plain roentgenogram showed a round foreign body at the phagoesophageal contraction of the esophagus.
Emergent direct esophagoscopy was performed under general anesthesia, and the battery was removed about 4 hours after ingestion. Although this was the fastest possible removal, the mucosa was severely damaged, and a 2-centimeter ulceration had formed. About a month was necessary for the complete recovery of the damaged mucosa, which was confirmed by esophago-fiberscopy.
In the case of battery ingestion, damage to the GI tract can be caused by three mechanisms: 1) direct corosive action by the battery contents, 2) low voltage burns, 3) pressure necrosis. Once the battery is arrested in the esophagus, as happened in this case, the damage to the mucosa will begin immediately, resulting in perforation in the short term mainly because of the second mechanism (i. e., low voltage burns) before leakage of the battery contents occurs.
Immediate removal is strongly recommended in such cases.View full abstractDownload PDF (4198K)
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