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Volume 44 (1993)
- Issue 6 Pages 425-
- Issue 5 Pages 331-
- Issue 4 Pages 273-
- Issue 3 Pages 177-
- Issue 2 Pages 71-
- Issue 1 Pages 1-
Volume 44, Issue 6
Displaying 1-8 of 8 articles from this issue
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Tsutomu Fujisawa, Yasuji Nakasone, Kenji Koshii, Hideki Hirabayashi, K ...1993 Volume 44 Issue 6 Pages 425-435
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSwe reported aggressive treatment for patients with Stage III and IV laryngeal carcinomas based on our study of the records of 89 consecutive patients (previously untreated) who presented stage III and IV carcinomas of the larynx in the period 1975-89.Of these, 53 were stage III patients and 36 were stage IV, and the histological diagnosis in every case was squamous cell carcinoma. The average age of the patients was 66.2 years, and the male-female ratio was 9 to 1.
In the advanced laryngeal carcinoma, the incidence in the cases of supraglottic carcinoma (47/89, 52.8%) was higher than in the cases of glottic carcinoma (37/89, 41.6%). Thirty-one of the 47 cases of supraglottic carcinoma (66.0%) had metastasis to the jugular lymph nodes.
The 5-year cumulative survival rate, viewed by stages, was 63.8% for stage III glottic carcinoma, 74.4% for stage IV glottic carcinoma, 60.9% for stage III supraglottic carcinoma and 40.0% for stage IV supraglottic carcinoma.
Initial examinations revealed metastasis to the jugular lymph nodes in 41 cases. Prognosis was poor, with the 5-year cumulative survival rate for these cases (47.5%) lower than that for the 48 cases without metastasis (66.3%).
Twenty of the 89 cases of advanced laryngeal carcinoma were classified as poorly differentiated squamous cell carcinoma, and the 5-year cumulative survival rate for these (33.1%) was definitely lower than for that the well differentiated types (69.4%; P<0.05).
We conclude that wide resection with complete neck dissection, including irradiation and chemotherapy, is indicated for stage III and IV laryngeal carcinomas-particularly in patients who have supraglottic stage IV tumors with poorly differentiated squamous cell carcinoma. Adjuvant and neo-adjuvant chemotherapy should be administered to prevent lung metastasis, which is the most recurrent form of cancer.View full abstractDownload PDF (1446K) -
Yoshihiko Akiyama, Tohru Majima, Michiya Yamaguchi, Takashi Horie1993 Volume 44 Issue 6 Pages 436-448
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSChrysotherapy has been employed for the treatment of bronchial asthma, although, the mechanism of its action is still not clear.
In the present study, the effects of auranofine (an oral gold preparation) on tracheal smooth muscle contraction in guinea pigs-induced by acetylcholine, histamine, leukotriene (LT) C4 and LT D4-were examined. Auranofine suppressed the tracheal smooth muscle contraction induced by these various mediators in a dose-dependent manner. It also inhibited the relaxation of tracheal smooth muscle induced by isoproterenol.
Additionally, auranofine reduced the smooth muscle relaxation induced by atropine and d-chlorpheniramine, indicating competing antagonistic effects.
These results suggest that auranofine has a direct relaxing effect on smooth muscle, and wide-ranging antagonistic effects on the receptors in tracheal smooth muscle.View full abstractDownload PDF (1683K) -
Kentaroh Ohkawa, Kimiyo Yamasaki, Ryuta Haraguchi, Mitsuo Ohishi, Shig ...1993 Volume 44 Issue 6 Pages 449-455
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSPhosphodiesterase is the only enzyme that catalyzes the hydrolysis of cyclic AMP to 5′AMP, and the relaxation of smooth muscle is the result of an intracellular increase in the level of cyclic AMP. It has been generally assumed that the bronchodilatory properties of theophylline in asthma therapy are due to its cyclic AMP-phosphodiesterase inhibitory capacity. In recent years, a number of studies on the action of theophylline have led to a general hypothesis which suggests that xanthine derivatives act as adenosine receptor antagonists. In the present study, we reported that the lymphocyte cyclic AMP level showed an obvious increase only in asthma patients after the administration of theophylline, while the level was the same in asthma patients and healthy adults before this administration.
The difference in phosphodiesterase activity between patients and healthy adults in one of the causes of the difference in the lymphocyte cyclic AMP level.
In this study, we examined lymphocyte phosphodiesterase activity and the following results were obtained.
1) The lymphocyte phosphodiesterase activity was higher in patients with bronchial asthma than in healthy adults.
2) The lymphocyte phosphodiesterase activity level showed an obvious decrease only in patients with asthma.
These results suggest that phosphodiesterase activity is related to the mechanism of bronchial asthma, and the hypothesis that theophylline is an inhibitor of phosphodiesterase is confirmed.View full abstractDownload PDF (845K) -
Yasuo Hisa, Nobuhisa Tadaki, Toshiyuki Uno, Norio Yasuda, Yasushi Mura ...1993 Volume 44 Issue 6 Pages 456-462
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSOne hundred and twenty four cases of thyroid nodules treated surgically at the Department of Otolaryngology, Kyoto Prefectural University of Medicine from 1989 to 1992 were analyzed to evaluate the usefulness of various imaging techniques.
1. Plain neck X-rays were performed on 107 cases. Calcifications were found in 14% of the benign nodules, 39% of the malignant nodules and in 30% of all cases. All nodules with minute calcification were malignant.
2. Ultrasonography was performed on 100 cases. The results of a qualitative diagnosis were sensitivity 80.3%, specificity 79.5%, and accuracy 80.0%
3. Scintigraphy with 123I or 99mTcO4- followed by 201T1 was performed on 106 cases. The results of a qualitative diagnosis were sensitivity 71.6%, specificity 64.1%, and accuracy 69.8%.
4. CT scanning was performed on 101 cases, but 12 cases were not able to be qualitatively diagnosed because of lack of information or poor images.The results of a qualitative diagnosis of 89 cases were sensitivity 74.0%, specificity 69.2%, and accuracy 71.9%.
These results together with the physical stress and cost associated with each imaging technique, indicate that ultrasonography is the most useful imaging technique for a qualitative diagnosis of thyroid nodules.View full abstractDownload PDF (4194K) -
Hiroyoshi Ayabe, Akio Kawaguchi, Enju Shiraishi, Masao Tomita1993 Volume 44 Issue 6 Pages 463-466
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe surgical management of a case of intractable aspiration pneumonia was reported. The patient was a 62 year-old male. He had dysphagia and speech disturbance due to bulbar palsy after multiple cerebral infarction and suffered from intractable aspiration pneumonias. Under general anesthesia, his neck was opened and the trachea was divided transversely between the second and third tracheal cartilages. Anastomosis between the proximal trachea and the cervical esophagus in an end-to-side fashion with permanent tracheostomy was performed. The postoperative course was relatively smooth.
The patient could take a liquid diet and engage in an active daily life after the operation.View full abstractDownload PDF (4736K) -
Tadashi Ishimaru, Toru Takimoto, Koji Imoto1993 Volume 44 Issue 6 Pages 467-471
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA case of mediastinal emphysema in a 37-year-old woman caused by the use of a dental air-turbine during tooth extraction was reported.
The air from the air-turbine was blown into the subcutaneous tissue via a pocket in the left mandibular second molar, and this caused emphysema in the left eyelid, left bucca, neck and mediastinum. The authors presented CT-scans of the case as the most useful method for showing the spread of the emphysema. Treatment was designed to avoid infection, since the air is not free of bacteria and the root canal was also infected.
The causes of emphysemas related to dental treatment are the following. 1) Use of an air-turbine. 2) Use of an air-syringe. 3) Use of H2O2. 4) Sneezing. The first occurs during tooth extraction, but the second, third and fourth are known to occur after extraction.
Mediastinal emphysema caused by dental treatment has been known to dentists but unknown to otorhinolaryngolosists. The most important point in these cases is that if the emphysema is restricted to the face and neck, one should suspect mediastinal emphysema.View full abstractDownload PDF (2062K) -
Takaaki Kawaguchi, Yutaka Katoh, Hiromu Kakiuchi, Takaaki Kimura, Yasu ...1993 Volume 44 Issue 6 Pages 472-476
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSAn expandable metallic stent was used to treat a 57-year-old female who suffered from dyspnea caused by idiopathic tracheal stenosis. The patient had had total laryngectomy for the treatment of laryngeal cancer at the age of 45. The stenosis was 7cm below the tracheostoma, and an expandable metallic stent was successfully inserted using the intubation tube as a cartridge. CT and endoscopic findings revealed a satisfactory airway lumen obtained by the stent. The dyspnea disappeared after insertion of the stent, and no other complication has been observed during a two-year follow-up period.View full abstractDownload PDF (5856K) -
Masato Yokoyama, Niro Tayama, Takahide Kurauchi, Masahiro Mizuno, Seij ...1993 Volume 44 Issue 6 Pages 477-480
Published: December 10, 1993
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe authors have developed a new type of tracheal canula (Adjust Fit®), since poorly fitting canulae can cause various kinds of stomal or tracheal trouble. The new canula consists of a wired silastic tube with an adjustable wing, so that it is possible to control the curvature and the length between the wing and the tip of the canula.
Our clinical experience has shown that the new canula is very adaptable to patients with neuromuscular disease or advance neck tumors, with whom conventional canulae cannot be used properly.View full abstractDownload PDF (4371K)
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