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Volume 46 (1995)
- Issue 6 Pages 447-
- Issue 5 Pages 361-
- Issue 4 Pages 287-
- Issue 3 Pages 203-
- Issue 2 Pages 71-
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Volume 46, Issue 3
Displaying 1-10 of 10 articles from this issue
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Yoshinobu Ogawa, Takashi Matsunaga, Hiroshi Miyahara, Osamu Tanaka, Ka ...1995 Volume 46 Issue 3 Pages 203-208
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSAmong 126 patients with laryngeal cancer treated between September 1986 and August 1993 at Nara Medical University, we encountered six patients with multicentric cancer of the larynx. We statistically investigated the role of tobacco and alcohol consumption to determine the causal factors in these cases. We chose as controls 60 patients with laryngeal cancer who had received total laryngectomy without irradiation therapy from among the 126 patients with laryngeal cancer. We confirmed that these multicentric intralaryngeal lesions were noncontinuous by examining whole organ serial sections. Tobacco consumption was highly related to the risk of multicentric cancer in the larynx (p<0.01), while alcohol consumption was not related to the risk of such lesions.
Therefore, we conclude that synchronous secondary intralaryngeal lesions must not be overlooked and that the incidence of nonsynchronous secondary cancer of the larynx must be considered during follow-ups, when heavy-smokers are treated for laryngeal cancer by partial laryngectomy or irradiation therapy.View full abstractDownload PDF (4063K) -
Renzo Sugihara, Kentaroh Ohkawa, Ryuta Haraguchi, Yuuji Tohda, Kimiyo ...1995 Volume 46 Issue 3 Pages 209-218
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe examined the correlation between airway hyperreactivity and the density of muscarinic acetylcholine receptor (mACh-R), and reported that the density of mACh-R in OA-sensitized guinea pig was higher than that in a control group. We also examined the characteristics of the M1, M2 and M3 receptors in guinea pig pulmonary tissue, and the following results were obtained.
1) For the M1 and M2 receptors, no difference was observed between the density and affinity of OA-sensitized lungs and those of the control lungs.
2) The density of M3 receptors in the lung tissue of OA-sensitized guinea pigs washigher than that in the control group. No difference was observed between the affinity of M3 receptors in the OA-sensitized lungs and that in the control lungs.
3) Pilocarpine, which is an M2 receptor agonist, increased the density of M3 receptors in the lung tissue of guinea pigs, and the rate of the increase in the density of M3 receptors in OA-sensitized guinea pigs was less than that in the control group. On the other hand, methoctramine, which is an M2 receptor antagonist, decreased the density of M3 receptors in the lung tissue of guinea pigs, and the rate of this decrease was as same as that in the control group.
These results suggest that the increase in M3 receptors in the lung tissue of OA-sensitized guinea pigs is related to airway hyperreactivity and that there is a dysfunction of M2 receptors in OA-sensitized guinea pigs.View full abstractDownload PDF (1665K) -
Hidetsugu Katoh, Tohru Majima, Michiya Yamaguchi, Takashi Horie1995 Volume 46 Issue 3 Pages 219-236
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe pathogenetic trigger of bronchial asthma is airway hypersensitivity. Beclomethasone dipropionate (BDP), an adrenal cortical steroid preparation for inhalation, has been reported to suppress airway hypersensitivity. This study was designed to investigate the mechanism of this suppression of airway hypersensitivity in guinea pigs.
Using a whole-body exposure type inhalator equipped with a nebulizer of 38 liters capacity which pernuits puffing for 2 seconds, the animals were treated at a dose of 20 or 40 puffs a day (equivalent to a human dose of 600 or 1200μg/day, respectively), for 3 or 7 successive days. Airway hypersensitivity was assessed by the standard testing method of acetylcholine inhalation. Respiratory resistance was measured as an index representing the threshold of airway hypersensitivity. With 20puffs/day for 7 days, airway hypersensitivity tended to decrease. With 40 puffs/day for 3 days, it decreased more significantly (P<0.05). With 40 puffs/day for 7 days, it decreased with still significance (P<0.01).
Histamine levels in plasma and BALF significance (P<0.05) decreased after 7 days treatment at 40puffs/day. BDP seemed to inhibit airway hypersensitivity dependent upon and the number of days of inhalation as a result of the suppression of the mast cell-histamine chain. In addition, the drug tended to suppress capsaicin-stimulated airway hypersensitivity. The above results suggested that BDP suppresses airway hypersensitivity mediated by neuropeptides, especially by substance P.View full abstractDownload PDF (1270K) -
Masaru Sawataishi, Yoshiaki Karaki, Takuya Nagata, Kouji Hino, Yuji Ih ...1995 Volume 46 Issue 3 Pages 227-234
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe light and electron microscopic findings from a primary adenoid cystic carcinoma of the esophagus are described in a 70-year-old male patient. A large tumor from the middle to the upper intrathoracic esophagus was resected. The tumor exhibited a club shaped appearance and was histologically diagnosed as primary adenoid cystic carcinoma (ACC) of the esophagus. The patient died 5 months after surgery because of widespread distant metastasis. Histologically, the tumor showed an incomplete cribriform, duct-like or solid pattern. A small focus of squamous cell carcinoma (SCC) was found and transitional features intermediate between those of ACC and SCC were found. Under electron microscopy, the tumor cells were markedly similar to small duct cells of the normal esophageal glands. Membrane-coating granules and tonofibrils, which were found in the stratum granulosa of the esophageal squamous epithelium, were observed in the cytoplasm of the tumor cells. These results suggest that tumor cells possess the properties of both esophageal gland cells and squamous epithelial cells. It is assumed that ACC might originate from the esophageal glands, especially from small duct cells including intercalated ducts cells, and might be differentiating toward SCC.View full abstractDownload PDF (10130K) -
Takayuki Kuboi, Atsushi Sakakura, Ken Nakai, Kazuo Makimoto, Hiroaki T ...1995 Volume 46 Issue 3 Pages 235-241
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe studied the significance of chief complaints for the correct diagnosis of 104 patients (male 17, female 87), who underwent surgical excisions for thyroid diseases in our department from 1988 to 1992. In terms of histopathology, these consisted of 54 cases (51.9%) of benign diseases and 50 cases (48.1%) of malignant tumors. In terms of the age distributions, benign diseases showed a peak in the 40's and malignant tumors in the 50's. Patients who had no subjective symptoms or had not been conscious of their disease were more likely to be males (36.8%) than females (13.0%). This difference was statistically significant. These patients had had their thyroid disease discovered by chance at medical facilities. Female patients showed a higher rate (13.0%) of“abnormal sensations in the throat”than did of the male patients (5.3%). All patients who presented recurrent nerve paralysis preoperatively were diagnosed postoperatively as malignancies. Regardless of the benign or malignant nature of their disease, patients complaining of cervical pain showed a greater incidence (85.7%) of calcification in their thyriod lesions. General physicians found 40.0% of these cases of early thyroid cancer. This indicated the importance of palpating the thyroid region and the indispensable role of general physicians in addition to head and neck surgeons in the treatment of thyroid tumors.View full abstractDownload PDF (2498K) -
Yoshikatsu Nakamura, Masafumi Nakayama, Tomoo Suzuki, Hideo Miyata1995 Volume 46 Issue 3 Pages 242-247
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSCase 1 was a 62-year-old female whose main complaint was of a tight feeling in her chest and a heavy feeling in her throat. These feelings appeared not only when working but also at rest and sometimes lasted for more than fifteen minutes. As no significant data were found on her electrocardiogram, she came to our department, but we did not find any cause for her complaint. After UGI, a very tight feeling in her chest and vomitting seized her, and her pulse rate and blood pressure dropped suddenly. She was diagnosed as having an acute myocardial infarction in the lower wall, and then treated with PTCA. After treatment she felt no complaint in her chest and throat.
Case 2 was a 74-year-old male. He had felt an irregular pulse and discomfort in his chest since 1984. He had a “full”feeling in his throat, which was sometimes accompanied by pressure on his chest. He was diagnosed as having hypertension in 1989. After that he was treated with CAG and PTCA, and was diagnosed as having an old myocardiac infarction in the lower wall. In 1993, he was introduced to our department because of the persistent“full”feeling in his throat, but no problem was found. According to his clinical record, his feeling was reported as lighter after using Isosorbite dinitrate tablets or PTCA treatment. We felt that his complaint was caused by his heart disease.
When we examine a patient who complains of an abnormal sensation in the pharyngolaryngeal region with a tight feeling or pressure in his/her chest, we have to remember that ischemic cardiac disease can cause such feelings.View full abstractDownload PDF (1028K) -
Kiyoshi Oshima, Masaki Kato, Masafumi Yokokoji, Seiji Niimi1995 Volume 46 Issue 3 Pages 248-252
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe main issue in laryngotracheal trauma is the difficulty of treatment created by the multi-functionality of the larynx. We report the case of a 34-year-old male whose airway was cut from the second tracheal ring to the thyroid cartilage by a knife. Although he was left untreated for 11 hours, the wound was sutured, preserving the larynx and adequate voice function. There is said to be a‘golden period’ for the healing of a wound, but even after that period, there is still a good possibility of preserving the larynx. This fact suggests that in the treatment of laryngeal injuries, proper anti-infection therapies may extend the ‘golden period. ’ During the first stage of treatment, a silicone tube placed within the damaged laryngotracheal frame was very effective for the prevention of laryngeal stenosis.View full abstractDownload PDF (2568K) -
Yuumi Kagesato, Mamoru Tsukuda, Izumi Mochimatsu, Shigeru Furukawa, Ma ...1995 Volume 46 Issue 3 Pages 253-257
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSTwo cases of laryngeal foreign bodies are reported. The first case was a 8-month-old male, with sudden aphonia who had visited a pediatrist. An X-ray showed a glottic impaction of a foreign body.
The second case was a 12-year-old male. He complained of a sore throat and aphonia after swallowing a nut in a shell by mistake. Fiberscopic examination revealed a foreign body in the glottic region. An emergency tracheotomy was carried out and the nut was safely removed under general anesthesia.View full abstractDownload PDF (2084K) -
Takatsugu Shimazaki, Yoshikazu Yoshida, Yasushi Nomura1995 Volume 46 Issue 3 Pages 258-265
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSIn Japan, Zenker's diverticulum is a rare disease, with less than fifty cases thus far reported. The authors reported two cases of Zenker's diverticulum and discussed their clinical features and the cause of this disease and its treatment. A 69-year-old woman complained of swallowing difficulty, showed stenosis of the pharyngoesophageal region on fluoroscopic examination. After removing food under esophagoscopy, a large diverticulum was found. The second case, a 61-year-old man with a severe“lump”sensation of the throat was introduced to our clinic by a private practitioner. The patient received an endoscopic examination, however, a flexible fiberscope could not be inserted beyond the hypopharynx. Radiopharyngography demonstrated Zenker's diverticulum. In each case, diverticulectomy was performed according to Montgomery's technique without cricopharyngeal myotomy. The symptoms disappeard after the operation. Both pathological examinations diagnosed a pulsion diverticulum with a moderate chronic inflammatory infiltrate. There was no malignant tissue in either case.View full abstractDownload PDF (9698K) -
Ichirou Takamatsu, Noboru Ogahara, Kiminao Ooishi, Tarou Nagahara, Mam ...1995 Volume 46 Issue 3 Pages 266-269
Published: June 10, 1995
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSTracheostomy was performed in 62 patients during a 23-year period (1970-1993) at our clinic. Complications were analysed in 41 cases with long-term tracheostoma over one year.
Twenty one cases with long-term tracheostoma suffered from complications. There were 9 cases with distal tracheal granulations, 7 with intrastomal granulomas, 7 with suprastomal granulomas and 3 with stomal infection and abcess. Other complications were pneumonia, pneumothorax, accidental extubation and so on.
Distal tracheal granulations are difficult to treat, and we preferred conservative therapies. First, we inserted a nasotracheal tube from the stoma to the lower site of the granulation. If scar formation was ocurred, we changed it to a conventional or flexible tracheal tube. If the granulation was too large to insert the nasotracheal tube, we excised the granulations with an YAG laser or electrocoagulator. Then we inserted a conventional or flexible tracheal tube. In some cases, we performed a laryngotracheal separation.
However, mild Hunter's disease appeared difficult to treat because of misdeglutition and tracheobronchomalacia. It is important to consider the disease, general conditions and selection of a tracheostomy tube for the management of pediatric cases with long-term tracheostoma.View full abstractDownload PDF (2358K)
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