巻号一覧
47 巻, 1 号
選択された号の論文の9件中1～9を表示しています
- |<
- <
- 1
- >
- >|
-
石塀 紀彦, 辺土名 仁, 杉本 太郎, 原口 秀俊, 小松崎 篤1996 年 47 巻 1 号 p. 1-8
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーSixty-five patients of the hypopharyngeal carcinoma were treated at our clinic from 1984 to 1993, which were 48 pyriform sinus type, 12 postcricoid type and 5 posterior wall type ; 2 stage I, 6 stage II, 20 stage III and 37 stage IV. Seventy-four percent of patients clinically had metastatic nodes.
As for primary treatments, 51 patients out of 65, were treated with surgery, and 11 patients were treated with irradiation, radically in 4 and palliatively in 7. Three patients had no treatment because they refused any treatment. The surgical procedures were pharyngo-laryngoesophagectomy and free jejunum transplantation with bilateral or unilateral neck dissection in most cases.
The survival rate (Kaplan-Meier method) of all treated patients was 40.4% at 5 years. The five-year survival rate for stages I and II was 60%, III and IV was, 35.1% and 39.3%, respectively ; for nodal conditions, NO : 56.1%, Ni : 42.1%, N2 : 37.3%, N3 : 18.2% ; for site of lesion, pyriform sinus : 48.6%, postcricoid : 33.3%, posterior wall : 0 %; for treatment modalities, surgery : 45.7%, radical radiation : 50%, palliative radiation : 0 %.
Recently, the incidence of aged patients has increased. So we compared treatment modality, surgical procedure, complication and prognosis between patients aged 65 or above and under 65. As a result, we considered that we should treat aged patients aggressively almost the same as younger patients, taking care intensively for complications.抄録全体を表示PDF形式でダウンロード (1556K) -
声帯内アテロコラーゲン注入に関する基礎的研究として松井 真人, 宮野 龍太, 部坂 弘彦, 上出 洋介, 森山 寛1996 年 47 巻 1 号 p. 9-14
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーIn the treatment of unilateral laryngeal paralysis, we have been performing intracordal injection therapy with atelocollagen under observation with a flexible fiberscope on an outpatient basis. However, further study is required to determine the optimal injection sites and concentrations of atelocollagen. With the objective of evaluating the clinical effects of this therapy, we studied the intratissue dynamics of atelocollagen injected to rats. Using 18 Wistar rats, atelocollagen was injected into paralyzed and normal gastrocnemius and subdermal tissue at different concentrations, and the intratissue dynamics was investigated at regular intervals for 12 months. This study revealed the following. (1) The changes in the concentration of the atelocollagen and its reaction with tissue differ depending on the injection site. (2) The invasion of the inter-muscle bundle space by atelocollagen, which is thought to be due to muscular movement, occurs only in non-paralyzed (normal) gastrocnemius. (3) There is a tendency for the amount of remaining atelocollagen to be larger when the concentration injected is higher. The stability of the atelocollagen of the cross-linking type is thought to be considerable. However, it is necessary to conduct a separate study to evaluate whether the cross-linking agent causes damage to tissue. On the basis of the results reported above, it is concluded that the efficacy of current intracordal injection therapy with atelocollagen can be improved by using 3%, non-cross-linking atelocollagen and by studying the optimal sites and distance intervals for injection.抄録全体を表示PDF形式でダウンロード (2298K) -
7例の治療経験より片橋 立秋, 武宮 三三, 竹内 洋介, 嶋田 文之1996 年 47 巻 1 号 p. 15-20
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーOne hundred and nineteen cases of primary hyperparathyroidism were treated at the Chiba Cancer Center Hospital and its affiliates between 1972 and 1993. Of these, 7 cases had parathyroid carcinoma. These patients consisted of 2 men and 5 women with a mean age of 44.6 years. All of these patients had hypercalcemia and a high concentration of the serum parathyroid hormone. Palpation, computed tomography, magnetic resonance imaging, thallium/technetium subtraction scanning and ultrasonography were employed for localization studies. Preoperative localization succeeded in all cases, but only 2 cases were diagnosed as parathyroid carcinoma preoperatively because of invasive findings to the surrounding tissue in computed tomography and paralysis of recurrent laryngeal nerve.
All of the patients underwent an operation. In 5 patients, carcinoma was suspected intraoperatively with the finding of a grayish white firm mass and adhesion to adjacent structures. These patients underwent an en-bloc resection of the parathyroid tumor and ipsilateral thyroid lobe, with ipsilateral paratracheal and pretracheal dissection. Removal of the recurrent laryngeal nerve and dissection of the jugular chain of the ipsilateral side were also performed in one patient. Two patients underwent parathyroidectomy alone, because they had no suspicious findings of carcinoma at the time of operation. One patient underwent another operation after a histopathological diagnosis of parathyroid carcinoma was made. In this case, a resection of the thyroid lobe and para-pretracheal lymph node on the ipsilateral side was also done, but the hypercalcemia remained. Though the postoperative follow-up periods ranged from 2 to 17 years, no patient showed evidence of recurrence, except the one patient with remaining hypercalcemia. Thus, there was no patient in an aggressive state in our series and many of the cases underwent en-bloc resection at the time of the initial operation.
Our experience with these 7 cases confirms the importance of a careful evaluation of local findings in order to avoid missing carcinoma. Therefore, surgeons should plan delicate and bloodless operations.抄録全体を表示PDF形式でダウンロード (1191K) -
竹澤 裕之, 北 秀明, 東海林 黎吉, 形浦 昭克1996 年 47 巻 1 号 p. 21-24
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーInsertion of an endotracheal tube was performed in a 22-year-old cerebral palsy female, because of dyspnea caused by a respiratory tract infection. Since the period of intubation exceeded 3 weeks, a tracheotomy was performed. Under tracheotomy tube management, the dyspnea re-occurred because of tracheomalacia, granulation of trachea and aspiration. We selected laryngeal closure to prevent the aspiration. Although the tracheomalacia still remained, the granulation of the trachea decreased, and we were able to remove the tracheotomy tube.抄録全体を表示PDF形式でダウンロード (989K) -
米谷 博秀, 雲井 一夫, 小池 薫, 寺本 保二1996 年 47 巻 1 号 p. 25-30
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーA 65-year-old female was seen complaining of a vague discomfort in her laryngeal region and a nodular mass in her right anterior neck. Hemithyroidectomy was performed via the usual collar incision, however, the right recurrent nerve was not present in the right tracheoesophageal groove. In search of an anomalous nerve, a non-recurrent laryngeal nerve was found arising from the vagus at the level of the thyroid cartilage and taking a transverse course to directly enter the larynx. After surgery, an additional oesophagogram showed a marked indentation of the esophagus due to the abnormal right subclavian artery. MR angiography also disclosed the anomalous right subclavian artery originating from the aortic arch distal to the left subclavian artery. Surgical excision of the thyroid mass and release of the non-recurrent laryngeal nerve resulted in resolution of the laryngeal discomfort. The surgeon must always be aware of the possibility of a non-recurrent laryngeal nerve.抄録全体を表示PDF形式でダウンロード (1974K) -
布施 健生, 稲村 博雄, 青柳 優1996 年 47 巻 1 号 p. 31-33
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーA case with laryngeal granuloma treated endoscopically was reported. A 53-year-old female with a history of rheumatic arthritis was diagnosed as having a laryngeal granuloma. It was impossible to remove the granuloma under direct laryngoscopy because she could not open her mouth widely enough due to ankylosis of the temporomandibular joint. Endoscopic surgery using a flexible fiberscope was undergone under general anesthesia. The stalk of the granuloma was snared and coagulated with a high frequency coagulator. The granuloma was resected successfully without any recurrence for 4 months postoperative follow up study. This technique was considered as an adequate way to remove a laryngeal granuloma, when a patient has some problems to be examined and treated by direct laryngoscopy.抄録全体を表示PDF形式でダウンロード (959K) -
森 一功, 平野 実, 藤田 博正, 野明 俊裕, 秋吉 建二郎1996 年 47 巻 1 号 p. 34-38
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーRecently, expandable metalic stents have been used to hold the lumen of large vessels, the bile duct, urinary tract, and so on. A rare case of tracheo-gastric tube fistula caused by an expandable metalic stent was reported. A 61-year-old male underwent an operation for thoracic esophageal cancer and his thoracic esophagus was reconstructed using a gastric tube. After the operation, a tracheo-gastric tube fistula was caused by a peptic ulcer of the gastric tube, followed by atelectasis of the left lung. Expandable metalic stents were inserted into his trachea and left main bronchus. Since a part of one of these stents penetrated the ulcer into the gastric tube lumen, the fistula did not close spontaneously. After cutting this part of the stent using a specially designed forceps through hard esophagoscopy, the fistula closed.抄録全体を表示PDF形式でダウンロード (1579K) -
杉本 俊彦, 梅崎 俊郎, 松瀬 敏章, 進 武幹1996 年 47 巻 1 号 p. 39-43
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーSwallowing a corrosive, especially an alkali agent often cause a severe esophageal stricture which is usually very difficult to be treated. In this paper, a case of esophageal stricture treated by a balloon dilator was reported.
The patient was 46-year-old female complaining of swallowing difficulty. She had an episode of drinking sodium hydroxide in childhood by mistake. She had been diagnosed as esophageal stricture by a previous doctor. She underwent surgical treatments twice without any satisfactory result. She was referred to our clinic. Esophagography and endoscopy revealed two stenotic lesions in her lower esophagus. Under hospitalization, she was treated by a balloon dilator inflated at 2 atmospheric pressure. The dilator was inserted through her mouth and inflated four times a day. Each trial was fifteen minutes. Although the treatment was continued for a week, there was little improvement. Besides, severe erosive lesions around the stenosis were detected. Considering the risk of an esophageal perforation by frequent trial of insertion, the balloon dilator was inserted through the nose and kept in the esophagus. Inflation of the balloon for sixty minutes a day was performed for consecutive twenty days. After two courses of this treatment, the stenosis appeared to be dilated adequately.
The method using a balloon dilator may require a long period to improve an esophageal stricture, compared with other methods such as, laser resection or surgical removal. This method, however, is still useful because its safety and repeatability.抄録全体を表示PDF形式でダウンロード (1741K) -
青柳 聡, 小川 克二, 平山 方俊, 井口 芳明, 小野 雄一1996 年 47 巻 1 号 p. 44-49
発行日: 1996/02/10
公開日: 2010/10/20
ジャーナル フリーLaryngofissure was performed for the treatment of laryngo-subglottic stenosis in 5 infantile cases (a male of 2 years and 4 females aged from 3 months to 6 years). In spite of the use of a T-tube immediately after the laryngofissure, 3 cases out of the 5 developed a recurrence of stenosis after the surgery. In these 3 cases, a new type of stent tube (Ogawa's tube) having a plate at the top of the tube for prevention of adhesion between the vocal cords was used, and a good air way was eventually obtained. The development of the larynx in these cases has been found to be within the normal range after the surgery. It was emphasized that surgical treatment for laryngo-subglottic stenosis is indispensable in infantile cases in order to maintain normal language development.抄録全体を表示PDF形式でダウンロード (1550K)
- |<
- <
- 1
- >
- >|