巻号一覧
47 巻 (1996)
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47 巻, 3 号
選択された号の論文の11件中1～11を表示しています
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平野 滋, 大森 孝一, 庄司 和彦, 児嶋 久剛, 西村 恭昌1996 年 47 巻 3 号 p. 277-280
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーTo preserve the larynx in cases of T1b, T2 glottic cancer (squamous cell carcinoma), we have performed twice-a-day radiation therapy (60Co 1.2 Gy/fraction, over a-6-hour interval) for 3 T1b and 8 T2 patients between 1992 and 1994. The total dose administrated was 72-74.4 Gy. the preservation rates of the larynx were compared with those of a conventionally irradiated group (2 Gy/fraction, once-a-day, total dose 66 Gy) consisting of 24 T1b and 27 T2 patients treated between 1985 and 1994. The three-year preservation rates of the larynx in the conventionally treated group were 81% for T1b and 66.3% for T2 patients wile those in the twice-a-day group were 100% and 87.5% respectively. No major complications owing to the high total dose have been observed. Twice-a-day radiation therapy can thus be considered to be useful for preserving the larynx in the treatment of T1b, T2 glottic cancer.抄録全体を表示PDF形式でダウンロード (782K) -
当科における8年6カ月間の治療例から山田 弘之, 加藤 昭彦, 山田 哲生, 松浦 徹, 矢野原 邦生1996 年 47 巻 3 号 p. 281-286
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーAlthough the treatment plan for laryngeal and hypopharyngeal cancers is already well established, the prognosis for hypopharyngeal cancer is still poor. Our purpose in the present report is to provide some hints for the improvement of the prognosis for these diseases.
In our department, from March 1986 to August 1994, 62 patients with laryngeal cancer and 21 with hypopharyngeal cancer underwent initial treatment. In the 62 patients with laryngeal cancer, recurrence was observed in 13 cases; and in the 21 with hypopharyngeal cancer, recurrence was observed in 7 cases.
Five patients who had a recurrence in the larynx were saved with a second radical operation. On the other hand, distant metastasis was observed in 4 cases, and these patients died from their metastasis.
In the 7 patients with a recurrensce of hypopharyngeal cancer, 3 cases were observed in the primary region, 2 were in the cervical region, and 2 were in distant organs.
In the department, laryngeal cancer is first treated with radiotherapy to preserve the voice, and hypopharyngeal cancer is first treated with a radical operation including preoperative chemotherapy and postoperative radiotherapy for improvement of the prognosis.抄録全体を表示PDF形式でダウンロード (1227K) -
従来の手術法の再評価と新手術法の検討田中 信三, 田辺 正博, 箕山 学, 岩永 迪考1996 年 47 巻 3 号 p. 287-293
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーClosure of the posterior glottis after thyroplasty type 1 was retrospectively evaluated with fiberscopic video recordings of patients treated at the Osaka Red-Cross Hospital. It was revealed that this surgery was not an effective treatment of posterior glottis incompetence.
Results of an experimental study with excised human larynges indicated that a posterior window, incision of the inner perichondrial membrane and a medial compression in 8 to 10 mm of the vocal process of the arytenoid cartilage were necessary for the mobilization of the posterior vocal cord to the midline of the larynx.
The modified thyroplasty type 1 described above was performed for a patient with unilateral recurrent laryngeal nerve paralysis and a large gap in the posterior glottis. Normal voice and complete closure of the posterior glottis were obtained after surgery. This method was inferred to be useful for the improvement of posterior glottis incompetence.抄録全体を表示PDF形式でダウンロード (3871K) -
河田 了, 安田 範夫, 久 育男, 村上 泰1996 年 47 巻 3 号 p. 294-297
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーA single midline, T-shaped and U-shaped incisions are common in total laryngectomy. However, common faults of these incisions are 1) that they involve a three-point junction between the skin incision and the tracheal stoma, and 2) that it is difficult to extend the skin incision in case of neck dissection for recurrent tumors in the neck after total laryngectomy. Therefore, we designed a mountain-shaped incision whose top is at the level of the hyoid bone for total laryngectomy, and the tracheal stoma is made in the midline of the neck as a separate incision. This incision has the advantage that it involves no three-point junction in the tracheal stoma and that it is easy to extend the incision for neck dissection. General anesthesia by oral intubation is necessary for this incision. We prefer to use oral intubation, because it is generally accepted that cell dissemination by intubation is rare in laryngeal cancer.抄録全体を表示PDF形式でダウンロード (2865K) -
佐々木 裕美, 佐伯 克哉1996 年 47 巻 3 号 p. 298-304
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーAs a treatment for respiratory failure in chronic lung disease, an artificial airway is sometimes required for respiratory control. In these circumstances, endotracheal intubation is applied first. However, tracheotomy is sometimes performed when further respiretory care is needed.
Twenty three tracheotomies were performed in our department for this purpose during the last 7 years (from April 1998 to March 1995). Twelve patients have survived at present, and most of them were able to break away from mechanical respiration completely within a few days after their tracheotomy. Tracheotomy was more effective as an artificial airway than endotracheal intubation for these patients. On the other hand, seven of the non-surviving 11 patients died soon after tracheotomy. Thus, tracheotomy was not as effective for them as it was for the 12 survivors. It is doubtful whether tracheotomy, an invasive technique, is an appropriate therapy for these poor-prognostic patients. Before making a decision to use tracheotomy, the prognosis for life itself should be evaluated objectively and precisely.抄録全体を表示PDF形式でダウンロード (1257K) -
村山 公, 佐藤 博信, 大槻 穣治, 栄 圭男, 鈴木 武樹, 大塚 善久, 須田 清美, 畠中 康晴, 深瀬 知之, 小坂 和子, 田中 ...1996 年 47 巻 3 号 p. 305-311
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーFrom 1963 through 1994, 58 patients (70 lesions) with superficial esophageal cancer have been treated at the third Department of Surgery, Nihon University School of Medicine. Out of these 58 patients (70 lesions), 18 patients (20 lesions) were of the superficial and protruding type which appeared to be of the 0-I type. Of these 20 lesions, 11 were classified as 0-I p type, 8 lesions were of the 0-I pl type and 1 lesion was of the 0-I sep type Nine of these 18 patients (50%) have shown symptoms of various types of dysphagia. In 18 out of the 20 lesions, the cancer invaded the submucosal layer of the esophageal wall, while in only one lesion did the cancer invade the level of the muscularis mucosae.
Concerning the height of the tumors, all lesions were over 2 mm. There were many lesions of the 0-I p type which appeared under 3 cm in length and 3 mm in height, while there were many lesions of the 0-I pl type which appeared under 3 cm in length and over 3 mm in height. However, there was no relationship between tumor height and cancer invasion. Six of the 18 patients died from a recurrence of their cancer and of these 6 deaths, 5 cancers had invaded the submucosal layer. The overall 5-year survival rate of the 0-I type superficial esophageal cancer was 53.5%.抄録全体を表示PDF形式でダウンロード (3819K) -
中林 成一郎, 池田 勝久, 高坂 知節1996 年 47 巻 3 号 p. 312-317
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーA statistical study was made on 104 cases of esophageal foreign bodies treated in our clinic during the past 5 years and 7 months from 1990 to 1995. The results follow:
1) The male-female ratio was 1: 1.3, and 49 cases (47%) were over 50 years of age.
2) The most common foreign body was fish bones (38%), followed by P. T. P. (press through packs of medicine, 20%), coins (19%), dentures (6%) and others.
3) Fish bones were found in 39 cases, in which the male-female ratio was 1: 1.6, and 30 cases (77%) were over 50 years of age.
4) We classified the wounds resulting from fish bones in the esophagus as follows: normal, slight, moderate and severe.
5) The wound scores were significantly related to both the period from the onset to the visit to a clinic and the size of the fish bone.
6) In general, complications from fish bones in the esophagus, such as periesophageal abscess, retropharyngeal abscess and mediastinitis, rarely occur. When these major complications are suspected, a contrast-enhanced CT scan is recommended.抄録全体を表示PDF形式でダウンロード (1627K) -
加藤 昭彦, 山田 弘之, 山田 哲生, 松浦 徹1996 年 47 巻 3 号 p. 318-324
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーThree cases of right non-recurrent laryngeal nerve recognized during operations for thyroid cancer are reported. This anomaly of the recurrent nerve is explained by the process of nerve and blood vessel development from the embryologic branchial arches, since it is known to be associated with an anomalous origin of the right subclavian artery from the aortic arch. In two of our three cases, an aberrant right subclavian artery was postoperatively detected by esophagography and MRI. Recurrent nerve injury is one ofthe most important complications of posed by thyroid operations, and surgeons must be awere of the most important complications of posed by thyroid operations, and surgeons must be awere of the possibility of non-recurrent laryngeal nerves, especially on the right side.抄録全体を表示PDF形式でダウンロード (2583K) -
今西 順久, 志津木 健, 酒向 司, 加納 紅代, 加納 滋1996 年 47 巻 3 号 p. 325-332
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーInflammatory pseudotumor is known as a non-specific inflammatory disease which masquerades as a tumor-like lesion. The most frequent localization of inflammatory pseudotumors is in the lung and the orbital cavity. Histopathological diagnosis is generally reported as “plasma cell granuloma”in the literatures.
We reported the rare case of an inflammatory pseudotumor whish occurred in the trachea. An eight-year-old female who had been treated as having bronchial asthma was referred from a pediatrician because of uncontrollable dyspnea. Laryngeal fiberscopy found a tumor-like lesion in the subglottic space obstructing the airway. CT and MRI showed a mass on the posterior wall of the trachea.
The patient underwent exploratory surgery with a median longitudinal tracheotomy approach. Histopathology showed an inflammatory pleomorphic cellular infiltration consisting of plasma cells, lymphocytes and histiocytes, with proliferating fibroblastic cells. these findings were consistent with an inflammatory pseudotumor.
In order to control the regrowth of the pseudotumor, a second surgery was perfomed with submucosal mass resection and local injection of steroids. Additional treatment with steroids was effective. The patient has been tree from dyspnea up to the present time.抄録全体を表示PDF形式でダウンロード (3052K) -
越野 樹典, 廣瀬 肇, 岡本 牧人, 八尾 和雄, 平山 方俊, 青柳 聡氏, 山中 盾1996 年 47 巻 3 号 p. 333-339
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーA 22-year-old boy developed neck swelling and slight dyspnea after frequently diving into a pool. Physical examination revealed subcutaneous emphysema, and a subsequent X-ray examination confirmed the presence of air in the mediastinum. Fiberoptic bronchoscopy revealed localized submucosal hemorrhage and coating beneath the lower margin of the cricoid cartilage, suggesting tracheal repture. However, exploratory surgery of the neck could not confirm a rupture, and the case was diagnosed as spontaneous idiopathic mediastinal emphysema with subcutaneous emphysema.
A travheotomy was then performed for the continuing dyspnea, and antibiotic therapy was prescribed with bed rest. The mediastinal and subcutaneous emphysema gradually subsided within 10 days. On the 11th postoperative day, the tracheostoma was closed and the patient was discharged.
A statistival review was also made of 51 cases of spontaneous mediastinal emphysema including the present case, who have cisited the authors' clinic during the past 5 years.抄録全体を表示PDF形式でダウンロード (2199K) -
片田 彰博, 榎本 啓一, 小林 吉史, 野中 聡, 海野 徳ニ, 坂本 尚志1996 年 47 巻 3 号 p. 340-345
発行日: 1996年
公開日: 2010/10/20
ジャーナル フリーChanges in the laryngeal reflex were estimated after the cough reflex induced by repetitive stimulation (30 Hz) to the internal branch of the superior laryngeal nerve (iSLN) in ketamine-anesthetized cats. TThe laryngeal reflex was induced by a single iSLN stimulation (0.5 Hz). The magnitude of the laryngeal reflex in the thyroarytenoid muscle increased to about 200% of its level before the cough reflex. This significant increase continued for about 150 s after the cough reflex. These results suggest that the excitability of the motoneurons innervating the laryngeal adductor muscles is increased after the cough reflex.抄録全体を表示PDF形式でダウンロード (1152K)
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