巻号一覧
48 巻 (1997)
- 6 号 p. 431-
- 5 号 p. 371-
- 4 号 p. 297-
- 3 号 p. 211-
- 2 号 p. 51-
- 1 号 p. 1-
48 巻, 6 号
選択された号の論文の8件中1～8を表示しています
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特に臨床疫学面および喉頭温存率の面から藤井 隆, 佐藤 武男, 吉野 邦俊, 稲上 憲一, 長原 昌萬, 沖田 純1997 年 48 巻 6 号 p. 431-437
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーA total of 1160 patients with previously untreated laryngeal carcinoma were registered in our hospital between 1979 and 1994. The mean age was 64 years (range: 22-91 years). These patients consisted of 746 cases of glottis, 393 supraglottis, 14 subglottis, and seven multicentric carcinomas. Some trends in their clinical epidemiological status and the laryngeal preservation rate were observed and compaired between the following two periods; 1979-1986 and 1987-1994.
Our conclusions are listed below.
1) The age distribution was similar in both periods. Taking into account the increase in the ratio of early stages (stage I, II), however, it may be that there was a tendency toward older age.
2) The number of patients with glottic carcinoma increased from 356 to 390, whereas, those with supraglottic carcinoma decreased from 200 to 193.
3) The laryngeal preservation rate in glottic carcinomas increased from 58% to 78%, although the proportion of T1 to T2 cases showed an increase of only 7%. The laryngeal preservation rate in T1 and T2 cases increased from 68% to 85%. Similarly, the laryngeal preservation rate in supraglottic carcinoma increased from 10% to 27%, although the proportion of T1 to T2 cases showed an increase of 11%. The laryngeal preservation rate of T1 to T2 cases increased from 24% to 44%. Consequently, it was suggested that the increase in the laryngeal preservation rate in cases of laryngeal carcinoma was dependent on not only an increase in the proportion of T1 to T2 cases, but also on an improvement in their diagnosis and treatment.抄録全体を表示PDF形式でダウンロード (1108K) -
谷垣 裕二, 久保田 彰, 古川 まどか, 佃 守1997 年 48 巻 6 号 p. 438-444
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーThe incidence of multiple primary cancers in patients with head and neck cancer has increased recently. Recent reports descrive the frequency of second primary cancers as being over 10% of the incidence of first primary cancers.
Fifty five cases with multiple primary cancers were found among 501 cases with head and neck cancer who had been treated at the Department of Head and Neck Surgery, Kanagawa Cancer Center from 1986 to 1996. These patients were evaluated according to prognosis and therapy. The highest incidence of second primary cancers was found in hypopharyngeal cancers. Second primary cancers also developed frequently in stomach, esophagus and lung cancers. The 5-year survival rate of the patients was 24.4%. There was a significance in the survival rate according to the presence or the absence of curative treatment for first primary cancers. However, there was no significant difference between treatments for the second primary cancers, either curatively or palliatively.
Therefore, it was concluded that the control of first primary cancers is the most important factor in treatment, and it is suggested that second primary cancers be treated considering a patient's prognosis, quality of life and volition according to the tumor location.抄録全体を表示PDF形式でダウンロード (647K) -
当教室29年間の集計高橋 利弥, 金田 裕治, 小田島 葉子, 村井 和夫1997 年 48 巻 6 号 p. 445-450
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーOne hundred seventy cases of tracheo-bronchial foreign bodies, treated at our clinic between 1967 and 1995, were analyzed. Most of the tracheo-bronchial foreign bodies were observed in infants under 2 years of age. Eighty-four cases had aspirated peanuts. Foreign bodies were found in the trachea of 32 cases, in the right bronchus of 65 cases, in the left bronchus of 72 cases, and in both bronchi in 1 case. Almost all of the foreign bodies was removed by using a ventilation bronchoscope under general anesthesia.抄録全体を表示PDF形式でダウンロード (611K) -
大垣 治幸, 平林 秀樹, 山本 勝彦1997 年 48 巻 6 号 p. 451-457
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーThe prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was assessed in a bronchoesophagological ward (group A: patients with bronchoesophageal fistula, group B: medical staff controls) at Dokkyo University Hospital September to December 1995 and the nurse students in other hospitals in Saitama Prefecture (group C). The incidence of Staphylococcus aureus was 50-60% in the three groups and the frequency of MRSA was 60% in group A, 38% in group B, and 14% in group C.
Coagulase types and antimicrobial susceptabilities of isolated strains were determined. The coagulase typing for MSSA and MRSA was different. MRSA were multi-resistant, to β-lactams and to one or more antimicrobial agents, but were susceptible to streptomycin, habekacin, chloramphenicol, gentamicin, minocyclin, imipenum and vancomycin.抄録全体を表示PDF形式でダウンロード (829K) -
三井 雅夫, 越智 健太郎, 中島 博昭, 金子 卓爾, 木下 裕継, 宮本 康裕, 大塚 崇志, 大橋 徹, 加藤 功1997 年 48 巻 6 号 p. 458-462
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーDamage to the recurrent laryngeal nerve (RLN) or the external branch of the superior laryngeal nerve (ebSLN) remains a leading complication during thyroid or parathyroid surgery. A method for the identification and preservation of these nerves is described. We monitored the mobility of the vocal cords through a laryngeal fiberscope using an electric nerve stimulator. We identified the 8 RLNs and the 7 ebSLNs safely in six patients with thyroid tumors. We were able to confirm the integrity of these nerves at the end of the operation in all cases. The results of the function of these nerves were excellent. We observed no palsy after surgery in any of our cases. The main advantages of our method are its simplicity, noninvasiveness and cost effectiveness. Thus, this method for monitoring the RLN or ebSLN is highly recommended during surgical procedures.抄録全体を表示PDF形式でダウンロード (2760K) -
村川 哲也, 中之坊 学, 松永 毅, 北原 哲1997 年 48 巻 6 号 p. 463-467
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーChondrosarcoma of the larynx is a very rare tumor originating in cartilage. Endoscopic resection, laryngofissure and total laryngectomy have all been performed in such cases, depending on the size of tumor.
In this paper, we report on chondrosarcoma originating in the cricoid cartilage of a 51-year-old woman who required a total laryngectomy. The chief complaint was hoarseness. A hard tumor 2cm in diameter was palpable slightly to the left of the median line at the level of the cricoid cartilage. Endoscopic examination revealed a subcutaneous tumor under the glottis on the left and an upward displacement of the left vocal cord. On CT, the tumor consisted mainly of cricoid cartilage, but no destruction of the thyroid cartilage was seen. The percutaneous FNA was class IIIb, so chondrosarcoma was suspected. Since the tumor extended beyond the patient's median line, she was diagnosed by frozen section as having a malignant tumor. A total laryngectomy was performed. The diagnosis of chondrosarcoma was confirmed by a pathological examination.抄録全体を表示PDF形式でダウンロード (2851K) -
鈴木 敏弘, 河田 了, 村上 泰1997 年 48 巻 6 号 p. 468-474
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーWe reported on two cases of laryngeal hemangioma. One was a 67-year-old male complaining of hoarseness. Laryngoscopic findings suggested laryngeal hemangioma, and other examinations supported this diagnosis. We approached the tumor by a lateral laryngotomy on the contralateral side. Surgical findings showed that the tumor had developed from the false cord, and the histological examination revealed a cavernous hemangioma.
The second patient, a 75-year-old male, complained of throat discomfort. A dark red mass was found by laryngoscopy to be located on the left aryepiglottic fold and epiglottis. The tumor was resected by lateral pharyngotomy on the ipsilateral side. This case was also revealed to be a cavernous hemangioma by the histological examination.
As a result of these cases, lateral pharyngotomy and lateral laryngotomy were judged to be safe surgical approaches for larygeal lesions such as hemangioma.抄録全体を表示PDF形式でダウンロード (8780K) -
坂本 菊男, 森 一功1997 年 48 巻 6 号 p. 475-479
発行日: 1997/12/10
公開日: 2010/02/22
ジャーナル フリーRelapsing polychondritis (RP) is a rare disease of unkown etiology. It is generally thought to be a progressive inflammation of cartilagenous structures throughout the whole body. In this paper, a rare case of RP which successively caused esophageal stenosis was reported. A 50-year-old female, who had been aware of working dyspnea since 1986, was diagnosed as having RP by the serological method using anti-type-2 collagen antibody. Although she had been administered steroids orally since then, her tracheal stenosis was gradually impaired, and she underwent tracheal fenestration for dyspnea on February 1994. She was admitted to our hospital again on 1996, because of progressive swallowing difficulty. With the use of fluorography, CT and MRI, she was diagnosed as having an esophageal stenosis caused by a long-term inflammatory influence on the esophageal wall. Under general anesthesia, a balloon dilator was inserted through one of her nostrils and fixed. Water was inflated 3 times a day, monitoring her pain, from the next day. Each trial was 15 minutes. After the treatment was continued for 3 weeks, the dilator was removed and she could begin to eat orally. About a month later, she could eat normal food. For the year following this procedure, she has not complained of swallowing difficulty.
For the treatment of esophageal stenosis, surgical operation, the bougie method, endoscopic dilatation and balloon dilator have all been attempted. Using a ballooon dilator may require long-term treatment to improve esophageal stenosis, compared to other methods. However, it has thought to be the best selection for this patient since it involved little pain and avoided several complications.抄録全体を表示PDF形式でダウンロード (3765K)
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