巻号一覧
48 巻 (1997)
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48 巻, 5 号
選択された号の論文の9件中1～9を表示しています
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村上 泰1997 年 48 巻 5 号 p. 371-375
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーIn surgery for some selective cases with bronchoesophageal lesions, the cooperative work of several surgeons from different departments has been recommended and nowadays is regularly performed in many institutes. The increase in surgical specialization may necessitate the participation of many specialists. The increase in simultaneously developing carcinomas in different regions-such as esophageal carcinoma together with carcinoma of the head and neck regions-may give impetus to this phenomenon. It should be realized that better results can only be expected with the mutual agreement of the different surgeons involved.抄録全体を表示PDF形式でダウンロード (516K) -
浅井 昌大1997 年 48 巻 5 号 p. 376-380
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーThe cooperation of many departments is needed for surgery of head and neck cancer-for example, otolaryngologists, head and neck surgeons, dentists, anesthesiologists, thoracic surgeons, abdominal surgeons, neurosurgeons, plastic surgeons, psychooncologists and others are all needed. The cooperation of several departments is also needed for surgery of the hypopharynx, especially head and neck surgeons, thoracic surgeons and plastic surgeons. For the smooth cooperation of each team, the coordination of the timing is important when another department joins the first surgery group. Good team work and coordination leads to excellent results.抄録全体を表示PDF形式でダウンロード (1094K) -
宇田川 晴司, 鶴丸 昌彦, 中村 潔1997 年 48 巻 5 号 p. 381-386
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーAmong 254 patients undergoing resection of hypopharyngeal and cervical esophageal carcinoma since 1972, muscle, fasciocutaneous or musculocutaneous flaps were used in 26 cases. Free intestinal grafting was performed in 28 patients. The surgical treatment of these patients which required plastic surgery techniques was reviewed.
The combination of extended lymph node dissection of the superior mediastinum via right thoracotomy and median sternotomy, laryngopharyngectomy, and permanent tracheostomy can lead to friction between the brachiocephalic artery and the trachea, with a risk of lethal fistula formation between the two structures. Pectoralis muscle interposition between these two structures is an important, but not infallible, technique for preventing this lethal complication. Ischemic necrosis of the trachea and preoperative radiation are risk factors. Grillo's operation was successfully done in 8 patients. Pectoralis musculocutaneous flaps were used in 7 patients for reconstruction, and a latisimus dorsi muscle flap was used in 1 patient. Free intestinal grafting is a useful technique, but great care should be taken to avoid leaving another malignant lesion in the residual esophagus in the thorax.
When surgeons of various specialities work together on a patient with hypopharyngeal or cervical esophageal cancer, detailed preoperative discussion and flexible intraoperative judgments can help achieve success.抄録全体を表示PDF形式でダウンロード (562K) -
井上 要二郎, 田井 良明, 藤田 博正, 矢永 博子, 清川 兼輔, 森 一功1997 年 48 巻 5 号 p. 387-395
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーIn the 9 years from 1988 to 1996, a hundred and sixty-two patients (Surgery 81, ENT 81) underwent hypopharynx, cervical and thoracic esophageal reconstruction using microvascular anastomoses by our team (Thoracic Surgery, ENT and Head and Neck Surgery and Plastic Surgery). This series comprises 128 patients with reconstructions using a free jejunal transfer, and 34 patients with additional microvascular anastomoses supercharge in colonic interposition for thoracic esophageal replacement.
The free jejunal transfer success rate was 95.3% (122/128). Seventy-four patients undergoing typical reconstruction for hypopharyngeal cancer were reviewed. The fistula formation rate in anal and oral anastomosis was 4.1% (3 of 74) and 9.5% (7 of 74).
Twenty-nine patients underwent colonic pedicle interposition with additional microvascular anastomosis (supercharge). The middle colic artery and vein were the major donor vessels (17), and the internal mammary artery and vein were the major recipient vessels (18). Twenty-nine patients who had undergone colonic pedicle operation with supercharge were compared and reviewed with twenty-four patient who had had reconstruction without supercharge. The supercharged group was superior than the other group in terms of its fistula formation rate (p=0.01), the period which was needed for resumption of an oral diet after the operation and the average hospital stay.
Gastric pedicle with free jejunal interposition was performed in 21 patients. Fourteen of 21 patients underwent these operations because of a double cancer.抄録全体を表示PDF形式でダウンロード (2409K) -
新再建法田中 信三, 田辺 正博, 箕山 学, 廣芝 新也, 岩永 迪孝1997 年 48 巻 5 号 p. 396-400
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーA new method for the reconstruction of the arytenoid region and the vocal fold after subtotal laryngectomy was developed. The lateral half of the thyroid ala on the affected side was conserved with the thyropharyngeal and sternothyroid muscles attached. The superior and inferior horns were resected, and the thyroid cartilage was directly and firmly fixed to the cricoid cartilage. A local skin flap from the anterior neck was used to cover the inside of the thyroid cartilage.
This method was performed for a patient with T3 supraglottic carcinoma invading the pre-epiglottic space and the unilateral vocal fold. The superior half of the larynx including the hyoid bone, the arytenoid cartilage and the vocal fold on the affected side and the anterior third of the vocal fold on the unaffected side were resected. After surgery, the functions of phonation, respiration and swallowing were successfully conserved without a recurrence of the carcinoma.抄録全体を表示PDF形式でダウンロード (3894K) -
大垣 治幸, 平林 秀樹, 山本 勝彦1997 年 48 巻 5 号 p. 401-407
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーSho-seiryu-to, one of the traditional Chinese medicines was used in tracheostomy patients in an attempt to eradicate methicillin-resistant Staphylococcus aureus (MRSA). Sho-seiryu-to was administered to 10 patients and eliminated MRSA in 6 of these. Another study was performed to determine the anti-MRSA activity of kampo medicines. The antibacterial activity of 4 kampo medicines (Sho-seiryu-to, Sho-saiko-to, Juzen-taiho-to and Ninjin-yoei-to) was measured. Sho-seiryu-to had an anti-MRSA effect, but the other 3 kampo meds. had no effect. Investigation of the anti-MRSA activity due to the different components of Sho-seiryu-to was performed by the dilution method. Ephedra herb was effective, glucyrrhiza root, cinnamon bark, schizandra fruit, peony root and dried ginger rhizome were slightly effective; while pinellia tuber and asiasarum root were not effective.抄録全体を表示PDF形式でダウンロード (899K) -
徳山 豊, 久松 建一, 橘田 豊, 岡本 美孝1997 年 48 巻 5 号 p. 408-417
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーRecent studies have revealed that abundant neuropeptide positive fibers exist even in the epithelium, suggesting that neuropeptides released from these fibers by various stimuli take part in epithelial responses in allergy and inflammation. The aim of this study was to clarify the effect of tachykinin on tracheal mucosal ciliated cells.
Mucosal specimens were obtained from the trachea of a rabbit sacrificed following nembutal injection into the peritoneum. The mucosal specimens were cut into 4×4mm pieces and cultured with RPMI 1640 in a 100% and humidified thermoregulated chamber at 37°C under 5% CO2 and 95% air. The mucosal surface was observed on a TV monitor at a magnification of approximately 2, 500× and was recorded simultaneously on video tape. The ciliary activity was photoelectorically measured on a TV screen.
Substance P (SP) and neurokinin A (NKA) induced ciliostimulations in a concentration-dependent manner showing a peak 1 to 2 minutes after exposure. Capsaicin, a potent SP liberator, showed a similar ciliostimulation, also in a concentration dependent manner. These ciliostimulations were completely blocked by pretreatment with a tachykinin-receptor antagonist. Thiorphan prolonged the duration of the ciliostimulation induced by SP and/or NKA, while it did not affect its maximum level. SP- and NKA-induced ciliostimulations were also completely blocked by verapamil, but not by propranolol or indomethacin. These results indicate that SP and NKA promote ciliary activity via the calcium channel, thereby increasing calcium concentration in the cytoplasm of ciliated cells.
Leukotriene C4 induced mild temporary ciliostimulation, but pretreatment with a tachykinin-receptor antagonist completely blocked this phenomenon, suggesting neuropeptide-mediated ciliostimulation.抄録全体を表示PDF形式でダウンロード (1164K) -
中尾 一成, 田山 二朗, 水野 正浩, 新美 成二1997 年 48 巻 5 号 p. 418-421
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーA 80-year-old man developed impairment in his laryngeal movement, vocal fold fixation and severe misdeglutition after radiotherapy for laryngeal carcinoma. Despite of several surgical treatments for aspiration pneumonia, the misdeglutition did not cease because of the stiffness in his larynx until a laryngectomy was finally performed. The resected larynx showed marked fibrosis, and it was considered as a late complication of radiotherapy. The treatment course in this difficult case is discussed.抄録全体を表示PDF形式でダウンロード (2407K) -
甲斐 智朗, 森田 一郎, 武田 広誠, 小川 明, 大沼 秀行, 市来 浩人, 山口 健吾1997 年 48 巻 5 号 p. 422-425
発行日: 1997/10/10
公開日: 2010/02/22
ジャーナル フリーTwo cases of esophageal foreign bodies were reported. As they were difficult to remove with a rigid esophagoscope and forceps, we used other techniques and could eventually remove them successfully.
Case 1 was a 14-month-old boy who complained of vomiting. Since a plain radiogram of his neck and chest revealed a round shadow just at the cricopharyngeal constriction, we made a diagnosis of an esophageal foreign body, and surgery was performed. We tried to remove the foreign body with a rigid esophagoscope and forceps, but it was too smooth for the forceps to hold. Thus we inserted a Foley catheter over the foreign body with the forceps, inflated the balloon on the gastric side, and drew out the catheter with the foreign body. The foreign body turned out to be a marble made of glass.
Case 2 was a 69-year-old male who had ingested his dentures by mistake. The radiogram of his neck showed an opaque binding shadow at the cricopharyngeal constriction. Though we tried to remove this with a rigid esophagoscope and forceps, it was firmly affixed to the esophageal wall. When we inserted a rectoscope, instead, and expanded the cricopharyngeal constriction, the foreign body was mobilized and we could remove it successfully.
Both of the above cases experienced no severe complications. It is important to diagnose the general condition of patients and the variety of foreign body appropriately in order to better choose the proper method for their treatment.抄録全体を表示PDF形式でダウンロード (4277K)
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