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Volume 49 (1998)
- Issue 6 Pages 463-
- Issue 5 Pages 395-
- Issue 4 Pages 317-
- Issue 3 Pages 243-
- Issue 2 Pages 53-
- Issue 1 Pages 1-
Volume 49, Issue 3
Displaying 1-9 of 9 articles from this issue
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Fumiyo Kudoh, Yoshimi Sasamura, Sanzo Takemiya1998 Volume 49 Issue 3 Pages 243-248
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSEleven severely handicapped young patients with recurrent aspiration pneumonia were treated with the glottic closure procedure. Their diseases were hypoxic encephalopathy, cerebral palsy, mitochondrial myopathies and after effects of Reye's syndrome. Glotticclosure was successful in treating all of these patients. The incidence of recurring pneumonia and the suction frequency remarkably decreased. Home nursing requirements also decreased and the quality of the life of the patients and home nurses improved. It was concluded that this procedure was effective and posed little risk for the treatmentof aspiration in severely handicapped young patients.View full abstractDownload PDF (4696K) -
Masato Yokoyama, Natsuhiko Mitomi, Katsuhiko Tetsuka, Niro Tayama1998 Volume 49 Issue 3 Pages 249-258
Published: June 10, 1998
Released on J-STAGE: November 26, 2010
JOURNAL FREE ACCESSA quantitative analysis of the pharyngeal phase of swallowing was performed by simultaneous video recording of fluoroscopy and manometry on 32 asymptomatic young adult volunteers (16 males 16 females). Pressure changes were measured by an intraluminal manometric probe, outer diameter 3.0 mm, inserted into the cervical esophagus via the nose. Three radiopaque microsensors, spaced at 4 cm intervals and oriented posteriorly, recorded pressure changes from the oropharynx, hypopharynx and upper esophageal sphincter (UES). Motion pictures of the videotapes were bed into a personal computer, and laryngeal movement was measured horizontaly and verticaly. Oropharyngeal manometry revealed high intrabolus pressure, whereas hypopharyngeal manometry showed low intrabolus pressure except for the bolus tail passage. A correlation analysis revealed that there were significant increases in UES relaxation time with increasing UES transit time (r=0.72, p<0.0001). The rapidly ascending movement of larynx started significantly early, compared to the rapid forward movement (p=0.0001). UES pressure descended with the rapid forward movement of the larynx, and the minimum pressure (negative values in 22 cases) occurs immediately prior to the arrival of the bolus at the piriform sinus. Our study suggests that oropharyngeal pressure drives the bolus and not only minimizes pharyngeal residue after swallowing, and that the two directions of the laryngeal movement have different functions, first the ascending movement protects the airway by tilting the epiglottis. The forward movement decreases the UES pressure to enable the passage of the bolus.View full abstractDownload PDF (3185K) -
Hirokazu Uemura, Takeo Sato, Kunitoshi Yoshino, Takashi Fujii, Ken-ich ...1998 Volume 49 Issue 3 Pages 259-262
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSCervical esophageal cancer is usually diagnosed at an advanced stage, and treatment is often limited to palliation. So it is difficult for the patients to benefit fully from treatments such as surgery, irradiation and chemotherapy. Surgery, which offers the best relief of dysphagia, is controversial. Surgery must support the Quality of Life (QOL) of patients with cervical esophageal cancer. We treated 41 patients for cervical esophageal cancer, 20 patients by surgery, 18 patients by radiotherapy, and 3 patients by palliative chemotherapy. As is often the case in reports of cervical esophageal cancer, our results were poor. The 5-year overall survival rate was 12% (5/41). The patients treated surgically wereable to feed orally for a longer period than the patients treated with irradiation-a mean of 24 monthsand 13.4 months, respectively. Thus, surgery in cervical esophageal cancer can support one aspect of QOL in patients.View full abstractDownload PDF (755K) -
Shinya Hiroshiba, Masahiro Tanabe, Manabu Minoyama, Tadahiko Sugimaru, ...1998 Volume 49 Issue 3 Pages 263-268
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe reviewed 14 cases of tracheobronchial foreign bodies in infants treated between 1982 and 1996 at the Osaka Red-Cross Hospital. In all cases, the foreign bodies were successfully removed using a ventilation bronchoscope under general anesthesia. The most common foreign body was a peanut, as noted in other reports. Chest X-ray findings suggested hype lucency in 7 cases, pneumonia in 2 and mediastinal shift in 2, while there were no remarkable changes found in 3 cases. Major signs and symptoms were dyspnea, wheezing and coughs in 13 cases, fever in 10 and cyanosis in 7. Preoperative administration of steroids was effective in facilitating removal of a lonstanding foreign body. We suggest that steroids should be preoperatively administered to patients who have retained a foreign body for a long period.View full abstractDownload PDF (4414K) -
Rie Urakami, Yuji Tohda, Hirokazu Kubo, Masahiro Fukuoka, Shigenori Na ...1998 Volume 49 Issue 3 Pages 269-279
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe authors prepared a dual-phase asthmatic response model (DAR), an immediate asthmatic response model (IAR) and a continual asthmatic response model by sensitizing Hartley-strain male guinea pigs. The purpose was to study serial changes to T-cells in the bronchial tissue of each model with fluorescence stains using either anti-CD4 antibodies or anti-CD8 antibodies. Histologically, in the DAR group marked CD4+ cells were observed at 4 h after contact with aerosolised OA, which decreased after 24 h. CD8+ cells incresed at 24 h after contact in the bronchial walls of the DAR group. In IAR group, a few CD4+cells were seen 4 h after contact. In the continual asthmatic response group, marked CD4+cells were observed 4 h after contact, and infiltrates of CD4+ cells were not seen to decrease at 24 h after contact- Further, the DAR group received either an anti-CD4+ antibody or an anti-CD8+antibody intraperitoneally 30 min before contact. The depletion of CD8+cells in the model indicates the presence of DAR. In the asthma model, CD4+ T cells inhabited the LAR after antigen inhalation.View full abstractDownload PDF (10592K) -
Keiichi Chijiwa, Kazunori Mori, Tadashi Nakashima1998 Volume 49 Issue 3 Pages 280-286
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSBetween 1978 and 1996, 123 patients (25 males, 98 females) with T4 papillary thyroid carcinoma and a mean age of 60 years received surgical treatment at the Kurume Universit Hospital. In this paper, the maximum size and invasive portion of these tumors were reviewed, and their influence on overall survival rate was analysed. The TNM classfication was adopted in this study. With respect to T categories, there were 101 T4a and 22 T4b patients. With respect to N categories 34 patients were at stage NO, 65 were Nla, and 24 were Nib. As for the maximum size of the primary tumor, tumors with a size of more than 2 cm but less than 3 cm were most frequent (28%). The recurrent laryngeal nerve was most frequently observed in vasion site of the primary tumor. The overall five- and ten-year survival rates as determined by the Kaplan-Meier method were both 91% over the entire series. With respect to the T categories, the five-and ten-year survival rates of T4a were both 90%, whereas those of T4b were both 96%. From the point of view of treatment modalities, subtotal and total thyroidectomy are preferable for T4 cases whose tumor size is greater than 4 cm. In addition, extended dissection may be necessary for cases wherethe tumor invades the larynx, carotid artery and/or jugular vein.View full abstractDownload PDF (1301K) -
Kazunori Mori, Kazuhide Tomita, Buichiro Takase, Ryu Kusaba, Tadashi N ...1998 Volume 49 Issue 3 Pages 287-291
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSA two-yeas-old boy with subglottic cicatricious stenosis who underwent treatment with the use of specially designed T-tube was reported. He was admitted to our hospital complaining of difficulty in decanulation. Direct laryngoscopy revealed that his subglottis was stenotic and, in addition, that there was a posterior glottic stenosis. When he was five years old he underwent open reduction surgery. Laryngofissure was performed, and the cicatricious tissue was removed. After a posterior cn coid split was done, followed by an autograft of his rib cartilage, his cheek mucosa was transplanted. Three days after the operation, a specially designed T-tube was anchored. The top and of this silicone T-tube was convex-shaped and closed, and its size was pre-determined in consideration of his larynx and trachea. With the use of this T-tube, no granulation was observed, and no further stenosis developed, resulting in a good clinical outcome. This new type of T-tube seems to be useful and effective for the treatment of subglottic stenosis.View full abstractDownload PDF (4238K) -
Hironori Sakurai, Yoshiro Yazawa, Kazutomo Kitajima, Hiroshi Tanaka, H ...1998 Volume 49 Issue 3 Pages 292-295
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe case of a 26-year-old female with a laryngeal paraganglioma after treatment for a carotid body tumor is reported with a review of the literature. She first visited our department with a chief complaint of hoarseness in 1994. We found a submucosal tumor in her supraglottic area. She had been treated for a carotid body tumor at another hospital in 1989. We operated for the submucosal tumor by laryngofissure. The histopathological diagnosis was paraganghoma. The tumor has not recurred since the operation. Laryngeal paraganghoma is rare in the head and neck. In Japan, this is the first report of both laryngeal paraganglioma and carotid body tumor occurring in one persons. We also discussed the clinical characteristics of the laryngeal paraganglioma and the multiple characteristics of paraganglioma of the head and neck.View full abstractDownload PDF (2580K) -
Hidetsugu Katoh, Hikaru Ishizuka, Ichiroh Tsujino1998 Volume 49 Issue 3 Pages 296-300
Published: June 10, 1998
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe report a case of active pulmonary tuberculosis and coexistent lung cancer. A 65-yearold man was admitted to our hospital for investigation of a dry cough. This patient had a history of thoracoplasty inresponse to pulmonary tuberculosis. A flexible fiberoptic bronchoscopy was performed : the brushings and washings were negative for tubercle bachilh on smear but positive for adenocarcinoma. Immediately, the patient was placed on CDDP, VDS and MMC for lung cancer. Acid-fast bacilli were found on a culture of the sputum and washing fluid. M. tuberculosis was found on subsequent cultures at the end of the first antitumor chemotherapy. The patient was started on rifampicine, isoniazid and ethambutol for pulmonary tuberculosis and was given continued antitumor chemotherapy for lung cancer. There is so far no evidence of the recurrence of either the lung cancer or the pulmonary tuberculosis.View full abstractDownload PDF (6122K)
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