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Volume 50 (1999)
- Issue 6 Pages 579-
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- Issue 4 Pages 463-
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- Issue 2 Pages 217-
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Volume 50, Issue 6
Displaying 1-12 of 12 articles from this issue
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Yoichi Ikeda, Akira Kubota, Madoka Furukawa, Mamoru Tsukuda1999 Volume 50 Issue 6 Pages 579-584
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSUltrasonography has been used in detecting cervical lymphnode metastasis. During the 7 years from 1992 to 1998, we treated 91 cases with previously untreated laryngeal cancer. They were retrospectively reviewed and the long-term results were analysed. Generally, curative radiation therapy was indicated for T1 and T2 tumors (75 cases), and total laryngectomy was applied for T3 and T4 tumors (16 cases). Preventive treatment for the cervical lymphnodes was not performed in N0 cases.
The cause-specific, 5-year survival rate was 89%, and the larynx preservation rate was 66% of the total cases and 78% of the T1 and T2 cases.
In both the N0 and N+ cases, loco-regional control was good, but distant metastasis was remarkably observed in dead cases with N+. There were only two recurrences of cervical lymphnode metastasis in the N0 cases (2.6%). Therefore, it seems that preventive treatment for the cervical lymphnodes in N0 cases might not be necessary when they are evaluated with ultrasonography.View full abstractDownload PDF (1731K) -
Hiroshi Morikawa, Manabu Nakanoboh, Tetsuya Tanabe, Etsuyo Tamura, Sat ...1999 Volume 50 Issue 6 Pages 585-590
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe reviewed 20 cases of tracheo-bronchial foreign bodies in children below 15 years of age, who were treated at our department between 1978 and 1995. Clinical observations pointed out the importance of prevention, earlier diagnosis and earlier treatment. Ventilation bronchoscopy was performed in 22 cases. In 20 out of the 22 cases, tracheo-bronchial foreign bodies were confirmed. In one of the 20 cases, we did not suspect a tracheo-bronchial foreign body from the past history, X-ray or physical findings, but ventilation bronchoscopy was performed because the patient's condition worsened. Therefore, the past history should be reviewed in detail to pursure any possibility of tracheo-bronchial foreign bodies. In the case of children, operations should be performed at the earliest possible time to diagnose and treat tracheobronchial foreign bodies, if their presence is even suspected, because it often happens that their conditions worsen immediately.View full abstractDownload PDF (721K) -
Ichirou Motomura, Toshio Ichiwata, Hitoshi Hiraoka, Koshu Nagao1999 Volume 50 Issue 6 Pages 591-596
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSTracheobronchomalacia (TBM) causes severe symptoms such as intense dyspnea and loss of consciousness because of the obstruction of the upper respiratory tract associated with either, persistent or fitful coughing. The disease's course is frequently observed as intractable bronchial asthma.
We had 14 patients with TBM during the 15-year period after our hospital was founded, and we studied their clinical background. All of these patients had primary disease. In 12 of these 14 patients, chronic obstructive lung disease (8 patients with bronchial asthma and 6 patients with emphysema) was the diagnosis. Steroid dependence was observed in 6 patients. It was concluded that these complications had some relation to the disease in question. A saber-sheath type in 10 patients and a crescent-type in 4 patients were observed. Additionally, while examination of the lung function disclosed notch on flow-volume curve in 6 of the patients. The anteroposterior and transverse diameters of the bronchus, on chest X-ray, CT scans, cinebronchography, bronchoscopy, and the detection of notch on flow-volume curve were all useful for diagnosis.View full abstractDownload PDF (3790K) -
Hideto Saigusa, Minoru Akiyama, Seiji Niimi, Toshiaki Yagi1999 Volume 50 Issue 6 Pages 597-602
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSSome patients who have had their oropharyngeal organs resected due to malignant tumors (especially tongue carcinoma) suffer from a disorder involving transport of a bolus to the oropharynx. Similarly, some of nuromuscular disorders do not impair the pharyngeal swallowing function as much as the oral function. However, devices to aid in disorders of transporting food to the oropharyngeal cavity have not been developed.
Devices that can enable adequate control as to transporting point, direction, and feeding rate with ease are needed. They must be useable not only by the patients, but also by their helpers when patients can not use the devices by themselves. From this view point, we examined and improved on some new devices with our patients.View full abstractDownload PDF (3494K) -
Satoshi Kitahara, Tetsuya Tanabe, Manabu Nakanoboh, Takehiro Karaho, Y ...1999 Volume 50 Issue 6 Pages 603-608
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe experienced 21 patients who were administered surgical procedures to prevent aspiration in the Otolaryngology Department of the National Defense Medical College Hospital between January 1989 and March 1999. Details are as follows; 5 cases of Lindeman's tracheo-esophageal anastomosis; 2 cases of Lindemasn's laryngo-tracheal diversion; 1 case of Habal-Murray's laryngeal closure (epiglottis and aryepiglottic fold suture procedure; 7 cases of glottal closure, and 6 cases of closure of the false vocal folds. The surgical procedure had to be frequently restricted for each case according to the location of the tracheostoma, the etiology and prognosis of dysphagia, the condition of daily care, and other factors. However, to select a specific method we followed the principle that we should begin with explanation to the patient and his/her family about the available methods to prevent aspiration, as well as their expected outcomes. Then, the method chosen by the patient and his/her family was re-confirmed by the clinician.View full abstractDownload PDF (5341K) -
Satoshi Kawai, Mamoru Tsukuda, Izumi Mochimatsu, Yuumi Kagesato, Shige ...1999 Volume 50 Issue 6 Pages 609-614
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe discussed five cases of open injuries to the larynx with sharp instruments in suicide attempts.
In these cases, (1) laryngoplasty was performed early. (2) Tracheostomy was done at the lower part of the injury to keep the airway open. (3) The wound was observed carefully. And (4) The mucosa of the larynx was sutured firmly so as not to yield a raw surface with a synthetic monofilament, whether absorptive or not. Sometimes, the suture filament penetrated in the lumen of the larynx without any problem.
The prognosis for the larynx in these cases was generally good. The risk of permanent laryngeal palsy was supposed to be little.
However, all the patients might have psychiatric disease, i. e. schizophrenia or depression. We must consider their psychiatric background.View full abstractDownload PDF (2689K) -
Eiji Yoshimura, Kazuhiko Takeuchi, Yasuo Sakakura1999 Volume 50 Issue 6 Pages 615-619
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA rare case of adenosquamous carcinoma of the larynx was reported. The patient was a 79-year-old female who visited our clinic with complaints of dyspnea and hoarseness which had lasted for about four months. A large tumor extending into the supraglottic region was found. The histological diagnosis of a biopsied specimen was squamous cell carcinoma. Total laryngectomy and radical neck dissection on the right side were performed. The ultimate diagnosis of the removed tumor was adenosquamous carcinoma. There was a lymph node metastasis which consisted of squamous cell carcinoma only in the right mid-internal jugular nodes. The patient was free from recurrence for nine months, but died as a result of a hemorrhage in her digestive tract and pneumonia.View full abstractDownload PDF (5415K) -
Shotaro Karino, Takashi Fukaya, Niro Tayama, Katsuhiko Tezuka, Natsuhi ...1999 Volume 50 Issue 6 Pages 620-624
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThyroplasty type I is one of various surgical treatments for glottic insufficiency following unilateral recurrent nerve paralysis. However, the choice of materials for the prosthesis inserted into the thyroid cartilage is controversial with regard to stability and safety. We experienced a case of laryngeal palsy caused by syringomyelobulbia. Thyroplasty type I was performed with a silicone block 18 years ago to prevent aspiration pneumonia, but in accordance with progress of the laryngeal palsy, the patient developed severe pneumonia. We performed a total laryngectomy for the improvement of his dysphagia, and conducted a histopathological study of the larynx with the silicone prosthesis. We found slight fibrinogenesis around the silicone block, however, foreign body giant cells, inflammatory cells, or absorption of silicone were not observed. We tentatively concluded that these findings show the stability and safety of silicone as a prosthesis for thyroplasty type I.View full abstractDownload PDF (3717K) -
Taichi Furukawa, Manabu Nakanoboh, Etsuyo Tamura, Naoyuki Kohno, Satos ...1999 Volume 50 Issue 6 Pages 625-630
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSSpindle cell carcinoma of the hypopharynx is very rare. A 67-year-old man with spindle cell carcinoma of the pyriform sinus was presented at our clinic. The lesion was large with a massive tumor in the right hypopharynx filling the right pyriform sinus. Computed tomography revealed destruction of the thyroid cartilage. Metastasis was not detected. Since the first endoscopic biopsy of this lesion suggested small cell carcinoma, the patient was treated with chemotherapy consisting of CBDCA and VP-16, and the lesion was markedly reduced. After neo-adjuvant chemotherapy, partial laryngopharyngectomy and right neck dissection were performed. The pathological report for the surgical specimen was spindle cell carcinoma. Adjuvant chemotherapy (same regimen as the neo-adjuvant chemotherapy) was performed. One year after the surgery, a tumorous lesion could be seen in the right tonsil. The lesion was removed and the pathological finding for this lesion was squamous cell carcinoma. The relation between the spindle cell carcinoma of the pyriform sinus and the squamous cell carcinoma of the tonsil was unclear. The patient underwent postoperative radiotherapy at a dose of 42 Gy and shows no evidence of local recurrence or regional metastasis 6 months after the second surgery.View full abstractDownload PDF (8021K) -
Tomoya Koriyama, Shigeru Inafuku1999 Volume 50 Issue 6 Pages 631-636
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThis report describes a successful conservative treatment of cervical esophageal perforation due to a flexible fiberscopy. The cervical esophagus of a 38-year-old man was perforated during upper gastrointestinal endoscopy using a flexible fiberscopy. Oral intake was withheld and high-dose antibiotics were administered through the central venous system. Body temperature, WBC and CRP were monitored to locate early signs of infection. Surgery was not attempted since the only symptoms seen were an elevated WBC and CRP within 48 hours after the injury, with no further serious infection or abscess. Oral intake was restarted on the 11th day and the patient was discharged on the 13th day. He has shown no subsequent adverse symptoms and has returned to work.View full abstractDownload PDF (3951K) -
Yoshiaki Iguchi, Yoshitsugu Ogawa, Kazuhiro Yamamoto, Akihiko Itoh1999 Volume 50 Issue 6 Pages 637-642
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSWe performed arytenoidectomies under microlaryngoscopy in three cases, two males and one female, suffering from severe dyspnea secondary to vocal cord paralysis. In all three cases, a tracheostomy was made prior to the surgery. In two of the cases, bilateral paralysis of the vocal cords was found, while the other case showed a narrow glottis with left vocal cord paralysis and a twisted larynx from the thyroid carcinoma. After arytenoidectomy, the dyspnea was improved in all three cases, and the tracheostoma was closed in the former two cases. Although several surgical techniques have been reported for patients with narrow glottis, most of them present some technical difficulties. A microlaryngoscopic approach for arytenoidectomy requires no incision, and the technique is relatively easy compared to other methods and useful for the treatment of dyspnea due to vocal cord paralysis.View full abstractDownload PDF (6041K) -
Joji Ishii, Kensei Naito, Sho Miyata, Yoshio Senoh, Naoki Yokoyama, Re ...1999 Volume 50 Issue 6 Pages 643-647
Published: December 10, 1999
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSTo determine the influence of local antigen exposure doses of Japanese cedar pollen on the sensitization and severity of hay fever, we examined three groups of Brown Norway rats. These consisted of a high exposure group, a lower exposure group and controls. In the high exposure group, the rats were exposed daily to 20μg Cry j I, one of the major allergens for Japanese cedar pollinosis, 5 days per week for 6 months pernasally. In the lower exposure group, the rats were exposed to 2μg Cry j I, and nil in the controls. After local exposure, these rats were immunized twice on day 0 and day 13 with intraperitoneal injections of 10μg Cry j I with 4.5mg aluminium hydroxide gel.
The serum levels of anti-Cry j I IgE antibodies were determined by the method of reverse IgE-capture enzyme-linked immunosorbent assay (ELISA). The mean value of the serum specific IgE level in the high exposure group was significantly higher than that in the low group.
The mean value of the serum specific IgE in the low group was significantly higher than that in the controls. The extent of the local eosinophilia of the nasal mucosa in the high group was significantly greater than that in the controls but not than that in the low group. The extent of the laryngeal eosinophilia in the high group was significantly greater than that in the low group on the controls.
Only small eosinophil accumulations were observed in the tracheal mucosa of the three groups.View full abstractDownload PDF (2803K)
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