巻号一覧
50 巻 (1999)
- 6 号 p. 579-
- 5 号 p. 519-
- 4 号 p. 463-
- 3 号 p. 391-
- 2 号 p. 217-
- 1 号 p. 1-
50 巻, 3 号
選択された号の論文の8件中1～8を表示しています
- |<
- <
- 1
- >
- >|
-
高橋 典明, 阿久澤 浩司, 木曽原 朗, 山口 美樹, 大地 康司, 谷川 恵, 古屋 佳昭, 升谷 雅行, 堀江 孝至1999 年 50 巻 3 号 p. 391-395
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーA retrospective analysis was done of 88 patients with hemoptysis cared for between 1991 and 1997 at our institution. There were 56 male and 32 female patients, with a mean age of 52 years (range: 15 to 91 years). On chest X-ray, there were 31 patients (35.2%) with findings related to hemoptysis, and 57 patients (64.8%) with normal or no related findings. The part of lung from which the intrabronchial hemorrhage originated could be localized in 45 patients (51.1%) by bronchofiberscope. The upper right lobe was involved more often than the others. The most common underlying cause of hemoptysis was bronchiectasis, which accounted for 46.6% of our patients. Bronchial arteriography was performed in massive hemoptysis patients. Angiographic findings for the bronchial arteries consisted of dilatation, hypervascularity, bronchopulmonary shunts, and extravasation. Successful control of bleeding by conservative therapies was achieved for 64 patients (72.7%). There were 16 patients who underwent bronchial-artery embolization or operation, and 8 patients who had endobronchial treatment.抄録全体を表示PDF形式でダウンロード (592K) -
唐帆 健浩1999 年 50 巻 3 号 p. 396-409
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーThe purpose of this study was to determine the effect of the “chin-down” maneuver on the swallowing function. Ten normal volunteers were examined with videofluorography and manometry in both the neutral and the “chin-down” positions. The effect of this maneuver on the pharyngeal dimensions, hyoid motion, bolus flow, and manometric pressures at the base of tongue (BOT) was evaluated using 5ml of barium.
The “chin-down” maneuver significantly decreased the distance between the epiglottic tip and the posterior pharyngeal wall (PPW); the distance between the epiglottis and the arytenoid; the vallecular angle; the duration of the upper esophageal sphincter (UES) opening; and the duration of the anterior hyoid movement. The “chin-down” maneuver increased the epiglotto-tracheal angle; the duration of laryngeal closure; the duration of the BOT-PPW contact; the duration of the hyoid rest period in a maximal excursion; the maximum diameter between the anterior and the posterior wall of the UES; the peak pressure at the BOT; the duration of the pressure wave at the BOT; and the area under the curve of contraction at the BOT.
These results show that the “chin-down” maneuver advances airway protection, UES opening and the propelling force at the BOT during swallowing in normal volunteers. This maneuver may have a therapeutic value for treatment of dysphagic patients.抄録全体を表示PDF形式でダウンロード (5844K) -
手術術式の選択について石永 一, 加藤 昭彦, 山田 弘之1999 年 50 巻 3 号 p. 410-413
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーFrom 1986 to 1997, 16 patients with follicular carcinoma of the thyroid were treated at our department. Five patients underwent total thyroidectomy, and eleven patients lobectomy.
Two cases showed a post-operative recurrence and were diagnosed as having a widely invasive type of the underwent another operation.
Six patients underwent central neck dissection in addition to thyroidectomy, but all of these patients had no lymph node metastasis. The patients who had an insular pattern or a vascular invasion histologically were included in the widely invasive group.
Based on our findings, we adovocate hemithyroidectomy for patients with the minimally invasive type of cancer, total thyroidectomy for those of with the widely invasive type, and no prophylactic neck dissection for either group. Postoperative radio-iodine therapy is not neccesary for patients who will probably be resected completely.抄録全体を表示PDF形式でダウンロード (578K) -
河合 敏, 佃 守, 稲葉 鋭, 池間 陽子, 榎本 浩幸, 持松 いづみ, 廣瀬 肇1999 年 50 巻 3 号 p. 414-419
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーWe reported a rare adult case of chondromalacia of the epiglottic cartilage.
The patient was a 66-year-old male complaining of sleep apnea for the previous two years. There was neither a history of head and neck surgery, nor any head injury or coma.
Laryngofiberscopic findings showed a prolapse of the epiglottis during inspiration. Under polysomnography, this case was diagnosed as obstructive sleep apnea syndrome with an apnea index of 22.3. There were no physical findings suggesting elapsing polychondritis.
Considering the patient's age, a staged epiglottectomy was performed in order to avoid misswallowing after the operation. The staged operations to resect the majority of the free portion of the epiglottis were effective and resulted in no misswallowing.
The pathological finding for the resected epiglottic cartilage was chondromalacia of unknown etiology.抄録全体を表示PDF形式でダウンロード (6028K) -
千々和 圭一, 草場 隆, 森 一功, 中島 格1999 年 50 巻 3 号 p. 420-424
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーThe case of a 53-year-old man complaining of dyspnea and swelling in the left submandibular region was reported. Laryngoscopic examination revealed a swelling of the left aryepiglottic fold and false fold. Cervical tomography and CT imaging showed an air-filled mass in his left, lateral neck, superior and lateral to the thyroid cartilage. Based on these findings, the diagnosis was established as the combined type of laryngocele. After a tracheotomy was done under local anesthesia, the laryngocele was totally removed by the external approach under general anesthesia.
It has been reported that laryngocele is derived from an enlargement of the laryngeal saccule located in the laryngeal ventricle, and that the incidence of laryngocele in Japan is very rare in comparison with that in Europe and the USA. We reviewed papers and discussed the etiology, diagnosis and treatment of this disease.抄録全体を表示PDF形式でダウンロード (4460K) -
藤吉 達也, 権 徹1999 年 50 巻 3 号 p. 425-432
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーA 35-year-old man was involved in an automobile collision and was brought to the emergency room of our hospital by ambulance. He had cuts on his forehead and left knee, and complained of dyspnea and hoarseness. Since swelling and crepitation were palpable on his anterior neck without any other external injury, he was suspected of having sustained a laryngeal trauma caused by the seatbelt pressing on his neck. A CT scan indicated a slight disruption of the lower part of the laryngeal framework, which appeared to cause emphysema extending from the neck to the mediastinum. Examination with a flexible endoscope was tried, resulting in an unexpected exacerbation of the emphysema into a respiratory crisis possibly due to increased subglottic pressure. An immediate oral intubation relieved this crisis.
After his general condition was observed for two days in the ICU, we studied his larynx and hypopharynx using endoscopes under general anesthesia by tracheostomal intubation and found a mucosal disruption in the subglottic area. Under sequential open reduction, we also found fractures of the antero-lateral cricoid arch and the lower thyroid cartilage with disruptions of the sternohyoid muscle and the crico-thyroid muscle and ligament. The injuries healed well under repairs by suturing and wiring. We observed no sign of subglottic stenosis without a stent for a period of 5 weeks, and then repaired the tracheostome. Presently, the patient's vocal cords are mobile, and the vibratory patterns observed with a stroboscope appear normal. However, he has continued to demonstrate limitations in high-pitched phonation for 2 months.
We discuss in detail the effects of the laryngeal injuries in this case regarding postoperative phonatory function using 3D images reconstructed with a helical CT. In addition, we also discuss the usefulness of so-called endoscopic 3D-CT images in cases of laryngeal trauma with mucosal disruption as a non-invasive examination in place of endoscopy.抄録全体を表示PDF形式でダウンロード (10249K) -
坂本 達則, 山本 悦生, 篠原 尚吾, 金 泰秀, 田坂 康之, 辻 智子, 板谷 隆義, 村井 紀彦1999 年 50 巻 3 号 p. 433-437
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーA 53-year-old male with primary tracheal cancer was treated surgically with neoadjuvant chemotherapy and postoperative irradiation. Surgery was started under percutaneous cardiopulmonary support without oral intubation, which was thought to be impossible, followed by in site intubation and general anesthesia with inhalation narcotics. Approximately 5cm of tumor extension from the vocal cord required anterior mediastinal tracheostomy, which often leads to lethal complications, such as ruptured sutures in the mediastinum and massive bleeding from the fistula between the trachea and brachiocephalic artery. However, bilateral pectralis major muscular flaps were successfully utilized to protect the brachiocephalic artery and veins.抄録全体を表示PDF形式でダウンロード (4411K) -
権田 秀雄, 野田 康信1999 年 50 巻 3 号 p. 438-442
発行日: 1999/06/10
公開日: 2010/02/22
ジャーナル フリーAn adult case of organizing pneumonia with increasing parainfluenza virus antibody titer is reported. A 69-year-old man was admitted to this hospital because of bilateral pulmonary infiltrates involving the upper right and upper left lobes. PAPM and EM were administered intravenously. Sputum cultures yielded a normal respiratory flora. Bronchoscopic examination, including bacteriologic and cytologic examination of bronchoalveolar washings, was negative. Organizing pneumonia demonstrating organization not containing fibrin was diagnosed by transbronchial, lung biopsy (TBLB). Steroid pulse therapy was very effective in this case. The abnormal shadows in the chest X-rays disappeared. The antibody titer against the type 2 parainfluenza virus was increased. It seems that parainfluenza virus infection may cause some organizing pneumonia among adults.抄録全体を表示PDF形式でダウンロード (5676K)
- |<
- <
- 1
- >
- >|