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Volume 51, Issue 1
Displaying 1-9 of 9 articles from this issue
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Originals
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Yasushi Murakami, Ryo Kawata, Shigeru Nakai, Takayasu Kimura, Takashi ...2000 Volume 51 Issue 1 Pages 1-12
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSIn 52 cases of T2-4 glottic carcinoma, factors that may be responsible for neck metastasis were investigated by clinicopathological and immunohistochemical techniques. These factors included clinicopathological factors such as T-staging, tissue differentiation and the ploidy pattern of nuclear DNA ; ploliferation factors such as the S-phase cell labelling index (SLI) and EGF-R; factors related to the basement membrane such as Type-4 collagen and matrix metalloproteinase 2(MMP-2); and cell adhesion factors including E-cadherin, catenin, cathepsin D and desmoglein. The correlation of each factor to neck metastasis was evaluated statistically.
No significant difference was observed between T2 and T3-4, nor between any two groups of well, moderately and poorly differentiated carcinomas. No significant difference was seen between the diploid and aneuploid groups. On the other hand, cases with a positive expression of EGF-R showed a statistically higher incidence of neck metastasis than those with a nagative expression. Cases with an SLI higher than 30, especially those higher than 40, showed a greater incidence of neck metastasis than those with scores lower than 30. A significant difference was also found between the groups with positive and negative expressions of desmoglein. It was further observed that E-cadherin and catenin show the same pattern of expression, but cathepsin has an inverse correlation to them. As for the components of the basement membrane, Type-4 collagen had a close correlation with neck metastasis, and a much higher incidence of neck metastasis was found in cases with a fragmented or negative expressions. Cases with a higher tissue titer of MMP-2 that may degrade Type-4 collagen showed a higher incidence of neck metastasis. On the other hand, no significant difference was observed between the two groups with positive and negative expressions of p53 oncoprotein.View full abstractDownload PDF (1820K) -
Shogo Shinohara, Etsuo Yamamoto, Makito Tanabe, Toshiki Maetani, Tatsu ...2000 Volume 51 Issue 1 Pages 13-16
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSWe have performed laser-radiation combined therapy for stage I and II laryngeal cancers in order to preserve the larynx. In the present study, we retrospectively investigate the factors affecting the preservation of the larynx in stage II laryngeal cancer. The subjects consisted of 34 patients with stage II laryngeal cancer treated between 1988 and 1996 and observed for more than 2 years. Cases with involvement of the ventricle or false cord and those with impaired vocal cord movement showed a tendency towards the loss of their larynx. Moreover, these failures required a longer period to irradiate 1 gray on average than cases which led to a successful preservation of the larynx.View full abstractDownload PDF (282K) -
Yuka Iwahashi, Hiroyuki Kitamura, Shinichi Takagita, Han Sanson, Toshi ...2000 Volume 51 Issue 1 Pages 17-21
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSWe have performed glottic closure as a surgical procedure for 35 patients (30 men, 5 women) who had suffered from recurrent aspiration pneumonia since 1985 to 1997. The diseases which caused their aspiration included cerebrovascular disease, degenerative disease, cerebral tumor, ischemic heart disease, myocarditis, tumor of the head and neck region, pulmonary emphysema, tuberculosis etc.
Of these 35 cases, 33 patients underwent the glottic closure initially, and 29 cases of the 33 were successful. In the remaining 4 cases, a leakage of saliva was detected after the operation. 3 of these 4 cases then underwent a total laryngectomy, and the last patient had a second glottic closure operation. Two of the 35 cases underwent epiglottic closure, but in both of these cases saliva leakage was detected. One patient underwent a total laryngectomy after all, and another had the glottic closure operation. Both follow-up operations were successful.
In all patients, the pneumonia was improved. 29 patients were discharged. 5 patients died in hospital, and 1 is still in hospital.
As a glottic closure operation, Montgomery method is widely used. In this method, the laminae of the thyroid cartilage are perforated and sutured with the opposite arytenoid cartilages, and the vocal cords are sutured to each other. However, we use a “simplified” Montgomery method, in which the laminae of the thyroid cartilage are not perforated, and both arytenoid cartilages, the vocal cords and the false cords are sutured to each other. We have achieved good results with this procedure.View full abstractDownload PDF (392K) -
Chihiro Hatta, Hiroshi Ogasawara, Minoru Ishida, Masafumi Sakagami2000 Volume 51 Issue 1 Pages 22-27
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSTracheostomy was performed on 11 patients (9 males, 2 females) during an 11-year period (1984-1994) at the Osaka Prefectural General Hospital. The causative diseases were central nervous system disorders (5 cases), laryngo-tracheal stenosis (2 cases), achondroplasia (2 cases), Werdnig-Hoffmann disease (1 case)and Tay-Sacs disease (1 case). The indication of the tracheostomies was respiratory management in most of the cases. Complications after surgery included 5 cases of tracheal or stomal granulation, 1 case of tracheo-innomunate artery fistula, 1 case of failure of decannulation and 1 case of hypooxidecephalus due to obstruction of the T-tube. Regarding course and outcome, 5 of the 11 patients who underwent these tracheostomies left the hospital with a stoma and were under respiratory management in their homes and they achieved the improvement of the quality of life. Five patients died due to an aggravation of their primary disease.View full abstractDownload PDF (473K) -
Yasutaka Akita, Tadao Nishimura, Nobuhiro Shibata, Kenji Kawakatsu, Ch ...2000 Volume 51 Issue 1 Pages 28-35
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSAlthough general experience has suggested that the lateral sleeping position is the most effective for patients with sleep-related respiratory disorders, few studies have demonstrated this observation using controlled conditions and objective indicators. The aim of the present study was to investigate the sleeping position of 200 patients with sleep-related respiratory disorders, including some in whom obesity played a role. The apnea-hypopnea index (AHI) improved when patients moved from the supine to the lateral position, but the improvement was only slight in patients with a high AHI or a tendency to obesity. These findings suggest that advising patients to sleep in the lateral position will only be effective for those with a moderate to low AHI, or a minimal tendency to obesity.View full abstractDownload PDF (786K)
Case Reports
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Mitsuhiko Nakahira, Hiroaki Nakatani, Shuji Matsumoto, Taizo Takeda2000 Volume 51 Issue 1 Pages 36-39
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSThere have been only a few reports of patients with press through package (PTP) foreign bodies in the airway compared with PTPs found in the esophagus. We experienced a case with a PTP foreign body between the bilateral vocal cords. The PTP was safely removed from the larynx using a forceps through a flexible fiberscope. In our case, the time elapsed from the PTP entering the larynx to its detection was within one day. However, the detection of a PTP foreign body in the respiratory system usually requires more time. According to a review of the literature, 50% of such patients needed over three days after the onset of aspiration. On the other hand, PTP foreign bodies in the esophagus, as opposed to the respiratory system, are usually discovered within three days in over 90% of patients. The difference in the time required for detection of PTPs seems to be related to the severity of symptoms and the anatomical differences between the airway and the esophagus. Generally, the symptoms of PTP foreign bodies in the airway are mild and their detection is difficult, especially below the subglottic region, because a PTP is rediolucent. Therefore, detailed information about a patient's recent history and intensive observation by laryngo-tracheal fiberscope are important.View full abstractDownload PDF (677K) -
Kiminori Sato, Tadashi Nakashima2000 Volume 51 Issue 1 Pages 40-44
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSCO2 laser arytenoidectomy was performed for bilateral median vocal fold fixation caused by cricoarytenoid joint ankylosis. Submucosal laser arytenoidectomy was performed, and the wound was covered by the mucosa with fibrin glue. The patient did not complain of dyspnea and could eat normal food without aspiration two days after surgery. Voice quality after surgery was as good as before surgery.
CO2 laser arytenoidectomy is a useful surgical procedure not only for bilateral vocal fold paralysis but also for bilateral cricoarytenoid joint ankylosis.View full abstractDownload PDF (1143K)
Short Communications
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Yasuhiro Wada2000 Volume 51 Issue 1 Pages 45-47
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSFor the extraction of foreign bodies from the lower pharynx and larynx, histological tissue examination and outpatient operations for laryngeal polyp in the less time-consuming operations under weak local anesthesia are highly appreciated for alleviation of pain and speed of recovery.
To facilitate such operations, the “Fiberscopic-Laryngeal-Forceps” has been developed, which combines a fiberscope and a laryngeal forceps.
The author has carried out treatment and operation with the Fiberscopic-Laryngeal-Forceps observing the fiberscopic image on the monitor from a CCD camera attached to this system. I have found that the system made operations easier and greatly decreased the required amount of local anesthesia.View full abstractDownload PDF (430K) -
Koichiro Nishiyama, Jun Yamanaka, Takashi Hiroshimaya, Manabu Yokobori ...2000 Volume 51 Issue 1 Pages 48-53
Published: February 10, 2000
Released on J-STAGE: January 27, 2009
JOURNAL RESTRICTED ACCESSTwo technical modifications were attempted for the transplantation of fascia into the vocal folds. First, a roll-shaped fascia graft was inserted into a pocket prepared within the lamina propria mucosa of a vocal fold in order to prevent fall-off of the graft. In addition, a new suturing technique was devised to save the time required for the surgical procedure. Successful results were obtained when the new techniques were applied.View full abstractDownload PDF (1041K)
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