日本気管食道科学会会報
Online ISSN : 1880-6848
Print ISSN : 0029-0645
ISSN-L : 0029-0645
検索
詳細検索
OR
閲覧
検索
51 巻, 2 号
選択された号の論文の43件中1～43を表示しています
すべての抄録を表示する
    • |<
    • <
    • 1
    • >
    • >|
寄稿
  • 声帯振動と声帯病変
    新美 成二
    2000 年 51 巻 2 号 p. 61-67
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.61
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    Many investigations have been conducted to clarify the relation between voice quality and vocal fold pathology. In these studies, it is usually emphasized that in order to understand the production mechanism of the pathological voice, it is essential to know details of vocal fold vibration.
    Since the vocal folds vibrate at a rate of approximately 100 to 300 Hz for ordinary conversation, special techniques are required to monitor their vibration. Various methods have been utilized to study this problem. Each method has its advantages and disadvantages.
    We analyzed the vocal fold vibrations of 22 pathological larynges using a computer-assisted high speed digital imaging technique. The parameters observed included symmetry, regularity, phase difference, glottal closure, amplitude, the mucosal wave and any periodicity difference. Voice quality was evaluated using the GRBAS system, and the results of the high speed imaging system were correlated.
    Although there were no definite matches between vocal fold vibration patterns and any psycho-acoustic impression of hoarseness, the characteristic vibration patterns of these cases of R≧2.5, or diplophonia exhibited irregular glottal closure and periodicity differences resulting in a quasi-periodical perturbation of sound waves.
    抄録全体を表示
    PDF形式でダウンロード (450K)
  • DRG-PPS診断群分類別包括払い方式
    —外科医療はどうなるのか—
    出月 康夫
    2000 年 51 巻 2 号 p. 68
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.68
    ジャーナル 認証あり
    PDF形式でダウンロード (51K)
  • 肺気腫の病因
    西村 正治
    2000 年 51 巻 2 号 p. 69-75
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.69
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    Cigarette smoking is the major cause of pulmonary emphysema, yet the question remains of why only a small portion of smokers develop clinically-apparent emphysema. To address this issue, we have compared the levels of proteases and anti-proteases in bronchoalveolar lavage (BAL), together with the function of alveolar macrophages between asymptomatic community-based older volunteers who had emphysema detected by high resolution CT scans and those who had a similar smoking history but did not have emphysema. In a series of experiments we have found the following. (1) The concentration of the neutrophil elastase-α1 protease inhibitor complex (NE-α1PI) was significantly elevated in the BAL fluid of subjects with subclinical emphysema. (2) More NE-α1PI was released from cultured alveolar macrophages in emphysematous smokers, which supports the idea that more NE is taken up by macrophages in those subjects. (3) The level of elastin-derived peptides in the BAL fluid correlated with the level of NE-α1PI and was significantly higher in current smokers than former smokers. (4) The immunological level of cathepsin L, another potential protease candidate causing emphysema which originates mainly from macrophages, was significantly higher in the subjects with subclinical emphysema, but, when subjects aged < 60 yrs were chosen for comparison, there was no difference between the two groups for cathepsin L. However, the difference between these groups remained for NE-α1PI. (5) The levels of human neutrophil lipocalin and two matrix metalloproteinases, gelatinase B (MMP-9) and neutrophil collagenase (MMP-8), were also significantly elevated in the BAL fluid from subjects with subclinical emphysema compared to smokers without emphysema. (6) Among the several neutrophil and/or monocyte chemoattractants, only the level of IL-8 in the BAL fluid had a strong positive correlation with NE-α1PI, and was significantly elevated in the subjects with subclinical emphysema. These data support the notion that neutrophils and a neutrophil chemoattractant, IL-8, appear to be crucial in the early development of emphysema and provide a clue to solving the question of why only a small portion of smokers develop clinically-apparent emphysema.
    抄録全体を表示
    PDF形式でダウンロード (559K)
  • Adenocarcinoma of the Esophagogastric Junction : Classification, Staging, and Surgical Approach
    Alberto Peracchia, Luigi Bonavina
    2000 年 51 巻 2 号 p. 76-82
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.76
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    Diagnostic delay, nodal involvement, and incompleteness of resection carry an adverse effect on long-term prognosis of adenocarcinoma of the esophagogastric junction. Since three different tumor entities arise in this area, classification is important to compare surgical approaches and to investigate new therapeutic modalities in order to improve survival. The role of mediastinal nodal dissection and the impact of neo-adjuvant regimens are still controversial.
    Patients and Methods-Between November 1992 and December 1998, 248 patients with histologically proven adenocarcinoma of the esophagogastric junction were referred to our Department. In 7 patients (9.4%) cancer was discovered during endoscopic surveillance for Barrett's metaplasia. Overall, 169 patients (68.1%) underwent resection. A Ivor-Lewis approach was used in 140 patients ; of these, 57 underwent an extended mediastinal lymph node dissection.
    Results-The median cumulative survival was 22±3 months in patients undergoing resection, and 7±0.8 months in patients having palliation (p <0.01). Survival was significantly better in patients with negative nodes than in those with lymph node metastases (44.7±3.7 versus 22.3±2 months, p <0.01). Six of the 57 patients (10.5%) undergoing extended lymphadenectomy had metastases in the upper mediastinal nodes. Additional serial sections and immunohistochemistry were performed in 46 patients. In 6 of 18 patients (33.3%) with negative nodes at conventional hematoxylin-eosin examination, immunohistochemistry demonstrated micrometastases in the lesser curvature, paracardial, peripancreatic, or lower mediastinal nodes. Three of these patients had recurrent disease within the first year of follow-up.
    Conclusions-Endoscopic surveillance is mandatory in patients with Barrett's metaplasia. When a curative resection is attempted in patients with adenocarcinoma of the esophagogastric junction, extended lymphadenectomy improves tumor staging and may prevent local recurrences. Serial sections and immunohistochemistry provide additional accuracy in the staging of the disease and may prove useful to select patients for adjuvant therapy.
    抄録全体を表示
    PDF形式でダウンロード (507K)
  • History of Bronchology From the Old to New Biopsy Techniques and Bronchoalveolar Lavage
    Benito Leoncini
    2000 年 51 巻 2 号 p. 83-89
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.83
    ジャーナル 認証あり
    PDF形式でダウンロード (1360K)
特集1　シンポジウム：高齢化社会に伴う高齢者の癌治療対策
  • 司会者のまとめ
    白日 高歩, 渡辺 寛
    2000 年 51 巻 2 号 p. 90-92
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.90
    ジャーナル 認証あり
    PDF形式でダウンロード (392K)
  • 80歳以上の高齢者における頭頸部癌治療
    斉川 雅久, 海老原 敏, 吉積 隆
    2000 年 51 巻 2 号 p. 93-97
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.93
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    During the 10 years between 1979 and 1988, 81 head and neck cancer patients at the age of 80 or older visited the Division of Head and Neck Surgery, National Cancer Center Hospital. Radical treatment was possible in 76.8% of these cases. The three-year and five-year relative survival rates of the 81 cases were 65.4% and 73.3%, respectively. These results were considered very favorable because they included palliatively treated cases and those without any treatment. Post-treatment complications were observed in 25.3% of all patients, and three patients died of complications.
    We conclude that patients at the age of 80 or older can undergo a successful radical treatment for head and neck cancer with a favorable result if their general conditions are acceptable, social support is available, and they have a strong motivation to cure the disease. Before radical treatment, however, we must consider very carefully if any functional disabilities likely to be caused by the treatment will be acceptable to the patient.
    抄録全体を表示
    PDF形式でダウンロード (380K)
  • 治療内容から見た高齢者の癌治療とその問題点
    中島 格, 草場 隆, 坂本 菊男, 千々和 圭一, 森 一功
    2000 年 51 巻 2 号 p. 98-101
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.98
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    We have reviewed 1,356 patients (891 males, 465 females) with head and neck cancer who were treated at the Department of Otolaryngology, Kurume University Hospital between 1986 and 1995. In this analysis, we focused on the treatment status of the patients, whether they received the usual (curative) treatment or an unusual (non-curative) treatment, and estimated their prognoses by dividing them into age groups of 74 or younger (younger group) and older than 75 (older group). Sixty-two of the 1,120 patients (6%) in the younger group and 43 of the 236 patients (18%) in the older group received an unusual form of treatment. The prognosis for such patients was poor compared to that for the patients who received the usual treatment. The averages of some of the laboratory data (e.g. total protein, PSP etc.) were worse in the older group than those in the younger group. These results indicate the importance of observing the general condition as well as the laboratory data of patients, particularly in the elderly.
    抄録全体を表示
    PDF形式でダウンロード (293K)
  • 高齢者 (75歳以上) 肺癌手術症例の検討
    坂口 浩三, 池田 晋悟, 川野 亮二, 横田 俊也, 葛城 直哉, 郡 隆之, 柳田 正志, 羽田 圓城
    2000 年 51 巻 2 号 p. 102-108
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.102
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    The results of operations in 110 patients over 75 years of age with primary lung cancer are evaluated. There were 83 men and 27 women, 22 octogenarians. The eldest patient was an 87-year-old male. Pneumonectomy was carried out in 6 patients, lobectomy in 83, segmentectomy in 5, and partial resection in 16. As for lymphnode dissection, ND2 was performed in 82 patients, ND1 in 6, and ND0 in 21. The number of complete resections was 95, and that of incomplete resections was 15.
    The cumulative 5 year-survival rate was 40.0% and the MST was 2.61 years. The patients with curative operations had a good prognosis.
    The operation-related death rate was poor in the group 75-79 years old compared with those over 80. Most of the former patients had obstructive pulmonary damage and had a poor DLco· Pulmonary infections were directly related to a worsening of these poor conditions.
    Therefore, in order to improve the results of operations in elderly patients, it is necessary to reduce the number of operation-related deaths with low respiratory functions (obstructive pulmonary damage). For this, the control of air leakage with lung resection and the management of pulmonary rehabilitation, including sputum drainage, are very important for the prevention of pneumonia.
    抄録全体を表示
    PDF形式でダウンロード (501K)
  • 高齢者食道癌の外科治療の現況と対策
    青山 法夫, 南出 純二, 米山 克也, 小泉 博義
    2000 年 51 巻 2 号 p. 109-113
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.109
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    We estimated the results of radical esophagectomy with 2-field lymphadenectomy for thoracic esophageal cancer followed by reconstruction using the stomach in 162 cases. These were divided into 3 groups according to age : Group A (91 cases), under 65 years ; B (51 cases), over 65 but under than 75 ; and C (20 cases), over 75. There was no difference in the stage or location of tumors across the age groups. Preoperative VC, FEV, PaO2, ChE, Hb and renal function were lower in Groups B and C than in Group A. Moreover, in Groups B and C, the rate of patients with other preoperative diseases, especially circulatory diseases, was higher than in Group A (p < 0.01). There was no difference in the rate of postoperative complications across age groups. Although there was no significant difference between groups on overall survival curves (by the Kaplan-Meier method) after surgery, the curve of Group C was lower than those of the other groups. The 5-year survival rates for Group A, Group B and Group C were 57%, 61%, and 44%, respectively. The rates of death due to esophageal carcinoma in Groups A, B, and C were 80%, 59% and 55%, respectively (NS). The rate of death due to other factors including postoperative complications was higher in Groups B and C than in Group A (NS). Surgery for aged patients with esophageal cancer is relatively safe, but it should be performed with minimally invasive methods.
    抄録全体を表示
    PDF形式でダウンロード (387K)
  • 高齢者食道癌の治療対策
    佐藤 滋, 高木 融, 黒田 直樹, 逢坂 由昭, 高木 眞人, 林 幹也, 田村 和彦, 星野 澄人, 篠原 玄夫, 岡田 了祐, 大久保 ...
    2000 年 51 巻 2 号 p. 114-120
    発行日: 2000/04/10
    公開日: 2009/01/27
    DOIhttps://doi.org/10.2468/jbes.51.114
    ジャーナル 認証あり
    抄録を表示する抄録を非表示にする
    We encountered 588 patients with esophageal carcinoma between 1986 and 1998. For 96 (16.4%) of the patients 75-year-old or older, we examined the features and issues of esophageal carcinoma in elderly people based on preoperative conditions and treatment results. 1) Cardiac dysfunction was observed in 39 patients (40.6%). Concerning respiratory function, there was a significant difference in forced expiratory volume in 1 second (FEV1.0%) and % vital capacity (%VC) compared to patients under 75 years of ages (t-test). Furthermore, disorders of several organs were observed in 31 patients (32.2%). 2) Eleven patients underwent right thoracotomy and laparotomy. Three (25%) of these patients died in hospital postoperatively. The 3-year survival rate was 27.3%. 3) Fourteen patients underwent esophagectomy. Four (28.6%) of these patients died in hospital. The 3-year survival rate was 7.7%. 4) In 66 patients who did not undergo resection, the 3-year survival rate was 11.7%. 5) With respect to postoperative complications, the incidences of pulmonary complications and postoperative delirium were high. Some patients died during surgery or during hospitalization. Careful perioperative management is important. 6) There was no significant difference in long-term results between treatment methods. However, none of the patients who underwent C0 surgery survived more than 2 years. Therefore, this procedure should be avoided if possible.
    抄録全体を表示
    PDF形式でダウンロード (379K)
特集2　パネルディスカッション　1：逆流性食道炎の対策
特集3　パネルディスカッション　2 : 肺癌，頭頸部癌，食道癌の早期局在診断
特集4　パネルディスカッション　3 : 頭頸部レーザーの応用
特集5　パネルディスカッション　4 : 蛍光診断の最近のトピック
特集6　ビデオワークショップ　1 : 反回神経麻痺の対策
特集7　ビデオワークショップ　2 : 頸部食道癌,下咽頭癌切除後再建術
特集8　ビデオワークショップ　3 : 気道狭窄に対する治療手技
特集9　ランチョンレクチャー
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top