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Volume 58 (2007)
- Issue 6 Pages 519-
- Issue 5 Pages 433-
- Issue 4 Pages 365-
- Issue 3 Pages 301-
- Issue 2 Pages 85-
- Issue 1 Pages 1-
Volume 58, Issue 4
Displaying 1-11 of 11 articles from this issue
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Original
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Masatsugu Ohashi, Fumikazu Ota, Aya Ochiai, Atsushi Komori, Hirohisa T ...2007 Volume 58 Issue 4 Pages 365-370
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSAmong the various surgical methods performed for unilateral vocal cord paralysis, atelocollagen implantation in the vocal cord is convenient compared with other methods as it can be performed under local anesthesia as day surgery. Some problems have been pointed out concerning the method, however:namely, its limited effectiveness and problems in terms of foreign protein. We examined the validity of atelocollagen implantation based on maximum phonation time and mean airflow rate, both pre and post operation. We also examined the possibility of predicting postoperative effectiveness using values taken before the operation. In this study, we evaluated cases as effective when maximum phonation time increased 1 second or more along with a decrease in mean airflow rate. We treated 16 cases, and the treatment was effective in 10 cases. Although both values improved significantly postoperatively, no statistical association was found between preoperative values and the effectiveness of the operation.View full abstractDownload PDF (380K) -
Tomohito Fuke, Hiroyuki Ito, Takakuni Kato, Hiroyuki Yamada2007 Volume 58 Issue 4 Pages 371-376
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSSurgical therapy for intractable aspiration pneumonia leads to death prevention due to pneumonia and reduction of antibiotics. The procedure improves not only QOL of the patient but also QOL of the care person, and contributes to suppression of medical expenses.
When a tracheotomy is performed, frequent absorption of sputum is needed. If at-home treatment is required, burdens on the patient and care person increase. A total laryngectomy was conducted in three patients unable to speak due to progressive neural disease in the terminal stage, and we examined postoperative QOL of both patients and care persons. After the operation, absorption of sputum was needed 4-6 times a day. The economic burden was reduced because the patient's and care person's burdens were reduced; also, a tracheotomy tube became unnecessary and use of a suction tube decreased. There is no standard for adaptation of the surgical procedure to prevent aspiration, but adaptation should be examined considering not only the patient's burden but also that of care person.View full abstractDownload PDF (455K) -
Masashi Takemura, Masayuki Higashino, Harushi Osugi, Shigeru Lee, Sato ...2007 Volume 58 Issue 4 Pages 377-383
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSIt is known that a hypercoagulable state develops after radical esophagectomy for cancer. To prevent hypercoagulability, anti-inflammatory agents, such as steroids, are administrated. We studied the effect of neutrophil elastase inhibitor (Sivelestat sodium hydrate, SN) on coagulability in patients after radical esophagectomy. A total of 41 patients who had undergone radical esophagectomy together with reconstruction were stratified into two groups. In the SN+group (n=21), SN was administrated continuously, at 0.2mg/kg/hr, from just after surgery until the 5th post-operative day. In the other group no administration took place. All patients received an injection of methylpredonisolone of 500 mg/body just before surgery. The platelet count, level of fibrinogen (FBG), FDP, D-Dimer, AT3, TAT, activated partial thrombin time (APTT), protein C and alfa-2 plasmin inhibitor (A2PI) were measured before surgery and on the 1st to 7th days after operation. Differences in platelet count, and in levels of FBG, FDP, D-Dimer and TAT were not significant between the two groups. In the SN+group, the level of AT3 and protein C were higher than the SN- group on the 2nd and 3rd post-operative days, and α2PI on the 3rd post-operative day. In the SN- group, the level of APTT was higher on the 3rd postoperative day. In conclusion, continuous infusion of SN is effective to prevent hypercoagulability after radical esophagectomy.View full abstractDownload PDF (640K) -
Koichiro Nishiyama, Hiromi Nagai, Daisuke Usui, Takashi Masaki, Kentar ...2007 Volume 58 Issue 4 Pages 384-391
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSThere have been no substantial reports on the incidence of deglutition disorders at private ENT clinics in Japan. In this study, 81 subjects over the age of 75 years who visited Nishiyama ENT Clinic were examined for their deglutition functions. As the methods of examination, a speci-fically prepared questionnaire and videoendoscopy were selected. The subjects were classified into 3 groups: aspiration group (26), penetration group (21) and normal group (34). Weight loss over 2 kg within 1 year was noted in 7 cases within the aspiration group, 2 in the penetration group and 1 in the normal group. In those subjects who presented apparent misdeglutition, tactile sensation of the pharyngolaryngeal mucosa was deteriorated and effective cough ability was sup-pressed, and as a result the incidence of aspiration pneumonia increased. The findings suggest that aspiration pneumonia increases calorie consumption and leads to loss of body weight.View full abstractDownload PDF (487K) -
Toshiro Kawano, Osamu Shiono, Masanori Komatsu, Toshiyuki Kokatsu, Mam ...2007 Volume 58 Issue 4 Pages 392-397
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSIn daily medical examinations, the number of patients with foreign body sensation in the throat and glossodynia has been increasing. The causes of these complaints are thought to be (1) physical factors, (2) psychological factors and (3) a combination of both factor types. In the present study, we examined serum iron, copper, folic acid and zinc densities as well as the presence of candidiasis in the oral cavity in 18 cases with foreign body sensation in the throat and 14 cases with glossodynia. Furthermore, we examined the degree of symptom improvement with zinc drug administration in cases with low serum zinc. Low serum zinc was found in 12 of 18 cases (67%) with foreign body sensation in the throat, and 8 of 14 cases (57%) with glossodynia. In more than half of the cases, improvement of complaints was observed after the zinc drug administration. The possibility of low serum zinc should be considered in patients with foreign body sensation in the throat and glossodynia in daily medical examinations.View full abstractDownload PDF (858K) -
Shogo Shinohara, Masahiro Kikuchi, Yasushi Naito, Keizo Fujiwara, Tsun ...2007 Volume 58 Issue 4 Pages 398-403
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSExploration of all glands is a common procedure in operations involving parathyroid hyperplasia. We retrospectively investigated 19 patients who were diagnosed as renal or primary parathyroid hyperplasia in order to examine the clinical utility of three modalities, ultrasonography, CT or MRI, and 99mTc-MIBI scintigraphy in preoperative localization of parathyroid glands. Successful preoperative localization rates of these modalities were 53.6%, 64.2% and 44.9%, respectively. Fifty-three of 69 glands (76.8%) were properly localized using all of these modalities; however, the rate diminished to 42.9% in cases of simultaneous thyroid disease. The average weight of ultrasonographic positive glands was significantly more than that of negative glands. This significant difference in weight distribution was also seen between positive and negative glands in CT or MRI but not observed when 99mTc-MIBI scintigraphy was employed. By reviewing the histopathological difference between positive and negative glands with 99mTc-MIBI scintigraphy, we sug-gested that uptake of 99mTc-MIBI in the parathyroid gland depends on the oxyphilic cell population as well as on the weight of the gland.View full abstractDownload PDF (418K)
Case Report
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Makoto Ogawa, Megumi Nakamura, Yasumitsu Takimoto, Keisuke Enomoto, Ma ...2007 Volume 58 Issue 4 Pages 404-411
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSWe presented 4 cases with bilateral vocal cord paralysis, whose glottal space was successfully enlarged by submucosal tissue resection under laryngo-microscope, and investigated them mainly from the viewpoint of postoperative laryngeal closure function. Single cold resection of the posterior medial portion of the thyro-arytenoid muscle and the medial part of the arytenoid cartilage resulted in accomplishment of decannulation, except for one case that required additional arytenoidectomy. As the postoperative vocal findings, 2 cases showed breathy voice and 2 nearly normal voice. Adduction of the opposite vocal cord across the midline seems to be highly associated with the difference. In addition, all the cases presented normal supraglottic closure during breathholding, which brought neither laryngeal penetration nor aspiration under video-fluorogram. In conclusion, the findings demonstrated that submucosal resection of the vocal cord under laryngo-micro-scopy enlarged the glottal space enough to accomplish decannulation, and suggested the association between the postoperative vocal function and the degree of remaining potential of the contra-lateral vocal cord adduction.View full abstractDownload PDF (509K) -
Takumi Okuda, Katsuhiro Toyama, Noriaki Nagai, Hirokazu Kawano, Tetsuy ...2007 Volume 58 Issue 4 Pages 412-416
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSThe aspiration of a foreign body into the airways may cause upper airway obstruction and is a potentially fatal condition that requires prompt diagnosis and treatment. There for bronchoscopy, despite the fact that it is invasive, is often performed when a foreign body aspiration is suspected. A shift in the mediastinum on a chest X-ray is adequate finding to suspect the aspiration of a foreign body. Scimitar syndrome is a rare congenital malformation named by Neill et al. in 1960 as one of the partial anomalous pulmonary venous connections. The syndrome was diagnosed with characteristic findings such as 1) right pulmonary hypoplasia, 2) rightward shift of the mediastinum and 3) an anomalous right pulmonary vein which appears to have the shape of a Turkish sword, or scimitar, along the right heart border on a plain chest X-ray. Since findings 1) and 2) resemble those of foreign body aspiration, we should be aware of the similarity. A 10-month-old boy with severe cough and sputum was admitted to our department via a local pediatric clinic on suspicion of foreign body aspiration after a chest X-ray revealed insufficient right pulmonary aeration and a shift of the mediastinal contents to the right. We were able to deny the existence of a foreign body in the upper airway and diagnose this case as scimitar syndrome by using noninvasive 3D-CT virtual bronchoscopy.View full abstractDownload PDF (455K)
Short Communication
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Yasushi Furuta, Akihiro Homma, Nobuhiko Oridate, Yasushi Mesuda, Norik ...2007 Volume 58 Issue 4 Pages 417-421
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSSecondary placement of a voice prosthesis under rigid esophagoscopy is often difficult to perform due to strictures of the esophageal lumen or inability in flexing the neck after total laryngectomy and radiation therapy. We report a technique of secondary voice prosthesis placement using a side window of an endotracheal tube. An endotracheal tube and a flexible endoscope are inserted into the esophagus. In creating a tracheoesophageal puncture, a sharp grasping forceps is inserted through the side window of the tube. Then, a guide wire is introduced through the endotracheal tube and the voice prosthesis is placed by back-loading method. This method is easy and safe because there is no risk of perforation through the posterior esophageal wall.View full abstractDownload PDF (357K)
Glossary
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[in Japanese], [in Japanese]2007 Volume 58 Issue 4 Pages 422-423
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSDownload PDF (199K) -
[in Japanese]2007 Volume 58 Issue 4 Pages 424-425
Published: 2007
Released on J-STAGE: August 25, 2007
JOURNAL RESTRICTED ACCESSDownload PDF (186K)
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