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Volume 66 (2015)
- Issue 6 Pages 365-
- Issue 5 Pages 299-
- Issue 4 Pages 245-
- Issue 3 Pages 191-
- Issue 2 Pages 57-
- Issue 1 Pages 1-
Volume 66, Issue 4
Displaying 1-9 of 9 articles from this issue
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Original
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Rintaro Shimazu, Shigehisa Aoki, Yuichiro Kuratomi2015 Volume 66 Issue 4 Pages 245-249
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe previously generated a rat model of gastroesophageal reflux disease (GERD) and observed the histological changes caused by gastric acid reflux in the upper and lower airways. We herein report the use of GERD rat models for periods greater than 50 weeks. Significant fibrosis was observed in the respiratory tract. Although there were no histological changes at 10 weeks after surgery, thickening of the basal laminae and proliferation of the collagenous fibers were found in the alveolar epithelium at 20 weeks after surgery. At 50 weeks after surgery, the collagenous fibers obliterated the pulmonary alveoli and bronchial lumen. The findings observed in the GERD rats are similar to the pathology of human pulmonary fibrosis. This result suggests that gastric acid reflux may be one of the pathogenetic or exacerbating factors of pulmonary fibrosis.View full abstractDownload PDF (5417K) -
Aiko Oka, Atsuhiro Yoshida, Shin-ichi Sato2015 Volume 66 Issue 4 Pages 250-254
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe retrospectively reviewed the data of 41 children (27 boys and 14 girls) under 2 years old who underwent tracheostomy at Kurashiki Central Hospital between 2009 and 2013, and analyzed their complications and language development. Forty-six percent of all patients (n=19) were complicated with intratracheal and/or stomal granuloma, but there were no fatal complications such as massive bleeding or suffocation. Ten percent of the patients (n=4) experienced tube obstruction and 5% (n=2) had accidental decannulation, with one death occurring in each of these two groups. Intratracheal granuloma is characterized by a short distance between the skin and the anterior wall of the trachea. This results in tube inclination leading to a pressure lesion at the distal end of the tube on the anterior wall of the trachea, and formation of a granuloma. A tube with large angle should be chosen in such cases. Stomal granuloma generally occurs within a month postoperatively, and possible causes are infection and inflammation around the tracheostoma. Language development after tracheostomy was evaluated in 10 children using the Kyoto Scale of Psychological Development. There was no language retardation in any of the children who were without a developmental disorder.View full abstractDownload PDF (674K) -
Noriomi Suzuki, Kanako Takeda, Yoichi Kondo, Noriko Morimoto2015 Volume 66 Issue 4 Pages 255-261
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSPrior to decannulation of tracheostomies in children, we make it a practice to perform down-sizing and capping of tracheostomy tubes and to examine available images. We have experienced cases, however, in which we considered our preliminary evaluations to be sufficient but subsequently the patient's respiratory state worsened after decannulation. To assess the feasibility of safe decannulation methods, we reviewed the medical records of 354 patients who underwent management after tracheotomy in our department. A total of 110 patients (about 30%) were decannulated, and 13 patients exhibited respiratory difficulty after decannulation. The breakdown was as follows. ① Three cases required CPAP during sleep for more than several months after decannulation. ② Five cases needed re-tracheotomy due to exacerbation of the respiratory state after decannulation or closing of the trachea hole. ③ Five cases required reinsertion of tracheostomy tubes owing to exacerbation of their respiratory state within several hours after decannulation. Potential causes of exacerbation of the respiratory condition include upper airway constriction caused by glossoptosis, tracheal stenosis from invagination of the trachea front wall into the lumen, and tracheomalacia. We concluded that judgment of whether decannulation can be safely performed can be made prior to decannulation if airway evaluation is performed, including the subglottic and trachea, which combines imaging tests such as endoscopy and dynamic CT under general anesthesia.View full abstractDownload PDF (1205K)
Case Report
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Hiroko Monobe, Masato Mochiki, Katsumi Takizawa, Kazunari Okada2015 Volume 66 Issue 4 Pages 262-266
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSPharyngocutaneous fistula (PCF) is the most common complication in patients who have undergone a total laryngectomy. The increased use of radiation in the primary management of laryngeal carcinomas has resulted in an increased incidence of PCF after salvage laryngectomy. A limited number of patients are able to experience spontaneous PCF closure. Surgical closure of PCF, including closures with pectoralis major (PM) or deltopectoral (DP) flaps, is often required. More recently, the use of vacuum-assisted closure (VAC), negative pressure wound therapy (NPWT), and perifascial areolar tissue (PAT) grafts have been introduced for the treatment of PCFs. The role of PAT in these types of wounds requires further evaluation and discussion. We report two successful cases of PCF closure using a PAT graft. The patient in Case 1 underwent surgical closure of a PCF with a PAT graft for a laryngocutaneous fistula after salvage partial laryngectomy; Case 2 was an elderly patient who developed laryngocutaneous fistula after salvage laryngectomy and underwent surgical closure of PCF with a PAT graft. Non-vascularised PAT grafts have been used for covering intractable ulcers or fistulas in tendons or bones. PAT grafts have also been used for surgical closure of dead space after tumor resections, spinal fluid leakages, and fistulas. PAT is a pliable, loose, areolar tissue with a rich vascular plexus. The harvesting technique is quite simple and minimally invasive. Therefore, PAT grafts could represent a surgical option for flaps used in closures of PCF.View full abstractDownload PDF (1917K) -
Ippei Yamana, Shinsuke Takeno, Tatsuya Hashimoto, Kenji Maki, Ryosuke ...2015 Volume 66 Issue 4 Pages 267-272
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe herein report 2 cases of elderly patients with Zenker diverticulum. Case 1: An 86-year-old male was referred to our hospital with dysphagia. According to gastrointestinal endoscopy and esophagography findings, a diverticulum measuring 2×2 cm in size was identified on the right side of the pharyngoesophagus. A large quantity of food residue was recognized in the diverticulum. Case 2: An 83-year-old female was referred to our hospital with dysphagia. Based on gastrointestinal endoscopy and esophagography findings, a diverticulum measuring 5×5 cm in size was found on the right side of the pharyngoesophagus. A large quantity of food residue was recognized in the diverticulum. The giant diverticulum was adjacent to the bronchus and thyroid in both cases. Both patients underwent pharyngoesophageal diverticulectomy using a right cervical incision approach with cricopharyngeal myotomy. Postoperatively, both patients were able to achieve good oral intake. A diverticulum resection should therefore be considered as an indication for elderly patients demonstrating Zenker diverticulum with dysphagia.View full abstractDownload PDF (2504K) -
Taiji Kawasaki, Koichiro Wasano, Shuta Tomisato, Hideo Nameki, Noriomi ...2015 Volume 66 Issue 4 Pages 273-277
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe report a case of retropharyngeal venous malformation that was completely resected by minimally invasive surgery. The patient was a 66-year-old male who was referred to our hospital with a pharyngeal tumor, diagnosed by gastroscopy ; the patient complained of pharyngeal discomfort. In the initial assessment we observed a venous malformation indicative of a tumor of the pharyngeal back-wall. Laser therapy, excision, and sclerotherapy are the recommended treatments for this condition. Magnetic resonance imaging revealed that the disease had progressed into the retropharyngeal space. By contrast computed tomography, the tumor did not show a reinforcement effect. We chose a minimally invasive and trans-oral excision, and were able to treat the disease. Here, we review the literature with regard to treatment of venous malformations.View full abstractDownload PDF (1967K) -
Mayu Ono, Shigehiro Owaki, Yuichiro Oe, Takeshi Shimizu2015 Volume 66 Issue 4 Pages 278-283
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe report herein on the case of a 75-year-old male with hyalinizing trabecular tumor (HTT) of the thyroid. HTT is a rare thyroid tumor easily confused with papillary carcinoma based on the findings of aspiration cytology. In our case, the result of aspiration cytology was a class III tumor, and a partial thyroidectomy was subsequently performed. In the histological examination, cytokeratin 19 was negative, and the tumor was diagnosed as HTT. No conclusion has yet been made in this case as to whether the tumor is benign or malignant.View full abstractDownload PDF (2571K) -
Atsushi Kondo, Shigeru Koshiba, Nobuhiko Seki, Kenichi Takano, Makoto ...2015 Volume 66 Issue 4 Pages 284-290
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSWe performed combined resection of the common carotid artery (CCA) and vascular reconstruction for papillary thyroid carcinoma (PTC) in a case complicated with myelodysplastic syndrome (MDS). The subject was a 45-year-old male found to have severe anemia and a thyroid tumor at a previous hospital who was referred to our hospital. Bone marrow biopsy led to a diagnosis of MDS. The thyroid tumor was diagnosed as PTC by fine needle aspiration cytology, and preoperative computed tomogram and ultrasonogram revealed a suspicious invasion to the right CCA. We diagnosed PTC cT4bN0M0 stage IVb. A total thyroidectomy combined with right neck dissection, tracheostomy, right CCA resection, and vascular reconstruction was performed. Because operations involving carotid artery resection have risk of cerebral infarction, it is necessary to consider surgical indications in light of the prognosis of the disease. With operations involving MDS, perioperative management taking complications from pancytopenia into consideration is important.View full abstractDownload PDF (2429K)
Glossary
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[in Japanese]2015 Volume 66 Issue 4 Pages 291-293
Published: August 10, 2015
Released on J-STAGE: August 25, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (720K)
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