著者
西川 裕作 東田 有智
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.69, no.5, pp.290-296, 2018-10-10 (Released:2018-10-25)
参考文献数
8

アルコールは多くの疾患の発症や増悪に関わっており,呼吸器疾患においても同様である。誤嚥性肺炎や睡眠時無呼吸症候群はその代表的なものであり,慢性的に飲酒を行っている患者においては注意を要する。またあまり認知されていないが,気管支喘息においてもその増悪因子として重要である。アルコール誘発喘息の機序はアセトアルデヒドを酢酸に代謝させるアセトアルデヒドデハイドロゲナーゼ(ALDH)の活性を低下させるALDH2*2遺伝子の存在により血中のアセトアルデヒドの濃度が上昇することにある。アセトアルデヒドには肥満細胞からヒスタミンを遊離させる作用があり,その作用によりヒスタミンの血中濃度が上昇し喘息発作が誘発される。また一部の薬剤や食物の中にはアセトアルデヒドの代謝を阻害するものがある。それらによってもアルコール誘発喘息は促進される。この遺伝子は日本人を含むモンゴロイド人種に多く,白人や黒人にはほとんどないとされる。アルコール誘発喘息の診断にはALDH2*2遺伝子の検査や負荷試験が有用である。その予防にはアルコール含有物質の摂取の回避と薬剤治療としては従来の喘息治療に加え,抗ヒスタミン薬の投与やDSCG(クロモグリク酸ナトリウム)の吸入などが有効とされている。
著者
木村 美和子 千原 康裕 二藤 隆春 田山 二朗
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.57, no.6, pp.502-507, 2006 (Released:2006-12-25)
参考文献数
6
被引用文献数
3 2

ムンプスの合併症として,呼吸困難や咽喉頭浮腫は報告が少ない。今回われわれは咽喉頭浮腫を合併したムンプスの2症例を経験したので報告した。 症例は26歳男性と36歳女性。初診時より顎下部耳下部の腫脹,呼吸困難を認め当院救急外来受診,喉頭ファイバースコープにて咽喉頭に浮腫を呈しており入院となった。頸部CTでは,顎下腺,耳下腺とその周囲にびまん性の腫脹を認め,咽喉頭の浮腫状腫脹が著明であった。血液検査でWBC・CRP正常範囲内,血清アミラーゼ高値を認めた。ステロイド投与により呼吸困難は改善し退院した。その後の検査でムンプスウィルスIgM陽性を確認した。 2症例ともステロイド投与で咽喉頭浮腫は軽減し,気管切開を回避することができた。咽喉頭浮腫の原因は,顎下腺とその周囲軟部組織の炎症性浮腫により,二次的に咽喉頭から流出するリンパ管がうっ滞して循環障害を起し,咽喉頭粘膜にうっ血性の浮腫が生じたためと推察した。 咽喉頭浮腫を合併したムンプスの成人例を2症例報告した。耳鼻咽喉科の臨床現場では頸部腫脹と咽喉頭浮腫を合併した症例にしばしば遭遇するが,ムンプスウィルス感染の可能性も鑑別診断の1つにあげる必要があると考えられる。
著者
井上 真規 小河原 昇 田辺 輝彦 大石 公直 佃 守
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.62, no.6, pp.533-537, 2011

昭和60年以降に当科で診断された若年型喉頭乳頭腫4例において臨床症状・喉頭所見・治療内容・治療経過・分娩方法・出生順位で検討を行った。全例に嗄声を認め腫瘤は喉頭に多発していた。LMS·CO<sub>2</sub>レーザー治療施行後も全例で喉頭に再発がみられたが数回のLMS·CO<sub>2</sub>レーザー治療で2例は治癒した。1例は転居のため経過は不明で1例は経過観察中である。本疾患の病因はHPV (human papilloma virus) の経産道感染といわれ,発症の危険因子として経膣分娩や第1子などがあげられる。当科での4例では全例経膣分娩で2例が第2子,他は第1子,第3子であった。若年性喉頭乳頭腫は多発性で再発を繰り返し治療に難渋することが多いが,再発を繰り返した症例において,短期集中のLMS·CO<sub>2</sub>レーザー治療が有効であると思われた。
著者
山田 文則
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.10, no.4, pp.212-230, 1959-10-10 (Released:2010-02-22)
参考文献数
15
被引用文献数
5 5

The larygeal, tracheal and syringeal muscles of several birds (Gallus gallus var. Domesticus Brisson, Otus asio Teminck & Schlegel, Melopsittacus undulatus and Corvus levaillantii japonensis) were observed anatomically under binocular microscope, in paying attention to that the tone production of birds are performed not by larynx but by syrinx, and these muscles originate from the sterno-hyoid muscle system. Following results are obtained:-1 The laryngeal muscles are classified in delator and constrictor. The constrictor muscles are different according to the kind of birds, yet M. crico-arytenoideus lateralis, M. cricoideus dorsalis, and M. interarytenoideus are discriminated.2 Gallus gallus var. domesticus Brisson and Otusasio T. & S. make their tracheas move up and downby working M. sterno-trachealis and M. tracheo-lateralis to shut and open the space between the internal and external tympaniformic membrane, and by this movement the tone production and respiration are performed.3 Melopsittacus undulatus are absent of M. sterno-trachealis, but M. tracheo-lateralis, M. tracheo-bronchialis, and M. syringecs contribute to the movement of syrinx.4 Syringeal muscles of Corvus levaillantii japonensis are classified in M. cleido-trachealis, M. tracheo-lateralis, Mm. tracheo-bronchiales, M. tracheo-bronchialis dorsalis brevis, and Mm. syringei.5 The laryngeal muscls are chiefly innervated with glossopharyngeal nerve. The muscles connected with syrinx are controlled doubly by the upper and lower laryngeal branch of the hypoglosso-cervical nerve and the syringeal branch of the recurrent nerve.6 The syringeal branch of the recurrent nerve does not anastomose with the upper laryngeal branch of the hypoglossal nerve, going to among the muscle bundles of the tracheo-laterl muscle, and anastomoses with the branch of the glossopharyngeal nerve at the upper portion of the trachea. I confirmed this in Gallus gallus var. domesticus Brisson, Otus asio T. & S. Melopsittacus undulatus.
著者
上原 真由美 荒牧 元 清 恵里子 宮野 良隆
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.36, no.4, pp.406-409, 1985-08-10 (Released:2010-02-22)
参考文献数
6

Recently Heimlich maneuver has been recommended for the treatment of food choking in Japan. We think that the foreign body in the respiratory tract can not be removed by Heimlich maneuver in case of choking by some Japanese foods.We experimentally packed a small ping-pong ball, a mass of chicken, rice cake and chewing pork into the larynx of a mongrel dog, and tried Heimlich maneuver for removal of foreign bodies. A ping-pong ball and a mass of chicken could be removed by this maneuver, however, a mass of rice cake and chewing pork could not. Accordingly, we tried to remove these foreign bodies by finger maneuver and could remove them successfully.We recommend finger maneuver in case of difficulty in removing the foreign body by Heimlich maneuver.
著者
馬 燕 福田 宏之 牧野 克己 酒向 司 塩谷 彰浩 神崎 仁
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.43, no.4, pp.339-343, 1992-08-10 (Released:2010-06-11)
参考文献数
16

The therapeutic method for laryngeal papilloma is still not definitely established. It is a general principle that the laryngeal papilloma should be surgically removed as much as possible. For the purpose, laser surgery has been used and therapeutic potency could be expected to some extent. However, since this disease is a high recurrence, especially in case of infant or child, it is easily induced to papillomatosis, resulting in the tracheal invasion.Here, in this paper a case of laryngeal papillomatosis is reported. The patient is 10 years old, and received frequent surgical operations without any success. For this case, medication with the traditional Chinese medicine has been performed, resulting in no recurrence.
著者
川崎 順久 福田 宏之 辻 ドミンゴス浩司 塩谷 彰浩 高山 悦代 川井田 政弘
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.41, no.3, pp.236-240, 1990
被引用文献数
1

Recently CO2 laser surgery has been employed for Ti glottic cancer to avoid side effects caused by irradiation. However phonatory disturbance caused by post-operative anterior glottic web is sometime troublesome to patients. In this study, a survey of 17 patients with Ti glottic cancer, whose anterior comissure was vaporized with CO2 laser, was reviewed. In eight cases among them, anterior glottic web was observed during post operative course. Hence, we applied the fibrin glue (Tisseel) on the vaporized wound in 4 cases of Ti glottic cancer to avoid post-operative anterior glottic web. Post-operative wound healing of vocal folds were excellent in each cases. In the cases of anterior comissure involvement, the fibrin glue is applicable adjunct for prevention of anterior glottic web with CO2 laser surgery.
著者
唐帆 健浩
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.50, no.3, pp.396-409, 1999-06-10 (Released:2010-02-22)
参考文献数
40
被引用文献数
10 8

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.
著者
川崎 順久 福田 宏之 辻 (ドミンゴス)浩司 酒向 司 塩谷 彰浩 馬 燕 川井田 政弘
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.43, no.1, pp.38-42, 1992
被引用文献数
1

Neurinoma of the vocal fold is not common. A 43-year-old female with neurinoma of the left vocal fold was treated by microlaryngeal surgery. Clinical observation using laryngostrobovideography and CT revealed a smooth mass localized in the left vocal fold. The tumor was successfully removed under general anesthesia by microlaryngeal surgery. We applied the fibrin-glue (Tisseel®) on the surgical wound of the vocal fold to avoid post-operative scar. Postoperative wound healing of the vocal fold was excellent in this case. Her phonatory function was satisfactory and no tumor recurrence have been noted after surgery. In this case, the fibrin glue might have good effect on the wound healing of the vocal fold.

2 0 0 0 OA 頸部の解剖

著者
平野 実
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.38, no.6, pp.528-529, 1987-12-10 (Released:2010-02-22)
参考文献数
2
著者
太田 久彦
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.38, no.4, pp.374-384, 1987-08-10 (Released:2010-02-22)
参考文献数
29

Cold environment may alter cardiopulmonary function. The alteration of pulmonary blood flow (QC), respiratory water loss (VH2O), convective heat loss (CHL) and respiratory heat loss (RHL) were studied with subjects exposed to cold environment (5°C) and to thermoneutral environment. QC varied according to posture (supine, sitting and standing) and there was no significant difference between cold and thermoneutral temperature at the same posture. Apparently cold exposure of short duration had no effect on QC At the same temperature, QC was larger in the supine position than in the other positions.Before, during and after stepwise exercise in normal subjects, there was no significant difference in QC between cold and thermoneutral temperature.CHL increased significantly during stepwise exercise in the cold environment in compared with those at the thermoneutral temperature, however, VH2O and RHL also increased no significant degree. At both temperatures, VH2O, CHL and RHL increased during exercise in compared with those before exercise. RHL was elevated according to the increment of ventilation, and this elevation was more marked in the cold environment.
著者
武田 潤
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.38, no.6, pp.512-521, 1987-12-10 (Released:2010-02-22)
参考文献数
28

The study was undertaken to clarify the mechanism causing bronchoconstriction after inhalation of cold air and to determine the site of bronchus most severely affected. A series of experiments were performed on 11 healthy subjects who had history of bronchial asthma only in childhood. The respiratory resistance was continuously measured by a newly developed system to test the effect of cold air inhalation and also the pulmonary function was measured before and after the inhalation. The bronchial hyperresponsiveness to methacholine was measured by the astograph. The effects of various drugs (atropine, ipratropium bromide and disodium cromoglycate) on the increase of respiratory resistance were investigated. The respiratory resistance was increased immediately after the inhalation of cold air in all subjects. The increase in respiratory resistance was inhibited by atropine and ipratropium bromide but not by disodium cromoglycate. The decrease of V25 induced by inhalation of cold air was significantly greater than that of FEV1. Thus it was concluded that from a pharmacological point of view, inhalation of cold air caused bronchoconstriction, predominantly in small airway via cholinergic mechanism. Also, the degree of increase in the respiratory resistance was correlated with the bronchial sensitivity to methacholine.
著者
坂口 浩三
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.68, no.5, pp.339-347, 2017-10-10 (Released:2017-10-25)
参考文献数
36

国際がん研究機関(IARC)はたばこ煙の中に70種類の発癌物質を同定している。発癌性の強い物質の代表にニトロソアミン類,多環芳香族炭化水素(PAHs)がある。日本人での喫煙によるによる肺癌の相対発生危険度は男性で4.4倍,女性で2.8倍といわれている。夫が喫煙者である場合,非喫煙者である妻の受動喫煙による肺腺癌発生リスクは2.03倍と報告されている。喫煙が扁平上皮癌,小細胞肺癌発生との関連が強いのは既知のことであるが腺癌や大細胞神経内分泌癌(LCNEC)の発生にも有意に関与していることがわかってきた。肺腺癌におけるK-ras遺伝子変異は喫煙と関連が強い。若年性肺癌ではCYP1A1多型等の代謝遺伝子的因子の関与がたばこ煙の感受性を高めている。COPD患者は非COPD患者と比べて3~4倍肺癌発生頻度が高く,肺癌を発症した場合は全生存期間が有意に悪い。IIPs合併肺癌の外科治療では術後のIIPs急性増悪(AE)のリスクがある。近年7項目よりなるリスクスコアにより適切な症例選択がなされるようになった。喫煙者の肺癌は悪性度が高い傾向があり周術期合併症の頻度も増す。同じIA期肺癌でも非喫煙者は全生存期間が長い。喫煙者でも中年以前に禁煙することによりたばこの身体への危険性はかなり回避できるといわれている。
著者
児嶋 久剛
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.45, no.5, pp.360-364, 1994-10-10 (Released:2010-02-22)
参考文献数
16
被引用文献数
1 1

The literature on laryngeal function in the speech of aged persons is reviewed. Two major techniques have been used for the study of utterances in aged persons; one uses isolated voice sounds and the other conventional running speech for analysis.The former technique reveals aging-related changes in the vocal cords and in respiratory function. The voice of aged persons is characterized by hoarseness. That of males is also characterized by an increase in fundamental frequency, and that of females is characterized by a decrease. These changes are caused by an atrophy of the vocal folds in aged males and by an edematous change in aged females. However, this is only on among various aspects characteristic of the speech in aged persons.Other changes includes changes in the articulatory system and its movements. Aging affects the mobility of the tongue, pharyngeal wall and soft palate. In the production of a plosive, for example, aging leads to low intrapharyngeal pressure and poor glottal opening. As a result, the speech of aged person tends to be less clear.A combined study of isolated voice sounds and running speech is indispensable for the study of laryngeal function in aged persons.
著者
岡本 健
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.45, no.2, pp.87-89, 1994-04-10 (Released:2010-02-22)

Recently, in terms of its medical content, bronchoesophagology as a lawful medical title has been hardly understood by patients. Although the future progress of bronchoesophagology as a science is indispensable and promising, the main question is whether it can maintain its identity as a clinical field. It seems to be more appropriate that bronchoesophagology remain the title of subspecialty of a medical field than a title of a clinical field.
著者
真栄田 裕行 鈴木 幹男 上里 迅 島袋 拓也 仲吉 博紀 嘉陽 祐紀 照喜名 玲奈 金城 秀俊 安慶名 信也 又吉 宣
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.70, no.4, pp.278-283, 2019

<p>食道穿孔は日常診療において時に経験する病態であるが,多くの場合生じた穿孔は頸部や縦隔内と交通するため,頸部感染症や縦隔炎を誘発し,時に重篤となることがある。また開胸を伴う胸部外科手術と頸部手術の併施は,術直後の縦隔炎発生の可能性が高まるため,一般には敬遠されている。</p><p>今回われわれは胸骨正中切開を伴う大動脈弁置換術直後に,歯科用補綴物による頸部食道穿孔をきたした1例を経験した。症例は66歳の女性で主訴は頸部異物である。開胸手術直後に頸部に迷入した異物が確認され,直ちに頸部外切開による異物摘出術および瘻孔閉鎖術が施行された。異物は歯科用補綴物(クラウン)であり,金属製の突起を歯根に埋め込むタイプのものであった。本症例は開胸手術直後であったにもかかわらず頸部外切開手術を全身麻酔下に施行できたこと,異物を速やかに発見・除去できたこと,頸部創と胸部創が連続しないようにしたこと,気管切開を施行せずに術後も気管内挿管のまま気道管理をしたことが重篤な合併症を誘発しなかった理由としてあげられた。</p>
著者
福田 宏之 斎藤 成司 都築 達 牟田 弘 高山 悦代 藤岡 正 鈴木 理文 北原 哲 磯貝 豊 粉川 信行 市川 忠 牧野 克巳
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.35, no.2, pp.101-106, 1984-04-10 (Released:2010-02-22)
参考文献数
6
被引用文献数
4 3

Nobody can deny that lubrication is one of the factors which influences the phonatory function of the larynx. However, no notable studies on the mechanism of lubrication have ever been carried out. This study is an effort to clarify how the larynx is lubricated.In the present study, it is revealed that the secretory fluid from the tracheal and subglottic spaces passes instantly through the glottis at the moment of the onset of phonation. Thus, the initiation of the lubrication is accomplished. The fluid from the subglottis is then mixed with the supraglottic fluid which comes mainly from the ventricular gland. A lubricant column is bilaterally made by the mixed fluid on the upper surface of the vocal folds. This lubricant column is rotating perpendicularilly to the free edge of the folds. The lubricant column may lubricate the folds which vibrate during phonation. At the end of phonation, the column decomposes and mostly flows backward to the subglottis. By this flow, the glottis is lubricated again.In this paper, the results mentioned above were discussed and analyzed from the viewpoint of phonodynamics.
著者
三枝 英人 小野 卓哉 林 明聡 豊田 雅基 新美 成二 八木 聰明
出版者
The Japan Broncho-esophagological Society
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.48, no.4, pp.297-302, 1997-08-10 (Released:2010-02-22)
参考文献数
14

The treatments for patients with severe dysphagia and misdeglutition are very difficult. Some cases must have total laryngectomy or tracheo-esophageal separation to control their severe misdeglutition and prevent serious respiratory distress. However, in such cases, the phonatory function has to be sacrificed, resulting in a poor quality of life.In order to overcome this conflict between deglutition and phonation, we have developed an “artificial pharynx.” The artificial pharynx consists of a soft balloon and a plastic tube. The soft balloon is attached to a tube with an inlet hole. The whole assembly can be inserted through the patient's nose. The tip of the tube remains in the stomach and the balloon is inflated at the level of the pharynx to seal the airway. Our patient could breathe through a tracheal stoma which was created prior to using the artificial pharynx. The bolus was introduced through the inlet hole into the tube and moved down to the stomach by gravity. When the balloon was deflated, the patient could breathe and phonate with a speech valve of the cannula.We treated a patient using an artificial pharynx. He was a 62 years old male diagnosed as having terminal myotonic dystrophy and suffering from severe dysphagia. Because of his poor general condition, any surgical intervention for dysphagia and misdeglutition could not be performed without a tracheotomy. But, since he yearned to take some drinks and to preserve his phonatory function, the artificial pharynx was utilized with some success.