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

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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

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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 10

---

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

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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.

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

山口 健吾 北原 哲 田村 悦代 田部 哲也 島崎 英幸 海江田 純彦 中之坊 学 村川 哲也 兵頭 義浩 井上 鐵三

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.321-326, 1997-08-10

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.18, no.4, pp.213-226, 1967-08-10 (Released:2010-02-22)

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.32, no.2, pp.173-182, 1981-04-10 (Released:2010-10-20)

著者

田中 隆 森川 英雄 安広 矩明 木下 裕宣 虎渓 邦孝 佐藤 博信 市橋 正嘉 河口 忠彦 坂部 孝

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.30, no.3, pp.215-219, 1979-06-10 (Released:2010-02-22)

参考文献数

5

---

In 66 cases with esophageal achalasia who were treated in the authors' clinic during the last 20 years from 1958 to 1978, 22 cases had a history of respiratory complaints. Five cases out of the 22 had been treated for chronic bronchitis or bronchitis, the pertinent symptoms of which had apparently occurred from aspiration of ingested food into the bronchus. Cardioplasty was performed on these 5 cases mainly using the modified Girard's technique with successful results. In this report, the clinical courses of the 5 cases were presented with special reference to chest X-ray findings, preoperative care and anesthetic techniques.

著者

仙田 里奈 角木 拓也 黒瀬 誠 守本 倫子 高野 賢一

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.74, no.3, pp.228-234, 2023-06-10 (Released:2023-06-10)

参考文献数

11

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小児気管切開術は長期の気道・呼吸管理の管理に必須の治療である。経過の中で多様な合併症を引き起こすため,気管切開術の術式や術後の管理においてさまざまな工夫が求められることも多い。また,気管孔閉鎖においては確立されたプロトコルが存在せず各施設の経験に頼られている部分が大きい。周産期・小児医療の発達により今後も小児気管切開患者の増加が見込まれるため,その管理において指標となるデータおよびプロトコルが必要になると考える。今回われわれは,小児気管切開患者の安全な気道管理および気管孔閉鎖の実現を目的とした全国調査を実施した。対象施設202施設中57施設から回答を得た。過去10年間に小児気管切開術を施行している施設は29施設であり,過去1年間に行われた小児気管切開術症例は全196例であった。術式や術前の経過については各施設直近20症例,長期経過における合併症と気管孔閉鎖については過去10年間の症例で検討した。合併症の発症率が成人と比較して多い可能性や,気管孔閉鎖率が1割程度に留まることが明らかとなった。今後は長期管理や気管孔閉鎖についての共通認識を深めることが望まれる。

著者

井上 鐵三

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.5, pp.464-465, 1987-10-10 (Released:2010-02-22)

参考文献数

2

著者

大島 忠之 三輪 洋人

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.60, no.5, pp.401-408, 2009-10-10 (Released:2009-10-25)

参考文献数

23

---

胃食道逆流症(GERD)は欧米に多いと言われてきたが,食生活など生活習慣の欧米化,肥満の増加,酸分泌能の増加,Helicobacter pylori感染率の低下などから,わが国でも確実に増加傾向にある。GERDでは,胃から食道への逆流を防ぐ機構あるいは排出する機構が食道運動異常,下部食道括約筋の機械的あるいは機能的異常,食道クリアランス,胃内容の排出遅延などによって障害され,著しく生活の質(QOL)が損なわれている。わが国には非びらん性胃食道逆流症(NERD)や軽症の逆流性食道炎が圧倒的に多く,これら軽症のGERDが重症GERDに進行することは多くない。したがって自ずと治療目標は,自覚症状である胸やけ,呑酸などの症状改善や,これに伴う日常QOLの向上となる。最も有用な治療は胃酸分泌抑制であるが,この薬の効果が少ないときには治療に難渋することも多い。実際,食道粘膜傷害と症状が相関せず,NERDにおける,プロトンポンプ阻害薬(PPI)の効果は50%程度と言われている。近年,GERD治療における漢方薬のエビデンスが得られつつある。六君子湯は,酸分泌を抑制することなく,食道クリアランス,あるいは胃排出能や胃適応性弛緩作用を介してGERD患者,特にNERD患者で症状を改善する可能性が考えられる。

著者

倉上 和也 長瀬 輝顕 神宮 彰 和氣 貴祥

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.65, no.3, pp.252-259, 2014 (Released:2014-06-25)

参考文献数

20

被引用文献数

1 1

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アルカリ性薬物の誤飲による咽喉頭食道炎は,粘膜びらん,壊死,瘢痕狭窄などさまざまな病態を呈し,致死的な状況となりうる。アルカリ性薬物誤飲例の報告自体が稀であるが,喉頭蓋脱落を観察した症例は文献的にはない。今回われわれは,95%水酸化カリウム誤飲により生じた腐食性咽喉頭食道炎に対し,長期入院および手術的加療を行い救命し得た症例を経験したので,詳細な咽喉頭所見の経過を含め報告する。症例は39歳男性。飲酒後にアルカリ性パイプ洗浄剤を誤飲し,嘔吐,振戦様痙攣をしているところを家人に発見され,当院急患室へ救急搬送された。声門狭窄は認めなかったものの,中下咽頭,舌根部,披裂部,喉頭蓋に粘膜の腐食性変化を認めた。全身麻酔下に気管切開術を施行し,集中治療室にて人工呼吸管理を行った。喉頭浮腫や粘膜炎は徐々に軽快したものの,第37病日より喉頭蓋の脱落を認め,喉頭蓋はほぼ完全に脱落した。脱落後は,喉頭蓋基部で周囲組織と癒着し,発声および経口摂取が不能な状態になった。第175病日に咽頭喉頭食道摘出術および有茎空腸による再建,永久気管孔形成術を施行した。2年経過した現在,重大な有害事象の出現を認めず,社会復帰し,経過観察中である。

著者

平野 実 大久保 洋 吉田 哲二 江崎 修市 吉田 義一 進 武幹

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.32, no.5, pp.365-372, 1981-10-10 (Released:2010-10-20)

参考文献数

19

被引用文献数

6 3

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“Cricopharyngeal achalasia” appears to be defined as a failure of the cricopharyngeal muscle to relax or as its premature contraction during the pharyngeal stage of deglutition. Our electromyographic, radiographic and histological investigations led to the conclusion that there are NO such conditions. In the conditions where “cricopharyngeal achalasia” has been thought to exist in association with other neuromuscular diseases, the cricopharyngeal muscle does relax in normal timing. However, since the propelling force is lessened because of weakness of the lingual and/or pharyngeal muscles, bolus does not enter the esophagus during the cricopharyngeal relaxation. Therefore, it is not the cricopharyngeal muscle but the tongue and/or pharyngeal muscles that is responsible for dysphagia. In the conditions where “cricopharyngeal achalasia” appears to be the only problem, again the cricopharyngeal muscle does relax. This was confirmed electromyographically in 5 patients. Results of a histological study suggest that the genesis of dysphagia in these conditions is a decrease in expansibility of the cricopharyngeal muscle resulting from a myopathy. We propose that these conditions should be called “idiopathic cricopharyngeal myopathy.”

著者

粉川 信行

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.28, no.6, pp.323-332, 1977-12-10 (Released:2010-10-20)

参考文献数

18

被引用文献数

5 6

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Androgenic and anabolic hcrmones have often been used in treating various diseases. The treatment for dysphonia, one of their side effects, has not yet been ascertained. We have employed a new surgical procedure and have obtained successful results.It may be said that when the cricothyroid muscle is more dominant than the thyroarytenoid (TA) muscle, voice will be high-pitched.Based on this concept, a method of weakening the activity of the TA muscle was assumed to be effective for eliminating abncrmal high-pitched voice. Prior to clinical application, we designed electrophysiological and histochemical experiments.Using canine larynx, a portion of the terminal branch of the recurrent nerve in the TA muscle was severed by making an incision onto the vocal cord parallel to its free edge. By deepening the incision, evoked electromyographic activity was gradually decreased presumably due to reduction in action potentials of the muscle fibers to be picked up by the electrodes. Similar results were also obtained in chronic experiments using canine larynx.A histochemical study revealed that motor end-plates were remarkably degenerated one month after ncision. This finding would indicate that the incision has severed the branch in the TA muscle.This method have been successfully employed for 8 clinical cases. In this paper, the results were reported and descussed from the viewpoint of phoniatric examinations.

著者

梅野 博仁 濱川 幸世 権藤 久次郎 白水 英貴 吉田 義一 中島 格

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.53, no.3, pp.285-288, 2002 (Released:2007-10-25)

参考文献数

5

被引用文献数

5 3

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成人10名にカプサイシンを10-6 mol/mlに溶解させた蒸留水を口腔内に噴霧し,噴霧前と噴霧後の唾液中に含まれるサブスタンスP(以下SPと省略)の濃度を測定した。同様に,成人10名にカプサイシンを1枚につき6×10-8 mol程度含有した市販のガムを使用して,ガムを噛む前と噛んだ後の唾液中SPの濃度も測定した。その結果,カプサイシン投与後,ガムを噛んだ後,ともに有意な唾液中のSPの上昇を認めた。同様に筋萎縮性側索硬化症,パーキンソン病,眼咽頭型筋ジストロフィー症,ギランバレー症候群,脊髄小脳変性症患者でも,カプサイシン投与でSPが有意に上昇した。したがって,カプサイシン入りガムを噛むことで咀嚼・嚥下の訓練になり,さらに唾液中のSPが上昇することで嚥下反射が起こりやすくなることが期待できる。嚥下訓練にカプサイシン入りガムを用いるのは有用と考えられた。

著者

東本 有司

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.73, no.2, pp.152, 2022-04-10 (Released:2022-04-25)

著者

沢田石 勝 唐木 芳昭 川口 誠 斎藤 光和 佐伯 俊夫 山田 明 島崎 邦彦 宗像 周二 坂本 隆 真保 俊 田沢 賢次 藤巻 雅夫

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.40, no.3, pp.252-257, 1989-06-10 (Released:2010-02-22)

参考文献数

6

被引用文献数

5 4

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It has been well known that the normal esophageal epithelium is stained by a modified Lugol's solution. On the other hand, displastic or cancerous mucosa of the esophagus is not stained by Lugol's solution through the endoscopic staining method. It is not clear what kind of mechanism causes the coloring or uncoloring of these esophageal mucosa using Lugol's solution. Therefore, to clarify this mechanism, we examined the sections of surgically resected esophageal tissues with Lugol's solution using the light microscopy. At the same time, we detected an iodine element in each tissue instilled with Lugol's solution by means of X-ray microanalytic technique. In light microscopic study, the cells of the stratum corneum and stratum granulosa of the normal esophageal mucosa were strongly stained by Lugol's solution. Dysplastic epithelium showed a slight coloration property in its superficial layer. No cancerous lesions were histologically stained by Lugol's solution. In X-ray microanalytic study, the cells of stratum corneum and stratum granulosa displayed a high peak for iodine. An intermediate peak for iodine was detected in the superficial zone of the displastic mucosa. No peaks for iodine were found in any other portion of the cancer tissues. These results suggested that the difference in the coloration property of the normal esophageal epithelium, dysplastic regions and cancerous regions corresponded to the affinity of each of these cells of these regions with iodine.

著者

佐々木 裕美 佐伯 克哉

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.47, no.3, pp.298-304, 1996 (Released:2010-10-20)

参考文献数

10

---

As a treatment for respiratory failure in chronic lung disease, an artificial airway is sometimes required for respiratory control. In these circumstances, endotracheal intubation is applied first. However, tracheotomy is sometimes performed when further respiretory care is needed.Twenty three tracheotomies were performed in our department for this purpose during the last 7 years (from April 1998 to March 1995). Twelve patients have survived at present, and most of them were able to break away from mechanical respiration completely within a few days after their tracheotomy. Tracheotomy was more effective as an artificial airway than endotracheal intubation for these patients. On the other hand, seven of the non-surviving 11 patients died soon after tracheotomy. Thus, tracheotomy was not as effective for them as it was for the 12 survivors. It is doubtful whether tracheotomy, an invasive technique, is an appropriate therapy for these poor-prognostic patients. Before making a decision to use tracheotomy, the prognosis for life itself should be evaluated objectively and precisely.

著者

佐藤 達夫

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.50, no.2, pp.227-234, 1999-04-10 (Released:2010-02-22)

参考文献数

3

---

In function-preserving operations of the esophagus and lung, it is crucial to have a precise knowledge of the mediastinal and deep cervical lymphatics and their relationships to surrounding structures. The lymphatics of the mediastinum and neck, which are associated with the esophagus and run along the trachea, were dissected in detail in several anatomical specimens. The actual photographs taken during the dissection are included for a more complete understanding of the intricate topographical relationships. Although there are numerous transverse connections, the mediastinal lymphatics can be roughly divided into two major ascending pathways: the right and the left. Each pathway can then be subdivided into a superficial pathway along the major blood vessels and a deep pathway along the trachea and esophagus. Various deep right ascending pathways are shown to illustrate the problem of the differing levels at which lymph vesseles leave the paratracheal nodes to reach the right venous angle. Further, the brachiocephalic node group is discussed as the critical intermediary nodes between the superficial and deep pathways. Numerous deep left pathways are also dissected from the left tracheobronchial nodes. Some lymphatics ascend along the left recurrent nerve to finally reach the left venous angle, while some pathways traverse to the right side. Still other pathways directly connect to the thoracic duct.