著者

河合 敏 佃 守 持松 いづみ 陰里 ゆうみ 古川 滋 大石 公直 中川 千尋 古川 政樹

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.6, pp.609-614, 1999-12-10 (Released:2010-02-22)

参考文献数

19

被引用文献数

1 1

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We discussed five cases of open injuries to the larynx with sharp instruments in suicide attempts.In these cases, (1) laryngoplasty was performed early. (2) Tracheostomy was done at the lower part of the injury to keep the airway open. (3) The wound was observed carefully. And (4) The mucosa of the larynx was sutured firmly so as not to yield a raw surface with a synthetic monofilament, whether absorptive or not. Sometimes, the suture filament penetrated in the lumen of the larynx without any problem.The prognosis for the larynx in these cases was generally good. The risk of permanent laryngeal palsy was supposed to be little.However, all the patients might have psychiatric disease, i. e. schizophrenia or depression. We must consider their psychiatric background.

著者

瀧野 賢一

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.31, no.6, pp.421-426, 1980-12-10 (Released:2010-02-22)

参考文献数

9

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The author describes some personal views on accidents in bronchoscopy and esophagoscopy by classifying them largely into those occurred at the time of introduction of an endoscope, during and after the endoscopy, taking into consideration chiefly the lessons of previous investigators and the cases experienced by the author himself and others.1. Among the accidents occurred at the time of introduction of an endoscope, injuries caused by the endoscope included damages to the upper incisors and injuries of the soft tissues along the route of introduction. These accidents may be avoided by maintaining the head of a patient in an elevated extended position and by adequate use of an endoscope.2. With respect to the accidents occurred during the examination, various accidents were discussed by quoting some examples. The accidents classified into this category included 1) respiratory distress due to tracheal tumors, anterior mediastinal tumor and foreign bodies in the trachea; 2) profuse bleeding from a biopsy in a case with middle lobe syndrome and from esophageal varices; 3) injuries and perforations of the esophageal walls due to extraction of pointed foreign bodies or violent extraction; and 4) the accidents inflicting on the surgeon himself such as loss of sight due to injury of the eye by a foreign body, severe infection by tuberculous bacilli, which was caused by neglecting in taking adequate protective measures.3. As to the accidents after the procedure, edema of the glottis, difficult expectoration, crust formation after extraction of foreign bodies, accidents caused by tracheal cannula, cervical subcutaneous emphysema, pneumothorax, and mediastinal emphysema. These accidents indicate the importance of adequate post-procedure observations and cares. With respect to sudden death, it is important to investigate and seek after not only the immediate cause but also the conditions which are possible to become predisposing factors.

著者

川井田 政弘 福田 宏之 加納 滋 蓼原 東紅 大木 和明 凌 梅英 紀太 康一

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.3, pp.309-313, 1987-06-10 (Released:2010-02-22)

参考文献数

20

被引用文献数

1

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This is a report of a patient with sudden hoarseness which was probably caused by mis-inhalation of a commercially-available alkaline disinfectant. The patient was a 27-year-old female who sprayed it in a small room in order to prevent mould. She said she inhaled carelessly much amount of it. Next day, she suffered from hoarseness and strange sensation in her throat and visited our clinic.The laryngo-fiberscopical observation revealed that there were small masses with smooth suface at the posterior wall of the larynx bilaterally.The masses were resected under microlaryngoscopy and vaporized completely with a CO2 laser. A histopathological study revealed that the masses were nonspecific glanulomas.This disinfectant was one of strong alkalis chiefly consisting of NaOCl and NaOH. The corrosive action of the strong alkali might cause minute injuries around the bilateral vocal processes of the arytenoid cartilages. The granulomatous mass was probably produced by the injuries with secondarily occured bacterial infection.No recurrence has been found under the mirror-laryngoscopy after the treatment.

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

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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·CO₂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·CO₂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·CO₂レーザー治療が有効であると思われた。

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

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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

原田 利治

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.10, no.1-2, pp.39-44, 1959-03-20 (Released:2010-02-22)

参考文献数

7

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

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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

平野 実 進 武幹 吉田 義一 三橋 重信 吉田 哲二 大久保 洋

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.31, no.4, pp.285-290, 1980-08-10 (Released:2010-02-22)

参考文献数

16

被引用文献数

8 3

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Dynamic disorders of swallowing are caused by lesions of the neuro-muscular system that participates in swallowing. Aspiration resulting from such disorders can be classified into four types. This classification is helpful for selecting surgical treatments for aspiration as well as for difficulty in swallowing.Type I. In this type, aspiration occurs when the larynx is elevated and closed during swallowing. It results from incomplete laryngeal closure. Mediofixation of the paretic vocal fold, suture of the bilateral ventricular folds, and/or fixation of the larynx in a high position yields good laryngeal closure. Cricopharyngeal myotomy leads bolus easily into the esophagus.Type II. Aspiration takes place when the larynx descends and opens at the end of the second stage of swallowing. This type of aspiration results from a weak propelling force and/or a strong resistance at the entrance of the esophagus. The weak propelling force is attributed to an incompetent velopharyngeal closure, disturbances of tongue movement and/or a weak pharyngeal peristalsis. Pharyngeal flap operation, infrahyoid myotomy and/or reinforcement of the pharyngeal wall is the choice of treatment. In order to reduce the resistance at the entrance of the esophagus, cricopharyngeal myotomy and a fixation of the larynx in an antero-superior position are effective.Type III. Aspiration occurs in both phases of laryngeal rising and falling.Type IV. This type is observed in those patients who are unable to execute the movements of the second stage of swallowing. The inability of the second stage movements seems to be caused by one of the following two: a severe paralysis of the swallowing muscles and strong inhibitory stimuli to the swallowing center of the medulla oblongata. The latter is observed in those patients who would have a very severe aspiration if their swallowing center allowed them to execute swallowing. In this type, the bolus is transported from the mouth to the pharynx by the gravity and weak tongue movements. The larynx closes in reflex but does not present such rising and falling as are executed in normal second stage. When the larynx opens, the bolus staying in the pharynx enters the airway.

著者

横井 茂夫

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.49, no.5, pp.405-410, 1998-10-10 (Released:2010-10-20)

参考文献数

3

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Suckling motions were investigated by recording the oral motions of normal infants suckling their mother's milk using ultrasonic tomographic images from below the mandibular foramen. The suckling motion was revealed to be a back and forth waving motion of the whole tongue, including the root of the tongue beginning from the tongue tip and extending to the epiglottis, and a peristalsis-like motion which fixes and presses the nipple and transports the emerging milk.The oral motion around the tongue was also recorded with a small video camera built into a suction bottle, and the suckling motion was simultaneously using an instruments developed to measure the suckling pressure. The suckling motion of the tongue was revealed to be a peristalsis-like motion in which the tongue closely surrounds the nipple and the center of the tongue presses the palate first with the anterior part of the tongue and subsequently with the posterior part of the tongue. Up to the age of three months, the suckling pressure waveforms are regular, and suckling occurs as frequently as 80-90 per minute with a constant suckling pressure.

著者

長坂 行雄

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.2, pp.147-148, 1997-04-10 (Released:2010-02-22)

参考文献数

3

著者

小野 譲

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.20, no.1, pp.9-17, 1969-02-10 (Released:2010-10-20)

参考文献数

11

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It has been stated that in some animals foreign bodies are found in the esophagus but not in the tracheo-bronchial tree. In Man foreign bodies in the lower airway are of frequent occurrence. This difference between animals and Man prompted the author to investigate the comparative morphology and the basic principles involved.In this study domestic animals as horse, dog, ox, pig and sheep were employed in comparison with Man. The results obtained are as follows.In the animals studied, an elongated soft palate and a big epiglottis are in close contact with each other. In some, these two structures are overlapped so that the normal air tract is shut off from the oral cavity. The palate has lateral palatine fold which also assists in the exclusion of the mouth from nasal passages. In addition, the air and food highways in the animals do not cross at the same plane. These animals, therefore, can with impunity breathe and swallow at the same time.In Man it is not so. There is a gap of several centimeters between the soft palate and the epiglottis, the former being short and degenerated with uvula as its relic. Thus respiration and deglutition can not be carried out synchronously as during the act of swallowing the breathing mechanism has to cease or vice versa. Moreover, the air and food highways intersect at the same plane in the pharynx. In children, particularly, bronchial foreign body incidence frequently occurs resulting from underdeveloped epicritic sense in the sequential mechanism of respiration and deglutition.The author discusses other morphologic and functional factors which are attributable to the foreign body aspiration.

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

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

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

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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

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

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

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

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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.