The Tokai journal of experimental and clinical medicine
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Tokai J. Exp. Clin. Med. · Dec 2004
Case ReportsA case of the diaphragmatic flutter with an electromyographic study of the respiratory muscles.
A 28-year-old female was complained with dyspnea and involuntary rhythmic movements in her chest and upper abdomen. Diagnosis of the diaphragmatic flutter was established since high frequency intermittent discharges of the respiratory muscles superimposed on her ordinary respiratory activities. The origin of these abnormal discharges may be in the central nervous system and the psychosomatic factor is participating in the development of the diaphragmatic flutter.
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Tokai J. Exp. Clin. Med. · Sep 2004
Comparative StudyDeveloping and establishing an ideal method of continuous-infusion epidural analgesia for delivery using the double-catheter method.
We evaluated the efficacy of a new method of induction of epidural obstetric analgesia devised by us. The upper and lower catheters used for the epidural double-catheter method were connected to a compression-type disposable injector (Coopdech Syrinjector). 0.125 % bupivacaine + 2 microg/ml fentanyl (6 ml/h) were serially injected via the upper catheter. In the latter half of Stage 1 of labor, the same drugs were continuously infused via the lower catheter (4 ml/h). ⋯ The mean number of additional drug doses injected via the lower catheter was 0.37+/-0.57(range: 0-2). The number of additional doses in the 49 women averaged 0.16 per hour and 1.04 per delivery. Thus, good results were obtained.
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Tokai J. Exp. Clin. Med. · Sep 2004
Case ReportsAirway management during the laryngoscopic surgery for the benign laryngeal obstructive disease.
The airway management and anesthesia maintenance during the laryngoscopic surgery is essential for a safe operation. For the benign laryngeal obstructive disease such as a large mass or a foreign body of the upper airway, it is difficult to secure the airway. ⋯ They were successfully operated on with laryngomicrosurgery under neuroleptanalgesia (NLA) without intubation. The choice of the operation and airway management were discussed.
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Tokai J. Exp. Clin. Med. · Jun 2004
Comparative Study Clinical Trial Controlled Clinical TrialStraight advancement of epidural catheter--comparative assessments by method and site of epidural needle puncture and angle of puncture.
The catheter straight advancement rate for introduction into the epidural space was investigated using a radiopaque catheter. One hundred patients were divided into two groups and underwent thoracic or lumbar epidural punctures, with one of two different puncture methods: the median approach or paramedian approach. ⋯ A catheter was inserted into the epidural space about 5 cm cephalad and the course of the inserted catheter was ascertained by radiography. The results have shown that punctures performed at an insertion angle of 50-60 degrees yielded higher catheter straight advancement rates than those performed at an angle of 90 degrees in both thoracic and lumbar epidural punctures.
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Tokai J. Exp. Clin. Med. · Dec 2003
Blind endobronchial insertion of a movable bronchial blocker attached to an endotracheal tube, Univent tube.
The endotracheal tube with a movable bronchial blocker, Univent tube, used to effect one-lung ventilation is easy to use in endotracheal intubation. However, problems are often encountered when inserting the blocker into the bronchus. We herein describe a method which enables the easy blind insertion of the blocker into the left or right bronchus. ⋯ When strong resistance is left, the blocker should be retracted, the force of laryngeal displacement is altered and, then, the blocker is inserted again in a resistance-free manner. We have so far experienced no complications such as severe tracheobronchial hemorrhage, tracheobronchial perforation of laryngeal dislocation. We herein describe a useful and simple method for inserting the bronchial blocker of the Univent tube into the bronchus.