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

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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.

著者

宮内 靖史 加藤 貴雄 岩崎 雄樹 林 明聡 水野 杏一

出版者

The Japanese Society of Electrocardiology

雑誌

心電図 (ISSN:02851660)

巻号頁・発行日

vol.28, no.3, pp.210-215, 2008

被引用文献数

5

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【目的】用手計測法および自動計測法によるQT間隔詳細計測の精度と問題点について検討する.【方法と結果】用手計測は, 25mm/sec, 1cm/mVで記録した通常の心電図波形を200%拡大コピーし盲検化した後, 心電図解析に熟達した循環器専門医3名が接線法を用いて行った.再現性の確認のため1週間の間隔をあけて計2回計測した.第1回目と第2回目の測定値の差は, 平均で-1~2msecとほとんどばらつきがなく, 両者の相関係数は0.96~0.97であったが, 心拍ごとの測定値の差の絶対値は, 5~7msecとやや大きかった, 一方, コンピュータ画面上でのマニュアル修正を併用した自動計測法では, 差の絶対値は1±2msecと用手計測法に比して有意に小さく, 相関係数も0.997と, 再現性に優れていた.各測定者の用手計測値と自動計測値の相関は0.94~0.96と高く, 平均値の差も-1~4msecと小さかった.【結論】マニユアル修正を併用したQT間隔の自動計測法の精度はきわめて高く, 正確性が期待できる, 一方で記録紙からの用手計測法も, 計測に熟達すれば5msec程度の精度での評価が可能である.