| Project/Area Number |
16591546
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Ehime University |
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Principal Investigator |
NAGAR Nagaro Ehime University, School of Medicine, Associate Professor, 医学部, 助教授 (50108388)
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| Co-Investigator(Kenkyū-buntansha) |
KAMEI Michiko Ehime University, University Hospital, Instructor, 医学部附属病院, 助手 (10363243)
藤井 知美 愛媛大学, 医学部附属病院, 助手 (00325383)
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| Project Period (FY) |
2004 – 2005
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| Project Status |
Completed (Fiscal Year 2005)
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| Budget Amount *help |
¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2005: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2004: ¥800,000 (Direct Cost: ¥800,000)
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| Keywords | percutaneous cervical cordotomy / Respiratory function / CT-scanning / needle / complications / コルドトミー / レントゲンCT / 呼吸障害 / 運動障害 / CTスキャン |
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| Research Abstract |
The prevention of respiratory failure following percutaneous cervical cordotomy-The use of CT scanning-
Percutaneous cervical cordotomy (PCC), the interruption of nociceptive pathway in the anterolateral column, is one of the useful treatments of cancer pain. Most serious complications of PCC is the respiratory failure which occurs following the interruption of efferent and/or afferent respiratory fibers lying densely from the anterior quadrants to anterior portion of anterolateral quadrant in the high cervical cord. We have been performed PCC with a fine electrode to relieve the pain with a more selective and smaller lesion to prevent the derangement of respiratory function. We therefore examined the effect of PCC with a fine electrode(a Mullan-Portney electrode^<TM> : 0.25mm width and 2mm length and thermocouple-typed Levin electrode^<TM> : 0.27mm width and 2 mm length on the respiratory function from the changes of respiratory function test, arterial blood gas and the histopathologic
… More
al changes in the spinal cord following PCC. Unilateral PCC was performed in fifty-three patients, and bilateral PCC in 10 patients. There were no respiratory complications following PCC. In two patients with tachypnea and severe respiratory dysfunction properatively, one for unilateral and one for bilateral PCC, dyspnea occurred at the same time as the warm or painful sensation evoked with an electrostimulation of the cord. %VC decreased slightly in unilateral PCC group, from 66.2% to 60%, and no other parameters showed the derangement of respiratory function. No respiratory derangements were observed in bilateral PCC. The histological examination in 7 cases showed the destruction in the dorsal portion of the anterolateral column, not extended to the anterior column. These results showed the use of the fine electrode enable to make the selective lesion and prevent the respiratory failure. PCC was performed in 3 cases under the control of CT scanning with the 20 G guide needle with a hub made of plastic to prevent the enhancement of the needle on CT radiogram, in which the positional relation between the needle tip and spinal cord is clearly shown. These cases suggested that the use of CT will prevent the destruction of respiratory pathway and consequently respiratory failure. Less
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