Purpose:
We previously reported that using D-phenylalanine (D-PA) as a pre-medication increasingly enhanced acupuncture aneshesia effects occur. In order to investigate this effect clinically, we performed tooth extractions under acupuncture anesthesia using D-PA as a premed.
Method:
We divided the patients in the oral surgery department of our hospital for whom acupuncture-moxibustion was determined indicated, into 2 groups, a test group (9cases) to which D-PA (4.0g) was administered 30minutes prior to acupuncture anestesia, and an acupuncture anesthesia only group (about 31cases), and comparitively examined results.
The points used were: LI-4 on both sides in all cases, and indicated local points selected from among JOKAN, ST-7, GV-26, ST-2, LI-20, CV-24, ST-6, SI-18 and ST-5. Needles were inserted (in some cases a point surface electrode was used) and the acupuncture sensation aroused, following which low frequency current at 3-15Hz was administered.
The tooth extractions were begun about 30minutes later. The standard for determining results was a score of 1=absolutely no pain, 2=slight pain, 3=very painful, 4=a small amount of local anesthesia administered, as supplement, 5=attempt to use acupuncture anesthesia abandoned.
Results:
In the control group effective results (score 1 or 2) were obtained in about 30% of the cases while in the test group there was almost no need for supplementary local anesthesia and generally effective results were obtained in most cases.
Summary:
The results were more excellent in the group in which D-PA was used as a pre-med for tooth extractions with acupuncture anesthesia than in the group in which it was not used.

Objective: To evaluate the efficacy of high-flow nasal cannula oxygen (HFNC) for dyspnea in patients with advanced disease. Methods: A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Ichu-shi Web. Inclusion criteria were: 1) randomized controlled trials evaluating the effect of HFNC on dyspnea; 2) aged 18 years or older with advanced disease with hypoxemia; 3) control group was conventional oxygen therapy or noninvasive positive pressure ventilation. Exclusion criteria were: 1) patients in intensive care unit, 2) weaning from ventilator. Results: Six studies (4 from database searches, and 2 from hand searches) were included. In the 2 studies evaluating short-term intervention, one showed HFNC was more efficacious, and the other conventional oxygen was more efficacious. In the 2 studies evaluating long-term interventions: one showed HFNC was more efficacious, and the other showed no significant difference. In the 2 studies evaluating the intervention during exercise, one showed HFNC was more efficacious, and the other showed no significant difference. Conclusion: HFNC may be effective for dyspnea in patients with advanced disease associated with hypoxemia.