担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：一般社団法人 日本歯科麻酔学会  

DOI： 10.24569/jjdsa.51.4_123

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

Cephalic-phase insulin release (CPIR) occurs before blood glucose increases after a meal. Although glucose is the most plausible cue to induce CPIR, peripheral sensory systems involved are not fully elucidated. We therefore examined roles of sweet sensing by a T1R3-dependent taste receptor and sugar sensing by oral glucose transporters in the oropharyngeal region in inducing CPIR. Spontaneous oral ingestion of glucose significantly increased plasma insulin 5 min later in wild-type (C57BL/6) and T1R3-knockout mice, but intragastric infusion did not. Oral treatment of glucose transporter inhibitors phlorizin and phloretin significantly reduced CPIR after spontaneous oral ingestion. In addition, a rapid increase in plasma insulin was significantly smaller in WT mice with spontaneous oral ingestion of nonmetabolizable glucose analog than in WT mice with spontaneous oral ingestion of glucose. Taken together, the T1R3-dependent receptor is not required for CPIR, but oral glucose transporters greatly contribute to induction of CPIR by sugars.

DOI： 10.1186/s12576-023-00875-3

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その他リンク： https://link.springer.com/article/10.1186/s12576-023-00875-3/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00784-023-05166-0

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その他リンク： https://link.springer.com/article/10.1007/s00784-023-05166-0/fulltext.html

担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The Patient State Index (PSI) is the numerical value of anesthesia depth as measured using a SedLine Sedation Monitor (Masimo Corporation). In this pilot study, we evaluated PSI values captured during intravenous (IV) moderate sedation for dental treatment. During the dental treatment, a dental anesthesiologist maintained the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score at 3 to 4 by adjusting the administration of midazolam and propofol while PSI values were recorded. The mean (SD) and median (25th percentile, 75th percentile) PSI values during dental treatment under IV moderate sedation were 72.7 (13.6) and 75 (65, 85), respectively.

DOI： 10.2344/anpr-70-01-01

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Remimazolam, an ultra-short-acting benzodiazepine, is a new intravenous anesthetic used for sedation and general anesthesia. Because remimazolam is primarily metabolized by carboxylesterases in the liver and other tissues including the lung and has metabolites with little or no bioactivity, its anesthetic effect is not significantly influenced by renal dysfunction. Therefore, remimazolam may be considered an appropriate agent for hemodialysis patients and may have added benefits beyond midazolam and propofol. Remimazolam has also been suggested to cause less cardiac depression than propofol. This case report presents an 82-year-old female hemodialysis patient with chronic heart failure who underwent partial glossectomy for squamous cell carcinoma of the tongue under general anesthesia with remimazolam and remifentanil. Hemodynamic control was stable during the anesthetic, which was safely completed without any adverse events and resulted in a rapid, clear emergence without flumazenil. Remimazolam and remifentanil may be appropriate as first-line general anesthetic agents for hemodialysis patients with heart failure.

DOI： 10.2344/anpr-70-02-06

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3390/foods12061150

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Structured summary: Rationale: Nasal high-flow (NHF), a new method for respiratory management during procedural sedation, has greater advantages than conventional nasal therapy with oxygen. However, its clinical relevance for patients undergoing oral maxillofacial surgery and/or dental treatment remains uncertain and controversial, due to a paucity of studies. This scoping review compared and evaluated NHF and conventional nasal therapy with oxygen in patients undergoing oral maxillofacial surgery and/or dental treatment. Materials and methods: A literature search of two public electronic databases was conducted, and English writing randomized controlled trials (RCTs) of nasal high flow during dental procedure with sedation reviewed. The primary and secondary outcomes of interest were the incidence of hypoxemia and hypercapnia during sedation and the need for intervention to relieve upper airway obstruction, respectively. Results: The search strategy yielded 7 studies, of which three RCTs met our eligibility criteria, with a total of 78 patients. Compared with conventional nasal therapy with oxygen, NHF significantly reduced the incidence of hypoxemia and hypercapnia during procedural sedation. Conclusion: NHF can maintain oxygenation and possibly prevent hypercapnia in patients undergoing dental treatment. Additional RCTs are needed to clarify and confirm these findings.

DOI： 10.1016/j.jdsr.2022.05.003

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Patients with neurodegenerative diseases are at an increased risk of dysphagia and aspiration pneumonia. In this study, we examined whether ingestion of capsaicin prior to swallowing changes the temporal dynamics of swallowing in such patients. In a crossover, randomized controlled trial, 29 patients with neurodegenerative diseases were given a soluble wafer containing 1.5 μg capsaicin or an identical placebo 20 min prior to testing. For evaluation with video fluoroscopy (VF), patients consumed a barium-containing liquid plus thickening material. The durations of the latency, elevating and recovery periods of the hyoid were assessed from VF. Overall, no significant differences were observed in the duration of each period between capsaicin and placebo treatments. However, reductions in the latency and elevating periods were positively correlated with baseline durations. In subgroup analyses, that correlation was observed in patents with amyotrophic lateral sclerosis (ALS) but not in patients with Parkinson's disease. The consumption of wafer paper containing capsaicin before the intake of food may be effective in patients with dysphagia related with certain neurodegenerative diseases, particularly ALS patients. Further studies will be needed to validate this finding.

DOI： 10.18926/AMO/63412

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：英語  

DOI： 10.1016/j.joms.2021.06.031

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: In anesthetic management, it is widely accepted that obese patients are more likely to suffer airway obstructions and reductions in arterial oxygen saturation (SpO2). Therefore, it is important to take special measures to prevent oxygen desaturation during the deep sedation of obese patients. This clinical study examined whether the use of nasal high-flow systems (NHFS) keep higher SpO2 and reduced hypoxemia than conventional nasal cannula during the deep sedation of obese patients with intellectual disabilities for dental treatment. MATERIALS AND METHODS: Eighteen obese patients (body mass index: >25) with intellectual disabilities who underwent dental sedation were enrolled. In each case, sedation was induced using propofol and maintained at a bispectral index of 50 to 70. The subjects were randomly assigned to the control oxygen administration (5 L/min via a nasal cannula) or NHFS (40% O2, 40 L/min, 37 °C) arm in alternate shifts as a crossover trial. The primary endpoint was the minimum SpO2 value, and the incidence of hypoxemia during dental treatment was also evaluated. RESULTS: The mean minimum SpO2 value was significantly higher in the NHFS arm than in the control arm (95.8 ± 2.1 % vs 93.6 ± 4.1 %, P = 0.0052, 95% confidence interval: 0.608-3.947). Hypoxemic episodes (SpO2: ≤94%) occurred 3 cases (16.7%) in the NHFS arm and 11 cases (61.1%) in the control arm (P = 0.0076, odds ratio: 0.127, 95% confidence interval 0.0324 - 0.630). CONCLUSION: NHFS resulted in higher minimum SpO2 and reduced hypoxemia than nasal cannula in obese patients during deep sedation for dental treatment.

DOI： 10.1016/j.joms.2021.04.004

PubMed

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担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01093&link_issn=&doc_id=20210819250002&doc_link_id=%2Feq9shika%2F2021%2F004903%2F002%2F0081-0096%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2021%2F004903%2F002%2F0081-0096%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Extracellular vesicles (EV) heterogeneity is a crucial issue in biology and medicine. In addition, tumor-associated macrophages are key components in cancer microenvironment and immunology. We developed a combination method of size exclusion chromatography and concentration filters (SEC-CF) and aimed to characterize different EV types by their size, cargo types, and functions. A human monocytic leukemia cell line THP-1 was differentiated to CD14-positive macrophage-like cells by stimulation with PMA (phorbol 12-myristate 13-acetate) but not M1 or M2 types. Using the SEC-CF method, the following five EV types were fractionated from the culture supernatant of macrophage-like cells: (i) rare large EVs (500-3000 nm) reminiscent of apoptosomes, (ii) EVs (100-500 nm) reminiscent of microvesicles (or microparticles), (iii) EVs (80-300 nm) containing CD9-positive large exosomes (EXO-L), (iv) EVs (20-200 nm) containing unidentified vesicles/particles, and (v) EVs (10-70 nm) containing CD63/HSP90-positive small exosomes (EXO-S) and particles. For a molecular transfer assay, we developed a THP-1-based stable cell line producinga GFP-fused palmitoylation signal (palmGFP) associated with the membrane. The THP1/palmGFP cells were differentiated into macrophages producing palmGFP-contained EVs. The macrophage/palmGFP-secreted EXO-S and EXO-L efficiently transferred the palmGFP to receiver human oral carcinoma cells (HSC-3/palmTomato), as compared to other EV types. In addition, the macrophage-secreted EXO-S and EXO-L significantly reduced the cell viability (ATP content) in oral carcinoma cells. Taken together, the SEC-CF method is useful for the purification of large and small exosomes with higher molecular transfer activities, enabling efficient molecular delivery to target cells.

DOI： 10.3390/cells10061328

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.20944/preprints202104.0464.v1

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Over the past decade, dexmedetomidine (DEX) has been found to possess an anti-inflammatory effect. However, the local anti-inflammatory mechanism of DEX has not been fully clarified. Some intracellular inflammatory pathways lead to negative feedback during the inflammatory process. The cyclooxygenase (COX) cascade synthesizes prostaglandins (PGs) and plays a key role in inflammation, but is known to also have anti-inflammatory properties through an alternative route of a PGD2 metabolite, 15-deoxy-delta-12,14-prostaglandin J2 (15d-PGJ2), and its receptor, peroxisome proliferator-activated receptor gamma (PPARγ). Therefore, we hypothesized that DEX inhibits LPS-induced inflammatory responses through 15d-PGJ2 and/or PPARγ activation, and evaluated the effects of DEX on these responses. The RAW264.7 mouse macrophage-like cells were pre-incubated with DEX, followed by the addition of LPS to induce inflammatory responses. Concentrations of TNFα, IL-6, PGE2, and 15d-PGJ2 in the supernatants of the cells were measured, and gene expressions of PPARγ and COX-2 were evaluated in the cells. Furthermore, we evaluated whether a selective α2 adrenoceptor antagonist, yohimbine or a selective PPARγ antagonist, T0070907, reversed the effects of DEX on the LPS-induced inflammatory responses. DEX inhibited LPS-induced TNFα, IL-6, and PGE2 productions and COX-2 mRNA expression, and the effects of DEX were reversed by yohimbine. On the other hand, DEX significantly increased 15d-PGJ2 production and PPARγ mRNA expression, and yohimbine reversed these DEX's effects. Furthermore, T0070907 reversed the anti-inflammatory effects of DEX on TNFα and IL-6 productions in the cells. These results suggest that DEX inhibits LPS-induced inflammatory responses through PPARγ activation following binding to α2 adrenoceptors.

DOI： 10.1016/j.ejphar.2020.173733

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01093&link_issn=&doc_id=20210331260002&doc_link_id=%2Feq9shika%2F2021%2F004901%2F002%2F0004-0006%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2021%2F004901%2F002%2F0004-0006%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01093&link_issn=&doc_id=20210331260001&doc_link_id=%2Feq9shika%2F2021%2F004901%2F001%2F0001-0003%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2021%2F004901%2F001%2F0001-0003%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Perioperative pulmonary aspiration of gastric contents can induce complications of varying severity, including aspiration pneumonitis or pneumonia, which may be lethal. A 34-year-old man with no significant medical history presented to Okayama University Hospital for extraction of the third molars and incisive canal cystectomy under general anesthesia. He experienced pulmonary aspiration of clear stomach fluid during mask ventilation after induction. After aspiration occurred, the patient was immediately intubated, and suctioning was performed through the endotracheal tube (ETT). An anteroposterior (AP) chest radiograph was obtained that demonstrated atelectasis in the left lower lobe, in addition to increased peak airway pressures being noted, although SpO2 remained at 96% to 99% at an FiO2 of 1.0. The decision was made to proceed, and the scheduled procedures were completed in approximately 2 hours. A repeat AP chest radiograph obtained at the end of the operation revealed improvement of the atelectasis, and no residual atelectasis was observed on the next day. Although the patient reported following standard preoperative fasting instructions (no fluids for 2 hours preoperatively), more than 50 mL of clear fluid remained in his stomach. Because vomiting can occur despite following NPO guidelines, the need for continued vigilance by anesthesia providers and proper timely management is reinforced.

DOI： 10.2344/anpr-67-02-03

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01093&link_issn=&doc_id=20201021380004&doc_link_id=%2Feq9shika%2F2020%2F004804%2F004%2F0138-0140%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2020%2F004804%2F004%2F0138-0140%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Pain management is important for alleviating patients' suffering and early recovery. Although analgesic combinations are known to be effective, a comparison of the effectiveness of different combinations has never been performed specifically for ramus osteotomy procedures. Therefore, the purpose of this observational retrospective cohort study was to identify an effective combination for pain management throughout the intraoperative and immediate postoperative period for patients undergoing bilateral ramus osteotomy procedures. Inclusion criteria consisted of patients who had undergone bilateral mandibular ramus osteotomies over a 2-year period. The analyzed predictor variables included patient gender, age, body weight, operation, anesthetic method, duration of operation, intraoperative use of fentanyl, nonsteroidal anti-inflammatory drugs (NSAIDs), and intravenous acetaminophen administered in the operating room at the end of the surgery. The outcome variable was the necessity for additional rescue analgesics (yes/no) in the recovery room. Bivariate statistics and multivariate analysis were computed with a p-value of <0.05. The study sample was comprised of 78 patients requiring bilateral mandibular ramus osteotomies. From the multivariate analysis, the combination of NSAIDs-acetaminophen-fentanyl was an independent factor for no additional rescue analgesics during the first 1 hour after bilateral ramus osteotomies, indicating that the combination is significantly effective for bilateral ramus osteotomies compared with the other combinations. Considering that this study consisted of a small sample size, the results of this study suggest that some of the combinations, particularly NSAIDs-acetaminophen-fentanyl, are more effective than NSAIDs alone for postoperative pain control immediately following bilateral ramus osteotomy procedures.

DOI： 10.2344/anpr-67-01-05

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Some previous studies have indicated that valproate (VPA) might change the pharmacokinetics and enhance the effects of propofol. We evaluated whether clinical VPA therapy affected the propofol blood level, the protein-unbound free propofol level, and/or the anesthetic effects of propofol in the clinical setting. The subjects were divided into the control group (not medicated with antiepileptics), the mono-VPA group (medicated with VPA alone), and the poly-VPA group (medicated with VPA, other antiepileptics, and/or psychoactive drugs). General anesthesia was induced via the administration of a single bolus of propofol and a remifentanil infusion, and when the bispectral index (BIS) exceeded 60 sevoflurane was started. There were no significant differences in the total blood propofol level at 5, 10, 15, and 20 min or the protein-unbound free propofol level at 5 min after the intravenous administration of propofol between the 3 groups. However, the minimum BIS was significantly lower and the time until the BIS exceeded 60 was significantly longer in the poly-VPA group. In the multivariate regression analysis, belonging to the poly-VPA group was found to be independently associated with the minimum BIS value and the time until the BIS exceeded 60. Clinical VPA therapy did not influence the pharmacokinetics of propofol. However, multi-drug therapy involving VPA might enhance the anesthetic effects of propofol.

DOI： 10.1038/s41598-020-58460-2

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01093&link_issn=&doc_id=20190628280005&doc_link_id=%2Feq9shika%2F2019%2F004702%2F005%2F0047-0049%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2019%2F004702%2F005%2F0047-0049%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The aim of this study was to determine the effects of prolonged hyperoxia on salivary glands and salivary secretion in mice. DESIGN: Male C57BL/6 J mice were kept in a 75% oxygen chamber (hyperoxia group) or a 21% oxygen chamber for 5 days. We measured the secretion volume, protein concentration, and amylase activity of saliva after the injection of pilocarpine. In addition, we evaluated the histological changes induced in the submandibular glands using hematoxylin and eosin and Alcian blue staining and assessed apoptotic changes using the TdT-mediated dUTP nick end labeling (TUNEL) assay. We also compared the submandibular gland expression levels of heme oxygenase-1 (HO-1), superoxide dismutase (SOD)-1, and SOD-2 using the real-time polymerase chain reaction. RESULTS: In the hyperoxia group, salivary secretion was significantly inhibited at 5 and 10 min after the injection of pilocarpine, and the total salivary secretion volume was significantly decreased. The salivary protein concentration and amylase activity were also significantly higher in the hyperoxia group. In the histological examinations, enlargement of the mucous acini and the accumulation of mucins were observed in the submandibular region in the hyperoxia group, and the number of TUNEL-positive cells was also significantly increased in the hyperoxia group. Moreover, the expression levels of HO-1, SOD-1, and SOD-2 were significantly higher in the hyperoxia group. CONCLUSION: Our results suggest that hyperoxia reduces salivary secretion, and oxidative stress reactions might be involved in this.

DOI： 10.1016/j.archoralbio.2018.11.001

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recently, attention has been focused on the role of hyperpolarization-activated cyclic nucleotide-gated (HCN) channels in the mechanism of and as a treatment target for neuropathic and inflammatory pain. Ivabradine, a blocker of HCN channels, was demonstrated to have an effect on neuropathic pain in an animal model. Therefore, in the present study, we evaluated the effect of ivabradine on inflammatory pain, and under the hypothesis that ivabradine can directly influence inflammatory responses, we investigated its effect in in vivo and in vitro studies. METHODS: After approval from our institution, we studied male Sprague-Dawley rats aged 8 weeks. Peripheral inflammation was induced by the subcutaneous injection of carrageenan into the hindpaw of rats. The paw-withdrawal threshold (pain threshold) was evaluated by applying mechanical stimulation to the injected site with von Frey filaments. Ivabradine was subcutaneously injected, combined with carrageenan, and its effect on the pain threshold was evaluated. In addition, we evaluated the effects of ivabradine on the accumulation of leukocytes and TNF-alpha expression in the injected area of rats. Furthermore, we investigated the effects of ivabradine on LPS-stimulated production of TNF-alpha in incubated mouse macrophage-like cells. RESULTS: The addition of ivabradine to carrageenan increased the pain threshold lowered by carrageenan injection. Both lamotrigine and forskolin, activators of HCN channels, significantly reversed the inhibitory effect of ivabradine on the pain threshold. Ivabradine inhibited the carrageenan-induced accumulation of leukocytes and TNF-alpha expression in the injected area. Furthermore, ivabradine significantly inhibited LPS-stimulated production of TNF-alpha in the incubated cells. CONCLUSION: The results of the present study demonstrated that locally injected ivabradine is effective against carrageenan-induced inflammatory pain via HCN channels. Its effect was considered to involve not only an action on peripheral nerves but also an anti-inflammatory effect.

DOI： 10.1371/journal.pone.0217209

PubMed

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担当区分：最終著者  

J-GLOBAL

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Neuronal inflammation is caused by systemic inflammation and induces cognitive dysfunction. IL-6 plays a crucial role in therapies for neuronal inflammation and cognitive dysfunction. Remifentanil, an ultra-short-acting opioid, controls inflammatory reactions in the periphery, but not in the brain. Therefore, the anti-inflammatory effects of remifentanil in neuronal tissue and the involvement of cAMP in these effects were investigated in the present study. METHODS: Mice were divided into 4 groups: control, remifentanil, LPS, and LPS + remifentanil. Brain levels of pro-inflammatory cytokine mRNA, and serum levels of corticosterone, catecholamine and IL-6 were measured in the 4 groups. The co-localization of IL-6 and astrocytes in the mouse brain after the LPS injection was validated by immunostaining. LPS and/or remifentanil-induced changes in intracellular cAMP levels in cultured glial cells were measured, and the effects of cAMP on LPS-induced IL-6 mRNA expression levels were evaluated. RESULTS: Remifentanil suppressed increase in IL-6 mRNA levels in the mouse brain, and also inhibited the responses of plasma IL-6, corticosterone, and noradrenaline in an inflammatory state. In the hypothalamus, IL-6 was localized in the median eminence, at which GFAP immunoreactivity was specifically detected. In cultured cells, remifentanil suppressed increase in IL-6 mRNA levels and intracellular cAMP levels after the administration of LPS, and this enhanced IL-6 mRNA expression in response to LPS. CONCLUSION: Remifentanil suppressed increase in IL-6 mRNA levels in the brain in an inflammatory state, and this effect may be attributed to its direct action on neuronal cells through the inhibition of intracellular cAMP rather than corticosterone.

DOI： 10.1007/s00540-018-2548-y

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: It has been reported that oral valproate (VPA) reduces the dose of propofol required for sedation. As  a potential reason for this, it is considered that VPA displaces serum protein-bound propofol and increases the proportion of protein-unbound-free propofol. To examine this hypothesis, the present in vitro study investigated the influence of VPA on the proportion of protein-unbound-free propofol in human serum samples. METHODS: Serum samples were collected from 10 healthy volunteers, who were not taking any medication. VPA (final concentration: 0.05, 0.1 or 1 mg/mL) and propofol (final concentration: 1 or 5 µg/mL) were mixed with serum samples with normal (4.0 g/dL) or low (2.5 g/dL) albumin concentrations. Then, protein-unbound-free propofol was extracted from the samples, and its concentration was measured using high-performance liquid chromatography. We compared the proportion of protein-unbound-free propofol in each of the VPA-containing samples with that in serum samples without VPA (control). RESULTS: In the serum samples with normal albumin concentrations, 1 mg/mL VPA significantly increased the proportion of protein-unbound-free propofol at 1 and 5 µg/mL propofol. Furthermore, in the serum samples with low albumin concentrations, the proportion of protein-unbound-free propofol was significantly increased by both 0.1 and 1 mg/mL VPA at propofol concentrations of 1 and 5 µg/mL. CONCLUSION: VPA might increase the proportion of protein-unbound-free propofol in human serum via displacement reactions.

DOI： 10.1007/s00540-018-2540-6

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We conducted this study to determine the short-term treatment outcomes of multidisciplinary approaches to chronic pain management for outpatients in Japan. We evaluated pain reduction and improvement in quality of life (QOL) after treatment. We analyzed 32 patients who had experienced intractable chronic pain for > 3 months. The patients received multidisciplinary therapeutic self-managed exercise instructions and then underwent evaluations 1 and 3 months after the treatment. We used the Pain Disability Short Form-36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Disability Assessment Scale (PDAS) to evaluate QOL. Although the pain levels were the same before and after the physical exercise program, the patients showed significant improvements in physical function on the SF-36 (48.5 vs. 54.5, 3 months vs. 1 month; p=0.0124), the magnification subscale on the PCS (6.8 vs. 5.9, 1 month vs. before; p=0.0164) and the PDAS (29.2 vs. 23.4, 3 months vs. before; p=0.0055). Chronic pain should be treated with a biopsychosocial approach, but time constraints and costs have limited the implementation of multidisciplinary and behavioral approaches to chronic pain management. Our findings demonstrate that clinical improvements are possible for patients with chronic pain, using multidisciplinary team resources widely available in Japanese clinical practice.

DOI： 10.18926/AMO/56169

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01093&link_issn=&doc_id=20180830380007&doc_link_id=%2Feq9shika%2F2018%2F004603%2F006%2F0139-0141%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2018%2F004603%2F006%2F0139-0141%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1111/jir.12448

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記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：{SAGE} Publications  

DOI： 10.1177/2380084416674670

Scopus

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：日本歯科医学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The extraction of lower wisdom teeth is often performed under general anesthesia in patients with intellectual disabilities. However, the choice of analgesics has not yet been investigated. OBJECTIVE: To analyze the use of analgesics during general anesthesia for extraction including lower wisdom teeth in patients with intellectual disabilities. METHODS: This research is a retrospective observational study. The study population was composed of all patients presenting for extraction of lower wisdom teeth under ambulatory general anesthesia in the clinic of Special Needs Dentistry in Okayama University Hospital from April 2011 to March 2016. The distribution of the combination of analgesics and the relationship between the use of analgesics and the type of extraction were investigated. RESULTS: One hundred and twelve cases were enrolled in this study. Intravenous injections of flurbiprofen, acetaminophen and betamethasone were used in 96 (85.7%), 12 (10.7%) and 26 cases (23.2%), respectively. Flurbiprofen is a non-steroid anti-inflammatory drugs (NSAIDs). Acetaminophen is an old analgesic, but an injection of acetaminophen is new, which was released in 2013 in Japan. And betamethasone is not an analgesic, but a steroid. Betamethasone was used in combination with other analgesics, and was used at a higher dose in a case in which four wisdom teeth were extracted. CONCLUSION: Flurbiprofen was the main analgesic used for extraction of wisdom teeth under general anesthesia in patients with intellectual disabilities. Betamethasone was used to support flurbiprofen or acetaminophen for extractions of multiple wisdom teeth, with the aim of controlling swelling rather than relieving pain.

DOI： 10.2174/1874210601711010181

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Some patients have transient hypertension before dental treatment as a result of anxiety and stress. Midazolam is an anxiolytic, and thought to be effective for the management of this sort of transient hypertension. We have evaluated in a randomised, controlled trial whether a low dose of midazolam can lower blood pressure in dental patients to an acceptable level without excessive sedation. Suitable patients were randomised to be given midazolam (trial group) or physiological saline (control group) intravenously. Blood pressure, heart rate, degree of anxiety, and amount of sedation were measured before and after injection. After injection, blood pressure in the trial group significantly decreased to clinically acceptable levels compared with controls. The degree of anxiety in the trial group was also significantly less than that in the control group, but there were no significant differences in sedation. These results suggest that injection of a low dose of midazolam stabilises the blood pressure of dental patients with transient hypertension.

DOI： 10.1016/j.bjoms.2016.02.006

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Dental treatment of intellectually disabled patients is frequently performed under general anesthesia or sedation. Many of these patients have epilepsy and are medicated with antiepileptic drugs (AEDs). Carbamazepine (CBZ) and phenytoin (PHT) are known to promote the metabolism of midazolam, and the blood levels of midazolam in patients medicated with CBZ or PHT may be different from those in healthy individuals. In this study, we clarified the influences of CBZ and PHT on the blood level of intravenously administered midazolam in patients medicated with CBZ or PHT. The subjects were divided into the following groups: not medicated with AEDs (control group), medicated with only CBZ or PHT (mono CBZ/PHT group), and medicated with CBZ or PHT or both and other AEDs (poly CBZ/PHT group). General anesthesia was achieved using midazolam, propofol, and remifentanil, and then the blood midazolam level was measured at 10, 30, and 60 min after intravenous midazolam administration. According to the results, the blood midazolam level was significantly lower in the mono and poly CBZ/PHT groups than in the control group. This finding suggests that intravenously administered midazolam may have a weaker effect in patients medicated with CBZ or PHT.

DOI： 10.1007/s00540-015-2063-3

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.

DOI： 10.1371/journal.pone.0168378

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Sedation may minimize physiologic and behavioral stress responses. In our facility, the infusion rate of propofol is adjusted according to the bispectral index (BIS) in all cases of implant-related surgery; multivariate analysis of retrospective data enabled us to extract independent factors that affect the dose of propofol in sedation that are considered useful indicators for achieving adequate sedation. The study population comprised all patients undergoing implant-related surgery under intravenous sedation in Okayama University Hospital from April 2009 to March 2013. The infusion rate of propofol was adjusted to maintain the BIS value at 70-80. The outcome was the average infusion rate of propofol, and potential predictor variables were age, sex, body weight, treatment time, and amount of midazolam. Independent variables that affected the average infusion rate of propofol were extracted with multiple regression analysis. One hundred twenty-five subjects were enrolled. In the multiple regression analysis, female sex was shown to be significantly associated with a higher average infusion rate of propofol. Females may require a higher infusion rate of propofol than males to achieve adequate sedation while undergoing implant-related surgery.

DOI： 10.2344/0003-3006-63.2.67

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recent studies showed that the administration of dexmedetomidine relieved hyperalgesia in the presence of neuropathic pain. These findings have led to the hypothesis that the local administration of dexmedetomidine is useful for relieving acute inflammatory nociception, such as postoperative pain. Thus, we evaluated the inhibitory effect of locally injected dexmedetomidine on acute inflammatory nociception. Acute inflammatory nociception was induced by an intraplantar injection of 1% carrageenan into the hindpaws of rats, and dexmedetomidine was also injected combined with carrageenan. The paw withdrawal threshold based on von Frey filament stimulation was measured until 12 h after injection. We compared the area under the time-curve (AUC) between carrageenan and carrageenan with dexmedetomidine. To clarify that the action of dexmedetomidine was via α2-adrenoceptors, we evaluated the effect of yohimbine, a selective antagonist of α2-adrenoceptors, on the anti-nociception of dexmedetomidine. As the results, the intraplantar injection of carrageenan with over 10 μM dexmedetomidine significantly increased AUC, compared to that with only carrageenan injection. This effect of dexmedetomidine was reversed by the addition of yohimbine to carrageenan and dexmedetomidine. These results demonstrated that the locally injected dexmedetomidine was effective against carrageenan-induced inflammatory nociception via α2-adrenoceptors. The findings suggest that the local injection of dexmedetomidine is useful for relieving local acute inflammatory nociception.

DOI： 10.1016/j.ejphar.2015.06.054

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本有病者歯科医療学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Recently, attention has been paid to dexmedetomidine, a selective α-2 adrenoceptor agonist, as a possible additive for local anesthesia. However, the effect of locally injected dexmedetomidine on the anesthetic action in humans has not fully been clarified. Thus, the purpose of the present study was to evaluate the effect of dexmedetomidine injected into the oral mucosa in combination with lidocaine on local anesthetic potency in humans. MATERIALS AND METHODS: Twenty healthy volunteers were included in the present crossover double-blinded study. Lidocaine solution or lidocaine plus dexmedetomidine solution was submucosally injected into the alveolar mucosa in a crossover and double-blinded manner. The local anesthetic effect of the solutions was evaluated by measuring the current perception threshold (CPT) in the oral mucosa for 120 minutes after injection. Furthermore, the sedation level, blood pressure, and heart rate of the volunteers were evaluated. For statistical analysis, the Wilcoxon signed rank test and 2-way repeated measures analysis of variation were used. RESULTS: The CPT was increased with the 2 solutions and peaked 10 minutes after injection. CPT values 10 and 20 minutes after injection of lidocaine plus dexmedetomidine solution were considerably higher than those with lidocaine solution. The duration of an important increase in the CPT after injection with lidocaine plus dexmedetomidine solution was longer than that with lidocaine. Furthermore, the area under the time curve of CPT was considerably higher with lidocaine plus dexmedetomidine solution than with lidocaine solution. No volunteer showed a change in sedation level, blood pressure, or heart rate after injection with either test solution throughout the experiment. CONCLUSION: The present study showed that a combination of dexmedetomidine plus lidocaine considerably enhances the local anesthetic potency of lidocaine without any major influences on the cardiovascular system when locally injected into the oral mucosa.

DOI： 10.1016/j.joms.2014.09.029

PubMed

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担当区分：最終著者   掲載種別：研究論文（学術雑誌）  

DOI： 10.2344/0003-3006-62.1.8

Scopus

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose : The purpose of this study was to identify independent factors associated with prolonged recovery time after intravenous sedation for dental treatment in patients with intellectual disabilities. Methods : This study was designed as a prospective cohort study. Participants were patients with intellectual disabilities, for whom sedation for dental treatment was planned in Okayama University Hospital. The outcome variable was recovery time. The predictor variables were patient background, antiepileptic and psychotropic drugs, and anesthesia-related variables. Factors affecting the outcome were examined with multiple regression analysis. Results : We enrolled 260 cases in this study. Oral midazolam was a strong independent determinant in prolonged recovery time. Teeth extraction, short treatment time and lower body mass index were significant independent predictors of prolonged recovery time. Conclusion : Oral midazolam is a clear independent determinant of prolonged recovery time after sedation, while psychotropic drugs and antiepileptic drugs were not independent determinants in this study.

DOI： 10.2174/1874210601509010146

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本有病者歯科医療学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：日本歯科医学会  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Dexmedetomidine, a highly selective agonist of α2-adrenoceptors, is a commonly used sedative; however, a potent anti-inflammatory effect has also been found. In the present study we evaluated the inhibitory effect of locally injected dexmedetomidine on inflammatory responses in the injected region. METHODS: Local inflammation was induced in the hindpaws of male mice (aged 6-8 weeks) by intraplantar injection of lambda-carrageenin. To offset the central effect of tested agents, different agents were blindly injected into the left and right paws in the pairs of comparison. The effect of dexmedetomidine on edema (increase in paw volume), the accumulation of leukocytes, and production of tumor necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2) were evaluated after carrageenin injection, using water displacement plethysmometry, histological imaging, immunohistochemistry, and Western blotting analysis. Furthermore, we also evaluated the effect of yohimbine, a full antagonist of α2-adrenoceptors, and phenylephrine, an agonist of the α1-adrenoceptor, on dexmedetomidine's action on inflammatory responses. RESULTS: Paw volume and amount of leukocytes in the injected region significantly increased after the injection of carrageenin. Similarly, TNF-α and COX-2 production was found in the subcutaneous region injected with carrageenin, 4 hours after injection. Dexmedetomidine significantly inhibited all increases in paw volume, leukocytes, and production of TNF-α and COX-2. Furthermore, yohimbine significantly antagonized the anti-inflammatory effects of dexmedetomidine, whereas phenylephrine did not significantly alter them. CONCLUSIONS: The findings suggest that locally injected dexmedetomidine exhibits an anti-inflammatory effect against local acute inflammatory responses, mediated by α2-adrenoceptors.

DOI： 10.1213/ANE.0000000000000060

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：{BMJ}  

DOI： 10.1097/aap.0000000000000048

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The GABAergic system in the spinal cord has been shown to participate in neuropathic pain in various animal models. GABA transporters (GATs) play a role in controlling the synaptic clearance of GABA; however, their role in neuropathic pain remains unclear. In the present study, we compared the betaine/GABA transporter (BGT-1) with other GAT subtypes to determine its participation in neuropathic pain using a mouse model of sciatic nerve ligation. 1-(3-(9H-Carbazol-9-yl)-1-propyl)-4-(2-methyoxyphenyl)-4-piperidinol (NNC05-2090), an inhibitor that displays moderate selectivity for BGT-1, had an antiallodynic action on model mice treated through both intrathecally and intravenous administration routes. On the other hand, SKF89976A, a selective GAT-1 inhibitor, had a weak antiallodynic action, and (S)-SNAP5114, an inhibitor that displays selectivity for GAT-3, had no antiallodynic action. Systemic analysis of these compounds on GABA uptake in CHO cells stably expressing BGT-1 revealed that NNC05-2090 not only inhibited BGT-1, but also serotonin, noradrenaline, and dopamine transporters, using a substrate uptake assay in CHO cells stably expressing each transporter, with IC50: 5.29, 7.91, and 4.08 μM, respectively. These values were similar to the IC50 value at BGT-1 (10.6 μM). These results suggest that the antiallodynic action of NNC05-2090 is due to the inhibition of both BGT-1 and monoamine transporters.

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Adrenaline (epinephrine) is included in dental local anesthesia for the purpose of vasoconstriction. In Japan, adrenaline is contraindicated for use in patients receiving antipsychotic therapy, because the combination of adrenaline and an antipsychotic is considered to cause severe hypotension; however, there is insufficient evidence supporting this claim. The purpose of the present study was to clarify the changes in hemodynamics caused by drug interaction between adrenaline and an antipsychotic and to evaluate the safety of the combined use of adrenaline and an antipsychotic in an animal study. Male Sprague-Dawley rats were anesthetized with sodium pentobarbital. A catheter was inserted into the femoral artery to measure blood pressure and pulse rate. Rats were pretreated by intraperitoneal injection of chlorpromazine or chlorpromazine and propranolol, and after 20 minutes, saline or 1 of 3 different doses of adrenaline was administered by intraperitoneal injection. Changes in the ratio of mean arterial blood pressure and pulse rate were measured after the injection of adrenaline. Significant hypotension and tachycardia were observed after the injection of adrenaline in the chlorpromazine-pretreated rats. These effects were in a dose-dependent manner, and 100 μg/kg adrenaline induced significant hemodynamic changes. Furthermore, in the chlorpromazine and propranolol-pretreated rats, modest hypertension was induced by adrenaline, but hypotension and tachycardia were not significantly shown. Hypotension was caused by a drug interaction between adrenaline and chlorpromazine through the activation of the β-adrenergic receptor and showed a dose-dependent effect. Low-dose adrenaline similar to what might be used in human dental treatment did not result in a significant homodynamic change.

DOI： 10.2344/0003-3006-61.4.150

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記述言語：日本語   出版者・発行元：一般社団法人 日本クリニカルパス学会  

<p> 慢性痛は、患者を苦しめるのみならず、医療経済、社会経済へも大きな損失をもたらすため、早急な対策が必要である。慢性痛は、心理・社会的な要因を含み複雑になるため、集学的に診療することが勧められている。しかし日本の医療体制では各科の壁を取り除いたチーム医療を行うのは困難な場合が多い。我々は、麻酔科、整形外科、精神科、総合リハビリテーション部、歯科麻酔科、看護部等で診察やカンファレンスを行い、診断治療を行う「痛みリエゾン外来」を2012年4月から開始した。痛みリエゾン外来は、複数の医療者で診療し、運動療法を通じて生活の質の向上を目指す外来である。しかし、複数での診療体制は複雑であり、患者、医療者側ともに混乱を生じた。そこで、「痛みリエゾン外来クリニカルパス」を作成した。クリニカルパスを通じて、痛みリエゾン外来の意義、診療の流れ、役割、目標などが明確になり、スムーズな診療ができるようになった。クリニカルパスは慢性痛の診療にも有効であると考える。</p>

DOI： 10.50842/jjscp.16.1_23

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その他リンク： http://search.jamas.or.jp/link/ui/2014223957

記述言語：日本語   出版者・発行元：中国・四国整形外科学会  

Background : A multidisciplinary approach has been shown to be effective for treatment of intractable pain. However, few hospitals in Japan have established liaison clinics for such patients. We investigated the short-term results of a liaison clinic for patients with intractable chronic pain.<br>Methods : This study included 32 outpatients (11 males, 21 females) with intractable chronic pain who visited to our hospital between April 2012 and June 2012. At the baseline, patients completed a self-reported questionnaire and provided demographic and clinical information. Experts in various fields (anesthesia, orthopaedic surgery, psychiatry, physical therapy, and nursing) examined the patients and attended the conference once a week. At the conference we discussed the physical, psychological, and social problem of the patients and decided on courses of treatment. The degree of catastrophizing was measured using the Pain Catastrophizing Scale (PCS). Psychological co-morbidity was evaluated using the Hospital Anxiety Depression Scale (HADS) , and functional disability was measured using both the Pain Disability Assessment Scale (PDAS) and the Oswestry Disability Index (ODI). Clinical severity was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ).<br>Results : After a follow-up period of three months, there was no significant change in the scores for the PDAS, HADS for depression, ODI or JOACMEQ. Both PCS and HADS for anxiety were significantly decreased after three months of treatment. Lumbar function assessed by the JOABPEQ was significantly improved after three months of treatment.<br>Conclusions : This liaison clinic for patients with intractable chronic pain was able to improve the patients' lumbar function and anxiety.

DOI： 10.11360/jcsoa.26.23

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Orofacial pain is often difficult to diagnose and treat. However, there have been few reports on the clinical observation of dental patients with orofacial pain. We retrospectively investigated the characteristics of 221 dental patients who had suffered from persistent orofacial pain. Data were collected from the outpatient medical records in our clinic over the past 12 years. More than half of the patients (53.8%) had suffered with pain for more than 6 months from pain onset until the first visit to our clinic. The main diagnoses were neuropathic pain (30.3%), myofascial pain (23.5%), psychogenic pain (20.4%), odontogenic toothache (17.2%), and others (7.7%) such as temporomandibular disorders and glossitis. The treatments included pharmacotherapy, splint therapy, and others such as nerve block, dental treatment, physiotherapy, and/or psychotherapy. Excluding the patients (52 of 221 initially enrolled patients) with unknown responses to treatment, 65.7% showed remission or a significant improvement in pain in response to treatment. Although only a small group of patients had odontogenic toothache, the rate of improvement was highest for this disorder. In conclusion, early consultation with a dentist is useful to prevent chronicity of odontogenic pain and to make a differential diagnosis in patients with orofacial pain.

PubMed

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記述言語：日本語   出版者・発行元：日本重症心身障害学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J03091&link_issn=&doc_id=20131216160012&doc_link_id=10.24635%2Fjsmid.38.3_487&url=https%3A%2F%2Fdoi.org%2F10.24635%2Fjsmid.38.3_487&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本摂食嚥下リハビリテーション学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1111/pan.12178

Scopus

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Teeth are fundamental to maintaining good quality of life, but are often lost prematurely in individuals with intellectual disability. Furthermore, since bone mass decreases in menopausal women, women with intellectual disability have an augmented risk of losing their teeth. However, the relationship between periodontal disease-related tooth loss and bone mass has never been studied specifically in patients with intellectual disability. This study evaluated this relationship in a retrospective cohort study. Participants were female dental patients aged between 20 and 50 years and with an intellectual disability, who were treated in the Special Needs Dentistry unit of the Okayama University Hospital from January 2009 to March 2010. Logistic regression analysis was used to analyze which factors affect periodontal disease-related tooth loss. Information relating to 12 predictor variables, including age and bone mass level, was derived from medical records. The 27 subjects had a total of 704 teeth at the time of initial examination, but 20 teeth (2.8%) had been lost owing to periodontal disease by the time bone mass measurements were recorded. Results of the multinomial logistic regression analysis indicated a significant odds ratio for three items: number of missing teeth at the time of initial examination, bone mass, and living environment. This result suggests that low bone mass is an independent risk factor in tooth loss secondary to periodontal disease in patients with intellectual disability. Dentists should thus take account of this heightened risk of tooth loss when caring for post-menopausal women with intellectual disability.

DOI： 10.2174/1874210601307010157

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Some patients with intellectual disabilities (IDs) who undergo total intravenous anesthesia (TIVA) have complications associated with the anesthesia such as prolonged recovery. The purposes of this study were to estimate the frequency of TIVA complications among patients with IDs and to identify factors associated with TIVA complications. MATERIALS AND METHODS: This study was designed as a retrospective cohort study. Study samples were selected from the clinical records of patients with IDs who underwent ambulatory general anesthesia in a special dental clinic at the Okayama University Hospital, Okayama, Japan. Predictor variables were patient background, anesthesia-related variables, and dental treatment. Outcome variables were delayed recovery and the complication of agitation. Factors affecting delayed recovery and complications were examined with multivariable analysis. RESULTS: We enrolled 106 cases (81 male and 25 female patients) in this study. The mean age was 23.9 years. Serious complications were not observed in any cases. The amount of intravenous midazolam was an independent determinant of delayed recovery. Oral midazolam contributed to delayed recovery, although it is very useful for induction in patients with a high level of fear. Oral midazolam and a younger age were independent predictors of agitation. CONCLUSIONS: Intravenous midazolam may not have an advantage in ambulatory general anesthesia. Oral midazolam contributes to delayed recovery and is an independent predictor of agitation.

DOI： 10.1016/j.joms.2012.01.004

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：日本歯科医療福祉学会  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

CONTEXT: Brain oxidative reactions are involved in epilepsy as well as neurodegenerative diseases. In animal convulsion models, some anticonvulsants have been found to suppress oxidative reactions associated with convulsions. However, the effect of anticonvulsants on brain oxidative reactions has not fully been clarified. OBJECTIVE: Midazolam and phenobarbital are often used as an intravenous anesthetic, and are known to have anticonvulsive effect, but antioxidative effect of these drugs has rarely been studied. Thus, the purpose of this study was to evaluate the effects of these drugs on the degree of convulsions and brain oxidative reactions in an animal convulsion model. MATERIALS AND METHODS: In order to evaluate brain oxidative reactions, we measured malondialdehyde (MDA) level and heme oxygenase (HO)-1 mRNA expression level in the brain of mice in a convulsion model generated by a single injection of pentylenetetrazole (PTZ). We evaluated the effects of midazolam and phenobarbital on the degree of PTZ-induced convulsions and on the changes in brain MDA level and HO-1 mRNA expression level. RESULTS: After PTZ injection, severe convulsions were observed in all mice. MDA level was increased in the whole brain, while HO-1 mRNA expression level was increased only in the hippocampus. Both midazolam and phenobarbital prevented the convulsions and suppressed the increase in both MDA level and HO-1 mRNA expression level in the brain. CONCLUSION: In this study, both midazolam and phenobarbital suppressed PTZ-induced MDA and HO-1 reactions in the brain, suggesting that these drugs inhibit brain oxidative reactions in a convulsion model.

DOI： 10.3109/08923973.2011.595417

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

CONTEXT: Interleukin-6 (IL-6) plays an important role in immune and inflammatory responses. Midazolam has been reported to modulate IL-6 response. Cyclooxygenase (COX) inhibitors, which are used together with midazolam in some patients undergoing surgery, also modulate it. We hypothesized that their combination results in eliciting the synergistical effect on the IL-6 response. OBJECTIVE: The aim of the present study was to evaluate the effect of the combination of midazolam and a COX inhibitor on IL-6 production. MATERIALS AND METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from healthy volunteers and incubated with lipopolysaccharide (LPS), midazolam, and/or COX inhibitors, including indomethacin, SC-560, a COX-1 selective inhibitor, and NS-398, a COX-2 selective inhibitor. The supernatant concentrations of IL-6 and prostaglandins (PGs), including PGE2, PGF2α, PGD2, and 15-deoxy-Δ¹²,¹⁴-prostaglandin J2 (15dPGJ2) were measured. RESULTS: Midazolam had no effect on IL-6 production in the cells incubated for 12 h, and any COX inhibitors also had no effect. However, the combination of midazolam and NS-398 significantly inhibited it. Midazolam raised the concentration of 15dPGJ2 in the supernatant of the cells, but not the concentration of other PGs. DISSCUSSION AND CONCLUSION: The results in the present study demonstrated that the combination of midazolam and a COX-2 inhibitor inhibited LPS-induced IL-6 production in human PBMCs even if each drug separately did not have any effect on it. The finding suggests that their combination is effective against excessive IL-6 production such as severe inflammatory response and that the effect of midazolam on IL-6 production is possibly elicited via 15dPGJ2.

DOI： 10.3109/08923973.2011.577783

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

In sedation of dental patients with moderate or severe mental retardation, it is difficult to identify the optimum sedation level and to maintain it appropriately. Moreover, many patients have concomitant epilepsy and are medicated with oral antiepileptic drugs (AEDs), which influence the drug-metabolizing enzymes. In particular, valproate (VPA) has been demonstrated to inhibit propofol metabolism in vitro. Therefore, the objective of the present study was to investigate the clinical influence of oral VPA on the required dose of propofol for sedation, with use of a prospective cohort study design. We studied 45 patients with moderate or severe mental retardation who underwent dental treatment under sedation. Propofol was infused, and sedation was maintained at the same level in all patients using a bispectral index (BIS) monitor. After the completion of treatment for the scheduled patients, patients were divided into those with oral VPA treatment (VPA group: 20 patients) and without any oral antiepileptic treatment (control group: 25 patients). The propofol dose required for sedation and times to the recovery of the eyelash reflex and spontaneous eye opening were evaluated. The median required propofol doses in the VPA and control groups were 4.15 (range 1.97-5.88) and 5.67 (2.92-7.17) mg/kg/h, respectively. We observed a statistically significant difference between the two patient groups with respect to median VPA dose (p < 0.01). However, no statistically significant differences were noted in the time until eyelash reflex recovery or spontaneous eye opening between the two groups. The results suggest that oral VPA reduces the dose of propofol required for sedation during dental treatment in patients with moderate or severe mental retardation.

DOI： 10.1111/j.1528-1167.2011.03328.x

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Treatment for acute lymphoblastic leukemia (ALL) mainly consists of chemotherapy, irradiation and bone marrow transplantation. In terms of long-term treatment effects, dental abnormalities and chronic graft-versus host disease (GVHD) are problems. We present a patient surviving relapse of ALL at one year of age. He had extreme dental abnormalities and multiple caries. Most of his permanent teeth were abnormal, and multiple caries were observed. Since he had a strong vomiting reaction to dental treatment, general anesthesia was given. During the general anesthesia, much sputum was aspirated because of chronic GVHD. His dental condition was worse than other cases reported previously. Since the survival rate has increased recently, the dental effects of ALL treatment have become significant. Especially, in patients undergoing total body irradiation at under 2 years of age, it is highly likely that dental problems will occur in the future.

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY OBJECTIVE: To investigate the use of propofol sedation using Bispectral Index (BIS)-guided target-controlled infusion (TCI) in dental patients with intellectual disability. DESIGN: Single-center, prospective, randomized clinical trial. SETTING: Academic outpatient clinic. SUBJECTS: 40 ASA physical status 1 and 2 patients with intellectual disability. INTERVENTIONS: Patients were randomized to two groups. The manual control (MC) group (n = 20) had sedation by manually controlled infusion of propofol without a BIS index monitor. The BIS-TCI group (n = 20) had sedation by BIS-guided TCI of propofol. MEASUREMENTS: The required dose of propofol, recovery time for the eyelash reflex, and spontaneous eye opening times were recorded. MAIN RESULTS: BIS-TCI significantly reduced the dose of propofol and shortened the recovery times for eyelash reflex and spontaneous eye opening. CONCLUSION: Propofol sedation using BIS-guided TCI is a useful and safe method in the management of patients with intellectual disability.

DOI： 10.1016/j.jclinane.2011.04.008

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Propofol and midazolam have a synergistic anesthetic action. One of the reasons for this is thought to be the inhibitory effect of propofol on midazolam metabolism. However, because both drugs bind strongly to serum protein, their interaction may not only involve the effects of propofol on midazolam metabolism, but may also involve propofol's effects on serum protein-binding. Against this background, we investigated the characteristics of midazolam binding to serum albumin, and evaluated the effects of both propofol and ketamine on this binding. Midazolam was added to a serum albumin solution with propofol or ketamine, and, after incubation for 1 h, albumin-free solution was separated from the sample and the midazolam concentration was measured using a high-performance liquid chromatography system. The albumin-unbound rate of midazolam was evaluated and compared with the rate in the control solution (only midazolam). Propofol significantly raised the rate of albumin-unbound free midazolam, while ketamine had no effect on the binding of midazolam to serum albumin. These findings suggest that the increase in albumin-unbound free midazolam brought about by propofol is involved in the synergistic effect of these two agents.

DOI： 10.1007/s00540-011-1176-6

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

The oral administration of midazolam has often been used for sedation in pediatric patients. However, oral administration of an intravenous formulation of midazolam is difficult for younger pediatric patients because of its bitter taste. Liposomes have been developed as vesicles encapsulating various kinds of drugs to serve as a medical drug-delivery system. Thus, the aim of the present study was to produce pH-sensitive liposomes encapsulating midazolam and to evaluate its pharmacokinetics on rabbits. Liposome-encapsulated midazolam was produced from hydrogenated L-α-phosphatidylcholine, cholesterol, dipalmitoylphosphatidic acid, and midazolam. The capacity of liposomes to encapsulate midazolam (encapsulation efficiency), stability of encapsulation, and release efficiency were evaluated in vitro. Further, the produced liposome-encapsulated midazolam solution was orally administered to rabbits in vivo. As a result, midazolam was encapsulated by liposomes with a high encapsulation efficiency and was stably encapsulated in a physiological medium. Further, the produced liposomes rapidly and effectively released midazolam in an acidic medium in vitro. When the liposome-encapsulated midazolam solution was orally administered to rabbits, the time to achieve the maximum plasma concentration of midazolam after administration was slightly longer, but both the maximum plasma concentration and area under the concentration-time curve were higher than those receiving midazolam solution. In conclusion, we produced pH-sensitive liposome-encapsulated midazolam, which remained stable in a physiological medium and showed efficient release in an acidic environment. The results suggest that it is possible to clinically use liposome-encapsulated midazolam for oral administration as a useful drug-delivery vehicle.

DOI： 10.3109/08982104.2010.498002

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Some dental patients have histories of adverse reactions to local anesthesia. The aim of the present study was to investigate the frequency of allergy to local anesthetics of dental patients who had histories of adverse reactions to local anesthesia based on the results of allergy tests in our institute over a period of 5 years. We investigated the past medical records of dental patients retrospectively, and twenty patients were studied. Three of the 20 showed a positive or false-positive reaction in the intracutaneous test, and one patient showed a false-positive reaction in the challenge test. Our results suggest that the frequency of allergy to local anesthetics is low even if patients have histories of adverse reactions to local anesthesia. However, allergy tests of local anesthetics should be performed in patients in whom it is uncertain whether they are allergic.

DOI： 10.2174/1874210601105010146

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Iron, a source of oxidative stress, plays a major role in the pathology of neurodegenerative disease. In Alzheimer's disease, the hippocampus is vulnerable to oxidative stress, leading to impairment in memory formation. In our previous study, a brain oxidative reaction was induced after intraperitoneal injection of ferric nitrilotriacetate (Fe-NTA). However, since only a small amount of iron reached the brain in the previous study, Fe-NTA was administered into the hippocampus using an osmotic pump in this study. After continuous injection of Fe-NTA for 2 weeks, a high level of apoptotic change was induced in the hippocampus, in accordance with the iron localization. After injection for 4 weeks, the hippocampus was totally destroyed. A small amount of iron infiltrated into the cerebral cortex and the striatum, and deposition was observed at the choroid plexus and ependymal cells. However, no apoptotic reaction or clear tissue injury was observed in these areas. In addition, muscarinic acetylcholine receptors (M1, M2, and M4) were decreased in both the cortex and hippocampus while it increased in the striatum. Thus, the hippocampus is likely vulnerable to oxidative stress from Fe-NTA, and the oxidative stress is considered to bring the disturbance in the muscarinic acetylcholine receptors.

DOI： 10.1179/174329211X13049558293597

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.joms.2009.09.083

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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担当区分：最終著者  

DOI： 10.1007/s00540-009-0827-3

Scopus

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：(一社)日本摂食嚥下リハビリテーション学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Iron is known to be involved in neuronal diseases such as neurodegenerative diseases, brain ischemia and epilepsy. However, it is unclear if a high level of peripheral iron induces these pathological conditions. Since ferric nitrilotriacetate (Fe-NTA), a low molecule iron chelate, causes kidney carcinoma and diabetes in animals due to its strong and unique oxidative stress, it is also considered to cause pathological conditions in the brain. Therefore, we studied brain changes after intraperitoneal (i.p.) injection of Fe-NTA. We investigated iron distribution in the brain and evaluated heme oxygenase (HO)-1 mRNA, IL-6 mRNA and 4-hydroxy-2-nonenal (4-HNE) quantitatively. In addition, changes in muscarinic acetylcholine receptor mRNAs were measured. It was found that iron was localized in the cortex and the hypothalamus, but not in other areas of the brain. HO-1 was induced in both the cortex and hypothalamus, and the levels of IL-6 and 4-HNE were raised in the hypothalamus, but not in the cortex. In the cortex, expression in M1 and M2 mAChRs were suppressed. In conclusion, iron reached the brain parenchyma after i.p. injection of Fe-NTA, and Fe-NTA caused oxidative reactions and suppression of mAChRs in the brain.

DOI： 10.1179/135100009X392575

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J02489&link_issn=&doc_id=20081125310004&doc_link_id=%2Fcp2disab%2F2008%2F002904%2F003%2F0600-0610%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp2disab%2F2008%2F002904%2F003%2F0600-0610%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Dental Society of Anesthesiology ({ADSA})  

DOI： 10.2344/0003-3006-55.3.73

Scopus

PubMed

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担当区分：最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Clonidine, an alpha-2 adrenoceptor agonist, is a common adjunct in both central and peripheral blocks. Dexmedetomidine, a more selective alpha-2 adrenoceptor agonist, is also known to enhance central neural blockades. Its peripheral effect, however, has not been fully elucidated. Thus, we evaluated the effect of dexmedetomidine and other alpha-2 adrenoceptor agonists on the local anesthetic action of lidocaine at the periphery and explored the mechanism involved. METHODS: alpha-2 Adrenoceptor agonists, including dexmedetomidine, clonidine, and oxymetazoline, combined with lidocaine were intracutaneously injected into the back of male guinea pigs. The test of six pinpricks was applied every 5 min until 60 min after the injection. The number of times which the prick failed to elicit a response during the 60-min period was added and the sum served as an anesthetic score indicating the degree of local anesthesia. Differences from the control value within the group were analyzed using an analysis of variance followed by a post hoc Dunnett's test. Furthermore, we evaluated the antagonism of the effect of dexmedetomidine by yohimbine, an alpha-2A, 2B, and 2C adrenoceptor antagonist, or prazosin, an alpha-1, alpha-2B, and 2C adrenoceptor antagonist, analyzed using a two-way analysis of variance. RESULTS: All alpha-2 adrenoceptor agonists enhanced the degree of local anesthesia of lidocaine in a dose-dependent manner. Furthermore, yohimbine inhibited the effect of dexmedetomidine, whereas prazosin did not. CONCLUSION: We demonstrated that alpha-2 adrenoceptor agonists enhanced the local anesthetic action of lidocaine, and suggest that dexmedetomidine acts via alpha-2A adrenoceptors.

DOI： 10.1213/ane.0b013e318176be73

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Delirium occurs in 23% of sepsis patients, in which pro-inflammatory cytokines and nitric oxide are suggested to be involved. However, in animal experiments, even a subseptic dose of lipopolysaccharide (LPS) injection induces both pro-inflammatory cytokines and inducible nitric oxide synthase in the brain, suggesting that the brain oxidative reaction can be induced in the subseptic condition. Then, we evaluated the changes of heme oxygenase-1 (HO-1), a sensitive oxidative marker, as well as interleukin (IL)-1beta, IL-6, and inductible nitric oxide synthase (iNOS) mRNA in the hypothalamus and hippocampus of rats using real-time PCR after peripheral injection of LPS (2.0 mg/kg). As a result, these four kinds of mRNAs were induced significantly in both areas after LPS injection. These results suggest that peripheral inflammation induces an oxidative reaction in the brain, even if the inflammation is not lethal. It is also considered that several pathways are involved in brain HO-1 induction.

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J02489&link_issn=&doc_id=20080723390005&doc_link_id=%2Fcp2disab%2F2008%2F002902%2F005%2F0146-0146%26dl%3D2&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp2disab%2F2008%2F002902%2F005%2F0146-0146%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Our aim was to find out the optimal dose of oral midazolam to sedate children according to age. Thirty-five patients aged 10 or under who had minor oral operations under sedation with midazolam were enrolled. Correlations between age (X) and dose of midazolam (mg/kg; Y) were analysed by Pearson's correlation coefficient, and relations were fitted by simple regression. Doses of midazolam were significantly reduced as age increased (Y=0.969-0.04X; R=0.48) in the satisfactory group (n=25), whereas those in the overdose group (n=10) (patients who vomited, became agitated, or took some time to come round) were significantly higher, decreased with age, and showed a better correlation coefficient (Y=1.375-0.65X; R=0.78). These findings suggest that both the requirement and threshold of midazolam decreases with age.

PubMed

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J01093&link_issn=&doc_id=20071023380010&doc_link_id=%2Feq9shika%2F2007%2F003505%2F010%2F0693-0694%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2007%2F003505%2F010%2F0693-0694%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Takotsubo cardiomyopathy (TCM) is a relatively new concept in cardiovascular disease. The clinical symptoms of TCM are similar to those of a myocardial infarction, but both the mechanism and the management of TCM are different from those of myocardial infarction. The cause of TCM is unclear, but it is suggested to occur in conjunction with excessive circulating catecholamines due to stress. Thus, control of the stress reaction and restriction of catecholamine levels are considered important for prevent of TCM onset. We report the dental management of a patient with intellectual disability who had anamnesis of TCM and cardiopulmonary arrest under restraint during a previous dental appointment in another dental clinic. We used intravenous sedation with both midazolam and propofol, by which the excessive hormonal reaction that caused TCM onset and cardiopulmonary arrest was controlled, for dental treatment in our facility. All planned dental treatment was then performed without any problems.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J01093&link_issn=&doc_id=20070129330016&doc_link_id=%2Feq9shika%2F2007%2F003501%2F016%2F0070-0071%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feq9shika%2F2007%2F003501%2F016%2F0070-0071%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：日本医療ガス学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J04022&link_issn=&doc_id=20060829260008&doc_link_id=%2Fcd5megas%2F2006%2F000801%2F008%2F0032-0033%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcd5megas%2F2006%2F000801%2F008%2F0032-0033%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：(公社)日本補綴歯科学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We investigated the role of peripheral N-methyl-D-aspartate (NMDA) receptors in the myenteric plexus in mediating nonadrenergic noncholinergic (NANC) nitrergic relaxation of the lower esophageal sphincter (LES). Isometric contraction of LES strips from Japanese White rabbits was measured. NANC relaxation was induced by KCl (30 mM) in the presence of atropine and guanethidine. The concentration of 3',5'-cyclic guanosine monophosphate (cGMP) was measured using a radioimmunoassay. The muscle strips were exposed to diethyldithiocarbamic acid (DETCA; 3 mM) to inactivate Cu/Zn superoxide dismutase. MK801 (5-methyl-10,11-dihydroxy-5H-dibenzo(a,d)cyclohepten-5,10-imine) inhibited NANC relaxation in a concentration-dependent manner (EC50 = 1.5 x 10(-5) M), accompanied by a decrease in cGMP production. NMDA induced a concentration-dependent relaxation, which was antagonized by MK801. NMDA stimulated cGMP production, which was inhibited by N(G)-nitro-L-arginine. Superoxide dismutase (100 U/mL) shifted the concentration-response relationship of MK801-mediated inhibition of NANC relaxation to the right (EC50 = 3.4 x 10(-5) M), whereas catalase did not. Treatment with DETCA shifted the concentration-response relationships of pyrogallol-, ketamine- and MK801-mediated inhibition of NANC relaxation to the left. These findings suggest that the peripheral NMDA receptors mediate NANC smooth muscle relaxation, and modulate it, in part, through extracellular production of superoxide anions, thus eliminating the relaxant effect of endogenous nitric oxide.

DOI： 10.1213/01.ANE.0000184137.37687.B7

PubMed

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In this study, we tested changes of internal standard genes of the brain after electrical tail shock in rats. The level of 28S rRNA of the amygdala was increased significantly after the stress. There was no significant change in GAPDH, beta-actin, 36B4 mRNA and 28S rRNA at the subfornical organ and the hippocampus.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本有病者歯科医療学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：日本歯科医療福祉学会  

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記述言語：日本語   出版者・発行元：日本歯科医療福祉学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：日本麻酔・薬理学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1365-2788.2004.00598.x

PubMed

CiNii Article

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the prevalence of blood pressure levels and hypertension-related diseases and to evaluate the risks associated with dental patients in Japan. RESEARCH DESIGN: Retrospective cross-sectional. METHOD: Blood pressure levels and medical histories of hypertension-related diseases obtained from 3,811 adult outpatients consulting a University Dental Hospital were investigated. Blood pressure levels were compared with those reported in the Japanese national survey obtained from a standard Japanese population. The relationships between gender or age and blood pressure level or the rate of the subjects with a hypertension-related disease were evaluated. RESULTS: Mean values of blood pressure in the present study were similar to those in the Japanese national survey. Among hypertension-related diseases, hypertension showed the highest prevalence (10.9%) in subjects. Blood pressure levels and the rates of subjects with hypertension-related diseases were significantly related to increasing age. Elderly subjects had a tendency to combine hypertension or high blood pressure with hypertension-related diseases. Further, 20.4% of subjects who had not been diagnosed with hypertension had high blood pressure. Among them, 1.5% had blood pressure more than 180/110 mmHg. CONCLUSIONS: The results suggested that blood pressure levels of dental patients would reflect the prevalence of blood pressure levels and hypertension in the Japanese general population, and that high blood pressure and increasing age are the greatest risk factors in the medical status of dental patients. Furthermore, because many subjects examined were unaware of their high blood pressure levels, caution is required prior to performing dental procedures.

PubMed

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY OBJECTIVE: To evaluate the effect of induced hypotension with isoflurane or prostaglandin E(1) (PGE(1)) on cytokine responses to surgery. DESIGN: Prospective, randomized study. SETTING: University hospital. PATIENTS: 24 ASA physical status I and II patients undergoing elective oral and maxillofacial surgery. INTERVENTIONS: Patients were randomly allocated to three groups be anesthetized in the normotension (Control group), isoflurane-induced hypotension (Isoflurane-H group), and PGE(1)-induced hypotension (PGE(1)-H group). Mean arterial pressure during hypotension was maintained at approximately 80% of baseline values. MEASUREMENTS AND MAIN RESULTS: Blood samples were taken before induction of anesthesia and during and after hypotension. Plasma tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels were measured using enzyme-linked immunosorbent assay. There were no differences in TNF-alpha or IL-10 levels among the groups. However, the elevation of the plasma IL-6 level in the PGE(1)-H group was found during hypotension, compared with the control group (p < 0.05). CONCLUSIONS: PGE(1)-induced hypotension has an effect on IL-6 response to oral and maxillofacial surgery.

PubMed

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担当区分：筆頭著者,　責任著者  

DOI： 10.1111/j.0001-5172.2004.0320a.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Angioedemas are a rare but significant event in simple oral surgery because they can cause an acute life-threatening laryngeal edema. We report a case of a tooth extraction in a patient with hereditary angioedema, for which the C1-inhibitor (C1-INH) concentration administered effectively controlled edema during and after extraction. We also review case reports of oral surgery management in patients with hereditary and acquired angioedemas. In 2 of 36 cases, laryngeal edema occurred after teeth extraction. One was considered to be a type 2 acquired angioedema, which tolerates replacement therapy with fresh frozen plasma. The other case was managed only with danazol, and it was suggested that this was on occasion insufficient. Safety of oral surgery on patients with angioedema depends on the type of angioedema and the availability of C1-INH concentration. An exact diagnosis of the type of angioedema is needed to know the effect of replacement therapy with C1-INH.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Intracellular and field potential recordings were taken from the hippocampal CA1 and CA3 neurons in rat brain slices to investigate the effects of 2,6 di-isopropylphenol (propofol) on the neuronal excitability during GABA(A)-C1 channel blockade by picrotoxin (100 microM). Propofol produced a membrane hyperpolarization and an inhibition of the magnitude of the 'voltage sag' that was mediated by the activation of a hyperpolarization-activated inward current (I(H)). Propofol (>100 microM) decreased the spontaneous discharge rate of epileptiform burst responses in CA1 neurons up to 38+/-6% of the control level. Propofol also markedly reduced the duration of both spontaneous and evoked epileptiform burst responses. A propofol-induced decrease in the spontaneous discharge rate in CA3 neurons was coincident with that in CA1 neurons. The effects of propofol on the membrane potential and spontaneous discharge rate but not on the duration of burst responses were duplicated by ZD7288 (potent selective antagonist for I(H) channels), indicating that the blockade of I(H) significantly contributes to reduction of cell's excitability. The present study suggests that various actions including suppressive effects on I(H) contribute to the anesthetic and anti-convulsant properties of propofol.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Nonadrenergic noncholinergic (NANC) nerves are known to be nitrergic and to have an important role in the regulation of gastrointestinal motility and function. Cardiac antiarrhythmic therapy in humans is accompanied by a high incidence of gastrointestinal side-effects. We investigated the effect of mexiletine, a class Ib antiarrhythmic drug, on NANC lower oesophageal sphincter relaxation. Mexiletine concentration dependently inhibited the NANC relaxation induced by 30 mM KCl (EC(50)=4.4 x 10(-6) M); the production of 3',5'-cyclic guanosine monophosphate (cGMP) after KCl stimulation was concentration dependently decreased. The relaxation induced by the exogenous nitric oxide (NO) donor, diethylamine NONOate (10(-5) M), was not inhibited by mexiletine, and the cGMP production after diethylamine NONOate application was not altered. Mexiletine did not alter the activity of NO synthase. These findings suggest that mexiletine inhibits NANC relaxation via NO-cGMP pathway modulation, possibly by inhibiting myenteric nitrergic neurotransmission in the lower oesophageal sphincter in rabbits.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The authors previously reported that ketamine and midazolam inhibited nitric oxide-mediated nonadrenergic noncholinergic (NANC) lower esophageal sphincter (LES) relaxation nitric oxide-3',5'-cyclic guanosine monophosphate pathway modulation. The mechanisms inhibiting the NANC relaxation by ketamine and midazolam were investigated. METHODS: The isometric tension of circular distal esophageal muscle strips from Japanese White rabbits was examined. NANC relaxation was induced by KCl (30 mm) in the presence of atropine (3 x 10(-6) m) and guanethidine (3 x 10(-6) m). Nitric oxide synthase activity in the absence and presence of ketamine and midazolam was analyzed using the biochemical conversion of L-[3H]arginine to L-[3H]citrulline. RESULTS: The ketamine-induced inhibition of the NANC relaxation was partly reversed by superoxide dismutase (200, 400 U/ml) but not by catalase (100 U/ml). Ketamine concentration-dependently inhibited the relaxation induced by N-ethylethanamine:1,1-diethyl-2-hydroxy-2-nitrosohydrazine (diethylamine NONOate) and S-nitrosoglutathione. The NANC relaxation itself was not affected by superoxide dismutase. The midazolam-induced inhibition of the NANC relaxation was reversed neither by superoxide dismutase nor by catalase, and midazolam did not affect the relaxations induced by nitric oxide donors. The nitric oxide synthase activity was concentration-dependently suppressed by midazolam, but there was no marked effect of ketamine. Pyrogallol, a superoxide generator, inhibited the NANC and the diethylamine NONOate-induced relaxations. The pyrogallol-induced inhibition of the NANC relaxation was reversed by superoxide dismutase. CONCLUSION: These findings suggest that ketamine inhibits NANC LES relaxation by the extracellular production of superoxide anion, and that midazolam inhibits it by the inhibition of nitric oxide synthase activity.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：(公社)日本補綴歯科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2002&ichushi_jid=J01189&link_issn=&doc_id=20030116360005&doc_link_id=%2Fdv5hotet%2F2002%2F004605%2F005%2F0649-0654%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdv5hotet%2F2002%2F004605%2F005%2F0649-0654%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s0304-3940(01)02169-3

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1006/cyto.2001.0940

Scopus

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1097/00000542-200107000-00028

Scopus

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本有病者歯科医療学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2001&ichushi_jid=J03962&link_issn=&doc_id=20030528260006&doc_link_id=10.11255%2Fjjmcp1992.9.30&url=https%3A%2F%2Fdoi.org%2F10.11255%2Fjjmcp1992.9.30&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Informa {UK} Limited  

DOI： 10.1080/08869634.2001.11746152

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s0003-9969(99)00028-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s0003-9969(98)00127-7

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s0024-3205(98)00409-3

Scopus

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本障害者歯科学会  

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s1079-2104(98)90417-6

Scopus

PubMed

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

DOI： 10.1016/s1079-2104(96)80140-5

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記述言語：日本語   出版者・発行元：(一社)日本小児口腔外科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=1995&ichushi_jid=J02675&link_issn=&doc_id=19950912420003&doc_link_id=%2Fcb2syone%2F1995%2F000501%2F003%2F0021-0025%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb2syone%2F1995%2F000501%2F003%2F0021-0025%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児口腔外科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=1994&ichushi_jid=J02675&link_issn=&doc_id=19950082320001&doc_link_id=10.11265%2Fpoms1991.4.61&url=https%3A%2F%2Fdoi.org%2F10.11265%2Fpoms1991.4.61&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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記述言語：日本語   出版者・発行元：(一社)日本小児口腔外科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=1993&ichushi_jid=J02675&link_issn=&doc_id=19940083350002&doc_link_id=10.11265%2Fpoms1991.3.7&url=https%3A%2F%2Fdoi.org%2F10.11265%2Fpoms1991.3.7&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media {LLC}  

DOI： 10.1007/s0054010050123

Scopus

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：中国・四国歯科麻酔研究会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本歯科麻酔学会  

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担当区分：筆頭著者,　責任著者   記述言語：日本語   出版者・発行元：岡山歯学会  

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総ページ数：239p   記述言語：日本語

CiNii Books

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担当ページ：p236-237   記述言語：日本語

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記述言語：日本語

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記述言語：日本語

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記述言語：日本語

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記述言語：日本語

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担当ページ：133-144   記述言語：日本語

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担当ページ：216-238   記述言語：日本語

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記述言語：日本語

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記述言語：日本語

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担当ページ：p81-105   記述言語：日本語

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担当ページ：p236-237   記述言語：日本語

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担当ページ：pp230-249   記述言語：日本語

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記述言語：日本語   出版者・発行元：(公社)東京都歯科医師会  

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記述言語：日本語   出版者・発行元：社団法人 日本口腔外科学会  

<p>Dental anesthesiologists have the following roles in oral and maxillofacial surgery: providing patients with high-quality anesthesia during operations, providing the best conditions for surgeons in an operating room, having to ensure patients have no complications, and relieving pain and anxiety of patients after operations. To achieve these, close cooperation with oral and maxillofacial surgeons is essential, and the general preoperative management of patients, especially preoperative evaluation, is very important. So, in the present review I focused on the following topics that should be considered on preoperative evaluation:</p><p>1） Preoperative image inspection of oral and maxillofacial regions, including Cephalo X-ray, C-T, and MR imaging of the head and neck region, is clinically useful to predict the airway condition of patients during and after operations under general anesthesia.</p><p>2） Preoperative respiratory conditions and lung diseases of patients undergoing operations under general anesthesia should be carefully evaluated because general anesthesia generally inhibits the respiratory function. So, the operation should be delayed until the respiratory condition improves if possible.</p><p>3） Preoperative cardiovascular conditions of patients undergoing operations should be evaluated according to evidence-based guidelines incorporating stepwise assessments, such as "Active Cardiac Condition" or not, physical ability, and other complications. In the case of patients with poor conditions, consultation with specialists of cardiovascular diseases is necessary. The goal is to minimize the incidence of cardiovascular complications in patients during and after operations.</p><p>4）The blood pressure and pulse rate (ECG if necessary) should be monitored in patients with cardiovascular disease such as hypertension during operations, even during tooth extraction under local anesthesia.</p>

DOI： 10.5794/jjoms.63.2

CiNii Article

CiNii Books

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記述言語：日本語   出版者・発行元：日本歯科医学教育学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本運動器疼痛学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本歯科医師会  

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記述言語：日本語   出版者・発行元：(株)ヒョーロン・パブリッシャーズ  

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記述言語：日本語   出版者・発行元：岡山歯学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(株)第一歯科出版  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：日本語   出版者・発行元：岡山歯学会  

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記述言語：日本語   出版者・発行元：(株)メディカル・サイエンス・インターナショナル  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

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出願人：国立大学法人 岡山大学

出願番号：特願2010-535676  出願日：2009年10月29日

公表番号：WO2010-050211  公表日：2010年5月6日

特許番号/登録番号：特許第5536661号  登録日：2014年5月9日 

J-GLOBAL

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出願人：国立大学法人 岡山大学

出願番号：特願2009-130375  出願日：2009年5月29日

公開番号：特開2010-275242  公開日：2010年12月9日

特許番号/登録番号：特許第5638204号  登録日：2014年10月31日 

J-GLOBAL

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種別：講演会

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種別：講演会

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種別：講演会

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種別：講演会

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種別：講演会

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種別：講演会

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執筆者：本人 

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