Keiko Miura

Changes in blood pressure and heart rate variability during dental surgery

The objective of the present study was to determine the changes in blood pressure, pulse rate, and heart rate variability during dental surgery. The study included 40 patients, 19 to 74 years of age (mean age: 42.7+/-3.0 years), who underwent tooth extraction at our hospital. Holter electrocardiographic monitoring was used to determine the power spectrum of R-R variability before and during dental surgery. The low frequency (LF: 0.041 to 0.140 Hz), high frequency (HF: 0.140 to 0.500 Hz), and total spectral powers (TF; 0.000 to 4.000 Hz) were calculated, and the ratio of LF to HF and percentage of HF relative to TF (%HF: HF/TF x 100) were used as indices of sympathetic and parasympathetic activities, respectively. The baseline blood pressure and pulse rate were 121+/-3/70+/-2 mm Hg and 70+/-1 beats/min, respectively. After the administration of local anesthetic (2% lidocaine) containing 1:80,000 epinephrine, both the blood pressure and pulse rate increased. During dental surgery, blood pressure increased further to 132+/-3/73+/-2 mm Hg. The increase in blood pressure was greater in middle-aged and older patients (> or =40 years old). In young patients (<40 years old), the %HF decreased and the LF/HF increased during local anesthesia. In contrast, in middle-aged and older patients, the LF/HF decreased during local anesthesia. These results suggest 1) that middle-aged and older patients have a greater increase in blood pressure during dental surgery than younger patients, and 2) that the regulation of the autonomic nervous system during dental surgery differs between younger and older patients.

Lack Of Association Between Qt Dispersion And Blood Pressure Response During Dental Surgery

1. It is well known that dental surgery induces increases in blood pressure. However, the factors influencing this increase are not yet fully understood. We have determined the relationship between QTc (= QT/RR 1 /2, with RR being the R‐R interval in seconds) dispersion, measured with a 12‐lead surface electrocardiogram, and changes in blood pressure during tooth extraction.

Schwannoma of the Parapharyngeal Space

Abstract A rare case of Schwannoma in a 31-year-old man derived from the cervical sympathetic nerve is reported. The tumour was composed mostly of Antoni A tissue occurring in the left parapharyngeal space. The tumour was completely removed through an external incision. The postoperative course was uneventful.

Clinicopathological Study of Neo-adjuvant Chemotherapy for Oral Squamous Cell Carcinoma

In the present study, we investigated the clinical and histopathological effects of CP therapy by combined use of cisplatin (CDDP 50 mg/m2) or carboplatin (CBDCA 300mg/m2) and Peplomycin (PEP 5mg/day) for 24 cases with oral squamous cell carcinorna. The effect of treatment and associated complications were as follows: 1. Complete response (CR) was achieved in 8 and partial response (PR) in 13 of the 24 cases. The overall clinical response rate was 87.5%. The histological response rate was 62.5 %. 2. The clinical effects did not always agree with the histopathological effects. There were discrepancies between clinical and histopathological effects, especially in PR determined by clinical findings. 3. The principal adverse reaction was gastrointestinal disturbances, but symptorns were